Serum zinc levels in diabetic patients and effect of zinc supplementation on glycemic control of type 2 diabetics. Disturbed zinc homeostasis in diabetic patients by in vitro and in vivo analysis of insulinomimetic activity of zinc. Zinc supplementation for improving glucose handling in pre-diabetes: A double blind randomized placebo controlled pilot study. Effects of zinc and multimineral vitamin supplementation on glycemic and lipid control in adult diabetes Potential Antioxidant Effects of Zinc and Chromium Supplementation in People with Type 2 Diabetes Mellitus Inflammation markers predict zinc transporter gene expression in women with type 2 diabetes mellitus. Lipid peroxidation in insulin-dependent diabetic patients with early retina degenerative lesions: effects of an oral zinc supplementation. Oral zinc therapy in diabetic neuropathy. Effects of combination of zinc and vitamin A supplementation on serum fasting blood sugar, insulin, apoprotein B and apoprotein A-I in patients with type I diabetes Effect of zinc supplementation on serum homocysteine in type 2 diabetic patients with microalbuminuria. Effect of zinc supplementation on microalbuminuria in patients with type 2 diabetes: a double blind, randomized, placebo-controlled, cross-over trial. Hyperzincuria in individuals with insulin-dependent diabetes mellitus: concurrent zinc status and the effect of high-dose zinc supplementation. Antioxidant Effects of Zinc Supplementation in Tunisians with Type 2 Diabetes Mellitus Zinc supplementation in prediabetes: A randomized double‐blind placebo‐controlled clinical trial† Short-term zinc supplementation in women with non-insulin-dependent diabetes mellitus: effects on plasma 5'-nucleotidase activities, insulin-like growth factor I concentrations, and lipoprotein oxidation rates in vitro. Comparison of the effects of vitamins and/or mineral supplementation on glomerular and tubular dysfunction in type 2 diabetes. Sources of evidence for systematic reviews of interventions in diabetes. Plasma zinc concentrations during the first 2 years after diagnosis of insulin-dependent diabetes mellitus: a prospective study. The effectiveness of yoga to prevent diabetes mellitus type 2 A randomized trial of insulin aspart with intensified basal NPH insulin supplementation in people with Type 1 diabetes.
OBJECTIVE The present study is an attempt to assess serum zinc level in a sample of diabetic patients ( both type 1 and type 2 diabetics ) in comparison with those of apparently healthy controls , and to ascertain the relationship between the levels of serum zinc with some epidemiological variables . Furthermore , a trial of zinc supplementation for 3 months conducted to assess the effect of zinc supplementation on glycemic control of the studied type 2 diabetic patients , and the factors that affect the response to this supplementation . METHODS Collection of data was carried out during the period between November 2002 to February 2003 at the Diabetic Center of Merjan Teaching Hospital in Babil Governorate , Iraq . In the first part of the study ( a case-control study ) , the diabetic group included 133 diabetic patients ( type 1 and 2 ) who were chosen from patients attending the Diabetic Center during the period of the study . The control group included 133 apparently healthy subjects who were selected from the workers of the same hospital . Selection of cases and controls was carried out by using systematic r and om sampling procedure . In the second part of the study ( single blind were intervention study ) , type 2 diabetic patients ( 101 patients ) divided into 2 groups ; the first group included 50 patients supplemented with oral zinc sulfate ( 30 mg of elemental zinc/cap/day ) for 3 months and second group included 51 patients given placebo and design ed as control group . RESULTS The first part of the study shows that the mean value for serum zinc level was significantly lower in diabetic patients than healthy controls ( 64.2 + /- 12.6 microg/dl for type 1 diabetics , and 68.9 + /- 11.9 microg/dl for type 2 diabetics versus 83.4 + /- 12.5 microg/dl for healthy controls ) . Using simple linear regression , significant positive correlation was found between serum zinc level and years of education and significant negative correlation was found between serum zinc level and baseline HbA1c% value , in the diabetic group . While significant positive correlation found between serum zinc level and estimated zinc intake in the control group . Using multiple regression analysis , serum zinc level showed significant positive correlation with gender ( being a male compared with female ) , and estimated zinc intake and significant negative correlation with diabetes state ( diabetic compared with non-diabetic ) , residence ( urban compared with rural residents ) , and plant protein intake . The second part of the study shows that the mean value for HbA1c% concentration of the supplemented group decreased significantly at the end of the 3 months of follow up , while no significant changes were found in the mean value for HbA1c% of the control group . The present study showed that the change in HbA1c% after supplementation had significant negative correlation with baseline HbA1c% value . CONCLUSION Diabetic patients have significantly lower mean serum zinc levels compared with healthy controls . Zinc supplementation for type-2 diabetics has beneficial effects in elevating their serum zinc level , and in improving their glycemic control that is shown by decreasing their HbA1c% concentration Disturbances of zinc homeostasis have been observed in several diseases , including diabetes mellitus . To further characterize the association between zinc and diabetes , we recruited 75 patients with type 1 or type 2 diabetes and 75 nondiabetic sex-/age-matched control subjects in order to analyze differences concerning human zinc transporter 8 ( hZnT-8 ) expression , single nucleotide polymorphisms ( SNPs ) in the genes of hZnT-8 as well as metallothionein 1A and serum/intracellular zinc . Furthermore , we investigated the relation between insulin and zinc homeostasis in type 2 diabetic subjects and consoli date d our results by in vitro analysis of the effect of insulin on cellular zinc status and by analysis of the modulation of insulin signal transduction by intracellular zinc homeostasis . Concerning the expression of hZnT-8 and the SNPs analyzed , we did not observe any differences between diabetic and control subjects . Serum zinc was significantly lower in diabetic patients compared to controls , and intracellular zinc showed the same tendency . Interestingly , type 2 diabetes patients treated with insulin displayed lower serum zinc compared to those not injecting insulin . In vitro analyses showed that insulin leads to an increase in intracellular zinc and that insulin signaling was enhanced by elevated intracellular zinc concentrations . In conclusion , we show that type 1 and type 2 diabetic patients suffer from zinc deficiency , and our results indicate that zinc supplementation may qualify as a potential treatment adjunct in type 2 diabetes by promoting insulin signaling , especially in zinc-deficient subjects AIMS There are a number of studies showing that zinc supplementation may improve glucose h and ling in people with established diabetes . We sought to investigate whether this zinc-dependent improvement in glucose h and ling could potentially be harnessed to prevent the progression of pre-diabetes to diabetes . In this double-blind r and omized placebo-controlled trial , we determined participants ' fasting blood glucose levels , ( FBG ) and Homeostasis Model Assessment ( HOMA ) parameters ( beta cell function , insulin sensitivity and insulin resistance ) at baseline and after 6 months of zinc supplementation . METHODS The Bangladesh Institute of Health Sciences Hospital ( BIHS ) ( Mirpur , Dhaka , Bangladesh ) data base was used to identify 224 patients with prediabetes , of whom 55 met the inclusion criteria and agreed to participate . The participants were r and omized either to the intervention or control group using block r and omization . The groups received either 30 mg zinc sulphate dispersible tablet or placebo , once daily for six months . RESULTS After six months , the intervention group significantly improved their FBG concentration compared to the placebo group ( 5.37±0.20mmol/L vs 5.69±0.26 , p<0.001 ) as well as compared to their own baseline ( 5.37±0.20mmol/L vs 5.8±0.09 , p<0.001 ) . Beta cell function , insulin sensitivity and insulin resistance all showed a statistically significant improvement as well . CONCLUSION To our knowledge this is the first trial to show an improvement in glucose h and ling using HOMA parameters in participants with prediabetes . Larger r and omized controlled trials are warranted to confirm these findings and to explore clinical endpoints Aims : To evaluate the effects of zinc with or without other antioxidants on blood glucose , lipid profile , and serum creatinine in adult diabetics on long-term follow-up . Material s and methods : Patients ( n = 96 ) were r and omly allocated to three groups : group A ( n = 29 ) was supplemented with oral zinc sulfate ( 22 mg/day ) and multivitamin/mineral ( zinc+MVM ) preparation ; group B ( n = 31 ) was given the same preparation without zinc ( MVM ) ; and group C ( n = 36 ) was given a matching placebo for a period of 4 months in a single-blinded study . Blood sample s were taken at baseline and after 4 months of supplementation to assess blood glucose ( fasting and postpr and ial ) and glycosylated