BACKGROUND: The role of chromium in human nutrition was first reported in 1977 on a patient on total parenteral nutrition manifesting with neuropathy and impaired glucose tolerance attributed to chromium deficiency. After correction, nerve conduction and glucose tolerance tests normalized. Chromium is postulated to act as a cofactor for insulin action by enhancing insulin receptor phosphorylation and stimulating insulin receptor tyrosine kinase.
OBJECTIVE: To compare the effect of chromium picolinate versus placebo on glycated hemoglobin (HbA1C), fasting blood sugar (FBS), 2-hours postprandial blood sugar (2HPPBS), fasting insulin (FI) and lipid profile among T2DM patients.
METHODS: Literature search in Medicine, Cochrane and Herdin was made using terms such as chromium, chromium picolinate intake of >= 3 months among T2DM patients. Two reviewers independently screened abstracts and full articles. Results were plotted using Revman 4.2.
RESULTS: Thirty four trials were found and six trials were included in the meta-analysis. The pooled data for 467 patients with T2DM reported lowering of HbA1c -0.34% (CI -0.45, 0.24 p0.06); FBS -16.6 mg/dl (CI -18.9, -14.41 p 0.30); 2HPPBS -17.33 mg/dL (CI -20.21, -18..81 p <0.01) and FI -19.51 mg/dL (CI -20.21, -18.81 p<0.01). Chromium picolinate has no effect on lipids.
CONCLUSION: Chromium picolinate lowers HbA1c, FBS, 2HPPBS and FI moderately but it has no effect on lipids, However, the short duration of studies, variable quality and large heterogeneity across these data limits the strength of our conclusion, hence further studies are recommended.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Blood Glucose ; Chromium ; Glucose Intolerance ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated ; Insulin ; Lipids ; Phosphorylation ; Picolinic Acids ; Postprandial Period ; Protein-tyrosine Kinases ; Receptor, Insulin

Background: The interpretation of thyroid hormone function during pregnancy is difficult due to its physiologic changes. Differences in iodine status in previous studies led to different intervals; therefore the use of trimester-specific, method-specific and probably country-specific reference values is advocated. Objective: To establish trimester-specific reference interval for thyroid function tests in pregnant Filipino women. Methodology: Six hundred sixteen pregnant patients (5–40 weeks gestation) attending a tertiary center were recruited. Level of serum thyroid stimulating hormone (TSH) was measured using immunoradiometric assay while free thyroxine (FT4), free triiodothyronine (FT3) and thyroid peroxidase antibodies (TPOAb) were measured by radioimmunoassay method. Main outcome measures are trimester-specific reference interval based on 2.5th and 97.5th percentiles for TSH, FT4 and FT3 among TPOAb-negative pregnant patients. Results: The reference intervals for each trimester were as follows: TSH (0.05-4.24, 0.13-3.95, and 0.20-3.00 uIU/mL); FT4 (9.80-21.88, 9.10-18.95 and 9.16-18.64 pmol/L) and FT3 (2.40-6.20, 2.77-5.00 and 2.09-3.70 pmol/L). FT4 and FT3 are strongly and negatively correlated with age of gestation (p=<0.01and <0.01 respectively). No correlation is found with TSH and age of gestation (p=0.52). Conclusions Trimester-specific intervals among pregnant Filipino women are different from their non-pregnant counterparts and laboratory cutoffs. Thus, these reference values should be used in the country.
Thyroid Function Tests

Objective: A diabetes prevention program is being proposed in the rural agricultural town of San Juan, Batangas, Philippines. This study aims to determine the prevailing level of food intake, physical activity, and health beliefs prior to any intervention. Methodology: Adults were recruited via random sampling with proportional allocation. Interviews were done to determine food intake and physical activity. Small group discussions were held to determine prevailing health beliefs. Results: The average energy intake (1,547 kcal/d) is only 72% of the recommended values for Filipinos. Only 12% of the respondents achieved the recommended energy intake. Carbohydrates comprise a large part (71%) of calorie intake. A majority (91%) already have moderate to high levels of physical activity. There are prevailing health beliefs that need to be considered when dietary modifications and physical activity interventions are to be done. Conclusion Internationally recommended diabetes prevention interventions such as reducing calorie intake and increasing physical activity may not be directly applicable here. We recommend that the features of a diabetes prevention program for this locale must include the following: 1) introduction of affordable plant sources of proteins; 2) decreasing the proportion of rice as a source of carbohydrates in the diet; 3) maintaining the level of physical activity; and 4) being sensitive to the prevailing health beliefs.
Culture ; Diet ; Life Style ; Prediabetic State ; Rural Population