Sugar Control Research Articles

Strategies for reducing the burden of cardiovascular diseases in the United Arab Emirates

This commentary outlines the strategies implemented by the United Arab Emirates (UAE) to reduce the burden of cardiovascular diseases (CVDs) through national health policies and initiatives. These strategies aim to enable sustainable actions for CVDs prevention and control by addressing key risk factors, such as tobacco use, unhealthy dietary habits, and physical inactivity. Assessment of cardiovascular risk is fundamental for early detection and timely treatment. The UAE has reported the availability of essential medicines and basic technologies for preventing heart attack and stroke. Future directions include improving data reporting systems to provide up-to-date statistics on CVDs prevalence and risk factors, including diet, physical activity, body weight, smoking, blood pressure, blood sugar, and cholesterol control. In addition, these efforts will cover data on the quality of care, procedures, and economic costs. Strengthening collaboration between academic research institutes and government policymakers is crucial for shaping the UAE’s research agenda. Key steps to further reduce the burden of CVDs in the UAE include enhancing primary health care and emergency medical services, building health-care worker capacity, and improving the accessibility and affordability of priority interventions.

Unveiling the Potential Role of Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists in Offering Protection of the Cardiovascular, Renal, and Neural Systems: An Updated Narrative Review.

Glucagon-like peptide-1 (GLP-1) receptor agonists have drawn a lot of interest lately for their therapeutic advantages over controlling blood sugar levels in the management of type 2 diabetes mellitus (T2DM). This review aims to provide an overview of the research that has been done on the neuroprotective, renoprotective, and cardioprotective effects of GLP-1 receptor agonists. Studies suggest that these medicines could provide protective benefits beyond glucose regulation, possibly reducing the risks of cardiovascularand renal issues; mechanisms underlying these advantages are still not fully understood. The review emphasizes how crucial it is to conduct more studies to determine the clinicalsignificance and underlying mechanisms of these protective benefits. Improvedknowledge of GLP-1 receptor agonists may result in T2DM treatment plans that improve neurological, cardiovascular, and renal function in addition to blood sugar control. Therefore, further research is necessary to fully understand the potential of GLP-1 receptor agonists in providing comprehensive protection against complications related to T2DM.

دراسة تأثير استخدام السوبر بروتين، فيتامين C و E كبديل غذائي في نشاط طوائف نحل العسل

The research was conducted in a native apiary in Baghdad Governorate- Al-Buaitha, to evaluate the effect of adding super protein, vitamin C and vitamin E to the diet of honeybee colonies, and to study their effect on the activity, growth, development and productivity of the colonies of honey. The results of the research showed that super protein nutrition achieved the best percentages, and according to the results of the statistical analysis, it significantly outperformed the sugar solution feeding and control, in terms of measuring the honey area 2.631 cm2, the brood area 1.622 cm2 and the pollen area 0.378 cm2. The results of the use of vitamins also showed that the best treatments were using vitamin C nutrition, and according to the results of the statistical analysis, it significantly outperformed all other treatments in terms of measuring the honey area 3.820 cm2 and the brood area 1.821 cm2 and pollen area 0.608 cm2. The results showed that vitamin E nutrition outperformed the sugar solution feeding and control, as the average area of honey, brood and pollen grains were (2.960 cm2, 1.624 cm2 and 0.473 cm2) respectively.

Does Dolutegravir-Based Treatment in HIV-Infected Diabetic Individuals Require More Intensive Cardiovascular Health Monitoring: A Point of Concern for Developing Nations

We are all aware that obesity is a growing health problem globally. An estimated 600 million adults are affected with some form of obesity-related metabolic complications worldwide. It increases cardiovascular disease, diabetes mellitus, chronic kidney disease, nonalcoholic fatty liver disease, and cancer in the long run. Human immunodeficiency virus (HIV) infection is a common occurrence throughout the World. Developed countries can access early diagnosis, standardized treatment protocols, and close monitoring. It not only prevents incidences of opportunistic infections but also takes care of non-infective complications. On the contrary, lack of education, awareness, and access to good healthcare facilities are often responsible for delayed diagnosis and advanced disease at presentation. Even those who are initiated on therapy also have persistent modifiable risk factors for cardiovascular events. The Importance of regular exercise, a healthy diet, and tight control of blood sugar, hypertension, and dyslipidemia are often under-practiced and must be stressed.

