Research purposes
1。 To explore the effect of chromium on glucose metabolism in people with type 2 diabetes.
2。 To understand the effects of different chromium supplementation methods on type 2 diabetes.
Research background
1955, Dr. Mertz and Dr. Schwarz in the United States found that supplementing beer yeast can correct the abnormal glucose tolerance in rats, and found that the component that works on glucose tolerance is a chromium-containing compound.
GTF (Glucose Tolerance Factor)-Glucose Tolerance Factor. Since then, the research on chromium has entered the fields of nutrition and medicine.
Jeejeebhoy found in 1977 that chromium supplementation can correct abnormal glucose tolerance, peripheral neuritis and weight loss in patients who depend on intravenous high nutrition for life support. Other scholars have reported similar phenomena in 1979 and 1986. At the same time, papers on chromium supplementation can improve protein's malnutrition in children, hypercholesterolemia in adults and hypoglycemia in type 2 diabetes have been published one after another.
The effect of chromium on glucose metabolism is mainly to strengthen insulin function. In insulin-dependent tissues, even if a small amount of chromium is added, the insulin function will be obviously improved; Insufficient chromium intake will increase the body's demand for insulin.
Chromium deficiency can make glucose tolerance abnormal, blood insulin increase, insulin affinity decrease, β cell sensitivity decrease, insulin receptor decrease, and blood sugar become too high or too low. This abnormality can be corrected after chromium supplementation. Experiments show that organic chromium supplementation can improve the metabolism of diabetes. What happened? Hey hey hey hey hey hey. 5-2% of Zhang Shixin and 20-30% of organic chromium.
RDA (Food Safety Recommendation Committee) in the United States recommends 50-200 micrograms of chromium per day. The Environmental Protection Commission of the United States has determined that even if the daily intake of chromium exceeds 300 times the recommended amount, there is no adverse reaction. Trivalent chromium is one of the safest essential trace elements for human body, especially in oral form.
Because trivalent chromium has been officially listed as one of the essential trace elements for human body 13, it belongs to nutritional products, so chromium nutritional products listed in the United States do not need to be tested by drug inspection institutions.
It is very difficult to conduct human experiments in the United States. However, due to the research history of chromium, the scientific authority of the Human Nutrition Center of the United States Department of Agriculture, and the proof of RDA and the US Environmental Protection Committee, the Human Nutrition Center of the United States Department of Agriculture and Georgetown University School of Medicine jointly conducted a 150 human experiment on diabetic patients. This provides a scientific clinical premise for China to start the experiment of human chromium supplementation, fill the blank of this research, alleviate the pain of diabetic patients and improve people's health level and quality of life.
Materials and methods
Learning medicine
Chromium picolinate oral nutrition provided by American Nutrition 2 1 Century Company. This product is the research result of Professor Mertz, Chairman of American Nutrition Research Center, and Dr. Anderson, the academic leader of chromium research at present, for nearly 40 years.
research objects
1。 180 patients with type 2 diabetes living in Beijing, including 96 males and 84 females, aged 35-65;
2。 The blood sugar level was stably controlled for more than half a year, and the fasting blood sugar was 7.2- 15.5 mmol/L, 2 hours after meals.
Blood sugar was 9.4- 16.7 mmol/L, glycosylated hemoglobin was 8.0- 12%, and medical history was 10 year.
Downward;
3。 No serious cardiac, cerebral and renal complications;
research method
1。 Randomly double-blind placebo control method, 180 patients were randomly divided into three groups, and 60 patients in placebo group took it daily.
60 people in the chromium 200 microgram group and 60 people in the chromium 1000 microgram daily group. Breakfast and dinner for each patient every day.
After meals, take chromium picolinate capsules or placebo capsules 1 time for ***4 months, and keep the original hypoglycemic agent during the medication.
The dosage of food, control diet, and keep physical exercise every day.
2。 Ask patients to come to the clinic every month to find out whether there are any adverse reactions, and pay attention to their diet and mental mood fluctuations, especially
Pay attention to control yourself taking other drugs, such as syrup, and fill in the experimental form strictly. Give it to patients 1 time every month.
In case of special circumstances such as business trip and visiting relatives, patients can be given multiple doses 1 time as appropriate to ensure uninterrupted medication.
3。 Judgement index: Blood was drawn ***3 times before taking the medicine, 2 months and 4 months after taking the medicine, and fasting blood glucose and meals were checked.
Blood sugar, insulin content, glycosylated hemoglobin and body weight were measured 2 hours later. The specific operation is: the morning of blood drawing.
Draw blood on an empty stomach at 7-8 o'clock 1 time, then take the original dose of hypoglycemic drugs and experimental observation drugs orally, and then eat.
100g steamed bread, and the blood was drawn for the second time after chewing the first steamed bread for 2 hours.
research results
180 patients are middle-aged patients with type 2 diabetes mellitus, with normal height and weight, a medical history of less than 10 years and no complications. During the study, 19 subjects did not complete all the examinations, and the data of the other 6 subjects were incomplete, so they were not included in the final statistical analysis. The general situation of 155 patients who completed the trial is shown in table 1.
