Date of Graduation

Summer 8-8-2015

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Annjanette Sommers, PA-C, MS

Abstract

Background: Type 2 diabetes mellitus is a chronic disease that has been increasing in prevalence in the United States every year. Diabetes is associated with numerous physical health complications, most notably the development of cardiovascular disease. In addition, the financial burden imposed by diabetes is great and includes medical costs and lost work time. Most patients with diabetes take prescription oral anti-diabetic medications (OADs) but still do not have adequate glycemic control. When adequate glycemic control is not achieved with these medications, injectable insulin is then required; it is understandable that patients object to this type of invasive treatment and would prefer to remain on oral therapies. Over-the-counter dietary supplements, specifically chromium picolinate and biotin, have been studied for their efficacy as glycemic control agents; the purpose of this metasynthesis was to review existing literature pertaining to concurrent use of both chromium picolinate and biotin supplements as adjunct therapy to prescription OADs to determine if improved glycemic control is achieved in patients with type 2 diabetes mellitus.

Methods: An exhaustive search was conducted using Medline-OVID, CINAHL, and Web of Science using the keywords: diabetes, chromium picolinate and biotin. Relevant articles were assessed for quality using the GRADE system. A search on the NIH clinical trials site revealed there are no trials currently registered relating to the concomitant use of chromium picolinate and biotin in patients with type 2 diabetes mellitus.

Results: Ninety-six articles were reviewed for relevancy; two met inclusion criteria and were included in this systematic review. Both studies included were randomized, double blind, placebo-controlled trials that found a statistically significant improvement in glycemic control with dual chromium picolinate and biotin treatment.

Conclusion: Chromium picolinate and biotin appear to modestly improve glycemic control. Chromium picolinate and biotin are safe, over-the-counter supplements; due to evidence obtained from prior animal studies, the lack of significant adverse drug reactions and modest-to-substantial blood-glucose reducing effects, chromium picolinate and biotin supplementation as adjunct therapy to prescription OADs may be clinically justified.

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