Med Sci Sports Exerc. 2010 Sep 24. [Epub ahead of print]

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

Gualano B, de Salles Painneli V, Roschel H, Artioli GG, Junior MN, Lúcia de Sá Pinto A, Rossi da Silva ME, Cunha MR, Otaduy MC, da Costa Leite C, Ferreira JC, Pereira RM, Brum PC, Bonfá E, Lancha AH Junior.

1University of Sao Paulo, School of Physical Education and Sports - Laboratory of Applied Nutrition and Metabolism 2University of Sao Paulo, School of Medicine - Division of Rheumatology 3University of Sao Paulo, School of Medicine - Division of Endocrinology Laboratory of Medical Investigation - LIM18 4University of Sao Paulo, School of Medicine - Division of Radiology - LIM44.

Abstract

Creatine supplementation improves glucose tolerance in healthy subjects.
PURPOSE: The aim was to investigate whether creatine supplementation has a beneficial effect on glycemic control of type 2 diabetic patients undergoing exercise training.
METHODS: A 12-week randomized, double-blind, placebo-controlled trial was performed. The patients were allocated to receive either creatine (CR) (5g/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.
RESULTS: Twenty-five subjects were analyzed (CR: n=13; PL: n=12). HBA1c was significantly reduced in the creatine group when compared to 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 the time 0, 30, and 60 minutes during a meal tolerance test and increased GLUT-4 translocation. Insulin and C-peptide concentrations, surrogates of insulin sensitivity, physical capacity, lipid profile, and side effects were comparable between the groups.
CONCLUSIONS: 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. ClinicalTrials.gov registration number: NCT00992043.