Beneficial effect of chromium supplementation on glucose, HbA1C and lipid variables in individuals with newly onset type-2 diabetes. The influence of chromium chloride-containing milk to glycemic control of patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial. The effect of chromium picolinate and biotin supplementation on glycemic control in poorly controlled patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized trial. Elevated Intakes of Supplemental Chromium Improve Glucose and Insulin Variables in Individuals With Type 2 Diabetes Chromium supplementation does not improve glucose tolerance, insulin sensitivity, or lipid profile: a randomized, placebo-controlled, double-blind trial of supplementation in subjects with impaired glucose tolerance. Beneficial Effect of Chromium Supplementation on Serum Triglyceride Levels in NIDDM Chromium Nicotinate Has No Effect on Insulin Sensitivity, Glycemic Control, and Lipid Profile in Subjects with Type 2 Diabetes Failure of trivalent chromium to improve hyperglycemia in diabetes mellitus. The effects of inorganic chromium and brewer's yeast supplementation on glucose tolerance, serum lipids and drug dosage in individuals with type 2 diabetes. Trivalent chromium and the diabetes prevention program. Effect of chromium dinicocysteinate supplementation on circulating levels of insulin, TNF-α, oxidative stress, and insulin resistance in type 2 diabetic subjects: randomized, double-blind, placebo-controlled study. Chromium treatment has no effect in patients with poorly controlled, insulin-treated type 2 diabetes in an obese Western population: a randomized, double-blind, placebo-controlled trial. Influence of chromium-enriched yeast on blood glucose and insulin variables, blood lipids, and markers of oxidative stress in subjects with type 2 diabetes mellitus Chromium supplementation shortens QTc interval duration in patients with type 2 diabetes mellitus. Chromium Treatment Has No Effect in Patients With Type 2 Diabetes in a Western Population Randomized crossover study of 40% vs. 55% carbohydrate weight loss strategies in women with previous gestational diabetes mellitus and non-diabetic women of 130-200% ideal body weight. Potential Antioxidant Effects of Zinc and Chromium Supplementation in People with Type 2 Diabetes Mellitus A Dietary Supplement Containing Cinnamon, Chromium and Carnosine Decreases Fasting Plasma Glucose and Increases Lean Mass in Overweight or Obese Pre-Diabetic Subjects: A Randomized, Placebo-Controlled Trial The effectiveness of yoga to prevent diabetes mellitus type 2 The effect of calcitriol on lipid profile and oxidative stress in hyperlipidemic patients with type 2 diabetes mellitus Chromium Picolinate and Biotin Combination Reduces Atherogenic Index of Plasma in Patients with Type 2 Diabetes Mellitus: A Placebo-Controlled, Double-Blinded, Randomized Clinical Trial Comparison of a high-carbohydrate and a high-monounsaturated fat, olive oil-rich diet on the susceptibility of LDL to oxidative modification in subjects with Type 2 diabetes mellitus. Impact of prebiotic supplementation on T-cell subsets and their related cytokines, anthropometric features and blood pressure in patients with type 2 diabetes mellitus: A randomized placebo-controlled Trial.
PROJECT Chromium is an essential nutrient involved in normal carbohydrate and lipid metabolism . It influences glucose metabolism by potentiating the action as taking part in insulin signal amplification mechanism . A placebo-controlled single blind , prospect i ve study was carried out to investigate the effect of chromium supplementation on blood glucose , HbA(1)C and lipid profile in newly onset patients with type-2 diabetes . PROCEDURE Total 40 newly onset type-2 diabetics were selected and after 1 month stabilization further r and omly divided into two groups viz . study group and placebo group . The study group received 9 g brewer 's yeast ( 42 μg Cr ) daily and the other placebo group received yeast devoid of chromium for 3 months . Subjects were instructed not to change their normal eating and living habits . Fasting blood glucose , HbA(1)C and lipid profile were analyzed at beginning and completion of the study . RESULTS Results revealed that fasting blood glucose level significantly reduced in the subjects consuming yeast supplemented with chromium ( 197.65±6.68 to 103.68±6.64 mg/dL ; p<0.001 ) . HbA(1)C values improved significantly from 9.51±0.26 % to 6.86±0.28 % ; p<0.001 indicating better glycaemic control . In experimental group total cholesterol , TG and LDL levels were also significantly reduced from 199.66±3.11 to 189.26±3.01 mg/dL ; p<0.02 , 144.94±8.31 to 126.01±8.26 ; p<0.05 and 119.19±1.71 to 99.58±1.10 ; p<0.001 respectively . CONCLUSIONS These data demonstrate beneficial effect of chromium supplementation on glycaemic control and lipid variables in subjects with newly onset type-2 diabetes The aim of this study is to evaluate the effect and safety of chromium-containing milk powder in patients with type 2 diabetes mellitus . A r and omized , double-blind , placebo-controlled trial was conducted in Taiwan . A total of 60 patients with type 2 diabetes mellitus , aged 30 to 75 years , and on a dose of gliclazide sulfonylurea agent ( < or = 160 mg/d ) for at least 3 months were enrolled . Their glycosylated hemoglobin ranged from 7.5 % to 12 % , fasting plasma glucose ( FPG ) from 140 to 250 mg/dL , and body mass index from 20 to 35 kg/m(2 ) . The subjects were divided into 2 groups , one group to receive chromium-containing milk powder ( chromium 200 microg/20 g milk powder ) and the other to receive placebo twice a day for 16 weeks . Frequently sample d intravenous glucose tolerance test ( IVGTT ) was performed before and after treatment . The chromium group demonstrated a lower FPG and fasting insulin ( -38.1 + /- 9.2 vs 63 + /- 8 . 