Table 2: Studies relating Glucosamine use with the onset of Insulin Resistance.

Author [reference]Sample and/or amount of trialsSupplement type, doses.Conclusions

Monauni et al. [97]10 healthy subjectsGlucosamine (infusion: 1.6 micromol/min−1/kg−15 micromol/min−1/kg−1) Type not specifiedIVGTT and EIC were performed during either a saline infusion or a low (1.6 micromol) or high (5 micromol) GluN infusion. GluN did not change glucose utilization or intracellular metabolism, nor did it affect readily releasable insulin levels, GSIS, or the time constant of secretion, but it increased both the glucose threshold of GSIS and plasma fasting glucose. These effects were present at high GluN doses.

Pouwels et al. [98]18 healthy subjectsGS (infusion: 4 micromol/dL)EIC was performed throughout at least 300 minutes during infusion of GluN (4 micromol/dL); 90–240 min, 0–300 min, or during saline infusion. GluN had no effect on insulin-induced glucose uptake.

Muniyappa et al. [99]40 lean subjects and 40 obese subjectsGH (500 mg TID) versus PlaceboThis study found no differences in EIC between patients receiving GH and placebo after 6 weeks of therapy, within both the lean and obese groups.

Biggee et al. [50]16 patients with exclusive diagnoses of OA, treated with GSGS (1500 mg OD)In this study, carried out in subjects without any metabolic disorders (such as TDM2 and IFG), 3 out of 16 individuals displayed disruption of oral glucose tolerance after treatment with GS. This suggests the necessity for a period of time for this supplements to exert metabolic modifications in this group of patients as well as trials in poorly controlled subjects.

Scroggie et al. [100]Patients treated with GC: 22, placebo: 12GH (1500 mg OD) + CS (1200 mg OD) versus PlaceboThis randomized, double-blind, placebo-controlled clinical trial carried out in patients with controlled TDM2 determined that the oral adminstration of GH at recommended doses did not alter glycemic control in this group of patients.

Albert et al. [101]12 patients in a randomized, double-blind, placebo-controlled, cross-over trialGlucosamine (1500 mg OD) Type not specifiedThis study inferred glucosamine at commonly used doses, may not significatively affect glycemic control, lipid profile, or apoAI levels in diabetic patients after 2 weeks of treatment.

Simon et al. [102]23 trials with different methodologies: glucosamine IV (infused): 2, oral glucosamine: 21GS or GH versus placeboThis meta-analysis included trials with both IV and oral formulations, and even long-term reports, concluding that glucosamine consumption at habitual doses may not affect the metabolism of normoglycemic, “prediabetic,” or diabetic subjects and that currently no definitive motives are valid for their restriction in these groups of individuals.

Dostrovsky et al. [103]11 trials with different methodologies: RCT: 6, prospective studies: 5GS, GH, or SC versus placeboThis meta-analysis highlighted 3 trials where OA glucosamine was used, followed by modifications in insulin sensitivity and basal glycemia. Additionally, studies that included subjects with IFG or IR showed greater impact over carbohydrate metabolism. Thus, this population should be a target of further research.

IVGTT: intravenous glucose tolerance test; EIC: euglycemic insulin clamp; GluN: glucosamine;. GSIS: glucose-stimulated insulin secretion; TID: three times a day; OD: once daily; GS: glucosamine sulfate; CS: chondroitin sulfate; OA: osteoarthrosis; GH: glucosamine hydrochloride; TDM2: type 2 diabestes mellitus; apoAI: apolipoprotein AI; IFG: impaired fasting glucose; IV: intravenous; RCT: randomized controlled trials; AO: administered orally; IR: insulin resistance.