Effect of zinc replacement on lipids and lipoproteins in type 2-diabetic patients.

Abnormal zinc and lipid plasma levels occur more frequently in metabolically uncontrolled diabetic patients. These lipid alterations are key factors in the emergence of microvascular complications, which lead to death in those patients. Yet, zinc sulfate supplementation may be a therapeutical resource to recover some functioning and improve life span. This article reports the assessment of lipid profile from type 2-diabetes mellitus patients treated with hypoglycemic therapy drugs, who additionally presented zinc levels lower than average in Mexican reference. The patients received a 100 mg zinc sulfate treatment in a crossover double-blind design of clinically controlled study with starch as placebo. The diabetic patients had changes in their lipid profile after a 12-week zinc treatment as compared with placebo treatment. The 100 mg zinc sulfate treatment was well tolerated, significantly reduced total cholesterol and triglyceride concentrations, and increased those corresponding to zinc as well as HDL cholesterol in the bloodstream. Thus, using this treatment the cardiovascular involvement is expected to decrease in the type 2-diabetes mellitus patients, especially those with myocardial infarction and stroke, which are the main death causes in Mexico.

[Glycosylated hemoglobin (HbA1) in pregnancy]. / Hemoglobina glicosilada (HbA1) en el embarazo.

The life style, genetic predisposition and metabolic changes occurring during pregnancy can modify the percent value of glycated hemoglobins (HbA1 and HbA1c). In addition, research papers from different laboratories in the world have reported contradictory results on this respect. The purpose of this trial was to know the percent value of HbA1 in healthy women, during the different trimesters of pregnancy. 206 pregnant (E) healthy women who came over for prenatal control to UMF No 80 IMSS in Morelia, Michoacan with no previous history of Diabetes mellitus or Essential Hypertension were classified by trimesters of pregnancy (1T, 2T, 3T) and chronological age (I, 18-24; 11, 25-30; III, 31-35 years). Their chronological and gestational ages, weight, height, body mass index and parity were recorded. % HbA1 (ion exchange chromatography) was determined on each patient. Control group was formed by 187 non pregnant healthy women (NE) chosen with same criterion that pregnant women. % HbA1 was lower in E during pregnancy (7.11 +/- 1.53 vs 7.78 +/- 1.12%, p < 0.0001) than NE group. % HbA1 in E group was lower in the 1T and 2T than in the 3T (p < 0.001), same situation was observed in 18 to 24 (group I) and 25 to 30 (group II) years old. In the other hand, in E from group II on the 2T the weeks of gestation were correlated with % HbA1 (r = 0.72, p < 0.05). This results show a diminished HbA1 percent in E group with a lower values in the 1T and 2T. Moreover, these results will allow us to know HbA1 appearance in diabetic pregnant women and to evaluate the degree of metabolic control.

[Perinatal morbidity and mortality in pregnant women with diabetes mellitus]. / Morbimortalidad perinatal en mujeres con diabetes mellitus y embarazo.

The purpose of this study was to investigate the perinatal morbidity and mortality in all the diabetic pregnancies seen at the HGO-"LCA" from January 1992 to December 1993. In that period 186 women (mean age 31 yr) were diagnosed as having diabetes during pregnancy: 54% of them had DMG, 40% DM-II and 6% DM-I, with serum glucose concentration of 133 +/- 41 mg/dL. Neonatal morbidity was given by macrosomia (17%), prematurity (14%), hyperbilirubinemia (11%), hypoglycemia (8%), congenital malformation (6%) and hypocalcemia (4%). Perinatal mortality was 5.3%. The principal causes of maternal morbidity were preeclampsia (17%), polyhydramnios (16%), pyelonephritis (4%) and ketoacidosis (0.05%). Cesarean section was performed in 62% of all diabetic patients. There was not any maternal death. This results showed a high perinatal morbidity-mortality in pregnancies complicated by diabetes mellitus which reclaim a better metabolic control during gestation period.

