Type 2 Diabetes Mellitus Control Research Articles

Achieving Effective Weight Loss for Type 2 Diabetes Mellitus Control: From Evidence to Practice

Type 2 diabetes mellitus (T2DM) poses a significant public health concern in Singapore. It is well established that T2DM is strongly associated with obesity. In Singapore, the prevalence of obesity and overweight in adults has been increasing over the last two decades. By 2050, the prevalence of obesity in the nation is predicted to reach 15.9 percent, a rise from 4.3 percent in 1990. The total prevalence of T2DM is also projected to rise to 15 percent in 2050, which was 7.3 percent in 1990, in tandem with the rise in obesity prevalence. Moderate and sustained weight loss (5-10 percent) improves glycaemic control and cardiovascular risk factors in overweight or obese patients with T2DM. Disease-modifying effects in T2DM and improvement in long-term cardiovascular outcomes and mortality are associated with larger and sustained weight losses (>10 percent). In this article, we highlight the growing burden of T2DM and its complications in Singapore and the role of weight loss in T2DM control. This article aims to provide an overview of multidisciplinary/multipronged strategies (lifestyle interventions, patient-centred approach with preferential use of glucose-lowering medications of weight neutral/weight loss effect, consideration of pharmacotherapy for weight loss and metabolic surgery) to achieve effective weight loss for T2DM control.

The Association between the Differential Expression of lncRNA and Type 2 Diabetes Mellitus in People with Hypertriglyceridemia

Compared with diabetic patients with normal blood lipid, diabetic patients with dyslipidemia such as high triglycerides have a higher risk of clinical complications, and the disease is also more serious. For the subjects with hypertriglyceridemia, the lncRNAs affecting type 2 diabetes mellitus (T2DM) and the specific mechanisms remain unclear. Transcriptome sequencing was performed on peripheral blood samples of new-onset T2DM (six subjects) and normal blood control (six subjects) in hypertriglyceridemia patients using gene chip technology, and differentially expressed lncRNA profiles were constructed. Validated by the GEO database and RT-qPCR, lncRNA ENST00000462455.1 was selected. Subsequently, fluorescence in situ hybridization (FISH), real-time quantitative polymerase chain reaction (RT-qPCR), CCK-8 assay, flow cytometry, and enzyme-linked immunosorbent assay (ELISA) were used to observe the effect of ENST00000462455.1 on MIN6. When silencing the ENST00000462455.1 for MIN6 in high glucose and high fat, the relative cell survival rate and insulin secretion decreased, the apoptosis rate increased, and the expression of the transcription factors Ins1, Pdx-1, Glut2, FoxO1, and ETS1 that maintained the function and activity of pancreatic β cells decreased (p < 0.05). In addition, we found that ENST00000462455.1/miR-204-3p/CACNA1C could be the core regulatory axis by using bioinformatics methods. Therefore, ENST00000462455.1 was a potential biomarker for hypertriglyceridemia patients with T2DM.

A Clinical Study on Musculoskeletal Changes Seen in Type 2 Diabetes Mellitus: A Single-Center Study

Abstract Background: Type 2 Diabetes mellitus (T2DM) may affect the musculoskeletal (MSK) system in a variety of ways. The impacts can be debilitating enough to impair functional ability and quality of life. MSK complications are the most common endocrine arthropathies which are often under-recognized and poorly treated. This study was done to evaluate the prevalence of MSK complications and its correlation with microvascular complications of T2DM given the paucity of similar studies in India particularly South India. Materials and Methods: A cross-sectional study was conducted on 130 diabetic patients at a tertiary care hospital in Bengaluru. The patient’s demographic details, clinical profile including history, general physical examination, systemic examination, and relevant investigations were done to record microvascular complications. A thorough MSK system examination along with imaging of bones and joints was also performed. Results: Out of 130 diabetic patients, 21 patients (16.2%) had MSK complications of which 47.6% (n = 10) of them had carpal tunnel syndrome and 42.8% (n = 9) had frozen shoulder and 9.5% (n = 2) had diabetic amyotrophy. It was also noted that patients who were on oral hypoglycemic agents alone were more likely to develop MSK complications (57.14%) than patients solely on insulin (14.2%). Poor glycemic control, existing microvascular complications, and low high-density lipoprotein were found to be associated with increased risk of MSK complications. Conclusion: The prevalence of MSK complications in T2DM patients is quite significant and is also associated with microvascular complications. Improved glycemic control in T2DM was found to reduce the burden of such complications. Early identification of MSK complications can improve the quality of life in diabetic patients and hence demands proper screening and follow-up.

