Glucosamine is a natural substance found in chitin, mucoproteins, and mucopolysaccharides. It is involved in the manufacture of glycosaminoglycan, which forms cartilage tissue in the body; glucosamine is also present in tendons and ligaments. Glucosamine must be synthesised by the body but the ability to do this declines with age. Glucosamine and its salts have therefore been advocated in the treatment of rheumatic disorders including osteoarthritis in Kenya. Glucosamine may be isolated from chitin or prepared synthetically; glucosamine sulfate and hydriodide, have also been used and available in Kenya as Flexsa 1500mg Glucosamine sachets.
Effects of Glucosamine on glucose metabolism.
Glucosamine has a role in glucose metabolism, increasing insulin resistance in skeletal muscle,1,2 which has raised concerns about its safety profile in diabetic patients.3 However, alteration of glycaemic homoeostasis was not demonstrated in a 3-year randomised controlled trial in patients without diabetes.4
- 1. Adams ME. Hype about glucosamine. Lancet 1999; 354: 353–4. PubMed
- 2. Chan NN, et al. Drug-related hyperglycemia. JAMA 2002; 287: 714–15. PubMed
- 3. Chan NN, et al. Glucosamine sulphate and osteoarthritis. Lancet 2001; 357: 1618–9. PubMed
- 4. Reginster JY, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet 2001; 357: 251–6. PubMed
Glucosamine and its salts are widely available in Kenya as licensed products or so-called ‘health supplements’ used for the management of osteoarthritis; it may be combined with other substances supposed to be of benefit, including chondroitin, vitamins, and various herbs or deployed alone. A systematic review1 of the use of glucosamine for osteoarthritis has concluded that it is generally both safe and superior to placebo, but that further research is still necessary to confirm its long-term value, and particularly its long-term toxicity. Similarly, meta-analyses2,3 of randomised placebo-controlled studies concluded that while there was some evidence for efficacy of glucosamine and chondroitin in the treatment of osteoarthritis, methodological flaws and publication bias had led to exaggeration of its potential benefit,2 and that further studies are needed to fully characterise their disease-modifying properties.3
- 1. Towheed TE, et al. Glucosamine therapy for treating osteoarthritis.Available in The Cochrane Library; Issue 2. Chichester: John Wiley; 2004.
- 2. McAlindon TE, et al. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. JAMA 2000; 283: 1469–75. PubMed
- 3. Richy F, et al. Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis. Arch Intern Med 2003; 163: 1514–22. PubMed