hemoglobin ( HbA1C% ) and serum levels of zinc , creatinine , and lipids . Results : The zinc+MVM group had a mean change of fasting blood sugar −0.33 mmol/L ( st and ard error of the mean 0.21 mmol/L ) and was significant ( P = 0.05 ) when compared with the other two groups ( mean change in the MVM group + 0.19 ( 0.31 ) mmol/L and + 0.43 ( 0.23 ) mmol/L in the control group , respectively ) . The HbA1C% level reduced significantly , irrespective of the baseline level , in zinc+MVM-supplemented individuals . In the other two groups , the change of HbA1C% level was not significant . Serum lipid levels reduced significantly in the zinc+MVM and MVM groups . Conclusions : Zinc+MVM supplementation showed beneficial effects in the metabolic control of adult diabetics in addition to elevating their serum zinc level . Zinc supplementation  improved glycemic control measured by HbA1C% and fasting and postpr and ial glucose . Furthermore , zinc supplementation  lowered serum cholesterol and cholesterol/high-density lipoprotein ratio Objective : To determine the effects of combined zinc ( Zn ) and chromium ( Cr ) supplementation on oxidative stress and glucose homeostasis of people with type 2 diabetes . Design : Tunisian adult subjects with HbA1C > 7.5 % were supplemented for 6 months with 30 mg/d of Zn as Zn gluconate or 400 μg/d of Cr as Cr pidolate or combined Zn/Cr supplementation or placebo . The effects of supplementation on plasma zinc ( Zn ) , copper ( Cu ) , selenium ( Se ) , urinary Zn , Cr , plasma thiobarbituric acid reactive substances ( TBARS ) , Cu-Zn superoxide dismutase ( SOD ) and Se glutathione peroxidase ( GPx ) in red blood cells , blood lipids and lipoproteins , HbA1C and fasting glucose were measured at the beginning of the study and after six months . Results : At the beginning of the study , more than 30 % of the subjects may have been Zn deficient with plasma Zn values less than 10.7 μmol/L , whereas levels of plasma Cu , Se and antioxidant RBC enzyme activities were in the normal ranges . Following supplementation , there were significant decreases of plasma TBARS in the Cr ( 13.6 % ) , Zn ( 13.6 % ) and Zn/Cr ( 18.2 % ) groups with no significant changes in the placebo group . The value for the TBARS of the control healthy Tunisian subjects was 2.08 ± 0.04 μmol/L and that of the Tunisian subjects with diabetes was 3.32 ± 0.05 μmol/L. This difference of 1.24 μmol/L between the control group and the subjects with diabetes was reduced from 36 % to 50 % in the three supplemented groups . Supplementation did not modify significantly HbA1C nor glucose homeostasis . No adverse effects  of Zn supplementation were observed on Cu status , HDL cholesterol nor interactions in Zn or Cr . Conclusions : These data suggest the potential beneficial antioxidant effects of the individual and combined supplementation of Zn and Cr in people with type 2 DM . These results are particularly important in light of the deleterious consequences of oxidative stress in people with diabetes The pathology of type 2 diabetes mellitus ( DM ) often is associated with underlying states of conditioned zinc deficiency and chronic inflammation . Zinc and omega-3 polyunsaturated fatty acids each exhibit anti-inflammatory effects and may be of therapeutic benefit in the disease . The present r and omized , double-blind , placebo-controlled , 12-week trial was design ed to investigate the effects of zinc ( 40 mg/day ) and α-linolenic acid ( ALA ; 2 g/day flaxseed oil ) supplementation on markers of inflammation [ interleukin (IL)-1β , IL-6 , tumor necrosis factor (TNF)-α , C-reactive protein ( CRP ) ] and zinc transporter and metallothionein gene expression in 48 postmenopausal women with type 2 DM . No significant effects of  zinc or ALA supplementation were observed on inflammatory marker concentrations or fold change in zinc transporter and metallothionein gene expression . Significant increases in plasma zinc concentrations were observed over time in the groups supplemented with zinc alone or combined with ALA ( P=.007 and P=.009 , respectively ) . An impact of zinc treatment on zinc transporter gene expression was found ; ZnT5 was positively correlated with Zip3 mRNA ( P<.001 ) only in participants receiving zinc , while zinc supplementation abolished the relationship between ZnT5 and Zip10 . IL-6 predicted the expression levels and CRP predicted the fold change of the ZnT5 , ZnT7 , Zip1 , Zip7 and Zip10 mRNA cluster ( P<.001 and P=.031 , respectively ) . Fold change in the expression of metallothionein mRNA was predicted by TNF-α ( P=.022 ) . Associations among inflammatory cytokines and zinc transporter and metallothionein gene expression support an interrelationship between zinc homeostasis and inflammation in type 2 DM DESIGN Placebo for 3 months , followed by 30 mg/day zinc gluconate in identical capsules . SETTING Diabetic out patients clinic at the University Hospital , Grenoble . SUBJECTS Diabetic patients cared for type I diabetes mellitus . 