Defects In Insulin Action Research Articles

In-silico Assessment of Polyherbal Oils as Anti-diabetic Therapeutics.

Diabetes mellitus (DM) is characterized by elevated blood glucose levels either due to insufficient insulin production, defective insulin action, or both. It affects nearly 537 million individuals worldwide. Pharmacological treatment involves the use of oral antidiabetic agents as mono or combination therapy that effectively aids in controlling hyperglycemia. Despite providing therapeutic benefits, these medications limit their use owing to adverse side effects. Certain natural products, including essential oils, have promising anti-diabetic properties. The present study explores the effectiveness of two polyherbal oils and their compound towards the treatment of DM based on an In-silico approach to drug investigations Methods: Compounds present in the polyherbal oil formulation were identified using GCMS/ MS analysis. Selected compounds undergo molecular docking with the receptor, and proteins play an important role in DM. The potential compounds showing higher interactions than the known inhibitors or inducers were evaluated using molecular dynamic simulations RMSD value. The compounds identified through GC-MS analysis possess anti-diabetic and antiinflammatory properties. With the aid of in silico prediction methods, compounds such as geraniol, cinnamaldehyde, anethole, caryophyllene, terpinyl acetate, cymene, linalool, menthol, Phenol,2-methoxy-3-(2-propenyl), and 2,6- octadienal,3,7-dimethyl were identified as strong binders of GLUT4 and insulin receptor proteins. Geraniol and Phenol,2-methoxy-3-(2-propenyl) interaction with GLUT4 were of particular importance owing to their conformational stability. Our data suggest an agonistic effect of compounds on target proteins aiding in enhanced insulin activity and could serve as a potential anti-diabetic agent.

Extended duration linagliptin nanoparticles: a novel, safe and effective future of diabetes treatment?

Dear Editor, Diabetes Mellitus (DM), a chronic disease characterised by hyperglycaemia caused by either underproduction of insulin or defective insulin action, has become more prevalent globally; affecting 1 in every 10 adults over the past years with type 2 diabetes being more common in the low- and middle-income countries and type 1 in high-income countries (1). Pakistan, being a lower-middle-income country, has a 26.7% prevalence of diabetes and age-adjusted comparative prevalence of 30.8% affecting 1 in approximately every 4th adult (2). The current guidelines for the management of diabetes include insulin, metformin, sulfonylureas, and sodium-glucose co-transporters type 2 (SGLT-2) inhibitors. However, hypoglycaemia, weight gain, gastrointestinal problems and contraindication of their use in patients with pre-existing renal diseases pose problems for clinicians. Poor patient compliance in following the regular antidiabetic regimen also make treatment plans ineffective. Thus, newer drugs are constantly being researched (3). Metformin has been an excellent treatment option with only a slight risk for some specific patients to develop lactic acidosis. It is the most commonly prescribed medication for DM. Another drug, Linagliptin (Lina) was approved by the FDA in 2011 as an effective dipeptidyl peptidase inhibitor for the treatment of DM. It has been used as monotherapy and in combination with dapagliflozin, an SGLT2 inhibitor, for the treatment of diabetes in patients with a history of metformin therapy. However, its use was limited due to its low bioavailability (4). Recent research suggests that the extended duration (ED) Lina via the use of poly d, l-lactic-co-glycolic acid (PLGA) polymers in nanoparticle form could be beneficial in the management of type 2 DM. It has an increased bioavailability, fewer reported side effects and a reduced need for regular dosage. Furthermore, the use of nanoparticles facilitates a targeted delivery of the drug which may omit the pain that is caused by the use of implants (5). Lina is also thought to be effective in Type 3 Diabetes which causes Alzheimer’s disease. As dementia can lead to forgetting to take medications regularly, the ED Lina, which is taken once weekly, may be a suitable option. This new formulation is being considered for its better safety profile compared to other antidiabetics and its effectiveness in controlling HbA1C both as monotherapy and in combination therapy (4,6) ---Continue

