References for Chromium, Vitamin C, and Vitamin E for Diabetes Treatment

In 1946 Dr Evan Shute had a letter published in "Nature" (1946 157:772) about the effectiveness of vitamin E and coronary heart disease. Several articles follwed in medical publications. His father Dr. R James Shute had starting studying Vitamin E in 1933, 3 years before it was isolated from wheat germ oil. His brother Dr William Shute also studied vitamin E. They published its effectiveness in diabetes in the "J of Clin Endocrinology" in 1944 8:883 and "Medical Record" 1948 161:363. In response to this, the AMA cited these articles and stated (nearly 50 years ago) "It is regretable that the hopes of sufferers of heart disease and other cardiovascular conditions, as well as those of countless diabetic persons, should be falsely raised by unbridled enthusiasm." I hope you've discovered the importance of vitamin E in heart disease (along with the NEJM), and suggest its use in diabetes. Vitamin E is well known for thinning the blood (but it does not exascerbate the effects of NSAIDs or coumadin). In William Shute's 1977 book, he details remarkable success in diabetics suffering from symptoms characteristic of insufficient blood flow. The most easily measurable improvements seem to be in eyesight at 1,600 IU. =================== Begin Vitamin E ==================== TITLE: Pharmacologic doses of vitamin E improve insulin action in healthy subjects and non-insulin-dependent diabetic patients.AUTHORS: Paolisso G; D'Amore A; Giugliano D; Ceriello A; Varricchio M; D'Onofrio FAUTHOR AFFILIATION: Department of Geriatric Medicine and Metabolic Diseases, First Medical School, University of Naples, Italy.SOURCE: Am J Clin Nutr 1993 May;57(5):650-6CITATION IDS: PMID: 8480681 UI: 93243305ABSTRACT: Ten control (healthy) subjects and 15 non-insulin-dependent diabetics underwent an oral glucose-tolerance test and a euglycemic hyperinsulinemic glucose clamp before and after vitamin E supplementation (900 mg/d for 4 mo). In control subjects (placebo- treated vs vitamin E-supplemented subjects, respectively) vitamin E reduced the area under the curve for glucose (344 +/- 21 vs 287 +/- 13 mmol.L-1 x min-1; P < 0.05) and increased total body glucose disposal (39.0 +/- 0.3 vs 47.6 +/- 0.4 mumol.kg lean body mass-1 x min-1; P < 0.05) and non-oxidative glucose metabolism (23.4 +/- 0.2 vs 30.8 +/- 0.3 mumol.kg lean body mass-1 x min-1; P < 0.05). In diabetics (placebo- treated vs vitamin E-supplemented subjects, respectively) vitamin E supplementation reduced glucose area under the curve (614 +/- 129 vs 544 +/- 98 mmol.L-1 x min-1; P < 0.03) and increased glucose disappearance (19.4 +/- 0.4 vs 26.4 +/- 0.7 mumol.kg lean body mass- 1.min-1; P < 0.03), total glucose disposal (19.0 +/- 0.7 vs 28.1 +/- 0.4 mumol.kg lean body mass-1 x min-1; P < 0.02), and nonoxidative glucose metabolism (8.5 +/- 0.3 vs 13.9 +/- 0.3 mumol.kg lean body mass- 1 x min-1; P < 0.02). Therefore we conclude that administration of pharmacologic doses of vitamin E is a useful tool to reduce oxidative stress and improve insulin action. TITLE: Low vitamin E status is a potential risk factor for insulin-dependent diabetes mellitus.AUTHORS: Knekt P; Reunanen A; Marniemi J; Leino A; Aromaa AAUTHOR AFFILIATION: National Public Health Institute, Helsinki, Finland.SOURCE: J Intern Med 1999 Jan;245(1):99-102CITATION IDS: PMID: 10095823 UI: 99195527ABSTRACT: OBJECTIVES: To study the association of vitamin E status with occurrence of insulin-dependent diabetes mellitus (IDDM). DESIGN: A case-control study nested within a 21-year follow-up study. SUBJECTS: Nineteen incident IDDM patients with an average age of 28 years and three individually matched controls per patient. MAIN OUTCOME MEASURE: Serum concentrations of alpha-tocopherol. RESULTS: Serum alpha- tocopherol concentration