Skip to main content

Advertisement

SpringerLink
Log in

Current Concepts About Chromium Supplementation in Type 2 Diabetes and Insulin Resistance

  • Published:
Current Diabetes Reports Aims and scope Submit manuscript

Abstract

Chromium has been established to be an essential trace element in mammals in regard to maintenance of normal carbohydrate metabolism. Studies that provided chromium to human subjects in documented deficiency states noted improved glucose levels. However, controversy exists as to whether dietary supplementation with chromium should be routinely recommended in subjects without documented deficiencies. Over the recent past, several well-designed clinical trials have provided evidence in favor of and against a beneficial effect of chromium. It appears that across all subject phenotypes (eg, lean and obese, insulin sensitive and insulin resistant), a consistent significant and beneficial effect of chromium may not be observed. Specifically, recent data fail to demonstrate significant improvement in carbohydrate metabolism in individuals with metabolic syndrome, impaired glucose tolerance, or consistently in individuals with type 2 diabetes. However, patient selection may be an important factor in determining clinical response, as it was concluded that a clinical response to chromium (ie, decreased glucose and improved insulin sensitivity) may be more likely in insulin-resistant individuals with type 2 diabetes who have more elevated fasting glucose and hemoglobin A1c levels.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as follows: • Of importance

  1. Cefalu WT: Pharmacotherapy for the treatment of patients with type 2 diabetes mellitus: rationale and specific agents. Clin Pharmacol Ther 2007, 81:636–649.

    Article  CAS  PubMed  Google Scholar 

  2. Riddle MC: Glycemic management of type 2 diabetes: an emerging strategy with oral agents, insulins and combinations. Endocrinol Metab Clin North Am 2005, 34:77–98.

    Article  CAS  PubMed  Google Scholar 

  3. Jeppesen J, Hansen TW, Rasmussen S, et al.: Insulin resistance, the metabolic syndrome, and risk of incident cardiovascular disease: a population-based study. J Am Coll Cardiol 2007, 49:2112–2119.

    Article  CAS  PubMed  Google Scholar 

  4. Haffner SM: Abdominal obesity, insulin resistance, and cardiovascular risk in pre-diabetes and type 2 diabetes. Eur Heart J Suppl 2006, 8(Suppl B):B20–B25.

    Article  Google Scholar 

  5. Grundy SM: Obesity, metabolic syndrome, and cardiovascular disease. J Clin Endocrinol Metab 2004, 89:2595–2560.

    Article  CAS  PubMed  Google Scholar 

  6. Stafylas PC, Sarafidis PA, Lasaridis AN: The controversial effects of thiazolidinediones on cardiovascular morbidity and mortality. Int J Cardiol 2009, 131:298–304.

    Article  PubMed  Google Scholar 

  7. Neuhouser ML: Dietary supplement use by American women: challenges in assessing patterns of use, motives and costs. J Nutr 2003, 133:1992S–1996S.

    PubMed  Google Scholar 

  8. Mehta DH, Gardiner PM, Phillips RS, McCarthy EP: Herbal and dietary supplement disclosure to health care providers by individuals with chronic conditions. J Altern Complement Med 2008, 14:1263–1269.

    Article  PubMed  Google Scholar 

  9. Schwarz K, Mertz W: A glucose tolerance factor and its differentiation from factor 3. Arch Biochem Biophys 1957, 72:515–518.

    Article  CAS  PubMed  Google Scholar 

  10. Anderson RA: Chromium in the prevention and control of diabetes. Diabetes Metab 2000, 26:22–27.

    CAS  PubMed  Google Scholar 

  11. Schroeder HA: Chromium deficiency in rats: a syndrome simulating diabetes mellitus with retarded growth. J Nutr 1966, 88:439–445.

    CAS  PubMed  Google Scholar 

  12. Freund H, Atamian S, Fischer JE: Chromium deficiency during total parenteral nutrition. JAMA 1979, 241:496–498.

    Article  CAS  PubMed  Google Scholar 

  13. Anderson RA, Kozlovsky AS: Chromium intake, absorption and excretion of subjects consuming self-selected diets. Am J Clin Nutr 1985, 41:1177–1183.