An eco-friendly approach for analysing sugars, minerals, and colour in brown sugar using digital image processing and machine learning

Brown sugar is a natural sweetener obtained by thermal processing, with interesting nutritional characteristics. However, it has significant sensory variability, which directly affects product quality and consumer choice. Therefore, developing rapid methods for its quality control is desirable. This work proposes a fast, environmentally friendly, and accurate method for the simultaneous analysis of sucrose, reducing sugars, minerals and ICUMSA colour in brown sugar, using an innovative strategy that combines digital image processing acquired by smartphone cell with machine learning. Data extracted from the digital images, as well as experimentally determined contents of the physicochemical characteristics and elemental profile were the variables adopted for building predictive regression models by applying the kNN algorithm. The models achieved the highest predictive capacity for the Ca, ICUMSA colour, Fe and Zn, with coefficients of determination (R2) ≥ 92.33 %. Lower R2 values were observed for sucrose (81.16 %), reducing sugars (85.67 %), Mn (83.36 %) and Mg (86.97 %). Low data dispersion was found for all the predictive models generated (RMSE < 0.235). The AGREE Metric assessed the green profile and determined that the proposed approach is superior in relation to conventional methods because it avoids the use of solvents and toxic reagents, consumes minimal energy, produces no toxic waste, and is safer for analysts. The combination of digital image processing (DIP) and the kNN algorithm provides a fast, non-invasive and sustainable analytical approach. It streamlines and improves quality control of brown sugar, enabling the production of sweeteners that meet consumer demands and industry standards.

Interpretation of the 2024 American Diabetes Association guidelines for the comprehensive management of non-alcoholic fatty liver disease combined with diabetes mellitus

Non-alcoholic fatty liver disease (NAFLD) is a common concomitant disease in adults with type 2 diabetes mellitus (T2DM) and prediabetes. Therefore, T2DM/NAFLD patient populations are at high risk for cardiovascular disease. The occurrence and progression of non-alcoholic fatty liver disease-related liver fibrosis and cardiovascular disease have a severe impact on the patient's prognosis and mortality rate. The American Diabetes Association's 2024 "Guidelines for the Standardized Management of Diabetes" put forward recommendations relevant to the screening, evaluation, treatment, and management of NAFLD in T2DM and prediabetic populations, as well as liver fibrosis. The important measures for decelerating liver inflammation and fibrosis progression and the risk of cardiovascular disease are based on improvements in lifestyle methods, weight loss, and blood sugar control.

The In Vitro and In Silico Study of α-glucosidase Inhibition by Kombucha Derived from Syzygium polyanthum (Wight) Walp. Leaves

Kombucha is a fermented tea drink using a symbiotic culture of bacteria and yeast. This drink has been widely used to maintain blood sugar levels. Meanwhile, leaf boiled water of Syzygium polyanthum (Wight) Walp. has been used as an alternative medicine for diabetes mellitus in Indonesia. If this herb is made into kombucha, it may have higher antihyperglycemic activity than kombucha from tea leaves. However, there are no scientific reports of antihyperglycemic activity from S. polyanthum leaf kombucha by inhibiting alpha-glucosidase. This study aims to determine the activity and kinetics inhibition of S. polyanthum leaves kombucha against α-glucosidase. Samples were prepared at varying concentrations (12.5, 25, 37.5, 50 g/L), while phytochemical components in the products were identified, and the inhibitory activity as well as kinetics were comprehensively analyzed. In silico evaluations were conducted to further explore the inhibitory activity. The results showed that the products contained secondary metabolites such as flavonoids, saponins, and tannins. The inhibitory activity against α-glucosidase ranged from 81.05 to 89.41%. The inhibition mechanism was identified as uncompetitive, with a Michaelis-Menten constant (KM) of 0.1357 mM and a vmax value of 27.7008 U/ml minute. Several metabolites showed promising inhibition potential due to their strong binding interactions with α-glucosidase, including hydrogen bonding (H-bond), hydrophobic interactions, van der Waals forces, and electrostatic forces. Additionally, two metabolites, farnesol and α-pinene, were found to interact with other human proteins. These observations showed the potential of S. polyanthum leaves kombucha as a health-promoting beverage that might aid blood sugar control in diabetic individuals.

