Carnosine Cut OGGT Glucose Levels in Prediabetes and T2D

The study covered in this summary was published on medRxiv as a preprint and has not yet been peer reviewed.

Key Takeaway

• A 14-week regimen of carnosine supplementation reduced glucose levels following an oral glucose tolerance test (OGTT) for patients with prediabetes and type 2 diabetes but had no effect on insulin concentrations or obesity measures.

Why This Matters

• The findings make carnosine a promising candidate for treating people with type 2 diabetes or prediabetes and for preventing diabetes onset, particularly because of carnosine’s additional protective benefits to cardiovascular and inflammatory outcomes relevant to diabetes, but further study of carnosine supplementation for cardiometabolic conditions is required in large-scale and long-term randomized, controlled trials.

• Carnosine is safe, cost-effective, and available over the counter in most countries, and the demonstrated reductions in glucose levels make carnosine an attractive candidate for management of prediabetes and diabetes.

• Current medications for type 2 diabetes have side effects, including hypoglycemia, and they can’t be prescribed for patients with some common comorbidities, such as severe chronic kidney disease.

• Prior studies that investigated the role of carnosine in glucose metabolism were limited by small numbers of participants and frequent concomitant treatment with a variety of glucose-lowering medications. In addition, these were not randomized, placebo-controlled studies that enrolled people with overweight or obesity.

• Carnosine supplementation has been shown to improve glycemic control and insulin levels for adults with prediabetes and diabetes and to have other positive health effects.

Study Design

• The single-center, prospective study randomly assigned 22 adults with prediabetes and 21 adults with type 2 diabetes to consume either 1 g of carnosine orally twice a day or matching placebo for 14 weeks.

• The researchers recruited participants from the local community. Participants either were not receiving treatment with an antidiabetic agent or were only taking metformin. Participants were required to have a body mass index (BMI) of less than 40 kg/m² and stable body weight. Average BMI at entry was about 29 kg/m².

• The study’s primary outcome was plasma glucose level, measured 2 hours following a 75-g OGTT challenge.

Key Results

• Compliance with the intervention tablets was 100% in both the active and the control groups.

• Compared with control partipants who received placebo, for those who received carnosine, glucose levels were significantly reduced by an average of 1.60 mmol/L at 90 minutes and by an average of 1.40 mmol/L at 120 minutes. Carnosine treatment also was significantly linked with an average 3.30 mmol/L cut in the area under the curve for glucose levels during 2 hours of follow-up following glucose ingestion. These changes did not appear to be affected by diabetic status, obesity status, or metformin intake.

• There were no changes in any other measures of glucose or insulin or in measures of insulin resistance, insulin sensitivity, or beta-cell function.

• After 14 weeks, average BMI decreased by 0.74kg/m² among patients who received carnosine treatment compared with control participants, but this difference was not significant after adjustment for possible confounders.

• There were no significant differences between the carnosine-treated patients and control patients in average body weight, waist circumference, waist-to-hip ratio, body fat percentage, fat mass, or fat-free mass. These parameters showed no interaction with diabetes status, obesity status, or metformin intake.

• Neither group had treatment-related adverse events.

Limitations

• The study used surrogate measures of insulin sensitivity and secretion that are less sensitive than standard measures.

• Data were missing for some study participants.

• Baseline insulin level were overall about 30% higher for the carnosine group compared with the control patients.

• The sample size was small, and the study’s duration was short.

Disclosures

• The study received no commercial funding.

• None of the authors had disclosures.

This is a summary of a preprint research study, “Carnosine Supplementation Improves Glucose Control in Adults With Pre-Diabetes and 2 Type 2 Diabetes: A Randomized Controlled Trial,” by researchers primarily at Monash University, Clayton, Australia, published on medRxiv and provided to you by Medscape. This study has not yet been peer reviewed. The full text of the study can be found on medRxiv.org.

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