    CAS  PubMed  Google Scholar 

  14. Preuss HG, Anderson RA: Chromium update: examining recent literature 1997–1998. Curr Opin Clin Nutr Metab Care 1998, 1:509–512.

    Article  CAS  PubMed  Google Scholar 

  15. Mummel M, Schnell SO: Chromium in metabolic and cardiovascular disease. Horm Metab Res 2007, 39:743–751.

    Article  Google Scholar 

  16. Davies S, McLaren Howard J, Hunnisett A, Howard M: Age-related decreases in chromium levels in 51,665 hair, sweat, and serum samples from 40,872 patients: implications for the prevention of cardiovascular disease and type II diabetes mellitus. Metabolism 1997, 46:469–473.

    Article  CAS  PubMed  Google Scholar 

  17. Evans GW, Pouchnik DJ: Composition and biological activity of chromium-pyridine carboxylate complexes. J Inorg Biochem 1993, 49:177–187.

    Article  CAS  PubMed  Google Scholar 

  18. Cefalu WT, Hu F: Chromium in health and in diabetes. Diabetes Care 2004, 27:2741–2751.

    Article  CAS  PubMed  Google Scholar 

  19. • Balk EM, Tatsioni A, Lichtenstein AH, et al.: Effect of chromium supplementation on glucose metabolism and lipids: a systematic review of randomized controlled trials. Diabetes Care 2007, 30:2154–2163. This systematic review suggested that chromium supplementation significantly improved glycemia among patients with diabetes. However, the authors suggested that future studies that address the limitations in the current evidence are needed before definitive claims can be made about the effect of chromium supplementation.

    Google Scholar 

  20. Broadhurst CL, Domenico P: Clinical studies on chromium picolinate supplementation in diabetes mellitus—a review. Diabetes Technol Ther 2006, 8:677–687.

    Article  CAS  PubMed  Google Scholar 

  21. Feiner JJ, McNurlan MA, Ferris RE, et al.: Chromium picolinate for insulin resistance in subjects with HIV disease: a pilot study. Diabetes Obes Metab 2008, 10:151–158.

    CAS  PubMed  Google Scholar 

  22. Lydic ML, McNurlan M, Bembo S, et al.: Chromium picolinate improves insulin sensitivity in obese subjects with polycystic ovary syndrome. Fertil Steril 2006, 86:243–246.

    Article  CAS  PubMed  Google Scholar 

  23. Via M, Scurlock C, Raikhelkar J, et al.: Chromium infusion reverses extreme insulin resistance in a cardiothoracic ICU patient. Nutr Clin Pract 2008, 23:325–328.

    Article  PubMed  Google Scholar 

  24. Albarracin CA, Fuqua BC, Evans JL, Goldfine ID: Chromium picolinate and biotin combination improves glucose metabolism in treated, uncontrolled overweight to obese patients with type 2 diabetes. Diabetes Metab Res Rev 2008, 24:41–51.

    Article  CAS  PubMed  Google Scholar 

  25. Wang ZQ, Qin J, Martin J, et al.: Phenotype of subjects with type 2 diabetes mellitus may determine clinical response to chromium supplementation. Metabolism 2007, 56:1652–1655.

    Article  CAS  PubMed  Google Scholar 

  26. Cefalu WT, Bell-Farrow AD, Stegner J, et al.: Effect of chromium picolinate on insulin sensitivity in vivo. J Trace Elem Exp Med 1999, 12:71–83.

    Article  CAS  Google Scholar 

  27. Anderson RA, Cheng N, Bryden NA, et al.: Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes 1997, 46:1786–1791.

    Article  CAS  PubMed  Google Scholar 

  28. Martin J, Wang ZQ, Zhang XH, et al.: Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes. Diabetes Care 2006, 29:1826–1832.

    Article  CAS  PubMed  Google Scholar 

  29. Gunton JE, Cheung NW, Hitchman R, et al.: 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. Diabetes Care 2005, 28:712–713.

    Article  PubMed  Google Scholar 

  30. Kleefstra N, Houweling ST, Bakker SJ, et al.: Chromium treatment has no effect in patients with type 2 diabetes in a Western population: a randomized, double-blind, placebo-controlled trial. Diabetes Care 2007, 30:1092–1096.

