Carnosine is a naturally present dipeptide in humans and over-the counter available food additive. It has been shown to suppress many biochemical processes that accompany aging and age-related chronic diseases (processes such as chronic low-grade inflammation (CLI), advanced glycation (AGEs), protein cross-linking and oxidative stress). There are more than 2000 published in vitro and animal studies on carnosine, and more than 200 of these concern carnosine, diabetes and cardiovascular disease. Specifically, there is evidence from animal studies that carnosine supplementation reduces, in a dose-dependent manner, weight, glucose, HbA1c, lipid levels, lipid peroxidation, atherosclerotic plaque instability, and blood pressure; and it increases insulin sensitivity and secretion, along with β-cell mass and prevents diabetes in db/db mice. There have been no human intervention trials using carnosine supplementation to target both diabetes and cardiovascular risk factors and explore underlying mechanisms such as CLI, AGEs and oxidative stress.

We have provided first evidence that carnosine is related to adiposity and insulin resistance in humans. In addition, we conducted a pilot RCT investigating if carnosine supplementation can reduce diabetes and cardiovascular risk in individuals at high risk of type 2 diabetes.

Our data supports extensive animal data and suggests a role of carnosine supplementation in prevention of type 2 diabetes and cardiovascular disease. Large-scale intervention studies targeting obesity, insulin resistance andcardiovascular risk factors in individuals at risk of and with diabetes are necessary to establish the role of carnosine and the underpinning mechanisms of action in prevention and management of type 2 diabetes and cardiovascular disease.