The impact of self-management education on prevention and control of type-2 Diabetes mellitus

The impact of self-management education on prevention and control of type-2 Diabetes mellitus

Impact of glycemic control on biventricular function in patients with type 2 diabetes mellitus: a cardiac magnetic resonance tissue tracking study

BackgroundPoor glycemic control is associated with left ventricular (LV) dysfunction in patients with type 2 diabetes mellitus (T2DM). Nonetheless, the association between glycemic control and right ventricular (RV) function in T2DM has not been studied. This study aimed to evaluate the correlation between glycemic control and biventricular function and assess whether one ventricular function was mediated by the other ventricular changes using cardiac magnetic resonance.Materials and methodsA total of 91 T2DM patients with normal ejection fraction were enrolled and divided into two groups according to glycated hemoglobin (HbA1c) with a cut off 7%. Twenty controls were included. Biventricular ventricular strain parameters, including global peak systolic radial strain, global peak systolic circumferential strain (GCS), global peak systolic longitudinal strain (GLS), peak diastolic radial strain rate (RSR), peak diastolic circumferential strain rate (CSR) and peak diastolic longitudinal strain rate (LSR) were measured.ResultsCompared with controls, patients with both HbA1c < 7% and HbA1c ≥ 7% showed significantly lower LVGCS, LVGLS, LVCSR, LVLSR, RVGLS, RVRSR, RVCSR and RVLSR. Patients with HbA1c ≥ 7% elicited significantly higher RVGCS than controls and lower LVGLS, LVCSR, LVLSR, RVGLS and RVLSR. Multivariable linear regression demonstrated that HbA1c was independently associated with LVGLS, LVLSR, RVGLS and RVLSR after adjustment for traditional risk factors. LV (RV) was not statistically mediated by the other ventricular alterations.ConclusionIn T2DM patients, glycemic control was independently associated with impaired LV and RV systolic and diastolic function and these associations were not mediated by the other ventricular changes.

CLINICAL PROFILE OF TYPE-1 DIABETES PEDIATRIC PATIENTS IN DR. SOETOMO GENERAL ACADEMIC HOSPITAL SURABAYA: CORRELATION OF GROWTH STATUS AND METABOLIC CONTROL

Highlights1. Diabetes mellitus type 1 (DM) is a chronic autoimmune illness characterized by insulin insufficiency and hyperglycemia as a consequence.2. Stable HbA1c levels may be indicative of improved growth rates. AbstractBackground: Type-1 diabetes mellitus (DM) is a chronic auto-immune disease characterized by insulin insufficiency and resultant hyperglycemia caused by the destruction of insulin-producing beta cells in the pancreas. Metabolic control in type-1 DM affects the metabolism of patients, one of which is growth status, which is influenced by growth hormone. Improved growth rates can indicate stable HbA1c levels. However, whether growth is affected by the degree of diabetic control is still debatable. Objective: This study was conducted to determine whether the metabolic control correlates with growth status of children with type-1 diabetes in the Endocrine Polyclinic at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Material and Method: Retrospective observational analysis with a cross-sectional method was conducted on 96 type-1 DM patients at Dr. Soetomo General Academic Hospital Surabaya, Indonesia. The analysis was carried out using Chi-Square test to determine whether there was a correlation. Result: From a total of 96 pediatric patients, the majority was male (54.1%), patients with high-risk metabolic control were 79.2%, and those with z-score normal category were 62.5%. The results indicated no significant correlation between growth status and metabolic control of pediatric patients, with Chi-Square test results showed p=0.421 (p&gt;0.05). Conclusion: There was no significant correlation between growth status and metabolic control of type-1 diabetes pediatric patients at the Endocrine Polyclinic Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Serum metabolomic analysis revealed potential metabolite biomarkers for diabetes mellitus with coronary heart disease.