    Article  CAS  PubMed  Google Scholar 

  31. • Kleefstra N, Houweling ST, Jansman FG, et al.: 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. Diabetes Care 2006, 29:521–525. This study evaluated a Western population consisting of poorly controlled subjects with type 2 diabetes and reported that chromium supplementation did not improve parameters of glycemic control.

  32. Iqbal N, Cardillo S, Volger S, et al.: Chromium picolinate does not improve key features of metabolic syndrome in obese non-diabetic adults. Metab Syndr Relat Disord 2009, 7:143–150.

    Article  CAS  PubMed  Google Scholar 

  33. Komorowski J, Juturu V: 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: response to Gunton et al. Diabetes Care 2005, 28:1842–1843.

    Article  Google Scholar 

  34. • Cefalu WT, Rood J, Pinsonat P, et al.: Characterization of the metabolic and physiologic response from chromium supplementation in subjects with type 2 diabetes. Metabolism 2009 Dec 22 [Epub ahead of print]. This study provides a comprehensive assessment of chromium in a wide range of phenotypes in subjects with type 2 diabetes. The data demonstrated that chromium did not have a consistent effect across all phenotypes. However, the data suggested that a response to chromium is more likely in insulin-resistant subjects with poorer glucose control.

  35. Wang ZQ, Zhang XH, Russell JC, et al.: Chromium picolinate enhances skeletal muscle cellular insulin signaling in vivo in obese, insulin-resistant JCR:LA-cp rats. J Nutr 206, 136:415–420.

  36. Cefalu WT, Wang ZQ, Zhang XH, et al.: Oral chromium picolinate improves carbohydrate and lipid metabolism and enhances skeletal muscle Glut-4 translocation in obese, hyperinsulinemic (JCR-LA corpulent) rats. J Nutr 2002, 132:1107–1114.

    CAS  PubMed  Google Scholar 

  37. Anderson RA: Nutritional factors influencing the glucose/insulin system: chromium. J Am Coll Nutr 1997, 16:404–410.

    CAS  PubMed  Google Scholar 

  38. Vincent JB: Elucidating a biological role of chromium at a molecular level. Acc Chem Res 2000, 33:503–510.

    Article  CAS  PubMed  Google Scholar 

  39. Vincent JB: Mechanisms of chromium action: low-molecular-weight chromium-binding substance. J Am Coll Nutr 1999, 18:6–12.

    CAS  PubMed  Google Scholar 

  40. Vincent JB: The biochemistry of chromium. J Nutr 2000, 130:715–718.

    CAS  PubMed  Google Scholar 

  41. Brautigan DL, Kruszewski A, Wang H: Chromium and vanadate combination increases insulin-induced glucose uptake by 3T3-L1 adipocytes. Biochem Biophys Res Commun 2006, 347:769–773.

    Article  CAS  PubMed  Google Scholar 

  42. Davis CM, Sumrall KH, Vincent JB: A biologically active form of chromium may activate a membrane phosphotyrosine phosphatase (PTP). Biochemistry 1996, 35:12963–12969.

    Article  CAS  PubMed  Google Scholar 

  43. Davis CM, Vincent JB: Chromium oligopeptide activates insulin receptor tyrosine kinase activity. Biochemistry 1997, 36:4382–4385.

    Article  CAS  PubMed  Google Scholar 

  44. Wang H, Kruszewski A, Brautigan DL: Cellular chromium enhances activation of insulin receptor kinase. Biochemistry 2005, 44:8167–8175.

    Article  CAS  PubMed  Google Scholar 

  45. • Horvath EM, Tackett L, McCarthy AM, et al.: Antidiabetogenic effects of chromium mitigate hyperinsulinemia-induced cellular insulin resistance via correction of plasma membrane cholesterol imbalance. Mol Endocrinol 2008, 22:937–950. These data suggest a plasma membrane cholesterol basis for hyperinsulinemia-associated insulin resistance and importantly highlight the reversible nature of this abnormality.

  46. Pattar GR, Tackett L, Liu P, Elmendorf JS: Chromium picolinate positively influences the glucose transporter system via affecting cholesterol homeostasis in adipocytes cultured under hyperglycemic diabetic conditions. Mutat Res 2006, 610:93–100.