Effect of Long Suffering Diabetes Mellitus on Blood Ureum Levels

Diabetes mellitus is a disease characterized by increasing blood sugar levels caused by defective insulin secretion or action. Increased levels of sugar in the blood have a direct impact on the blood vessels in the kidneys. Such as decreasing the function of the kidney, the disturbing kidney function will increase the level of urea in the blood.To find out whether there is an effect of long-suffering from Diabetes mellitus on blood urea levels. This research is analytical observational research with a cross-sectional approach. The samples used Diabetes mellitus patients with variations in length suffering of 1-3 years, 4-6 years, and > 6 years. Data were collected and analyzed using Kruskal Wallis non-parametric statistical test. The average blood urea level of Diabetes mellitus patients who suffer 1-3 years, 4-6 years, and > 6 years is 29.17 mg/dL, 53.25 mg/dL, and 118.11 mg/dL. The Kruskal Wallis test showed a significant value = 0.000 < 0.05 (Pα) which indicated that the duration of suffering from Diabetes mellitus affected increasing blood urea levels

Health Literacy among Diabetic Patients Visiting the Outpatient Department of a Tertiary Care Hospital: A Cross-Sectional Study

Background: Diabetes Mellitus is a metabolic syndrome characterized by hyperglycemia either due to defective insulin secretion or defective insulin action or both. It is estimated to become the 7th leading cause of death by 2030. Health literacy play a significant role in self-care, adherence to medication and clinical outcomes in diseased individual. The objective of this study is to find the prevalence of poor health literacy among the diabetic patients visiting the outpatient department of a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among 422 diabetic patients visiting the outpatient department of a tertiary care hospital from July 2020 to Jan 2021. Ethical approval was obtained from the Institutional Review Committee (Reference number: IRC/1805/020). Patients aged ≥18 years, irrespective of gender, diagnosed with Diabetes Mellitus at least 3 months before and presenting to the outpatient department for complications or follow-up were included in the study. Convenience sampling was used. Result: Among 422 diabetic patients, poor health literacy was obtained among 165 (39.09%) (34.49-43.69 at 95% Confidence Interval). Low adherence to anti-diabetic medication was seen in 78 (47.27%) patients with majority 94 (56.97%) patients having diabetic range HbA1C level and a poor knowledge on diabetes. Conclusion: There is poor health literacy among diabetic patients that is reflected in low adherence to anti-diabetic medication and overall diabetic self-care. Targeted intervention for health promotion of diabetic patients might be needed.

Role of Ayurveda in the Management of Diabetes Mellitus: A Comprehensive Review to explore the awareness

Diabetes mellitus (DM) is very oldest and common metabolic disease, characterized by a chronic hyperglycemic condition over a prolong extent of time. The disease is resulting due to insufficient insulin secretion or defects in insulin action or both. Diabetes is classified under non communicable disease (NCD) and it is referred as fourth most common among all NCDs. Diabetes is one of the leading causes of mortality in India and near about one million patients are died every year due to diabetes. The prevalence of diabetic is increasing rapidly worldwide and WHO (world health organization) has predicted that by the end of 2030, the number of adults with diabetes would have almost doubled, from 177 million in 2000 to 370 million Diabetes is mainly classified under two classes Type-1 and Type-2 DM. In the late 1936, a distinction between Type-1 and Type-2 DM was clearly made. Type-1 diabetes is a result of an autoimmune reaction to proteins of islets cells of pancreas and Type-2 is result of impaired insulin resistance. Genetic and some environmental factors such as overeating, stress, obesity and lack of physical exercise, smoking may also play a key role in development of DM. There are various treatment approach are being used to reduce the burden of DM worldwide. These approaches include modern medicines (allopathic), Ayurvedic therapies and gene therapy. Ayurvedic system of treatment is a holistic science which is discovered several years ago and plays a very important role in the management of DM. Ayurvedic therapies are able to provide permanent cure of certain chronic disease are, which remains incurable in allopathic systems. Present review article aims to highlight the role of ayurveda in management of DM.

Antidiabetic effects of genistein: Mechanism of action.