22 patients began the study , 4 dropped out . 10 patients suffered of an early retinopathy , 8 patients had no retinopathy . INTERVENTIONS In this order : T0 biological measurements , 3 months placebo treatment , T1 biological measurements , 3 months zinc gluconate treatment , T2 biological measurements . Plasma Zn , Cu , Se , thiobarbituric acid reactants and antioxidant enzymes were measured [ plasma and red glutathione peroxidase ( Se-GPx ) , red cell superoxide dismutase ( Cu-Zn-SOD ) ] . RESULTS Lower plasma zinc level in the two groups . An increase in zinc level was observed and was more important in diabetic patients with no retinopathy ( P = 0.05 ) . The thiobarbituric acid reactants were above the reference values in all the patients , and were decreased at T2 ( P < 0.05 ) . Increase of GPx activity after zinc supplementation in patients with retinopathy . CONCLUSIONS Zinc deficiency in insulin-dependent diabetic patients is corrected by a zinc supplementation . Moreover this supplementation decreases lipid peroxidation . The effects of zinc are different in diabetic patients with or without retinopathy . The increase in Se-GPx activity observed in patients with retinopathy could be linked to the protective effect of zinc on the protein itself The present double blind r and omized study was conducted on 50 subjects ; 20 age and sex matched healthy controls ( Group -- I ) ; 15 patients of diabetes mellitus with neuropathy who received placebo for 6 weeks ( Group -- IIA ) ; and 15 patients of diabetes mellitus with neuropathy who were given supplemental zinc sulphate ( 660 mg ) for 6 weeks ( Group -- IIB ) .  Serum zinc level , fasting blood sugar ( FBS ) and post pr and ial blood sugar ( PPBS ) levels and motor nerve conduction velocity ( MNCV ) were estimated on day 0 and after 6 weeks in all subjects . Serum zinc levels were significantly low ( p < 0.001 ) in group IIA and IIB as compared to healthy controls ( Group -- I ) at baseline . After 6 weeks the change in pre and post therapy values of FBS , PPBS and MNCV ( median and common peroneal nerve ) were highly significant ( P = < 0.001 ) for group IIB alone with insignificant change ( P = > 0.05 ) in group IIA . No improvement ( P = > 0.05 ) in autonomic dysfunction was observed in either groups . Therefore , oral zinc supplementation helps in achieving better glycemic control and improvement in severity of peripheral neuropathy as assessed by MNCV Background and aim There is accumulating evidence that shows the metabolism of zinc and vitamin A are altered in diabetes mellitus type I ( DMTI ) , thus the present study was conducted to evaluate the effects of combination of zinc and vitamin A supplementation on serum fasting blood sugar ( FBS ) , insulin , apoprotein B and apoprotein A-I in patients with DMTI . Design Forty-eight , 7-year-old to 20-year-old patients with at least 2 years of DMTI history , without any metabolic condition or medicine intake with insulin treatment , participated in a r and omized double-blind clinical trial for 12 weeks . They were divided into zinc and vitamin A (VAZ)-supplemented ( 10 mg elemental zinc per day and one-half of a 25,000 IU vitamin A tablet every other day ) and /or placebo groups after matching for sex , age and DMTI duration . Nutrient intake was estimated using 24 h recall and was analyzed by food processor program . Serum apoproteins B and A-I , FBS and insulin levels were determined at the beginning and end of the trial . Results There was significant increase in apoprotein A-I ( P < 0.0001 ) and a significant decrease in apoprotein B ( P < 0.0001 ) and apoprotein B/apoprotein A-I ratio ( P < 0.0001 ) at the end of the study compared with baseline values in the VAZ group but apoprotein A-I had a significant increase ( P < 0.0001 ) and the apoprotein B/apoprotein A-I ratio had a significant decrease ( P = 0.02 ) at the end of study in the VAZ group compared with the control group Conclusion It seems that combined zinc and vitamin A supplementation can improve serum apoprotein A-I , apoprotein B and the apoprotein B/apoprotein A-I ratio in patients with DMTI OBJECTIVES Elevated homocysteine levels are considered to be an independent risk factor for cardiovascular complications in diabetic patients . The aim of this study was to find out if zinc supplementation improves homocysteine levels , which may exert vascular-protective effects in type 2 diabetes subjects with microalbuminuria . METHODS In a r and omized , double-blind , controlled , crossover study , 50 type 2 diabetic patients with microalbuminuria were subdivided into two groups and