Antidiabetic Treatment Research Articles

The Effect of HBV Therapy on Glycemic Control in HBV-Infected Patients With Diabetes: A 90-day Multicenter Study.

Patients with diabetes are at increased risk of HBV infection; however, the effects of HBV infection and anti-HBV therapy on the management of type 1 diabetes (T1D), type 2 diabetes (T2D), and latent autoimmune diabetes in adults (LADA) remain unclear. From 2016 to 2023, we recruited a multicenter cohort of 355 HBV-infected inpatients, including 136 with T1D, 140 with T2D, and 79 with LADA. The control group included 525 HBV-uninfected inpatients, comparing 171 with T1D, 204 with T2D and 150 with LADA. We employed propensity-score matching between cases and controls to minimize confounding effects. Hemoglobin A1c (HbA1c) was monitored at baseline and at months 1, 2, and 3. At baseline, median HbA1c was significantly higher in HBV-infected patients compared to their HBV-uninfected controls: T1D (10.4% vs. 7.5%, p < 0.01), T2D (9.6% vs. 8.6%, p = 0.01), and LADA (9.4% vs. 8.4%, p = 0.03). Baseline HbA1c levels were significantly lower in HBV-treated patients compared to those HBV-untreated patients, regardless of whether they were on antidiabetic therapy (p < 0.05). A 90-day follow-up consistently indicated lower HbA1c levels at baseline, as well as at months 1, 2, and 3 among HBV-treated patients with T1D, T2D, or LADA. Both univariate and multivariate analyses identified HBV therapy (OR = 0.44, p < 0.001) and antidiabetic treatment(OR = 0.51, p = 0.031) as protective factors for glycemic control in HBV-infected patients with diabetes. Poor glycemic control is found in HBV-infected patients with diabetes, but the intervention of anti-HBV therapy and antidiabetic treatment contributes to improved glycemic control in HBV-infected patients with T1D, T2D, or LADA.

Sex differences in intracranial plaque burden in patients with type 2 diabetes mellitus with acute ischemic cerebrovascular disease: a pilot study based on high-resolution MRI

BackgroundAtherosclerosis (AS) is the main cause of macrovascular disease. Previous studies have found sex differences in the prevalence of type 2 diabetes mellitus (T2DM) and its associated macrovascular disease outcomes. However, the relationship between sex differences, T2DM, and AS is not fully understood. This study attempts to explore possible associations between sex, treatment, and the burden of intracranial atherosclerosis (ICAS) in patients with T2DM who have experienced an acute ischemic cerebrovascular disease.MethodsWe focused on patients with T2DM with acute ischemic stroke or transient ischemic attack due to intracranial atherosclerotic stenosis. ICAS was assessed by 3T cardiovascular magnetic resonance vascular wall imaging. Plaque counts of the total, proximal, and distal intracranial arteries were used to assess plaque burden. Patients with a history of T2DM and currently taking hypoglycemic drugs were defined as being treated. Poisson regression models or negative binomial regression models were used to analyze the interaction between sex and treatment in relation to plaque burden.ResultsA total of 495 plaques were detected in 120 patients (75 male; mean age, 60.77 ± 11.01 years), including 311 proximal and 184 distal plaques. The intracranial culprit plaque was located proximal to the artery in both male (85.3%) and female (88.9%) patients. The adjusted total and proximal intracranial plaque burdens were 1.261 times (95% confidence interval [CI], 1.050–1.515, P=0.013) and 1.322 times (95%CI, 1.055–1.682, P=0.016) higher in male than in female patients. The risk ratio for proximal plaque burden in untreated male versus female patients was 0.966 (95%CI, 0.704–1.769). However, the proximal plaque risk ratio for treated male versus female patients was 1.530 (95%CI, 1.076–2.174). The interaction of sex and treatment significantly affected the proximal plaque burden.ConclusionMale patients with T2DM and acute cerebrovascular disease have a significantly higher adjusted risk of total and proximal intracranial plaque burden compared to female patients. Female patients undergoing antidiabetic treatment have a significantly reduced risk of proximal plaque to males. Considering that culprit plaques tend to accumulate in the proximal arteries, understanding how to reduce the burden of proximal plaques may help reduce the risk of adverse cerebrovascular events.

Pyridine Derivatives: A Comprehensive Review of Their Potential as Anti-Diabetic Agents.

