الفهرس 
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Abstract
Diabetes mellitus (DM) is a metabolic disease, involving inappropriately elevated blood glucose levels Diabetic nephropathy (DN) is one of the most important microvascular complications of DM . Diabetic nephropathy is the leading cause of chronic kidney disease as it responsible for 30-40% of all end-stage renal disease (ESRD) cases. Trace elements as (Zn and copper) are essential micronutrients required for the normal functioning of the body. Zn deficiency is associated with insulin resistance ,Diabetic nephropathy has been related to oxidative stress. Antioxidant deficiency can result from impaired synthesis of enzymes, such as glutathione peroxidase due to zinc deficiency There is evidence that the metabolism of copper is altered in patients with diabetes mellitus and might have specific roles in the pathogenesis and progression of diabetes and its complication The aim of our study is to investigate changes in serum levels of zinc and copper and their association with the incidence of diabetic nephropathy in patients with diabetes mellitus type 2. It is an observational study conducted on 80 participants. Sixty of them were of type 2 DM with/out DN. The patients have been recruited from the Internal Medicine Department at Tanta University Hospitals. The study last for one year started from June 2022 and ended at may 2023. The study participants were divided into three groups; • group 1: Patients with type 2 diabetic mellitus without DN (n=20). • group 2: patients with type 2 diabetic mellitus and diabetic nephropathy (n=40). group 2 subdivided into two groups microalbuminuria (30 to 300 mg/g) macroalbuminuria (>300 mg/g) • group 3: healthy control group (n =20). Results According to risk factors the systolic blood pressure was statistically significantly higher in the diabetic with nephropathy group than the other groups.also, the median diastolic blood pressure showed statistically significant difference between the all groups. The mean FBG was statistically significantly higher in the diabetic with nephropathy group than the other groups. On the other hand, The mean HBA1C distribution showed statistically significant difference between the all groups. The median ZINC distribution was significantly lower in group1 and group 2 than group three. the correlation t-Test between zinc level in both micro and macro albuminuria groups shows that serum zinc level more in microalbuminuria than macroalbuminuria group. The median COPPER distribution was significantly high in diabetic group than other groups In addition. The correlation t-Test between cooper level in both micro and macro albuminuria groups showing that more serum copper precipitate was found in microalbuminuria group.