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Study Finds Glucosamine Safe for Diabetics

By Greg Arnold, DC, CSCS, January 30, 2010, abstracted from “A comprehensive review of oral glucosamine use and effects on glucose metabolism in normal and diabetic individuals” in Diabetes Metabolism Research Review

Glucosamine Sulfate is one of the most popular dietary supplements on the market, used mostly because of its ability to help maintain joint health (1). It has been named as one of the five dietary supplements that could save billions in healthcare costs (2) in amounts of 1500 mg per day (3).

Glucosamine’s widespread use among the elderly has raised concerns about its effect on blood sugar, since glucosamine supplement studies in animals have shown glucosamine to induce insulin resistance (4, 5) and an estimated 9% of elderly men, 7% of elderly women, 400,000 elderly diabetics and 2.7 million pre-diabetic individuals use glucosamine (6). Now a review of the research (7) has found that glucosamine is indeed safe for diabetics.

In the review, the researchers found that oral supplementation of 1500 mg per day of glucosamine maximizes blood levels of glucosamine (3-8 micromoles/Liter) with no further increases seen with 3000 mg per day (8). When looking at glucosamine’s effect on insulin levels, no effect was observed, even with very high levels of glucosamine given intravenously (40 micromoles/L/min) which produced glucosamine blood levels of 810 micromoles/Liter (9).

In patients diagnosed with diabetes, no significant differences were seen in levels of HbA1c (a measure of longer-term blood sugar levels) with 1500 mg per day of glucosamine and 1200 mg per day of chondroitin for 90 days. No deleterious effects were seen on blood sugar control with long-term use of glucosamine (1500 mg/day for 3 years) (10, 11).

These results led the researchers to conclude that “The totality of scientific evidence does not indicate any adverse effects of GlcN,[glucosamine] at therapeutic doses normally consumed, on glucose metabolism in subjects with poor glucose tolerance or in subjects with type 2 diabetes.”

Greg Arnold is a Chiropractic Physician practicing in Danville, CA. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com

Reference:

1. Ng N. Efficacy of a progressive walking program and glucosamine sulphate supplementation on osteoarthritic symptoms of the hip and knee: a feasibility trial. Arthritis Research & Therapy 2010, 12:R25 doi:10.1186/ar2932
2. Dietary Supplement Information Bureau press release on September 22, 2004: “FACT SHEET - Improving Public Health, Reducing Health Care Costs: An Evidence-Based Study of Five Dietary Supplements”
3. Pavelka, K., et al., Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med, 2002. 162(18): p. 2113-23
4. Slone Epidemiology Center. Patterns of Medication Use in the United States 2006. A Report from the Slone Survey. Slone Epidemiology Center at Boston University: Boston, Mass., 2006.
5. Rossetti L, Hawkins M, Chen W, Gindi J, Barzilai N. In vivo glucosamine infusion induces insulin resistance in normoglycemic but not in hyperglycemic conscious rats. J Clin Invest 1995; 96: 132–140
6. Patti ME, Virkamaki A, Landaker EJ, Kahn CR, Yki-Jarvinen H. Activation of the hexosamine pathway by glucosamine in vivo induces insulin resistance of early postreceptor insulin signaling events in skeletal muscle. Diabetes 1999; 48: 1562–1571.
7. Simon RR. A comprehensive review of oral glucosamine use and effects on glucose metabolism in normal and diabetic individuals. Diab Metab Res Rev 2010; 2011; 27: 14–27
8. Biggee BA, Blinn CM, Nuite M, Silbert JE, McAlindon TE. Effects of oral glucosamine sulphate on serum glucose and insulin during an oral glucose tolerance test of subjects with osteoarthritis. Ann Rheum Dis 2007; 66: 260–262
9. Pouwels M-J, Jacobs JR, Span PN, Lutterman JA, Smits P, Tack CJ. Shortterm glucosamine infusion does not affect insulin sensitivity in humans. J Clin Endocrinol Metab 2001; 86: 2099–2103
10. Pavelk´a K, Gatterova J, Olejarova M, Machacek S, Giacovelli G, Rovati LC. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3- year, randomized, placebo-controlled, double-blind study. Arch Intern Med 2002; 162: 2113–2123
11. Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet 2001; 357: 251–256