Diabetes mellitus and obesity are two of the most frequent health conditions in the world, prompting medical researchers to seek novel effective treatments. According to World Health Organization (WHO) regulations and several research studies, diabetes is regarded as a significant and leading health concern worldwide. The search for efficient and safe antidiabetic drugs has led to the study of pyridine derivatives, a family of molecules with a wide range of pharmacological characteristics. Pyridines are important heterocyclic chemicals renowned for their various pharmacological properties. Materials were compiled using the three databases of ScienceDirect, PubMed, and Google Scholar. For this study, only English-language publications have been evaluated based on their titles, abstracts, and full texts using keywords like diabetes, pyridine Derivatives, α- glucosidase inhibitors, and α-amylase inhibitors. Pyridine and its derivatives have received a lot of attention due to their wide range of potential uses in medicinal chemistry and pharmacology. Structural alterations and optimization efforts have resulted in higher effectiveness, selectivity, and safety characteristics. These discoveries highlight the importance of pyridine analogues as a novel class of therapeutic agents for diabetes management. The review highlights the significance of pyridine analogues in the development of antidiabetic treatments, opening new avenues for developing drugs and clinical use. The ongoing advancements in the discovery of pyridine derivatives underscore their potential as prospective agents in diabetic treatments.

Nighttime systolic blood pressure a major factor of retinal vascular caliber changes in patients with newly diagnosed type 2 diabetes mellitus.

Changes in retinal vessel caliber are crucial for detecting early retinopathy, a significant cause of blindness in individuals with Diabetes Mellitus type 2 (T2DM). This study aims to evaluate the changes in retinal vessel caliber and identify factors associated with these changes in recently diagnosed T2DM patients. The study included newly diagnosed T2DM patients (within 6 months of diagnosis) who were free of antidiabetic treatment (except metformin) and matched individuals based on age and blood pressure (BP). Data collected included somatometric measurements, BP (office and 24-hour), hematological data, albuminuria (via 24-hour urine collections), ten-year atherosclerotic cardiovascular disease risk (ASCVD score), endothelial dysfunction (measured by Asymmetric Dimethylarginine, ADMA), retinal microvascular changes, assessed as central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), and arteriovenous ratio (AVR) using specialized software on non-mydriatic fundus photographs. The study involved 87 T2DM patients and 90 controls, aged 57±11 years. Key findings include no significant differences in CRAE, CRVE, and AVR between T2DM patients and controls. Age (p=0.019) and nighttime systolic BP (SBP) (p=0.002) were independent predictors of AVR. CRAE was independently associated with nighttime SBP (p=0.048). CRVE was independently associated with age (p=0.016), dipping (p=0.002), and smoking (p=0.018). In normotensive subjects, AVR was significantly lower in T2DM patients (p=0.035). The study concludes that increased nighttime SBP is a more critical factor than hyperglycemia in affecting retinal vascular caliber changes in newly diagnosed T2DM patients. This highlights the importance of managing nocturnal hypertension to prevent retinal damage in this patient population.

Polyphenolic Compounds in Fabaceous Plants with Antidiabetic Potential.

Diabetes mellitus (DM) is a chronic non-communicable disease with an increasing prevalence in Latin America and worldwide, impacting various social and economic areas. It causes numerous complications for those affected. Current treatments for diabetes include oral hypoglycemic drugs, which can lead to adverse effects and health complications. Other natural alternatives for DM treatment have been studied as adjunct therapies that could reduce or eliminate the need for antidiabetic medications. Several natural supplements may offer an alternative way to improve the quality of life for patients with DM, and they may have other nutraceutical applications. Due to their phenolic compound content, some leguminous substances have been proposed as these alternatives. Phenolic compounds, with their high antioxidant activity, have shown promising potential in insulin synthesis, secretion, and the functionality of the endocrine pancreas. This review provides valuable information on various leguminous plants with anti-diabetic properties, including antioxidant, hypoglycemic, anti-fat-induced damage, and anti-apoptotic properties in vitro and in vivo, attributed to the high content of phenolic compounds in their seeds. Natural products with antidiabetic and pharmacological treatment potential improve diabetes management by offering more effective and complementary alternatives. To integrate these herbal remedies into modern medicine, further research on phenolic compound type, doses, efficacy, and safety in the human population is needed.

Diabetes Fact Sheets in Korea 2024.