Diabetes mellitus is a metabolic disease recognized by abnormal glucose levels due to defects in ‎insulin action, insulin secretion, or both. Administration of soybean and isoflavones are accompanied by ‎a lower risk of diabetes. ‎The present review analyzed the previous published papers related to genistein. This isoflavone, which has been used for the prevention of ‎some chronic diseases can inhibit hepatic glucose production, increase β-cell proliferation, ‎reduce β-cell apoptosis, and show potential antioxidant and anti-diabetic effects. Therefore, ‎genistein may be useful in the management of diabetes. The beneficial effects of this isoflavone ‎on metabolic syndrome, diabetes, cardiovascular disease, osteoporosis, and cancer have been ‎reported in animal and human studies. Moreover, genistein reduces hepatic ‎glucose production, normalizes hyperglycemia, and gut microbiota as well as shows potential ‎anti-oxidative, anti-apoptotic, and hypolipidemic effects. However, studies on the underlying ‎mechanisms of the action of genistein are very limited. Therefore, the present study reviews ‎multifaceted aspects of genistein to reveal a possible anti-diabetic mechanism of this agent. Genistein by regulating several signaling pathways can be used for the prevention and management of diabetes.

Diabetes Mellitus: A Review and Update

Diabetes mellitus is a group of metabolic diseases which are typified by the development of hyperglycaemia which do emanate from defects in insulin secretion, insulin action, or both. The chronic hyperglycaemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels. Various types of diabetes mellitus exist which have been discussed in the main part of this article. Many pathogenic processes are involved in the development of diabetes mellitus. These pathogenic processes range from autoimmune destruction of the beta-cells of the pancreas with consequent insulin deficiency to abnormalities which result in resistance to insulin action. The basis of the abnormalities in carbohydrate, fat, and protein metabolism in diabetes is deficient action of insulin on target tissues. Deficient insulin action ensues inadequate insulin secretion and / or diminished tissue responses to insulin at one or more points within the complex pathways of hormone action. Impairment of insulin secretion and defects in insulin action frequently coexist in the same patient, and it is often unclear which abnormality, if either alone, is the primary cause of the hyperglycaemia. The manifestations of marked hyperglycaemia do include: polyuria, polydipsia, weight loss, sometimes with polyphagia, and blurred vision. Impairment of growth and susceptibility to certain infections may also ensue chronic hyperglycaemia. Acute, life-threatening consequences of diabetes mellitus include: hyperglycaemia with ketoacidosis or the nonketotic hyperosmolar syndrome. Long-term complications of diabetes mellitus do include: diabetic retinopathy with potential loss of vision; diabetic nephropathy which leads to kidney (renal) failure; peripheral neuropathy with risk of foot ulcers, amputation, and Charcot joints; as well as autonomic neuropathy which cause gastrointestinal, genitourinary, as well as cardiovascular symptoms and sexual dysfunction. Glycation of tissue proteins and other macromolecules and excess production of polyol compounds from glucose are among the mechanisms that had been postulated to produce tissue damage from chronic hyperglycaemia. Patients who have diabetes mellitus do have an increased incidence of atherosclerotic cardiovascular, peripheral vascular, and cerebrovascular disease. Hypertension, abnormalities of lipoprotein metabolism, and periodontal disease are often found in people who have diabetes mellitus. The emotional and social impact of diabetes mellitus as well as the demands of treatment of diabetes and its complications could cause significant psychosocial dysfunction in patients who have diabetes mellitus as well as their families. Even though there are many types of diabetes mellitus, the vast majority of cases of diabetes mellitus do fall into two broad etiopathogenetic categories which have been extensively discussed in the ensuing article below that has been divided into (a) Overview and (b) miscellaneous narrations. In one category of diabetes mellitus type 1 diabetes mellitus, the cause is an absolute deficiency of insulin secretion. Individuals at increased risk of developing this type of diabetes could often be identified by serological evidence of an autoimmune pathological process that occur within the pancreatic islets and by genetic markers. In the other type of diabetes mellitus, which is the much more prevalent category that is referred to as type 2 diabetes mellitus, the cause of the disease is a combination of resistance to insulin action and an inadequate compensatory insulin secretory response. In the latter category, a degree of hyperglycaemia sufficient to cause pathological and functional changes in various target tissues, but without clinical symptoms, could be present for a long period of time before diabetes mellitus is diagnosed. During this asymptomatic period, it is possible to demonstrate an abnormality in carbohydrate metabolism by measurement of plasma glucose in the fasting state or after a challenge with an oral glucose load. Considering that diabetes mellitus is common as well as the symptoms of diabetes mellitus are non-specific symptoms that may simulate diabetes mellitus, a number of individuals who are afflicted by diabetes mellitus do not know they have diabetes mellitus, there is need for a global educational program on the manifestations and approach that is needed for early diagnosis of the disease so that all clinicians and the entire global population would have a high index of suspicion of the disease. There also a global life style education including regular exercise that would delay onset of or reduce the severity of type 2 diabetes and to improve the quality of life of patients who have diabetes mellitus. It is important to dedicate time to read the article carefully which contains documentations related to the World Health Organization’s global effort to reduce the incidence and severity of diabetes mellitus and all individuals globally should follow carefully recommendations of the World Health organization as well as recommendations of other organizations in the world that have devoted their time to health education on diabetes mellitus. and a number of people