5 mg/dL and -1.7 + /- 0.2 vs 1.9 + /- 0.3 microU/mL , respectively ; P < .05 ) , especially in male patients ( -41 + /- 9.2 vs 85 + /- 11.7 mg/dL and -2.7 + /- 0.2 vs 3.1 + /- 0.3 microU/mL , respectively ; P < .01 ) , at the end of the study . Lower glycosylated hemoglobin was observed in chromium-treated male patients ( -1.1 + /- 0 . 5 vs 0.7 + /- 0 . 2 ; P < .05 ) . However , there were no significant changes in other metabolic parameters ( lipid profiles including total cholesterol , triglyceride , low-density lipoprotein cholesterol , and high-density lipoprotein cholesterol ) , except improvement of insulin resistance ( homeostasis model assessment for insulin resistance and insulin sensitivity index from frequently sample d intravenous glucose tolerance test ) observed in male patients ( -2.1 + /- 1.1 vs -0.41 + /- 1.12 and 0.18 + /- 0.11 vs -0.15 + /- 0 . 2 , respectively ; P < .05 ) . There were no adverse events in both groups , except for mild complaints in the chromium group on constipation ( 5 % ) and flatulence ( 5 % ) . Intake of milk powder containing 400 microg/d of chromium for 16 weeks in subjects with type 2 diabetes mellitus result ed in lowering of FPG , fasting insulin , and improvement of metabolic control in male patients BACKGROUND Pre clinical studies have shown that the combination of chromium picolinate and biotin significantly enhances glucose uptake in skeletal muscle cells and enhances glucose disposal . The present pilot study was conducted to determine if supplementation with chromium picolinate and biotin can improve glycemic control in patients with type 2 diabetes mellitus with suboptimal glycemic control despite use of oral antihyperglycemic agents . METHODS Forty-three subjects with impaired glycemic control ( 2-h glucose > 200 mg/dL ; glycated hemoglobin > or=7 % ) , despite treatments with oral antihyperglycemic agents  , were r and omized to receive 600 microg of chromium as chromium picolinate and biotin ( 2 mg/day ) ( Diachrome ( , Nutrition 21 , Inc. , Purchase , NY ) in addition to their pre study oral antihyperglycemic agent therapy . Measurements of glycemic control and blood lipids were taken at baseline and after 4 weeks . RESULTS After 4 weeks , there was a significantly greater reduction in the total area under the curve for glucose during the 2-h oral glucose tolerance test for the treatment group ( mean change -9.7 % ) compared with the placebo group ( mean change + 5.1 % , P < 0.03 ) . Significantly greater reductions were also seen in fructosamine ( P < 0.03 ) , triglycerides ( P < 0.02 ) , and triglycerides/ high-density lipoprotein cholesterol ratio ( P < 0.05 ) in the treatment group . No significant adverse events were attributed to chromium picolinate and biotin supplementation . CONCLUSIONS This pilot study demonstrates that supplementation with a combination of chromium picolinate and biotin in poorly controlled patients with diabetes receiving antidiabetic therapy improved glucose management and several lipid measurements .  Chromium picolinate/ biotin supplementation may represent an effective adjunctive nutritional therapy to people with poorly controlled diabetes with the potential for improving lipid metabolism Chromium is an essential nutrient involved in normal carbohydrate and lipid metabolism . The chromium requirement is postulated to increase with increased glucose intolerance and diabetes . The objective of this study was to test the hypothesis that the elevated intake of supplemental chromium is involved in the control of type 2 diabetes . Individuals being treated for type 2 diabetes ( 180 men and women ) were divided r and omly into three groups and supplemented with : 1 ) placebo , 2 ) 1.92 μmol ( 100 μg ) Cr as chromium picolinate two times per day , or 3 ) 9.6 μmol ( 500 μg ) Cr two times per day . Subjects continued to take their normal medications and were instructed not to change their normal eating and living habits . HbA1c values improved significantly after 2 months in the group receiving 19.2 pmol ( 1,000 pg ) Cr per day and was lower in both chromium groups after 4 months ( placebo , 8.5 ± 0.2 % ; 3.85 pmol Cr , 7.5 ± 0.2 % ; 19.2 pmol Cr , 6.6 ± 0.1 % ) . Fasting glucose was lower in the 19.2-μmol group after 2 and 4 months ( 4-month values : placebo , 8.8 ± 0.3 mmol/1 ; 19.2 μmol Cr , 7.1 ± 0.2 mmol/1 ) . Two-hour glucose values were also significantly lower for the subjects consuming 19.2 μmol supplemental Cr after both 2 and 4 months ( 4-month values : placebo , 12.3 ± 0.4 mmol/1 ; 19.2 μmol Cr , 10.5 ± 0.2 mmol/1 ) . Fasting and 2-h insulin values decreased significantly in both groups receiving supplemental chromium after 2 and 4 months . Plasma total cholesterol also decreased after 4 months in the subjects receiving 19.2 μmol/day Cr . These data