This study aimed to investigate the prevalence, management, and comorbidities of diabetes mellitus among Korean adults. Data from the Korea National Health and Nutrition Examination Survey (2019-2022) were analyzed to assess the prevalence, treatment, risk factors, and comorbidities of diabetes. Comparisons between young and older adults with diabetes were emphasized. Among Korean adults aged ≥30 years, the prevalence of diabetes is 15.5% during 2021-2022. Of these, 74.7% were aware of their condition, 70.9% received antidiabetic treatment, and only 32.4% achieved glycosylated hemoglobin (HbA1c) <6.5%. Moreover, 15.9% met the integrated management targets, which included HbA1c <6.5%, blood pressure <140/85 mm Hg, and low-density lipoprotein cholesterol <100 mg/dL. In young adults aged 19 to 39 years, the prevalence of diabetes was 2.2%. Among them, 43.3% were aware of their condition, 34.6% received treatment, and 29.6% achieved HbA1c <6.5%. Obesity affected 87.1%, and 26.9% had both hypertension and hypercholesterolemia. Among adults aged ≥65 years, the prevalence of diabetes was 29.3%, with awareness, treatment, and control rates of 78.8%, 75.7%, and 31.2%, respectively. Integrated management targets (HbA1c <7.5%, hypertension, and lipids) were achieved by 40.1%. Diabetes mellitus remains highly prevalent among Korean adults, with significant gaps in integrated glycemic, blood pressure, and lipid control. Older adults with diabetes show higher awareness and treatment rates but limited integrated management outcomes. Young adults with diabetes bear a significant burden of obesity and comorbidities, alongside low awareness and treatment rates. Therefore, early intervention programs, education, and strategies tailored to younger populations are urgently required.

Implications of prognostic nutritional index in predicting adverse outcomes of uncontrolled diabetic patients: a cohort study of the national health and nutrition examination survey from 2005 – 2018

BackgroundDiabetes mellitus (DM) is a metabolic disorder with increasing prevalence and poor control rates, leading to adverse events. Prognostic nutritional value (PNI) has been identified as a protective factor in DM, but its role in uncontrolled DM remains unclear.MethodsThis study based on the representative cohort of National Health and Nutrition Examination Survey from 2005 to 2018. A total of 3,313 participants with uncontrolled DM were included in our analyses. PNI was calculated as 5×lymphocyte count (109/L)+ 10×serum albumin (g/L). The endpoints were DM-related and cardiovascular mortality, which were obtained from National Death Index. Univariable and multivariable cox proportional hazard regression were performed to investigate prognostic value of PNI.ResultsAmong 3,313 patients with uncontrolled DM (mean age of 61.75 ± 12.78 years, 53.4% male), PNI level was negatively associated with inflammatory markers and positively associated with metabolic markers of lipid and protein. During a median follow-up of 77 months, 247 DM-related deaths and 205 cardiovascular deaths occurred. Higher PNI levels independently predicted low DM-related (adjusted Hazard ratio [HR] = 0.872, 95% confidence interval [CI] 0.840–0.906, P < 0.001) and cardiovascular mortality (adjusted HR = 0.872, 95% CI 0.834–0.912, P < 0.001). The prognostic value of PNI significantly varied across different DM treatment conditions, which was more pronounced in patients receiving antidiabetic treatments (adjusted HR: insulin + oral antidiabetic drugs [OADs]: 0.832; insulin: 0.863; OADs: 0.894, all adjusted P < 0.001), but was absent in those without antidiabetic treatment.ConclusionsA higher PNI level is an independent protective predictor for DM-related and cardiovascular mortality in uncontrolled DM patients. Evaluation of PNI level in uncontrolled DM patients could conduce to stringent intervention. Improvement of PNI could enhance the effective of antidiabetic therapy, especially the insulin therapy, and reduce DM-related mortality.

Targeting central pathway of Glucose-Dependent Insulinotropic Polypeptide, Glucagon and Glucagon-like Peptide-1 for metabolic regulation in obesity and type 2 diabetes.

Obesity and type 2 diabetes are significant public health challenges that greatly impact global well-being. The development of effective therapeutic strategies has become more and more concentrated on the central nervous system and metabolic regulation. The primary pharmaceutical interventions for the treatment of obesity and uncontrolled hyperglycemia are now generally considered to be incretin-based anti-diabetic treatments, particularly glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide receptor agonists. This is a result of their substantial influence on the central nervous system and the consequent effects on energy balance and glucose regulation. It is increasingly crucial to understand the neural pathways of these pharmaceuticals. The purpose of this review is to compile and present the most recent central pathways regarding glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide and glucagon receptors, with a particular emphasis on central metabolic regulation.