supplemented with 30 mg/d of zinc ( group 1 ) or placebo ( group 2 ) for three months with a four-week wash out period . Serum creatinine , vitamin B(12 ) , folate , fasting plasma glucose , HbA1c , lipid profiles , zinc , homocysteine levels and r and om urine albumin were measured before and after the first and second phase of the study in all participants . RESULTS Mean serum zinc was significantly increased after zinc supplementation ( from 76 + /- 16 mug/dl to 93 + /- 20 microg/dl ; p < 0.05 ) , while there was no change in the placebo group ( 75 + /- 16 microg/dl to 75 + /- 15 microg/dl ) . With  zinc supplementation  , homocysteine levels reduced significantly ( from 13.71 + /- 3.84 mumol/l to 11.79 + /- 3.06 mumol/l ; p < 0.05 ) , which did not occur on placebo ( from 12.59 + /- 2.13 mumol/l to 13.36 + /- 2.03 mumol/l ) . Simple regression was used to show a positive correlation between urine albumin excretion and serum homocysteine ( r = 0.37 , p = 0.023 ) . Vitamin B(12 ) and folate levels increased significantly in patients who received zinc in comparison to those who received placebo . A negative correlation was observed between homocysteine and vitamin B(12 ) concentration ( r = -0.36 , p = 0.025 ) . CONCLUSION Zinc supplementation reduced serum homocysteine and increased vitamin B(12 ) and folate concentrations in type 2 diabetic patients with microalbuminuria OBJECTIVES Oxidative stress can contribute to microvascular complications in diabetes . A decisive event associated with this condition may be the decrease in the synthesis of zinc-containing antioxidant enzymes such as superoxide dismutase and glutathione peroxidase . This consideration led us to investigate the effect of zinc supplementation versus placebo on microalbuminuria in diabetic patients in a r and omized double blind clinical trial . METHODS Fifty diabetic patients with microalbuminuria were enrolled .  Fasting plasma glucose , HbA1c , lipid profiles , plasma zinc levels and r and om urine for albumin and creatinine were measured . Patients r and omly received 30 mg elemental zinc ( group 1 ) or placebo ( group 2 ) for 3 months . After a 4 week wash-out period , the groups were crossed over ( i.e. the zinc group were given placebo , and the placebo group were given zinc ) and the protocol was repeated . RESULTS From an initial number of 50 selected patients ( 25 in each of two groups ) , 39 patients ( 21 in group 1 and 18 in group 2 ) completed the study . In group 1 , after zinc supplementation , urinary albumin excretion decreased significantly from 86.5 + /- 57 to 75 + /- 71 mg/g ( p = 0.01 ) . After placebo , patients in group 1 showed no significant reduction in microalbuminuria ( 85 + /- 72 mg/g to 83 + /- 63 mg/g creatinine ) . In group 2 , no change in albumin excretion was observed after placebo treatment ( 90.5 + /- 63 mg/g to 90 + /- 60 mg/g creatinine ) . After zinc supplementation , a significant reduction was observed in albumin excretion , from 90 + /- 60 mg/g to 85 + /- 57 mg/g creatinine ( p = 0.003 ) . CONCLUSIONS Zinc supplementation reduced albumin excretion in microalbuminuric type 2diabetic patients . This outcome may be due to the antioxidant effect of zinc The urinary excretion of zinc in individuals with insulin-dependent diabetes mellitus ( IDDM ) is approximately doubled . In the absence of a compensatory mechanism , this hyperzincuria should induce a deficient or marginal Zn status . We examined parameters of Zn status in plasma and in blood cells with respect to urinary Zn losses and Zn supplementation . We measured Zn levels in the urine , plasma , and erythrocytes of 14 IDDM subjects and 15 nondiabetics who kept dietary records for 3 consecutive days . Subsequently , six IDDM subjects and seven nondiabetics were supplemented with 50 mg Zn daily for 28 days . We measured the above parameters , as well as mononuclear leukocyte Zn ( MNL-Zn ) and the plasma subfraction of albumin-bound Zn ( alb-Zn ) . The total plasma Zn-binding capacity was also assessed . Plasma copper and erythrocyte Cu were monitored as indicators of potential Zn toxicity . Individuals with IDDM displayed the expected hyperzincuria , but had normal blood Zn parameters . Zincuria increased by a similar amount in both groups during supplementation , as did the MNL-Zn content . However , erythrocyte Zn ( e-Zn ) was refractory , so a trend toward lower e-Zn among IDDM subjects persisted during Zn supplementation . Hemoglobin A1c ( HbA1c ) increased markedly in the Zn-supplemented IDDM group . Despite their chronic hyperzincuria , individuals with IDDM appear not to be Zn-deficient . Large-dose Zn supplementation increases MNL-Zn and induces an undesirable elevation of HbA1c in all individuals . This is especially disconcerting for those with IDDM , and may reflect an