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Systematic review and meta-analysis of the efficacy and safety of chromium supplementation in diabetes.
J Clin Pharm Ther 2014; 39(3):292-306JC

Abstract

WHAT IS KNOWN AND OBJECTIVE

Chromium is an essential mineral for carbohydrate and lipid metabolism. Results of previous systematic reviews and meta-analyses of chromium supplementation and metabolic profiles in diabetes have been inconsistent. Recently, several published trials have emerged. We conducted a systematic review and meta-analysis to assess the effects on metabolic profiles and safety of chromium supplementation in diabetes mellitus.

METHODS

Clinical trials were identified through MEDLINE, the Cochrane library, CINAHL, Web of Science, Scopus and www.clinicaltrial.gov up to May 2013. Historical search of reference lists of related articles was also conducted. Studies were included if they (i) were randomized controlled trials comparing chromium mono- or combined supplementation against placebo, (ii) reported HbA1c or fasting plasma glucose and (iii) were of at least 3 weeks when reporting fasting plasma glucose, or of at least 8 weeks if HbA1c was reported. No language restriction was imposed. Treatment effect and adverse events were estimated with mean difference and odds ratio, respectively.

RESULTS AND DISCUSSION

Twenty-five randomized controlled trials met the inclusion criteria. Of these, 22 studies evaluated chromium monosupplementation. One study evaluated chromium yeast combined with vitamins C and E, and two others evaluated chromium picolinate plus biotin (CPB). Overall, chromium mono- and combined supplementation significantly improved glycaemic control (mean difference for HbA1c -0·55%; 95% CI -0·88 to -0·22%; P = 0·001, mean difference for FPG -1·15 mm; 95% CI -1·84 to -0·47 mm; P = 0·001). In particular, chromium monotherapy significantly reduced triglycerides and increased HDL-C levels. The effects on glucose and triglycerides levels were shown especially with chromium picolinate. Glycaemic control may improve with chromium monosupplementation of more than 200 μg daily. HbA1c and FPG also improved in patients with inadequate glycaemic control at baseline. The risk of adverse events did not differ between chromium and placebo.

WHAT IS NEW AND CONCLUSIONS

The available evidence suggests favourable effects of chromium supplementation on glycaemic control in patients with diabetes. Chromium monosupplement may additionally improve triglycerides and HDL-C levels. Chromium supplementation at usual doses does not increase the risk of adverse events compared with placebo. Data on chromium combined supplementation are limited and inconclusive. Long-term benefit and safety of chromium supplementation remain to be further investigated.

Authors+Show Affiliations

Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

24635480

Citation

Suksomboon, N, et al. "Systematic Review and Meta-analysis of the Efficacy and Safety of Chromium Supplementation in Diabetes." Journal of Clinical Pharmacy and Therapeutics, vol. 39, no. 3, 2014, pp. 292-306.
Suksomboon N, Poolsup N, Yuwanakorn A. Systematic review and meta-analysis of the efficacy and safety of chromium supplementation in diabetes. J Clin Pharm Ther. 2014;39(3):292-306.
Suksomboon, N., Poolsup, N., & Yuwanakorn, A. (2014). Systematic review and meta-analysis of the efficacy and safety of chromium supplementation in diabetes. Journal of Clinical Pharmacy and Therapeutics, 39(3), pp. 292-306. doi:10.1111/jcpt.12147.
Suksomboon N, Poolsup N, Yuwanakorn A. Systematic Review and Meta-analysis of the Efficacy and Safety of Chromium Supplementation in Diabetes. J Clin Pharm Ther. 2014;39(3):292-306. PubMed PMID: 24635480.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systematic review and meta-analysis of the efficacy and safety of chromium supplementation in diabetes. AU - Suksomboon,N, AU - Poolsup,N, AU - Yuwanakorn,A, Y1 - 2014/03/17/ PY - 2013/12/23/received PY - 2014/02/05/accepted PY - 2014/3/19/entrez PY - 2014/3/19/pubmed PY - 2015/1/6/medline KW - chromium KW - diabetes mellitus KW - glycaemic control KW - meta-analysis KW - metabolic profiles KW - systematic review SP - 292 EP - 306 JF - Journal of clinical pharmacy and therapeutics JO - J Clin Pharm Ther VL - 39 IS - 3 N2 - WHAT IS KNOWN AND OBJECTIVE: Chromium is an essential mineral for carbohydrate and lipid metabolism. Results of previous systematic reviews and meta-analyses of chromium supplementation and metabolic profiles in diabetes have been inconsistent. Recently, several published trials have emerged. We conducted a systematic review and meta-analysis to assess the effects on metabolic profiles and safety of chromium supplementation in diabetes mellitus. METHODS: Clinical trials were identified through MEDLINE, the Cochrane library, CINAHL, Web of Science, Scopus and www.clinicaltrial.gov up to May 2013. Historical search of reference lists of related articles was also conducted. Studies were included if they (i) were randomized controlled trials comparing chromium mono- or combined supplementation against placebo, (ii) reported HbA1c or fasting plasma glucose and (iii) were of at least 3 weeks when reporting fasting plasma glucose, or of at least 8 weeks if HbA1c was reported. No language restriction was imposed. Treatment effect and adverse events were estimated with mean difference and odds ratio, respectively. RESULTS AND DISCUSSION: Twenty-five randomized controlled trials met the inclusion criteria. Of these, 22 studies evaluated chromium monosupplementation. One study evaluated chromium yeast combined with vitamins C and E, and two others evaluated chromium picolinate plus biotin (CPB). Overall, chromium mono- and combined supplementation significantly improved glycaemic control (mean difference for HbA1c -0·55%; 95% CI -0·88 to -0·22%; P = 0·001, mean difference for FPG -1·15 mm; 95% CI -1·84 to -0·47 mm; P = 0·001). In particular, chromium monotherapy significantly reduced triglycerides and increased HDL-C levels. The effects on glucose and triglycerides levels were shown especially with chromium picolinate. Glycaemic control may improve with chromium monosupplementation of more than 200 μg daily. HbA1c and FPG also improved in patients with inadequate glycaemic control at baseline. The risk of adverse events did not differ between chromium and placebo. WHAT IS NEW AND CONCLUSIONS: The available evidence suggests favourable effects of chromium supplementation on glycaemic control in patients with diabetes. Chromium monosupplement may additionally improve triglycerides and HDL-C levels. Chromium supplementation at usual doses does not increase the risk of adverse events compared with placebo. Data on chromium combined supplementation are limited and inconclusive. Long-term benefit and safety of chromium supplementation remain to be further investigated. SN - 1365-2710 UR - https://www.unboundmedicine.com/medline/citation/24635480/Systematic_review_and_meta_analysis_of_the_efficacy_and_safety_of_chromium_supplementation_in_diabetes_ L2 - https://doi.org/10.1111/jcpt.12147 DB - PRIME DP - Unbound Medicine ER -