Elucidation of the clinical traits of diabetic chorea through a questionnaire survey of people with diabetic chorea from 59 Japanese hospitals.

Diabetic chorea refers to sudden involuntary movements developing in people with diabetes mellitus and is known to occur mainly in those with severe hyperglycemia. We conducted a questionnaire survey of case-reporting facilities in Japan to elucidate their clinical characteristics. We searched the PubMed and Ichushi databases for case reports published from January 1, 2012, to December 31, 2017, using "diabetes" and "chorea" as keywords, and sent a questionnaire to the reporting institutions. Data from a total of 64 cases were included in this study. While most cases had severe hyperglycemia at the onset of diabetic chorea, hypoglycemia/improvement of the plasma glucose served as the trigger for the symptom in 14 cases (21.9%). The Early Remission Group (≤6 months) consisted of 39 cases (60.9%), while the Prolonged Partial Remission Group (>6 months) included 25 cases (39.1%). In the Prolonged Partial Remission Group (>6 months), there were more cases with widespread involuntary movement symptoms, a higher number of cases exhibiting typical imaging findings, and a greater incidence of chorea onset after the initiation of antidiabetic treatment, including hypoglycemia. Most reported cases of diabetic chorea in Japan were elderly persons with type 2 diabetes mellitus and severe hyperglycemia, although there were also some cases in which the symptom developed in the setting of hypoglycemia. It has been suggested that rapid plasma glucose correction and hypoglycemia might be associated with the risk of development and prognosis of diabetic chorea.

Differential effects of liraglutide naltrexone/bupropion, and caloric restriction on metabolic parameters and beta-cell regeneration in type 2 diabetic rat model: role of beta arrestin 1.

Traditional antidiabetic treatments often carry the risk of beta-cell exhaustion, highlighting the need for therapies that promote beta-cell regeneration. This study investigates the comparative effects of Liraglutide, naltrexone/bupropion (NTX + BUP), and caloric restriction on metabolic control and beta-cell regeneration in a rat model of obese type 2 diabetes. Fifty male albino rats were randomized into five groups: normal control, diabetic control, diabetic + caloric restriction (50%), diabetic + NTX + BUP (4mg/45mg /kg/day orally), and diabetic + liraglutide (0.3mg/kg/day, S.C). Body weight, BMI, serum glucose, insulin, lipid profile, atherogenic indices, beta-arrestin-1 levels, pancreatic histopathology, and immunohistochemical staining for insulin and Ki67 were assessed. All interventions significantly improved body weight, BMI, glycemic control, lipid profiles (except HDL), and atherogenic indices compared to the diabetic control group. NTX + BUP and caloric restriction resulted in greater weight loss compared to liraglutide. Of note, liraglutide significantly decreased β-arrestin-1 levels compared toboth NTX + BUP and caloric restriction. Furthermore, liraglutide and caloric restriction significantly increased anti-insulin antibodies and Ki67 indicating beta-cell regeneration, whileNTX + BUP showed insignificant effects. Thus we can conclude that,while NTX + BUP demonstrates efficacy in improving metabolic parameters in obese type 2 diabetic rats, it shows limitations in promoting beta-cell regeneration compared to liraglutide and caloric restriction.

Novel Quinoline- and Naphthalene-Incorporated Hydrazineylidene-Propenamide Analogues as Antidiabetic Agents: Design, Synthesis, and Computational Studies.

