Research Journal of Pharmacy and Technology

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Effect of Zinc as an Add-on to Metformin Therapy on Glycemic Control, Serum Insulin, and C-peptide Levels and Insulin Resistance in Type 2 Diabetes Mellitus Patient


Affiliations
1 Alssalam Teaching Hospital, Ninevah Health Directorate, Mosul,, Iraq
2 College of Medicine, University of Mosul, Mosul,, Iraq
3 College of Medicine, Ninevah University, Mosul,, Iraq
4 College of Pharmacy, Ninevah University, Mosul,, Iraq
     

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Type 2 diabetes mellitus (T2DM) is an insidious disorder that may progress asymptomatically, leading to secondary complications. Diabetics were found to have a significantly lower zinc level. This study aims to assess the effects of zinc supplementation for eight weeks on glycemic control, serum insulin level, serum C-peptide level, and insulin resistance. Zinc plus metformin using group had a significant decrease in fasting blood glucose level and glycated hemoglobin, as well as a significant increase in serum insulin and C-peptide levels, but no effect on insulin resistance compared to zinc-free metformin group. Comparing the two groups at the end of the study, the combined effect of zinc plus metformin was highly important versus metformin only except for C-peptide and insulin resistance. Zinc levels were significantly elevated and returned to normal in the interventional group, while in the control group, levels were rather decreased.

Keywords

Glycemic, Insulin, Metformin, Zinc, Diabetes.
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  • Chabosseau P. Rutter GA. Zinc and Diabetes. Archives of Biochemistry and Biophysics. 2016; 611: 79-85. doi.org/10.1016/j.abb.2016.05.022

  • Ranasinghe P. Pigera S. Galappatthy P. Katulanda P. Constantine GR. Zinc and Diabetes Mellitus: Understanding Molecular Mechanisms and Clinical Implications. DARU Journal of Pharmaceutical Sciences. 2015; 23(1): 1-3. doi.org/10.1186/s40199-015-0127-4

  • Prasad AS. Zinc in Human Health: Effect of Zinc on Immune Cells. Molecular Medicine. 2008; 14(5):353-7. doi.org/10.2119/2008-00033.Prasad

  • Shidfar F. Aghasi M. Vafa M. Heydari I. Hosseini S. Shidfar S. Effects of Combination of Zinc and Vitamin A Supplementation on Serum Fasting Blood Sugar, Insulin, Apoprotein B and Apoprotein AI in Patients with Type I Diabetes. International Journal of Food Sciences and Nutrition. 2010; 61(2):182-91. doi.org/10.3109/09637480903334171

  • Gunasekara P. Hettiarachchi M. Liyanage C. Lekamwasam S. Effects of Zinc and Multimineral Vitamin Supplementation on Glycemic and Lipid Control in Adult Diabetes. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2011; 4:53. doi.org/10.2147/DMSO.S16691

  • Matthews DR. Hosker JP. Rudenski AS. Naylor BA. Treacher DF. Turner RC. Homeostasis Model Assessment: Insulin Resistance and β-Cell Function from Fasting Plasma Glucose and Insulin Concentrations in Man. Diabetologia. 1985; 28(7):412-9. doi.org/10.1007/BF00280883

  • Payahoo L. Ostadrahimi A. Mobasseri M. Bishak YK. Farrin N. Jafarabadi MA. Mahluji S. Effects of Zinc Supplementation on the Anthropometric Measurements, Lipid Profiles and Fasting Blood Glucose in the Healthy Obese Adults. Advanced Pharmaceutical Bulletin. 2013; 3(1):161. doi.org/10.5681/apb.2013.027

  • do Nascimento Marreiro D. Geloneze B. Tambascia MA. Lerário AC. Halpern A. Cozzolino SM. Effect of Zinc Supplementation on Serum Leptin Levels and Insulin Resistance of Obese Women. Biological Trace Element Research. 2006; 112(2):109-18. doi.org/10.1385/BTER:112:2:109

  • Haase H. Maret W. Protein Tyrosine Phosphatases as Targets of the Combined Insulinomimetic Effects of Zinc and Oxidants. Biometals. 2005; 18(4):333-8. doi.org/10.1007/s10534-005-3707-9

  • Fernández-Cao JC. Warthon-Medina M. H Moran V. Arija V. Doepking C. Serra-Majem L. Lowe NM. Zinc Intake and Status and Risk of Type 2 Diabetes Mellitus: a Systematic Review and Meta-Analysis. Nutrients. 2019; 11(5):1027. doi.org/10.3390/nu11051027

  • Jafarnejad S. Mahboobi S. McFarland LV. Taghizadeh M. Rahimi F. Meta-Analysis: Effects of Zinc Supplementation Alone or with Multi-Nutrients, on Glucose Control and Lipid Levels in Patients with Type 2 Diabetes. Preventive Nutrition and Food Science. 2019; 24(1):8. doi.org/10.3746/pnf.2019.24.1.8

  • Ranasinghe P, Wathurapatha WS, Ishara MH, Jayawardana R, Galappatthy P, Katulanda P, Constantine GR. Effects of Zinc Supplementation on Serum Lipids: a Systematic Review and Meta-Analysis. Nutrition & Metabolism. 2015; 12(1):1-6. doi.org/10.1186/s12986-015-0023-4

  • Parham M, Amini M, Aminorroaya A, Heidarian E. Effect of Zinc Supplementation on Microalbuminuria in Patients with Type 2 Diabetes: a Double Blind, Randomized, Placebo-Controlled, Cross-Over Trial. The review of diabetic studies: RDS. 2008; 5(2):102. doi.org/10.1900/RDS.2008.5.102