Maternal protein restriction combined with postnatal sugar consumption alters liver proteomic profile and metabolic pathways in adult male offspring rats

This study investigated the impact of maternal protein restriction (MPR) and early postnatal sugar consumption (SUG) on the liver health of adult male descendant rats. Male offspring of mothers fed a normal protein diet (NPD) or a low protein diet (LPD) were divided into four groups: Control (CTR), Sugar Control (CTR + SUG), LPD during gestation and lactation (GLLP), and LPD with sugar (GLLP + SUG). Sugar consumption (10% glucose diluted in water) began after weaning on day 21 (PND 21), and at 90 days (PND 90), rats were sacrificed for analysis. Sugar intake reduced food intake and increased water consumption in CTR + SUG and GLLP + SUG compared to CTR and GLLP. GLLP and GLLP + SUG groups showed lower body weight and total and retroperitoneal fat compared to CTR and CTR + SUG. CTR + SUG and GLLP + SUG groups exhibited hepatocyte vacuolization associated with increased hepatic glycogen content compared to CTR and GLLP. Hepatic catalase activity increased in GLLP compared to CTR. Proteomic analysis identified 223 differentially expressed proteins (DEPs) among experimental groups. While in the GLLP group, the DEPs enriched molecular pathways related to cellular stress, glycogen metabolic pathways were enriched in the GLLP + SUG and CTR + SUG groups. The association of sugar consumption amplifies the effects of MPR, deregulating molecular mechanisms related to metabolism and the antioxidant system.

How Sugar Labeling Affects Consumer Sugar Reduction: A Case of Sucrose Grade Labels in China.

The effectiveness of sugar labeling depends not only on direct sugar reduction but also on the extent to which compensatory eating occurs. This study focuses on the use of sucrose grade labels in the Chinese market to investigate not only consumers' willingness to pay (WTP) for different sucrose labels but also the consistency of their sugar control behavior when confronted with unlabeled processed foods. The findings reveal that consumers are willing to pay approximately 4%, 7%, and 7% more for yogurt labeled as "low sucrose", "no sucrose", and "no sucrose with sugar substitutes", respectively, compared to yogurt labeled as "regular sucrose." Furthermore, when subsequently presented with unlabeled toast, a significant proportion of consumers who initially chose "no sucrose" yogurt continued to select wholewheat toast, which contains less sugar than white and coconut toast. This indicates their commitment to maintaining their sugar control behavior. The study provides valuable experimental evidence for researchers, food manufacturers, and policymakers regarding the efficacy of sucrose grade labels. In particular, it offers policymakers insights into guiding consumers to promote sustainable healthy diets.