Background: Type 2 diabetes has become a significant global health challenge. Numerous drugs have been developed to treat the condition, either as standalone therapies or in combination when glycemic control cannot be achieved with a single medication. As existing treatments often come with limitations, there is an increasing focus on creating novel therapeutic agents that offer greater efficacy and fewer side effects to better address this widespread issue. Methods: The methylene derivatives 3a,b were coupled with phenyl/ethyl isothiocyanate in the basic medium, and dimethyl sulfate was subsequently added. Further, 5a-d were reacted with the quinoline/naphthalene hydrazides 6a,b. The target compounds 7a-g were subjected to the in vitro enzyme inhibition studies on α-glucosidase, α-amylase, and aldose reductase. Results: 7g exerted remarkable inhibitory effects on α-glycosidase [Inhibitory Concentration (IC50): 20.23 ± 1.10 µg/mL] and α-amylase (17.15 ± 0.30 µg/mL), outperforming acarbose (28.12 ± 0.20 µg/mL for α-glycosidase and 25.42 ± 0.10 µg/mL for α-amylase), and exhibited a strong inhibition action on aldose reductase (12.15 ± 0.24 µg/mL), surpassing quercetin (15.45 ± 0.32 µg/mL) and the other tested compounds. In a computational study, 7g demonstrated promising binding affinities (-8.80, -8.91 kcal/mol) with α-glycosidase and α-amylase, compared to acarbose (-10.87, -10.38 kcal/mol) for α-glycosidase and α-amylase. Additionally, 7g had strong binding with aldose reductase (-9.20 kcal/mol) in comparison to quercetin (-9.95 kcal/mol). Molecular dynamics (MDs) simulations demonstrated that 7g remained stable over a 100 ns simulation period, and the binding free energy estimates remained consistent throughout this time. Conclusions: We reported the modification of quinoline and naphthalene rings to hydrazineylidene-propenamides 7a-g using various synthetic approaches. 7g emerged as a leading candidate, exhibiting greater inhibition of α-glycosidase, α-amylase, and aldose reductase. These findings underscore their potential as essential molecules for the development of innovative antidiabetic treatments.

Anti-diabetic therapies on dental implant success in diabetes mellitus: a comprehensive review.

Dental implant therapy faces challenges in patients with Type 1 and Type 2 Diabetes Mellitus (T1DM and T2DM) due to adverse effects on bone metabolism and immune response. Despite advancements, diabetic patients face higher risks of peri-implantitis and compromised osseointegration. This review assesses the impact of anti-diabetic medications on implant outcomes, offering insights to bridge the gap between animal studies and clinical practice. By evaluating pharmacotherapeutic strategies in preclinical models, this review guides future research designs to improve implant success rates in diabetic individuals. A comprehensive literature review identified 21 animal studies examining the impact of anti-diabetic medications on dental and bone implants. These studies explored diabetes models, medication regimens, and designs to assess outcomes related to bone metabolism, osseointegration, and peri-implant tissue responses. The findings are systematically summarized, highlighting the scope, design, and procedures of each study. An example includes placing a dental implant in the molar region of a mouse, providing insight into preclinical approaches. Twenty-one animal studies, primarily using rodents, investigate various anti-diabetic medications on dental and bone implants. Interventions include insulin, aminoguanidine, voglibose, sitagliptin, exenatide, and metformin, analyzing outcomes like bone-implant contact (BIC), bone volume (BV), and counter-torque values in T1DM and T2DM models. The impacts of these medications on implant osseointegration under diabetic conditions are detailed, with their benefits and shortcomings assessed. The findings and challenges of existing animal studies on diabetes mellitus (DM) and implant osseointegration are presented. Despite T2DM prevalence, research primarily focuses on T1DM models due to easier experimental practicalities, limiting applicability. Inconsistent protocols in studies compromise reliability regarding anti-diabetic treatments' effectiveness on osseointegration. Standardized methodologies and long-term assessments of local drug delivery alongside systemic anti-DM treatments are crucial to manage DM-related complications in implant dentistry. Insulin administration in short-term T1DM animal studies enhances implant osseointegration. However, the efficacy of non-insulin medications remains inconclusive. Rigorous experimental designs are needed to address inconsistencies and assess long-term impacts. Larger-sized (e.g., porcine) animal studies across various intraoral implant scenarios are required. Future research should focus on enhancing clinical applicability and improving implant stability in evolving conditions.

Prevalence of obesity, determinants, and its association with hyperglycaemia among community dwelling older adolescents in India.

Globally, obesity and diabetes mellitus (DM) are emergent public health concerns in the adolescent population. India, home to the largest adolescent population and the second largest diabetes cohort is experiencing rapid but unplanned urbanization, with accompanying unhealthy nutritional transition, and sedentary lifestyle. To determine prevalence and determinants of obesity and hyperglycaemia and their association among community-dwelling older adolescents (15-19 years) in India. This cross-sectional analysis from the national family health survey-5 included data of 258028 adolescents aged 15-19 across India (2019-2021). The survey employed stratified two-stage sampling, with systematic random sampling in rural and urban areas. Statistical analysis included descriptive statistics, bivariate, and multivariable logistic regression, employing generalized linear models. The weighted prevalence of DM was 1.09% including 0.77% [95% confidence interval (CI): 0.72-0.83] previously diagnosed and 0.32% (95%CI: 0.29-0.35) newly diagnosed cases detected on survey screening. On adjusted analysis, increasing age, higher education levels, higher wealth index, and overweight/obesity were the factors significantly associated with presence of DM. Only 61% of the adolescents with previously diagnosed DM were on anti-diabetes treatment. The weighted prevalence of overweight/obesity among older adolescents was 6.9% with significantly higher odds in the male sex, having higher educational levels, urban residence, and those with a higher wealth index. Nearly one in hundred older adolescents in India have diabetes, with one in three undiagnosed. Strengthening DM screening and treatment access among adolescents through public health programs is urgently warranted.

