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CAM Project

Diabetes overview

Chromium - Non-herbal dietary
supplement

Insulin - Allopathic Treatment

Clinical Research
Diabetes
Group of diseases that affect how your body uses
glucose (Blood sugar)
Diabetes means too much glucose in your blood
Important source of energy for the cells that make
up your muscles and tissues
Brains main source of fuel
Diabetes
How Insulin Works
Hormone that comes from the pancreas and
secrets insulin into bloodstream. Insulin
circulates enabling sugar to enter cells. Insulin
lowers amount of sugar in bloodstream. As
blood sugar level drops, so does the secretion
of insulin from pancreas
Diabetes
Role of glucose

Comes from two major sources – food and your
liver. Sugar absorbed into bloodstream where it
enters cells with the help of insulin. Liver stores
and makes glucose

When insulin levels low – liver metabolizes
stored glycogen into glucose to keep level
within normal range.
Diabetes
TYPE 1
Your immune system attacks and destroys the insulin
producing cells in the pancreas leaving you with little
or no insulin. Caused by genetic susceptibility and
environmental factors
TYPE 2
Your cells become resistant to the action of insulin and
your pancreas is unable to make enough insulin to
overcome. Sugar builds in bloodstream. Caused by
genetic and environmental factors. Being overweight
may be a factor
Diabetes, Mayo Clinic,
www.mayoclinic.org/diseases-conditions/diabetes/basics/causes/con-20033091
Chromium

Mineral humans require in
trace amounts

Mechanisms of action in the body and the
amounts needed for optimal health not well
defined

Found two forms
− Trivalent – biologically active and found in food
− Hexavalent - toxic form that results from industrial
pollution
Chromium

Known to enhance the action of insulin

Critical to the metabolism and storage of
carbohydrate, fat and protein in the body

In 1957 a compound in brewers' yeast was
found to prevent an age-related decline in the
ability of rats to maintain normal levels of
glucose in their blood. That compound was
chromium

Found naturally in foods such as broccoli,
grape juice, English muffins and potatoes
Chromium

Chromium deficiency impairs the bodies ability
to use glucose to meet its energy needs and
raises insulin requirements

May help control type 2 diabetes or the glucose
and insulin responses in persons at high risk of
developing diabetes
“Chromium”, National Institutes of Health – Office of Dietary Supplements,
www.ods.od.nih.gov/factsheets/Chromium-HealthProfessional/
Insulin – Allopathic Treatment

FDA first approved insulin in 1939.

Derived from beef and pork pancreas as well as
recombinant technology (From humans -FDA
approved in 1982)

Administered by injection under the skin

Preferable injection site under the skin of the
abdomen because absorption of the insulin is
most consistent from this location
Insulin
HOW DOES INSULIN WORK?

Since glucose is a problem with diabetics –
increase in the uptake of glucose by cells and
reducing the concentration of glucose in the
blood – insulin prevents or reduces the long-
term complications of diabetes

Complications include damage to blood
vessels, eyes, kidneys and nerves
Marks, Jay W. & Ogbru, Omudhome, “Insulin”,
www.medicinenet.com/insulin/article.htm
Insulin

The following video details how insulin works in
the body
Clinical research study 1

Hypothesis - elevated intake of supplemental
chromium is involved with the control of type 2
diabetes

180 subjects all with type 2 diabetes – between
age 36-65
− 60 received placebo
− 60 received 3.85 umol Cr (chromium picolinate)
− 60 received 19.2 umol Cr
Clinical research study 1
Fasting Results
− At 0 months

Placebo 9.5, 3.85 @ 10.5, 19.2 @9.3
− At 2 months

Placebo @ 9.2, 3.85 @ 9, 19.2 @ 6.8
− At 4 months

Placebo @ 8.6, 3.85 @ 8.4, 19.2 @ 6.7

2 Hr Glucose Results
− At 0 months

Placebo 14.6, 3.85 @ 16.3, 19.2 @ 14.7
− At 2 months

Placebo @ 13.2, 3.85 @ 13.6, 19.2 @ 10.9
− At 4 months

Placebo @ 12.2, 3.85 @ 12.4, 19.2 @ 10.3
Clinical research study 1

Fasting blood glucose concentrations
significantly lower in the group receiving the
highest dosage after 2 & 4 months

