Diabetic wound healing is a dynamic medical process that takes place in an environment within the body that is complex and contains elevated sugar levels, oxygen deprivation, and cellular oxidative stress. Phloridzin (Phlorizin) is one of the most well-known polyphenols found in apples because of its anti-inflammatory, antioxidant, antibacterial, antidiabetic, and antiseptic properties; it can also play a significant part in the healing of diabetic wounds. The study aimed to investigate the role of phloridzin as an efficient DPP-4 inhibitor with additional therapeutic effects in diabetic wound healing, as Dipeptidyl Peptidase-4 (DPP-4) expression increases in response to increases in glucose, Reactive Oxygen Species (ROS), and inflammation. Phloridzin inhibiting DPP-4 preserves Stromal cell-derived Factor-1α (SDF-1α), Insulin-like Growth Factor (IGF), and Glucagon-like Peptide-1 (GLP-1), which are possible DPP-4 substrates involved in wound healing. The accessible material from systemic searches in PubMed, Scopus, and published articles was reviewed with no period of limitation. The in silico study showed strong binding of phloridzin with DPP-4 protein (2P8S); also, in vitro DPP-4 inhibition assay has shown better inhibition by phloridzin. This study offers new research directions for examining phloridzin's capacity to withstand oxidative stress, as well as for redefining its tactical function as a powerful DPP-4 inhibitor to regulate the process involved in the healing of diabetic wounds.

Diabetic Foot Ulcer (DFU) is a serious and chronic complication of uncontrolled diabetes, significantly increasing the risk of amputation and mortality in diabetic patients. Conventional wound healing techniques often fail to manage chronic wounds in DFU due to several limitations, which eventually raises the need for advanced, innovative, and efficient treatment strategies for the better management of DFU. Many novel interventions, such as growth factor therapy, stem cell therapy, gene therapy, nanotechnology, bioengineered skin substitutes, 3D-bioprinting, and regenerative medicine, have shown promising roles in wound healing and tissue regeneration, suggesting their potential implications in the treatment and control of DFU. An integrated and multidisciplinary approach was proven to be a promising option for rapid and effective DFU management, eventually reducing the financial burden on the patients and healthcare system. Besides, AI-- driven medical technologies were found to support the healthcare system for the prevention, prediction, diagnosis, and personalized treatment of DFU. The present review article provides a brief overview of DFU and its pathophysiology. It highlights traditional DFU treatment strategies, their limitations, and focuses on emerging innovative strategies, emphasizing their potential for addressing DFU. Moreover, it sheds light on challenges and future research areas of these emerging interventions.

This work overviews some complex molecular interactions and phosphorylation events in the insulin receptor (IR) signaling pathway and explains its central role in metabolic control, which starts from the synthesis and secretion of insulin by pancreatic β-cells under elevated blood glucose. The triggered pathway coordinates a cascade of molecular processes that results in the activation of primary metabolic functions. Insulin bound to its receptor starts a sequence of events, such as the autophosphorylation of the receptor β subunit for initiating downstream signaling cascades, glycogen synthesis, and the appropriate regulation of lipid metabolism. The complexity and specificity of the signaling pathway involve insulin receptor substrates, phosphatidylinositol-3-kinase (PI3K), and protein kinase B (PKB). A detailed molecular interaction analysis in the IR has pointed to the crucial role of some residues and structural elements necessary for enzymatic functionalities and substrate binding. These factors include the kinase domain of the IR with specific amino acid residues, and subsequent activation of downstream signaling proteins. The structural changes on phosphorylation promote the binding of SH2 domain-containing adaptor proteins, which lead to the initiation of multifunctional signaling complexes central to insulin signal transduction. These molecular mechanisms provide insight into pathophysiology relating to metabolic diseases and potential treatment targets. This review aims an understanding of insulin receptor operation, elucidating the molecular intricacies behind the eventful metabolic insulin signaling pathways and highlighting possible research and therapeutic development in the field of medicine.

Diabetes, regarded as a prevalent metabolic disorder with multifactorial origins, contributes to a myriad of global complications. These cumulate an elevated susceptibility to kidney failure, nerve impairment, blindness, atherosclerosis, heart ailments, and even strokes. Recent investigations underscore the diverse roles of associated biomarkers in diabetes progression. Among these are biomarkers for diabetes mellitus such as DPP-4, PPAR-ϒ, SGLT-2, α-amylase, and α-glucosidase, which are linked to the onset of diabetes and its related problems. As a result of undesirable adverse consequences linked to extant synthetic antidiabetic medications, research attention is increasingly directed towards formulating natural antidiabetic drugs, aiming for enhanced efficacy and reduced complications. Cyanobacteria stand out as a pivotal repository of natural bioactive metabolites extensively harnessed for pharmaceutical and nutraceutical development. The potent bioactive compounds sourced from cyanobacteria hold substantial promise, kindling high expectations in scientific research and presenting vast prospects for drug discovery and advancement. Some of these bioactive compounds have demonstrated impressive effectiveness, displaying successful applications across various phases of clinical trials. This review strives to provide a more precise understanding of diabetes mellitus, encompassing its clinical manifestation, epidemiological data, complications, and prevailing treatment modalities. The objective of this review is to contribute researchers and readers an enhanced and accurate understanding of diabetes mellitus by covering its clinical manifestation, epidemiological evidence, difficulties, and prevailing therapeutics possibilities.

