{"id":"f134d56f-d9bb-58ab-8905-28cd6b3f55cf","stable_key":"4d8e4781-3878-5818-8d0a-7dbd6e024555:chromium-parenteral-glucose-1977","predicate":"supplementation_followed_by_improvement_in","statement":"In the 1977 case, intravenous chromium was followed by normalization of the measured glucose-tolerance rate and respiratory quotient after two weeks, with insulin subsequently no longer required.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"context_dependent","is_public":true,"mechanism_event_id":"c794dfc7-2092-55ce-82c8-b10c53420f70","mechanism_event_label":"The patient improved after chromium was added to intravenous nutrition, but a single case cannot establish the general mechanism.","subject":{"id":"1d98d864-31cb-5d4f-a587-2b0eb692faa0","slug":"chromium","display_name":"Chromium","entity_type_key":"nutrient_element"},"object":{"id":"b0fcea7a-0388-5f63-b7bb-38817cd5924f","slug":"glucose-tolerance","display_name":"Glucose tolerance","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"c794dfc7-2092-55ce-82c8-b10c53420f70","stable_key":"4d8e4781-3878-5818-8d0a-7dbd6e024555:chromium-parenteral-glucose-1977-event","event_type":"observed_intervention","label":"The patient improved after chromium was added to intravenous nutrition, but a single case cannot establish the general mechanism.","description":"In the 1977 case, intravenous chromium was followed by normalization of the measured glucose-tolerance rate and respiratory quotient after two weeks, with insulin subsequently no longer required.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"279192ff-cf40-55db-865c-821a44103bb7","slug":"respiratory-quotient","display_name":"Respiratory quotient","entity_type_key":"cellular_process"},"role":"measured_endpoint","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"1d98d864-31cb-5d4f-a587-2b0eb692faa0","slug":"chromium","display_name":"Chromium","entity_type_key":"nutrient_element"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"b0fcea7a-0388-5f63-b7bb-38817cd5924f","slug":"glucose-tolerance","display_name":"Glucose tolerance","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""}]},"contexts":[{"dimension":"availability_state","value_text":"nutrient_deficiency","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null},{"dimension":"evidence_span","value_text":"{\"source_cache\": \"artifacts/chromium-research/192066.abstract.txt\", \"locator\": \"Exact primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"77f1130259582a7565cecbf7bf6d04dd0f54fb6c54ebf8d4498341c48ec3cd8c\", \"start_char\": 0, \"end_char\": 1943, \"text_sha256\": \"77f1130259582a7565cecbf7bf6d04dd0f54fb6c54ebf8d4498341c48ec3cd8c\"}","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Historical long-term parenteral-nutrition case report","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"More than five years of parenteral nutrition; 250 µg chromium/day added for two weeks after impaired glucose tolerance and neuropathy","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Single uncontrolled case with complex nutrition and treatment changes. Historical blood/hair reference ranges are not validated current diagnostic thresholds; response to pharmacological chromium does not by itself prove an essential dietary requirement.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Chromium research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"chromium","display_name":"Chromium","entity_type_key":"nutrient_element"}},{"dimension":"organism","value_text":"Human adult patient","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"The patient improved after chromium was added to intravenous nutrition, but a single case cannot establish the general mechanism.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[chromium-p192066] Chromium deficiency, glucose intolerance, and neuropathy reversed by chromium supplementation, in a patient receiving long-term total parenteral nutrition. (1977). https://pubmed.ncbi.nlm.nih.gov/192066/ DOI: 10.1093/ajcn/30.4.531","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Systemic glucose utilization and peripheral nerves","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"trigger_kind","value_text":"nutrient_deficiency","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null}],"evidence":[{"id":"824d8c20-fecd-520b-a955-cb6d603c25f7","evidence_kind":"source_excerpt","locator":"Lines 887-898","start_line":887,"end_line":898,"excerpt":"### chromium-parenteral-glucose-1977\nIn the 1977 case, intravenous chromium was followed by normalization of the measured glucose-tolerance rate and respiratory quotient after two weeks, with insulin subsequently no longer required.\nCondition category: nutrient_deficiency\nnutrient_topic: Chromium research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: The patient improved after chromium was added to intravenous nutrition, but a single case cannot establish the general mechanism.\norganism: Human adult patient\ntissue_or_cell_type: Systemic glucose utilization and peripheral nerves\nexperimental_model: Historical long-term parenteral-nutrition case report\nlimitations: Single uncontrolled case with complex nutrition and treatment changes. Historical blood/hair reference ranges are not validated current diagnostic thresholds; response to pharmacological chromium does not by itself prove an essential dietary requirement.\nexposure: More than five years of parenteral nutrition; 250 µg chromium/day added for two weeks after impaired glucose tolerance and neuropathy\nevidence_span: {\"source_cache\": \"artifacts/chromium-research/192066.abstract.txt\", \"locator\": \"Exact primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"77f1130259582a7565cecbf7bf6d04dd0f54fb6c54ebf8d4498341c48ec3cd8c\", \"start_char\": 0, \"end_char\": 1943, \"text_sha256\": \"77f1130259582a7565cecbf7bf6d04dd0f54fb6c54ebf8d4498341c48ec3cd8c\"}\n[chromium-p192066] Chromium deficiency, glucose intolerance, and neuropathy reversed by chromium supplementation, in a patient receiving long-term total parenteral nutrition. 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