    CAS  PubMed  Google Scholar 

  47. Chen G, Liu P, Pattar GR, et al.: Chromium activates glucose transporter 4 trafficking and enhances insulin-stimulated glucose transport in 3T3-L1 adipocytes via a cholesterol-dependent mechanism. Mol Endocrinol 2006, 20:857–870.

    Article  CAS  PubMed  Google Scholar 

  48. Goldstein BJ, Zhu L, Hager R, et al.: Enhancement of post-receptor insulin signaling by trivalent chromium in hepatoma cells is associated with differential inhibition of specific protein-tyrosine phosphatases. J Trace Elem Exp Med 2001, 14:393–404.

    Article  CAS  Google Scholar 

  49. Miranda ER, Dey CS: Effect of chromium and zinc on insulin signaling in skeletal muscle cells. Biol Trace Elem Res 2004, 101:19–36.

    Article  CAS  PubMed  Google Scholar 

  50. Dong F, Kandadi MR, Ren J, Sreejayan N: Chromium (D-phenylalanine)3 supplementation alters glucose disposal, insulin signaling, and glucose transporter-4 membrane translocation in insulin-resistant mice. J Nutr 2008, 138:1846–1851.

    CAS  PubMed  Google Scholar 

  51. Chen WY, Chen CJ, Liu CH, Mao FC: Chromium supplementation enhances insulin signalling in skeletal muscle of obese KK/HlJ diabetic mice. Diabetes Obes Metab 2009, 11:293–303.

    Article  CAS  PubMed  Google Scholar 

  52. Sreejayan N, Dong F, Kandadi MR, et al.: Chromium alleviates glucose intolerance, insulin resistance, and hepatic ER stress in obese mice. Obesity (Silver Spring) 2008, 16:1331–1337.

    Article  CAS  Google Scholar 

  53. Penumathsa SV, Thirunavukkarasu M, Samuel SM, et al.: Niacin bound chromium treatment induces myocardial Glut-4 translocation and caveolar interaction via Akt, AMPK and eNOS phosphorylation in streptozotocin induced diabetic rats after ischemia-reperfusion injury. Biochim Biophys Acta 2009, 1792:39–48.

    CAS  PubMed  Google Scholar 

  54. Thirunavukkarasu M, Penumathsa SV, Juhasz B, et al.: Niacin-bound chromium enhances myocardial protection from ischemia-reperfusion injury. Am J Physiol Heart Circ Physiol 2006, 291:H820–H826.

    Article  CAS  PubMed  Google Scholar 

  55. Jain SK, Rains JL, Croad JL: Effect of chromium niacinate and chromium picolinate supplementation on lipid peroxidation, TNF-alpha, IL-6, CRP, glycated hemoglobin, triglycerides, and cholesterol levels in blood of streptozotocin-treated diabetic rats. Free Radic Biol Med 2007, 43:1124–1131.

    Article  CAS  PubMed  Google Scholar 

  56. Lee YH, White MF: Insulin receptor substrate proteins and diabetes. Arch Pharm Res 2004, 27:361–370.

    Article  CAS  PubMed  Google Scholar 

  57. Olefsky JM: Insulin resistance and the pathogenesis of non-insulin dependent diabetes mellitus: cellular and molecular mechanisms. Adv Exp Med Biol 1993,334:129–150.

    CAS  PubMed  Google Scholar 

Download references

Disclosure

Dr. William T. Cefalu has received funding from the National Institutes of Health to conduct studies evaluating chromium supplementation in humans. The supplements used for the study were provided by Nutrition 21, a company that makes chromium supplements. However, no monies were received from Nutrition 21. No other potential conflicts of interest relevant to this article were reported.

Author information

Authors and Affiliations

  1. Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA

    Zhong Q. Wang & William T. Cefalu

Authors
  1. Zhong Q. Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. William T. Cefalu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to William T. Cefalu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wang, Z.Q., Cefalu, W.T. Current Concepts About Chromium Supplementation in Type 2 Diabetes and Insulin Resistance. Curr Diab Rep 10, 145–151 (2010). https://doi.org/10.1007/s11892-010-0097-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11892-010-0097-3

Keywords

Search

Navigation