title: Creatine in type 2 diabetes: a randomized, double-blind, placebo-controlled trial.
abstract: Creatine supplementation improves glucose tolerance in healthy subjects.
  
  
  OBJECTIVE
  The aim was to investigate whether creatine supplementation has a beneficial effect on glycemic control of type 2 diabetic patients undergoing exercise training.
  
  
  METHODS
  A 12-wk randomized, double-blind, placebo-controlled trial was performed. The patients were allocated to receive either creatine (CR) (5 g·d) or placebo (PL) and were enrolled in an exercise training program. The primary outcome was glycosylated hemoglobin (HbA1c). Secondary outcomes included the area under the curve of glucose, insulin, and C-peptide and insulin sensitivity indexes. Physical capacity, lipid profile, and GLUT-4 protein expression and translocation were also assessed.
  
  
  RESULTS
  Twenty-five subjects were analyzed (CR: n=13; PL: n=12). HbA1c was significantly reduced in the creatine group when compared with the placebo group (CR: PRE=7.4 ± 0.7, POST=6.4 ± 0.4; PL: PRE=7.5 ± 0.6, POST=7.6 ± 0.7; P=0.004; difference=-1.1%, 95% confidence interval=-1.9% to -0.4%). The delta area under the curve of glucose concentration was significantly lower in the CR group than in the PL group (CR=-7790 ± 4600, PL=2008 ± 7614; P=0.05). The CR group also presented decreased glycemia at times 0, 30, and 60 min during a meal tolerance test and increased GLUT-4 translocation. Insulin and C-peptide concentrations, surrogates of insulin sensitivity, physical capacity, lipid profile, and adverse effects were comparable between the groups.
  
  
  CONCLUSIONS
  Creatine supplementation combined with an exercise program improves glycemic control in type 2 diabetic patients. The underlying mechanism seems to be related to an increase in GLUT-4 recruitment to the sarcolemma.
authors.affiliation: Laboratory of Applied Nutrition and Metabolism, School of Physical Education and Sports, University of São Paulo, São Paulo, Brazil. gualano@usp.br
authors.forename: Bruno
authors.initials: B
authors.lastname: Gualano
authors.forename: Vitor
authors.initials: V
authors.lastname: DE Salles Painneli
authors.forename: Hamilton
authors.initials: H
authors.lastname: Roschel
authors.forename: Guilherme Giannini
authors.initials: GG
authors.lastname: Artioli
authors.forename: Manoel
authors.initials: M
authors.lastname: Neves
authors.forename: Ana Lúcia
authors.initials: AL
authors.lastname: De Sá Pinto
authors.forename: Maria Elizabeth Rossi
authors.initials: ME
authors.lastname: Da Silva
authors.forename: Maria Rosária
authors.initials: MR
authors.lastname: Cunha
authors.forename: Maria Concepción García
authors.initials: MC
authors.lastname: Otaduy
authors.forename: Claudia Da Costa
authors.initials: Cda C
authors.lastname: Leite
authors.forename: Júlio César
authors.initials: JC
authors.lastname: Ferreira
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Pereira
authors.forename: Patrícia Chakur
authors.initials: PC
authors.lastname: Brum
authors.forename: Eloisa
authors.initials: E
authors.lastname: Bonfá
authors.forename: Antonio Herbert
authors.initials: AH
authors.lastname: Lancha
mesh_terms: D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects*; D015153:Blotting, Western; D003401:Creatine / Q000008:administration & dosage* / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D019587:Dietary Supplements; D004311:Double-Blind Method; D002149:Energy Intake / Q000502:physiology; D015444:Exercise / Q000502:physiology; D005260:Female; D006442:Glycated Hemoglobin / Q000008:administration & dosage; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D010725:Phosphocreatine / Q000032:analysis
chemical_list: D001786:Blood Glucose; D003401:Creatine; D006442:Glycated Hemoglobin; D008055:Lipids; D010725:Phosphocreatine; C517652:hemoglobin A1c protein, human