With Comments from Russell H. Greenfield, MD
Glucosamine and Blood Sugar
Source: Scroggie DA, et al. The effect of glucosamine-chondroitin supplementation on glycosylated hemoglobin levels in patients with type 2 diabetes mellitus. Arch Intern Med 2003;163:1587-1590.
Goal: To assess the effect of glucosamine-chondroitin on glycemic control in patients with Type 2 diabetes mellitus (DM).
Design: Double-blind, randomized, placebo-controlled trial completed over 90 days.
Subjects: A total of 38 people (mean age > 65 years) with Type 2 DM and a stable HbA1c level either under strict dietary control or using a stable dose of oral antihyperglycemic medication (data from 36 included in analysis).
Methods: Participants were randomized to receive a combination tablet of glucosamine-chondroitin (n = 26) or placebo (n = 12). Two capsules were taken each morning and one at night. Daily finger-stick glucose was monitored and logged. HbA1c was determined at baseline and at trial’s end.
Results: HbA1c levels increased from 6.45% to 6.50%, but this was not statistically significant. A non-significant decrease in HbA1c levels was noted in the placebo group (6.25% to 6.09%).
Conclusion: Daily administration of glucosamine-chondroitin to people with Type 2 DM over a period of 90 days does not result in clinically significant changes in glycemic control.
Study strengths: Generalizable subject group; close follow-up.
Study weaknesses: Small sample size (74/113 patients eligible for the study chose not to participate); short duration.
Of note: Three of four patients who withdrew from the treatment arm did so for significant medical reasons (myocardial infarction, congestive heart failure, worsening atrial fibrillation).
We knew that: The prevalence of DM in Americans age 50 and older is 10-15%; osteoarthritis affects 40% of Americans age 60 and older.
Clinical import: Concerns have been raised about the use of glucosamine, especially, and poor glycemic control in the setting of DM. As the authors note, many people age 50 and older have both osteoarthritis and DM, making the use of nonsteroidal anti-inflammatory drugs by these people commonplace and risky. Identifying an agent that could relieve joint discomfort without adversely affecting glucose levels or incurring undue risk of side effects is a priority for such patients. Glucosamine-chondroitin is a viable candidate, but this study is too limited in scope to prove its safety in the setting of DM, especially considering the chronic nature of osteoarthritis. The paper does suggest that the supplement is safe for people with DM, and the issue warrants further investigation.
What to do with this article: Keep a copy of the abstract on your computer.
Dr. Greenfield, Medical Director, Carolinas Integrative Health, Carolinas HealthCare System, Charlotte, NC, is Executive Editor of Alternative Medicine Alert.
Greenfield RH. Glucosamine and blood sugar. Altern Med Alert 2003;6(9):108.
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