Significant effects both statistically and clinically
of supplemental chromium at 19.2 umol/day

Fasting glucose and insulin concentration
document elevated intakes of supplemental
chromium
Clinical research study 2

Objective – To investigate the effects of daily
chromium picolinate supplementation on serum
measures of glucose tolerance and insulin
sensitivity to patient at high risk for type 2
diabetes

59 participants
Clinical research study 2

Randomized, double-blind, placebo-controlled,
modified cross-var clinical trial

6 months sequences of intervention and
placebo followed by 6 month post intervention
assessment

Adult patients with impaired fasting glucose,
impaired glucose tolerance or metabolic
syndrome

Chromium (500 or 100 mcg per day) or placebo
Clinical research study 2
RESULTS

No changes in glucose level, insulin level or
HOMA-IR after 6 months at either dosage level
when compared with placebo

Does not appear to ameliorate insulin
resistance or impaired glucose metabolism in
patients at risk for type 2 diabetes. Unlikely to
attenuate diabetes risk
Research Works Cited

Anderson, Richard A, Cheny, Nanzheng, Bryden, Noella A., Polansjy,
Marilyn M., Cheng, Nanping, Chi, Jiaming, Feng, Jinguang, “Elevated intake
of supplemental chromium improves glucose and insulin variables in
individuals with type 2 diabetes”, Available:
www.diabetes.diabetesjournals.org/content/46/11/1786.full.pdf+htm

Ali A, Ma Y, Reynolds H, Wise JP Sr, Inzucchi SE, Katz DL, “Chromium
effects on glucose tolerance and insulin sensitivity in persons at risk for
diabetes mellitus”, Endocr Pract, 2011, Jan-Feb; 17(1):16-+25, Available:
www.ncbi.nlm.nih.gov/pubmed/20634174l

