Diabetes is a progressive disease characterized by continued decline in insulin secretion that results in worsening of glycemic control over time.1 The study by Scroggie et al2 provided evidence that the use of glucosamine-chondroitin supplementation for the treatment of osteoarthritis in patients with diabetes does not pose a significant risk to worsening glycemic control in the form of elevated hemoglobin A1c levels.2 The study included 18% of patients who were only diet controlled and a median number of 1 hypoglycemic agent per patient in the rest of the population and demonstrated excellent blood glucose control as evidenced by the mean glycohemoglobin level of 6.45%. The lack of negative impact of glucosamine on glycemic control may be explained by a compensatory increase in endogenous insulin secretion in response to a possible increase in insulin resistance due to glucosamine in these patients who are at a potentially early stage in the course of the diabetes disease process. These results may not hold true in patients in a later stage of the disease, who may lack the ability to compensate for the effects of glucosamine because of their inability to increase insulin secretion. If these same results could be shown across a more encompassing spectrum of diabetic patients, it would be extremely beneficial in validating another osteoarthritis treatment option in this population.
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