Morbimortalidad perinatal en mujeres con diabetes mellitus y embarazo / Perinatal morbimortality in women diabetes mellitus and pregnancy

El propósito de este estudio fue conocer las causas de morbilidad y mortalidad perinatal en mujeres con diabetes mellitus y embarazo en el HGO-"LCA", durante el período comprendido entre enero de 1992 y diciembre de 1993. Se atendieron 186 mujeres, con edad promedio de 31 años, el 54 por ciento tuvieron DMG, 40 por ciento DM-II y 6 por ciento DM-I. El promedio de glucosa sérica fue de 133 ñ 41 mg/dL. La morbilidad en los HMDM estuvo dada principalmente por macrosomía (17 por ciento), prematurez (14 por ciento), hiperbilirrubinemia (11 por ciento), hipoglucemia (8 por ciento), malformaciónes congénitas (6 por ciento) e hipocalcemia (4 por ciento). La mortalidad neonatal fue del 5.3 por ciento y la principal causa fue la muerte intrauterina. La causa principal de morbilidad materna fue la preeclampsia (17 por ciento), seguida de polihidramnios (16 por ciento), pielonefritis (4 por ciento) y cetoacidosis (0.05 por ciento). La cesárea se indicó en el 62 por ciento de las pacientes con diabetes mellitus y embarazo. No hubo mortalidad materna. Este trabajo pone de manifiesto que la morbimortalidad perinatal en embarazos complicados con diabetes mellitus continúa siendo alta, por lo que se requiere un mejor control metabólico de la diabetes mellitus durante la gestación

HbA1, height velocity and weight gain as indicators of metabolic control in type I diabetic children. A 5 year survey.

The purpose of this study was to evaluate the metabolic control of the type I diabetic patients seen from 1984 to 1988. We analyzed the results of HbA1, height velocity and weight gain. Results showed that from 1984 1985 a 90% of diabetics were in poor metabolic control with HbA1 > 11% (good control < 11%). For 1988 the percentage of poor controlled patients descended to 78%. On the other hand, these patients observed a significant decrease in height velocity and weight gain compared with diabetics with HbA1 < 11% (p < 0.005 and p < 0.001). In addition, diabetics in poor metabolic control were under 10 and 3 number percentiles of the weight and growth diagrams. Finally, we found a significant correlation between HbA1 and height velocity as well as HbA1 and weight gain (r = -0.77 and r = -0.79; p < 0.001 for both). Our results showed that a great percent of our patients were in poor metabolic control with a decreased height velocity and weight gain.

Experimental study of the hypoglycemic effect of some antidiabetic plants.

The purpose of this work is to look for the hypoglycemic effect of 12 plants most used in Mexico for controlling diabetes mellitus. The studies were realized in 27 rabbits submitted weekly to glucose tolerance tests after gastric administration of water, tolbutamide or a preparation of the plant. The results showed that tolbutamide and studied plants (except Aloe barbadensis) decreased significantly (p less than 0.05) the area under glucose tolerance curve, in relation with the water control. The strongest effect was yielded by Psacalium peltatum (27.9%), followed by Curcubita ficifolia (26.4%), Lepechinia caulescens (26.0%), Opuntia streptacantha (21.4%), Slanum verbascifolum (21.1%), Teucrium cubense (19.4%), Cecropia obtusifolia (18.9%), Phaseolus vulgaris (18.5%), Tecoma stans (17.5%), Eriobotrya japonica (17.2%), Salpianthus macrodonthus (15.0%), tolbutamide (14.3%), and Aloe barbadensis (1.4%). Our results point out that the majority of the plants most used by the Mexican population to control diabetes mellitus have an evident hypoglycemic action.

Bone mineral content, 25-hydroxycalciferol and zinc serum levels in insulin-dependent (type I) diabetic patients.

To determine the relationship between bone mineral content (BMC), 25-Hydroxycalciferol (25OHD) and zinc serum levels in young insulin-dependent diabetics, we performed photon absorptiometry on a poorly controlled group of 22 patients. Zinc, 25OHD and alkaline phosphatase were measured in fasting serum. Ca, P, Mg, glucose and cAMP were determined in serum and in 24 hours urine collection. The diabetic group showed a significant decrease in BMC (less than 0.001) with raised urinary excretion rate of calcium (p less than 0.001). On the other hand, serum levels of zinc and 25OHD showed a significant decrease (p less than 0.001, both). We found a positive and significant correlation between glycosuria and urinary excretion rate of calcium (r = 0.77; p less than 0.001) and negative one for 25OHD and urinary excretion rate of calcium (r = -0.77; p less than 0.001). We conclude that decreased zinc and 25OHD serum levels in poorly controlled insulin-dependent (Type I) diabetic patients, in addition to raised urinary excretion rate of calcium, as result of the osmotic diuresis, contribute to bone loss in these patients.