Chromium Effects on Insulin and Vascular Function in People at Risk for Diabetes - Full Text View

Sponsor:	National Center for Complementary and Alternative Medicine (NCCAM)
Collaborator:	Yale University
Information provided by:	National Center for Complementary and Alternative Medicine (NCCAM)
ClinicalTrials.gov Identifier:	NCT00067626

Purpose

The purpose of this study is to investigate the effects of Chromium on glucose tolerance and endothelial function in people at risk for type II diabetes.

Condition	Intervention	Phase
Obesity Pre-Diabetes Insulin Resistance Impaired Glucose Tolerance Impaired Fasting Glucose	Dietary Supplement: Chromium	Phase II

Study Type:	Interventional
Study Design:	Prevention, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Placebo Control, Crossover Assignment, Efficacy Study
Official Title:	Chromium Effects on Insulin and Vascular Function in People at Risk for Diabetes

Resource links provided by NLM:

MedlinePlus related topics: Diabetes Obesity

Drug Information available for: Insulin Chromium

U.S. FDA Resources

Further study details as provided by National Center for Complementary and Alternative Medicine (NCCAM):

Primary Outcome Measures:

Serum Insulin [ Time Frame: Baseline, 6, 12, 18 months ] [ Designated as safety issue: No ]
2-hour Oral Glucose Tolerance Test [ Time Frame: Baseline, 6, 12, 18 months ] [ Designated as safety issue: No ]
Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) [ Time Frame: Baseline, 6, 12, 18 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

HbA1C [ Time Frame: Baseline, 6, 12, 18 months ] [ Designated as safety issue: No ]
blood pressure [ Time Frame: Baseline, 6, 12, 18 months ] [ Designated as safety issue: No ]
lipid profile (total cholesterol, LDL, HDL, TG) [ Time Frame: Baseline, 6, 12, 18 months ] [ Designated as safety issue: No ]
BMI [ Time Frame: Baseline, 6, 12, 18 months ] [ Designated as safety issue: No ]
urine albumin:creatinine ratio [ Time Frame: Baseline, 6, 12, 18 months ] [ Designated as safety issue: Yes ]
endothelial function measures as percent flow-mediated dilitation (FMD). [ Time Frame: Baseline, 6, 12, 18 months ] [ Designated as safety issue: No ]

Estimated Enrollment:	60
Study Start Date:	April 2005
Estimated Study Completion Date:	January 2009
Estimated Primary Completion Date:	January 2009 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
1: Experimental 500/1000 mcg oral chromium taken daily or placebo (crossover)	Dietary Supplement: Chromium 500/1000 mcg oral chromium picolinate taken daily or placebo (crossover)
2: Experimental 500/1000 mcg oral chromium taken daily or placebo (crossover)	Dietary Supplement: Chromium 500/1000 mcg oral chromium picolinate taken daily or placebo (crossover)

Detailed Description:

Impaired glucose tolerance (IGT), impaired fasting glucose (IFG), and insulin resistance (IR) are precursors to type II diabetes mellitus (DM) and its sequelae, and are cardiac risk factors in their own right. The worsening epidemic of DM in the US, along with the increasing prevalence of obesity, insulin resistance, and IGT, render the identification of promising interventions for these states a matter of some urgency. While lifestyle interventions based on dietary pattern and physical activity can delay or prevent the onset of diabetes, and reduce cardiovascular risk, adherence at the population level is severely limiting. Pharmacotherapy offers promise for diabetes prevention, but with associated high costs, unacceptability to many patients, and potential toxicity. In this context, the potential role of chromium (Cr), an insulin co-factor, in IGT is of great interest. Chromium use is widespread, but evidence of any therapeutic effect is limited.

Proposed, therefore, is a randomized, double-blind, placebo controlled pilot trial conducted at the Yale Prevention Research Center, to investigate the effects of daily Cr for 6 months at two dose levels on serum measures of glucose tolerance, and on endothelial function, in adults with IGT, IFG, and IR. A modified crossover design will allow for paired and unpaired analyses including comparison of both 500 mcg and 1,000 mcg of Cr daily to placebo; comparison between 500 mcg and 1000 mcg of chromium; and evaluation of Cr washout time. The study is powered to detect a clinically meaningful effect of Cr supplementation at either dose on glucose control, and to compare the two doses for equivalence. The study will investigate effects of Cr on both measures of glucose tolerance (glucose, insulin, OGTT) and brachial artery endothelial function, thus combining serum measures with a physiologic test of Cr effects on the vasculature.

