From the Guidelines
Creatine supplementation may help decrease insulin resistance, though the evidence is not conclusive. The provided evidence does not directly address the effect of creatine supplementation on insulin resistance. However, it discusses various aspects of managing insulin resistance, such as lifestyle changes, exercise, and dietary interventions.
Given the lack of direct evidence on creatine supplementation in the provided studies, we must rely on general knowledge about creatine's effects on metabolism. Creatine works by enhancing cellular energy metabolism, potentially improving glucose uptake in muscles and reducing blood glucose levels. It may increase the expression of glucose transporter type 4 (GLUT4), which helps move glucose from the bloodstream into muscle cells. This mechanism could explain why some studies show improved glycemic control with creatine supplementation.
The typical recommended dose is 3-5 grams of creatine monohydrate daily, taken consistently over time. No loading phase is necessary for this metabolic benefit. The supplement is generally safe for most people, though staying well-hydrated is important while taking it. Those with kidney disease should consult a healthcare provider before starting creatine.
While promising, creatine should be considered a complement to, not a replacement for, established methods of managing insulin resistance such as exercise, healthy diet, and weight management, as emphasized in studies like 1, 1, and 1. These studies highlight the importance of lifestyle interventions, including regular physical activity and dietary changes, in improving insulin sensitivity and reducing the risk of type 2 diabetes.
In conclusion, based on the available evidence and general knowledge about creatine supplementation, it is reasonable to consider creatine as a potential adjunct to traditional therapies for managing insulin resistance, but always in conjunction with established lifestyle modifications.
From the Research
Creatine Supplementation and Insulin Resistance
- Creatine supplementation has been studied for its potential effects on glucose metabolism and insulin resistance, with some studies suggesting that it may improve glycemic control in individuals with type 2 diabetes mellitus 2, 3.
- A systematic review of randomized clinical trials found that creatine supplementation was effective in decreasing glycemic levels and glycosylated hemoglobin concentrations compared to placebo in patients with type 2 diabetes 3.
- However, another systematic review and meta-analysis found that creatine supplementation had no significant effect on fasting blood glucose and insulin resistance in both healthy and diabetic individuals 4.
- The relationship between creatine and insulin resistance is complex, and some studies suggest that increased plasma creatine concentrations may be associated with the risk of type 2 diabetes, rather than causing it 5.
- Exercise training, which can be combined with creatine supplementation, has been shown to improve glucose metabolism and insulin sensitivity, and may be an important factor in the potential benefits of creatine supplementation on glycemic control 2, 6.
Potential Mechanisms
- The possible mechanism underlying the effects of combined exercise and creatine supplementation on glucose metabolism is an enhanced glucose transport into muscle cells by type 4 glucose transporter (GLUT-4) translocation to sarcolemma 2.
- Creatine supplementation may also stimulate insulin secretion in vitro, improve muscle glycogen stores, and ameliorate hyperglycemia in animals 2.
- The role of mitochondrial creatine kinase 2 (CKMT2) in mitochondrial function and insulin resistance has been identified as a potential target for therapeutic interventions, with exercise training shown to up-regulate CKMT2 expression in both humans and mice 5.
Limitations and Future Directions
- The current evidence for the effects of creatine supplementation on insulin resistance and glycemic control is limited by the small sample sizes and methodological quality of the studies 3, 4.
- Well-designed randomized controlled trials with larger sample sizes and long-term outcomes are needed to confirm the potential benefits of creatine supplementation on glycemic control and insulin resistance 3, 4.
- Further research is needed to fully understand the mechanisms by which creatine supplementation may affect glucose metabolism and insulin resistance, and to identify the potential therapeutic applications of creatine supplementation in the management of type 2 diabetes mellitus 2, 5.