EVALUATION OF ZINC STATUS AMONG PATIENTS WITH DIABETES MELLITUS

Abstract

Background and objectives A general observation in diabetes, type 1 as well as type 2 is hypozincemia which may be the result of increased urinary excretion or decreased gastrointestinal absorption of zinc or both. The resulting decrease in total body zinc maycontribute to diabetic complications. Hence, the present study was conducted to evaluate zinc status for diabetic patients, in an effort to identify diabetic group for whom zinc supplementation may be concern. The objective was to assess zinc status among randomlyselected diabetic patients of Duhok city.Methods Collection of data was carried out during the period from September 2009 to June 2010 at the Duhok Diabetes Center in Duhok Governorate/Kurdistan region/ Iraq. In the first part of the study (cross sectional study), a total of 362 subjects were involved. Among these, 206 were diabetic patients (type 1 DM, n=48; Type 2 DM, n=158) and the remainders were 156 apparently healthy subjects. In the second part of the study (intervention study), twenty eight type 2 diabetic patients were selected according to selection criteria and were supplemented with 40 mg elemental zinc as zinc gluconate per day for 3 months, from those 23 completed the trial. General information for each subject was obtained by questionnaire designed for the study. Fasting serum glucose (FSG), lipid profile, glycoselated hemoglobin (HbA1c) and serum zinc were measured for each subject.Results The prevalence of hypozincemia was 33.0% for the 362 individuals included in the study. The prevalence was significantly higher in diabetic patients than healthy controls (43.7% vs 19.9%, P<0.01). To evaluate changes of zinc levels, relating for someepidemiological variables. However, no statistically significant effect was found using a P value of 0.05; for sex, BMI, central obesity, physical activity, family history of diabetes mellitus, type of diabetes, and duration of diabetes mellitus. But, the mean serum zinc level was significantly lower (P<0.01) for elderly diabetic subjects compared with adults and children. The mean serum zinc level for low social status (based on crowding index) patientswas significantly lower (P<0.01), compared to the high social status patients. Significant difference was also noticed in mean ± SD values for serum zinc of good glycemic control and poor glycemic control of diabetics (p<0.01). The second part of the study showed that the mean value of serum triglycerides of the supplemented group decreased at the end of 90 days by 7.3%, whereas the mean values of serum zinc increased by 51.8%. In addition the mean values of serum glucose and HbA1c% of the supplemented group decreased by 6.6% and5.9% respectively.Conclusions Marginal zinc deficiencies were observed in the individuals studied with a higher prevalence in diabetic group. The measured zinc status is associated with the glycemic control of diabetes.