Pramlintide, currently approved by the FDA for diabetes to take in combination with insulin to control their blood sugar levels. Previous research also linked pramlintide to weight loss, report Dr. Christian Weyer, of Amylin Pharmaceuticals in San Diego, California, and colleagues.
To further evaluate the drug’s potential for affecting weight loss, Weyer’s group assessed different pramlintide dosing regimens among nondiabetic obese subjects (about 70 percent female) involved in a lifestyle altering weight-loss program.
In addition to changing diet, physical activity and behavior, the 411 mostly middle-aged and otherwise healthy participants were assigned to inject 120, 240 or 360 micrograms pramlintide 2- or 3-times daily or to inject a placebo.
After 4 months, 240 participants remained in the study. Those taking pramlintide had lost from 3.8 to 6.1 kilograms (about 8.4 to 13.4 pounds), the investigators report in the journal Diabetes Care. By contrast, the placebo group lost 2.8 kg (about 6.2 pounds) on average.
The investigators offered these 240 participants the opportunity to continue their respective treatment through 12 months. Of the 146 who completed the extended treatment, those taking pramlintide generally maintained or continued to lose weight, while the placebo group largely regained their weight.
The most common pramlintide side effect was nausea, reported by up to 29 percent of participants during the initial 4-month study period. However, this generally subsided over time and less than 10 percent of pramlintide users reported nausea during extended use.
These findings support the potential of pramlintide in treating obesity, the investigators note. However, larger, longer-term studies must confirm the safety and efficacy of pramlintide as a weight loss medication.
SOURCE: Diabetes Care, September 2008
How it works
Recent research suggests that chromium may play a role in managing type 2 diabetes because of its positive effect on insulin. Your body uses insulin to shuttle glucose into cells, where it’s used for energy. Type 2 diabetes and prediabetes occur when the body stops using insulin effectively. When insulin regulation breaks down, glucose builds up in the blood, starving the body of energy. Chromium may help this situation by making cells respond better to insulin.
Evidence
A 2002 study published in the American Journal of Clinical Nutrition reviewed 15 clinical trials and determined that chromium had no effect on glucose or insulin concentrations in nondiabetic subjects and that the data on those with diabetes was inconclusive. But research on animals indicates that chromium might make insulin receptors more efficient, so type 2 diabetics need less insulin to metabolize glucose, says John Vincent, Ph.D., a chemistry professor at the University of Alabama. A study published last year in Diabetes Care found that combining 1,000 micrograms of chromium per day (in the form of chromium picolinate) with a standard diabetes medication, Glucotrol XL (which stimulates the pancreas to make more insulin), significantly improved the body’s response to insulin in those with type 2 diabetes.
How to take it
Chromium comes as a singleingredient supplement, in combination formulas, and in multivitamin/mineral pills. Research suggests that chromium picolinate may be absorbed slightly better than chromium chloride. Daily Adequate Intakes (AIs) for adults are 35 mcg for men and 25 mcg for women, which are amounts generally found in multivitamin/mineral products. (AIs decrease for older adults; no safe dose has been established for women who are pregnant or breastfeeding, or for people with liver or kidney disease.) You can also meet your needs by eating plenty of whole grains, green beans, and broccoli.
Caveats
Vincent has found evidence of DNA damage in fruit flies exposed to chromium picolinate, but not in those exposed to chromium chloride. In a 2004 statement, the U.K. Department of Health said the balance of research suggests that chromium picolinate doesn’t damage DNA. Vincent advises looking for chromium chloride in a multivitamin. Ask your doctor if chromium interacts with any medications you’re taking.
The Bottom Line
Chromium may help to control type 2 diabetes in combination with diabetes medication, but more research is needed. Check with your doctor to see if you are a candidate for the supplement.
She and her colleagues analyzed data from 5,140 people, ages 20 to 69, who completed a hearing test and a diabetes questionnaire as part of the National Health and Nutrition Examination Survey from 1999 to 2004.
The age-adjusted prevalence of low- or mid-frequency hearing impairment of mild or greater severity in the ear with the worst hearing was 21.3 percent among the 399 adults with diabetes compared to 9.4 percent among the 4,741 adults without diabetes.
The age-adjusted prevalence of high-frequency hearing impairment of mild or greater severity in the ear with the worst hearing was 54.1 percent among adults with diabetes and 32 percent among those without diabetes.
Diabetes can damage small blood vessels and nerves in the body.
“It is possible that high blood sugar levels damage the small blood vessels and nerves of the inner ear, resulting in hearing impairment. People with diabetes might benefit from having their hearing checked,” Bainbridge said.
The study was published on the Web site of the journalAnnals of Internal Medicine. The editors of the journal noted that diabetes was self-reported by the people in this study and was verified in only a small percentage of participants. In addition, the researchers didn’t distinguish between type 1 and type 2 diabetes, and participants self-reported their history of noise exposure.
More information
The American Speech-Language-Hearing Association has more about hearing loss .
SOURCE:Annals of Internal Medicine, news release, June 16, 2008