Nutr Res Pract.  2008 Dec;2(4):283-288. 10.4162/nrp.2008.2.4.283.

Glycemic control of type 2 diabetic patients after short-term zinc supplementation

• Oh HM
• Yoon JS

• KMID: 2139204
• DOI: http://doi.org/10.4162/nrp.2008.2.4.283

Abstract

This study was carried out to determine whether a short-term zinc supplementation contributes to beneficial changes in glycemic control among type 2 diabetic patients. Seventy-six diabetic subjects and 72 normal adults participated in this study. Subjects were divided into supplemented and control groups. Forty-four diabetic patients and 34 normal subjects were supplemented with 50 mg zinc daily as zinc gluconate for 4 weeks. Zinc status was assessed from fasting plasma levels and urinary excretion. The effects of zinc supplementation on fasting blood glucose, HbA1c, insulin, and C-peptide were measured at the beginning of the study and after 4 weeks of supplementation. The changes in glycemic control indicators were compared between diabetic groups, classified by baseline HbA1c levels, and by diabetic duration. At baseline, the incidence of marginal zinc deficiency in the diabetic group, as determined by plasma zinc level, was approximately twice as high as in the normal adult group. The changes of HbA1c concentration, and fasting blood glucose following supplementation were not statistically significant in diabetic subjects. In normal subjects, a significant decrease of HbA1c occurred only in the zinc supplemented group. No significant changes were observed for serum insulin and C-peptide in diabetic as well as normal subjects. However, when the changes were compared by baseline HbA1c level, we found that diabetic subjects with HbA1c > or = 7.5% showed significantly improved levels of HbA1c and fasting glucose after Zn supplementation. While such improvement in fasting blood glucose was significant among diabetics with shorter diabetic duration, significant levels of increase in serum insulin and C-peptide were observed in zinc supplemented subjects with longer diabetic duration. Fasting blood glucose was significantly decreased, whereas serum insulin and C-peptide were increased in diabetics with marginal zinc status. Therefore, we suggest that Zn supplementation for a short-term period may improve glycemic control in diabetic patients with higher HbA1c levels and marginal zinc status.

Keyword

Diabetes; zinc supplementation; diabetic duration; glycemic control

MeSH Terms

Adult
Blood Glucose
C-Peptide
Fasting
Gluconates
Glucose
Humans
Incidence
Insulin
Plasma
Zinc
Blood Glucose
C-Peptide
Gluconates
Glucose
Insulin
Zinc

Reference

1. Anderson RA, Roussel AM, Zouari N, Mahjoub S, Matheau JM, Kerkeni A. Potential antioxidant effects of zinc and chromium supplementation in people with type 2 diabetes mellitus. J Am Coll Nutr. 2001. 20:212–218.

2. Al-Maroof RA, Al-Sharbatti SS. Serum zinc levels in diabetic patients and effect of zinc supplementation on glycemic control of type 2 diabetics. Saudi Med J. 2006. 27:344–350.

3. Bonham M, O'Connor JM, Alexander HD, Coulter J, Walsh PM, McAnena LB, Downes CS, Hannigan BM, Strain JJ. Zinc supplementation has no effect on circulating levels of peripheral blood leucocytes and lymphocyte subsets in healthy adult men. Br J Nutr. 2003. 89:695–703.

4. Chandra RK. Excessive intake of zinc impairs immune responses. J Am Med Assoc. 1984. 252:1443–1446.

5. Chausmer AB. Zinc, Insulin and Diabetes. J Am Coll Nutr. 1998. 17:109–115.

6. Chen MD, Liou SJ, Lin PY, Yang VC, Alexander PS, Lin WH. Effect of zinc supplementation on the plasma glucose level and insulin activity in genetically obese (ob/ob) mice. Biol Trace Elem Res. 1998. 61:303–311.

7. Cunningham JJ, Fu A, Mearkle PL, Brown RG. Hyperzincuria in individuals with insulin-dependent diabetes mellitus : concurrent zinc status and the effect of high-dose zinc supplementation. Metabolism. 1994. 43:1558–1562.

8. de Sena KC, Arrais RF, das Graças Almeida M, de Araújo DM, dos Santos MM, de Lima VT, de Fãtima Campos Pedrosa L. Effects of zinc supplementation in patients with type 1 diabetes. Biol Trace Elem Res. 2005. 105:1–9.

9. Faure P, Benhamou PY, Perard A, Halimi S, Roussel AM. Lipid peroxidation in insulin-dependent diabetic patients with early retina degenerative lesions: effects of an oral zinc supplementation. Eur J Clin Nutr. 1995. 49:282–288.

10. Franz MJ, Bantle JP, Beebe CA, Brunzell JD, Chiasson JL, Garg A, Holzmeister LA, Hoogwerf B, Mayer-Davis E, Mooradian AD, Purnell JQ, Wheeler M. Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care. 2003. 26:S51–S61.

