Almass F Hassan¹*, Maged S Khattab¹, Abdelrauof M El Deib², Hind M Salama¹, Mohamed A Mohamed¹, Hassan A Shora⁴ and Ismail Dahshan¹

¹Family Medicine Department, Faculty of Medicine, Suez Canal University, Egypt

*Corresponding Author: Hassan A Shora, Senior Research Scientist, Head of Medicine & Diabetes Center, Port-Said University & Ismailia Medical Complex, Egypt, E-mail: hassanshora56@gmail.com.

Received: December 06, 2021; Published: December 20, 2021

Abstract

Objective: Type 2 diabetes mellitus is one of the world’s most prevalent and fatal diseases. Zinc is involved in metabolism of glucose via its participation in insulin crystallization and signaling. This study aimed to evaluate the effect of zinc supplementation on glycemic control in type 2 diabetic patients.

Materials and Methods: The participants consisted of 200 type 2 diabetic patients attending the family medicine outpatient clinics in Suez Canal University who were randomly assigned into two groups, intervention, and control group. The study was approved by Ethics Committee of Suez canal University and all participant’ consent was assured. This study was carried out between April 2019 and June 2019. The intervention group received oral capsule of zinc sulphate (25 mg) daily, the second control group was given placebo, identical for 12 weeks. outcome measures consisted mainly of Glycated haemoglobin (HbA1c %) that was assessed at baseline and after 12 weeks. Follow up visits were conducted at the 4^th, 8^th and 12^th week from beginning of the study to check adherence to treatment every visit by interview and pill counts.

Results: Glycated haemoglobin (HbA1c %) was significantly reduced in zinc group compared to placebo group (p = 0.008).

Conclusion: Zinc supplementation addition to routine management of adult type 2 diabetics on oral hypoglcemics only may improve glycemic control in this short single blinded randomized controlled trial.

Keywords: Type 2 Diabetes; Zinc Supplementation; Glycemic Control; Randomized Controlled Trial

References

1. Zaccardi F., et al. “Pathophysiology of type 1 and type 2 diabetes mellitus: a 90-year perspective”. Postgraduate Medical Journal1084 (2016): 63-69.
2. International Diabetes Federation. “IDF Diabetes Atlas, 8^th ed”. Brussels, Belgium: International Diabetes Federation (2017).
3. International Diabetes Federation. “IDF Diabetes Atlas. 6^th ed” (2013).
4. Jansen J., et al. “Zinc and diabetes--clinical links and molecular mechanisms”. Journal of Nutritional Biochemistry 6 (2009): 399-417.
5. Fukunaka A and Fujitani Y. “Role of Zinc Homeostasis in the Pathogenesis of Diabetes and Obesity”. International Journal of Molecular Sciences 2 (2018): 476.
6. Sladek R., et al. “A genome-wide association study identifies novel risk loci for type 2 diabetes”. Nature 445 (2007): 881-885.
7. Perez A., et al. “Association between zinc nutritional status and glycemic control in individuals with well-controlled type-2 diabetes”. Journal of Trace Elements in Medicine and Biology 50 (2018): 560-565.
8. Sakpal TV. “Sample size estimation in clinical trial”. Perspectives in Clinical Research 2 (2010): 67-69.
9. Parham M., et al. “Effect of zinc supplementation on microalbuminuria in patients with type 2 diabetes: a double blind, randomized, placebo-controlled, cross-over trial”. Review of Diabetic Studies 2 (2008): 102-109.
10. Afkhami-Ardekani M., et al. “Effect of zinc sulfate supplementation on lipid and glucose in type 2 diabetic patients”. Pakistan Journal of Nutrition4 (2008): 550-553.
11. Khan MI., et al. “Effect of high-dose zinc supplementation with oral hypoglycemic agents on glycemic control and inflammation in type-2 diabetic nephropathy patients”. Journal of Natural Science, Biology, and Medicine 2 (2013): 336-340.
12. Al-Maroof RA and Al-Sharbatti SS. “Serum zinc levels in diabetic patients and effect of zinc supplementation on glycemic control of type 2 diabetics”. Saudi Medical Journal3 (2006): 344-350.
13. Jayawardena R., et al. “Effects of zinc supplementation on diabetes mellitus: a systematic review and meta-analysis”. Diabetology and Metabolic Syndrome1 (2012): 13.
14. Yoshikawa Y., et al. “Insulinomimetic bis (maltolato) zinc (II) complex: blood glucose normalizing effect in KK-A (y) mice with type 2 diabetes mellitus”. Biochemical and Biophysical Research Communications 281 (2001): 1190-1193.
15. Haase H and Maret W. “Protein tyrosine phosphatases as targets of the combined insulinomimetic effects of zinc and oxidants”. Biometals 4 (2005): 333-338.
16. Tang X and Shay NF. “Zinc has an insulin-like effect on glucose transport mediated by phosphoinositol-3-kinase and Akt in 3T3-L1 fibroblasts and adipocytes”. Journal of Nutrition5 (2001): 1414-1420.
17. El-Ashmony SM., et al. “Effect of zinc supplementation on Glycemic control, lipid profile and renal functions in patients with type 2 diabetics: a single blinded, randomized, placebo-controlled trial”. Journal of Biology, Agriculture and Healthcare 2 (2012): 33-41.
18. Oh HM and Yoon JS. “Glycemic control of type 2 diabetic patients after short-term zinc supplementation”. Nutrition Research and Practice 4 (2008): 283-288.
19. Roussel AM., et al. “Antioxidant effects of zinc supplementation in Tunisians with type 2 diabetes mellitus”. Journal of the American College of Nutrition 4 (2003): 316-321.
20. Pérez A., et al. “Zinc Supplementation Does Not Affect Glucagon Response to Intravenous Glucose and Insulin Infusion in Patients with Well-Controlled Type 2 Diabetes”. Biological Trace Element Research 2 (2018): 255-261.
21. Norouzi S., et al. “Zinc stimulates glucose oxidation and glycemic control by modulating the insulin signaling pathway in human and mouse skeletal muscle cell lines”. PLoS ONE1 (2018): e0191727.

Citation

Citation: Almass Hassan, Maged Khattab, Abdelrauof El Deib, Hind Salama, Mohamed Mohamed Hassan Shora and Ismail Dahshan. “Impact of Oral Zinc Supplementation on Glycemic Control in Type 2 Diabetic Patients: Single-blinded Randomized Controlled Trial". Acta Scientific Medical Sciences 6.1 (2022): 217-225.

Copyright

Copyright: © 2022 Almass Hassan, Maged Khattab, Abdelrauof El Deib, Hind Salama, Mohamed Mohamed Hassan Shora and Ismail Dahshan. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.