The effect of psyllium on fasting blood sugar, HbA1c, HOMA IR, and insulin control: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials

There is equivocal evidence that psyllium can prevent or attenuate increases in fasting blood sugar. Therefore, this systematic review and meta-analysis sought to investigate the influence of psyllium on hemoglobin A1C (HbA1c), fasting blood sugar (FBS), insulin, and Homeostatic Model Assessment of Insulin Resistance (HOMA IR). We searched PubMed, ISI Web of Science (WOS), and Scopus for eligible publications, up to 15 July 2022, including randomized controlled trials (RCT) assessing the effect of psyllium on HbA1c, FBS, insulin, and HOMA IR levels in adults. Using a random effects model, we report the weighted mean differences (WMD) with 95% confidence intervals (CI). In this article, 19 RCT studies, consisting of 962 participants, were included. Psyllium significantly decreased FBS, HbA1c, and HOMA IR levels, but not insulin levels, as compared to placebo (FBS: WMD): -6.89; 95% CI: -10.62, -3.16; p < .001), HbA1c: (WMD: -0.75; 95% CI: -1.21, -0.29; p < .001), HOMA IR: (WMD: -1.17; 95% CI: -2.11, -0.23; p < .05), and insulin: (WMD: -2.08; 95% CI: -4.21, -0.035; p > .05)). Subgroup analyses illustrated differences in the effects of psyllium on FBS: dosages less than and more than 10 g/d showed significant differences (p value < 0.05). However, it was not significant in intervention durations less than 50 days (p value > 0.05). For HbA1c: psyllium consumption less than 10 g/d (p value > 0.05) was non-significant. For HOMA IR and insulin: no significant changes were noted with psyllium consumption less than vs. more than 10 g/d. In conclusion, we found that psyllium could significantly decrease FBS, HbA1c, and HOMA IR levels, but not insulin levels, as compared to placebo.

RELATIONSHIP BETWEEN SEXUAL DYSFUNCTION AND SEXUAL SELF-CONCEPT IN PATIENTS WITH DIABETES MELLITUS: A SCOPING REVIEW

Background: An often-occurring complication of diabetes mellitus is sexual dysfunction, often linked to poor blood sugar control. Despite its significant impact on patients' lives, issues related to sexual desire, education, and timely detection and management of sexual problems have historically been overlooked in diabetes interventions. This neglect may affect individuals' sexual self-concept and overall well-being. The purpose of this study is to investigate the relationship between sexual dysfunction and sexual self-concept in diabetics. Design: This research employs a scoping review design. Data Sources: A comprehensive literature search was conducted using databases such as Web of Science, Open Alex, Crossref, Google Scholar, PubMed, Scopus, and Semantic Scholar. Articles published between January 2018 and October 2023 were included. Review Methods: The analysis followed the Arksey and O'Malley model and PRISMA guidelines. 26 quantitative articles were reviewed, including 24 cross-sectional studies and 2 observational studies, all using quantitative methodologies. Results: Sexual dysfunction is prevalent among diabetes type 1 and type 2 in both men and women, influenced by physiological factors and glycemic control. Men may experience issues like diminished libido, premature ejaculation, and difficulty achieving orgasm, while women may face reduced sexual desire, arousal difficulties, and dyspareunia. Factors contributing to sexual dysfunction include age, duration of diabetes, glycemic control, comorbidities, medication use, psychological factors, and lifestyle elements like physical activity and stress levels. Sexual dysfunction in people with diabetes has a significant impact on sexual self-concept, which includes feelings, views, and beliefs about sexual relationships. Conclusion: There hasn't been any specific research conducted on diabetic patients concerning the correlation between sexual dysfunction and sexual self-concept, highlighting the need for dedicated studies to address this association and raise awareness.

Case Report: Bullous Pemphigoid and the Association with Dipeptidyl-peptidase 4 Inhibitors