at the baseline examination was inversely associated with IDDM occurring 4-14 years later. The cholesterol- adjusted relative risk of IDDM between the highest and lowest thirds of the vitamin concentration was 0.12 (95% confidence interval = 0.02- 0.85). CONCLUSIONS: The finding corroborates the hypothesis of a protective effect of vitamin E against development of IDDM. Because of the relatively old age of the patients in the present population, further epidemiological studies on the topic are warranted. TITLE: Vitamin E and nicotinamide have similar effects in maintaining residual beta cell function in recent onset insulin-dependent diabetes (the IMDIAB IV study) [published erratum appears in Eur J Endocrinol 1997 Nov;137(5):558]AUTHORS: Pozzilli P; Visalli N; Cavallo MG; Signore A; Baroni MG; Buzzetti R; Fioriti E; Mesturino C; Fiori R; Romiti A; Giovannini C; Lucentini L; Matteoli MC; Crino A; Teodonio C; Paci F; Amoretti R; Pisano L; Suraci C; Multari G; Suppa M; Sulli N; De Mattia G; Faldetta MR; Suraci MT$[corrected to Suraci C]AUTHOR AFFILIATION: Department of Diabetes and Metabolism, St Bartholomew's Hospital Medical College, London, UK.SOURCE: Eur J Endocrinol 1997 Sep;137(3):234-9CITATION IDS: PMID: 9330586 UI: 97471645ABSTRACT: OBJECTIVE: Protection of residual beta cell function at the time of diagnosis of insulin-dependent diabetes mellitus (IDDM) by intensive insulin therapy and the addition of nicotinamide (NA) has been established. The objective of this study was to evaluate the effect of a free oxygen radical scavenger such as vitamin E (Vit E) on residual beta cell function and parameters of metabolic control in patients with recent onset IDDM undergoing intensive insulin therapy. DESIGN: The effect of Vit E was compared with that of NA (control group) in a randomized multicentre trial. METHODS: Eighty-four IDDM patients between 5 and 35 years of age (mean age 15.8 +/- 8.4 (s.d.) years) entered a one year prospective study. One group of patients (n = 42) was treated with Vit E (15 mg/kg body weight/day) for one year; the other group (n = 42) received NA for one year (25 mg/kg body weight/day). All patients were under intensive insulin therapy with three to four injections a day. Basal and stimulated (1 mg i.v. glucagon) C-peptide secretion, glycosylated haemoglobin and insulin dose were evaluated at diagnosis and at three-monthly intervals up to one year. RESULTS: Preservation and slight increase of C-peptide levels at one year compared with diagnosis were obtained in the two treated patient groups. No statistically significant differences were observed in basal or stimulated C-peptide levels between the two groups of patients for up to one year after diagnosis. Glycosylated haemoglobin and insulin dose were also similar between the two groups; however patients receiving Vit E under the age of 15 years required significantly more insulin than NA-treated patients one year after diagnosis (P < 0.04). CONCLUSIONS: Our data indicate that Vit E and NA possess similar effects in protecting residual beta cell function in patients with recent onset IDDM. Since their putative mechanism of protection on beta cell cytotoxicity is different, combination of these two vitamins may be envisaged for future trials of intervention at IDDM onset. TITLE: Chronic intake of pharmacological doses of vitamin E might be useful in the therapy of elderly patients with coronary heart disease.AUTHORS: Paolisso G; Gambardella A; Giugliano D; Galzerano D; Amato L; Volpe C; Balbi V; Varricchio M; D'Onofrio FAUTHOR AFFILIATION: Department of Geriatric Medicine and Metabolic Diseases, II, University of Naples, Italy.SOURCE: Am J Clin Nutr 1995 Apr;61(4):848-52CITATION IDS: PMID: 7702030 UI: 95216593ABSTRACT: Thirty elderly (mean +/- SEM: 73.8 +/- 2.1 y) nondiabetic, moderately obese (body mass