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Title: Influence of Dietary Zinc Supplement in Combination with Different Anti-Diabetic Drugs on the Control of type II Diabetes Mellitus
Authors: Gul, Zeba
Keywords: Biological & Medical Sciences
Issue Date: 2018
Publisher: Hazara University, Mansehra
Abstract: Diabetes is a cluster of metabolic disorders with diverse etiologies, and mainly characterized by chronic hyperglycemia and impairment of carbohydrate, fat, and protein metabolism as a result of insufficient insulin production by the pancreas or lack of body response to insulin or both simultaneously. Among several reasons, hypozincemia accompanied by hyperzincuria in diabetes is an established fact. Molecular and cellular studies affirm that the mineral zinc plays a significant part in insulin biosynthesis and works under normal physiological conditions. Therefore, this study was designed to determine the effects of zinc in combination with the oral hypoglycemic in diabetic patients of different ethnic groups, with varying age group and diabetes duration. 15 This study was conducted between April 2015 ̶ July 2015. Initially 211 Type II diabetic patients were screened in the Jinnah Postgraduate Medical Center. 150 diabetic patients were included in this study. These patients were further grouped as intervention and control. Patients in the intervention group were supplemented with zinc sulfate 20 mg/day plus oral hypoglycemic, while the control group was supplemented with placebo plus oral hypoglycemic for three months. At first visit and at the end of 3 rdmonth blood samples from all patients were taken for analysis of serum zinc, serum insulin, HbA1c%, fasting blood glucose (FBG), serum creatinine (SC), and total cholesterol (TC). Overall 32.67, 31.68, 35.64% Patthan, Punjabi, and Urdu speaking, (of which 48.5% male and 51.5% female) respectively, completed this study. The parameters studied were serum zinc, serum insulin, HbA1c%, fasting blood glucose, serum creatinine, total cholesterol, body mass index, systolic/diastolic blood pressure, and HOMA parameters. Serum zinc improved in a pattern of 38.2, 37.4 and 34.6 mg/dL in Patthan, Punjabi, and Urdu speaking groups, (p<0.001), respectively. In the zinc supplemented group, mean serum insulin level for males was increased from 7.7 to 8.8 µIU/mL (p<0.01), while in females it was increased from 7.6 to 8.6 µIU/mL (p<0.01) respectively. Control group depicts no such change in serum insulin level. Among ethnic groups (Patthan, Punjabi, and Urdu speaking) mean serum insulin was 10.8, 7.9 and 7.4µIU/mL (p<0.01) at the end of the study. Different duration of diabetes (0-2, 3-5, 6-10, and ˃10 years) revealed an overall increase in mean serum insulin level in zinc supplemented groups as 7.7, 9.1, 9.8, and 8.3µIU/mL (p<0.01). Similarly, mean serum insulin in control groups in different ethnicities was improved 0.2 µIU/mL in Patthan, 0.1 µIU/mL, Punjabi while Urdu speaking did not show any change. After zinc supplementation, HbA1c % was reduced from 8.8 ±1.7 to 8.1 ± 1.7 in the zinc supplemented group as compared to 16 control group. Fasting blood glucose after three month zinc supplementation was significantly (p<0.001) reduced in Patthan followed by Urdu speaking and Punjabi group likewise. In Patthan, Urdu speaking and Punjabi females fasting blood glucose was attenuated significantly (p<0.001) up to 27.33, and 23.30 mg/dL (p<0.001), (p<0.001) to 17.22 ± 7.95 mg/dL simultaneously. The mean reduced systolic/diastolic blood pressure was 8.3/7.4, 10.4/6.3 mmHg in male and female (p<0.01). Ethnic groups reduced systolic/diastolic blood pressure was 9.2/6.3, 10/7.6, 9/6.5 mmHg in Patthan, Punjabi, and Urdu speaking (p<0.01), (p<0.01).Total cholesterol was reduced from 5.9 to5.2 mmol/L (p<0.01) in both male and female. Similarly, ethnic groups attenuation in TC was by an average 0.8 mmol/L (p<0.01) in Patthan, and Urdu speaking groups, while 0.7 mmol/L (p<0.01) in the Punjabi ethnic group. No significant change was observed in serum creatinine level in all ethnic groups. Reduction in homeostasis model assessment of insulin resistance (HOMA-IR), was greater among Patthan followed by Urdu speaking and then Punjabi with the significance of (p<0.0010), (p<0.0001) and (p<0.0129), respectively. HOMA-β was improved 3.31 (p<0.0049) in Patthan, 3.1 (p<0.0142) in Urdu speaking, and 3.78 (p<0.0231) in Punjabi, ethnic group. This study indicates, that significant improvement in serum zinc, serum insulin, fasting blood glucose, HbA1c%, and total cholesterol levels in zinc supplemented diabetic patients were achieved. However, further investigations are required for exploring a precise relationship between zinc supplementation and glycemic control.
Gov't Doc #: 23670
Appears in Collections:PhD Thesis of All Public / Private Sector Universities / DAIs.

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