demonstrate that supplemental chromium had significant beneficial effects on HbA1c , glucose , insulin , and cholesterol variables in subjects with type 2 diabetes . The beneficial effects of chromium in individuals with diabetes were observed at levels higher than the upper limit of the Estimated Safe and Adequate Daily Dietary Intake Chromium supplements are thought to be the second most commonly taken nutritional supplement , used by an estimated 10 million Americans ( 1 ) . Chromium is an essential element in humans , and deficiency is associated with the development of diabetes , which was first noted in patients receiving long-term parenteral nutrition before the advent of routine chromium supplementation  ( 2,3 ) . In these patients , diabetes resolved following chromium replacement ( 2–4 ) . The dietary requirement for chromium is controversial , with the recommended daily intake in the U.S. being 0.05–0.20 μg ( 5 ) . Chromium is abundant in the environment ; however , aside from the extreme situation of unsupplemented parenteral nutrition , it has proven difficult to ascertain any clinical effects , due solely to chromium deficiency . Despite these difficulties , chromium supplements are widely promoted in the complementary health industries . There are many studies examining the effects of various forms of chromium supplementation ( rev . in 6,7 ) . These studies utilized a variety of chromium formulations , varying doses , and patients with normal glucose tolerance , diabetes , or gestational diabetes . The outcomes have been inconsistent . Some studies showed no benefit , and other studies have shown inconsistent improvements in glucose , insulin resistance , and /or lipids . The paucity of data has prompted the National Institutes of Health to release a program announcement to address the issue : “ Chromium as an adjuvant therapy OBJECTIVE To investigate the effect of chromium picolinate supplementation on the lipid profile of the predominantly Hispanic population of non-insulin-dependent diabetes mellitus ( NIDDM ) patients in San Antonio , Texas . RESEARCH DESIGN AND METHODS A prospect i ve , double-blind , placebo-controlled , crossover study was performed on 14 men and 16 women . Initially , each patient was r and omly assigned to receive either chromium picolinate or placebo for 2 months . This initial treatment phase was followed by a 2-month washout period . Subjects were then crossed-over and received the alternate capsule for an additional 2 months . Fasting blood glucose , HbA1c , and serum lipids were compared at the end of each treatment phase . RESULTS Twenty-eight of the originally enrolled 30 patients completed the study . There were no adverse reactions to chromium reported . There were no differences noted between the control and chromium-treated subjects in glucose control , high-density lipoprotein cholesterol levels , or low-density lipoprotein cholesterol levels . Triglyceride ( TG ) levels were reduced significantly ( 17.4 % ; P < 0.05 ) during the 2 months of chromium supplementation . CONCLUSIONS Ours is the first report of a significant reduction in serum TGs in a group of NIDDM patients treated with chromium . The low cost and excellent safety profile of chromium make it an attractive lipid-lowering agent for this population . Long-term studies are needed to determine if the short-term changes in plasma lipids can be sustained Objective : To investigate the effect of chromium nicotinate supplementation on insulin sensitivity , glycemic control , and lipid profile in subjects with type 2 diabetes . Material s and Methods : In a double-blind clinical trial , 56 overweight individuals with type 2 diabetes were r and omized into 3 groups : placebo ( NC0 ) , 50 μg ( NC50 ) , and 200 μg ( NC200 ) of chromium as chromium nicotinate .  Chromium status , sensitivity to insulin , glycemic control , and lipid profile were assessed at the beginning of the study and 45 days and 90 days after . Results : In the beginning , most subjects showed low concentrations of serum chromium ( 71.88 % ) , regular levels of urinary chromium ( 80.65 % ) , and insulin resistance ( 73.80 % ) . The serum chromium concentrations did not differ among the groups over time ( p = 0.2549 ) . The changes in serum chromium and urine concentrations did not relate to changes in fasting glucose ( p > 0.05 ) . At 90 days of intervention , there was no significant difference between groups in fasting glucose , glycosylated hemoglobin , homeostasis model assessment insulin resistance ( HOMA-IR ) , total cholesterol , and low-density lipoprotein ( LDL ) ; there was increase in homeostasis model assessment β-cell function ( HOMA-β ; p = 0.0349 ) and high-density lipoprotein ( HDL ; p = 0.0425 ) in the NC0 group and a reduction of triglycerides in the NC0 ( p = 0.0177 ) and NC50 ( p = 0.0336 ) groups . Conclusion : Supplementation at 50 and 200 μg of chromium as chromium nicotinate did not promote glycemic control , increase insulin sensitivity , or change the lipid profile of subjects with diabetes Abstract Through the use of a double-blind cross-over investigative method , the effect of trivalent chromium supplements on blood sugar concentrations of normal and diabetic human subjects was evaluated . Four normal and 10 diabetic subjects took 50 μg . of trivalent chromium