Essential elements (Ca, Mg, Zn, Cu, Fe, Cr, Mn and V) and non-essential elements (As, Cd, Hg and Pb) were measured in scalp hair samples of 45 diabetic subjects and 59 control subjects in Japan using inductively coupled plasma mass spectrometry. All diabetic subjects took insulin and/or antidiabetic agents, with glycated hemoglobin (HbA1c) ranging between 6.2 and 14.4%. The levels of Zn, Cu and Cr in the diabetic subjects (HbA1c>7) were significantly lower than those in the control subjects (p<0.05), and these concentrations decreased significantly with increases in HbA1c (p<0.01). The levels of Fe and Mg in the diabetic subjects were insignificantly lower, and the concentration of Fe decreased significantly with increases in HbA1c (p<0.05) and the concentration of Mn tended to decrease (p<0.10). In contrast, the concentration of As tended to increase with increases in HbA1c ( p<0.10). The concentrations of other elements, such as Ca, Mn, V, Pb, Cd and Hg, in the diabetic subjects were similar to those of control subjects, and did not correlate with HbA1c. The average of estimated glomerular filtration rate (eGFR) in the diabetic subjects was 77.7 29.7 mL/min/1.73 m 2 with large variation (12.7-148 mL/min/1.73 m 2 ), and previous study reported the increase of urinary excretion of Zn, Cr, Mn and Mg in diabetic subjects. The decreases of Zn, Cu, Cr, Fe and Mg concentrations in hair may reflect increased urinary excretion of these elements due to diabetic nephropathy.Key words diabetes; scalp hair; glycated hemoglobin (HbA1c); zinc; chromium; copper Diabetes mellitus is a serious and chronic metabolic disorder. Type 2 diabetes results from a disruption in glucose metabolism associated with a reduction in insulin production and utilization by tissues. Glycated hemoglobin (HbA1c) levels are used for screening and diagnostic purposes as HbA1c indicates the quality of blood glucose control over the previous 1-2 or 2-3 months. A HbA1c (%) value greater than 6.5 is a cut-off point for diabetic subjects and is highly prognostic for longterm diabetes-related complications such as nephropathy, retinopathy and neuropathy, and maintenance of the HbA1c value below 7.0 is a therapeutic guideline for the prevention of such complications of the Japan Diabetic Society. Estimated glomerular filtration rate (eGFR) is used for screening for nephropathy. The glomerular filtration rate (GFR) generally decreases as diabetes progresses, but the early stage of diabetic nephropathy is characterized by hyperfiltration (increase of GFR). 1) Deficiencies in trace elements such as Cr, Zn, Cu, Mg and Mn have been shown to predispose a person to glucose tolerance and to promote the development of diabetic complications. 2,3) Insulin resistance (IR) is defined as the condition in which insulin sensitive tissues become numb to insulin reception, and a Cr deficiency can induce IR. 2) Zn is known to synthesize insulin as well as stabilize insulin that has been stored in the beta cells of the pancreas. 4) Further, Zn has an important role in the sec...