In-vitro and in-silico assessment of thiazole-thiazolidinone derivatives as selective inhibitors of urease and α-glucosidase.

Current research work aims to synthesize hybrid compounds with a thiazole-thiazolidinone structure, as potent inhibitors of urease and α-glucosidase enzymes. These compounds were characterize through1HNMR,13CNMR and HREI-MS techniques. These compounds were also evaluated for their potential to inhibit urease and α-glucosidase enzymes for the treatment of urinary tract infections (UTIs) and diabetes treatments. Moreover, molecular docking and ADMET analysis was carried out to confirm biological outcomes. Compounds-4 (IC50 = 1.80 ± 0.80 and 3.61 ± 0.59 μM against urease and α-glucosidase, respectively) exhibited significant effectiveness in inhibiting the activity of both enzymes in comparison to the conventional inhibitors thiourea and acarbose. Molecular docking experiments showed that potent compounds exhibited favorable binding orientations in the active sites of urease and α-glucosidase playing a pivotal role in inhibition profile of these compounds. These compounds were also investigated for their drug likeness and were found with desirable attributes for pharmaceutical development. Based on the findings of this research, these compounds have the potential to be developed into effective anti-diabetic and anti-urease treatments in the future.

Sungkai Leaf Extract (Peronema canescens Jack) Decrease Blood Glucose Levels in Rat Models of Diabetes Mellitus

Diabetes mellitus (DM) is a long-term metabolic condition marked by hyperglycemia, which, if it persists, will generate an excess of free radicals, contributing to problems from diabetes. Sungkai (Peronema canescens Jack) is a plant that provides antioxidants and antidiabetic properties. Finding out how sungkai leaf extract affects blood glucose levels in diabetic rat models is the aim of this study. In this study, the Post Test-Only Control Group is used as part of an experimental design. The 35 rats were split up into six groups: the DM control group (KDM) of rats given glibenclamide, the positive control group (K+) of rats given alloxan, the negative control group (K-), and the group that received sungkai leaf extract (Peronema canescens Jack) P1 (dose 150 mg/kgBB), P2 (dose 300 mg/kgBB), and P3 (dose 600 mg/kgBB) for 30 days. Using a spectrophotometer and the GOD-PAP technique, blood glucose levels were assessed. According to the findings, sungkai leaf extract (Peronema canescens Jack) reduced blood glucose levels (p&lt;0.05). In summary, sungkai leaf extract may be used as an antidiabetic treatment. Keywords: Hyperglycemia, Sungkai Leaf Extract, Antidiabetic

Investigation of the effect of disease acceptance and action status of type 2 diabetes patients receiving oral antidiabetic and insulin treatment on their compliance to treatment

Aims: This study aimed to determine the effect of disease acceptance and action status on treatment compliance in Type 2 DM patients receiving oral antidiabetic and insulin treatment. Methods: This study is a comparative cross-sectional study. A total of 122 patients, including 61 patients receiving oral antidiabetic treatment and 61 patients receiving insulin treatment, were included in this study. The data of the study were collected with the "Individual Introduction Form", "Acceptance and Action Diabetes Questionnaire", and "Type 2 Diabetes Mellitus Treatment Patient Compliance Scale". Results: There is a significant and negative correlation between the total score of the Acceptance and Action Diabetes Questionnaire and the total score of the Type 2 Diabetes Mellitus Treatment Patient Compliance Scale (r=-0.375; p&lt;0.05). The study observed that as the total score of the Acceptance and Action Diabetes Questionnaire increased, the total score of the Type 2 Diabetes Mellitus Treatment Patient Compliance Scale decreased. Conclusion: In our study, it was observed that the compliance level of type 2 DM patients using insulin or OAD was moderate, and their acceptance and action levels were above average.

Effects of Metformin Therapy on Thyroid Volume and Functions in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A Single-center Prospective Study.

