Improved glucose control associated with i.v. chromium administration in two patients receiving enteral nutrition.
OBJECTIVE
The effect of i.v. chromium administration on glucose control in two patients receiving enteral nutrition is described.


CONCLUSIONS
Chromium supplementation has been hypothesized to potentiate the actions of insulin in facilitating cellular uptake of glucose. We report two cases-one involving a diabetic patient and the other a nondiabetic patient-in which chromium administration appeared to decrease insulin requirements. In case 1, a diabetic patient given a single course of chromic chloride appeared to have a probable response to the drug. Within the first day of chromic chloride administration, insulin requirements declined. When chromic chloride was discontinued, insulin requirements did not rise, suggesting efficacy and sustained effect. The patient's glucose intake and blood glucose levels remained relatively stable, while there was a significant decline in insulin requirements. Serum chromium levels were not assessed, so it is uncertain if the patient experienced chromium deficiency or if it was adequately treated with chromium supplementation, and a dose-response relationship could not be ascertained because the patient received a continuous infusion of chromium. In case 2, the insulin requirements of a nondiabetic patient appeared to decrease in response to multiple courses of chromic chloride. Upon initial discontinuation of chromic chloride, the patient's lower insulin requirements were sustained for a few days, but changes in clinical status and other medications precipitated elevated insulin requirements and the need for subsequent chromic chloride administration. Further research in more controlled settings is necessary to elucidate chromium's effect on insulin requirements.


CONCLUSIONS
Infusion of chromic chloride appeared to reduce insulin requirements in one diabetic patient and one nondiabetic patient.
University of Connecticut (UC)/Hartford Hospital (HH) Evidence-Based Practice Center, Hartford, CT 06102-5037, USA.
Olivia J
OJ
Phung
Robert A
RA
Quercia
Kevin
K
Keating
William L
WL
Baker
Jennifer L
JL
Bell
C Michael
CM
White
Craig I
CI
Coleman
D000063:Accidents, Traffic; D000430:Alcohol Withdrawal Delirium / Q000188:drug therapy / Q000523:psychology; D000435:Alcoholic Intoxication; D001786:Blood Glucose / Q000378:metabolism*; D002712:Chlorides / Q000008:administration & dosage / Q000627:therapeutic use*; D017608:Chromium Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D003920:Diabetes Mellitus / Q000097:blood* / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy; D004750:Enteral Nutrition; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007275:Injections, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007333:Insulin Resistance; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications / Q000188:drug therapy; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy
D001786:Blood Glucose; D002712:Chlorides; D017608:Chromium Compounds; D007004:Hypoglycemic Agents; D007328:Insulin; C022990:chromic chloride; D008775:Methylprednisolone