&lt;p&gt;大皰性類天皰瘡(bullous pemphigoid)是一種自體免疫表皮下水泡疾病，表現為全身性瘙癢性蕁麻疹斑塊和緊繃的表皮下水泡。發生率大約每百萬人年為4至22例個案，而且有逐漸增加之趨勢。這種疾病最常影響老年人，除了老年化社會增加罹患風險外，神經疾病增加、與可能誘發類天皰瘡之藥物使用增加皆與該疾病增加的趨勢有關。&lt;/p&gt; &lt;p&gt;本個案為一位90歲的女性，過去疾病包括小腦出血性中風、帕金森氏症、失智症、高血壓、及糖尿病。糖尿病於一年前新診斷並開始使用 linagliptin及glimepiride等藥物控制血糖。主訴近半年多來開始會有全身的癢疹，尤其是軀幹及四肢，兩週前開始在皮膚縐摺處出現水泡及破裂傷口，經過臨床檢驗後診斷為大皰性類天皰瘡，搜索相關文獻後懷疑與 Linagliptin 的使用有關，於是改用其他藥物控制血糖，並開始使用外用及口服類固醇治療。經治療後皮膚明顯改善，不再有新水泡產生。本個案報告簡介大皰性類天皰瘡，亦討論該疾病與降血糖藥物dipeptidyl-peptidase 4 inhibitors (DPP4-inhibitor)之關係，研究發現某些類型的DPP4-inhibitor例如linagliptin與大皰性類天皰瘡的發生機率相關。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Bullous pemphigoid is an autoimmune subepidermal blistering disease characterized by generalized pruritic urticarial plaques and tense subepidermal blisters. The incidence is approximately 4 to 22 cases per million people per year, with a rising trend. This disease predominantly affects the elderly, and the increasing trend is attributed to the aging population, rising incidence of neurological disorders, and the use of medications that may trigger bullous pemphigoid.&lt;/p&gt; &lt;p&gt;This case is a 90-year-old female with a medical history of cerebellar hemorrhagic stroke, Parkinson’s disease, dementia, hypertension, and diabetes. Diabetes was newly diagnosed a year ago, and medications like linagliptin and glimepiride were initiated for blood sugar control. The patient complained of generalized itching and rash for the past six months, particularly on the trunk and limbs. Two weeks ago, blisters and ruptured wounds appeared in the skin folds. After clinical examination, the diagnosis of bullous pemphigoid was made. After reviewing relevant literature, it was suspected to have connection with the use of linagliptin and bullous pemphigoid. We shifted linagliptin to other drugs to control blood sugar, and topical and oral corticosteroid treatment was initiated. The skin significantly improved after treatment. This case report not only introduces bullous pemphigoid but also discusses the association between this disease and dipeptidyl-peptidase 4 inhibitors (DPP-4 inhibitors). Research suggests a correlation between certain types of DPP-4 inhibitors, such as linagliptin, and the occurrence of bullous pemphigoid.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Personalized prediction of diabetic foot ulcer recurrence in elderly individuals using machine learning paradigms.

This study utilizes machine learning to analyze the recurrence risk of diabetic foot ulcers (DFUs) in elderly diabetic patients, aiming to enhance prevention and intervention efforts. The goal is to construct accurate predictive models for assessing the recurrence risk of DFUs based on high-risk factors, such as age, blood sugar control, alcohol consumption, and smoking, in elderly diabetic patients. Data from 138 elderly diabetic patients were collected, and after data cleaning, outlier screening, and feature integration, machine learning models were constructed. Support Vector Machine (SVM) was employed, achieving an accuracy rate of 93%. Experimental results demonstrate the effectiveness of SVM in predicting the recurrence risk of DFUs in elderly diabetic patients, providing clinicians with a more accurate tool for assessment. The study highlights the significance of machine learning in managing foot ulcers in elderly diabetic patients, particularly in predicting recurrence risk. This approach facilitates timely intervention, reducing the likelihood of patient recurrence, and introduces computer-assisted medical strategies in elderly diabetes management.