index = 28.3 +/- 0.6 kg/m2) patients with stable effort angina underwent an oral-glucose-tolerance test and a euglycemic hyperinsulinemic glucose clamp before and after vitamin E supplementation (900 mg/d for 4 mo). The study was of a randomized, placebo-controlled, double-blind, and crossover design. Anthropometric indexes were stable throughout the study. Despite similar fasting and 2- h plasma glucose concentrations, vitamin E administration (compared with placebo) lowered fasting (88 +/- 14 and 68 +/- 9 pmol/L, P < 0.02) and 2-h (348 +/- 43 and 263 +/- 28 pmol/L, P < 0.05) plasma insulin concentrations, plasma triglyceride concentrations (1.34 +/- 0.06 and 1.07 +/- 0.03 mmol/L, P < 0.05), and the ratio of plasma LDL to HDL cholesterol (7.64 +/- 0.31 and 5.52 +/- 0.38, P < 0.02). Vitamin E administration was associated with higher nonoxidative glucose metabolism (18.1 +/- 0.5 and 10.6 +/- 0.7 mumol.kg lean body mass-1.min- 1, P < 0.03) than was placebo administration during the euglycemic glucose clamp. We conclude that chronic intake of pharmacological doses of vitamin E might be useful in the therapy of elderly insulin- resistant patients with coronary heart disease. ============== Begin Vitamin C ============== 1973, Dice and Daniel "The Hypoglycemin Effect of Ascorbic Acid in a Juvenile-onset Diabetic" International Res Communications 1:41 Each gram of ascorbic acid by mouth reduced insulin required by 2 units. In 1971, Dr. Klenner, a vitamin C enthusiast wrote: (the full article is at http://www.orthomed.com/klenner.htm and is a good starting place for those interested in vitamin C) Klenner in the J of Applied Nutrition, 1971: "Diabetes mellitus response to 10 grams ascorbic acid by mouth. Over the past 17 years we have studied the effect of 10 grams by mouth, in patients with diabetes mellitus. We found that every diabetic not taking supplemental vitamin C could be classified as having sub-clinical scurvy. For this reason they find it difficult to heal wounds. The diabetic patient will use the supplemental vitamin C for better utilization of his insulin. It will assist the liver in the metabolism of carbohydrates and to reinstate his body to heal wounds like normal individuals. We found that 60% of all diabetics could be controlled with diet and 10 grams ascorbic acid daily. The other 40% will need much less needle insulin and less oral medication. ============ Linus Pauling's 1986 book "How to Live Longer and Feel Better" is the best place to start for anyone interested in how to be and remain healthy and for more info on vitamin C. Despite the title, it's not a light book. =================== TITLE: The glucose/insulin system and vitamin C: implications in insulin- dependent diabetes mellitus.AUTHORS: Cunningham JJAUTHOR AFFILIATION: Department of Nutrition, University of Massachusetts, Amherst 01003- 1420, USA.SOURCE: J Am Coll Nutr 1998 Apr;17(2):105-8CITATION IDS: PMID: 9550452 UI: 98209822ABSTRACT: The cellular uptake of vitamin C (ascorbic acid, ASC) is promoted by insulin and inhibited by hyperglycemia. If a rise in plasma ASC is uncoupled from insulin replacement in insulin-dependent diabetes mellitus (IDDM) then the degree of hyperglycemia could account for "tissue scurvy" in IDDM. Leukocyte ASC is lower in IDDMs compared with nondiabetics when vitamin C consumption is adequate and our data suggest that this is a variable component of the pathophysiology of IDDM. The complications of diabetes mellitus are believed to result from either the intracellular accumulation of sorbitol or the nonenzymatic glycoxidation of proteins or both. With respect to the abnormal cellular accumulation of sorbitol, vitamin C supplementation has been shown to be effective in several studies of adults with diabetes; the situation regarding the prevention of protein glycoxidations by