exacerbation of a chronic " Zn diabetes . " These data suggest a potential for toxicity from large-dose Zn supplementation Objective : To determine the effects of zinc ( Zn ) supplementation on oxidative stress in persons with type 2 diabetes mellitus ( type 2 DM ) . Design : Tunisian adult subjects with HbA1c > 7.5 % were supplemented for six months with 30 mg/day of Zn as Zn gluconate or placebo . The effects of supplementation on plasma zinc ( Zn ) , copper ( Cu ) , urinary Zn , plasma thiobarbituric acid reactive substances ( TBARS ) , Cu-Zn superoxide dismutase ( SOD ) and glutathione peroxidase activities ( GPX ) in red blood cells , blood lipids and lipoproteins , HbA1c and fasting glucose were measured at the beginning of the study and after three and six months . Results : At the beginning of the study , more than 30 % of the subjects exhibited plasma Zn values less than the normal minimum of 10.7 μmol/L , whereas levels of plasma Cu and antioxidant RBC Cu-Zn SOD and GPx enzyme activities were in the normal ranges . Oxidative stress , monitored by plasma TBARS , was increased in individuals with diabetes compared with healthy Tunisian subjects ( 3.32 ± 0.05 μmol/L vs. 2.08 ± 0.04 μmol/L ) and an inverse correlation was found between Zn plasma levels and plasma TBARS . After three and six months of Zn supplementation , all of the subjects exhibited plasma Zn values greater than 10.7 μmol/L. There was a decrease of plasma TBARS in Zn supplemented group after six months ( 15 % ) with no significant changes in the placebo group . Supplementation did not alter significantly HbA1c nor glucose homeostasis . No adverse effects of Zn supplementation were observed on Cu status or HDL cholesterol . Conclusions : These data suggest the potential beneficial antioxidant effects of Zn supplementation in persons with type 2 DM . These results are particularly important in light of the deleterious consequences of oxidative stress in persons with diabetes BACKGROUND This study evaluated the effects of zinc supplementation on glycemic control , other cardiometabolic and anthropometric parameters , and  disease progression in prediabetes . METHODS A r and omized double-blind placebo-controlled Phase 2 clinical trial was conducted over a 12-month period in 200 subjects ( 43 % male ; mean [ ± SD ] age 51.8 ± 7.3 years ) , r and omly assigned ( 1 : 1 ) to the treatment or control group . The treatment group received zinc ( 20 mg daily ) . Subjects were evaluated at baseline and at 1 , 3 , 6 , and 12 months . The primary outcome was the change in glycemic control from baseline . Multiple regression analyses were performed , with change in outcome variables after intervention from baseline used as continuous dependent variables . RESULTS In both groups , mean serum zinc concentrations prior to the trial were below normal ( 15.29 - 21.41 μmol/L ) . During the 12-month follow-up , a significantly higher percentage of participants developed type 2 diabetes in the control compared with zinc-treated group ( 25.0 % vs 11.0 % respectively ; P = 0.016 ) . Fasting plasma glucose ( FPG ) , 2-h glucose levels in the oral glucose tolerance test ( OGTT ) , homeostasis model assessment of insulin resistance ( HOMA-IR ) , total cholesterol ( TC ) , and low-density lipoprotein cholesterol ( LDL-C ) were significantly lower in the treated group , with significant improvement in β-cell function . In all four regression models , the best predictor of the dependent variables ( i.e. change in FPG , 2-h glucose in the OGTT , HOMA-IR , and homeostatic model assessment of β-cell function ) was zinc treatment . CONCLUSIONS Zinc supplementation reduced blood glucose and insulin resistance while improving β-cell function . Furthermore , supplementation reduced disease progression to diabetes and had beneficial effects on TC and Non-insulin-dependent diabetes mellitus ( NIDDM ) may cause vulnerability to moderate zinc deficiency . In this study , short-term zinc supplementation ( 30 mg/d as amino acid chelate for 3 wk ) elevated plasma zinc and activities of 5'-nucleotidase , a zinc-dependant enzyme , in 20 postmenopausal women with NIDDM .  