White rice with ghee does not increase blood sugar level in type 2 diabetes patients

Introduction: Type 2 diabetes in which India is the second largest globally, characterized by hyperglycemia resulting from defects in insulin action. Rice is the staple food of over half of the world’s population, having multiple Nutritional Benefits. Objective: To see the effect of white rice with ghee by cooking in an open vessel on blood sugar level in diabetic patients.
 Materials and Methods: Experimental study with Clinical Trial performed at Vishwaraj Hospital Pune, to correct Blood Sugar Level in type 2 diabetes patients by Nutritional Intervention of White Rice which was cooked in an open vessel with Ghee after Institutional Ethics Committee approval and registered under Clinical Trial Registry of India -CTRI/2022/05/042533. All 103 enrolled participants were provided written information of ‘Method of Rice preparation’. During intervention, telephonic follow up had taken every 15th day, till 90 days. After 90 days of intervention, all patients were asked to repeat HBA1C level to compare their previous HBA1C which was done before enrollment.
 Results: After 3 months of intervention, 86.41% participants had decreased HBA1C level, 13.59% participants had increased HBA1C. Statistical analysis done by Paired t Test which compares the means of two measurements of HBA1C taken from same individual i.e. paired observations, purpose of test is to determine whether there is statistical evidence that the mean difference between paired observations is significantly different from zero.
 Conclusion: This study concluded that white rice prepared with ghee in an open vessel does not increase blood sugar level in type 2 diabetes patients.
 Keywords: “blood sugar level”, “Diabetes”, “ghee”, “hba1c level”, “type 2 diabetes”, “white rice”

To Assess and Compare the Knowledge, Attitude and Practice of Patients with Diabetes in Control and Intervention Groups.

Diabetes is a combination of heterogeneous disorders presenting with episodes of hyperglycemia and glucose intolerance, as a result of lack of insulin, defective insulin action, or both. There are more than 387 million people with Diabetes Mellitus (DM) and the number is likely to reach 592 million by 2035. The prevalence of DM is 9.1% in India. With increasing incidence of diabetes worldwide, evaluation of diabetes knowledge, attitude and practice (KAP) has become crucial for guiding behavioral changes for persons with diabetes and individuals at risk. KAP-related studies are important in tailoring a health programme to help curb the threats caused by the disease. Adequate information helps the public understand the risks of diabetes and its complications, seeks treatment of existing disease, takes preventive measures and develops proactive attitude towards health. This was an interventional study where patients of either gender with ≥1-year history of DM were enrolled into the study after obtaining the consent. A total of 200 patients were included in this study. The p-value (<0.0001) showed that there was significant improvement in the KAP score of intervention group patients from baseline to follow up compared to that of control group. This study shows that improvement in knowledge of the disease has positive impact on Attitude and Practice of the subjects, thus improving their glycemic control.