supplementation is presently unclear. The roles of ASC as an aldose reductase inhibitor and a water soluble antioxidant in body fluids are potentially very important as adjuncts to tight glycemic control in the management of diabetes. Tissue saturation and maximal physiologic function in IDDM may require supplemental vitamin C intake. TITLE: Low plasma ascorbate levels in patients with type 2 diabetes mellitus consuming adequate dietary vitamin C.AUTHORS: Sinclair AJ; Taylor PB; Lunec J; Girling AJ; Barnett AHAUTHOR AFFILIATION: University Department of Geriatric Medicine, Cardiff Royal Infirmary, UK.SOURCE: Diabet Med 1994 Nov;11(9):893-8CITATION IDS: PMID: 7705029 UI: 95219971ABSTRACT: Low ascorbate concentrations in diabetes may be secondary to inadequate dietary vitamin C intake or may relate to the varied metabolic roles of the vitamin. To determine whether inadequate dietary intake is a factor we calculated daily vitamin C intakes using both a vitamin C questionnaire and a 4-day food diary in a group of 30 patients with Type 2 diabetes (mean age 68.8 +/- 6.9 yr, 17M/13F) and in 30 community controls (mean age 68.0 +/- 5.5 yr, 12M/18F)). Measures of plasma glucose, serum fructosamine, and plasma ascorbic and dehydroascorbic acid were obtained from 20 subjects in each group. There was no significant difference in daily vitamin C intake between the two groups using both methods: food diary, 61.4 +/- 28.3 (patients) vs 69.5 +/- 33.4 (controls) mg; questionnaire, 54.0 +/- 28.9 (patients) vs 65.0 +/- 30.9 (controls) mg. Vitamin C intake derived from both methods was significantly correlated (p < 0.001). Plasma ascorbate (30.4 +/- 19.1 mumol l-1) and dehydroascorbate (27.6 +/- 6.4 mumol l-1) levels were significantly lower in patients vs in controls (68.8 +/- 36.0 and 31.8 +/- 4.8 mumol l-1, respectively), p < 0.0001 and p < 0.01. Plasma ascorbate levels were significantly correlated with vitamin C intake derived from the food diary (p < 0.01) and questionnaire (p < 0.01) methods in the diabetic group only. Low ascorbate levels in diabetes appears to be a consequence of the disease itself and not due to inadequate dietary intake of vitamin C. A short vitamin C questionnaire is a convenient and reliable estimate of vitamin C intake. TITLE: Metabolic benefits deriving from chronic vitamin C supplementation in aged non-insulin dependent diabetics.AUTHORS: Paolisso G; Balbi V; Volpe C; Varricchio G; Gambardella A; Saccomanno F; Ammendola S; Varricchio M; D'Onofrio FAUTHOR AFFILIATION: Department of Geriatric Medicine and Metabolic Diseases, II University of Naples, Italy.SOURCE: J Am Coll Nutr 1995 Aug;14(4):387-92CITATION IDS: PMID: 8568117 UI: 96025408ABSTRACT: OBJECTIVE: Our study investigated the metabolic benefits deriving from chronic pharmacological vitamin C administration in aged non-insulin dependent (Type II) diabetic patients. METHODS: Forty type II diabetic patients (age: 72 +/- 0.5 years) underwent placebo and vitamin C (0.5 g twice daily) administration in double-blind, randomized, cross-over fashion. All patients were treated by oral hypoglycaemic agents which continued throughout the study. After baseline observations, treatment periods lasted 4 months and were separated by a 30-day wash-out period. RESULTS: Patients' antropometric data were unchanged throughout the study. Chronic vitamin C administration vs placebo was associated with a significant decline in fasting plasma free radicals (0.26 +/- 0.06 vs 0.49 +/- 0.07 p < 0.03) and insulin (90 +/- 4 vs 73 +/- 6 pmol/L p < 0.04), total- (7.3 +/- 0.5 vs 5.8 +/- 0.4 mmol/L p < 0.03), LDL- cholesterol (5.6 +/- 0.6 vs 4.1 +/- 0.3 mmol/L p < 0.05) and triglycerides (2.58 +/- 0.07 vs 2.08 +/- 0.04 mmol/L p < 0.04) levels. In 20 patients, chronic vitamin C administration improved whole body glucose disposal and nonoxidative