Serum Levels of Zinc, Magnesium and Selenium among First Trimester Pregnant Saudi Women with Pre-Diabetes and Diabetes

Background: Glycosylated hemoglobin (HbA1c) was found to be a valuable predictor of the risk of congenital malformations. Other studies documented diabetic complications in subjects with HbA1c at the pre-diabetic levels. Objectives: This study was done to compare serum levels of zinc, magnesium and selenium between pregnant women with normal glycemic control, diabetes and pre-diabetes. Subjects/Methods: The data was part of a large prospective cohort study aimed at identifying some preventable risk factors that cause congenital malformations among Saudi women. 1103 healthy first trimester pregnant were randomly selected from antenatal clinics in twenty one health care centers and two hospitals at Al-Madinah Al- Monawarah, KSA. Clinical history, examination and lab analysis were done (serum levels of magnesium, zinc, selenium, and HbA1c). Subjects were classified by their HbA1c levels as normal (HbA1c<5.7%), pre-diabetic (HbA1c 5.7<6.5%), and undiagnosed type 2 diabetics (HbA1c≥6.5%), comparison in the lab results was done between the groups. Results: About 78. 9% (870 subjects) had normal HbA1c, 19.1% (211 subjects) had HbA1c in the range of prediabetes and 1.99% (22 subjects) had HbA1c>6.5% denoting undiagnosed type 2 diabetes Serum levels of nutrients were significantly lower among pre-diabetics compared to normal subjects, same results were obtained when comparing diabetics and pre-diabetics and diabetics and normal subjects. There was a significant negative correlation between the levels of HbA1c and zinc, magnesium and selenium. Conclusion and Recommendations: Changes in serum levels of zinc, magnesium and selenium occurs at the pre-diabetic stage and precedes the development of diabetes & may be responsible for medical complications that are recently reported at this stage. Studies should be done for re-establishment of safe target levels of HbA1c.