Creatine in Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled Trial

• Published in: Medicine and science in sports and exercise 2011-05, Vol.43 (5), p.770-778
• Main Authors: GUALANO, Bruno, DE SALLES PAINNELI, Vitor, FERREIRA, Júlio Cesar, PEREIRA, Rosa Maria, CHAKUR BRUM, Patricia, BONFA, Eloisa, LANCHA, Antonio Herbert, ROSCHEL, Hamilton, GIANNINI ARTIOLI, Guilherme, NEVES, Manoel, LUCIA DE SA PINTO, Ana, ROSSI DA SILVA, Maria Elizabeth, CUNHA, Maria Rosaria, GARCIA OTADUY, Maria Concepcion, DA COSTA LEITE, Claudia
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Blood Glucose - analysis; Blood Glucose - drug effects; Blotting, Western; Creatine - administration & dosage; Creatine - metabolism; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - metabolism; Dietary Supplements; Double-Blind Method; Energy Intake - physiology; Exercise - physiology; Female; Fundamental and applied biological sciences. Psychology; Glycated Hemoglobin A - administration & dosage; Humans; Lipids - blood; Male; Middle Aged; Oxygen Consumption - physiology; Phosphocreatine - analysis; Space life sciences; Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports
• ISSN: 0195-9131; 1530-0315
• DOI: 10.1249/MSS.0b013e3181fcee7d

Creatine supplementation improves glucose tolerance in healthy subjects. The aim was to investigate whether creatine supplementation has a beneficial effect on glycemic control of type 2 diabetic patients undergoing exercise training. A 12-wk randomized, double-blind, placebo-controlled trial was performed. The patients were allocated to receive either creatine (CR) (5 g·d) or placebo (PL) and were enrolled in an exercise training program. The primary outcome was glycosylated hemoglobin (HbA1c). Secondary outcomes included the area under the curve of glucose, insulin, and C-peptide and insulin sensitivity indexes. Physical capacity, lipid profile, and GLUT-4 protein expression and translocation were also assessed. Twenty-five subjects were analyzed (CR: n=13; PL: n=12). HbA1c was significantly reduced in the creatine group when compared with the placebo group (CR: PRE=7.4 ± 0.7, POST=6.4 ± 0.4; PL: PRE=7.5 ± 0.6, POST=7.6 ± 0.7; P=0.004; difference=-1.1%, 95% confidence interval=-1.9% to -0.4%). The delta area under the curve of glucose concentration was significantly lower in the CR group than in the PL group (CR=-7790 ± 4600, PL=2008 ± 7614; P=0.05). The CR group also presented decreased glycemia at times 0, 30, and 60 min during a meal tolerance test and increased GLUT-4 translocation. Insulin and C-peptide concentrations, surrogates of insulin sensitivity, physical capacity, lipid profile, and adverse effects were comparable between the groups. Creatine supplementation combined with an exercise program improves glycemic control in type 2 diabetic patients. The underlying mechanism seems to be related to an increase in GLUT-4 recruitment to the sarcolemma.