The review "Do glucosamine and chondroitin worsen blood sugar control in diabetes?" (J Fam Pract 2006; 55:1091-1093) is timely and important, given that glucosamine is a popular supplement beside potential to adversely affect glucose homeostasis. The authors state that short-term glucosamine administration does not affect glycemic control and speculate that long-term effects are unlikely to fluctuate. However, they advocate for secondary investigations (including long-term studies) in patients with poorly controlled diabetes or glucose intolerance.
A recent quality newspaper of ours sheds some light on the robustness concerns of glucosamine supplements at standard doses (500 mg orally, 3 times daily). (1) This treatise and others (2) have shown that culmination plasma concentrations of glucosamine achieved after a 500 mg oral dose are 1000- to 10,000-fold smaller quantity than the mM concentrations of glucosamine used in cell-based, animal, or human studies demonstrating effects of glucosamine to cause insulin resistance. (2,3) Moreover, giving glucosamine to humans at standard oral does of 500 mg 3 times each day does not cause any change in steady-state level of plasma glucosamine. It's unlikely that exogenously administered glucosamine will be transported into cells where on earth it may impact on glucose homeostasis. Indeed, endogenous glucosamine production (~12 g/day) is considerably higher (3) than standard oral doses of glucosamine supplements.
In our study, using state-of-the-art methods to gauge insulin sensitivity and endothelial function, we did not observe any evidence that glucosamine supplements at standard doses for 6 weeks produce or worsen insulin resistance or endothelial dysfunction in healthy or obese subjects. We do not believe that more studies evaluating the safekeeping or efficacy of oral glucosamine for longer durations in patients with poorly controlled diabetes are necessary.
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