Decreased Blood Glucose Research Articles

(D-Ala2)GIP Inhibits Inflammatory Bone Resorption by Suppressing TNF-α and RANKL Expression and Directly Impeding Osteoclast Formation.

Glucose-insulinotropic polypeptide (GIP) is an incretin hormone that induces insulin secretion and decreases blood glucose levels. In addition, it has been reported to suppress osteoclast formation. Native GIP is rapidly degraded by dipeptidyl peptidase-4 (DPP-4). (D-Ala2)GIP is a newly developed GIP analog that demonstrates enhanced resistance to DPP-4. This study aimed to evaluate the influence of (D-Ala2)GIP on osteoclast formation and bone resorption during lipopolysaccharide (LPS)-induced inflammation in vivo and in vitro. In vivo, mice received supracalvarial injections of LPS with or without (D-Ala2)GIP for 5 days. Osteoclast formation and bone resorption were evaluated, and TNF-α and RANKL expression were measured. In vitro, the influence of (D-Ala2)GIP on RANKL- and TNF-α-induced osteoclastogenesis, LPS-triggered TNF-α expression in macrophages, and RANKL expression in osteoblasts were examined. Compared to the LPS-only group, calvariae co-administered LPS and (D-Ala2)GIP led to less osteoclast formation, lower bone resorption, and decreased TNF-α and RANKL expression. (D-Ala2)GIP inhibited osteoclastogenesis induced by RANKL and TNF-α and downregulated TNF-α expression in macrophages and RANKL expression in osteoblasts in vitro. Furthermore, (D-Ala2)GIP suppressed the MAPK signaling pathway. The results suggest that (D-Ala2)GIP dampened LPS-triggered osteoclast formation and bone resorption in vivo by reducing TNF-α and RANKL expression and directly inhibiting osteoclastogenesis.

Role of clinical pharmacists in multidisciplinary collaborative management of blood glucose in COVID-19 patients with hyperglycemia

BackgroundDuring the ongoing global pandemic of COVID-19, the association between hyperglycemia and COVID-19 infection has emerged as a notable concern. Therefore, finding effective methods to manage hyperglycemia in patients with COVID-19 is crucial. ObjectiveTo introduce the clinical pharmacists participating in multidisciplinary collaborative whole hospital blood glucose management mode, and to explore its effect on blood glucose control in patients with coronavirus disease 2019 infection and complicated with hyperglycemia. MethodsPatients with COVID-19 treated at Nanjing Drum Tower Hospital from December 2022 to January 2023 were assigned to routine diagnosis and treatment group and whole hospital blood glucose management group according to the blood glucose management plan received by patients. The groups were compared in regards to their adherence to management advice, blood glucose levels, fluctuation, inflammation-related indicators, medical service-related indicators, and incidence of hypoglycemia and adverse events. ResultsAfter 5 days of glucose management, both groups showed a decrease in fasting and postprandial blood glucose. Postprandial blood glucose in the whole hospital glucose management group was significantly lower than the routine group (P < 0.05). The whole hospital glucose management group showed a significant increase in compliance rate, improved inflammation-related indicators, and higher detection rates for hemoglobin and islet function (P < 0.05). Implementation rates for medical orders and treatment plans were also higher in the whole hospital group (P < 0.05). There was no significant difference in incidence of adverse events. ConclusionsMultidisciplinary blood glucose management is highly recommended for patients with COVID-19 who have hyperglycemia due to its effectiveness, standardization, safety, and improvement of inflammation indicators.

Chitosan Versus Dapagliflozin in a Diabetic Cardiomyopathy Mouse Model.