Prevalence of Hypogonadism in Male Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study

Background: Type 2 Diabetes Mellitus (T2DM) is a widespread metabolic disorder linked with various complications, including hypogonadism—a condition marked by reduced testosterone levels and symptoms such as erectile dysfunction, decreased libido, and increased fatigue. Hypogonadism remains underdiagnosed in diabetic populations, posing significant challenges to healthcare systems, especially in regions with high diabetic populations such as India. Methods: This cross-sectional study comprised 173 male T2DM patients aged 35 to 65. The study employed the Androgen Deficiency in Aging Males (ADAM) questionnaire to screen for hypogonadism, alongside physical examinations and biochemical tests to assess testosterone levels and other metabolic parameters. Results: The incidence of hypogonadism was found to be 27.2% among the study participants. Higher prevalence rates were related with older age, higher body mass index, greater waist circumference, and longer period of diabetes. Elevated fasting blood sugar and poor glycemic control (HbA1c ? 7%) were also significantly correlated with low testosterone levels. Conclusion: The significant association between T2DM and hypogonadism underscores the need for routine screening for testosterone deficiency in diabetic care, particularly given the condition’s impact on quality of life and metabolic health. Recommendations: Based on the findings, it is recommended that screening for hypogonadism be integrated into the regular management protocols for T2DM, particularly for patients presenting with metabolic syndrome features or those with poor glycemic control. Keywords: Type 2 Diabetes Mellitus, Hypogonadism, Testosterone, Metabolic Health, Indian Population

Relationship between gut microbiota and the pathogenesis of gestational diabetes mellitus: a systematic review.

Gestational diabetes mellitus (GDM) is a form of gestational diabetes mellitus characterized by insulin resistance and abnormal function of pancreatic beta cells. In recent years, genomic association studies have revealed risk and susceptibility genes associated with genetic susceptibility to GDM. However, genetic predisposition cannot explain the rising global incidence of GDM, which may be related to the increased influence of environmental factors, especially the gut microbiome. Studies have shown that gut microbiota is closely related to the occurrence and development of GDM. This paper reviews the relationship between gut microbiota and the pathological mechanism of GDM, in order to better understand the role of gut microbiota in GDM, and to provide a theoretical basis for clinical application of gut microbiota in the treatment of related diseases. The current research results on the interaction between GDM and gut microbiota were collected and analyzed through literature review. Keywords such as "GDM", "gut microbiota" and "insulin resistance" were used for literature search, and the methodology, findings and potential impact on the pathophysiology of GDM were systematically evaluated. It was found that the composition and diversity of gut microbiota were significantly associated with the occurrence and development of GDM. Specifically, the abundance of certain gut bacteria is associated with an increased risk of GDM, while other changes in the microbiome may be associated with improved insulin sensitivity. In addition, alterations in the gut microbiota may affect blood glucose control through a variety of mechanisms, including the production of short-chain fatty acids, activation of inflammatory pathways, and metabolism of the B vitamin group. The results of this paper highlight the importance of gut microbiota in the pathogenesis of GDM. The regulation of the gut microbiota may provide new directions for the treatment of GDM, including improving insulin sensitivity and blood sugar control through the use of probiotics and prebiotics. However, more research is needed to confirm the generality and exact mechanisms of these findings and to explore potential clinical applications of the gut microbiota in the management of gestational diabetes. In addition, future studies should consider the interaction between environmental and genetic factors and how together they affect the risk of GDM.

IMPLEMENTATION OF MEWMA CHART USING TIME SERIES MODEL FOR MONITORING THE WHITE CRISTAL SUGAR QUALITY

The basic assumption of implementing a control chart is that the observed process values should be normally distributed and independent. However, the production process at the factory is carried out repeatedly with the same machine, so there is a possibility that the observation data is not independent and the resulting control chart becomes inaccurate. Therefore, a time series model approach is needed to create an accurate control chart. This study aims to conduct statistical quality control of white crystal sugar (WCS) production at Madukismo Sugar Factory (MSF) Yogyakarta to maintain product stability and quality according to the standards. MSF performs quality control on WCS products with several quality characteristic variables, including drying shrinkage (%), grain size (mm), polarization, and color of sugar solution (ICUMSA). This study is only limited to the four quality characteristics with research data in the form of secondary data from the MSF QC Laboratory. The data used were WCS quality characteristics from May 9 - July 16, 2022. The four characteristics influence each other, so a MEWMA control chart is used. This study found autocorrelation between observations so that time series modeling was carried out and resulted in VARIMA (1,1,2) as the best time series model. While the implementation of the MEWMA chart shows uncontrollable results with an optimal weighting value λ of 0.8. For process capability, the results show that the process is capable.