Table 1
Placebo group 200 μ g group 1000 μ g group
Height (m)
Total1.67 0.01(50)1.67 0.01(53)1.65 0.01(52).
Female1.61.01(17)1.600.01(20)1.590.01.
Male1.700.01(33)1.71.01(33)1(26).
Weight (kg)
Total 69.1.1.369.01.567.81.4.
Female 66.4 2.5 63.4 2.5 63.4 1.6
Male 70.51.472.61.572.01.8.
Specific gravity (kg/m2)
Total 24.8 0.5 25.0 0.5 24.8 0.4
Female 25.81.125.0 0.9 25.0 0.6
Male 24.3 0.5 25.0 0.5 24.6 0.6
History of diabetes (year)
The total is 5.4 0.7 8.0 1.05.3 0.7.
Female 5.61.08.41.66.81.
Male 5.2 0.97.8 1.23.7 0.7
age
Total 55.51.255.71.254.61.4.
Female 56.41.8 53.81.8 54.12.3
Male 55.1.1.5 56.81.7 55.21.8.
During the four-month study, no side effects caused by chromium supplementation were found, and more than 90% patients could tolerate this product well. Compared with the placebo group, the blood sugar and insulin levels of both groups have improved.
Fasting blood glucose and glucose tolerance were improved in both groups, and the value of patients taking 1000 μ g chromium daily decreased especially in 2 ~ 4 months. Compared with the placebo group, the fasting insulin and postprandial insulin levels in the two groups decreased significantly after treatment.
Glycosylated hemoglobin (HBA 1c) is a reliable and long-term parameter to measure the blood sugar control of diabetic patients. At 4 months, the value of the drug treatment group decreased significantly, while the patients who took 1000μg chromium daily improved significantly at 2 months.
Table 2 shows the changes of fasting blood glucose (FBS), postprandial blood glucose (PBS), glycosylated hemoglobin (HBA 1c), fasting insulin (INS) and postprandial insulin (PINS) in the three groups before and after treatment:
Table 2
Fbspbsba1cins pin
Placebo group (50) before treatment 91.56133.149 2.5918.63888.0.
2 Months 91.4413.22919162 * * 836 * *
-0.6% -5% -0.2% 13% 5%
4 months 9 2.5713.73917151.8 * * 8013.6.
7.8% -6% -0.9% 14.8% 9%
Before treatment, 9.7 216 3102.819 387.810 in 200 μ g group.
2 Months 91* *142 * * 92 * *13.73 * * 764 * *
6%** 8.7%** 8.7%* 28.5%** 12.9%**
4 Months 8 2 * *13 3 * * 7.91.5 * *13 274 5 * *
19.5%** 18.5%** 32.6%** 14%
Before treatment 1000 μ g group was102152.610.72.4203.9846.
2 months 6.611* *10/* * 7.61* *132 * * 75 6 * *
32%** 32%** 28%** 34%** 10.7%*
4 Months 6.81* *101* * 71* *132 * * 75 5.5 * *
28%** 28% 33% 34%** 1 1%
* Compared with before treatment (P < 0). 05)
* * Compared with before treatment (P < 0). 0 1)
discuss
The experiment shows that chromium supplementation can significantly improve the blood sugar and insulin levels of patients with type 2 diabetes. Fasting and 2-hour postprandial insulin levels were also improved. But it is more convincing that chromium supplementation can reduce glycosylated hemoglobin. We know that glycosylated hemoglobin is closely related to the life span of red blood cells, which is the key value to evaluate the plasma glucose content in a period of time and can reflect the accumulation of glycosylation in cells and tissues. Experiments show that:
With the decrease of blood sugar level, glycosylated hemoglobin level also decreased rapidly in the second month of treatment and remained stable until four months later. This effect is the same for both male and female patients.
There are many studies on the effect of chromium on diabetes, and it is considered that the trace element chromium is closely related to diabetes. As early as the end of 1950s, Schwarz and Mertz proposed that trivalent chromium was the central active component of glucose tolerance factor (GTF). In 1969, Mertz and others summarized the physiological function of trivalent chromium: 1. Chromium deficiency in animals can lead to impaired glucose tolerance or develop into diabetes, hyperlipidemia and atherosclerosis. 2。 The effect of chromium is directly related to insulin.
This study shows that chromium has a significant beneficial effect on blood sugar and insulin in patients with type 2 diabetes and should be taken every day.
1000 micrograms of chromium is better than 200 micrograms.
The effect of long-term use of low-dose chromium on diabetic patients and whether long-term use can prevent diabetic complications need further study.
Note: 1. Baelz Ville Human Nutrition Research Center, USDA;
Brandon Polanski
2。 Beijing hospital: late
3。 The First Affiliated Hospital of Beijing Medical University: Feng
4。 Armed Police General Hospital: Cheng Nanping