Predictive Modeling for Early Hyperglycemia Detection in Type 2 Diabetes

Type 2 Diabetes (T2D) is characterized by a combination of defects in insulin action and impairment in insulin secretion. Deficient insulin action causes people with Type 2 Diabetes to have difficulty controlling their blood glucose concentration (BGC) and experience periods of high (hyperglycemia) and low (hypoglycemia) BGC. Continuous glocuse monitoring (CGM) sensors and machine learning algorithms can automate the process of meal size estimation, improve the accuracy of the carbohydrate estimations, and reduce the involvement of the subject. The aim of this project was to use dynamic Partial Least Squares (PLS) regression to model blood glucose data from CGM devices and optimize the model parameters for best accuracy of the predictive modelling. The parameters were optimized by explicit enumeration and grid search approach to minimize the mean square error (MSE), and the lowest MSE was obtained with the number of latent variables as 5 and past horizon as 5 (25 minutes). Future research will develop the logic inference using the first- and second-order derivatives of the predicition curve that will sound the alarms based on the predicitions made in the current work.

An Overview of Inter-Tissue and Inter-Kingdom Communication Mediated by Extracellular Vesicles in the Regulation of Mammalian Metabolism.

Obesity and type 2 diabetes are associated with defects of insulin action in different tissues or alterations in β-cell secretory capacity that may be triggered by environmental challenges, inadequate lifestyle choices, or an underlying genetic predisposition. In addition, recent data shows that obesity may also be caused by perturbations of the gut microbiota, which then affect metabolic function and energy homeostasis in the host. Maintenance of metabolic homeostasis in complex organisms such as mammals requires organismal-level communication, including between the different organs and the gut microbiota. Extracellular vesicles (EVs) have been identified in all domains of life and have emerged as crucial players in inter-organ and inter-kingdom crosstalk. Interestingly, EVs found in edible vegetables or in milk have been shown to influence gut microbiota or tissue function in mammals. Moreover, there is a multidirectional crosstalk mediated by EVs derived from gut microbiota and body organs that has implications for host health. Untangling this complex signaling network may help implement novel therapies for the treatment of metabolic disease.

A study of hormonal and anthropometric parameters in polycystic ovarian syndrome.

Polycystic Ovarian Syndrome (PCOS) is an endocrinopathy with a complex metabolic disorder. PCOS is characterized by reproductive hormonal imbalances leading to the clinical presentation of hyperandrogenism and infertility. PCOS is also showing an increased prevalence of several other conditions such as obesity, dyslipidemia, hypertension, metabolic syndrome and type 2 diabetes mellitus (DM2) when compared with women without PCOS. The principal symptoms in patients with PCOS are irregular menstruation, acne, and excessive amounts of androgenic hormones. The Rotterdam PCOS consensus workshop has given specific criteria to establish PCOS diagnosis only after exclusion of other known disorders. Obesity is a common finding of women with PCOS, but it is not part of the diagnostic criteria. PCOS has metabolic characteristics that include prominent defects in insulin action and beta-cell function, defects that confer a substantially increased risk for obesity and type 2 diabetes mellitus. PCOS women have an increased level of luteinizing hormone (LH) and a decreased level of follicle-stimulating hormone (FSH), which leads to disorders in the regulation of the menstrual cycle. The values of LH and FSH are dependent on the day of the menstrual cycle in which the hormones are measured. Obesity also has an influence on these values. The objective of this study was to compare the hormonal and anthropometric parameters in women with PCOS and healthy control group. This study was carried out in the Department of Pathology, Dr. D Y Patil Medical College and Research Centre, Pune, Maharashtra. Fifty female patients aged 16-40 years diagnosed with PCOS by known criteria were included in the study and compared with 50 healthy control group females. Elevated levels of thyroid-stimulating hormone, LH, FSH, and prolactin along with increased body mass index and waist-to-hip ratio were predictors of PCOS and the early metabolic abnormalities.

Diabetic Encephalopathy: Role of Oxidative and Nitrosative Factors in Type 2 Diabetes.

