Control Of Blood Glucose Levels Research Articles

Relationship Between Eating Behaviors and Physical Activity with Blood Glucose Levels in Type 2 Diabetes Mellitus Patients in Gayaman Public Health Center Mojokerto

Introduction: Diabetes mellitus can be caused by an unhealthy lifestyle including poor eating behavior and mild physical activity which can affect glucose metabolism so that blood glucose levels are high. This study aims to determine the relationship between eating behavior and physical activity with blood glucose levels in type 2 diabetes mellitus patients.
 Method: The study design used correlation analysis with a cross-sectional approach. The population in this study was all type 2 diabetes mellitus patients at the Gayaman Public Health Center Mojokerto. The sampling technique of this study was consecutive sampling. The research instrument used an eating behavior questionnaire adopted from the Aethelstone and physical activity level (PAL) questionnaire and was analyzed using the Spearman Rho test.
 Results: The results showed that 44.6% of respondents had poor eating behaviors, 48.2% had mild physical activity, and 80.4% had high blood glucose levels. The results of the Spearman Rho test showed that there was a significant relationship between eating behavior with blood glucose levels (p value=0,001;α<0,05) and physical activity with blood glucose levels (p value=0,002;α<0,05) in patients with type 2 diabetes mellitus at the Gayaman Public Health Center Mojokerto.
 Conclusion: Poor eating behaviors tend to cause high blood glucose levels because of excessive intake of food and drinks that contain carbohydrates which are metabolized to be glucose, if the patient is not doing physical activity then the glucose levels become high. The importance of controlling blood glucose levels in Type 2 Diabetes Mellitus patients by improving eating behavior includes an eating schedule, reducing food and drinks that contain a lot of glucose, and increasing physical activity

Progress and Perspectives of Mid-Infrared Photoacoustic Spectroscopy for Non-Invasive Glucose Detection.

The prevalence of diabetes is rapidly increasing worldwide and can lead to a range of severe health complications that have the potential to be life-threatening. Patients need to monitor and control blood glucose levels as it has no cure. The development of non-invasive techniques for the measurement of blood glucose based on photoacoustic spectroscopy (PAS) has advanced tremendously in the last couple of years. Among them, PAS in the mid-infrared (MIR) region shows great promise as it shows the distinct fingerprint region for glucose. However, two problems are generally encountered when it is applied to monitor real samples for in vivo measurements in this MIR spectral range: (i) low penetration depth of MIR light into the human skin, and (ii) the effect of other interfering components in blood, which affects the selectivity of the detection system. This review paper systematically describes the basics of PAS in the MIR region, along with recent developments, technical challenges, and data analysis strategies, and proposes improvements for the detection sensitivity of glucose concentration in human bodies. It also highlights the recent trends of incorporating machine learning (ML) to enhance the detection sensitivity of the overall system. With further optimization of the experimental setup and incorporation of ML, this PAS in the MIR spectral region could be a viable solution for the non-invasive measurement of blood glucose in the near future.

Extraction Efficiency and Alpha-Glucosidase Inhibitory Activities of Green Tea Catechins by Different Infusion Methods.

Alpha-glucosidase is an important target for glycemic control with the aim of reducing the risk of type 2 diabetes (T2D). Green tea catechins have been reported to inhibit alpha-glucosidase activity as a potential beverage to control blood glucose levels. However, the effects of the daily infusion style of green tea on tea catechins and their activity remain unclear. In this study, the extraction efficiency of catechins was investigated for 12 green tea extracts (GTEs) infused with 70% ethanol (70% EtOH for 24 h, a favored solvent for catechin extraction), room temperature water infusion (RT H2O for 24 h, an easy way to drink tea), and hot water infusion (Hot H2O for 90 s, a standard way to drink tea). Eight catechins were quantified by HPLC, and the inhibitory effect of GTEs and their catechins on alpha-glucosidase was measured with both rat intestinal enzymes and human Caco-2 cells. The inhibitory mechanism was further analyzed in silico by docking catechins to human alpha-glucosidase using Molecular Operating Environment software. The results showed that total catechins and gallate catechins were efficiently extracted in the order of 70% EtOH, RT H2O, and Hot H2O, and the inhibitory activity against alpha-glucosidase also followed a similar order. Pearson correlation analysis indicated that the alpha-glucosidase inhibitory activity of GTEs was significantly positively correlated with the contents of total catechins, especially gallate catechins. Gallate catechins, such as EGCg and ECg, showed lower IC50 values than free catechins for the enzyme in both rats and humans. In silico simulation revealed that gallate catechins were bound to the different sites with free catechins, and the docking energy of gallate catechins was lower than that of free catechins. Taken together, our data indicated that the daily infusion style of green tea significantly impacted the extraction efficiency and alpha-glucosidase inhibitory activities of catechins, which will give us insight into the use of green tea catechins for glycemic control through efficient infusion.