Diabetes, including its predominant form, type 2 diabetes mellitus (T2DM), has a distinctive correlation with coronary heart disease (CHD). Patients with diabetes have shown statistically higher potential risk of developing CHD complications than those without diabetes. In this study, we have conducted a metabolomic analysis of serum samples from healthy controls as well as patients with T2DM or both T2DM and CHD (CHD-T2DM). Statistical analysis of the metabolomic data revealed 611 and 420 significantly altered metabolic signatures in T2DM and CHD-T2DM patients, respectively, when compared to the healthy controls. Meanwhile, 653 metabolic features were significantly different between the CHD-T2DM and T2DM groups. Some of the metabolites at significantly different levels were identified and may serve as potential biomarkers for T2DM or CHD-T2DM. We selected three candidates, phosphocreatine (PCr), cyclic guanosine monophosphate (cGMP) and taurine for further validation among independent T2DM, CHD-T2DM and healthy control populations. These three metabolites were found to be significantly elevated in the CHD-T2DM group when compared to both T2DM and healthy control groups by the metabolomic analysis. Our results indicated that both PCr and cGMP but not taurine were successfully validated and may serve as predictive biomarkers of CHD in patients with T2DM.

Comparative Study between laparoscopic Sleeve Gastrectomy and laparoscopic Mini Gastric Bypass in Control of Type2 Diabetes Mellitus in obese patients

Comparative Study between laparoscopic Sleeve Gastrectomy and laparoscopic Mini Gastric Bypass in Control of Type2 Diabetes Mellitus in obese patients

Влияние дапаглифлозина на жировой и углеводный обмен у пациентов с сахарным диабетом 2 типа

Aim: To determine the effects of dapagliflozin in impaired carbohydrate and fat metabolism in type 2 diabetes mellitus (T2DM). Design: An open cohort controlled prospective study. Materials and methods. In this study 60 patients with T2DM and obesity were examined. Dapagliflozin 10 mg was added to metformin monotherapy. Carbohydrate metabolism and fat metabolism markers were evaluated for 6 months: anthropometry, body composition analysis, assessment of adipokines (adiponectin, leptin, irisin, interleukin (IL) 6) and lipid panel. Results. Dapagliflozin addition resulted in glycated hemoglobin level decrease by an average of 0.6% (p = 0.093) along with significant positive effects on fat metabolism markers. The mean body mass decrease was 3.3 kg (p &lt; 0.05). There was also a significant decrease in fat mass of 3 kg (p = 0.001) and a muscle mass extension, according to a body composition analysis report, which correlated with leptin levels decrease (p = 0.073) and adiponectin and irisin levels increase (p &lt; 0.05). A significant decrease in total cholesterol, triglycerides and low-density lipoproteins levels also occurred (p = 0.001). Conclusion. Leptin and IL-6 levels decrease and irisin and adiponectin levels increase correlating with a fat mass reduction and muscle mass expansion occurred with dapagliflozin added to the therapy. These findings suggest the possibility of metabolically unhealthy obesity transitioning to metabolically healthy obesity. Adipose tissue dysfunction treatment as a focus of therapy may provide not only a better control of T2DM, but also cardiometabolic risks reduction. Keywords: type 2 diabetes mellitus, dapagliflozin, adiponectin, leptin, irisin, interleukin 6, lipid panel, fat metabolism.

Laparoscopic Roux-en-Y gastric bypass for excess weight and diabetes: a multicenter retrospective cohort study in China

Aim: The aims of this study were to better understand the outcomes of Roux-en-Y gastric bypass (RYGB) surgery in patients across multiple hospitals in China along with patients with type 2 diabetes mellitus (T2DM) and to explore the potential preoperative predictors of diabetes outcomes after RYGB. Methods: This was a retrospective cohort study in Chinese patients who underwent laparoscopic RYGB at five Chinese hospitals from April 2009 to December 2014 and returned for follow-up approximately one-year post-surgery. The STROCSS guideline checklist was applied. Results: In total, 130 patients underwent RYGB: 85 males and 45 females; age, 43.4 ± 11.3 years; and preoperative body mass index (BMI), 33.1 ± 9.0 kg/m2. Of those, 103 (79.2%) had T2DM duration of 6.6 ± 4.7 years and pre-RYGB HbA1c of 8.1 ± 1.9%. Among the patients with T2DM, glycemic control (HbA1c &lt; 7.0%) increased from 28.7% before surgery to 79.3% at 12 months post-procedure, with a concurrent reduction in the use of anti-hyperglycemic agents, including a reduction in insulin requirement from 55.4% to 27.0%. The percentage of excess weight loss was -42.8 ± 44.2%. Among 71 patients with T2DM and data about remission status, 14 (19.7%) achieved T2DM remission at 12 months post-surgery. Age and duration of T2DM were lower in the remission group, while baseline BMI and weight were higher compared with the non-remission group. Conclusion: RYGB may be effective for weight loss and T2DM control in Chinese patients, and outcomes are consistent with the literature in Western populations. Younger patients with T2DM and with a higher BMI pre-surgery and shorter duration of T2DM were more likely to achieve T2DM remission.

