Abstract

Background: Disturbances of trace elements and pancreatic exocrine function are common in type 2 diabetes mellitus (T2DM), but few studies have investigated the glycaemic status, serum trace element levels and pancreatic enzymes simultaneously in patients with T2DM compared to those without pancreatitis, especially for Middle Eastern populations. Objective: This cross-sectional study aims to analyse the levels of HbA1c, FSG, Ca, Zn, Cu, and Fe, and the enzymes amylase and lipase, in three groups: control healthy individuals (Group A), controlled T2DM patients (Group B), and uncontrolled T2DM patients complicated by pancreatitis (Group C). Methods: A sample of 172 patients presenting to the major hospitals in Kirkuk, Iraq were included. Analyses were performed on blood samples using commercially available reagent kits and automated clinical chemistry analyzers. Statistical analyses were conducted using GraphPad Prism 11.0.0, with one-way ANOVA/Tukey's test for parametric data or Kruskal-Wallis/Dunn's test for non-parametric data. Results: HbA1c, and FSG levels were significantly higher in Group B (P <0.05) with a stepwise increase from Group A to C. Although Group B showed a slight increase of calcium, it markedly decreased in Group C reaching hypocalcemic levels, especially females. Zinc decreased consistently, while copper and iron elevated significantly with disease severity. Amylase and lipase showed a biphasic response, with decreased levels in Group B (subclinical exocrine insufficiency) and increased levels in Group C (active pancreatic injury). Conclusion: T2DM with pancreatitis leads to glycemic deterioration, disease-severity-dependent trace-element imbalance, and a biphasic enzymatic trajectory. Composite Evaluation of Glycated, Trace Elemental and Enzymatic Markers Might Allow Early Identify Pancreatic Complications in Type II Diabetes mellitus.