and a chromium-placebo thrice daily by mouth for 16-week periods . Chromium did not improve hyperglycemia in diabetic patients , and there was no difference in diabetic glucose tolerance measured after placebo and chromium treatment . Normal glucose tolerance was also unaffected . Despite evidence that trivalent chromium may be an essential micronutrient for maintenance of normal glucose tolerance in rats , results of this investigation do not support suggestions of a similar role in man OBJECTIVE To study the effects of supplementation with organic and inorganic chromium on glucose tolerance , serum lipids , and drug dosage in type 2 diabetes patients , in the hope of finding a better and more economical method of control . METHODS Seventy eight type 2 diabetes patients were divided r and omly into two groups and given Brewer 's yeast ( 23.3ug Cr/day ) , and CrCl3 ( 200ug Cr/day ) sequentially with placebo in between , in a double blind cross-over design of four stages , each lasting 8 weeks . At the beginning and end of each stage , subjects were weighed , their dietary data and drug dosage recorded , and blood and urine sample s were collected for analysis of glucose ( fasting and 2 hour post 75 g glucose load ) fructosamine , triglycerides , total and HDL-cholesterol , and serum and urinary chromium . RESULTS Both supplements caused a significant decrease in the means of glucose ( fasting and 2 hour post glucose load ) , fructosamine and triglycerides . The means of HDL-cholesterol , and serum and urinary chromium were all increased . The mean drug dosage decreased slightly ( and significantly in case of Glibenclamide ) after both supplements and some patients no longer required insulin . No change was noted in dietary intakes or Body Mass Index . A higher percentage of subjects responded positively to Brewer 's yeast chromium , which was retained more by the body , with effects on fructosamine , triglycerides , and HDL-cholesterol maintained in some subjects when placebo followed it , and mean urinary chromium remaining significantly higher than zero time mean . CONCLUSION Chromium supplementation gives better control of glucose and lipid variables while decreasing drug dosage in type 2 diabetes patients . A larger scale study is needed to help decide on the convenient chemical form , and dosage required to achieve optimal response The Diabetes Prevention Program is a new , 150 million dollar , NIH-sponsored study design ed to determine whether non-insulin-dependent diabetes mellitus can be prevented or delayed in persons with impaired glucose tolerance . Four thous and subjects will be r and omly assigned to one of four study groups and followed for 4.5 years . Study groups include intensive lifestyle intervention with diet and exercise ; metformin ( Glucophage ) or troglitazone ( an investigational drug ) with st and ard diet and exercise ; and a control group . Insulin resistance is an important pathogenic factor in impaired glucose tolerance . Trivalent chromium , a dietary supplement that potentiates the action of insulin , was not included in the program . Like metformin and troglitazone , trivalent chromium decreases insulin resistance and has an acceptable side-effect profile ; furthermore , it is available at a fraction of their cost . Trivalent chromium should have been included in the Diabetes Prevention Program ; it is unfortunate that it was omitted SCOPE Chromium and cysteine supplementation have been shown to improve glucose metabolism in animal studies . This study examined the hypothesis that chromium dinicocysteinate ( CDNC ) , a complex of chromium and l-cysteine , is beneficial in lowering oxidative stress , vascular inflammation , and glycemia in type 2 diabetic subjects . METHODS AND RESULTS Type 2 diabetic subjects enrolled in this study were given placebo for 1 month for stabilization and then r and omized into one of three groups : placebo ( P ) , chromium picolinate ( CP ) , or CDNC , after which they received daily oral supplementation for 3 months . Of the 100 patients enrolled in the study , 74 patients completed it . There were 25 patients in the P supplemented group , 25 in the CP supplemented and 24 in the CDNC supplemented group who completed the study . Blood markers of glycemia , vascular inflammation , HOMA insulin resistance , and oxidative stress were determined at r and omization and after 3 months of supplementation with P , CP , or CDNC . There was a significant decrease at 3 months in insulin resistance ( p = 0.02 ) and in the levels of protein oxidation ( p = 0.02 ) and TNF-α ( p = 0.01 ) in the CDNC supplemented cohort compared to baseline . However , there was no statistically significant change in these markers in the CP supplemented group compared to baseline . Insulin levels significantly decreased ( p = 0.01 ) for subjects receiving CDNC but not CP . There was no significant impact of supplementation on HbA(1c ) or glucose levels in either of the groups . CONCLUSION CDNC supplementation  lowers insulin resistance by reducing blood levels of TNF-α , insulin , and oxidative stress in type 2 diabetic subjects . Therefore , CDNC supplementation has potential as an adjunct therapy for individuals with type 2 diabetes OBJECTIVE Chromium treatment has been reported to improve glycemic control and insulin sensitivity