Info sheet on “Supplements studied for diabetes/insulin resistance”

NYBC has prepared an updated version of its info sheet on the topic of supplements that have been studied for diabetes or insulin resistance. Here’s the text below:

SUPPLEMENTS STUDIED FOR DIABETES/INSULIN RESISTANCE

Multivitamin/multimineral: Regular use of a multivitamin/multimineral supplement helps people with diabetes maintain good health and reduce infections. Clinical evidence indicates that diabetics have unique nutritional needs, and should take a daily multivitamin to supplement their normal diet.

Note: NYBC stocks Jarrow’s Multi 1-to-3; Douglas Lab’s Added Protection, and SuperNutrition’s family of multivitamins (such as the Opti-Pack).

Reference: Barringer, et al. Effect of a Multivitamin and Mineral Supplement on Infection and Quality of Life. Annals of Internal Medicine. 3/4/2003.

Omega-3 fatty acids (Fish Oil): Many people with diabetes have high blood pressure and elevated cholesterol, which can increase the risk of heart disease and stroke. Omega-3 fatty acids have shown benefit for cardiovascular health in recent randomized controlled clinical trials. The FDA has also approved a health claim for fish oil: “supporting but not conclusive evidence shows that the consumption of EPA and DHA omega-3 fatty acids from fish oil may reduce the risk of coronary heart disease.”

Note: NYBC stocks Max DHA –Omega-3 Fish Oil Purified by Molecular Distillation (Jarrow); and ProOmega –Nordic Naturals (60 softgels or 180 softgels).

Alpha-Lipoic Acid: Alpha-Lipoic Acid (ALA) has the ability to assist with glucose metabolism, and also promotes healthy nerve function. A recent study concluded that ALA (600mg) could be useful in helping to treat the symptoms of diabetes-related neuropathy (= generally, pain, tingling, numbness in feet and hands).

Note: NYBC stocks ALA (Montiff) 300mg/60.

Reference: Ametov et al. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: The SYDNEY Trial. Diabetes Care. 2003, 26 (3)

Other supplements studied for diabetes: Chromium and biotin (these two supplements, taken together, are believed to play an active role in balancing insulin production with glucose uptake). Also: evening primrose oil, resveratrol, bitter melon.

Talk to your doctor before you use these or other supplements. Do not discontinue medications you are taking for diabetes/glucose control without first discussing with your healthcare provider any complementary treatments you are considering!

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Hepatitis C and HIV Co-infection: A Treatment Update from CATIE

The Canadian AIDS Treatment Information Exchange (CATIE) has devoted the June/July Issue 2008 of its Treatment Update to a review of recent research on Hepatitis C and HIV. Here are some of the main points:

1. Although commonly viewed as simply a liver disease, Hepatitis C in recent research is strongly linked to diabetes, pre-diabetes and insulin resistance. In fact, about one-third of people with Hep C show insulin resistance, a complication that reduces chances of recovery and may lead to additional problems. Thus, researchers “need to find ways to reverse IR [insulin resistance]. Such methods could include clinical trials of diet, exercise programs and insulin-sensitizing drugs or supplements such as chromium.”

2. The HIV medication ddI (didanosine, Videx or Videx EC) has been associated with liver disease in some cases. Researchers have speculated that ddI decreases levels of a protective compound called glutathione (GSH), which is used in the body to make enzymes that help detoxification. NAC, or N-acetyl-cysteine, has been shown to raise GSH levels in people with HIV, and so could be helpful in countering ddI-related liver problems. (However, no clinical trials have yet been conducted to assess NAC’s impact on the liver health of people with HIV taking ddI.)

Read the complete Treatment Update issue here:

CATIE Treatment Update June/July 2008

For more information on the supplements mentioned above, see the NYBC entries on

CHROMIUM

NAC or N-acetylcysteine

Or, see further entries for these two supplements on this blog.

CATIE Treatment Update: Chromium supplements for metabolic problems in people with HIV

The Canadian AIDS Treatment Information Exchange (CATIE) website has posted news about a new study of chromium supplements for metabolic abnormalities in people with HIV. Here’s the introduction:

Can chromium supplementation help body shape?

