A comprehensive review of oral glucosamine use and effects on glucose metabolism in normal and diabetic individuals

Glucosamine (GlcN) is a widely utilized dietary supplement that is used to promote joint health. Reports that oral GlcN supplementation at usual doses adversely affects glucose metabolism in subjects with impaired glucose tolerance have raised concerns that GlcN should be contraindicated in individuals with diabetes and those at risk for developing it. This review addresses its potential, when used at typical doses, to affect glucose metabolism and insulin sensitivity in healthy individuals and those with diabetes or ‘pre-diabetes’. Publicly available scientific information and data on GlcN were systematically compiled using the electronic search tool, Dialog®, and reviewed with special emphasis on human studies. In long-term clinical trials, including those containing subjects with type 2 diabetes or ‘pre-diabetes’, GlcN produced a non-significant lowering of fasting blood glucose concentrations in all groups of subjects treated for periods of up to 3 years. Owing to limitations in study design, conclusions based on studies that report adverse affects of GlcN on insulin sensitivity and glucose tolerance in pre-diabetic subjects are suspect. However, no definitive long-term studies of GlcN use for individuals with pre-diabetes are available. Nevertheless, based on available evidence, we conclude that GlcN has no effect on fasting blood glucose levels, glucose metabolism, or insulin sensitivity at any oral dose level in healthy subjects, individuals with diabetes, or those with impaired glucose tolerance

Nonprescription medication use by infants and children: Product labeling versus evidence-based medicine

Nonprescription or over-the-counter (OTC) medication use has been an increasing market over the past years. In addition to adult use of these medications, children also account for this trend. Although relatively safe when used according to package labeling and professional direction, serious adverse drug events and toxicity associated withOTC use among infants and children are becoming more common. The purpose of this review is to help the health care practitioner select and counsel on pediatric OTC products based on labeling and efficacy data in 3 main areas: cough and cold, analgesics, and treatment of gastroenteritis. © 2006 Sage Publications