Islamic Spiritual Guidance on Changes In Blood Sugar Levels In Type 2 Diabetes Mellitus Patients

Diabetes Mellitus in Indonesia is increasing every year. Diabetes mellitus can be prevented, delayed and slowed down by controlling blood glucose levels. Controlling blood glucose levels in diabetics can be done with Islamic spiritual guidance. This study aims to analyze the effect of Islamic spiritual guidance on changes in blood sugar levels in Type 2 Diabetes Mellitus patients. The research method used was quasi-experimental using a pretest-posttest two group design. A sample of 22 respondents for the intervention group and 22 respondents for the control group. Data analysis used Wilcoxon test, dependent t-test, and Spearman rank correlation. The results showed that the mean blood sugar levels of the intervention group decreased 17.96 mg / dl. Statistically there is influence of Islamic spiritual guidance on blood sugar level (p = 0,000). The total energy requirement is a confounding variable that affects changes in blood sugar levels (p = 0.002). Diabetes mellitus patients are expected to apply spiritual guidance of Islam regularly to control blood sugar levels in order to improve the health of the body and prevent complications of diabetes.

Dumping Syndrome in Children: A Narrative Review.

Dumping syndrome (DS) is a typical side effect of stomach surgery, which includes cancer, non-cancer esophageal and gastric surgery, and bariatric surgery. It is marked by the fast evacuation of undigested food from the stomach into the small intestine, which causes a variety of symptoms. Early dumping symptoms include gastrointestinal symptoms such as stomach discomfort, diarrhea, and nausea, as well as vasomotor symptoms such as drowsiness and face flushing, and occur within the first hour following a meal. Late dumping symptoms appear one to three hours after a meal and are related to reactive hypoglycemia, resulting in hypoglycemia, sweating, palpitations, and confusion. Early dumping pathophysiology involves abnormalities in stomach structure and function, which result in rapid transit of stomach contents to the duodenum, insufficient digestion, and fluid transfers from the vascular compartment to the intestine. Late dumping occurs as a result of hyperinsulinemia caused by the fast passage of undigested foods to the gut. Symptom-based questionnaires and diagnostic testing such as plasma glucose measurement and stomach emptying studies can be used to confirm a diagnosis of DS. The primary approach to managing DS is dietary modifications, including eating smaller, more frequent meals and avoiding high glycemic index carbohydrates. Dietary supplements and medications may be used to slow down gastric emptying or control blood glucose levels. Pharmacological options include alpha-glycosidase inhibitors, somatostatin analogs, glucagon-like peptide-1 analogs, and sodium-glucose cotransporter inhibitors. In severe cases, refractory to conservative measures, surgical interventions may be considered. DS can arise in children following gastric surgery for obesity or corrective surgery for congenital abnormalities. It is frequently misdiagnosed and can have serious implications, such as hypoglycemia-related cognition deficits. Screening and early identification using glucose tolerance testing and continuous glucose monitoring (CGM) are critical in at-risk youngsters. Children's treatment techniques are similar to those used in adults, with dietary changes and medication therapies serving as the cornerstone of care. Overall, DS is a complex condition that requires a multidisciplinary approach to diagnosis and management. Further research is needed to improve understanding of its pathophysiology and optimize treatment strategies, particularly in children. This review aims to provide a well-rounded informative summary of the most recent literature on the under-recognized clinical and scientific aspects of DS among the children age group. It incorporates the quality of life, pathophysiology, diagnosis, prevalence, and treatment.