Decreased muscle mass in type-2 diabetes. A hidden comorbidity to consider

an expert report is presented on the situation of loss of muscle mass in people with type 2 diabetes mellitus (T2DM), with a proposal of what the clinical approach to this comorbidity should be, based on the evidence from the literature and clinical experience. a qualitative expert opinion study was carried out using the nominal approach. A literature search on diabetes and muscle was made and submitted to a multidisciplinary group of 7 experts who through a face-to-face meeting discussed different aspects of the role of muscle mass in T2DM. muscle mass must be taken into account in the clinical context of patients with T2DM. It has an enormous impact on patient function and quality of life, and is as important as adequate metabolic control of T2DM. in addition to drug therapy and diet adjustments, aerobic and strength activities are essential for maintaining muscle mass and function in diabetic patients. In concrete situations, artificial oral supplementation specific for muscle care could improve the situation of malnutrition and low muscle mass. Measures such as the walking speed test, chair test, or the SARC-F questionnaire, together with the Barthel index, constitute a first step to diagnose relevant impairment requiring intervention in patients with T2DM. This document seeks to answer some questions about the importance, assessment, and control of muscle mass in T2DM.

Traditional Chinese medicine body constitution predicts new-onset diabetic albuminuria in patients with type 2 diabetes: Taichung diabetic body constitution prospective cohort study

This prospective cohort study explored whether body constitution (BC) independently predicts new-onset albuminuria in persons with type 2 diabetes mellitus (T2DM) enrolled in the diabetes care management program (DCMP) of a medical center, providing evidence of integrating traditional Chinese medicine into DCMP for improving care quality. Persons with T2DM (n = 426) originally without albuminuria enrolled in DCMP were recruited in 2010 and were then followed up to 2015 for detecting new-onset albuminuria. The participants received urinalysis and blood test annually. Albuminuria was determined by an elevated urinary albumin/creatinine ratio (≥ 30 µg/mg), and poor glucose control was defined as Glycosylated hemoglobin above or equal to 7%. BC type (Yin deficiency, Yang deficiency, and phlegm stasis) was assessed using a well-validated body constitution questionnaire at baseline. Risk factors for albuminuria (sociodemographic factors, diabetes history, lifestyle behaviors, lipid profile, blood pressure, and kidney function) were also recorded. Hazard ratios (HR) of albuminuria for BC were estimated using multivariate Cox proportional hazards model. During the 4-year follow-up period, albuminuria occurred in 30.5% of participants (n = 130). The HR indicated that Yin deficiency was significantly associated with an increased risk of new-onset albuminuria in persons with T2DM and good glucose control after adjustment for other risk factors (HR = 2.09; 95% confidence interval = 1.05-4.17, P = .04), but not in those with poor glucose control. In persons with T2DM and poor glucose control, phlegm stasis was also significantly associated with a higher risk of albuminuria (2.26; 1.03-4.94, P = .04) after multivariate adjustment, but not in those with good glucose control. In addition to already-known risk factors, BC is an independent and significant factor associated with new-onset albuminuria in persons with T2DM. Our results imply Yin deficiency and phlegm stasis interacting with glucose control status may affect new-onset albuminuria in persons with T2DM.