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Health diabetes

  • 1. CAM Project  Diabetes overview  Chromium - Non-herbal dietary supplement  Insulin - Allopathic Treatment  Clinical Research
  • 2. Diabetes Group of diseases that affect how your body uses glucose (Blood sugar) Diabetes means too much glucose in your blood Important source of energy for the cells that make up your muscles and tissues Brains main source of fuel
  • 3. Diabetes How Insulin Works Hormone that comes from the pancreas and secrets insulin into bloodstream. Insulin circulates enabling sugar to enter cells. Insulin lowers amount of sugar in bloodstream. As blood sugar level drops, so does the secretion of insulin from pancreas
  • 4. Diabetes Role of glucose  Comes from two major sources – food and your liver. Sugar absorbed into bloodstream where it enters cells with the help of insulin. Liver stores and makes glucose  When insulin levels low – liver metabolizes stored glycogen into glucose to keep level within normal range.
  • 5. Diabetes TYPE 1 Your immune system attacks and destroys the insulin producing cells in the pancreas leaving you with little or no insulin. Caused by genetic susceptibility and environmental factors TYPE 2 Your cells become resistant to the action of insulin and your pancreas is unable to make enough insulin to overcome. Sugar builds in bloodstream. Caused by genetic and environmental factors. Being overweight may be a factor Diabetes, Mayo Clinic, www.mayoclinic.org/diseases-conditions/diabetes/basics/causes/con-20033091
  • 6. Chromium  Mineral humans require in trace amounts  Mechanisms of action in the body and the amounts needed for optimal health not well defined  Found two forms − Trivalent – biologically active and found in food − Hexavalent - toxic form that results from industrial pollution
  • 7. Chromium  Known to enhance the action of insulin  Critical to the metabolism and storage of carbohydrate, fat and protein in the body  In 1957 a compound in brewers' yeast was found to prevent an age-related decline in the ability of rats to maintain normal levels of glucose in their blood. That compound was chromium  Found naturally in foods such as broccoli, grape juice, English muffins and potatoes
  • 8. Chromium  Chromium deficiency impairs the bodies ability to use glucose to meet its energy needs and raises insulin requirements  May help control type 2 diabetes or the glucose and insulin responses in persons at high risk of developing diabetes “Chromium”, National Institutes of Health – Office of Dietary Supplements, www.ods.od.nih.gov/factsheets/Chromium-HealthProfessional/
  • 9. Insulin – Allopathic Treatment  FDA first approved insulin in 1939.  Derived from beef and pork pancreas as well as recombinant technology (From humans -FDA approved in 1982)  Administered by injection under the skin  Preferable injection site under the skin of the abdomen because absorption of the insulin is most consistent from this location
  • 10. Insulin HOW DOES INSULIN WORK?  Since glucose is a problem with diabetics – increase in the uptake of glucose by cells and reducing the concentration of glucose in the blood – insulin prevents or reduces the long- term complications of diabetes  Complications include damage to blood vessels, eyes, kidneys and nerves Marks, Jay W. & Ogbru, Omudhome, “Insulin”, www.medicinenet.com/insulin/article.htm
  • 11. Insulin  The following video details how insulin works in the body
  • 12. Clinical research study 1  Hypothesis - elevated intake of supplemental chromium is involved with the control of type 2 diabetes  180 subjects all with type 2 diabetes – between age 36-65 − 60 received placebo − 60 received 3.85 umol Cr (chromium picolinate) − 60 received 19.2 umol Cr
  • 13. Clinical research study 1 Fasting Results − At 0 months  Placebo 9.5, 3.85 @ 10.5, 19.2 @9.3 − At 2 months  Placebo @ 9.2, 3.85 @ 9, 19.2 @ 6.8 − At 4 months  Placebo @ 8.6, 3.85 @ 8.4, 19.2 @ 6.7  2 Hr Glucose Results − At 0 months  Placebo 14.6, 3.85 @ 16.3, 19.2 @ 14.7 − At 2 months  Placebo @ 13.2, 3.85 @ 13.6, 19.2 @ 10.9 − At 4 months  Placebo @ 12.2, 3.85 @ 12.4, 19.2 @ 10.3
  • 14. Clinical research study 1  Fasting blood glucose concentrations significantly lower in the group receiving the highest dosage after 2 & 4 months  Significant effects both statistically and clinically of supplemental chromium at 19.2 umol/day  Fasting glucose and insulin concentration document elevated intakes of supplemental chromium
  • 15. Clinical research study 2  Objective – To investigate the effects of daily chromium picolinate supplementation on serum measures of glucose tolerance and insulin sensitivity to patient at high risk for type 2 diabetes  59 participants
  • 16. Clinical research study 2  Randomized, double-blind, placebo-controlled, modified cross-var clinical trial  6 months sequences of intervention and placebo followed by 6 month post intervention assessment  Adult patients with impaired fasting glucose, impaired glucose tolerance or metabolic syndrome  Chromium (500 or 100 mcg per day) or placebo
  • 17. Clinical research study 2 RESULTS  No changes in glucose level, insulin level or HOMA-IR after 6 months at either dosage level when compared with placebo  Does not appear to ameliorate insulin resistance or impaired glucose metabolism in patients at risk for type 2 diabetes. Unlikely to attenuate diabetes risk
  • 18. Research Works Cited  Anderson, Richard A, Cheny, Nanzheng, Bryden, Noella A., Polansjy, Marilyn M., Cheng, Nanping, Chi, Jiaming, Feng, Jinguang, “Elevated intake of supplemental chromium improves glucose and insulin variables in individuals with type 2 diabetes”, Available: www.diabetes.diabetesjournals.org/content/46/11/1786.full.pdf+htm  Ali A, Ma Y, Reynolds H, Wise JP Sr, Inzucchi SE, Katz DL, “Chromium effects on glucose tolerance and insulin sensitivity in persons at risk for diabetes mellitus”, Endocr Pract, 2011, Jan-Feb; 17(1):16-+25, Available: www.ncbi.nlm.nih.gov/pubmed/20634174l