Patients with impaired glucose metabolism have increased thyroid volume and a higher prevalence of nodules. Yet, some studies show that there is an improvement in these thyroid parameters after diabetes treatment. Our observational study aimed to reveal the effect of treatment on thyroid function, thyroid volume, and the presence of nodules in newly diagnosed type 2 diabetes mellitus (T2DM) patients who were started on metformin treatment. Euthyroid and subclinically hypothyroid patients with a serum TSH level of <10 mU/L, who were newly diagnosed with T2DM and started on metformin as an antidiabetic treatment and not used any thyroid medication previously, were included in our study. Patients' characteristics were recorded. Baseline and 6th-month serum thyroid function tests were scheduled. Baseline and 6th-month thyroid gland characteristics were examined by thyroid ultrasonography. A total of 101 (37 males, 64 females) newly diagnosed T2DM patients with euthyroid (n=95) or subclinical hypothyroidism (n=6) were included in the study. The mean age of the patients was 53.02 ± 11.9 years, and the mean BMI was 29.60 ± 3.9 kg/m2. Fifty-two (52%) patients were classified as obese. Body weight, BMI, serum TSH, ALT, Anti-TPO levels, and thyroid volume decreased significantly in the 6th-month compared to baseline values (p = 0.000; p = 0.000; p = 0.011; p = 0.022; p = 0.000, respectively). Serum anti-Tg, fT4, fT3 levels, and thyroid nodule count did not change significantly. A high agreement was found between the baseline and 6thmonth nodule counts (gamma= 0.886; p < 0.001) and the presence of multi-nodularity in the thyroid (gamma= 0.941; p < 0.001), but no significant change was observed. Anti-TPO levels showed a significant decrease in both with and without obesity groups at the end of 6 months (p = 0.003, p = 0.009, respectively). Serum TSH level decreased significantly only in non-obese subjects (p = 0.004), and thyroid volume decreased significantly only in obese subjects (p = 0.000). Our results suggest that metformin treatment significantly reduces body weight, BMI, thyroid volume, and serum TSH, ALT, and Anti-TPO levels in patients with newly diagnosed T2DM. Moreover, serum TSH levels showed a significant decrease in non-obese subjects, while thyroid volume showed a significant decrease in obese subjects.

A Study Protocol on the Evaluation of Comparative Efficacy of Waj (Acorus calamus Linn.) versus Pregabalin in Diabetic Peripheral Neuropathy

Background: Diabetes is a major global health concern in the twenty-first century. The International Diabetes Federation (IDF) estimates that by the end of 2021, complications from diabetes would have killed 747,000 peoples in India. Diabetic peripheral neuropathy (DPN) is a disorder that develops in patients with diabetes (type 1 and type 2) and is not attributable to any other peripheral neuropathy causes. Clinically, it may manifest as burning, tingling, numbness, or neuropathic pain in the foot that tends to get worse at night. DPN frequently results in ulceration, infection, deterioration of the skin, and ultimately amputation. Methods: This study will be conducted as randomized standard-controlled, single-blind trial on 150 DPN subjects with type 2 diabetes by randomly assigned them to two groups (test or standard), where test group will receive two capsules twice (containing 500 mg powder of test drug in each capsule) with water and control group will receive one capsule of pregabalin 75 mg twice. Both groups will be treated for 60 days with 30 days post treatment follow-up addition to their regular anti-diabetic treatment. The subjective parameters of burning, tingling, and pain in the feet will be evaluated every two weeks using the visual analog scale (VAS) and arbitrary scale. Objective parameters, Toronto Clinical Scoring System (TCSS) will be assessed fortnightly along with vibratory perception threshold (VPT), assessed pre and post-treatment. Data will be assessed statistically with appropriate tests.

Major electrolyte disorder and associated factors among patients with chronic disease in Ethiopia: a systematic review and meta-analysis

