Like vitamins, minerals are essential to life, and theoretically should be available from foods. Since most multivitamins also contain minerals, it may be presumed that the decrease in diabetic incidence and complications seen with vitamin supplementation may include minerals as well. Several specific minerals, however, bear further mention.

Chromium

Trivalent chromium (Cr3) is a key constituent of glucose-tolerance factor, and deficiency has been linked to decreased glucose tolerance, increased serum insulin levels, and decreased number of insulin receptors. There is evidence that marginal chromium deficiency is common in the United States.

Chromium is a part of a glucose/insulin system that maintains homeostatic control of blood glucose. Cr3 has also been shown to have a positive influence on individuals with no diabetic symptoms. Serum chromium levels in healthy individuals were found to be inversely related to insulin peaks in response to a glucose challenge. In people with diabetes, however, levels did not fluctuate with respect to insulin.

Chromium deficiency has been associated with hyperglycemia in test animals as well as humans, and is reversible by supplementation. It is effective in treating various types of diabetes, including type 1 and 2, gestational, and steroid-induced. Treatment of type 2 diabetes with Cr3 has led to improvement in blood glucose, insulin, and HbAlc levels in a dose-dependent manner. Higher Cr3 doses also resulted in a decrease in cholesterol levels.

While many studies show positive effects with chromium supplementation, the results are mixed. Further, some concern exists regarding high doses and renal dysfunction, including decreased thirst, fatigue, and urinary frequency. Other studies did not replicate this finding at the same dose; no changes in renal or hepatic function were found by laboratory testing. The Drug-Induced Nutrient Depletion Handbook states that side effects and toxicity with chromium supplementation are virtually nonexistent in humans.

Diets high in simple sugars increase urinary excretion of chromium, but show no change in absorption rates. Antacids have been found to decrease absorption.

Magnesium

Hypomagnesemia is common in diabetes. Deficiency can potentially cause states of insulin resistance, and supplementation may prevent some of the complications of diabetes such as retinopathy and heart disease.

Magnesium levels are related to insulin resistance in type 1 and type 2 diabetes, as well as nondiabetics. Between 25% and 48% of type 2 diabetics have been shown to have low magnesium levels.

The research on magnesium supplementation and glycemic control is mixed. Two trials showed a decrease in fasting plasma glucose and an increase in postprandial insulin. Three other trials did not show a change in blood glucose or HbAlc level. However, magnesium deficiency in people with diabetes is not under dispute. Given that magnesium toxicity is rare, it would seem wise to consider supplementation. Caution should be used, as high doses may cause diarrhea.

Potassium

A high potassium diet has several positive results for diabetes control: it yields improved insulin sensitivity, responsiveness, and secretion; it replaces potassium lost by exogenous insulin administration; and it reduces the risk of heart disease, atherosclerosis, and cancer. A potassium-depleted diet was found to lead to insulin resistance at postreceptor sites, reversible when potassium was resupplied.

Diet is the preferred method of increasing potassium intake, as supplementation with potassium salts can cause nausea, vomiting, diarrhea, and ulcers. Further, kidney disease can result from potassium toxicity in people with diabetes, so supplementation other than dietary should be used with care.

Vanadium (Vanadyl Sulfate)

Vanadium is a trace mineral believed to regulate fasting blood sugar and improve sensitivity to insulin. It is thought to be insulin-mimetic, and upregulate insulin receptors.

In three small studies, vanadium has been shown to decrease fasting blood sugar in people with diabetes; two of these also reported improvement in HbAlc and insulin sensitivity. Beneficial effects remained after cessation of active treatment. No change in insulin sensitivity was found with supplementation in obese nondiabetics.

Gastrointestinal discomfort was reported by many subjects, however, organically chelated vanadium compounds cause less irritation than vanadium salts.

Zinc

Zinc is involved with the synthesis, secretion, and utilization of insulin. It also exerts a protective effect against beta-cell destruction. People with diabetes are prone to insulin depletion due to excess excretion, and zinc supplementation has been shown to improve insulin levels in both type 1 and type 2 diabetes.

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