The Effectiveness of Micronutrient Supplementation in the Management of Diabetes among US Adults receiving dietary treatment Open Access
Chou, Po Heng (Spring 2024)
Abstract
Background: Different researchers have explored the benefits of micronutrients, aiming to clear the uncertainty that engulfs aspects of their role in diabetes dietary therapy. This thesis will review and synthesize existing evidence to establish whether micronutrient supplementation/ intake in diabetes dietary therapy is effective in preventing the progression of the disease or even restoring optimal insulin action to enhance remission in adult populations. Among the notable micronutrients are zinc, potassium, vitamin B-12, and magnesium, which are associated with the homeostasis of glucose metabolism.
Methods: This review employs a clear search protocol to obtain relevant papers from various databases including PubMed/Medline, EMBASE, and Web of Science. To search and identify relevant papers from these databases, the current review employs search strings that combine keywords obtained from the primary research questions by employing Boolean operators (AND/and OR). The current review aims at synthesizing the state of knowledge on the role of four micronutrients (zinc, potassium, magnesium and the vitamin B-12- metformin interaction), which are part of the diabetes management intervention for individuals aged 18 years and above (excluding pregnant women) in the US.
Results: The searches retrieved a total of 1215 articles. Of the 1215 articles, total, 1001 articles were eliminated in the screening phase. The full texts of the remaining 214 articles were subjected to a quality review process. 196 articles were excluded for various reasons including not focusing on adults with type 2 diabetes. In total, 19 studies were included in this review. Although some primary studies examined zinc's importance, they yielded inconclusive results regarding glucose homeostasis and other important outcomes, while others did not find a significant impact; Magnesium levels were found to decrease with certain diabetes risk factors like obesity (Mikalsen et al., 2019) and periodontitis, leading to a decrease in the patient's glycemic status; Reduced potassium intake and low blood potassium concentration result in decreased insulin sensitivity and increased insulin secretion, which increases the risk of T2DM.In addition, research has explored in great detail how metformin use affects serum concentrations of key minerals and vitamins, specifically vitamin B-12. The reviewed studies revealed some notable gaps in the extant literature that require further investigations.
Table of Contents
Table of Contents
Chapter I: Introduction............................................................................................................ 1
1.1 Background of the Study.................................................................................................... 1
1.1.1 Diabetes Prevalence among US Adults .............................................................................. 1
1.1.2 The Importance of Effective Diabetes Management ........................................................... 1
1.1.3 Micronutrients as a Potential Intervention in Diabetes Management................................... 2
1.2 Problem Statement............................................................................................................ 3
1.2.1 Gaps in Current Diabetes Management Interventions......................................................... 3
1.3 Research Objectives and Questions..................................................................................... 4
1.3.1 Research Objectives......................................................................................................... 4
1.3.2 Primary Research Questions............................................................................................. 5
1.4 Thesis Organization........................................................................................................... 5
Chapter 2: Methodology........................................................................................................... 6
2.1 Search Strategy.................................................................................................................. 6
2.2 Study Selection.................................................................................................................. 7
2.2.1 Inclusion and Exclusion Criteria........................................................................................ 8
2.2.2 Screening and Quality Assessment..................................................................................... 9
2.3 Data Extraction................................................................................................................... 9
2.4 Data Analysis..................................................................................................................... 10
Chapter 3: Results..................................................................................................................... 10
3.1 Search Results and Selection of Studies................................................................................ 10
3.2 Characteristics of the Studies............................................................................................... 12
3.3 Summary of the Findings..................................................................................................... 14
Chapter 4: Discussion................................................................................................................ 26
4.1 Role of Micronutrients Intake and Supplementation in Diabetes Management......................... 27
4.1.1 Zinc................................................................................................................................. 27
4.1.2 Magnesium....................................................................................................................... 32
4.1.3 Potassium......................................................................................................................... 36
4.1.4 B Vitamins........................................................................................................................ 39
4.2 Metformin Use and Vitamin B-12 Deficiency.......................................................................... 41
Chapter 5: Conclusion................................................................................................................ 46
5.1 Summary of Key Findings..................................................................................................... 46
5.2 Implications of the Review.................................................................................................... 47
5.3 Limitations of the Study........................................................................................................ 48
5.4 Future Research.................................................................................................................... 48
REFERENCES.............................................................................................................................. 51
About this Master's Thesis
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