Diabetes mellitus is a metabolic disorder with global economic implications that can lead to complications such as diabetic cardiomyopathy. The aim of this study was to compare the effects of chitosan versus dapagliflozin in mouse diabetic cardiomyopathy. We used 32 C57Bl/6 male mice aged between 8 and 10 weeks, which were randomly divided into Control-without diabetes mellitus (DM), type 1 DM (T1DM), T1DM + Chitosan, and T1DM + Dapapgliflozin groups. We induced diabetes with streptozotocin and treated the animals for 12 weeks. The analysis showed a reduction in intramyocardial fibrosis in the T1DM + Dapapgliflozin compared to T1DM animals. In T1DM + CHIT, a reduction in intramyocardial fibrosis was observed although, accordingly, there was also no significant decrease in blood glucose. The level of oxidative stress was reduced in the groups of treated animals compared to T1DM. All these observed changes in the structure and function of hearts were highlighted in the echocardiographic examination. In the treated groups, there was delayed appearance of left ventricular (LV) hypertrophy, a slight decrease in the ejection fraction of the LV, and an improved diastolic profile. The results demonstrate that chitosan has promising effects on diabetic cardiomyopathy that are comparable to the beneficial effects of dapagliflozin.

Effect of various pharmacotherapy regimens on the state of carbohydrate metabolism in patients with urination disorders

Aim. To evaluate the efficacy and safety of various pharmacotherapy regimens in patients with urination disorders and type 2 diabetes mellitus during their preparation for surgery.Materials and methods. In total, 130 people (56 men and 74 women) aged from 18 to 81 years (average 65 years) were included in the research. All the patients were on standardized hypoglycemic therapy in combination with alpha1-blockers (doxazosin, terazosin) and vitamin-like drugs (alpha-lipoic acid, levocarnitine). Patients were divided into male and female subgroups, as well as into age subgroups, including under 65 years and over 65 years. Tabular methods of assessing the clinical symptoms of urinary disorders were used, along with instrumental, laboratory, and statistical methods (Mann-Whitney test, Spearman rank correlation coefficient).Results. The duration of therapy averaged 16± 2 months. The observation found that alpha1-blockers lead to a number of positive changes in the composition of carbohydrate metabolism, i.e., the level of serum glucose and insulin. In the general observation group, a significant decrease in blood glucose from 6.64 to 6.27 mmol/L, insulin from 18.07 to 14.03 mU/mL, and C-peptide from 3.67 to 2.98 ng/mL was detected. In the male subgroup, glucose levels decreased from 6.45 to 6.00 mmol/L, insulin from 18.92 to 13.99 mU/mL, and C-peptide from 3.76 to 2.97 ng/mL. In the female subgroup, blood glucose levels decreased from 6.98 to 6.77 mmol/L, insulin from 16.41 to 14.1 mU/mL, and C-peptide from 3.51 to 2.99 ng/mL. In the group of patients younger than 65 years of age, a decrease in glucose from 6.22 to 5.93 mmol/L, insulin from 17.87 to 14.36 mU/mL, and C-peptide from 3.49 to 3.01 ng/mL were also observed. In the group of patients older than 65 years of age, similar dynamics of the above parameters was established.Conclusions. The data obtained suggest that alpha1-blockers in combination with vitamin-like drugs contribute to reducing the level of serum glucose, insulin, and C-peptide during a long-term (at least 1 year) therapy, which may be promising in the correction of metabolic disorders during preparation of patients for surgery.

Reduced Progression of Diabetic Nephropathy in Streptozocin-Induced Diabetic rats by Lannea coromandelica Leaf Extract

Objectives: An important contributor to end-stage renal failure globally is diabetic kidney disease. The current study looked at the safeguarding results of an infusion of Ethanol from Lannea coromandelica houtt leaves (ELCL)in diabetic kidney disease that was caused by streptozotocin with the intention to treat diabetic nephropathy, creating supportive and substitute medicine is necessary. The development of DN may be slowed down by itsanti-inflammatory, anti-diabetic and antioxidant qualities. The novelity lies in the plant selection for the study. Methods: Streptozotocin (45mg/kg, i.p.) was administered as a single dosage to rats to induce diabetes. During 8 weeks, oral dosages of ELCL (100mg/kg and 200mg/kg.) were given to rodents with STZ diabetes. Blood sugar amounts and body and kidney weights were measured at the conclusion of the trial period. The parameters of serum and urine were evaluated. The kidney levels of lipid peroxide and antioxidant enzymes were assessed. Results: In STZ-diabetic rats and rats treated with extract, ethylacetate extract dramatically raised body weight and decreased blood glucose, blood urea levels, blood nitrogen levels, and the creatinine levels. All kidney antioxidants, including glutathione synthetase, glutathione-S-transferase, catalase, superoxide dismutase and NAD(P) H dehydrogenase [quinone]1 were highly upregulated by the extract. Conclusion: According to research, ELCL may have antioxidant, antihyperglycemic, and anti-glycation properties that could slow the progression of diabetic nephropathy.