glucose metabolism. Percent increase in plasma vitamin C levels correlated with the percent decline in plasma LDL-cholesterol (r = 0.44; p < 0.007) and insulin levels (r = 0.42; p < 0.006). Finally percent increase in plasma vitamin C levels was correlated with the percent decline in plasma free radicals and increase in GSH levels. CONCLUSIONS: Chronic vitamin C administration has beneficial effects upon glucose and lipid metabolism in aged non- insulin dependent (type II) diabetic patients. TITLE: Renal excretion of ascorbic acid in insulin dependent diabetes mellitus.AUTHORS: Seghieri G; Martinoli L; Miceli M; Ciuti M; D'Alessandri G; Gironi A; Palmieri L; Anichini R; Bartolomei G; Franconi FAUTHOR AFFILIATION: Diabetes Unit, Spedali Riuniti, Pistoia, Italy.SOURCE: Int J Vitam Nutr Res 1994;64(2):119-24CITATION IDS: PMID: 7960490 UI: 95049161ABSTRACT: Serum ascorbic acid (AA) is reduced in diabetic patients. Aim of this study was 1) to verify whether such a decrease might be due to an altered urinary excretion of AA, and 2) whether this latter was modified in presence of early diabetic nephropathy with microalbuminuria (albumin excretion rate [AER] > 20 micrograms/min) in a group of 21 patients affected by insulin-dependent (type 1) diabetes mellitus (IDDM) as compared with 13 healthy controls matched for sex, age, dietary AA intake, and creatinine clearance per 1.73 m2 (CCl). Mean serum AA (+/- SD) was lower in diabetics (40.3 +/- 14 microM/l) than in controls (85.1 +/- 23.5 microM/l; p = 0.0001) and there was no difference between serum AA of patients with or without microalbuminuria. ================ Begin Chromium ================ AUTHOR AFFILIATION: Department of Diabetes, The Linn Clinic, Oranim University of Haifa, Israel.SOURCE: Diabet Med 1999 Feb;16(2):164-7 three patients with steroid-induced diabetes with 600 microg per day of chromium as chromium picolinate. RESULTS: Urinary chromium losses following corticosteroid treatment increased from 155+/-28 ng/d before corticosteroid treatment to 244+/-33 ng/d in the first 3 days following treatment. Chromium supplementation of patients with steroid- induced diabetes resulted in decreases in fasting blood glucose values from greater than 13.9 mmol/l (250 mg/dl) to less than 8.3 mmol/l (150 mg/dl). AUTHOR AFFILIATION: Beltsville Human Nutrition Research Center, U.S. Department of Agriculture, Maryland 20705-2350, USA. anderson@307.bhnrc.usda.govSOURCE: Diabetes 1997 Nov;46(11):1786-91 Individuals being treated for type 2 diabetes (180 men and women) were divided randomly into three groups and supplemented with: 1) placebo, 2) 1.92 micromol (100 microg) Cr as chromium picolinate two times per day, or 3) 9.6 micromol (500 microg) 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 microg) Cr per day and was lower in both chromium groups after 4 months (placebo, 8.5 +/- 0.2%; 3.85 micromol Cr, 7.5 +/- 0.2%; 19.2 micromol Cr, 6.6 +/- 0.1%). Fasting glucose was lower in the 19.2-micromol group after 2 and 4 months (4-month values: placebo, 8.8 +/- 0.3 mmol/l; 19.2 micromol Cr, 7.1 +/- 0.2 mmol/l). Two-hour glucose values were also significantly lower for the subjects consuming 19.2 micromol supplemental Cr after both 2 and 4 months (4-month values: placebo, 12.3 +/- 0.4 mmo/l; 19.2 micromol Cr, 10.5 +/- 0.2 mmol/l). 