Diabetes mellitus is a set of complex metabolic disorders characterized by chronic hyperglycaemic condition due to defective insulin secretion (Type 1) and action (Type 2), which leads to serious micro and macro-vascular damage, inflammation, oxidative and nitrosative stress and a deranged energy homeostasis due to imbalance in the glucose and lipid metabolism. Moreover, patient with diabetes mellitus often showed the nervous system disorders known as diabetic encephalopathy. The precise pathological mechanism of diabetic encephalopathy by which it effects the central nervous system directly or indirectly causing the cognitive and motor impairment, is not completely understood. However, it has been speculated that like other extracerebellar tissues, oxidative and nitrosative stress may play significant role in the pathogenesis of diabetic encephalopathy. Therefore, the present review aimed to explain the possible association of the oxidative and nitrosative stress caused by the chronic hyperglycaemic condition with the central nervous system complications of the type 2 diabetes mellitus induced diabetic encephalopathy.

Neutrophil-lymphocyte ratio and its relation to microvascular complication in geriatric patients with diabetes: a case-controlled study

BackgroundDiabetes mellitus is a complex chronic disease characterized by chronic hyperglycemia resulting from defective insulin secretion, defective insulin action, or both. Chronic hyperglycemia related to diabetes can lead to end-organ dysfunction or failure, and changes related to diabetes involving arterioles and capillaries are responsible for long-term microvascular complications in diabetic patients. The neutrophil-to-lymphocyte ratio (NLR) is a novel, simple, and inexpensive marker of subclinical inflammation.Aim of workTo evaluate the possibility that neutrophil-lymphocyte ratio (NLR) could be used as a predictor of microvascular complications during follow-up of elderly patients with type 2 diabetes.Patients and methodsSixty elderly diabetes patients ≥ 65 years old, diagnosed 16 according to ADA criteria, were collected from the endocrine clinic in Kasr El-Ainy Hospital. For every patient, full history and examination were done (including 18 neurological and fundus examinations). Labs (CBC with a differential in blood and 19 albumin/creatinine ratio in urine) were done and the neutrophil/lymphocyte ratio.ResultsWe found that NLR has a statistically significant difference in the detection of nephropathy and retinopathy. There is a significant correlation between nephropathy and NL ratio in all patients (r = 0.44, P < 0.001). Elderly diabetic patients (with or without hypertension) with microvascular complications had a higher NLR value than those without complications.ConclusionNLR value can be used as a non-invasive simple marker for predicting microvascular complications in elderly diabetics with/without hypertension.

IL-6 and Type 2 Diabetes Mellitus Associations

Type 2 Diabetes Mellitus (T2DM) is a group of metabolic syndromes characterized by hyperglycemia associated with the defect of insulin action. Globally, the number of people with diabetes mellitus (DM) has been increased by four folds in the past three decades because of urbanization and associated lifestyle change [1].

Evaluation of Liver Enzymes Activities among Type 2 Diabetic Patients, Attending Alribat University Hospital, Khartoum State