Dental Stem Cell-Based Therapy for Glycemic Control and the Scope of Clinical Translation: A Systematic Review and Meta-Analysis

Background: The tooth is a repository of stem cells, garnering interest in recent years for its therapeutic potential. The aim of this systematic review and meta-analysis was to test the hypothesis that dental stem cell administration can reduce blood glucose and ameliorate polyneuropathy in diabetes mellitus. The scope of clinical translation was also assessed. Methods: PubMed, Cochrane, Ovid, Web of Science, and Scopus databases were searched for animal studies that were published in or before July 2023. A search was conducted in OpenGrey for unpublished manuscripts. Subgroup analyses were performed to identify potential sources of heterogeneity among studies. The risk for publication bias was assessed by funnel plot, regression, and rank correlation tests. Internal validity, external validity, and translation potential were determined using the SYRCLE (Systematic Review Center for Laboratory Animal Experimentation) risk of bias tool and comparative analysis. Results: Out of 5031 initial records identified, 17 animal studies were included in the review. There was a significant decrease in blood glucose in diabetes-induced animals following DSC administration compared to that observed with saline or vehicle (SMD: −3.905; 95% CI: −5.633 to −2.177; p = 0.0004). The improvement in sensory nerve conduction velocity (SMD: 4.4952; 95% CI: 0.5959 to 8.3945; p = 0.035) and capillary-muscle ratio (SMD: 2.4027; 95% CI: 0.8923 to 3.9132; p = 0.0095) was significant. However, motor nerve conduction velocity (SMD: 3.1001; 95% CI: −1.4558 to 7.6559; p = 0.119) and intra-epidermal nerve fiber ratio (SMD: 1.8802; 95% CI: −0.4809 to 4.2413; p = 0.0915) did not increase significantly. Regression (p &lt; 0.0001) and rank correlation (p = 0.0018) tests indicated the presence of funnel plot asymmetry. Due to disparate number of studies in subgroups, the analyses could not reliably explain the sources of heterogeneity. Interpretation: The direction of the data indicates that DSCs can provide good glycemic control in diabetic animals. However, methodological and reporting quality of preclinical studies, heterogeneity, risk of publication bias, and species differences may hamper translation to humans. Appropriate dose, mode of administration, and preparation must be ascertained for safe and effective use in humans. Longer-duration studies that reflect disease complexity and help predict treatment outcomes in clinical settings are warranted. This review is registered in PROSPERO (number CRD42023423423).

Transplantation of beige adipose organoids fabricated using adipose acellular matrix hydrogel improves metabolic dysfunction in high-fat diet-induced obesity and type 2 diabetes mice.

Transplantation of brown adipose tissue (BAT) is a promising approach for treating obesity and metabolic disorders. However, obtaining sufficient amounts of functional BAT or brown adipocytes for transplantation remains a major challenge. In this study, we developed a hydrogel that combining adipose acellular matrix (AAM) and GelMA and HAMA that can be adjusted for stiffness by modulating the duration of light-crosslinking. We used human white adipose tissue-derived microvascular fragments to create beige adipose organoids (BAO) that were encapsulated in either a soft or stiff AAM hydrogel. We found that BAOs cultivated in AAM hydrogels with high stiffness demonstrated increased metabolic activity and upregulation of thermogenesis-related genes. When transplanted into obese and type 2 diabetes mice, the HFD + BAO group showed sustained improvements in metabolic rate, resulting in significant weight loss and decreased blood glucose levels. Furthermore, the mice showed a marked reduction in nonalcoholic liver steatosis, indicating improved liver function. In contrast, transplantation of 2D-cultured beige adipocytes failed to produce these beneficial effects. Our findings demonstrate the feasibility of fabricating beige adipose organoids in vitro and administering them by injection, which may represent a promising therapeutic approach for obesity and diabetes.