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 micromol/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. ============== TITLE: Chromimum, glucose intolerance and diabetes.AUTHORS: Anderson RAAUTHOR AFFILIATION: Nutrient Requirements and Functions Laboratory, Beltsville Human Nutrition Research Center, US Department of Agriculture, ARS, Beltsville, Maryland 20705-2350, USA.SOURCE: J Am Coll Nutr 1998 Dec;17(6):548-55CITATION IDS: PMID: 9853533 UI: 99068422ABSTRACT: Within the last 5 years chromium (Cr) has been shown to play a role in glucose intolerance, Type 2 diabetes mellitus (Type 2 DM), and gestational diabetes. In addition, diabetes and the neuropathy of a patient on home parenteral nutrition were alleviated when supplemental Cr was added to total parenteral nutrition (TPN) solutions. In a study conducted in China that has been supported by studies in the United States, supplemental Cr as Cr picolinate improved the blood glucose, insulin, cholesterol, and hemoglobin A1C in people with Type 2 DM in a dose dependent manner. Follow-up studies of > 1 year have confirmed these studies. The requirement for Cr is related to the degree of glucose intolerance: 200 microg/day of supplemental Cr is adequate to improve glucose variables of those who are mildly glucose intolerant. However, people with more overt impairments in glucose tolerance and diabetes usually require more than 200 microg/day. Daily intake of 8 microg of Cr per kg body weight was also more effective than 4 microg/kg in women with gestational diabetes. The mechanism of action of Cr involves increased insulin binding, increased insulin receptor number, and increased insulin receptor phosphorylation. In summary, supplemental Cr has been shown to have beneficial effects without any documented side effects on people with varying degrees of glucose intolerance ranging from mild glucose intolerance to overt Type 2 DM. TITLE: Nutritional factors influencing the glucose/insulin system: chromium.AUTHORS: Anderson RAAUTHOR AFFILIATION: Nutrient Requirements and Functions Laboratory, United States Department of Agriculture, Beltsville, Maryland 20705-2350, USA.SOURCE: J Am Coll Nutr 1997 Oct;16(5):404-10CITATION IDS: PMID: 9322187 UI: 97463403ABSTRACT: Chromium (Cr) improves the glucose/insulin system in subjects with hypoglycemia, hyperglycemia, diabetes and hyperlipemia with no detectable effects on control subjects. Chromium improves insulin binding, insulin receptor number, insulin internalization, beta cell sensitivity and insulin receptor enzymes with overall increases in insulin sensitivity. There have been several studies involving Cr supplementation of subjects with NIDDM and/or lipemia and most have reported beneficial effects of Cr on the glucose/insulin system. In a recent study, Chinese subjects with NIDDM were divided into three groups of 60 subjects and supplemented with placebo, 100 or 500 micrograms of Cr as chromium picolinate 2 times per day for 4 months. Improvements in the glucose/insulin system were highly significant in the subjects receiving 500 micrograms twice per day with less or no significant improvements in the subjects receiving 100 micrograms twice per day after 2 and 4 months. In summary, Cr is involved in the control of the glucose/insulin system and the amount, and likely form of chromium, are critical when evaluating the role of chromium in this system. TITLE: Chromium in human nutrition: a review [see comments]AUTHORS: Mertz WAUTHOR AFFILIATION: U.S. Department of Agriculture, Beltsville Human Nutrition Research Center, MD 20705.SOURCE: J Nutr 1993 Apr;123(4):626-33CITATION IDS: PMID: 8463863 UI: 93217574COMMENT: Comment in: J Nutr 1994 Jan;124(1):117-9 ABSTRACT: This review summarizes the results of 15 controlled studies supplementing defined Cr(III) compounds to subjects with impaired glucose tolerance. Three of these (3-4 mumol Cr/d for > 2 mo) produced no beneficial effects: serum glucose, insulin and lipid concentrations remained unchanged. The remaining 12 interventions improved the efficiency of insulin or the blood lipid profile of subjects (ranging from malnourished children and healthy middle-aged individuals to insulin-requiring diabetics). TITLE: Chromium supplementation of human subjects: effects on glucose, insulin, and lipid variables.AUTHORS: Anderson RA; Polansky MM; Bryden