A research team at Toronto General Hospital found a statistical link between low chromium levels in the blood and HIV infection, particularly in HAART users. The Toronto team also noted that some of the symptoms of chromium deficiency are similar to the metabolic problems—higher-than-normal levels of blood sugar and insulin and the weakened effects of insulin—in some HIV positive people. So the team later conducted a double-blind study with a modest dose of chromium vs. placebo in people with HIV infection. Their findings suggest that chromium supplementation may confer some benefit(s) in people with HIV/AIDS (PHAs) in the short-term.

Read the entire article on the CATIE website.

This April/May 2008 post from CATIE follows after news of several other studies regarding chromium supplementation and metabolic complications in people with HIV. In February 2008, for example, the 15th Conference on Retroviruses and Opportunistic Infections in Boston included a report
entitled “Chromium supplementation decreases insulin resistance and trunk fat.”

For more background on this dietary supplement, see the NYBC entry CHROMIUM.

Chromium and biotin supplementation may help control diabetes

We were interested to see a report from last month on a study of chromium plus biotin to help in managing diabetes.
The study, conducted by Yale University researchers, found that daily supplementation with these two items improved glucose tolerance by 15 per cent, compared to placebo. The investigation focused on the glycemic control and blood lipids of 36 overweight or obese people with type 2 diabetes. Reporting the results in the journal Diabetes Technology and Therapeutics, lead author Gregory Singer concluded that supplementing with chromium and biotin on a daily basis improved blood sugar control and cholesterol metabolism in diabetes patients on an antidiabetic treatment regimen, and could be considered as an adjunct to conventional oral diabetes therapy.

We also note that biotin and lipoic acid have recently been investigated for their potential in helping manage diabetes. See the NYBC entry on biotin for further details.

Chromium and glucose tolerance factor

Since there are a number of federally funded research studies dealing with chromium supplementation and blood glucose levels (see other posts under “Chromium” on this blog), we’d be very interested in hearing about the experience of our members in using this product.

Jarrow Chromium GTF
Here’s an extract of the manufacturer’s product description:


Chromium GTF (Jarrow) Each bottle, 100 caps. Each capsule, 200 mcg of chromium (in a food matrix of 100 mg of Saccharomyces cerevisiae nutritional yeast).


Chromium has been shown to be deficient in populations that consume high carbohydrate diets and especially high in simple sugars. Chromium is an important component in eliciting the glucose tolerance factor (GTF) action upon serum glucose and more importantly enhancing the effectiveness of insulin in glucose disposal into the cell. This makes sense. The more carbs you eat, the more your body will need the chromium to manage them. This could help offset the losses of chromium used up in that effort to take care of the carbs. Of course, this points to another logical step: reduce carb intake!! Check out the glycemic index of the foods you eat and focus on those with lower numbers. This index tells you how rapidly a particular carbohydrate turns into sugar. Check out the URL below for more information on the glycemic index:
http://www.hsph.harvard.edu/nutritionsource/carbohydrates.html

New research on Chromium supplemention’s potential in the prevention of Type 2 Diabetes and Coronary Artery Disease

Here’s another federally-funded study of chromium supplementation to counter insulin resistance and potentially help prevent the development of Type 2 Diabetes and Coronary Artery Disease.

