Abstract
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 systematically evaluate the literature and meta-analyze the effects of Zinc supplementation on diabetes. A systematic review of published studies reporting the effects of Zinc supplementations on diabetes mellitus was undertaken. The literature search was conducted in the following databases; PubMed, Web of Science and SciVerse Scopus. A meta-analysis of studies examining the effects of Zinc supplementation on clinical and biochemical parameters in patients with diabetes was performed. The total number of articles included in the present review is 25, which included 3 studies on type-1 diabetes and 22 studies on type-2 diabetes. There were 12 studies comparing the effects of Zinc supplementation on fasting blood glucose in patients with type-2 diabetes. The pooled mean difference in fasting blood glucose between Zinc supplemented and placebo groups was 18.13mg/dl (95%CI:33.85,2.41; p<0.05). 2-h post-prandial blood sugar also shows a similar distinct reduction in (34.87mg/dl [95%CI:75.44; 5.69]) the Zinc treated group. The reduction in HbA1c was 0.54% (95%CI:0.86;0.21) in the Zinc treated group. There were 8 studies comparing the effects of Zinc supplementation on lipid parameters in patients with type-2 diabetes. The pooled mean difference for total cholesterol between Zinc supplemented and placebo groups was 32.37mg/dl (95%CI:57.39,7.35; p<0.05). Low-density lipoprotein cholesterol also showed a similar distinct reduction in the Zinc treated group, the pooled mean difference from random effects analysis was 11.19mg/dl (95%CI:21.14,1.25; p<0.05). 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. Further studies are required to identify the exact biological mechanisms responsible for these results.
Highlights
The number of people with diabetes and pre-diabetes are exponentially increasing worldwide due to population growth, aging, urbanization, unhealthy eating habits, increasing prevalence of obesity and physical inactivity [1]
A meta-analysis of studies examining the effects of Zinc supplementation on the following clinical and biochemical parameters in patients with type-2 diabetes was performed; Fasting Blood Glucose (FBG), 2-h Post Prandial Blood Glucose (2-h PPBS), Glycated Haemoglobin (HbA1c), Total Cholesterol (TC), Low Density Lipoprotein Cholesterol (LDL-c), High Density Lipoprotein Cholesterol (HDL-c) and Triglycerides (TG)
There have not been significant effects on renal and liver functions due to Zinc supplementation, as observed by unchanged blood urea, serum creatinine levels and plasma AST/ALT levels in those receiving Zn sulfate (22 mg/day) and Zn acetate (50 mg/ day) for a period of 3–4 months [33,35]. This is the first comprehensive systematic review and meta-analysis of studies evaluating the effects of oral Zinc supplementation in patients with diabetes mellitus
Summary
The number of people with diabetes and pre-diabetes are exponentially increasing worldwide due to population growth, aging, urbanization, unhealthy eating habits, increasing prevalence of obesity and physical inactivity [1]. The prevalence is expected to double between years 2005–2030, with the greatest. Ninety percent of those with diabetes have type-2 diabetes, characterized by insulin resistance, hyper insulinaemia, β-cell dysfunction and subsequent β–cell failure [6]. Et al showed that high concentrations of glucose and other secretagogues decrease the islet cell labile Zinc and video fluorescence analysis showed Zinc concentrated in the islet cells was related to the synthesis, storage and secretion of insulin [9]. Zinc is a structural part of key anti-oxidant enzymes such as superoxide dismutase, and Zinc deficiency impairs their synthesis, leading to increased oxidative stress [12]. In addition Zinc deficiency is more common in developing countries [15], where diabetes is showing an exponential increase in prevalence [2]
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