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Originally published on July 9, 2007.
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ARTICLE

Effects of Long-Term Selenium Supplementation on the Incidence of Type 2 Diabetes

A Randomized Trial

right arrow Saverio Stranges, MD, PhD; James R. Marshall, PhD; Raj Natarajan, MS; Richard P. Donahue, PhD; Maurizio Trevisan, MD; Gerald F. Combs, PhD; Francesco P. Cappuccio, MD; Antonio Ceriello, MD; and Mary E. Reid, PhD

21 August 2007 | Volume 147 Issue 4 | Pages 217-223

Background: Findings from animal models suggest that selenium supplementation improves glucose metabolism.

Objective: To examine the effect of long-term selenium supplementation on the incidence of type 2 diabetes.

Design: Secondary analysis of a randomized, double-blind, placebo-controlled trial.

Setting: Areas of low selenium consumption of the eastern United States.

Patients: 1202 persons seen in dermatology clinics who did not have type 2 diabetes at baseline.

Intervention: Oral administration of selenium, 200 µg/d, or placebo.

Measurements: Incidence of type 2 diabetes.

Results: During an average follow-up of 7.7 years (SD, 2.7), type 2 diabetes developed in 58 selenium recipients and 39 placebo recipients (incidence, 12.6 cases per 1000 person-years vs. 8.4 cases per 1000 person-years, respectively; hazard ratio, 1.55 [95% CI, 1.03 to 2.33]). The lack of benefit of selenium supplementation on the incidence of type 2 diabetes persisted in analyses stratified by age, sex, body mass index, and smoking status. An exposure–response gradient was found across tertiles of baseline plasma selenium level, with a statistically significantly increased risk for type 2 diabetes in the highest tertile of baseline plasma selenium level (hazard ratio, 2.70 [CI, 1.30 to 5.61]).

Limitations: Diabetes was a secondary outcome in the parent trial. Diagnoses of diabetes were self-reported but were validated in most participants. The sample was mostly older and white.

Conclusions: Selenium supplementation does not seem to prevent type 2 diabetes, and it may increase risk for the disease.

Click here for related information on selenium.


Editors' Notes
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Context

  • Research suggests that selenium supplements may improve glucose metabolism.

Contribution

  • The investigators examined the incidence of type 2 diabetes among participants in a clinical trial designed to assess the effects of selenium supplementation on skin cancer. Participants randomly assigned to receive selenium were more likely to develop type 2 diabetes than were those assigned to placebo.

Cautions

  • Diabetes was a secondary outcome of the original trial. The diagnosis was self-reported, and most participants were older and white.

Implication

  • Long-term selenium supplementation appears to increase the risk for type 2 diabetes.

—The Editors

 

Author and Article Information
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From the State University of New York at Buffalo and Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, New York; Clinical Sciences Research Institute, Warwick Medical School, Coventry, United Kingdom; and U.S. Department of Agriculture Human Nutrition Research Center, Grand Forks, North Dakota.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Saverio Stranges, MD, PhD, Clinical Sciences Research Institute, Warwick Medical School, University Hospital Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, United Kingdom; e-mail, s.stranges{at}warwick.ac.uk.

Current Author Addresses: Drs. Stranges, Cappuccio, and Ceriello: Clinical Sciences Research Institute, Warwick Medical School, University Hospital Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, United Kingdom.

Drs. Marshall and Reid and Mr. Natarajan: Roswell Park Cancer Institute, Carlton House Building, Elm and Carlton Streets, Buffalo, NY 14263.

Drs. Donahue and Trevisan: Department of Social and Preventive Medicine, State University of New York at Buffalo, South Campus, 3435 Main Street, Farber Hall, Buffalo, NY 14214.

Dr. Combs: Human Nutrition Research Center, U.S. Department of Agriculture, 2420 Second Avenue North, Stop 9034, Grand Forks, ND 58202.

Author Contributions: Analysis and interpretation of the data: S. Stranges, R. Natarajan, R.P. Donahue, M. Trevisan, G.F. Combs, F.P. Cappuccio.

Drafting of the article: S. Stranges, R.P. Donahue, M. Trevisan.

Critical revision of the article for important intellectual content: S. Stranges, R.P. Donahue, M. Trevisan, G.F. Combs, F.P. Cappuccio.

Final approval of the article: S. Stranges, M. Trevisan, F.P. Cappuccio.

Statistical expertise: R. Natarajan, M. Trevisan.

Administrative, technical, or logistic support: G.F. Combs, F.P. Cappuccio.

Collection and assembly of data: G.F. Combs.


Related articles in Annals:

Editorials
Selenium and Diabetes: More Bad News for Supplements
Joachim Bleys, Ana Navas-Acien, AND Eliseo Guallar
Annals 2007 147: 271-272. [Full Text]  

Summaries for Patients
Long-Term Use of Selenium Supplements and Risk for Type 2 Diabetes
Annals 2007 147: I-14. [Full Text]  



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BMI and selenium confounding?
David Sokal
Annals Online, 10 Jul 2007 [Full text]
This may be due to excessive testosterone...
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Annals Online, 10 Jul 2007 [Full text]
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