Serum Trace Elements Deficiency in Sudanese Individuals Living with Diabetes Mellitus: A Cross-Sectional Comparative Study

Diabetes mellitus is associated with metabolic and oxidative disturbances that may influence serum trace element levels. Data on trace element status among individuals with diabetes in Sudan are limited, despite the potential clinical relevance of micronutrient imbalance in glycemic control and diabetes-related complications. This article aims to compare serum levels of zinc (Zn), copper (Cu), magnesium (Mg), and iron (Fe) between Sudanese individuals with diabetes mellitus and normoglycemic participants, and to explore their associations with selected demographic and clinical characteristics. This descriptive cross-sectional comparative study was conducted in River Nile State, Sudan. A total of 242 participants were enrolled, including 182 individuals with diabetes mellitus (type 1 or type 2) and 60 age- and sex matched normoglycemic participants. Sociodemographic and clinical data were collected using structured questionnaires. Fast blood samples were obtained, and serum trace element concentrations were measured using atomic absorption spectrometry. Data were analyzed using appropriate descriptive and inferential statistical methods. A p-value <0.05 is considered significant. Compared with the 60 normoglycemic participants, the 182 patients with diabetes had significantly lower mean serum concentrations of Zn (0.16 ± 0.05 mg/L vs. 0.60 ± 0.15 mg/L, p < 0.001), Cu (0.18 ± 0.06 mg/L vs. 0.70 ± 0.13 mg/L, p < 0.001), Mg (1.80 ± 0.29 mg/L vs. 2.00 ± 0.16 mg/L, p = 0.001), and Fe (69.8 ± 35.0 μg/L vs. 99.0 ± 19.2 μg/L, p < 0.001). The study showed a significant correlation between zinc and creatinine levels, while ferrous showed a significant correlation with waist circumference and creatinine. Serum iron levels were significantly lower in female participants, smokers, and those residing in rural areas. There were no significant differences in trace elements, duration, medications, or diabetes complications, except lower ferrous levels in diabetes > 10 years and higher copper levels in insulin users. Serum levels of copper, zinc, magnesium, and ferrous were lower in individuals with diabetes than in healthy normoglycemic individuals. Monitoring and correcting trace element deficiencies may help reduce metabolic complications and improve glycemic control; thus, longitudinal studies are needed to establish causality.