Awareness of Population Regarding GLP-1 (liraglutide and Semaglutide) Prescribing in PHCC in Abha City, KSA

Background: GLP-1 is a peptide hormone related to the glucagon superfamily and shares a significant amino acid sequence with glucagon. The glucagon superfamily peptides are secreted from the small intestine, pancreas, brain, and peripheral nerves. Furthermore, GLP-1 controls intestinal motility and decreases gastric motility. It also has an effect of satiety, which may be attributed to its effect on the gut, but it also has a direct effect on the hypothalamic feeding centers. Aim: This study aims to assess the population awareness level regarding GLP-1 prescribing in PHCC in Abha City. Methods: A descriptive cross-sectional web-based study was used. An online questionnaire was developed by the study researchers based on a literature review and after consultation of the field experts. The questionnaire of this study included participants’ demographic data, medical history, and GLP-1 use and satisfaction. Also, it covered participants’ awareness regarding GLP-1 and its effects. Results: A total of 160 participants who used GLP-1 completed the study survey. Participants’ ages ranged from 18 to more than 50 years with a mean age of 34.8 ± 13.9 years old. Exactly 89 (55.6%) participants were females. The most used GLP-1 were Saxenda (39.4%), Ozempic (37.5%), and Trulicity (14.4%) while 8.8% used a combination of them. Exactly 127 (79.4%) participants had an overall poor awareness level regarding GLP-1 while only 33 (20.6%) had a good awareness level. Conclusion: In conclusion, the current study revealed that a significant portion of diabetic and obese persons use GLP-1 for reducing weight and controlling blood glucose levels. On the other hand, their awareness level regarding the drugs was unsatisfactory. Keywords: GLP-1, diabetes, obesity, awareness, use, population, knowledge, Saudi Arabia

In vitro Anti-diabetic Activity of Aqueous Methanolic Extract of Ailanthus Altissima Bark

The intestinal digestive enzyme alpha-glucosidase plays a vital role in the carbohydrate digestion. One anti-diabetic therapeutic approach reduces the postprandial glucose level by the inhibition of the alpha-glucosidase enzyme. The present study aimed to investigate the anti-diabetic activity of extract of Ailanthus altissima bark, in vitro. Three different plant extracts were formulated by using distilled water, methanol, and a mixture of methanol and water (70:30) to compare the best effect of the extract, while distilled water and metformin were used as negative and positive controls. Four different concentrations of plant extract in all solvents were used to find percentage inhibition of alpha-glucosidase. Maximum percentage inhibition was examined against 1.5 mL of all solvent extracts but aqueous methanolic plant extract showed maximum73% inhibition that was comparable to standard drug inhibition (80%). One-way ANOVA was followed for statistical analysis to find out the P-value based on which most significant and insignificant were declared. Aqueous methanolic plant extract showed the most significant results because the value of p<0.5 through the goodness of the model while aqueous plant extract showed insignificant results because the P- value is > 0.05. The assay results suggest that the presence of bioactive compounds are responsible for the versatile medicinal properties against diabetes, the aqueous methanolic extract exhibit a dose-dependent increase in inhibitory effect on alpha-glucosidase enzyme up to 73%. The current study proves aqueous methanolic extract of A. altissima bark has anti-diabetic activity in vitro and is a strong candidate for postprandial control of blood glucose level.

Natural α-glucosidase inhibitors from selected medicinal plants in Malaysia

The most prevalent subtype of diabetes is Type 2 Diabetes Mellitus which results from an abnormal postprandial increase in blood glucose. Inhibition of the carbohydrate-hydrolysing enzymes (alpha-glucosidase and alpha-amylase) in the human digestive organs can control blood glucose levels, making it an important strategy in the management of Type 2 Diabetes Mellitus. A majority of the oral synthetic drugs which have been developed to treat Type 2 Diabetes Mellitus are expensive and have undesirable side effects. As a result, plant-derived remedies have become preferred alternatives as they are easily available, affordable and less harmful. Angustine (1) the major constituent in Nauclea subdita (Korth.) Steud., and (E)-labda-8(17),12-dien-15,16-dial (2) and zerumin A (3) of Alpinia pahangensis Ridley were evaluated for their α-glucosidase inhibitory activity. (E)-Labda-8(17),12-dien-15,16-dial (2) (IC50 = 39.7 μM) was identified as the most potent inhibitor among all three, followed by angustine (1) (IC50 = 48.1 μM) and zerumin A (3) (IC50 = 53.3 μM). Enzyme kinetic studies indicated that angustine (1) was a mixed-type inhibitor, while (E)-labda-8(17),12-dien-15,16-dial (2), and zerumin A (3) were non-competitive inhibitors. Molecular docking and molecular dynamics (MD) simulation studies were performed to predict the key interactions between the ligands and the target protein, 1AGM (complex of acarbose with glucoamylase from Aspergillus awamori). The results of the study of binding interaction energy suggested that angustine (1) has the potential to be used as a natural drug lead in the treatment of type 2 diabetes mellitus.

