Zinc Supplementation in Type 1 Diabetes Mellitus Management

Type 1 diabetes mellitus (T1DM) is the most prevalent (9.5%) endocrine disorder affecting children. Although trace elements (TE) have been implicated in DM development and progression, data concerning TE levels in children with T1DM remains scarce. 

A recent study investigated the serum zinc and copper levels in children with T1DM. This was a prospective case-control study undertaken in a children's hospital. Overall, 15 children between the ages of 1 and 18 and with T1DM were enrolled over a 2-year span, in addition to 15 healthy controls – matched in age and gender. Children with type-2DM (T2DM)and those on multivitamin medicationsin the past three months were excluded from the study. TE levels were assessed using inductively coupled plasma-optical emission spectroscopy. The standard range for normal serum zinc and copper levels was 600-1200 µg/L and 510-1530 µg/L, respectively.

The results showed that in children with T1DM, the mean ± standard deviation (SD) of zinc levels was 501.33 ± 65.36 µg/L, whereas in controls, it was 734.60 ± 111.28 µg/L. Meanwhile, the mean ± SD of copper levels in T1DM children was 1828.20 ± 145.19 µg/L, compared to 1108.47 ± 276.30 µg/L in the control group. The findingssuggested that the T1DM cohort had hypozincemia and hypercupremia.

Previous studies have reported alterations in several TE in individuals with diabetes mellitus. Zincplays a pivotal role in insulin synthesis, storage, and secretion, as well as in regulating insulin receptor intracellular events that influence glucose tolerance and the pancreatic response to glucose intake. The low serum zinc levels observed in this study could be attributed to increased urinary loss of zinc, as hyperglycemia disrupts the active transport of zinc back into renal tubular cells. 

Further, hypercupremia could also be linked to hyperglycemia, which stimulates glycation and the release of copper ions from proteins’ copper-binding sites. 

The findings revealed that children with T1DM hadhypozincemia and hypercupremia, indicating the need for extensive multicenter trials to determine the potential benefits of zinc supplementation in T1DM management.

Source: Ganesh R, Meenakshi B. Indian Journal of Pediatrics. 2023 Jul 14:1-.