Creatine is one heck of a supplement - inexpensive, safe and incredibly effective at building muscle and strength.

Type 2 diabetes is (adult-onset diabetes) is a metabolic disorder characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency.

How could creatine help diabetes?

Really glad you asked!

Along with diet and medication, physical activity has been considered the primary prevention strategy for managing type 2 diabetes [1]. Strategies capable of mimicking and/or enhancing the effects of exercise are potentially therapeutic, hence the emergence of creatine supplementation as a novel alleged candidate for treating diabetes [2].

The combination of creatine supplementation with resistance exercise is a research-proven way to manage and improve type-2 diabetes.

Creatine has rapidly become one of the most consumed nutritional supplements due to its ability to enhance muscle phosphorylcreatine content, thus enhancing athletic performance and lean mass. The research supports the role of creatine supplementation in improving acute work capacity during intermittent short-duration high-intensity exercise. The efficacy of this supplement on skeletal muscle protein synthesis is less clear [3,4].

A number of therapeutic potential applications of creatine have been revealed in a broad range of diseases, notably muscle disorders, neurodegenerative conditions, and metabolic dysfunctions [5]. Interestingly, it’s suggested that creatine supplementation may improve glucose metabolism, particularly when combined with exercise [6].

Research has consistently shown that creatine supplementation along with muscle contraction can augment glycogen accumulation in humans [7,8]. Also, creatine has shown to offset the decline in muscle GLUT-4 expression after 2 weeks of immobilization and enhances GLUT-4 content during subsequent rehabilitation training in healthy males [6].

Furthermore, creatine intake is suggested to improve hyperglycemia, typical of Huntington transgenic mice, delaying the onset of diabetes [9]. In support of this, another study [10] verified that creatine can reduce the insulinogenic index in an animal model of inherited type 2 diabetes. Also, creatine combined with aerobic training promoted greater improvement on glucose tolerance than aerobic training alone in physically inactive males [2].

A group of researchers from the University of Sao Paulo, Sao Paulo, Brazil [11] conducted a study to investigate the effects of creatine supplementation combined with exercise training on glycemic control in type 2 diabetic patients. Men and women (˃45yr) prediagnosed with type 2 diabetes, physically inactive for at least 1 yr, and with BMI ≥ 30 kg·m⁻² participated in the study (n=25). All patients were randomly assigned to receive either creatine (5 g·d⁻¹) or placebo (dextrose 5 g·d⁻¹) in a double-blind fashion. All patients undertook a program of moderate intensity aerobic training combined with strengthening exercises for 3 months. Patients were assessed at baseline and after 12 wk.

This study is the first randomized controlled trial to describe the beneficial effects of creatine supplementation on glycemic control in type 2 diabetic patients who underwent exercise training. The creatine group demonstrated a significant increase in muscle phosphorylcreatine content and subsequent improvement in glycemic control. The mean reduction of glycosylated hemoglobin (HbA1c) (-1.1%) was superior to that commonly seen with exercise training [12] or metformin [13] treatment alone, pointing out the therapeutic potential of this novel nutritional intervention.

HbA1c is a form of hemoglobin which is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. The glycemia-lowering effect of creatine is most likely an explanation for this metabolic response. Another interesting finding was that creatine supplementation further enhanced the GLUT-4 translocation in the diabetic patients, suggesting this supplement acts directly on type 2 diabetes pathogenesis (i.e., suboptimal GLUT-4 translocation), thus improving hyperglycemia and consequently glycemic control.

Interestingly, only the creatine group experiences improvements in glycemic control, although both groups had undertaken an exercise training program. It is tempting to speculate that the addition of creatine might have maximized the effects of exercise on insulin sensitivity and glycemic control, but it is impossible to distinguish whether the current findings result from creatine treatment or the interaction between creatine and exercise. Some research hypothesize that creatine-associated changes in CHO metabolism result from the interaction between creatine supplementation and other mediators of muscle glucose transport (i.e. muscle contraction).

On the other hand, recent data suggests creatine per se can modulate expression of key proteins and genes related to insulin sensitivity and glycemic control (e.g., GLUT-4, protein kinase B, myocyte enhancer factor-2, insulin-like growth factor-1) [14]. Further research is needed to address this question.

In summary, this research presents a novel therapeutic role of creatine supplementation on metabolic control in type 2 diabetic patients and provides convincing evidence that creatine might modulate glucose uptake in these patients mainly via an increase in GLUT-4 recruitment to the sarcolemma.

Improving insulin sensitivity and glycemic control is crucial to health, it enhances the ability of muscles to utilize more glucose and store more glycogen (via enhanced GLUT-4 recruitment to sarcolemma), thus improving your metabolic environment - just another one of the many benefits of creatine monohydrate supplementation Read more about how to use Creatine to accelerate your results here.

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Dr. Paul Henning is leading scientist at the Military Performance Division, United States Army Research Institute of Environmental Medicine. Paul's an avid bodybuilder, lives the MP lifestyle and is a proud member of the MP Team.  To read more from Dr Henning click here

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