NA; Roginski EE; Mertz W; Glinsmann WSOURCE: Metabolism 1983 Sep;32(9):894-9CITATION IDS: PMID: 6350814 UI: 83296903ABSTRACT: Seventy-six normal, free-living subjects were given supplements of 200 micrograms chromium (Cr) in the form of chromic chloride or a placebo in a double-blind crossover study with 3-month experimental periods. Twenty of the 76 subjects had serum glucose concentrations greater than or equal to 100 mg/dL 90 minutes after a glucose challenge (1 g glucose per kilogram of body weight). Chromium supplementation significantly decreased (P less than 0.05) the 90-minute glucose concentration of these subjects from 135 +/- 9 to 116 +/- 11 mg/dL; fasting glucose concentrations also decreased significantly. The 90-minute serum glucose levels of the 35 subjects with glucose concentrations less than the fasting serum glucose level were increased significantly by Cr supplementation, from 71 +/- 1 to 81 +/- 4 mg/dL. Fasting and 90-minute serum glucose concentrations of the remaining subjects who displayed 90- minute glucose concentrations greater than fasting levels but less than 100 mg/dL were not affected by Cr supplementation. In this study, immunoreactive serum insulin concentration, body weight, lipids, and other selected clinical variables did not change significantly during Cr supplementation. These data demonstrate that Cr supplementation decreases the serum glucose levels of subjects with 90-minute glucose concentrations greater than or equal to 100 mg/dL following a glucose challenge, increases serum glucose levels of subjects with 90-minute glucose concentrations less than fasting levels, and has no effect on the serum glucose levels of subjects with 90-minute glucose values similar to but greater than fasting levels. TITLE: The effects of chromium supplementation on serum glucose and lipids in patients with and without non-insulin-dependent diabetes.AUTHORS: Abraham AS; Brooks BA; Eylath UAUTHOR AFFILIATION: Department of Medicine B, Shaare Zedek Medical Center, Jerusalem, Israel.SOURCE: Metabolism 1992 Jul;41(7):768-71CITATION IDS: PMID: 1619996 UI: 92318771ABSTRACT: Seventy-six patients with established atherosclerotic disease were treated daily with either 250 micrograms of chromium orally as chromium chloride or a placebo for a period of 7 to 16 months (mean, 11.1 months). Serum chromium increased from 2.69 +/- 0.09 to 12.12 +/- 0.77 nmol/L (mean +/- SE, P less than .005). Serum triglycerides were lower (1.68 +/- 0.11 and 2.10 +/- 0.14 nmol/L, respectively; P less than .02) in the chromium-treated patients than in the patients who received placebo, and serum high-density lipoprotein (HDL) increased (from 0.94 +/- 0.05 to 1.14 +/- 0.07 mmol/L, P less than .005) in the patients who received chromium. There was no change in serum cholesterol or blood glucose during the study. TITLE: Trivalent chromium, in atherosclerosis and diabetes.AUTHORS: Mossop RTSOURCE: Cent Afr J Med 1991 Nov;37(11):369-74CITATION IDS: PMID: 1806247 UI: 92217041ABSTRACT: The known effects of trivalent chromium (Cr) in lowering blood levels of low density lipoproteins (LDL), raising high density lipoproteins (HDL) and improving glucose tolerance are summarised. Chromium deficiency cannot easily be established by direct means, but can be inferred by the reversal of symptoms and signs following the administration of trivalent chromium. This evidence can be supported by knowledge or suspicion of a deficiency in the diet, common in those who use highly refined cereal foods. It is considered that the beneficial effects of chromium repletion are now so well established and the trivalent form is so free of toxicity that it should now be used in clinical medicine for the benefit of those with some forms of diabetes and its complications and those suffering from atherosclerosis. =====================