EFFECT OF CHROMIUM PICOLINATE ON GLUCOSE CONTROL IN TYPE 2 DIABETIC PATIENTS

在初步研究中，吡啶甲酸铬有利于改善肥胖、非糖尿病患者的胰岛素作用。如果胰岛素敏感性得到改善，它可以作为治疗糖尿病的补充。然而，铬改善碳水化合物代谢的确切机制尚不清楚。可能有人认为有直接影响，也可能是通过身体成分的变化产生的间接影响。上述研究的目的是比较补充铬与安慰剂对2型糖尿病患者血糖控制、胰岛素敏感性和身体成分的影响。研究设计为双盲安慰剂对照试验。所有受试者将进行一个月的药物洗脱期，洗脱期结束后进行血糖钳、CT扫描、血糖指标和口服糖耐量试验。患者在钳夹前一晚入院接受胰岛素输注以维持钳夹前的血糖。在确定胰岛素敏感性后，所有受试者将接受三个月的口服磺脲治疗，并重复所有参数。在磺脲期结束时，患者将继续接受含1000ug吡啶酸铬或安慰剂的口服药物治疗。受试者将接受为期6个月的评估，在此期间将评估血糖参数、胰岛素、饮食摄入和依从性。在研究结束时，将重复所有研究参数。需要验证的假设是，补充铬会改善胰岛素抵抗，这将反映在改善2型糖尿病患者的血糖参数上。如果这一假设被证明是正确的，未来将计划开展旨在确定具体机制的研究。

Chromium picolinate has been shown in pilot studies to favorably improve insulin action as demonstrated in obese, non-diabetic individuals. If insulin sensitivity is improved, it could be used as a supplement in the treatment of diabetes. Yet the precise mechanism by which chromium may improve carbohydrate metabolism is not yet known. It may be argued that there is a direct effect, or it may be an indirect effect through changes in body composition. The purpose of the above mentioned study is to compare the efficacy of chromium supplementation vs placebo on glycemic control, insulin sensitivity, and body composition in Type 2 diabetic subjects. The study design was a double blinded placebo controlled trial. All subjects will have a one month drug washout at the end of which a euglycemic clamp, CT scan, glycemic indices and oral glucose tolerance test will be obtained. Patients are admitted the night prior to clamping for insulin infusion to maintain glycemia prior to the clamp. After the determination of insulin sensitivity, all subjects will then be treated for three months with an oral sulfonulurea and all parameters repeated. At the end of the sulfonylurea phase, patients will be continued to receive the oral medication with 1000ug chromium picolinate or placebo. Subjects will be evaluated for 6 months during which glycemic parameters, insulin, dietary intake, and compliance will be assessed. At the end of the study, all study parameters will be repeated. The hypothesis to be tested is that chromium supplementation will improve insulin resistance and this will be reflected in improved glycemic parameters for the Type 2 diabetic patient. If the hypothesis proves correct, future studies aimed at defining the specific mechanism would be planned.