Ketone ester supplementation of Atkins-type diet prolongs survival in an orthotopic xenograft model of glioblastoma.

Heavy reliance on glucose metabolism and a reduced capacity to use ketone bodies makes glioblastoma (GBM) a promising candidate for ketone-based therapies. Ketogenic diet (KD) is well-known for its promising effects in controlling tumor growth in GBM. Moreover, synthetic ketone ester (KE) has demonstrated to increase blood ketone levels and enhance animal survival in a metastatic VM-M3 murine tumor model. Here, we compared the efficacy of a KE-supplemented Atkins-type diet (ATD-KE) to a classic KD in controlling tumor progression and enhancing survival in a clinically relevant orthotopic patient-derived xenograft GBM model. Our findings demonstrate that ATD-KE preserves body weight (percent change from the baseline; 112±2.99 vs. 116.9±2.52 and 104.8±3.67), decreases blood glucose (80.55±0.86 vs. 118.6±9.51 and 52.35±3.89 mg/dl), and increases ketone bodies in blood (1.15±0.03 mM vs. 0.55±0.04 and 2.66±0.21 mM) and brain tumor tissue (3.35±0.30 mM vs. 2.04±0.3 and 4.25±0.25 mM) comparable to the KD (results presented for ATD-KE vs. standard diet [STD] and KD, respectively). Importantly, the ATD-KE treatment significantly enhanced survival compared to the STD and was indistinguishable from the KD (47 days in STD vs. 56 days in KD and ATD-KE), suggesting that a nutritionally balanced low carbohydrate ATD combined with KE may be as effective as the KD alone in reducing brain tumor progression. Overall, these data support the rationale for clinical testing of KE-supplemented low-carb diet as an adjunct treatment for brain tumor patients.

Alpha-glucosidase inhibitory and hypoglycemic effects of imidazole-bearing thioquinoline derivatives with different substituents: In silico, in vitro, and in vivo evaluations

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by high blood sugar levels. It was shown that modulating the activity of α-glucosidase, an enzyme involved in carbohydrate digestion and absorption, can improve blood sugar control and overall metabolic health in individuals with T2DM. As a result, in the current study, a series of imidazole bearing different substituted thioquinolines were designed and synthesized as α-glucosidase inhibitors. All derivatives exhibited significantly better potency (IC50 = 12.1 ± 0.2 to 102.1 ± 4.9 µM) compared to the standard drug acarbose (IC50 = 750.0 ± 5.0 µM). 8g as the most potent analog, indicating a competitive inhibition with Ki = 9.66 µM. Also, the most potent derivative was subjected to molecular docking and molecular dynamic simulation against α-glucosidase to determine its mode of action in the enzyme and study the complex's behavior over time. In vivo studies showed that 8g did not cause acute toxicity at 2000 mg/kg doses. Additionally, in a diabetic rat model, treatment with 8g significantly reduced fasting blood glucose levels and decreased blood glucose levels following sucrose loading compared to acarbose, a standard drug used for blood sugar control. The findings suggest that the synthesized compound 8g holds promise as an α-glucosidase inhibitor for improving blood sugar control and metabolic health.

Mxene-based mild hyperthemia microneedle patch for diabetic wound healing

The treatment of diabetic wounds remains a serious challenge due to the unfavorable diabetic microenvironment, characterized by high glucose levels, excessive reactive oxygen species (ROS), and chronic inflammation. For decades, several hypoglycemic drugs have been used clinically to decrease blood glucose levels; however, they are unable to regulate in situ hyperglycemic microenvironments. In this study, we introduced a poly (γ-glutamic acid) (γ-PGA)-based microneedle (MN) patch encapsulated with glucose oxidase (GOx)-loaded Ti3C2 MXene nanosheets (MXene) termed MN-PGA-MXene-GOx. GOx, which lowers local glucose and pH by oxidizing glucose, is delivered deep into tissues via the MN patch, while MXene ensures its prolonged release. When the MN patch is exposed to external NIR light, MXene can induce mild hyperthermia, enhance the catalytic activity of GOx, and promote cell proliferation, migration, angiogenesis, and tissue remodeling. Both γ-PGA and MXene possess antioxidant properties, mitigating ROS in the diabetic environment and reducing hydrogen peroxide (H2O2) produced during glucose oxidation. In conclusion, this multifunctional microneedle patch provides a novel approach for accelerating diabetic wound healing, utilizing GOx and MXene for in-situ glucose management and mild hyperthermia.

