Chromium is an essential nutrient involved in the metabolism of glucose, insulin and blood lipids. Suboptimal dietary intake of chromium is associated with increased risk factors associated with diabetes and cardiovascular diseases. Within the past five years, chromium has been shown to improve glucose and related variables in subjects with glucose intolerance and type 1, type 2, gestational and steroid-induced diabetes. Severe neuropathy and glucose intolerance of a patient on total parenteral nutrition, who was receiving currently recommended levels of chromium, were reversed by additional supplemental chromium. Chromium increases insulin binding to cells, insulin receptor number and activates insulin receptor kinase leading to increased insulin sensitivity. Additional studies are urgently needed to elucidate the mechanism of action of chromium and its role in the prevention and control of diabetes.