Microwave substrate integrated waveguide resonator sensor for non-invasive monitoring of blood glucose concentration: Low cost and painless tool for diabetics

In this study, a microwave resonant sensor with an operation frequency of 9 GHz and a quality factor of 240 has been designed, fabricated and tested by fingertips of the users to control blood glucose levels. The proposed method includes the implementation of a band-pass filter in the substrate integrated waveguide cavity, which has been carried out using a modified split ring resonator. In this research, 4 volunteers with glucose level changes ranging from 92 to 141 mg dL−1 have been tested invasive (by a glucometer) and non-invasive (by the designed sensor). For this range of glucose level changes, the frequency detection resolution is 7.67 MHz (mg dL−1)−1.

Short-Term Effect of Continuous Subcutaneous Insulin Infusion and Multiple Daily Injection in Perioperative Patients with Type 2 Diabetes Mellitus.

Hyperglycemia is common and difficult to control in perioperative patients with type 2 diabetes mellitus (T2DM), which impacts their prognosis after operation. Our study investigated the short-term effect of continuous subcutaneous insulin infusion (CSII) and multiple daily injection (MDI) in perioperative T2DM patients using the data envelopment analysis (DEA). T2DM patients (n = 639) who underwent surgeries in Guangdong Provincial Hospital of Traditional Chinese Medicine (2009.01-2017.12) were included. Insulin was provided to each patient during the study and separated into a CSII group (n = 369) and an MDI group (n = 270). DEA was performed to compare the therapeutic indexes and investigate the short-term effect of the CSII group and MDI group. Scale efficiencies of the CSII group with CCR model and BCC model were better than that of the MDI group. Regarding slack variables, with higher surgical levels, the CSII group was closer to the ideal state than the MDI group, which indicated in improving the average fasting blood glucose (AFBG), antibiotic use days (AUD), preoperative blood glucose control time (PBGCT), first postoperative day fasting blood glucose (FPDFBG), and postoperative hospitalization days (PHD). CSII could effectively control blood glucose levels and shorten perioperative hospitalizing time for T2DM patients, indicating that CSII was beneficial in perioperative period and should be promoted clinically.

Monitoring & healing dual channel system designed for continuous glucose monitoring decorated with high-efficient self-healing CuO nanoflakes glucose catalytic electrode

Continuous glucose monitoring (CGM) system provides diabetics with an extremely attractive alternative in controlling blood glucose level. Compared with enzymatic and noble meal-based electrode, copper-based electrode presents a better stability and anti-interference property, which is more suitable to be applied in CGM system for long-term working. The investigation of the failure behavior of copper-based electrode is of vital importance for the application in CGM system. In this paper, the damaged mechanism of copper-based electrode was investigated by analyzing the variation of structure and catalytic properties of CuO nanoflakes (NFs) electrode after long-term working. The results indicated that the main reason for the failure of CuO NFs electrode was structure damage. Copper anodization is an effective electrochemical method to construct the nanostructured film in situ and was used to repair the damaged structure. Based on the damaged mechanism of the copper-based catalytic electrode and the dissolution-precipitation mechanism of copper anodization, a monitoring & healing dual channel (M&H) system decorated with highly efficient self-healing CuO NFs electrode was designed for CGM system. The M&H system enable the monitoring and healing process to be achieved by only adjusting the working potential in the same supporting electrolyte (0.1 M NaOH aqueous), which greatly facilitates glucose measurement and has instructive significance for engineering applications in commercial glucose sensors.

Evaluation of Diabetes Care Performance in Cambodia Through the Cascade-of-Care Framework: Cross-Sectional Study.

