• chromium picolinate;
  • glucose clamp;
  • highly active antiretroviral therapy;
  • HIV;
  • insulin resistance;
  • toxicity

Aim:  Multidrug regimens in HIV disease are associated with an increased incidence of insulin resistance, by as much as 50%. Not only does insulin resistance predisposes subjects to diabetes but also it is associated with the metabolic syndrome and increased risk of cardiovascular disease. Previous studies suggest that chromium picolinate can improve insulin resistance in patients with type 2 diabetes. The objective was to study the efficacy and safety of chromium picolinate as a treatment of insulin resistance in subjects infected with HIV.

Methods:  The ability of chromium picolinate (1000 μg/day) to improve insulin sensitivity, determined with a hyperinsulinaemic–euglycaemic insulin clamp, was determined in eight HIV-positive subjects on highly active antiretroviral therapy.

Results:  The mean rate of glucose disposal during the clamp was 4.41 mg glucose/kg lean body mass (LBM)/min (range 2.67–5.50), which increased to 6.51 mg/kg LBM/min (range 3.19–12.78, p = .03), an increase of 25% after 8 weeks of treatment with chromium picolinate. There were no significant changes in blood parameters, HIV viral burden or CD4+ lymphocytes with chromium picolinate treatment. Two subjects experienced abnormalities of liver function during the study. Another subject experienced an elevation in blood urea nitrogen.

Conclusions:  The study shows that chromium picolinate therapy improves insulin resistance in some HIV-positive subjects, but with some concerns about safety in this population.