BackgroundAlterations in electrolytes are associated with a number of clinical problems and prompt diagnosis of electrolyte disorder and treatment are crucial in the management of patients with chronic illness. Even though, major electrolyte disorders are common among patients with chronic diseases, the problem were not received enough attention. Thus, the aim of this review was to determine the pooled prevalence and associated factors of major electrolyte disorder among patients with chronic diseases.MethodsThe PubMed, Cochrane Library, Science Direct, African Journals Online, and Google Scholar databases were searched by two authors (WCT and YAF) from January 15/2024 to January 22/2024 to identify articles reporting the prevalence of electrolyte disorders in patients with chronic disease in Ethiopia. A random-effects model was used to estimate the pooled prevalence of electrolyte disorder. Important data were extracted with Microsoft Excel and then exported to STATA software version 11 (STATA Corp LLC, TX, USA) for analysis. Cochran's Q test at a significance level of less than 0.05 and the I2 index were used to examine the statistical heterogeneity among the included studies. A random-effects model was used to estimate the pooled prevalence of major electrolyte disorder due to the presence of heterogeneity.ResultsThe finding of this review showed that, the pooled estimate of electrolyte disorder among patients with chronic diseases in Ethiopia was found to be 56.66% (95% CI: 44.54, 68.79, P < 0.001). Having no formal education (POR = 7.06, 95% CI = 1.35, 36.98), taking diuretic (POR = 4.41, 95% CI = 1.78, 10.91), patients with anti-diabetic medication (POR = 10.11, 95% CI = 3.45, 29.66), having a body mass index ≥ 30 kg/m2 (POR = 6.99, 95% CI = 2.01, 5.93) and having uncontrolled blood glucose [POR: 7.09, 95% CI = 5.10–9.80) were factors associated with electrolyte disorders among patients with chronic diseases.ConclusionThis systematic review and meta-analysis revealed that the pooled electrolyte disorders among patients with chronic disease was significant in Ethiopia. Patients who had no formal education, taking diuretic, taking anti-diabetic medication, body mass index ≥ 30 kg/m2, alcohol consumption and having high uncontrolled blood glucose were significantly associated with electrolyte disorders. Special emphasis on the status of serum electrolytes should be given for patients with chronic disease in those taking diuretic and anti-diabetic treatments and who are overweight.Trial registrationProspero registration: CRD42024579411.

Echocardiographic Assessment of Biventricular Mechanics of Fetuses and Infants of Gestational Diabetic Mothers: A Systematic Review and Meta-Analysis.

Gestational diabetes mellitus (GDM) is the most common complication in pregnancy, representing a serious risk for the mother and fetus. Identifying new biomarkers to ameliorate the screening and improving GDM diagnosis and treatment is crucial. During the last decade, a few studies have used speckle tracking echocardiography (STE) for assessing the myocardial deformation properties of fetuses (FGDM) and infants (IGDM) of GDM women, providing not univocal results. Accordingly, we performed a meta-analysis to examine the overall influence of GDM on left ventricular (LV) and right ventricular (RV) global longitudinal strain (GLS) in both FGDM and IGDM. All echocardiographic studies assessing conventional echoDoppler parameters and biventricular strain indices in FGDM and IGDM vs. infants born to healthy pregnant women, selected from PubMed and EMBASE databases, were included. The studies performed on FGDM and IGDM were separately analyzed. The subtotal and overall standardized mean differences (SMDs) in LV-GLS and RV-GLS in FGDM and IGDM studies were calculated using the random-effect model. The full texts of 18 studies with 1046 babies (72.5% fetuses) born to GDM women and 1573 babies of women with uncomplicated pregnancy (84.5% fetuses) were analyzed. Compared to controls, FGDM/IGDM were found with a significant reduction in both LV-GLS [average value -18.8% (range -11.6, -24.2%) vs. -21.5% (range -11.8, -28%), p < 0.05)] and RV-GLS [average value -19.7% (range -13.7, -26.6%) vs. -22.4% (range -15.5, -32.6%), p <0.05)]. Large SMDs were obtained for both LV-GLS and RV-GLS studies, with an overall SMD of -0.91 (95%CI -1.23, -0.60, p < 0.001) and -0.82 (95%CI -1.13, -0.51, p < 0.001), respectively. Substantial heterogeneity was detected for both LV-GLS and RV-GLS studies, with an overall I2 statistic value of 92.0% and 89.3%, respectively (both p < 0.001). Egger's test gave a p-value of 0.10 for LV-GLS studies and 0.78 for RV-GLS studies, indicating no publication bias. In the meta-regression analysis, none of the moderators (gestational age, maternal age, maternal body mass index, maternal glycosylated hemoglobin, white ethnicity, GDM criteria, ultrasound system, frame rate, FGDM/IGDM heart rate, and anti-diabetic treatment) were significantly associated with effect modification in both groups of studies (all p > 0.05). The sensitivity analysis supported the robustness of the results. GDM is independently associated with biventricular strain impairment in fetuses and infants of gestational diabetic mothers. STE analysis may allow for the early detection of subclinical myocardial dysfunction in FGDM/IGDM.