Cambodia has seen an increase in the prevalence of type 2 diabetes (T2D) over the last 10 years. Three main care initiatives for T2D are being scaled up in the public health care system across the country: hospital-based care, health center-based care, and community-based care. To date, no empirical study has systematically assessed the performance of these care initiatives across the T2D care continuum in Cambodia. This study aimed to assess the performance of the 3 care initiatives-individually or in coexistence-and determine the factors associated with the failure to diagnose T2D in Cambodia. We used a cascade-of-care framework to assess the T2D care continuum. The cascades were generated using primary data from a cross-sectional population-based survey conducted in 2020 with 5072 individuals aged ≥40 years. The survey was conducted in 5 operational districts (ODs) selected based on the availability of the care initiatives. Multiple logistic regression analysis was used to identify the factors associated with the failure to diagnose T2D. The significance level of P<.05 was used as a cutoff point. Of the 5072 individuals, 560 (11.04%) met the definition of a T2D diagnosis (fasting blood glucose level ≥126 mg/dL and glycated hemoglobin level ≥6.5%). Using the 560 individuals as the fixed denominator, the cascade displayed substantial drops at the testing and control stages. Only 63% (353/560) of the participants had ever tested their blood glucose level in the last 3 years, and only 10.7% (60/560) achieved blood glucose level control with the cutoff point of glycated hemoglobin level <8%. The OD hosting the coexistence of care displayed the worst cascade across all bars, whereas the OD with hospital-based care had the best cascade among the 5 ODs. Being aged 40 to 49 years, male, and in the poorest category of the wealth quintile were factors associated with the undiagnosed status. The unmet needs for T2D care in Cambodia were large, particularly in the testing and control stages, indicating the need to substantially improve early detection and management of T2D in the country. Rapid scale-up of T2D care components at public health facilities to increase the chances of the population with T2D of being tested, diagnosed, retained in care, and treated, as well as of achieving blood glucose level control, is vital in the health system. Specific population groups susceptible to being undiagnosed should be especially targeted for screening through active community outreach activities. Future research should incorporate digital health interventions to evaluate the effectiveness of the T2D care initiatives longitudinally with more diverse population groups from various settings based on routine data vital for integrated care. International Standard Randomized Controlled Trials Number (ISRCTN) ISRCTN41932064; https://www.isrctn.com/ISRCTN41932064. RR2-10.2196/36747.

A Study on Enumeration of Factors Prone to the Development of COVID-19-Associated Mucormycosis

Abstract Background Patients with pre-existing chronic medical conditions with altered immunity are prone to COVID-19-associated mucormycosis (CAM). Objective In this study, our objectives were to identify the risk factors that increase the chances of developing CAM and to determine the severity of the risk factors of CAM. Thereby, we can optimize the modifiable risk factors for developing CAM in coronavirus disease 2019 (COVID-19) patients. For instance, better control of blood glucose levels in COVID-19 patients can decrease the risk of developing CAM. Materials and Methods The data was collected retrospectively from 1000 COVID-19 infected patients, above the age of 18 years during the time period of March 2021 to August 2021, in which 86 patients had confirmed CAM. Statistical Analysis Binary logistic regression and curve estimation analysis were performed using SPSS software version 29 for identifying the associated risk factors of CAM with the significance of p-value less than 0.05. Results Factors such as severe inflammation (p = 0.048), high dose of steroid administration (p = 0.005), increasing age (p &lt; 0.001), and prolonged hospital stay (p &lt; 0.001) were statistically proven to be significant risk factors, associated with CAM. Conclusion Increasing age, severe inflammation, high dose of steroid administration, and prolonged hospital stay have association with occurrence of CAM.

Development of Blood Sugar Regulatory Products from Momordica cochininensis via Probiotic Fermentation