Comorbidity of Depression and Diabetes: A Literature Review on Systemic Flaws in Healthcare and the Benefits of Collaborative Diagnosis and Treatment in Primary Care Settings.

The increasing specialization and dispersion of healthcare systems have led to a shortage of resources to address comorbidities. Patients with coexisting mental and physical conditions are disadvantaged, as medical providers often only focus on the patient's mental illness while neglecting their physical needs, resulting in poorer health outcomes. This study aimed to shed light on the systemic flaws in healthcare systems that contribute to suboptimal health outcomes in individuals with comorbid diseases, including depression and diabetes. This paper also discusses the clinical and economic benefits of collaborative methods for diagnosing and treating depressive disorders in primary care settings. A comprehensive literature review of the relationship between depression and diabetes was conducted. The outcomes of the literature review were carefully analyzed. Several databases were searched using keywords such as "diabetes," "depression," "comorbidity," "prevalence," "epidemiology," and "risk factors" using Google Scholar and PubMed as search engines. The review and research papers written between 1961 and 2023 were our main focus. This study revealed improved depressive symptoms and better blood sugar and blood pressure control. Additionally, individuals with comorbid depression and diabetes have higher direct and secondary medical costs. Antidepressants and psychological interventions are equally effective in treating depressive symptoms in patients with diabetes, although they have conflicting effects on glycemic control. For individuals with comorbid diabetes and depression, clear care pathways, including a multidisciplinary team, are essential for achieving the best medical and mental health outcomes. Coordinated healthcare solutions are necessary to reduce the burden of illness and improve therapeutic outcomes. Numerous pathophysiological mechanisms interact with one another and may support the comorbidities of T2DM, and depressive disorders could exacerbate the course of both diseases.

Acarbose Impairs Gut Bacteroides Growth by Targeting Intracellular GH97 Enzymes.

Acarbose is a type-2 diabetes medicine that inhibits dietary starch breakdown into glucose by inhibiting host amylase and glucosidase enzymes. Numerous gut species in the Bacteroides genus enzymatically break down starch and change in relative abundance within the gut microbiome in acarbose-treated individuals. To mechanistically explain this observation, we used two model starch-degrading Bacteroides, Bacteroides ovatus (Bo) and Bacteroides thetaiotaomicron (Bt). Bt growth is severely impaired by acarbose whereas Bo growth is not. The Bacteroides use a starch utilization system (Sus) to grow on starch. We hypothesized that Bo and Bt Sus enzymes are differentially inhibited by acarbose. Instead, we discovered that although acarbose primarily targets the Sus periplasmic GH97 enzymes in both organisms, the drug affects starch processing at multiple other points. Acarbose competes for transport through the Sus beta-barrel proteins and binds to the Sus transcriptional regulators. Further, Bo expresses a non-Sus GH97 (BoGH97D) when grown in starch with acarbose. The Bt homolog, BtGH97H, is not expressed in the same conditions, nor can overexpression of BoGH97D complement the Bt growth inhibition in the presence of acarbose. This work informs us about unexpected complexities of Sus function and regulation in Bacteroides, including variation between related species. Further, this indicates that the gut microbiome may be a source of variable response to acarbose treatment for diabetes.

