When it comes to blood sugar control, it makes sense to avoiding eating too much in the way of foods that tend to disrupt blood sugar levels. This is particularly true for diabetics whose bodies tend not to handle sugar at all well. However, in addition to eating a ‘carbohydrate-controlled’ diet, it can also help to supplement with certain nutrients that might help the body keep blood sugar levels in check. Two nutrients known to participate in the body processes that control blood sugar levels are biotin (one of the B-group vitamins) and chromium (a trace mineral).
Previous research has found that giving these nutrients in combination helped blood sugar control in diabetics [1]. In this study 600 mcg of chromium (in the form of chromium picolinate) and 2 mg of biotin or placebo were given to a group of individuals with type 2 diabetes. Although the treatment lasted only 4 weeks, the nutrient therapy led to significantly lower blood sugar level overall after study participants consumed a glucose-rich drink. Individuals treated with chromium and biotin saw other benefits too, including a reduction in the levels of unhealthy blood fats called triglycerides.
This study yielded promising results, but was somewhat hampered by its short duration and a relatively small number of subjects (just 43). More recently, 600 mcg of chromium and 2 mg of biotin were used again in a group of type 2 diabetics, this time for longer (90 days) and in a larger group of individuals (447) [2].
The individuals in this study had blood their blood sugar levels assessed in two ways:
1. by measuring fasting blood sugar levels
2. by measuring the levels of a substance known as HbA1c (also known as ‘glycosylated haemoglobin) that gives an
indication of blood sugar control over the previous 3 months or so
In non-diabetic individuals, HBA1c levels are usually around 4-6 per cent. Diabetics are generally considered to be doing well if they can keep their HbA1c levels below about 7 per cent. In this study, all individuals had HBA1c levels of 7 per cent or higher, and were considered to be generally ‘poorly controlled’. All participants in this study were taking oral medication for their diabetes.
The results of this study were:
Treatment with chromium and biotin brought about a significant reduction in HBA1c levels of 0.54 per cent (e.g. someone with an HbA1c of 7.54, on average, would have seen their level drop to 7.00).
In individuals with an HbA1c of 10 per cent or more, HBA1c levels fell by an average of 1.76 per cent).
In the group as a whole, fasting blood sugar levels fell significantly (by an average of about 10 mg/dl or 0.5 mmol/l)
In individuals with an HbA1c of 10 per cent or more, fasting blood sugar levels fell by an average of about 35 mg/dl or 1.75 mmol/l)
These results, especially when taken in the context of previous research, suggest that a combination of chromium and biotin may be of considerable benefit to individuals with type 2 diabetes, particularly those whose blood sugar level is generally poorly controlled.
References:
1. Singer GM, et al. The effect of chromium picolinate and biotin supplementation on glycemic control in poorly controlled patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized trial. Diabetes Technol Ther 2006;8(6):636-43
2. Albarracin CA, et al. 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(1):41-51
The way I interpret this study (and similar studies that show a slight decrease in abnormally high BG) is that taking biotin and chromium supplements might be a nice little addition, sort of like “dessert” but carbohydrate restriction is the real “meal” of controlling blood glucose. One shouldn’t have “dessert” without having a good “meal”.
If someone has a high fasting BG of say, 190 mg/dl, reducing it by 10mg/dl isn’t much of a significant benefit. It’s still very high and cell damage continues to occur. At most, a 10 mg reduction ever so slightly slows the progression of complication development, but progression still takes place. And someone with an A1c of over 10 must have very high BG indeed, so even a reduction of 35 mg/dl is peanuts compared to reductions they would see with carb restriction. It would be interesting to see what the range of reduction was, rather than the averages.
And human nature being what it is, many uninformed people would “splurge” on carby foods that aren’t good for their BG because they think they have added “protection” with extra chromium and biotin.
I think the benefits of many, if not all, of the supplements that are suggested to people with diabetes are modest. The slight improvements in BG are not enough to be a major part of BG control, merely an adjunct to an already effective treatment program.
When I tell people I am pre-diabetic (my weight is normal, my fasting BG is still in the high normal range, but my post meal BG can go into diabetic ranges for too long with moderate and high carb foods, so I restrict concentrated sugars and starches to keep BG normal and steady), inevitably they offer the suggestion to take cinnamon, chromium, whole grains or whatever else is in the news. I’ve tried this. It isn’t that simple. Nothing, I mean nothing works as well as keeping concentrated sugar and starch out of my diet. My BG stays in a normal, tight range without sugars and starches. Supplements might improve that a tiny bit more, but they won’t allow me to include sugars and starches in my diet. I can continue to avoid meds if I do this, and perhaps, dramatically slow or even halt the progression to full blown diabetes.
These studies demonstrate that supplements are, at best, an addition to a carb restricted diet, not a supplement for one. I’m not suggesting that people not try the supplements, but they should also understand that supplements are not the biggest part of the solution.
Anna
Thanks for these comments. Your sentiment regarding supplementation being an adjunct to, rather than a replacement for, a carb-restricted diet, mirrors my own feelings on the subject.
What about other forms of chromium. The multi-vitamin I take has chromium (amino acid chelate).
Sorry to go off topic, but having just listened to your original podcast, I’m wondering if any more will be coming? Hopefully with a better cellphone connection. 😉
Anna seems to have studied the effects and benifits of the chromium pilconate and biotin in depth, this was never going to be the be all and end all of type 2 diabetes, but an added means of control, I read an article on this same subject and the added benifit that this article explained that the chromium piliconate helps to battle the cravings for carbs and sweets, am i on the right track here