{"id":1489,"date":"2020-01-16T08:28:25","date_gmt":"2020-01-16T08:28:25","guid":{"rendered":"https:\/\/seleniumfacts.com\/?p=1489"},"modified":"2020-01-17T06:45:36","modified_gmt":"2020-01-17T06:45:36","slug":"selenium-supplementation-and-diabetes-risk","status":"publish","type":"post","link":"https:\/\/seleniumfacts.com\/index.php\/selenium-supplementation-and-diabetes-risk","title":{"rendered":"Selenium Supplementation and Glucose Metabolism"},"content":{"rendered":"<p><figure id=\"attachment_1501\" aria-describedby=\"caption-attachment-1501\" style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-1501 size-medium\" src=\"https:\/\/seleniumfacts.com\/wp-content\/uploads\/2019\/11\/Se_diabetes-300x270.png\" alt=\"\" width=\"300\" height=\"270\" srcset=\"https:\/\/seleniumfacts.com\/wp-content\/uploads\/2019\/11\/Se_diabetes-300x270.png 300w, https:\/\/seleniumfacts.com\/wp-content\/uploads\/2019\/11\/Se_diabetes-768x690.png 768w, https:\/\/seleniumfacts.com\/wp-content\/uploads\/2019\/11\/Se_diabetes.png 960w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-1501\" class=\"wp-caption-text\"><strong>The evidence from a randomized controlled trial shows that 2.9 years of supplementation with 200 micrograms per day had no effect on insulin sensitivity and no effect on pancreatic beta-cell function compared with placebo [Jacobs 2019]. The evidence from randomized controlled trials does not support a role for selenium in the risk of developing type-2 diabetes [Kohler 2018].<\/strong><\/figcaption><\/figure><strong><strong>The findings from a 2018 meta-analysis show no consistent evidence that selenium supplementation plays a role in the development of type 2 diabetes among adults.<\/strong><\/strong><\/p>\n<p>Researchers at the University of Arizona in Tucson, home of the Arizona Cancer Center, identified a statistically significant direct relationship between selenium and Type-2 diabetes <em>in observational studies<\/em> but no statistically significant relationship <em>in randomized controlled trials<\/em> [Kohler 2018].<\/p>\n<p><strong><em>Note<\/em><\/strong>: Randomized controlled trials are the gold standard for scientific evidence in the bio-medical field. The randomization of the study participants should produce comparable groups and should eliminate accidental bias.&nbsp; In observational studies, the researchers do not randomly assign the study participants to groups and do not decide which treatments each group receives or does not receive.<\/p>\n<p>The differences between the findings in observational studies and in randomized controlled trials could be explained by the role of as-yet-unexplained uncontrolled confounding variables in the observational studies.&nbsp; There may be a third factor that affects both selenium status and the risk&nbsp; of&nbsp; type-2 diabetes that&nbsp; is&nbsp; not&nbsp; adequately&nbsp; controlled&nbsp; in&nbsp; the observational&nbsp; studies [Jacobs 2019].<\/p>\n<h4>Evidence from Three Clinical Trials of Selenium Supplementation<\/h4>\n<p>The University of Arizona researchers examined the <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30563119\" target=\"_blank\" rel=\"noopener noreferrer\"><em><strong>data from three randomized clinical trials<\/strong><\/em><\/a> with a combined total of 20,290 participants [Kohler 2018]:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/8971064\" target=\"_blank\" rel=\"noopener noreferrer\"><strong><em>Nutritional Prevention of Cancer Trial<\/em><\/strong><\/a> (n = 1202 men and women)<\/li>\n<li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21990298\" target=\"_blank\" rel=\"noopener noreferrer\"><strong><em>Selenium and Vitamin E Cancer Prevention Trial<\/em><\/strong><\/a> (n = 17,448 men)<\/li>\n<li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27530657\" target=\"_blank\" rel=\"noopener noreferrer\"><strong><em>Selenium Trial<\/em><\/strong><\/a> (n = 1640 men and women)<\/li>\n<\/ul>\n<p>Those three clinical trials assessed cancer or precancerous lesions as a primary outcome.