Increased cellular protein modification by methylglyoxal activates endoplasmic reticulum-based sensors of the unfolded protein response

The unfolded protein response (UPR) detects increased misfolded proteins and activates protein refolding, protein degradation and inflammatory responses. UPR sensors in the endoplasmic reticulum, IRE1α and PERK, bind and are activated by proteins with unexpected surface hydrophobicity, whereas sensor ATF6 is activated by proteolytic cleavage when released from complexation with protein disulfide isomerases (PDIs). Metabolic dysfunction leading to the formation of misfolded proteins with surface hydrophobicity and disruption of ATF6-PDI complexes leading to activation of UPR sensors remains unclear. The cellular concentration of reactive dicarbonyl metabolite, methylglyoxal (MG), is increased in impaired metabolic health, producing increased MG-modified cellular proteins. Herein we assessed the effect of high glucose concentration and related increased cellular MG on activation status of IRE1α, PERK and ATF6. Human aortal endothelial cells and HMEC-1 microvascular endothelial cells were incubated in low and high glucose concentration to model blood glucose control, with increase or decrease of MG by silencing or increasing expression of glyoxalase 1 (Glo1), which metabolizes MG. Increased MG induced by high glucose concentration activated IRE1α, PERK and ATF6 and related downstream signalling leading to increased chaperone, apoptotic and inflammatory gene expression. Correction of increased MG by increasing Glo1 expression prevented UPR activation. MG modification of proteins produces surface hydrophobicity through arginine-derived hydroimidazolone MG-H1 formation, with related protein unfolding and preferentially targets PDIs and chaperone pathways for modification. It thereby poses a major challenge to proteostasis and activates UPR sensors. Pharmacological decrease of MG with Glo1 inducer, trans-resveratrol and hesperetin in combination, offers a novel treatment strategy to counter UPR-related cell dysfunction, particularly in hyperglycemia associated with diabetes.

Polyphenol-Standardized Aphanamixis polystachya Leaf Extract Ameliorates Diabetes, Oxidative Stress, Inflammation, and Fibrosis in Streptozotocin-Induced Diabetic Rats

Background. Diabetes is a rising disorder that affects millions of people annually. It also creates more complications, such as neuropathy, oxidative stress, and hepatic and kidney impairment. Aphanamixis polystachya plant, which possesses multiple medicinal values, is used in this study to explore its potential in treating diabetes. Methods. A single dose (65 mg/kg) of intraperitoneal streptozotocin injection was utilized to mediate diabetes in Sprague-Dawley rats. Diabetic animals were treated orally with 250 or 500 mg/kg of standardized leaves’ extract of A. polystachya (AP) for 28 days to evaluate the antidiabetic and organ-protective effects of the plant. Different biochemical and histological markers are measured according to the established protocol. Results. Our results demonstrated a significant decrease in blood glucose (p &lt;0.001) and HbA1c (p &lt;0.05) levels in the diabetic animal after administering AP (250 and 500 mg/kg doses) compared to the control groups. AP can also regularize lipids, glycogen, alanine aminotransferase, and aspartate aminotransferase. Furthermore, serum urea nitrogen and creatinine decreased after treatment with AP in diabetic rats. AP also reduced oxidative stress markers and showed a substantial elevation in antioxidant enzymes in diabetic animals. Overall, AP at 500 mg/kg revealed comparable results against the standard antidiabetic drug glyburide. Besides, the histological investigation showed the AP’s efficacy in attenuating kidney tissue inflammation and damage. HPLC data elucidated that the AP leaf extract contains polyphenols with potential antioxidant, antidiabetic, and organ protective agents: gallic acid, rutin hydrate, and quercetin hydrate. Conclusion. Taken together, AP may be one of the potential sources of antidiabetic agents.