in specific population s of patients with type 2 diabetes . The aim of this study was to determine the effect of chromium treatment on glycemic control in a Western population of insulin-dependent patients with type 2 diabetes . RESEARCH DESIGN AND METHODS In this 6-month double-blind study , patients with an HbA(1c ) ( A1C ) > 8 % and insulin requirements of > 50 units/day were r and omly assigned to receive treatment with placebo or 500 or 1,000 mug chromium daily in the form of chromium picolinate . The primary efficacy parameter was a change in A1C . Secondary end points were changes in lipid profile , BMI , blood pressure , and insulin requirements . RESULTS In this per- protocol analysis ( n = 46 ) , the decrease in A1C was approximately equal across the three groups ( 0.4 % ) . All patients had a BMI > 25 kg/m(2 ) . No differences were found in the secondary end points . We found a weak relationship between an increasing serum chromium concentration and improvement of the lipid profile . CONCLUSIONS There is no evidence that high-dose chromium treatment is effective in obese Western patients with type 2 diabetes The aim of this study was to determine the effect of chromium (Cr)-enriched yeast on blood glucose and insulin variables , blood lipids , and blood markers of oxidative stress in persons with type 2 diabetes mellitus ( median duration : 3.0 yr ) . Thirty-six subjects ( 9 men , 27 women ; mean age : 61.3 yr ; mean body mass index : 34.33 kg/m2 ) were supplemented with 400 μg Cr/d as Cr-enriched yeast ( n=19 ) or placebo ( n=17 ) for 12 wk in a r and omized , double-blind study . The most interesting results were obtained by comparison of the change in the placebo group to the change in the Cr group . The Cr group showed a significantly greater increase in serum Cr compared to the placebo group ( p<0.05 ) . Supplementation with Cr-enriched yeast was associated with a significant decrease in fasting serum glucose compared to placebo ( p<0.01 ) . Blood markers of oxidative stress glutathione peroxidase activity and levels of reduced glutathione were essentially unchanged in the Cr group after 12 wk , but decreased significantly in the placebo group ( p<0.05 , p<0.01 , respectively ) , Serum HbA1c and glycated protein ( fructosamine ) were essentially unchanged in the Cr group , whereas HbA1c tended to increase in the placebo group ( from 6.94 % to 7.11 % ) . Fasting serum insulin decreased in both groups , with a greater tendency in the Cr group ( −16.5 % vs −9.5 % ) . These data suggest that supplementation of well-controlled type 2 diabetics with Cr-enriched yeast is safe and can result in improvements in blood glucose variables and oxidative stress BACKGROUND We investigated the potential effects of chromium supplementation on QTc interval duration in type 2 diabetic patients . METHODS Of 60 patients with type 2 diabetes mellitus , 30 were r and omly assigned to group A , and 30 to group B. Group A received 1000 microg of chromium picolinate ( CrPic ) daily for 3 months , followed by placebo in the next 3 months ; group B was treated with placebo for the first 3 months and CrPic in the next 3 months . At each visit , QT interval was measured on a  st and ard electrocardiogram  by averaging 3 consecutive beats in leads II and V4 and corrected for heart rate with Bazett formula . RESULTS Although baseline QTc interval was similar in both groups ( 422 + /- 34 milliseconds in group A vs 425 + /- 24 milliseconds in group B , P = .77 ) , QTc interval at 3 months was shorter in group A ( 406 + /- 35 milliseconds ) than in group B ( 431 + /- 26 milliseconds , P = .01 ) . In the following 3 months , QTc interval shortened in group B but not in group A , which result ed in a comparable QTc interval duration of both groups at the end of the study ( 414 + /- 28 milliseconds in group A vs 409 + /- 22 milliseconds in group B , P = .50 ) . Apart from body mass index ( 31.4 + /- 4.2 kg/m2 in patients with QTc shortening vs 28.7 + /- 4.2 kg/m2 in patients without QTc shortening , P = .03 ) , none of the clinical and laboratory variables predicted QTc interval shortening in our patient cohort . CONCLUSIONS Short-term chromium supplementation shortens QTc interval in patients with type 2 diabetes mellitus OBJECTIVE —Chromium treatment has been reported to improve glycemic control in patients with type 2 diabetes . However , concern exists about the possible toxic effects of chromium picolinate . The aim of this study was to determine the effect of chromium treatment in the form of chromium yeast on glycemic control in a Western population of patients with type 2 diabetes who were being treated with oral hypoglycemic agents . RESEARCH DESIGN AND METHODS —In this 6-month , double-blind study , patients with moderate glycemic control , being treated with oral hypoglycemic agents , were r and omly assigned to receive either a placebo or treatment with 400 μg of chromium daily in the form of chromium yeast . The primary efficacy parameter was a change in A1C . Secondary end points were changes in lipid profile , BMI , blood pressure , body fat , and insulin resistance . RESULTS —No differences were found for the change in A1C between the intervention and placebo groups , nor were any differences found between the groups for the secondary end points . CONCLUSIONS —There is no evidence that chromium in the form of chromium yeast is effective in improving glycemic control in Western patients with type 2 diabetes who are taking oral hypoglycemic agents OBJECTIVE The optimum diet composition for weight loss in obese women with or without previous gestational diabetes mellitus remains to be determined . Weight loss may be especially important for the latter group in terms of preventing future gestational as well as non-insulin dependent diabetes mellitus . We studied 40 % vs. 55 % carbohydrate calorically restricted diets to compare weight loss and metabolic response . METHODS We performed a prospect i ve , 12-week , blinded , r and omized crossover study of 25 obese women ; 13 of whom had previous gestational diabetes . Each woman was allocated to a treatment regimen for 6 weeks and then " crossed over " to the alternative regimen for an additional 6 weeks . Calories were provided in the form of nutritional supplement bars except for the evening meal that comprised 1/3 of the caloric needs . All subjects were seen and weighed weekly . Metabolic variables including glucose tolerance , glycated proteins , lipids , and percent body fat were measured at the beginning , crossover , and end of the study . RESULTS Women with previous gestational diabetes mellitus were comparable to obese women without a history of previous gestational diabetes except that the former had higher maximum levels of glucose on a glucose tolerance test and higher fasting insulin levels consistent with greater insulin resistance . Weight loss was comparable for all groups during the first 6 weeks but attenuated in all groups during the second 6 weeks of the trial regardless of diabetes history or treatment group allocation . Women with or without a previous history of gestational diabetes had higher triglycerides while on a 55 % carbohydrate diet than while on a 40 % carbohydrate diet . CONCLUSIONS A weight loss regimen consisting of 40 % carbohydrate results in lower triglyceride levels than those achieved with a 55 % carbohydrate content diet in obese women . Thus , the hypocaloric diet with the higher fat content produced the more favorable lipid profile in all obese women Objective : To determine the effects of combined zinc ( Zn ) and chromium ( Cr ) supplementation on oxidative stress and glucose homeostasis of people with type 2 diabetes . Design : Tunisian adult subjects with HbA1C > 7.5 % were supplemented for 6 months with 30 mg/d of Zn as Zn gluconate or 400 μg/d of Cr as Cr pidolate or combined Zn/Cr supplementation or placebo . The effects of supplementation on plasma zinc ( Zn ) , copper ( Cu ) , selenium ( Se ) , urinary Zn , Cr , plasma thiobarbituric acid reactive substances ( TBARS ) , Cu-Zn superoxide dismutase ( SOD ) and Se glutathione peroxidase ( GPx ) in red blood cells , blood lipids and lipoproteins , HbA1C and fasting glucose were measured at the beginning of the study and after six months . Results : At the beginning of the study , more than 30 % of the subjects may have been Zn deficient with plasma Zn values less than 10.7 μmol/L , whereas levels of plasma Cu , Se and antioxidant RBC enzyme activities were in the normal ranges . Following supplementation , there were significant decreases of plasma TBARS in the Cr ( 13.6 % ) , Zn ( 13.6 % ) and Zn/Cr ( 18.2 % ) groups with no significant changes in the placebo group . The value for the TBARS of the control healthy Tunisian subjects was 2.08 ± 0.04 μmol/L and that of the Tunisian subjects with diabetes was 3.32 ± 0.05 μmol/L. This difference of 1.24 μmol/L between the control group and the subjects with diabetes was reduced from 36 % to 50 % in the three supplemented groups . Supplementation did not modify significantly HbA1C nor glucose homeostasis . No adverse effects  of Zn supplementation were observed on Cu status , HDL cholesterol nor interactions in Zn or Cr . Conclusions : These data suggest the potential beneficial antioxidant effects of the individual and combined supplementation of Zn and Cr in people with type 2 DM . These results are particularly important in light of the deleterious consequences of oxidative stress in people with diabetes Background Preventing or slowing the progression of prediabetes to diabetes is a major therapeutic issue . Objectives Our aim was to evaluate the effects of 4-month treatment with a dietary supplement containing cinnamon , chromium and carnosine in moderately obese or overweight pre-diabetic subjects , the primary outcome being change in fasting plasma glucose ( FPG ) level . Other parameters of plasma glucose homeostasis , lipid profile , adiposity and inflammatory markers were also assessed . Methods In a r and omized , double-blind , placebo-controlled study , 62 subjects with a FPG level ranging from 5.55 to 7 mmol/L and a body mass index ≥25 kg/m2 , unwilling to change their dietary and physical activity habits , were allocated to receive a 4-month treatment with either 1.2 g/day of the dietary supplement or placebo . Patients were followed up until 6 months post-r and omization . Results Four-month treatment with the dietary supplement  decreased FPG compared to placebo ( -0.24±0.50 vs + 0.12±0.59 mmol/L , respectively , p = 0.02 ) , without detectable significant changes in HbA1c . Insulin sensitivity markers , plasma insulin , plasma lipids and inflammatory markers did not differ between the treatment groups . Although there were no significant differences in changes in body weight and energy or macronutrient intakes between the two groups , fat-free mass ( % ) increased with the dietary supplement compared to placebo ( p = 0.02 ) . Subjects with a higher FPG level and a milder inflammatory state at baseline benefited most from the dietary supplement . Conclusions Four-month treatment with a dietary supplement containing cinnamon , chromium and carnosine decreased FPG and increased fat-free mass in overweight or obese pre-diabetic subjects . These beneficial effects might open up new avenues in the prevention of diabetes . Trial Registration Clinical Trials.gov Background : Type 2 diabetes mellitus ( T2DM ) is becoming a leading problem worldwide . Emerging reports reveal alarming evidence of increasing prevalence of T2DM that has reached p and emic levels . Despite the significant incidence , there are limited reliable data re sources and comprehensive systematic review and meta- analysis on the effects of yoga on people who are a prediabetic or high risk for developing T2DM . Objective : The objective of this protocol is to conduct a full-scale systematic review and meta-analyses on the effects of yoga on people who are prediabetes or high risk of developing T2DM . Methods : The articles enrolled in the study will be retrieved from the online data bases between 2002 and the date the search es are executed . The search es will be repeated just before the final analyses and further relevant studies for inclusion . We will conduct a bibliographic search in data bases : Medline / PubMed , Scopus , Cochrane Library , EBSCO , and IndMED using keywords including prediabetes state , high risk for diabetes , metabolic syndrome , and yoga . A defined search strategy will be implemented along with selection criteria to obtain full-text articles of relevant studies . This study protocol was prepared according to the Preferred Reporting Items for Systematic Review s and Meta- Analysis for Protocol s 2015 guidelines . There will be no language restrictions . Ethics and dissemination : The proposed study will be based on published studies and publicly available anonymized data without directly involving human participants and therefore requires neither formal human ethical review nor approval by a human research ethics committee . We published an outline of the protocol in the International Prospect i ve Register of Systematic Review s ( PROSPERO ) in 2018 . We plan to disseminate the findings of this systematic review and meta- analysis through publication in a peer- review ed journal and presentation at relevant conference proceedings . In addition , we believe the results of the systematic review will have implication s for policy and practice . We will prepare policymaker summary using a vali date d format , disseminate through social media and email discussion groups . Review registration number : PROSPERO registration number CRD BACKGROUND Cardiovascular mortality is high among diabetic patients due to abnormalities in the plasma lipid and lipoprotein metabolism , and increased oxidative stress . This study aim ed to investigate the effects of active vitamin D on serum lipids and oxidative stress markers in type 2 diabetic patients . METHODS A double-blind r and omized placebo-controlled trial was carried out in 70 participants with type 2 diabetes , aged 30 - 75 years of age . The participants were r and omly assigned to two groups . One group received two capsules of calcitriol ( 0.25 µg 1,25-dihydroxycholecalciferol per capsule ) per day . The second group received placebo tablets . All participants received their oral hypoglycemic drugs as prescribed by the endocrinologist . At the beginning , after 6 weeks , and at the end of the 12-week supplementation trial , serum total cholesterol , low-density lipoprotein ( LDL ) , high-density lipoprotein ( HDL ) , triglyceride ( TG ) , and serum malondialdehyde ( MDA ) levels were measured . RESULTS There was a significant reduction in total cholesterol , LDL-cholesterol , TG , and MDA levels in both treatment and placebo groups ( P < 0.05 ) . Serum HDL-cholesterol level decreased significantly in the placebo group ( P < 0.05 ) , while it remained unchanged in the treatment group . However , the P values related to the between group ’s comparisons were not significant for any variables . CONCLUSION Active vitamin D  reduced lipid profile and oxidative stress markers in diabetic patients compared to the control group , but these alterations were not statistically Background : The atherogenic index of plasma ( AIP ) , defined as logarithm [ log ] of the ratio of plasma concentration of triglycerides to high-density lipoprotein ( HDL ) cholesterol , has recently been proposed as a predictive marker for plasma atherogenicity and is positively correlated with cardiovascular disease risk . The nutrient combination of chromium picolinate and biotin ( CPB ) has been previously shown to reduce insulin resistance and hyperglycemia in patients with type 2 diabetes ( T2DM ) . Methods : Thirty-six moderately obese subjects with T2DM and with impaired glycemic control were r and omized to receive CPB or placebo in addition to their oral hyperglycemic agents for 4 weeks .  