[Chromium in the treatment of clinical diabetes mellitus]

The trace element chromium (Cr, tri-valent) is described in textbooks as indispensable in carbohydrate metabolism, but there have been no indications as to how to administer it and in which cases it might be helpful. We gave 243 diabetic patients Cr (200 mcg/d) to study its effect on blood glucose balance. 105 were Type 1 (IDDM) and 138 Type 2 (NIDDM). Cr reduced insulin, sulfonylurea or metformin requirements in 115 patients. The success rate was greater in those with NIDDM (57.2%) than in those with IDDM (33.6%). More women, of either type, reacted than men (62.5 vs 50% in NIDDM and 37.6 vs 28.6% in IDDM). A placebo was ineffective. We have not found any clinical signs indicating which patients might benefit from Cr. However, the IV insulin-responsiveness test might help detect patients who might benefit from addition of Cr to their food. Patients given the Cr supplement were told to reduce their usual dose of hypoglycemic agent to avoid hypoglycemia, and to increase the dose should their glycemia increase.