Causes and effects: taking back control from diabetes

The cause of type 2 diabetes, as well as health-related effects need different methods of control for particular people. With a CPAP machine and chromium supplements, you'll be a step closer to managing the effects of diabetes.

Most people with type 2 diabetes have one thing in common: weight issues. In fact, nearly 90 percent of people with this form of diabetes are overweight. That's no coincidence.

• Being overweight is the single most important contributor to its development — and losing weight is the single most important step in getting it under control (or preventing it).

Up to one in four people with type 2 diabetes may also have obstructive sleep apnea (OSA), a condition that causes your breathing to pause over and over as you sleep. OSA makes blood-sugar control more difficult and may raise your risk for high blood pressure and heart disease.

• You may have OSA if your bed partner reports that you snore loudly and seem to gasp for air at night; if you wake up feeling tired, irritable, forgetful, and headachy; or if you're extremely sleepy during the day. (OSA raises the risk for traffic accidents by making you drowsy at the wheel, too.)

If this sounds like you, ask your doctor whether you should be evaluated at a sleep clinic. It's worth it: in one study of 25 people with diabetes who got treatment for their OSA, researchers found that after-meal blood-sugar levels dropped from 191 milligrams per decilitre (mg/dL) to a healthier 130 mg/dL.

• The best fix for OSA? A continuous positive air pressure (CPAP) machine that blows a gentle stream of air into your throat to keep airways open. In addition, new treatments are available for those who aren't successful using CPAP.

Even though chromium is one of the better-known micronutrients suggested for diabetes, research with people who have high blood sugar has produced mixed results. On the plus side, in a 2011 Indian study, 40 people newly diagnosed with type 2 diabetes were given either 42 micrograms of chromium a day or a placebo for three months.

• At the end of the study, the A1C blood-sugar levels (which indicate long-term blood-sugar control) of people in the chromium group dropped from 9.51 to 6.86, which shows healthier glycemic control. What's more, triglyceride and unhealthy cholesterol levels also dropped significantly.

In a larger study, 180 people were assigned to groups that got either chromium (two different doses were tried) or a dummy pill.

• Those who got the chromium significantly reduced their A1C numbers after four months, and those who got the highest dose (1,000 micrograms) lowered their cholesterol as well. Several other studies have shown similar results, but in some others, chromium either had no effect on blood sugar or the findings were ambiguous.
• If you take a supplement, stick to the recommended daily amount of 200 micrograms or less. Chromium is a heavy metal, and large doses may build up in the body, potentially leading to kidney damage. Chromium comes in different forms, but most studies use chromium picolinate, which the body absorbs better than another type, chromium chloride.