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Review
. 2016 Jul;74(7):455-68.
doi: 10.1093/nutrit/nuw011. Epub 2016 May 31.

Chromium supplements for glycemic control in type 2 diabetes: limited evidence of effectiveness

Rebecca B Costello  1 , Johanna T Dwyer  2 , Regan L Bailey  2
Affiliations
Review

Chromium supplements for glycemic control in type 2 diabetes: limited evidence of effectiveness

Rebecca B Costello et al. Nutr Rev. 2016 Jul.

Abstract

Some adults with type 2 diabetes mellitus (T2DM) believe that chromium-containing supplements will help control their disease, but the evidence is mixed. This narrative review examines the efficacy of chromium supplements for improving glycemic control as measured by decreases in fasting plasma glucose (FPG) or hemoglobin A1c (HbA1c). Using systematic search criteria, 20 randomized controlled trials of chromium supplementation in T2DM patients were identified. Clinically meaningful treatment goals were defined as an FPG of ≤7.2 mmol/dL, a decline in HbA1c to ≤7%, or a decrease of ≥0.5% in HbA1c. In only a few randomized controlled trials did FPG (5 of 20), HbA1c (3 of 14), or both (1 of 14) reach the treatment goals with chromium supplementation. HbA1c declined by ≥0.5% in 5 of 14 studies. On the basis of the low strength of existing evidence, chromium supplements have limited effectiveness, and there is little rationale to recommend their use for glycemic control in patients with existing T2DM. Future meta-analyses should include only high-quality studies with similar forms of chromium and comparable inclusion/exclusion criteria to provide scientifically sound recommendations for clinicians.

Keywords: chromium; fasting plasma glucose; hemoglobin A1c; type 2 diabetes mellitus..

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Figures

Figure 1
Figure 1
Literature search strategy and additional review criteria for categorizing studies by dose and duration in subjects with type 2 diabetes mellitus. Abbreviations: Cr, chromium; IGT, impaired glucose tolerance; RCTs, randomized controlled trials.
Figure 2
Figure 2
(A) Mean changes in HbA1c from baseline to postchromium supplementation for 14 studies and placebo arms. Solid line is chromium treatment, dashed line is placebo control, and heavy dotted line represents HbA1c treatment goal of ≤7.0%. (B) Mean changes in HbA1c by length of study, from pre- to postchromium supplementation, for 14 studies and placebo arms. Solid line is chromium treatment, dashed line is placebo control, and heavy dotted line represents HbA1c treatment goal of ≤7.0%. Abbreviations: CDNC, chromium dinicocysteinate; CR, chromium, CrPic, chromium picolinate; PLCB, placebo.
Figure 2
Figure 2
(A) Mean changes in HbA1c from baseline to postchromium supplementation for 14 studies and placebo arms. Solid line is chromium treatment, dashed line is placebo control, and heavy dotted line represents HbA1c treatment goal of ≤7.0%. (B) Mean changes in HbA1c by length of study, from pre- to postchromium supplementation, for 14 studies and placebo arms. Solid line is chromium treatment, dashed line is placebo control, and heavy dotted line represents HbA1c treatment goal of ≤7.0%. Abbreviations: CDNC, chromium dinicocysteinate; CR, chromium, CrPic, chromium picolinate; PLCB, placebo.
Figure 3
Figure 3
(A) Mean changes in fasting plasma glucose (FPG) from baseline to postchromium supplementation for all 20 studies (22 arms) and placebo arms. olid line is chromium treatment, dashed line is placebo control, and heavy dotted line represents FPG treatment goal of ≤7.2 mmol/L. (B) Mean changes in FPG by length of study, from pre- to postchromium supplementation, for 20 studies (22 arms) and placebo arms. Solid line is chromium treatment, dashed line is placebo control, and heavy dotted line represents FPG treatment goal of ≤7.2 mmol/L. Abbreviations: BY, brewer’s yeast; CDNC, chromium dinicocysteinate; CR, chromium; CrCl3, chromium chloride; CrPic, chromium picolinate; PLCB, placebo.
Figure 3
Figure 3
(A) Mean changes in fasting plasma glucose (FPG) from baseline to postchromium supplementation for all 20 studies (22 arms) and placebo arms. olid line is chromium treatment, dashed line is placebo control, and heavy dotted line represents FPG treatment goal of ≤7.2 mmol/L. (B) Mean changes in FPG by length of study, from pre- to postchromium supplementation, for 20 studies (22 arms) and placebo arms. Solid line is chromium treatment, dashed line is placebo control, and heavy dotted line represents FPG treatment goal of ≤7.2 mmol/L. Abbreviations: BY, brewer’s yeast; CDNC, chromium dinicocysteinate; CR, chromium; CrCl3, chromium chloride; CrPic, chromium picolinate; PLCB, placebo.
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