The proposed study will generate much needed data regarding the efficacy of Cr in those at risk for type II diabetes and offers the promise of guiding practice, as well as directing future study. By contributing to knowledge related to potential diabetes prevention strategies, this study addresses one of the more pressing public health issues in the US today. Risk to human subjects in this study is a minor increment over minimal due to the administration of nitroglycerin as a control in BARS testing.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Adults
18 years of age or older
Identified to have impaired glucose tolerance (IGT), impaired fasting glucose (IFG), or insulin resistance.

According to the 1999 World Health Organization (WHO) report, IGT is diagnosed if the following two criteria are met: 1) Plasma glucose two hours after consuming 75g glucose (OGTT) is at least 7.8 mmol/l (140 mg/dl) but below 11.1 mmol/l (200 mg/dl) and 2) Fasting plasma glucose level is less than 7.0 mmol/l (126 mg/dl). IFG is diagnosed by a fasting plasma glucose concentration of 5.6 mmol/l (100 mg dl/l) or greater, but less than 7.0 mmol/l (126 mg dl/l). NCEP ATP III guidelines define 5 components of insulin resistance.

At least 3 of the 5 criteria are required for the diagnosis. These components are:

Abdominal obesity determined by waist circumference >102cm(>40in) in men or >88cm(>35in) in women; triglyceride level ≥150mg/dL; HDL-C <40mg/dL in men or <50mg/dL in women; blood pressure ≥ 130/≥85mm Hg; and fasting glucose ≥ 100mg/dL.

-Connecticut residents willing to travel to Griffin Hospital in Derby, CT

Exclusion Criteria:

Known diabetes (Fasting Plasma Glucose > 126 mg/dl; 2-hour 75-g OGTT plasma glucose > 200 mg/dl;
Diabetes diagnosed by a physician and confirmed by other clinical data);
Self-reported hospitalization for treatment of heart disease in past 6 months;
Impaired renal function as measured by labwork at initial screening (serum creatinine greater than 2.0 Serum creatinine and urine albumin excretion will be tested every six months throughout the study). Significant changes from baseline or to outside of threshold will be reported to the DSMB for appropriate action, including removal from the study.
Self-reported pancreatitis. In the instance that potential subjects report that they are unsure whether they have been diagnosed with this condition, a primary medical doctor's note will be obtained confirming non-diagnosis before inclusion in the study.
Self-reported recent or significant abdominal surgery;
Self-reported pregnancy and/or intention become pregnancy during the study. Women of child-bearing age will consent to pregnancy testing at baseline, and will agree to avoiding pregnancy by reliable means throughout the duration of the study.
Self-reported polycystic ovarian syndrome or irregular menses will be excluded from the study. (In the future, people with self-reported polycystic ovarian syndrome or irregular menses may be allowed in the study, however, because their conditions have the potential of affecting the outcome of BARS testing (a secondary outcome), they will be treated as a subset of the population during data analysis).

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00067626

Locations

United States, Connecticut
Yale-Griffin Prevention Research Center
Derby, Connecticut, United States, 06418

Sponsors and Collaborators

National Center for Complementary and Alternative Medicine (NCCAM)

Yale University

Investigators

Principal Investigator:

David L Katz, MD, MPH

Yale University/Yale-Griffin Prevention Research Center

More Information

Additional Information:

Yale-Griffin Prevention Research Center This link exits the ClinicalTrials.gov site

No publications provided

Responsible Party:	Yale-Griffin Prevention Research Center ( David L. Katz, MD, MPH )
Study ID Numbers:	R21 AT001332
Study First Received:	August 25, 2003
Last Updated:	August 8, 2008
ClinicalTrials.gov Identifier:	NCT00067626 History of Changes
Health Authority:	United States: Federal Government

Keywords provided by National Center for Complementary and Alternative Medicine (NCCAM):

glucose tolerance test
minerals
chromium
complementary and alternative medicine

Additional relevant MeSH terms:

Obesity
Metabolic Diseases
Chromium
Growth Substances
Physiological Effects of Drugs
Glucose Intolerance
Diabetes Mellitus
Prediabetic State
Endocrine System Diseases
Trace Elements
Overweight

Pharmacologic Actions
Body Weight
Signs and Symptoms
Hyperinsulinism
Hyperglycemia
Nutrition Disorders
Overnutrition
Micronutrients
Insulin Resistance
Glucose Metabolism Disorders

ClinicalTrials.gov processed this record on November 09, 2009