Background: Diabetes mellitus is a metabolic disease known by chronic hyperglycemia which results from defective insulin action and secretion. Various studies have documented liver disease as a major cause of mortality in patients with type 2 diabetes. It is well known that the liver plays an important role in the maintenance of normal glucose levels during fasting as well as in the postprandial period Aim: To evaluate the levels of liver markers in type 2 diabetes patients in Khartoum state. Materials and Methods: The study was conducted in Alribat University hospital, Sudan during the period from January 2018 to April 2019. Hundred subjects were included in the study, fifty patients previously diagnosed with Type 2 diabetes and similar number of age- andgender-matchedhealthy control subjects. The design of the study was cross-sectional, with a retrospective historical review through apersonal interview of all subjects.Blood was collected in a heparinized tube at room temperature and centrifuged for 10 minutes at 3500rpm, Serum liver markers concentrations were estimated by an enzymatic method in a fully Automated Biochemistry Analyzer (Cobas 3546). The data were analyzed using SPSS version 20.Results: The majority of patients were &gt; 55 years. serum level of AST in type 2 diabetic patients and control group respectively were (31.26±10.34, 20.35±6.48) p value= 0.00), serum levels of ALT in type 2diabetic patients and control group respectively were (33.74±6.48, 19.70±6.23) p value= 0.00, serum level of ALP in Type 2 Diabetes patients and control group respectively were (125.20±49.61, 87.90±24.35) p value= 0.00,Serum level of GGT in Type 2 Diabetes patients and control group respectively were (47.72±9.01, 43.48±8.63) p value= 0.026. The mean BMI in type 2 diabetic patients and the control group respectively were (26.36±5.94,19.19±2.67), p value= 0.00, the correlation between duration of disease and liver enzymes GGT,ALT,AST and ALP respectively were (0.47,0.34,0.57,0.93). The current study showed in significant correlation between serum (GGT and ALT) and BMI of patients among type 2 diabetic patients (p value= 0.83,0.863) but significant correlation between serum (AST, ALT) and BMI of patients ( p value= 0.002,0.032).Conclusion: In the present study, a significant increase in the level of liver enzymes, ALT, AST, GGT ALP was observed in type 2 diabetic patients when compared to the normal group. Hence, we found an association between the level of liver enzymes, ALT, AST, and GGT in type 2 diabetic patients. Thus, these liver enzymes can be used as biomarkers for the assessment of type 2 diabetes, and we found no association between the level of liver enzymes, ALT, AST, and GGT in type 2 diabetic patients and duration of disease.

EVALUATION OF SERUM URIC ACID, GLUCOSE AND OTHER GLYCEMIC PARAMETER IN TYPE II DIABETIC INDIVIDUALS

Background: In spite of antioxidant property serum uric acid (SUA) has a positive association with blood glucose. SUA is considered as a strong and an independent risk factor for diabetes but low serum level of uric acid has been reported in the hyperglycemic state. Diabetes mellitus is a metabolic disorder of multiple etiologies resulting from defect in insulin action. So, aim of this study is to assess whether there is any change in SUA level and to establish whether there is any association with type II diabetes mellitus (DM) or not. Methods: A cross sectional study was conducted in 264 cases of DM. SUA, fasting blood glucose (FBG), post-prandial blood glucose (PPBG) and glycated hemoglobin (HbA1c) level were measured. Pearson’s correlation was employed to calculate the ‘r’ value by using SPSS version 15. Results: In our study prevalence of hyperuricemia was 18.5%. Mean SUA in male and female was 5.95 mg/dl and 5.54 mg/dl respectively in DM. HbA1c has positive correlation with FBG and PPBG (r value = 0.720 and 0.775, respectively p=&lt;0.001), while SUA has negative correlation with HbA1c, FBG and PPBG (r value= -0.179, p =0.004, -0.070, p=0.257 and -0.078, p=-0.204 respectively.). Conclusions: SUA level is increased in DM. SUA was high among male and SUA initially increased when FBS and HbA1c increases then decreases as FBG and HbA1c level were further increased. SUA has negative correlation with FBG, PPBG and HbA1c, while HbA1c has a positive correlation with FBG and PPBG.

Evaluation of Fetuin-A and Insulin Resistance among Iraqi Type 2 Diabetic Patients with and without Ischemic Heart Disease