Modified-release gliclazide acutely improves recovery but causes undesirable blood glucose decrease after a resistance exercise session in healthy adults: a pilot study for a randomized clinical trial.

Sulfonylureas have been used to improve performance in strength sports. However, this hypothetical effect has not been proven. We examined the ergogenic acute effect of gliclazide on resistance training performance and muscle recovery. We conducted a double-blind, randomized, crossover pilot study with 10 healthy resistance-trained adults (29.3 ± 4.4 years), nonusers of anabolic steroids. The participants were randomized to two exercise sessions. In the first session, five participants received placebo and the other five received gliclazide modified release, both administered 8 hours before the session. Session two was performed in a crossover fashion a week later. The volume load was calculated as the maximum number of repetitions of four sets multiplied by load (65% 1-RM). Blood samples were collected before and after exercise, as well as 24 hours and 48 hours after exercise for measurement of creatine kinase (CK-MM) and lactate dehydrogenase (LDH) activity. Blood glucose was measured with a glucometer before, during, and after the exercise sessions. Gliclazide did not enhance volume load for bench press (placebo: 2,698.0 ± 923.0 kg; gliclazide: 2,675.0 ± 1,088.0 kg; p = 0.073) or leg press (placebo: 10,866.0 ± 2,671.0 kg; gliclazide: 10,817.0 ± 2,888.0 kg; p = 0.135). However, CK-MM (-27.7%; p = 0.034) and LDH (-21.1%; p = 0.021) activities were decreased with gliclazide 48 hours after exercise. There was also a decrease in blood glucose in the gliclazide compared with the placebo session (p = 0.018). Gliclazide did not enhance performance in a single resistance training session, but promoted faster muscle recovery. The decrease in blood glucose post-exercise with gliclazide was an undesirable effect that could lead to long-term glucose metabolism disorders. Registered in ClinicalTrials.gov under number NCT04443777.

Impact of yoga therapy on glycemic control and heart rate variability among type 2 diabetes mellitus patients: A randomized controlled trial

ABSTRACT Background: Type 2 diabetes mellitus (T2DM) is a major lifestyle disorder with multiple systemic complications. Although conventional treatments have been able to combat the symptoms and complications, it has not been able to provide long-lasting control, hence yoga is considered more effective and alternate method of controlling diabetes mellitus. Objectives: The objective of this study was to evaluate the effect of yoga protocol on heart rate variability (HRV), glycemic control, and anthropometric parameters in T2DM individuals. Materials and Methods: This is a randomized, comparative study design. A total of 100 participants who met the inclusion criteria were randomly allocated into two groups, the test group (n = 50) received yogic protocol along with pharmacological treatment and the control group (n = 50) was on conventional treatment with regular activities for 90 days. The pre­post assessments of HRV, anthropometric measurements, and blood samples were collected at baseline and after 3 months. Data were analyzed using SPSS version 20.0. Results: The experimental group showed significant decrease in blood pressure, heart rate, low frequency (LF), LF/HF, blood glucose, HbA1c and anthropometric parameters as compared to control gorup. However, there was no significant effect of yoga therapy on waist-hip ratio. Conclusion: The result of the present study demonstrated that yoga is effective in reducing blood glucose levels in patients with T2DM. Hence, the given specific yogic intervention can be clinically used in the management of T2DM.

