title: Zinc supplementation for improving glucose handling in pre-diabetes: A double blind randomized placebo controlled pilot study.
abstract: OBJECTIVE
  There are a number of studies showing that zinc supplementation may improve glucose handling in people with established diabetes. We sought to investigate whether this zinc-dependent improvement in glucose handling could potentially be harnessed to prevent the progression of pre-diabetes to diabetes. In this double-blind randomized 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) database was used to identify 224 patients with prediabetes, of whom 55 met the inclusion criteria and agreed to participate. The participants were randomized either to the intervention or control group using block randomization. The groups received either 30mg 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.
  
  
  CONCLUSIONS
  To our knowledge this is the first trial to show an improvement in glucose handling using HOMA parameters in participants with prediabetes. Larger randomized controlled trials are warranted to confirm these findings and to explore clinical endpoints.
authors.affiliation: CCEB, School of Medicine and Public Health, The University of Newcastle and Hunter Medical Research Institute, Kookaburra Close, New Lambton Heights, Newcastle, NSW, Australia; Goulburn Valley Health, Shepparton, VIC, Australia; RHAC, the University of Melbourne, Shepparton, VIC 3630, Australia.
authors.forename: Md Rafiqul
authors.initials: MR
authors.lastname: Islam
authors.affiliation: CCEB, School of Medicine and Public Health, The University of Newcastle and Hunter Medical Research Institute, Kookaburra Close, New Lambton Heights, Newcastle, NSW, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Attia
authors.affiliation: Bangladesh University of Health Sciences, Mirpur, Dhaka, Bangladesh.
authors.forename: Liaquat
authors.initials: L
authors.lastname: Ali
authors.affiliation: CCEB, School of Medicine and Public Health, The University of Newcastle and Hunter Medical Research Institute, Kookaburra Close, New Lambton Heights, Newcastle, NSW, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: McEvoy
authors.affiliation: Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh.
authors.forename: Shahjada
authors.initials: S
authors.lastname: Selim
authors.affiliation: University Technology Sydney, Sydney, NSW, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Sibbritt
authors.affiliation: Goulburn Valley Health, Shepparton, VIC, Australia.
authors.forename: Ayesha
authors.initials: A
authors.lastname: Akhter
authors.affiliation: Institute of Child and Mother Health (ICMH), Demra, Matuail, Dhaka, Bangladesh.
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Akter
authors.affiliation: CCEB, School of Medicine and Public Health, The University of Newcastle and Hunter Medical Research Institute, Kookaburra Close, New Lambton Heights, Newcastle, NSW, Australia.
authors.forename: Roseanne
authors.initials: R
authors.lastname: Peel
authors.affiliation: Bangladesh University of Health Sciences, Mirpur, Dhaka, Bangladesh.
authors.forename: Omar
authors.initials: O
authors.lastname: Faruque
authors.affiliation: Centre for Health and Development (CHAD), West Rampura, Dhaka, Bangladesh.
authors.forename: Tazreen
authors.initials: T
authors.lastname: Mona
authors.affiliation: Medical College for Women, Uttara, Dhaka, Bangladesh.
authors.forename: Hafiza
authors.initials: H
authors.lastname: Lona
authors.affiliation: CCEB, School of Medicine and Public Health, The University of Newcastle and Hunter Medical Research Institute, Kookaburra Close, New Lambton Heights, Newcastle, NSW, Australia. Electronic address: Milton.Hasnat@newcastle.edu.au.
authors.forename: Abul Hasnat
authors.initials: AH
authors.lastname: Milton
mesh_terms: D000328:Adult; D001786:Blood Glucose; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011236:Prediabetic State / Q000097:blood / Q000188:drug therapy*; D016896:Treatment Outcome; D019287:Zinc Sulfate / Q000493:pharmacokinetics / Q000627:therapeutic use*
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D019287:Zinc Sulfate; D005947:Glucose
keywords: Bangladesh; Pre-diabetes; Zinc