Investigator: Dr. UMESH MASHARANI, Univ. of California at San Francisco

Sponsor: NCCAM/National Institutes of Health

Abstract: DESCRIPTION (provided by applicant): Background: Chromium is an essential nutrient for the maintenance of normal glucose tolerance. While studies of chromium supplementation in patients with type 2 diabetes (T2D) have indicated that this agent lowers glucose and insulin levels, its cellular mechanism of action is not welt understood. Studies both in humans and in cell culture suggest that chromium enhances the insulin signaling pathway. We propose, therefore, to study chromium’s effects on insulin-stimulated glucose uptake in a well characterized population of non-obese, non-diabetic subjects with insulin resistantance. This population is ideal for an analysis of the effects of chromium on insulin action, because they are as insulin resistant as T2D patients but do not have the important confounder of hyperglycemia. Because these insulin resistant subjects are at risk for the development of T2D, the Metabolic Syndrome, and coronary artery disease (CAD), a demonstration of the beneficial effects of chromium on insulin action could ultimately have important public health consequences. Hypotheses: (1) Chromium will improve insulin sensitivity in a general population of non-obese, insulin-resistant, non-diabetic subjects; and (2) The improvement of insulin action by chromium is due to its effects on the major components of the insulin signling pathway (insulin receptor, IRS proteins, PI 3-kinase, PKB/AKT and GLUT4); and/ or regulators of the insulin signaling pathway (PTP 1B, PC-1, IKK, NF-KappaB and PKC) Methods: The insulin sensitivity of 180 subjects will be initially estimated by homeostasis model assessment. The most insulin resistant subjects will then be randomized to 16 weeks of therapy with either chromium or placebo. To quantitate chromium-induced improvements in both in insulin sensitivity and the insulin signaling pathway, euglycemic hyperinsulinemic clamps with muscle biopsies will be performed before and after treament. Anticipated Results and Significance: We believe these studies will (1) confirm the beneficial effect of chromium on insulin sensitvity; (2) further our understanding of the molecular mechanisms of chromium action; and (3) form a basis for a larger project examining the long term efficacy of chromium in preventing the developement of T2D and CAD.

Novel Therapy for Glucose Intolerance in HIV Disease (Chromium picolinate)

This research is being funded by NCCAM, the federal government’s chief dietary supplement research agency. It builds on past knowledge about the role of an inexpensive dietary supplement, chromium, for management of diabetes (insulin resistance/glucose intolerance). This research study is directed especially to the case of people with HIV on multi-drug regimens, who experience insulin resistance/glucose intolerance at a high rate. 

——

Investigator: Dr. Marie C Gelato, State University of New York at Stony Brook 

Abstract: DESCRIPTION (provided by applicant): Multi-drug regimens in HIV disease are associated with an incidence of insulin resistance of at least 50%. Insulin resistance is associated with the development of dyslipidemia, type 2 diabetes, and hypertension. This constellation of metabolic abnormalities is known to cause accelerated atherosclerosis in patients with type 2 diabetes. The current guidelines from the American Diabetes Association and the American College of Endocrinologists recommends screening for glucose intolerance and treatment for patients at high risk of diabetes. This proposal seeks to establish a treatment option for insulin resistance / glucose intolerance in HIV/AIDS prior to the transition to overt diabetes. Chromium picolinate is a dietary supplement that has been shown to improve insulin sensitivity in patients with type 2 diabetes mellitus and, in a preliminary study, in HIV+ patients. This dietary supplement has a wide margin of safety and may provide substantial therapeutic benefit without serious side-effects. This proposal will test the hypothesis that chromium picolinate improves insulin-stimulated glucose uptake by increasing the insulin receptor-mediated tyrosine phosphorylation of insulin receptor substrate-1, resulting in increased activity of phosphatidylinositol 3-kinase. The hypothesis will be addressed in two specific aims. Specific Aim 1 will assess quantitative improvements in insulin-mediated glucose disposal in a double-blind, placebo-controlled study of chromium supplementation with 1000 microgram (19.2 mu/mol) of chromium as chromium picolinate, over a two month course of therapy of subjects with glucose intolerance (defined with an oral glucose tolerance test, OGTT). Both safety and efficacy (improved glucose disposal with a hyperinsulineminc, euglycemic clamp and insulin secretion, OGTT) will be evaluated. The cellular mechanism for improved insulin sensitivity with chromium supplementation will be determined in Specific Aim 2 by assessing the effect of chromium supplementation on the insulin-stimulated activity of insulin receptor substrate-1-associated phosphatidylinositol 3-kinase in biopsies of adipose tissue. Thus, this research will document the therapeutic benefit of chromium supplementation for insulin resistance / glucose intolerance in HIV disease and will provide a mechanistic framework to explain how chromium supplementation enhances insulin action.