A comparative study of the benefits of monotherapy rosiglitazone versus rosiglitazone with insulin in streptozotocin-induced diabetes in rats

Background: Diabetes is often associated with dyslipidemia, where plasma lipid and lipoprotein profile alterations increase the risk of coronary heart disease. Insulin resistance increases the risk of hyperinsulin and atherosclerosis, developing hypertension and diabetes. Patients with diabetes suffer from metabolic disorders in carbohydrates, fat, and proteins associated with hyperglycemia. Hence reducing insulin resistance is a therapeutic approach to treating diabetes. Aims and Objectives: The aim of the study was to evaluate the beneficial effects of monotherapy rosiglitazone, gemfibrozil, and insulin versus rosiglitazone, gemfibrozil, and insulin combination in streptozotocin-induced diabetes in rats. Materials and Methods: 42-Wistar rats of either sex were used in this study, except for the control group, streptozocin was used to induce diabetes. These rats were further allocated into five groups, each group consists of eight animals. Blood serum was used to estimate blood glucose and serum lipid levels were observed after a period of 6 weeks. Results were analyzed using SPSS software version 21.0. Results: Combination therapy of insulin + rosiglitazone + gemfibrozil showed a significant decrease in serum blood glucose, lipid levels in compared with vehicle and rosiglitazone groups. Conclusion: The results of our study demonstrated a more favorable lipid profile than the monotherapy regimen; adding gemfibrozil and insulin to rosiglitazone could help reverse the cardiovascular adverse events it causes.

Diabetes and vitamin D: The effect of insulin sensitivity and gut microbial health.

Current global estimation suggests that about 10% of adults worldwide have diabetes, thus, various strategies are needed to address the issue, including dietary factors such as vitamin D. Various studies have suggested an inverse associations between vitamin D and the risks and pathogenesis of all forms of diabetes (type 1, type 2 and gestational diabetes). The underlying mechanism is not fully understood; however, the expression of vitamin D receptors in pancreatic beta cells suggests an important physiological role for vitamin D in beta cell function. Vitamin D deficiency may impair blood glucose control and decrease insulin sensitivity by reducing insulin secretion from beta cells. Many studies suggest that vitamin D intervention may be beneficial; however, there is inconclusive evidence of the effectiveness of vitamin D supplementation on reducing the risks or managing the pathogenesis of all forms of diabetes. Part of the pathogenesis of vitamin D for reducing diabetes is thought to be related to its impact on gut microbiota profile, via the suggested prebiotic properties of vitamin D.

The GLP-1 receptor agonist exendin-4 reduces taurine and glycine in nucleus accumbens of male rats, an effect tentatively involving the nucleus tractus solitarius.

The physiological effects of glucagon-like peptide-1 (GLP-1) are mainly centered on its ability to decrease blood glucose levels and facilitate satiety. Additional physiological functions have been identified by means of GLP-1 agonists such as exenatide (exendin-4; Ex4). In particular, Ex4 reduces the intake of natural and artificial rewards, effects that to some extent involve activation of GLP-1 receptors in the nucleus tractus solitarius (NTS). Although Ex4 acts in the brain, the neurochemical mechanisms underlying this activation are not fully elucidated. Investigating Ex4-induced neurochemical alterations in the nucleus accumbens (NAc) would be valuable for understanding its impact on reward-related behaviors. The aim of the present exploratory in vivo microdialysis study was therefore to study how Ex4, administered either systemically or locally into the NTS, influences classical neurotransmitters like dopamine, serotonin, noradrenaline, glutamate and GABA as well as additional players such as glycine, taurine and serine in NAc of male rats. We showed that Ex4 reduced extracellular levels of serine, taurine and glycine, where the latter two declines appear to involve activation of GLP-1R in the NTS. Besides, after systemic Ex4 injection the metabolites DOPAC, HVA, and 5HIAA are elevated. Where the increase in metabolites related to dopamine, but not serotonin, involves GLP-1 receptors in other areas than the NTS. Although the descriptive nature of the present data does not provide causality, it may however serve as an indication of mechanisms underlying how Ex4 may modulate reward-related behaviors.

Ketogenic Diet: A Review of Composition Diversity, Mechanism of Action and Clinical Application.