<\/p>\n<p>In each trial, the study participants received <em><strong>200 micrograms of selenium daily<\/strong><\/em>:<\/p>\n<ul>\n<li>Nutritional Prevention of Cancer Trial (natural selenized yeast)<\/li>\n<li>Selenium and Vitamin E Cancer Prevention Trial (synthetic selenomethionine)<\/li>\n<li>Selenium Trial (natural selenized yeast)<\/li>\n<\/ul>\n<h4>Secondary Analysis of Data from the Selenium Clinical Trials<\/h4>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17620655\" target=\"_blank\" rel=\"noopener noreferrer\"><strong><em>Secondary analysis of the data<\/em> <\/strong><\/a>from the <strong><em>Nutritional Prevention of Cancer Trial<\/em><\/strong> showed that there was a statistically significantly increased risk of type-2 diabetes only in the highest tertile of the study participants\u2019 baseline plasma selenium levels: the study participants above 121.6 micrograms per liter [Stranges 2007].<\/p>\n<p>On the other hand, the <strong><em>Selenium and Vitamin E Cancer Prevention Trial<\/em><\/strong> (SELECT) and the <em><strong>Selenium Trial<\/strong> <\/em>showed <strong><em>no statistically significant overall increased risk for Type-2 diabetes risk<\/em> <\/strong>after supplementation with 200 micrograms of selenium per day compared with placebo supplementation [Jacobs 2019].<\/p>\n<p>Moreover, analysis of the data from a sub-set of 175 of the 400 individuals who participated in the <em><strong>Selenium Trial<\/strong><\/em> showed that the data <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30899530\" target=\"_blank\" rel=\"noopener noreferrer\"><strong><em>do not support a significant adverse effect of daily selenium supplementation with 200\u2009micrograms\/day of selenized yeast on beta-cell function or insulin sensitivity.<\/em><\/strong><\/a> These findings provide important&nbsp; evidence&nbsp; that&nbsp; selenium supplementation&nbsp; for&nbsp; up&nbsp; to&nbsp; three years&nbsp; in&nbsp; older&nbsp; individuals&nbsp; does not result in diabetogenic effects in humans.&nbsp; Sub-group analysis of the data by age and sex did not change the outcome [Jacobs 2019].<\/p>\n<h4>Relationship between Baseline Plasma Selenium Level, Supplementation, and Increased Risk of Diabetes?<\/h4>\n<p>Two Norwegian case-control studies have shown no statistically significant relationship between selenium and type-2 diabetes [Simic 2017; Hansen 2017].<\/p>\n<p>Kohler et al point out that the baseline blood selenium levels were considerably lower in the Norwegian study participants (median: 100-105 micrograms per liter) than in the three US randomized controlled trials [Kohler 2018]:<\/p>\n<ul>\n<li>Nutritional Prevention of Cancer Trial (median: 113 micrograms per liter)<\/li>\n<li>SELECT Trial (median: 135 micrograms per liter)<\/li>\n<li>Selenium Trial (median: 136 micrograms per liter)<\/li>\n<\/ul>\n<h4>Selenium Supplementation Reduces Fasting Insulin Levels, HOMA-IR Levels, and HOMA-<em>beta<\/em> Levels<\/h4>\n<p>Str\u00f3\u017cyk&nbsp;et al analyzed the data from four randomized controlled trials enrolling 241 study participants.&nbsp; In these studies, the selenium supplementation significantly reduced the fasting insulin levels, the HOMA-IR levels, and the HOMA-beta levels [Str\u00f3\u017cyk 2019].<\/p>\n<p><em><strong>Note<\/strong>: <\/em>HOMA-IR and HOMA-<em>beta<\/em> are equations used to assess insulin resistance and pancreatic beta\u2013cell function.<\/p>\n<p>Mahdavi Gorabi et al reviewed 12 articles published between 2004 and 2016.&nbsp; The 12 studies were all randomized, double-blind, placebo-controlled studies.&nbsp; They comprised 757 participants randomly assigned to an intervention group and 684 participants assigned to a control group [Mahdavi Gorabi].<\/p>\n<p>The aggregated data from the 12 studies showed that selenium supplementation resulted in a significant decrease in homeostasis model of assessment-estimated \u03b2-cell function(HOMA-B) and a significant increase in quantitative insulin sensitivity check index (QUICKI) as compared with the controls [Mahdavi Gorabi].<\/p>\n<p>Otherwise, the data showed no statistically significant improvements in glycemic indices such as fasting plasma glucose, insulin, homeostasis model of assessment-estimated insulin resistance (HOMA-IR), Hemoglobin A1c (HbA1c), and adiponectin. The researchers concluded that the meta-analysis indicated that selenium supplementation significantly decreased HOMA-B and increased QUICKI score [Mahdavi Gorabi].<\/p>\n<h4>Summary of Evidence Related to Selenium Supplementation and Type-2 Diabetes Risk<\/h4>\n<ul>\n<li>The relationship between selenium and selenoproteins and type-2 diabetes is undoubtedly complex.&nbsp; The <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/23597503\" target=\"_blank\" rel=\"noopener noreferrer\"><strong><em>mechanism for a possible cause-effect relationship between selenium exposure and type-2 diabetes risk is unknown<\/em><\/strong><\/a> [Rayman 2013].