Measurements of blood lipids ( including ratio of triglycerides to HDL cholesterol ) , fructosamine , glucose , and insulin were taken at baseline and after 4 weeks . Results : At the final visit , the active group had a significantly lower AIP compared to the placebo group ( P < 0.05 ) . A significant difference in triglyceride level ( P < 0.02 ) and the ratio of low-density lipoprotein ( LDL ) to HDL cholesterol ( P < 0.05 ) was also observed between the groups at the final visit . In the active group , the changes in urinary chromium levels were inversely correlated with the change in AIP ( P < 0.05 ) . Urinary chromium levels were significantly increased in the CPB group . In the CPB group , glucose levels decreased at 1 hour and 2 hours and glucose area under the curve and fructosamine level were significantly decreased . Ratios of total to HDL cholesterol , LDL to HDL cholesterol , and non-HDL to HDL cholesterol were significantly decreased between the treatments at final visit . No significant adverse events were observed in the CPB or placebo groups . Conclusions : These results suggest that the combination of chromium picolinate and biotin may be a valuable nutritional adjuvant therapy to reduce AIP and correlated CVD risk factors in people with T2DM AIMS To compare the effects of a high-carbohydrate ( CHO ) diet and a high-monounsaturated fatty acid ( MUFA ) diet on LDL oxidative resistance in free-living individuals with Type 2 diabetes mellitus . METHODS Twenty-two men and women out- patients with Type 2 diabetes , with mean age 61 years and in fair metabolic control ( HbA1c<8.0 % ) , were enrolled at a university hospital lipid clinic in a r and omized , crossover feeding trial comparing two isocaloric diets for 6 weeks each : CHO ( fat , 28 % energy ) and MUFA ( fat , 40 % energy ) based on virgin olive oil . Outcome measurements were changes in LDL susceptibility to oxidation , body weight , glycaemic control , and lipoprotein profiles . RESULTS Planned and observed diets were well matched . Participants preferred the MUFA diet over the CHO diet . The lag time of conjugated diene formation during Cu2 + -induced LDL oxidation was similar after the CHO and MUFA diets ( 36.4 + /- 12.2 min and 36.0 + /- 13.7 min , respectively ) . Body weight , glycaemic control , total triglycerides , and total , LDL- and HDL-cholesterol levels also were similar after the two diets . Compared with the CHO diet , the MUFA diet lowered VLDL-cholesterol by 35 % ( P=0.023 ) and VLDL triglyceride by 16 % ( P=0.016 ) . CONCLUSIONS Natural food-based high-CHO and high-MUFA diets have similar effects on LDL oxidative resistance and metabolic control in subjects with Type 2 diabetes . A MUFA diet is a good alternative to high-CHO diets for nutrition therapy of diabetes because it also has a beneficial effect on the lipid profile and superior patient acceptance BACKGROUND S AND AIMS Type 2 diabetic mellitus ( T2DM ) asone of the main causes of morbidity and mortality is associated with immune system disturbances and metabolic abnormalities . In the current study we aim ed to evaluate the effects of oligofructose-enriched inulin on T-cell subsets and their related cytokines , anthropometric and metabolic parameters in patients with T2DM . METHODS Forty-six diabetic females patients were r and omly allocated into intervention ( n=27 ) and control ( n=22 ) groups . Subjects in the intervention group received a daily dose of 10 g of oligofructose-enriched inulin and subjects in control group received a placebo for two months . Anthropometric variables , metabolic parameters including fasting serum glucose ( FSG ) , hemoglobin A1c ( HbA1c ) , lipid profile and blood pressure were measured at the beginning and after two months . Immune markers also included serum interleukin (IL)-4 , IL-12 and interferon (IFN)-γ concentrations were assessed and CD3(+ ) , CD4(+ ) , CD8(+ ) and CD11b(+)T-cell counts were determined by flow cytometry at baseline and end of the trial . RESULTS After two months intervention , significant improvements in anthropometric variables , blood pressure and serum lipids occurred in prebiotic-treated group ( P<0.001 ) . Serum IL-4 , IL-12 and IFN-γ concentrationsalso significantly decreased in intervention group ( P<0.001 ) . No significant changes in CD3(+ ) , CD4(+ ) , CD8(+ ) and CD11b(+ ) T-cell counts were observed in treatment groups after intervention . CONCLUSION The present study showed several beneficial effects of oligofructose-enriched inulin on the improvement of the glycemic status , lipid profile , and immune markers in patients with T2DM . Further studies are needed to confirming our findings and to better clarify the underlying mechanisms
The available evidence suggests favourable effects of chromium supplementation  on glycaemic control in patients with diabetes
INTRODUCTION Chromium is an essential trace mineral for carbohydrate and lipid metabolism , which is currently prescribed to control diabetes mellitus .
Results of previous systematic review s and meta-analyses of chromium supplementation and metabolic profiles in diabetes have been inconsistent .
AIM The objective of this meta- analysis was to assess the effects on metabolic profiles and safety of chromium supplementation in type 2 diabetes mellitus and cholesterol .