Complications after One-Year Observation of Patients with Type 2 Diabetes Mellitus and Various Types of Coronary Heart Disease

Aim: Evaluation of complications after one-year observation in patients with acute and chronic coronary heart disease (CHD) depending on the presence of type 2 diabetes mellitus (T2DM). Material and methods: This comparative clinical study included 202 men and women with acute and chronic CHD. Patients were divided into four groups, depending on the presence of type 2 diabetes mellitus: acute CHD and T2DM; acute CHD without T2DM (control group); chronic CHD and T2DM; chronic CHD without T2DM (control group). Depending on the results of clinical status and coronary angiography data, patients underwent myocardial revascularization (balloon angioplasty without stenting, stenting, coronary bypass grafting, stenting + coronary bypass grafting) followed by pharmacological treatment. One-year composite endpoints included: recurrent myocardial infarction, acute cerebrovascular accident, readmission, and death. Results: After admission, up to 80% of patients, regardless of CHD type and glycemic status, underwent revascularization. Patients without T2DM underwent stenting significantly more often compared with patients with T2DM. Coronary artery bypass grafting, including in combination with stenting, was more frequent in patients with T2DM with acute and chronic CHD. One year after discharge, readmissions and reoperations were more prevalent among patients with acute and chronic CHD and T2DM. The groups did not differ by the number of nonfatal and fatal complications. The total number of endpoints in patients with T2DM, regardless of the CHD type, were 2 times higher compared with the control group (p<0.001). Conclusion: Patients with acute and chronic CHD without T2DM, underwent stenting of one coronary artery more often, while patients with T2DM underwent coronary bypass surgery, including in combination with stenting. After one year of observation, the number of complications in patients with various CHD types and T2DM was higher than those without T2DM. This once again indicates the need for comprehensive secondary prevention.

Characteristic analysis of patients with type 2 diabetes mellitus combined with advanced stage chronic liver disease: a community population-based cross-sectional study in Heping District, Shenyang City (CHESS-LN 2101)

Objective: To investigate the prevalence and independent risk factors of non-alcoholic fatty liver disease (NAFLD) and advanced chronic liver disease among the type 2 diabetes mellitus (T2DM) population in the Shenyang community, so as to provide evidence for the prevention and control of T2DM combined with NAFLD. Methods: This cross-sectional study was conducted in July 2021. 644 T2DM cases from 13 communities in Heping District, Shenyang City were selected. All the surveyed subjects underwent physical examination (measurements of height, body mass index, neck circumference, waist circumference, abdominal circumference, hip circumference, and blood pressure), infection screening (excluding hepatitis B and C, AIDS, and syphilis), random fingertip blood glucose, controlled attenuation parameter (CAP), and liver stiffness measurement (LSM). The study subjects were divided into the non-advanced chronic liver disease group and the advanced chronic liver disease group according to whether the LSM value was greater than 10 kPa. Cirrhotic portal hypertension development was indicated in patients with LSM ≥ 15 kPa. The comparison of multiple mean values among the sample groups was performed by analysis of variance when the normal distribution was met. Results: In the T2DM community population, there were 401 cases (62.27%) combined with NAFLD, 63 cases (9.78%) combined with advanced chronic liver disease, and 14 cases (2.17%) combined with portal hypertension. There were 581 cases in the non-advanced chronic liver disease group and 63 cases (9.78%) in the advanced chronic liver disease group (LSM ≥10 kPa), including 49 cases (7.61%) with 10 kPa≤LSM<15 kPa, 11 cases (1.71%) with 15 kPa ≤LSM<25 kPa, and 3 cases (0.47%) with LSM ≥ 25 kPa. Age, body mass, body mass index, neck circumference, waist circumference, hip circumference, waist-to-height ratio, systolic blood pressure, and CAP were all statistically different between the non-advanced chronic liver disease group and the advanced chronic liver disease group (F=-1.983,-2.598,-4.091,-2.062,-3.909, -4.581,-4.295,-2.474, and -5.191, respectively; P<0.05). There was a statistically significant difference in terms of whether or not there was combined cerebrovascular disease (2=4.632, P=0.031); however, there were no statistically significant differences in terms of lifestyle, diabetes complications, and other complications (P>0.05). Conclusion: Patients with T2DM have a higher prevalence of NAFLD (62.27%) than those with advanced chronic liver disease (9.78%). 2.17% of T2DM cases in the community may not have had early diagnosis and early intervention, and they might have been combined with cirrhotic portal hypertension. So, the management of these patients should be strengthened.

Insights on the pathogenesis of type 2 diabetes as revealed by signature genomic classifiers in an African American population in the Washington, DC area.