#1299 The SGLT2 inhibitor canagliflozin, but not dapagliflozin or empagliflozin, ameliorates vascular calcification in a mouse model of nephrocalcinosis

Abstract Background and Aims Vascular calcification, defined as the abnormal deposition of minerals in blood vessels, is a major cardiovascular risk factor in patients with kidney failure. Sodium-glucose co-transporter 2 (SGLT2) inhibitors, commonly known as gliflozins, are a class of pharmaceutical compounds that have revolutionised the therapeutic management of type 2 diabetes. These drugs target the SGLT2 transporter, increasing glucose elimination through the urine, effectively lowering hyperglycaemia. In addition to their effect on blood sugar control, SGLT2 inhibitors have recently gained attention for potential cardiovascular benefits in patients with type 2 diabetes, chronic kidney disease (CKD) or established cardiovascular disease. Initially thought to be secondary to the promotion of urinary sodium and glucose excretion and weight loss, recent studies have also reported direct effects of gliflozins on the vascular compartment. Given the significant impact of vascular calcification on cardiovascular health in patients with kidney failure, the aim of this study was to investigate whether the three different SGLT2 inhibitors (canagliflozin, empagliflozin and dapagliflozin) could reduce the development of vascular calcification. Method Western blotting was used to investigate SGLT2 expression in mouse and human vascular smooth muscle cells (VSMC) and vascular explants. Human and mouse aortic VSMC and mouse aorta and human epigastric and iliac artery segments were treated with calcification medium supplemented with 1 or 5 µM of gliflozins. A nephrocalcinosis mouse model consisting of 2 weeks of high phosphorus diet (2%) in female DBA/2 mice was used in in vivo experiments. The animals were treated daily with the different gliflozins (3 mg/kg/j) by oral gavage. Calcium deposits were quantified using a quantitative colorimetric assay and alizarin red staining, blood and urine glucose levels were measured using a quantitative colorimetric assay and glomerular filtration rate (GFR) was measured using sinistrin-FITC excretion. Results We observed that SGLT2 is expressed in mouse and human vessels and vascular smooth muscle cells (VSMC). Treatment with canagliflozin, but not dapagliflozin or empagliflozin, reduced calcification in vitro, in human and mouse VSMC and ex vivo, in mouse aorta and human epigastric and iliac artery segments. The high phosphorus diet in mice led to nephrocalcinosis associated with impaired renal function as well as vascular calcification development in the aorta. In this model, although all 3 gliflozins showed efficacy in increasing urinary glucose excretion, blood glucose levels were not affected by gliflozins and renal function was not improved. However, canagliflozin, but not dapagliflozin or empagliflozin, significantly reduced vascular calcification in this nephrocalcinosis mouse model. Conclusion Our study demonstrated that canagliflozin reduces vascular calcification development, highlighting its potential as a therapeutic strategy. This protective effect was found to be drug-dependent and not class-dependent, as the other two SGLT2 inhibitors, dapagliflozin and empagliflozin, showed no significant effect on vascular calcification. Further studies are needed to understand the mechanisms and pathways involved and to determine whether the differential effect of the gliflozins is due to an off-target action of canagliflozin on other SGLT transporters.

DEVELOPMENT OF HEALTH COMPETENCE OF CHILDREN WITH DIABETES MELLITUS IN THE SUMMER CAMP ENVIRONMENT

Diabetes mellitus is becoming a leading disease in paediatric endocrinology, which causes health problems and complications that can shorten life expectancy. The object of the research is the development of health competence of children with diabetes mellitus in the summer camp environment. Research aim is to reveal the development of health competence of children with diabetes mellitus in the summer camp environment. Tasks: 1) to identify the development of health competence in the environment of summer camps; 2) to reveal health topics being discussed by children in summer camps; 3) to reveal pedagogical interactions between the educator and the students in the environment of summer camps. Research methods: theoretical: analysis, generalisation and systematisation of scientific literature; empirical: document analysis. The research found that not only does the environment of summer camps contribute to the development of health competence of children with diabetes mellitus but it also encourages them to fully get used to living with the disease and creates a favourable educational environment that encourages communication. The research revealed that in the summer camp environment children discuss the following topics: blood sugar control, causes of diabetes mellitus and independence in managing the disease. The summer camp environment is friendly, active as well as engaging and tolerant of learner interaction.