Diabetes Forecast July 2004

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FOR TYPE 2

Research Profile

Chromium
Can It Help Kids With Type 2?
by Terri Kordella

Sushil K. Jain, PhD, is researching the effects of a mineral called chromium on blood glucose and vascular inflammation in adolescents with type 2.	Sushil K. Jain, PhD Occupation Professor of Pediatrics, Physiology, and Biochemistry and Molecular Biology Louisiana State University Health Sciences Center at Shreveport Professional Focus Type 2 diabetes in children, type 1 diabetes Outside Interests Tennis, gardening, community service (including public lecturing on diabetes care) Research Funding ADA Innovation Award

The rate of type 2 diabetes among children and adolescents is rising at such an alarming rate, doctors and scientists are worried about a public health crisis in the coming years. Evidence is mounting that the lives of children who develop type 2 could be cut short by deadly complications. One study indicates that cardiovascular disease, once thought to be the sole province of people older than 50, can strike as early as 30 in people who develop type 2 as children.

Regular physical activity and proper nutrition will go a long way toward controlling diabetes and avoiding complications. But what else can be done to help stem the tide?

Sushil K. Jain, PhD, professor of Pediatrics, Physiology, and Biochemistry and Molecular Biology at the Louisiana State University Health Sciences Center at Shreveport, believes that taking a mineral called chromium may help. Using funds from an American Diabetes Association Innovation Award, Jain and his team are studying the effects of chromium on blood glucose control and vascular inflammation in adolescents with type 2.

Clearing Controversy

Chromium is a controversial supplement. It's most often promoted as a weight-loss aid, but scientists disagree about its effectiveness. It has also been studied for its effects on blood glucose. The jury is still out there, as well.

"Some studies in adults with diabetes have shown that fasting blood glucose may improve with chromium use," says Jain. "But it's controversial because we don't have a lot of scientific evidence about what it's doing at the molecular level."

Jain has dedicated much of his research in recent years to providing such evidence. His team has conducted studies in the lab involving chromium and cultured cells. In these studies, cells were exposed to high levels of glucose, comparable to those found in people with diabetes. In response, the cells increased production of proteins called "pro-inflammatory cytokines," which are proteins that promote inflammation. Elevated levels of pro-inflammatory cytokines have been associated with decreased insulin sensitivity and increased risk of cardiovascular disease.

In Jain's studies, when the cultured cells were exposed to chromium as well as glucose, the cells produced fewer pro-inflammatory cytokines than when they were exposed to glucose alone. "The chromium counteracted the effect of glucose," he says.

He notes that fewer pro-inflammatory cytokines may mean better insulin sensitivity—which would mean better blood glucose levels in people with type 2—and a reduced risk of cardiovascular disease.

But test tubes aren't kids.

To see how chromium affects blood glucose and pro-inflammatory cytokines in adolescents, Jain's study will involve 40 participants between the ages of 12 and 18 who have type 2.

First the researchers will give the participants blood tests and record their A1C and fasting blood glucose to get a clear picture of their blood glucose control and insulin sensitivity. The researchers will also measure the participants' levels of pro-inflammatory cytokines, along with their HDL ("good" cholesterol), LDL ("bad" cholesterol), and triglycerides. (Low HDL, high LDL, and high triglycerides are risk factors for cardiovascular disease that often appear in people with type 2.)

After the initial blood tests, half the participants will take 200 micrograms of chromium each day for six months. The other half will take a placebo (dummy pills). Then participants will return to the research center and have the same blood tests. The research team will compare the results of these blood tests with the results of the first blood tests and find out who took chromium and who took the placebo.

Looking Ahead

Jain anticipates finding lower A1Cs and fasting blood glucose levels in the group who took chromium than in the group who took placebo, which would indicate that chromium does help lower blood glucose. If that's the case, chromium could be another option for controlling blood glucose in adolescents with type 2.

In fact, he says, chromium may even be useful for adolescents who have pre-diabetes, a precursor to type 2 in which blood glucose is elevated, but not high enough to be considered diabetes. "It might have implications for diabetes prevention in kids who have impaired glucose tolerance (pre-diabetes) by improving their insulin sensitivity," he says.

Jain also hopes to see lower levels of pro-inflammatory cytokines and better cholesterol and triglyceride levels in the participants who took chromium than in the participants who took placebo. "If we see this effect, it may show that chromium can be useful and prevent some of the effects of high blood glucose," he says.

"I wish more people could understand how important it is to take care of their diabetes," he adds. "[Physical activity] and eating properly are very important. But if chromium helps, then we should consider it."