African Americans (AA) in the United States have a high risk of type 2 diabetes mellitus (T2DM) and suffer from disparities in the prevalence, mortality, and comorbidities of the disease compared to other Americans. The present study aimed to shed light on the molecular mechanisms of disease pathogenesis of T2DM among AA in the Washington, DC region. We performed TaqMan Low Density Arrays (TLDA) on 24 genes of interest that belong to three categories: metabolic disease and disorders, cancer-related genes, and neurobehavioural disorders genes. The 18 genes, viz. ARNT, CYP2D6, IL6, INSR, RRAD, SLC2A2 (metabolic disease and disorders), APC, BCL2, CSNK1D, MYC, SOD2, TP53 (Cancer-related), APBA1, APBB2, APOC1, APOE, GSK3B, and NAE1 (neurobehavioural disorders), were differentially expressed in T2DM participants compared to controls. Our results suggest that factors including gender, smoking habits, and the severity or lack of control of T2DM (as indicated by HbA1c levels) were significantly associated with differential gene expression. APBA1 was significantly (p-value <0.05) downregulated in all diabetes participants. Upregulation of APOE and CYP2D6 genes and downregulation of the INSR gene were observed in the majority of diabetes patients. Tobacco smoking and gender were significantly associated with case-control differences in expression of the APBA1 and APOE genes (connected with Alzheimer's disease) and the INSR and CYP2D6 (associated with metabolic disorders). The results highlight the need for more effective management of T2DM and for tobacco smoking cessation interventions in this community, and further research on the associations of T2DM with other disease processes, including cancer and neurobehavioral pathways.

Abstract 13272: Diabetic Cardiomyopathy as a Coronary Artery Disease Mimic: A Case Report

A 49-year-old female presented with complaints of angina and dyspnea on exertion for last 4 months, which caused significant limitation of ordinary physical activity. She had poorly controlled diabetes mellitus type 2 with HbA1C of 10.3%. EKG showed complete LBBB with QRS duration of 180 milliseconds. Echocardiogram was consistent with dilated left ventricle and global hypokinesia of left ventricle with ejection fraction of 25-30%. There was marked reduction in GLS (GLPS average of -7.0%). She underwent coronary angiogram which revealed normal epicardial coronary arteries. 99m Tc-sestamibi SPECT myocardial perfusion imaging (MPI) at rest, demonstrated moderate to severe ischemia involving apical, antero-septal, adjacent anterior wall and adjacent basal 2/3 rd of inferior wall segments of LV myocardium (involving approx.~73% of RCA territory and 57% of LAD territory at 50% uptake threshold). There was wall motion abnormality in above mentioned segments on ECG gated SPECT and estimated LVEF with QGS was ~29±5%. She has been started on anti-ischemic measures, guideline directed therapy for HFrEF and comprehensive diabetes care. Diabetic cardiomyopathy is myocardial dysfunction with normal epicardial coronary arteries and absence of other cardiovascular diseases. It is characterized by myocardial fibrosis and associated systolic dysfunction preceded by diastolic dysfunction. Cardiac insulin resistance leads to advanced glycation end products, microvascular dysfunction etc. Perfusion defects observed during MPI in patients with LBBB may be due to CAD, microvascular dysfunction, or artifacts. In the setting of LBBB, isolated anteroseptal defect has low probability of CAD but presence of perfusion defects in RCA territory and apical region increases probability of ischemic events.In this case, there was ischemia with systolic dysfunction in the absence of any overt clinical coronary artery disease and no other identifiable cause.

Could Duodenal Molecular Mechanisms be Involved in the Hypocholesterolemic Effect of Silicon Used as Functional Ingredient in Late-Stage Type 2 Diabetes Mellitus?

Hypercholesterolemia increases the risk of mortality in type 2 diabetes mellitus (T2DM), especially in the late-stage. Consumption of bioactive compounds as functional ingredients would help achieve therapeutic goals for cholesterolemia. Silicon has demonstrated a hypocholesterolemic effect and the ability to reduce fat digestion. However, it is unclear whether silicon exerts such effect in late-stage T2DM (LD) and the intestinal mechanisms involved. Three groups of eight rats were included: early-stage T2DM control (ED), LD, and the LD group treated with silicon (LD-Si) once the rats were diabetic. Morphological alterations of the duodenal mucosa, and levels of markers involve in cholesterol absorption and excretion, beside cholesterolemia, and fecal excretion were assayed. Silicon included as a functional ingredient significantly reduces cholesterolemia in part due to: 1) reducing cholesterol intestinal absorption by decreasing the absorptive area and Acetyl-Coenzyme A acetyltransferase-2 (ACAT2) levels; and 2) increasing cholesterol excretion to the lumen by induction of the liver X receptor (LXR) and consequent increase of adenosine triphosphate-binding cassette transporter (ABCG5/8). These results provide insight into the intestinal molecular mechanisms by which silicon reduces cholesterolemia and highlights the efficacy of the consumption of silicon-enriched functional foods in late-stage T2DM.