Recent research demonstrates that diabetes can lead to heart problems, neurological damage, and other illnesses. In this paper, we design a low-complexity Deep Learning (DL)-based model for the diagnosis of type 2 diabetes. In our experiments, we use the publicly available PIMA Indian Diabetes Dataset (PIDD). To obtain a low-complexity and accurate DL architecture, we perform an accuracy-versus-complexity study on several DL models. The results show that the proposed DL structure, including Convolutional Neural Networks and Multi-Layer Perceptron models (i.e., CNN+MLP model) outperforms other models with an accuracy of 93.89%. With these features, the proposed hybrid model can be used in wearable devices and IoT-based health monitoring applications.

Diabetic peripheral neuropathy (DPN) is the prevalent microvascular complication of diabetes mellitus (DM). 30-50% of diabetics are likely to be affected by DPN. It significantly impacts the skeletal muscles, resulting in an accelerated loss of muscle mass. The objective of this systematic review was to evaluate the ankle and foot muscle changes in diabetic peripheral neuropathy using ultrasound. A comprehensive search was conducted in Scopus, Embase, and PubMed databases, which yielded 64 studies, out of which 5 studies are included in this meta-analysis. The meta-analysis shows that the thickness and cross-section area of the extensor digitorum brevis muscle are reduced in DPN as compared to the control group with p-value<0.004 and p-value<0.001, respectively. The thickness of MIL muscle was also smaller in DPN p-value=0.02. Similarly, the thickness and CSA of AH muscle are also reduced in DPN patients compared to the control group, with p-values of 0.21 and 0.14. Meta-analysis reveals that diabetic peripheral neuropathy (DPN) patients have reduced foot muscle thickness and cross-sectional area (CSA) compared to controls without neuropathy. This highlights the importance of ultrasound in detecting muscle atrophy early in diabetic patients since it provides objective measures beyond traditional screening with its real-time and non-invasive nature.

Albuminuria in Diabetes mellitus (DM) patients may lead to nephropathy and end-stage renal disease. Our study aimed to assess the prevalence of albuminuria and its associated predictors among type 2 DM patients in the United Arab Emirates. A retrospective cross-sectional study was conducted among type 2 DM patients in the diabetic clinic at Fujairah Hospital from 1st January 2016 to 30th January 2020 after getting the ethical clearance. Data were collected electronically from the health information system and analyzed using SPSS version 26. Regression analysis and ANOVA were used for inferential analysis. A P-value of ≤0.05 was considered significant. Among the 200 patients included in the study, the mean age of the study population was 56 years, and the majority of them were females (71%). The prevalence of albuminuria was found to be 44%. By using regression analysis, glycated hemoglobin (HbA1c; P=0.038) and systolic blood pressure (SBP; P=0.003) were found to be predictors of albuminuria. One way ANOVA revealed that there were significant associations between the albumin levels and HbA1c (P=0.004), SBP (P= 0.002), diastolic blood pressure (DBP; P=0.028), serum creatinine (Scr) (P=0.039), and glomerular filtration rate (GFR; P=0.013). To the best of our knowledge, this is the first study from Fujairah emirate that explored the prevalence and predictors of albuminuria in type 2 DM patients. We found a high prevalence of albuminuria among type 2 DM patients. HbA1c and SBP directly contributed to albuminuria. To improve glycemic control, patients need to improve physical activity, reduce overweight and, adherence to medications that improve overall therapeutic outcomes.

Diabetes and sarcopenia are major age-related health issues in the world. Due to their bidirectional relationship, they significantly impact the quality of life of elderly men and women, especially those over 60 years old. In this brief communication, we incorporate the effect of sarcopenia into a previously developed mathematical model examining the impact of exercise on the dynamics of glucose and insulin. Extending a previous mathematical model by Derouich and Boutayeb, derived from the minimal model of Bergman, we present a new mathematical model using ordinary differential equations in which the parameter "S" is included to express the additive effect of sarcopenia. Considering that the sarcopenia effect is introduced multiplicatively, the new model proposed shows that sarcopenia lowers insulin sensitivity both in the presence and absence of physical exercise. The effects of sarcopenia on glucose dynamics are illustrated by simulations with varying model parameters. A large number of clinical studies have shown the link between Type 2 diabetes and sarcopenia. Some authors have particularly explored the causal relationship between insulin resistance and sarcopenia. The proposed mathematical model indicates that sarcopenia reduces insulin sensitivity in both the presence and absence of physical exercise, and that severe sarcopenia may negate the benefits of physical exercise. By theoretically demonstrating the relationship between sarcopenia and Type 2 diabetes, this mathematical model confirms the interrelationship between sarcopenia and Type 2 diabetes for any population worldwide, regardless of its regional, cultural, or environmental specificity.

Bullous pemphigoid (BP) is an autoimmune blistering disease that especially presents in elderly patients, but recently, its incidence has increased in patients treated with inhibitors of dipeptidyl peptidase-4 (DPP-4), among which teneligliptin is widely prescribed as an antidiabetic drug for the treatment of type 2 diabetes mellitus (T2DM). Recent studies describe the association of teneligliptin with the onset of BP, hypothesizing that DPP-4 inhibition could induce immune dysregulation able to trigger autoimmune responses against skin antigens BP180 and BP230. This mini-review discusses the immunomodulatory effects of teneligliptin, immune responses, and chronic inflammation associated with diabetes that predispose patients to BP. It also discusses the clinical implications, such as monitoring for BP in T2DM patients on teneligliptin therapy. Elucidation of this relationship may help in optimizing management strategies by highlighting discontinuation or alternative therapies in the case of a high risk of development of BP.