  • Tutuncu NB. Batur MK. Yildirir A. Tutuncu T. Deger A. Koray Z. Erbas B. Kabakci G. Aksoyek S. Erbas T. Melatonin Levels Decrease in Type 2 Diabetic Patients with Cardiac Autonomic Neuropathy. Journal of Pineal Research. 2005; 39(1):43-9. doi.org/10.1111/j.1600-079X.2005.00213.x

  • Kim J. Lee S. Effect of Zinc Supplementation on Insulin Resistance and Metabolic Risk Factors in Obese Korean Women. Nutrition Research and Practice. 2012; 6(3):221.doi.org/10.4162/nrp.2012.6.3.221

  • Jafarnejad S. Mahboobi S. McFarland LV. Taghizadeh M. Rahimi F. Meta-Analysis: Effects of Zinc Supplementation Alone or with Multi-Nutrients, on Glucose Control and Lipid Levels in Patients with Type 2 Diabetes. Preventive Nutrition and Food Science. 2019; 24(1):8. doi.org/10.3746/pnf.2019.24.1.8

  • Öztürk E. Arslan AK. Dokumaci AH. Yerer MB. Real-Time Analysis of Impedance Alterations by the Effects of Vanadium Pentoxide on Several Carcinoma Cell Lines. Turkish Journal of Pharmaceutical Sciences. 2018; 15(1): doi.org/1.10.4274/tjps.80764

  • Sima AA. Zhang W. Kreipke CW. Rafols JA. Hoffman WH. Inflammation in Diabetic Encephalopathy is Prevented by C-Peptide. The Review of Diabetic Studies: RDS. 2009; 6(1):37. doi.org/10.1900/RDS.2009.6.37

  • Roshanravan N. Alizadeh M. Hedayati M. Asghari-Jafarabadi M. Alamdari NM. Anari F. Tarighat-Esfanjani A. Effect of Zinc Supplementation on Insulin Resistance, Energy and Macronutrients Intakes in Pregnant Women with Impaired Glucose Tolerance. Iranian Journal of Public Health. 2015; 44(2):211. doi.org/10.1016/j.jdiacomp.2015.07.001.

  • Jain SK. Chandra R. Rai AK. Characterization of Ocular Delivery of Reverse Micelles Bearing Insulin. Research J. Pharm. and Tech. 2008;1(4):370-73. doi.org/10.5958/0974-360X

  • Patil UK. Sahu R. Yadav SK. Formulation and Evaluation of Controlled Release Microspheres Containing Metformin Hydrochloride. Research Journal of Pharmacy and Technology. 2009; 2(1):176-9. doi.org/10.5958/0974-360X

  • Patil PM, Phanse MA, Gaikwad VL, Chaudhari PD. Direct Spectrophotometeric Determination of metformin hydrochloride in pure form and in pharmaceutical formulations. Research Journal of Pharmacy and Technology. 2009;2(4):874-5. doi.org/10.5958/0974-360X

  • Srivastava B, Baghel US, Swarnkar P, Dave S. Simultaneous Spectrophotometric Estimation and Validation of Metformin Hydrochloride and Glibenclamide in Bulk Drug and Pharmaceutical Dosage Form. Research Journal of Pharmacy and Technology. 2010;3(1):109-12. doi.org/10.5958/0974-360X

  • Jain AK, Sharma N, Upadhyay A, Dixit A. Hypoglycemic activity of Curculigo orchioides Gaertn in normal and streptozotocin induced diabetic rats. Research Journal of Pharmacy and Technology. 2010;3(1):133-5. doi.org/10.5958/0974-360X

  • Bhangale PN, Mahajan HS, Wagh RD. Formulation and Development of Sustained Release Microspheres of Metformin Hydrochloride. Scanning Electron Microscopy. 2010;15:16. doi.org/10.5958/0974-360X


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  • Effect of Zinc as an Add-on to Metformin Therapy on Glycemic Control, Serum Insulin, and C-peptide Levels and Insulin Resistance in Type 2 Diabetes Mellitus Patient

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Authors

Hend Y. Younis
Alssalam Teaching Hospital, Ninevah Health Directorate, Mosul,, Iraq
Imad A. Thanoon
College of Medicine, University of Mosul, Mosul,, Iraq
Nabeel N. Fadhil
College of Medicine, Ninevah University, Mosul,, Iraq
Marwan M. Merkhan
College of Pharmacy, Ninevah University, Mosul,, Iraq

Abstract


Type 2 diabetes mellitus (T2DM) is an insidious disorder that may progress asymptomatically, leading to secondary complications. Diabetics were found to have a significantly lower zinc level. This study aims to assess the effects of zinc supplementation for eight weeks on glycemic control, serum insulin level, serum C-peptide level, and insulin resistance. Zinc plus metformin using group had a significant decrease in fasting blood glucose level and glycated hemoglobin, as well as a significant increase in serum insulin and C-peptide levels, but no effect on insulin resistance compared to zinc-free metformin group. Comparing the two groups at the end of the study, the combined effect of zinc plus metformin was highly important versus metformin only except for C-peptide and insulin resistance. Zinc levels were significantly elevated and returned to normal in the interventional group, while in the control group, levels were rather decreased.

Keywords


Glycemic, Insulin, Metformin, Zinc, Diabetes.

References