Network Pharmacology- and Molecular Dynamics Simulation-Based Bioprospection of Aspalathus linearis for Type-2 Diabetes Care.

The medicinal herb Aspalathus linearis (rooibos) is globally recognized in type-2 diabetes mellitus (T2DM) treatment due to its known and distinctive compounds. This work utilized network pharmacology (NP) coupled with molecular dynamics simulation in gaining new insight into the anti-diabetic molecular mechanism of action of rooibos teas. It looked at the interactions between rooibos constituents with various relevant protein receptors and signaling routes associated with T2DM progression. The initial analysis revealed 197 intersecting gene targets and 13 bioactive rooibos constituents linked to T2DM. The interactions between proteins and compounds to the target matrix were generated with the Cystoscope platform and STRING database. These analyses revealed intersecting nodes active in T2DM and hypoxia-inducible factor 1 (HIF-1) as an integral receptors target. In addition, KEGG analysis identified 11 other pathways besides the hub HIF-1 signaling route which may also be targeted in T2DM progression. In final molecular docking and dynamics simulation analysis, a significant binding affinity was confirmed for key compound-protein matrices. As such, the identified rooibos moieties could serve as putative drug candidates for T2DM control and therapy. This study shows rooibos constituents' interaction with T2DM-linked signaling pathways and target receptors and proposes vitexin, esculin and isovitexin as well as apigenin and kaempferol as respective pharmacologically active rooibos compounds for the modulation of EGFR and IGF1R in the HIF-1 signaling pathway to maintain normal homeostasis and function of the pancreas and pancreatic β-cells in diabetics.

Elevated IL-31 and IL-31RA with dyslipidemia in T2DM patients

Type 2 Diabetes mellitus (T2DM) is characterized by elevated of blood glucose, and considered as a chronic metabolic disease. Uncontrolled blood glucose levels cause many dangerous complications. One of these complications are diabetic foot ulcers (DFU). About 15% of these patients suffering of DFU that affected on their lives. Approximately 8.5% Iraqi suffer from T2DM. Sixty T2DM patients (32 male and 28 female) aged 39-65 years that participated in the present study. Thirty apparently healthy subjects (12 male and 18 female) were classified as a control group. Age and BMI are not significantly different between patients and controls. This was made to exclude the influence of body mass and age on the results. There is an expected significant increase in fasting blood glucose (FBG) (p &lt;0.001) and glycated hemoglobin (HbA1c). The results showed a significant increase (p&lt;0.001) in serum triglyceride (TG), VLDLc in T2DM as comparison with the control group, while There were no significant differences among T2DM patients and control group in total cholesterol (TC), HDLc and LDLc. This result maybe was by the effect of diabetic drug on lipid profile where some drugs such as metformin that reducing cholesterol.

Research Progress of Duodenal-Jejunal Bypass Liner in the Treatment of Obesity and Type 2 Diabetes Mellitus.

With the development of economy and improvement of people's living standards, the incidence of obesity and type 2 diabetes mellitus (T2DM) has increased significantly and obesity has also become one of the most important risk factors of T2DM. In light of these trends, there have been many ways to take effect in losing weight. However, they also have corresponding deficiencies including inapparent curative effect, complex and incomplete reversible procedures and severe complications. Duodenal-Jejunal Bypass Liner (DJBL), which mimics Roux-en-Y gastric bypass (RYGB), is proved to play a key role in weight loss and control of T2DM. DJBL is reversible, less invasive and is more suitable for the treatment of obesity and T2DM, which is associated with multiple mechanisms, including incretin effect, gastric emptying mechanism, bile acid regulation, intestinal microbiota, inflammatory reaction mechanism and neural mechanism. In our review, we aimed to elaborate DJBL's clinical efficacy, safety and mechanisms in detail.