<\/li>\n<li>The scientific evidence is inconsistent and confusing.&nbsp; Observational studies seem to show a link between selenium supplementation and type-2 diabetes [Kim 2019].&nbsp; However, the evidence comes more from observation studies done with selenium-replete Americans than from observational studies done with <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4377864\/\" target=\"_blank\" rel=\"noopener noreferrer\">selenium-poor Europeans<\/a> whose life-style differs from that of Americans [Steinbrenner 2011].<\/li>\n<li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30563119\" target=\"_blank\" rel=\"noopener noreferrer\"><strong><em>Randomized controlled trials, on the whole, do not show any conclusive evidence of such a link<\/em><\/strong><\/a> [Kohler 2018, Jacobs 2019].<\/li>\n<li>Some researchers warn against widespread and indiscriminate use of selenium supplements by the general public [Rayman 2013].&nbsp; It is best to have one\u2019s serum selenium level tested before deciding which dosage to take.&nbsp; The current evidence seems to suggest that there may be a modest increase in the risk of type-2 diabetes with higher levels of selenium in the blood circulation or with selenium supplementation for chemo-prevention [Kohler 2018].<\/li>\n<li>Professor Margaret P. Rayman suggests a <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/23597503\" target=\"_blank\" rel=\"noopener noreferrer\"><strong><em>U-shaped relationship between serum selenium status and disease risk<\/em><\/strong><\/a>.&nbsp; In her depiction, a serum selenium level of 125 micrograms per liter is labeled \u201cadequate.\u201d&nbsp; She does not say how far below and above 125 micrograms\/liter the significantly increased risk of disease begins [Rayman 2019].<\/li>\n<li>A study done in the UK has shown that a daily dietary intake of 55 micrograms of selenium combined with 50 or 100 micrograms in daily selenium supplements increases plasma selenium levels from a baseline of 95.7 micrograms per liter to just below and just above Professor Rayman\u2019s \u201cadequate\u201d level [Hurst 2010]:\n<ul>\n<li>To 118.3 micrograms per liter with a daily selenium supplement of 50 micrograms<\/li>\n<li>To 152.0 micrograms per liter with a daily selenium supplement of 100 micrograms<\/li>\n<\/ul>\n<\/li>\n<li>No studies have been done to distinguish the effects of specific species of selenium on diabetogenic activity.&nbsp; These studies are needed [Vinceti 2018].<\/li>\n<\/ul>\n<h4>Sources<\/h4>\n<p>Hansen AF, Simic A, Asvold BO, Romundstad PR, Midthjell K, SyversenT, Flaten TP. (2017). Trace elements in early phase type 2 diabetes mellitus\u2014a population-based study: the HUNT study in Norway. J Trace Elem MedBiol; 40:46\u201353.<\/p>\n<p>Jacobs ET, Lance P, Mandarino LJ, Ellis NA. (2019). Selenium supplementation and insulin resistance in a randomized, clinical trial. BMJ Open Diabetes Res Care, e000613.<\/p>\n<p>Kim J, Chung HS, Choi M-K, Roh YK, Yoo HJ, Park JH, Kim DS, Yu JM, Moon S. (2019). Association between serum selenium level and the presence of diabetes mellitus: a meta-analysis of observational studies. Diabetes Metab J, 43:e1.<\/p>\n<p>Kohler LN, Foote J, Kelley CP, Florea A, et al. (2018). Selenium and type 2 diabetes: systematic review. Nutrients, 10(12): E1924.<\/p>\n<p>Kohler LN, Florea A, Kelley CP, Chow S, Hsu P, Batai K, Saboda K, Lance P &amp; Jacobs ET. (2018), Higher plasma selenium concentrations are associated with increased odds of prevalent type 2 diabetes. J. Nutr; 148(8): 1333-1340.<\/p>\n<p>Mahdavi Gorabi A, Hasani M, Djalalinia S &amp; Zarei M. (2019). Effect of selenium supplementation on glycemic indices: a meta-analysis of randomized controlled trials; J Diabetes Metab Disord 2019 18 349-362.<\/p>\n<p>Rayman MP, Stranges S. (2013) Epidemiology of selenium and type-2 diabetes: can we make sense of it? Free Radic Biol Med, 65:1557\u20131564.<\/p>\n<p>Rayman MP. (2019). Selenium intake, status, and health: a complex relationship. Hormones (Athens), https:\/\/doi.org\/10.1007\/s42000-019-00125-5.<\/p>\n<p>Simic A, Hansen AF, Asvold BO, Romundstad PR, Midthjell K, SyversenT, Flaten TP. (2017). Trace element status in patients with type 2 diabetes in Norway: the HUNT3 survey. J Trace Elem Med Biol; 41:91\u20138.11.<\/p>\n<p>Steinbrenner H, Speckmann B, Pinto A, Sies H. (2011). High selenium intake and increased diabetes risk: experimental evidence for interplay between selenium and carbohydrate metabolism. J Clin Biochem Nutr, 48: 40-5.