ZINC, INSULIN AND DIABETES

The relationship between diabetes, insulin and zinc (Zn) is complex wi th no clear cause and effect relationships. In Type 1 diabetes there i s a lack of insulin production, in Type 2 diabetes resistance to the e ffects of insulin are predominant. Both Type 1 and Type 2 have the sam e long-term complications. Diabetes effects zinc homeostasis in many w ays, although it is most probably the hyperglycemia, rather than any p rimary lesion related to diabetes, which is responsible for the increa sed urinary loss and decreases in total body zinc. The role of Zn defi ciency, which could, at least potentially, exacerbate the cytokine-ind uced damage in the autoimmune attack which destroys the islet cell in Type 1 diabetes, is unclear. Since Zn plays a clear role in the synthe sis, storage and secretion of insulin as well as conformational integr ity of insulin in the hexameric form, the decreased Zn, which affects the ability of the islet cell to produce and secrete insulin, might th en compound the problem, particularly in Type 2 diabetes. Several of t he complications of diabetes may be related to increased intracellular oxidants and free radicals associated with decreases in intracellular Zn and in Zn dependent antioxidant enzymes. There appears to be a com plex interrelationship between Zn and both Type 1 and Type 2 diabetes. The role of Zn in the clinical management of diabetes, its complicati ons, or in its prevention is, at best, unclear.