Type II diabetes is the most important health issue in the whole world. Besides the use of prescribed drugs to control blood glucose level, recently, the development of health supplements is being actively explored. Owing to its high nutritional value, Momordica cochinchinensis Spreng. (Gac) is potentially a good source for developing this supplement. In recent years, the aril of Gac has been utilized as a substrate for developing various forms of supplements, but the pulp has been neglected as a byproduct. However, the pulp contains lots of phytochemicals that could provide health benefits, and the investigation using lactobacilli to ferment the pulp juices to lower blood glucose is not yet to be explored. Therefore, we set out to investigate the potential to develop the pulp-based juices for controlling blood glucose level by selecting an optimal strain of lactobacillus to ferment the pulp juice and measuring the inhibitory action of the fermented juice on α-glucosidase. This enzyme is crucial for controlling postprandial glucose absorbed into the bloodstream because it is the enzyme that hydrolyzes the carbohydrates to release glucose. First, we have successfully isolated a strain of lactobacillus which was capable of fermenting the pulp to produce α-glucosidase-inhibitory activity. Through a 16S rRNA sequence, this lactobacillus was named Lactiplantibacillus plantarum GBI 001. The optimal conditions for its growth in commercial culture medium were found to be 35 °C for 16 h to produce the highest α-glucosidase activity (72.03%). The optimal conditions for the strain to grow in Gac pulp juice were: 20% pulp juices as substrate with an initial pH adjusted to 4.0, growing at 35 °C for 16 h. Under these conditions, the fermented juice exhibited α-glucosidase activity of 24.36%, which is a 2.17-fold increase over the control group (11.23%). From its increase in α-glucosidase potency, using L. plantarum GBI 001 to ferment the pulp juices of Gac as soft drinks has great potential to develop a helpful drink as a food supplement to control postprandial blood glucose in patients with diabetes.

Advances in Studies of Chiglitazar Sodium, a Novel PPAR Pan-Agonist, for the Treatment of Type 2 Diabetes Mellitus.

Chiglitazar sodium is a new peroxisome proliferator-activated receptor (PPAR) pan-agonist with independent intellectual property rights in China. It can treat type 2 diabetes mellitus and regulate metabolism by modestly activating PPARα, PPARγ, and PPARδ to improve insulin sensitivity, regulate blood glucose, and promote fatty acid oxidation and utilization. Chiglitazar sodium has a significant insulin-sensitizing effect and is advantageous in reducing fasting and postprandial blood glucose levels, particularly at the 48 mg dose in patients with concomitant high triglycerides in terms of blood glucose and triglyceride level control.

FAM3D: A gut secreted protein and its potential in the regulation of glucose metabolism

The number of diabetic patients is rising globally and concomitantly so do the diabetes associated complications. The gut secretes a variety of proteins to control blood glucose levels and/or food intake. As the drug class of GLP-1 agonists is based on a gut secreted peptide and the positive metabolic effects of bariatric surgery are at least partially mediated by gut peptides, we were interested in other gut secreted proteins which have yet to be explored. In this respect we identified the gut secreted protein FAM3D by analyzing sequencing data from L- and epithelial cells of VSG and sham operated as well as chow and HFD fed mice. FAM3D was overexpressed in diet induced obese mice via an adeno-associated virus (AAV), which resulted in a significant improvement of fasting blood glucose levels, glucose tolerance and insulin sensitivity. The liver lipid deposition was reduced, and the steatosis morphology was improved. Hyperinsulinemic clamps indicated that FAM3D is a global insulin sensitizer and increases glucose uptake into various tissues. In conclusion, the current study demonstrated that FAM3D controls blood glucose levels by acting as an insulin sensitizing protein and improves hepatic lipid deposition.

Synergisticeffect of elevated glucose levels with SARS-CoV-2 spike protein induced NOX-dependent ROS production in endothelial cells.

Diabetic patients infected with coronavirus disease 2019 (COVID-19) often have a higher probability of organ failure and mortality. The potential cellular mechanisms through which blood glucose exacerbates tissue damage due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still unclear. We cultured endothelial cells within differing glucose mediums with an increasing concentration gradient of SARS-CoV-2 Spike protein (S protein). S protein can cause the reduction of ACE2 and TMPRSS2, and activation of NOX2 and NOX4. A high glucose medium was shown to aggravate the decrease of ACE2 and activation of NOX2 and NOX4 in cultured cells, but had no effect on TMPRSS2. S protein mediated activation of the ACE2-NOX axis induced oxidative stress and apoptosis within endothelial cells, leading to cellular dysfunction via the reduction of NO and tight junction proteins which may collectively be exacerbated by elevated glucose. In addition, the glucose variability model demonstrated activation of the ACE2-NOX axis in a similar manner observed in the high glucose model in vitro. Our present study provides evidence for a mechanism through which hyperglycemia aggravates endothelial cell injury resulting from S protein mediated activation of the ACE2-NOX axis. Our research thus highlights the importance of strict monitoring and control of blood glucose levels within the context of COVID-19 treatment to potentially improve clinical outcomes.