Placebo , given to 20 other women with NIDDM , had no effects on these indexes nor on any others taken in this study . Although zinc supplementation doubled the mean value for 5'-nucleotidase activity , values were still significantly lower than those of age-matched control subjects . Plasma insulin-like growth factor I concentrations increased with zinc treatment if starting concentrations were < 165 microg/L but were unchanged if they were > 165 microg/L. Lipoprotein oxidation in vitro , which has abnormal lag times and propagation rates for subjects with NIDDM and for moderately zinc-deficient rats , were unchanged by zinc supplementation . Possibly , this lack of effect occurred because the zinc treatment did not normalize zinc status . In conclusion , this study supports the contention that moderate zinc deficiency occurs frequently in subjects with NIDDM OBJECTIVE The present study was design ed to assess the effect of magnesium plus zinc , vitamins C plus E , and a combination of these micronutrients on nephropathy indexes in type 2 diabetic patients . RESEARCH DESIGN AND METHODS In a r and omized , double-blind , placebo-controlled clinical trial , 69 type 2 diabetic patients were r and omly divided into four groups , each group receiving one of the following daily supplement for 3 months : group M ( n = 16 ) , 200 mg Mg and 30 mg Zn ; group V ( n = 18 ) , 200 mg vitamin C and 100 IU vitamin E ; group MV ( n = 17 ) , minerals plus vitamins ; and group P ( n = 18 ) , placebo .  Urinary albumin excretion and N-acetyl-beta-d-glucosaminidase activity ( NAG ) in urine were determined at the beginning and at the end of the trial . Treatment effects were analyzed by general linear modeling . RESULTS Results indicate that after 3 months of supplementation , levels of urinary albumin excretion decreased in the V and MV groups ( P = 0.034 and P = 0.005 , respectively ) . Urinary NAG activity did not significantly change in any treatment groups . Levels of systolic , diastolic , and mean blood pressure significantly decreased in the MV group ( P = 0.008 , P = 0.017 , and P = 0.009 , respectively ) . Also , combination of vitamin and mineral supplementation had significant effects in decreasing fasting serum glucose ( P = 0.035 ) and malondialdehyde concentrations ( P = 0.004 ) and in increasing HDL cholesterol and apolipoprotein A1 levels ( P = 0.019 ) . There was no significant change in the levels of these parameters in the other three groups . CONCLUSIONS In conclusion , the results of the present study provide evidence for the effects of vitamins C and E and also combination of magnesium , zinc , and vitamins C and E supplementation on improvement of glomerular but not tubular renal function in type 2 diabetic patients AIMS To analyse the effect on systematic review s in diabetes interventions of including only trials that are indexed in medline , and to assess the impact of adding trials from other data bases and the grey literature . METHODS All systematic review s of diabetes interventions which included a meta- analysis of r and omized controlled trials , and were published since 1996 , were selected . The impact on the meta- analysis of including only those trials indexed in medline , and the effect of then adding trials from other sources , was assessed . Where possible this was measured quantitatively , by redoing the meta- analysis , otherwise a qualitative estimate was made . RESULTS Forty-four systematic review s met our inclusion criteria . There were 120 articles reporting trial data which were not indexed in medline . These came from 52 % of the review s. In 34 % of the review s , basing a meta- analysis on a search of only medline would miss trials that could affect the result . Sources of non- medline data which had the biggest effect on the meta-analyses were journal articles from central and embase ( mainly in Diabetes , Nutrition and Metabolism ) and unpublished data ( mainly from industry ) . The exceptions were journal articles on herbal medicine , mostly indexed in Chinese language data bases . CONCLUSIONS A search of only the medline data base is insufficient for systematic review s of diabetes , because in about 34 % of review s the missed trials could affect the results of the meta- analysis . It is recommended that central ( on the Cochrane Library ) also be search ed . Scanning meeting abstract s , and seeking unpublished data are also recommended if the intervention has only recently been introduced Studies of  zinc  status in insulin-dependent diabetes mellitus ( IDDM ) have shown contradictory results . Zinc is essential for many enzymes involved in the human metabolism and may play a role in the bio synthesis and storage of insulin in the B-cell . We therefore prospect ively followed 26 patients ( 14 males and 12 females ) with newly diagnosed IDDM in order to determine the plasma zinc variation at the time of diagnosis and after 1 , 3 , 6 , 12 and 24 months . Seventy-two healthy persons ( 36 males and 36 females ) served as controls . Only minor differences in plasma zinc were demonstrated during the first 2 years of IDDM . A sex difference was found in healthy controls but only after 24 months in the diabetics . Quantitative changes of the B-cell function , development of insulin antibodies , age , body weight and serum albumin did not correlate with the course of plasma zinc Background : Type 2 diabetes mellitus ( T2DM ) is becoming a leading problem