The ketogenic diet (KD) is a special high-fat, very low-carbohydrate diet with the amount of protein adjusted to one's requirements. By lowering the supply of carbohydrates, this diet induces a considerable change in metabolism (of protein and fat) and increases the production of ketone bodies. The purpose of this article is to review the diversity of composition, mechanism of action, clinical application and risk associated with the KD. In the last decade, more and more results of the diet's effects on obesity, diabetes and neurological disorders, among other examples have appeared. The beneficial effects of the KD on neurological diseases are related to the reconstruction of myelin sheaths of neurons, reduction of neuron inflammation, decreased production of reactive oxygen species, support of dopamine production, repair of damaged mitochondria and formation of new ones. Minimizing the intake of carbohydrates results in the reduced absorption of simple sugars, thereby decreasing blood glucose levels and fluctuations of glycaemia in diabetes. Studies on obesity indicate an advantage of the KD over other diets in terms of weight loss. This may be due to the upregulation of the biological activity of appetite-controlling hormones, or to decreased lipogenesis, intensified lipolysis and increased metabolic costs of gluconeogenesis. However, it is important to be aware of the side effects of the KD. These include disorders of the digestive system as well as headaches, irritability, fatigue, the occurrence of vitamin and mineral deficiencies and worsened lipid profile. Further studies aimed to determine long-term effects of the KD are required.

A comparative study: Probiotics number in fermented bitter melon (Momordica charantia) juice decreased blood sugar and lipid profiles

ABSTRACT Purposes - Momordica charantia (MC) contains triterpenes, proteins, and steroids with anti-diabetic and antioxidative properties. Developing type 2 diabetes (T2DM) in prediabetes can be reduced by probiotics consumption. The pathogenesis and progression of diabetes are induced by oxidative stress and followed by elevated triglyceride and cholesterol levels. This study aimed to evaluate blood sugar levels and lipid profiles before and after treatment. Experimental procedure - A total of 24 male Sprague-Dawley rats were induced by a single dose (60 mg/kg) of streptozotocin (STZ) and 120 mg/kg of nicotinamide. Following three days of induction, the rats were randomly divided into four groups and administered 10 ml/kg BW extract for 28 days. DM-MC was treated with MC extract. DM-FMC1 and DM-FMC2 were treated with fermented MC containing 3.7x107 CFU/ml and 3.7x1014 CFU/ml probiotics, respectively. DM-Ctrl was given distilled water. Blood glucose and lipid profile measurements were taken before and after treatment. The data was analyzed using a paired t-test, ANOVA and Tukey HSD for post hoc analysis. The level of significance was set at 0.05. Findings – The groups treated with FMC2 significantly showed a decreased blood sugar level compared to MC and FMC1 (p&lt;0.001), 89.4+3.94, 164.3+2.26, and 109.1+2.07, respectively. Lipid profiles showed the same pattern (p&lt;0.001). Fermented MC substantially decreases blood glucose and lipid profile compared to the MC group (p&lt;0.001). Originality/value - In type 2 diabetes, reducing blood sugar levels and improving lipid profiles are significantly impacted by the presence and number of probiotics.

Combining Lemon and Glycerin may Beneficially Regulate Blood Glucose Levels by Modulating Gut Microbiota in Non-obese Diabetic Mice

Both dietary lemon and glycerin have shown beneficial effects in diabetic humans and animals. It was hypothesized that there were potential therapeutic advantages of combining both agents in hyperglycemic and healthy mice. In a 6-month study using mature adult male non-obese diabetic (NOD) mice, oral treatment with either lemon or glycerin alone increased blood glucose levels during the third month glucose tolerance test and decreased the activity of the predicted glycolysis/gluconeogenesis pathways when compared to the vehicle control; however, this was no longer observed when lemon and glycerin were combined. Metabolomic analysis indicated that acetate was increased in the fecal samples after treatment with either glycerin or the combination. A 2-month study was also conducted in both male and female NOD mice and suggested that there were more gut microbiome changes at one month in comparison to six months. In older NOD male mice, treatment with the combination for six months decreased insulin resistance. In both adult male and female C57BL/6 mice, dosing with the combination for two months decreased blood glucose levels, as well as glucose tolerance and insulin resistance. In addition, treatment with the combination decreased body weights, especially in male mice, in all four studies. Overall, these studies suggest that lemon and glycerin in combination may reduce the side effects of individual treatments (e.g., transient hyperglycemia) and have some additional benefits (e.g., weight loss). Microbiome modulation likely contributed to the observed beneficial effects.