What else can we do to prevent diabetic retinopathy?

The classical modifiable factors associated with the onset and progression of diabetic retinopathy are the suboptimal control of blood glucose levels and hypertension, as well as dyslipidaemia. However, there are other less recognised modifiable factors that can play a relevant role, such as the presence of obesity or the abnormal distribution of adipose tissue, and others related to lifestyle such as the type of diet, vitamin intake, exercise, smoking and sunlight exposure. In this article we revisit the prevention of diabetic retinopathy based on modulating the modifiable risk factors, as well as commenting on the potential impact of glucose-lowering drugs on the condition. The emerging concept that neurodegeneration is an early event in the development of diabetic retinopathy points to neuroprotection as a potential therapeutic strategy to prevent the advanced stages of the disease. In this regard, the better phenotyping of very early stages of diabetic retinopathy and the opportunity of arresting its progression using treatments targeting the neurovascular unit (NVU) are discussed.

Fiber Intake and Vegan Lifestyle Behaviour on Blood Glucose Control in Type 2 Diabetes Mellitus Patients: A Case-Control Study.

The study aims to determine the relationship between blood glucose level control with a vegetarian diet and vegan lifestyle behavior in patients with T2DM. Diabetes prevalence escalates each year. Nutritional therapy is one of its management, by choosing a suitable diet to maintain nutrient intake. This was a case-control study including 46 patients with T2DM divided into 24 people for the case group and 22 people for the control group selected using purposive sampling method. Data was obtained using a general questionnaire; food intake with the SQFFQ; the 8-item Morisky Scale questionnaire, to assess medication adherence; the IPAQ, to assess physical activity. Blood sugar measurements were observed by measuring the respondents' fasting blood sugar in the last six months. The data was then analyzed using Chi-square statistical test and logistic regression. The results indicate a relationship between a vegetarian diet and a vegan lifestyle behavior that control blood sugar levels in patients with T2DM (P = 0.004). Diabetic patients on a nonvegetarian diet had a six times greater risk of having uncontrolled blood sugar (OR = 6.476). A significant relationship was found between a vegetarian diet and fasting blood sugar control based on bivariate analysis. In multivariate analysis, fiber intake was most significant to blood glucose control (OR=18.824; 95% CI 2.795-126.795). Vegetarian diet affects blood sugar control in T2DM patients. The type of nutritional intake needs to be more considered rather than the vegetarian diet in general, so that nutritional therapy in diabetics can be started by increasing fiber intake.

Green Synthesis and Characterizations of Chromium Oxide Nanoparticles (Cr&lt;sub&gt;2&lt;/sub&gt;O&lt;sub&gt;3&lt;/sub&gt; NPs) Derived from Pomegranate Husk and its α-Amylase Inhibitory and Antioxidant Properties

A disease of imbalanced control of blood glucose levels due to impairment of insulin secretion or acceptance is known as diabetes mellitus. It could be induced by the high intake of sugar in diets, or by genetic background, or both. The antioxidant, which plays a role in neutralising free radicals, is crucial as the free radical could increase the chances of getting diabetes through several pathways. Injection of insulin and anti-diabetic drugs are common approaches to treating diabetes, but unfortunately, many side effects have been reported. Green synthesis of metal oxide nanoparticle, which is one of the applications of nanotechnology, could be a promising method in combating diabetes as it is biocompatible, less toxic, and has large surface to volume ratio. In this study, green synthesis and characterization of Cr2O3 NPs were carried out. The Cr2O3 NPs were shown to be spherical in shape, with an average size that falls within 100 nm. The EDX spectrum indicated that only chromium (Cr) and oxygen (O) were present in the sample. Other characterization techniques such as FTIR and UV-VIS spectroscopy were conducted. For ABTS and DPPH assays, Cr2O3 NPs exhibited highest free radical scavenging properties at 74.57% and 84.12% at 30 minutes and 60 minutes at the concentrations of 5 mg/mL and 1 mg/mL, respectively. Lastly, Cr2O3 NPs showed 95.28 % at the concentration of 0.25 mg/mL in α-amylase inhibition assay.