worldwide . Emerging reports reveal alarming evidence of increasing prevalence of T2DM that has reached p and emic levels . Despite the significant incidence , there are limited reliable data re sources and comprehensive systematic review and meta- analysis on the effects of yoga on people who are a prediabetic or high risk for developing T2DM . Objective : The objective of this protocol is to conduct a full-scale systematic review and meta-analyses on the effects of yoga on people who are prediabetes or high risk of developing T2DM . Methods : The articles enrolled in the study will be retrieved from the online data bases between 2002 and the date the search es are executed . The search es will be repeated just before the final analyses and further relevant studies for inclusion . We will conduct a bibliographic search in data bases : Medline / PubMed , Scopus , Cochrane Library , EBSCO , and IndMED using keywords including prediabetes state , high risk for diabetes , metabolic syndrome , and yoga . A defined search strategy will be implemented along with selection criteria to obtain full-text articles of relevant studies . This study protocol was prepared according to the Preferred Reporting Items for Systematic Review s and Meta- Analysis for Protocol s 2015 guidelines . There will be no language restrictions . Ethics and dissemination : The proposed study will be based on published studies and publicly available anonymized data without directly involving human participants and therefore requires neither formal human ethical review nor approval by a human research ethics committee . We published an outline of the protocol in the International Prospect i ve Register of Systematic Review s ( PROSPERO ) in 2018 . We plan to disseminate the findings of this systematic review and meta- analysis through publication in a peer- review ed journal and presentation at relevant conference proceedings . In addition , we believe the results of the systematic review will have implication s for policy and practice . We will prepare policymaker summary using a vali date d format , disseminate through social media and email discussion groups . Review registration number : PROSPERO registration number CRD AIMS Insulin aspart has been shown to improve post-pr and ial and overall glycaemic control in people with Type 1 diabetes . We hypothesized that insulin aspart with intensified basal NPH insulin supplementation would result in better overall glycaemic control than human regular insulin with st and ard basal NPH insulin . METHODS The trial was conducted in 43 centres in seven countries . People with Type 1 diabetes were r and omized to mealtime insulin aspart with up to four daily NPH doses if meals were > 5 h apart and a 25 % increase in bedtime NPH dose ( n = 187 ) , or to mealtime human unmodified insulin with once or twice daily basal NPH insulin ( n = 181 ) . Efficacy and safety were evaluated at 12 weeks ( primary evaluation period ) and 64 weeks . RESULTS At 12 and 64 weeks there was no statistically significant difference in HbA1c between the insulin aspart and regular insulin groups : -0.09 ( 95 % confidence interval ( CI ) -0.23 , + 0.05)% and -0.14 ( -0.32 , + 0.04)% . Post-pr and ial glucose values were lower and the area under the 24-h self-monitored blood glucose curve above 7.0 mmol/l was 28 % smaller with insulin aspart ( 35.2 + /- 3.2 vs. 48.9 + /- 3.1 mmol/l h , P = 0.0015 ) . No significant differences were found in mild or severe hypoglycaemia , or adverse event rate . At 64 weeks treatment satisfaction was higher in the insulin aspart group ( difference 1.57 ( 95 % CI 0.49 , 2.64 ) points , P = 0.004 ) , while quality of life was not different . CONCLUSIONS Improved post-pr and ial glycaemic control and treatment satisfaction with insulin aspart were confirmed . Intensifying basal insulin supplementation result ed in a similar HbA1c decrement as previously found with the use of insulin aspart and st and ard NPH insulin supplementation . This does not support routinely basal NPH insulin intensification when using rapid-acting insulin analogues in daily practice
Studies have also shown a significant reduction in systolic and diastolic blood pressures after Zinc supplementation .
This first comprehensive systematic review and meta- analysis on the effects of Zinc supplementation in patients with diabetes demonstrates that Zinc supplementation  has beneficial effects on glycaemic control and promotes healthy lipid parameters .
The number of people with diabetes and pre-diabetes are exponentially increasing .
Studies on humans have shown the beneficial effects of Zinc supplementation in patients with diabetes .
The present study aims to systematic ally evaluate the literature and meta-analyze the effects of Zinc supplementation on diabetes .