Carnosine supplementation improves glucose control in adults with pre-diabetes and type 2 diabetes: a randomised controlled trial
Rohit Hariharan October 13, 2023
Highlights
• Carnosine, an endogenous histidine containing dipeptide, is known to have potent antiglycating effects from studies in humans.
• This trial investigated the effect of high dose carnosine (2g) in a cohort of individuals with type 2 diabetes and overweight for a prolonged time (14 weeks) and studied effect on body composition using dual energy x-ray absorptiometry (DEXA) and intramuscular adipose tissue by peripheral quantitative computed tomography (pQCT).
• Our trial successfully demonstrated that carnosine does improve glucose control, even in individuals with diabetes being treated with Metformin.
• Therefore, carnosine should be evaluated further as a potential add-on treatment to further optimize glucose control in individuals already being treated with glucose lowering medications.
Background and Aims
Type 2 diabetes (T2DM) is a major cause of morbidity and mortality globally. Carnosine, a naturally occurring dipeptide, has anti-inflammatory, antioxidant, and anti-glycating effects, with preliminary evidence suggesting it may improve important chronic disease risk factors in adults with cardiometabolic conditions.
Methods and Results
In this randomized controlled trial, 43 adults (30%F) living with prediabetes or T2DM consumed carnosine (2 grams) or a matching placebo daily for 14 weeks to evaluate its effect on glucose metabolism assessed via a 2-hour 75g oral glucose tolerance test. Secondary outcomes included body composition analysis by dual energy x-ray absorptiometry (DEXA), calf muscle density by pQCT and anthropometry. Carnosine supplementation decreased blood glucose at 90 minutes (-1.31mmol/L; p=0.02) and 120 minutes (-1.60mmol/L, p=0.02) and total glucose area under the curve (-3.30mmol/L; p=0.04) following an oral glucose tolerance test. There were no additional changes in secondary outcomes. The carnosine group results remained significant before and after adjustment for age, sex, and change in weight (all>0.05), and in further sensitivity analyses accounting for missing data. There were no significant changes in insulin levels.
Conclusion
This study provides preliminary support for larger trials evaluating carnosine as a potential treatment for prediabetes and the initial stages of T2DM. Likely mechanisms may include changes to hepatic glucose output explaining the observed reduction in blood glucose without changes in insulin secretion following carnosine supplementation.