11. Golik A, Cohen N, Ramot Y, Maor J, Moses R, Weissgarten J, Leonov Y, Modai D. Type II diabetes mellitus, congestive heart failure, and zinc metabolism. Biol Trace Elem Res. 1993. 39:171–175.

12. Heise CC, King JC, Costa FM, Kitzmiller JL. Hyperzincuria in IDDM women : Relationship to measure of glycemic control, renal function, and tissue catabolism. Diabetes care. 1988. 11:780–786.

13. Kazi TG, Afridi HI, Kazi N, Jamali MK, Arain MB, Jalbani N, Kandhro GA. Copper, chromium, manganese, iron, nickel, and zinc levels in biological samples of diabetes mellitus patients. Biol Trace Elem Res. 2008. 122:1–18.

14. Keen CL, Gershwin ME. Zinc deficiency and immune function. Annu Rev Nutr. 1990. 10:415–431.

15. Kim YI, Choi CS, Kim SW, Lee JS, Kim HH, Lee MS, Lee SI, Park JY, Hong SK, Lee KU. Prevalence of Diabetes Mellitus and impaired glucose tolerance in Korean adults living in Jungup District, South Korea. J Kor Diabetic Associ. 1998. 22:363–371.

16. Kinlaw WB, Levine AS, Morley JE, Silivis SE, McClain CJ. Abnormal zinc metabolism in type II diabetes mellitus. Am J Med. 1983. 75:273–277.

17. King JC, Keen CL. Shils ME, Olson JA, Shike M, editors. Zinc. Modern nutrition in health and disease. 1994. 8th ed. Malvern. UK: Lea & Febiger;214–230.

18. Lee JH, Lee HJ, Lee IK, Yoon JS. Zinc and copper status of middle- and old-aged woman in type 2 diabetes. The Korean Journal of Nutrition. 2005. 38:56–66.

19. Levine AS, McClain CJ, Handwerger BS, Brown DM, Morley JE. Tissue zinc status of genetically diabetic and streptozotocin-induced diabetic mice. Am J Clin Nutr. 1983. 37:382–386.

20. Marchesini G, Bugianesi E, Ronchi M, Flamia R, Thomaseth K, Pacini G. Zinc supplementation improves glucose disposal in patients with cirrhosis. Metabolism. 1998. 47:792–798.

21. Ministry of Health & Welfare. Report on 2005 National health and nutritional survey. 2006. Seoul, Korea:

22. Niewoehner CB, Allen JI, Boosalis M, Levine AS, Morley JE. Role of zinc supplementation in type II diabetes mellitus. Am J Med. 1986. 81:63–68.

23. Palumbo PJ. Glycemic control, mealtime glucose excursions, and diabetic complications in type 2 diabetes mellitus. Mayo Clin Proc. 2001. 76:608–618.

24. Rink L, Kirchner H. Zinc-altered immune function and cytokine production. J Nutr. 2000. 130:1407s–1411s.

25. Rho SN, Ko HS. A clinical properties on nutrients intake and serum concentration of diabetic subjects by duration in Ansung Kyunggi-do. The Korean Journal of Nutrition. 1997. 30:1203–1210.

26. Roussel AM, Kerkeni A, Zouari N, Mahjoub S, Matheau JM, Anderson RA. Antioxidant effects of zinc supplementation in Tunisians with type 2 diabetes mellitus. J Am Coll Nutr. 2003. 22:316–321.

27. Roth H, Kirchgessner M. Zinc and insulin metabolism. Biol Trace Elem Res. 1981. 3:13–32.

28. Salgueiro MJ, Krebs N, Zubillaga MB, Weill R, Postaire E, Lysionek AE, Caro RA, Paoli TD, Hager A, Boccio J. Zinc and Diabetes Mellitus. Is there a need of zinc supplementation in diabetes mellitus patients? Biol Trace Elem Res. 2001. 81:215–228.

29. Simon SF, Taylor CG. Dietary zinc supplementation attenuates hyperglycemia in db/db mice. Exp Biol Med. 2001. 226:43–51.

30. Walter RM, Uriu-Hare JY, Olin KL, Oster MH, Anawalt BD, Critchfield JW, Keen CL. Copper, zinc, manganese, and magnesium status and complications of diabetes mellitus. Diabetes Care. 1991. 14:1050–1056.

31. Yoon JS. Zinc status and dietary quality of type 2 diabetic patients: implication of physical activity levels. Nutrition Research and Practice. 2008. 2:41–45.

32. Yoon JS, Lee JH. A suggestion to improve zinc status of type 2 diabetic women: relation among zinc, protein and phytate intake. Journal of Korean Dietetic Association. 2007. 13:301–310.