<\/p>\n<p>Stranges S, Marshall JR, Natarajan R, Donahue RP, et al. (2007). Effects of long-term selenium supplementation on the incidence of type 2 diabetes: a randomized trial.<br \/>\nAnn Intern Med, 147: 217-23.<\/p>\n<p>Str\u00f3\u017cyk A, Osica Z, Przybylak JD, Ko\u0142odziej M, Zalewski BM, Mrozikiewicz-Rakowska B, Szajewska H. (2019).<br \/>\nEffectiveness and safety of selenium supplementation for type 2 diabetes mellitus in adults: a systematic review of randomised controlled trials. J Hum Nutr Diet; 32(5):635-645.<\/p>\n<p>Vinceti M, Filippini T, Del Giovane C, &amp; Crespi CM. (2018). Selenium for preventing cancer. Cochrane Database Syst Rev. CD005195.<\/p>\n<p>The information presented in this review article is not intended as medical advice and should not be used as such.<\/p>\n<p>16 January 2020<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The findings from a 2018 meta-analysis show no consistent evidence that selenium supplementation plays a role in the development of type 2 diabetes among adults. Researchers at the University of Arizona in Tucson, home of the Arizona Cancer Center, identified a statistically significant direct relationship between selenium and Type-2 diabetes in observational studies but no &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/seleniumfacts.com\/index.php\/selenium-supplementation-and-diabetes-risk\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Selenium Supplementation and Glucose Metabolism&#8221;<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16],"tags":[],"class_list":["post-1489","post","type-post","status-publish","format-standard","hentry","category-diabetes"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Selenium Supplementation and Glucose Metabolism - Seleniumfacts.com<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/seleniumfacts.com\/index.php\/selenium-supplementation-and-diabetes-risk\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Selenium Supplementation and Glucose Metabolism - Seleniumfacts.com\" \/>\n<meta property=\"og:description\" content=\"The findings from a 2018 meta-analysis show no consistent evidence that selenium supplementation plays a role in the development of type 2 diabetes among adults. 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Researchers at the University of Arizona in Tucson, home of the Arizona Cancer Center, identified a statistically significant direct relationship between selenium and Type-2 diabetes in observational studies but no &hellip; Continue reading \"Selenium Supplementation and Glucose Metabolism\"","og_url":"https:\/\/seleniumfacts.com\/index.php\/selenium-supplementation-and-diabetes-risk","og_site_name":"Seleniumfacts.com","article_publisher":"https:\/\/www.facebook.com\/pharmanord7100","article_published_time":"2020-01-16T08:28:25+00:00","article_modified_time":"2020-01-17T06:45:36+00:00","og_image":[{"url":"https:\/\/seleniumfacts.com\/wp-content\/uploads\/2019\/11\/Se_diabetes-300x270.png","type":"","width":"","height":""}],"author":"Richard Morrill","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Richard Morrill","Est. reading time":"8 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/seleniumfacts.com\/index.php\/selenium-supplementation-and-diabetes-risk#article","isPartOf":{"@id":"https:\/\/seleniumfacts.com\/index.php\/selenium-supplementation-and-diabetes-risk"},"author":{"name":"Richard Morrill","@id":"https:\/\/seleniumfacts.com\/#\/schema\/person\/b9ca24a1c31bad550ee4f8f37996fb0a"},"headline":"Selenium Supplementation and Glucose Metabolism","datePublished":"2020-01-16T08:28:25+00:00","dateModified":"2020-01-17T06:45:36+00:00","mainEntityOfPage":{"@id":"https:\/\/seleniumfacts.com\/index.php\/selenium-supplementation-and-diabetes-risk"},"wordCount":1523,"commentCount":0,"image":{"@id":"https:\/\/seleniumfacts.com\/index.php\/selenium-supplementation-and-diabetes-risk#primaryimage"},"thumbnailUrl":"https:\/\/seleniumfacts.com\/wp-content\/uploads\/2019\/11\/Se_diabetes-300x270.png","articleSection":["Diabetes"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/seleniumfacts.com\/index.php\/selenium-supplementation-and-diabetes-risk#respond"]}]},{"@type":"WebPage","@id":"https:\/\/seleniumfacts.com\/index.php\/selenium-supplementation-and-diabetes-risk","url":"https:\/\/seleniumfacts.com\/index.php\/selenium-supplementation-and-diabetes-risk","name":"Selenium Supplementation and Glucose Metabolism - 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