Your Questions Answered

Why are my blood glucose levels so high when I am doing all the right things?
This has to be one of the most common questions we get asked. And yes it can be very frustrating and worrying. But our answer has to be that since we don’t know you and what you are doing right or wrong, we suggest you see your doctor, dietitian, or diabetes educator and/or exercise specialist. We can only reiterate what you probably already know: lifestyle changes, including diet and exercise are an essential part of managing type 2 diabetes, along with any medication you need to take. Regular physical activity and improved eating habits really can reduce your blood glucose levels, improve how your body’s insulin works and reduce your risk of developing diabetes and its complications. Of course the key is knowing what to eat and the type and amount of exercise that will help.


Kate Marsh

So if you want to tune into some expert advice on managing diabetes, you may like to check out an audio CD that’s been put together by Accredited Practicing Dietitian and Diabetes Educator Kate Marsh and Accredited Exercise Physiologist Dr Adam Fraser. It covers everything you need to know about managing diabetes through lifestyle changes and all you have to do is pop it into your computer or download it to your iPod. It’s also helpful for anyone with pre-diabetes (impaired glucose tolerance) or insulin resistance who wants to reduce their risk of developing diabetes. Here’s what Kate says:

Play the Podcast above or download here

Kate and Adam have put together a special lifestyle changes audio CD for women with PCOS, too.

• Diabetes Made Easy AUD$55.00 including GST
• PCOS Made Easy AUD$55.00 including GST.

To order your copy, call Northside Nutrition and Dietetics on 612 9415 4845 or ORDER online.

Are chromium supplements advantageous for people suffering from type 2 diabetes, syndrome X or hypoglycemia.
Chromium is an essential mineral that plays an important role in how our bodies metabolise carbohydrate, fat and protein. Current research suggests that it helps insulin work more effectively in the cells of the body, which in turn will help the body manage blood glucose levels better. So, if you have type 2 diabetes, will taking extra chromium as a supplement improve your blood glucose levels? To date studies have yielded conflicting results. ‘A number of studies have been done to see whether or not people with diabetes benefit from a chromium supplement. To date, there’s no compelling evidence for Australians or North Americans,’ says New Glucose Revolution for Diabetes author Alan Barclay. ‘There is one study from China that showed significant improvement in blood glucose levels when people took either 200 or 1000 micrograms of chromium picolinate each day for 4 months. But the Chinese food supply is very different from that of Australia or North America. We would suggest that differences in both the food supply and people’s food choices account for the difference in results of the various studies from around the world.’

In GI News in September 2006 we reported on a small double blind study by Julie Martin from the University of Vermont that was published in Diabetes Care. She found that ‘chromium picolinate supplementation in subjects with type 2 diabetes who are taking sulfonylurea agents significantly improves insulin sensitivity and glucose control’. The researchers tested whether chromium supplements were useful in combination with a sulfonylurea medication – an older class of diabetes drugs that often spur weight gain. They randomly assigned 29 adults with diabetes to take either the medication plus 1,000 micrograms of chromium picolinate per day or the drug plus a placebo (sugar pill) for 6 months. In the end, study participants who took the supplement showed greater improvements in insulin sensitivity and blood glucose control. They also gained less weight and body fat than those on the medication alone. However, we would suggest caution re this interesting result – the researchers did not monitor the participants’ food or physical activity before or during the study. So it is not possible to say conclusively that the improvements were due to the chromium picolinate alone.

In addition, the body loses many vitamins and minerals (including chromium) in urine, and when urination increases, as it does with poorly managed diabetes, losses can be excessive and lead to a deficiency. Most people with type 2 diabetes can reverse this deficiency within a few months by achieving and maintaining optimal blood glucose levels. When first diagnosed, it may be useful to take a multivitamin and mineral supplement to boost the replenishment process. But once an individual is managing blood glucose levels and eating a healthy diet this should no longer be necessary. As for chromium, the body only needs only a minute amount – around 25 micrograms (mcg) a day for women and 35 mcg a day for men. And it is found in many foods. Good sources are bran-based breakfast cereals and wholegrain breads and cereals; egg yolk, brewers yeast and yeast extracts (eg, Vegemite); cheese; fruits such as apple, oranges and pineapple; vegetables such as broccoli, mushrooms, potatoes with their skin on, tomatoes; muscle and some organ meats (eg, liver); peanuts; and some spices.

Is there a role for chromium supplements in treating certain types of mood disorders including atypical depression? I have read that chromium relates to the way insulin affects neurotransmitters including serotonin in the brain.
A few studies, which have included a relatively small number of people, have demonstrated improvements in mental health (generally depressive type illnesses) after taking around 600 micrograms of chromium a day for several months. The brains preferred fuel is carbohydrate, and given chromium’s role in carbohydrate metabolism, it is perhaps unsurprising that some people may experience improvements in organic brain function and mental performance if they are deficient in this essential mineral. More research is definitely warranted in this interesting area.

However, there is no evidence of widespread chromium deficiency in North Americans or Australians, so it would be irresponsible for health authorities to recommend widespread chromium supplementation as a routine therapy for depressive or other mental illnesses at this stage. The general recommendation to all people to consume a healthy balanced diet is perhaps the best way to ensure chromium deficiency is not a contributing factor to these kind of illnesses.