Background: Diabetes mellitus (DM) is a metabolic disorder in which hyperglycemia is a characteristic feature due to impairment in insulin secretion, defective insulin action, or both reasons. One long-term complication is the ischemic heart disease (IHD) which is a major cause of morbidity and mortality. Insulin and fetuin-A are hormones that play a role in glucose metabolism regulation. Insulin is responsible for regulating glucose passage to the cells, while fetuin-A blocks insulin binding to its receptor, which is linked to insulin resistance in metabolic syndrome. Higher fetuin-A level patients have 4 times greater risk of developing IHD compared to patients with lower fetuin-A levels. Studies found that both hormones participate in the development of T2DM and IHD, beside their role in the pathophysiology of metabolic syndrome. Aim of the study: Evaluate serum fetuin-A concentrations in type2 diabetic (T2D) patients with and without IHD and compare them with healthy individuals. Assess serum glucose, insulin levels, and HOMA-IR in T2D patients and IHD and compare them with healthy individuals. Subjects and Methods: A case control study, that included 120 patients (60 have T2DM with IHD and 60 having T2DM without IHD age ranged from 30 to 70 years patient, who attended Al-Yarmouk Teaching Hospital and Iraqi Center for Myocardial Infarction, Medical City Hospital, Baghdad during the period from November 2020 until February 2021 and compare result with 60 healthy control which age ranged from 30 to 70 years. Female: male ratio is almost 1:1 in the three studied groups. The diagnosis of MI is based on medical reports, laboratory, and clinical tests for heart disease. Patients with neuropathy, retinopathy, thyroid dysfunction and liver diseases were excluded from the study. BMI, FBS, serum insulin, HOMA-IR, and fetuin-A were measured or calculated for each participant. Result: a statistical difference in BMI between participants is found; 46.70% of T2DM in the IHD group are obese. No significant association between disease duration and development of IHD is found. All the included markers showed statistical differences in mean ± SD between the diabetic and control group; fetuin-a mean ± SD level was 27.63 13.31, 12.39 ± 5.61 and 9.93 ± 5.1 in T2DM with IHD, T2DM without IHD and control group, respectively. There was no statistical association between the markers and fetuin-A except a moderate positive correlation with insulin. Conclusion: Fetuin-A can be used as a predictor of IHD development in diabetic patients.

Abnormal Obesity Phenotype Is Associated with Reduced eGFR among Diabetes Mellitus and Hypertensive Patients in a Peri-Urban Community in Ghana.

Background Diabetes mellitus (DM) is a chronic disease characterized by hyperglycemia due to obesity and defects in insulin action. Significant complications of DM include kidney disease due to its association with hypertension and obesity. Thus, the contribution of the various obesity phenotypes to the kidney impairment observed among hypertensive and diabetes mellitus patients is of major concern. Aim The study assessed the association between obesity phenotypes and reduced glomerular filtration rate among diabetes mellitus and hypertensive patients. Methods Three hundred and ten (310) adult patients diagnosed with type 2 diabetes mellitus, hypertension, or both who attended the Presbyterian Hospital, Dormaa Ahenkro, from October 2016 to March 2017 were recruited for the study. Blood samples were collected to analyze biochemical parameters (fasting blood glucose (FBG), lipid profile, and creatinine). Questionnaires were used to collect sociodemographic information, and anthropometrics were appropriately measured. The estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation, and reduced eGFR was defined as eGFR <90 ml/min/1.73 m2. Results The prevalence of metabolically healthy nonobese (MHNO), metabolically healthy obese (MHO), metabolically abnormal nonobese (MANO), and metabolically abnormal obese (MAO) phenotypes among the study participants was 30.65%, 4.50%, 52.90%, and 11.94%, respectively. The highest prevalence of reduced eGFR (29/37 (78.38%)) was seen among the MAO group. This was followed by the MANO, MHO, and MHNO with a reduced eGFR prevalence of 62.20%, 57.64%, and 37.89%, respectively. After normalization with MHNO, the reduced eGFR was 1.51, 1.64, and 2.06 times expressed in MHO, MANO, and MAO. For the total samples, when MHNO was maintained as a reference, reduced eGFR was significantly associated with MANO (aOR = 3.07 (95% CI = 1.76–5.35), P < 0.001) and MAO (aOR = 5.67 (95% CI = 2.66–17.27), P < 0.001) even after adjusting for age, gender, smoking, and alcohol intake. This association was maintained among the female study participants when stratified by gender, and in addition, among the female participants, reduced eGFR was also associated with MHO (aOR = 4.19 (95% CI = 1.06–16.53), P=0.041). Conclusion There is a high prevalence of abnormal metabolic phenotypes among diabetes mellitus patients, and these were significantly associated with reduced eGFR among our study participants.

Diosgenin reduces phosphodiesterase 3B (PDE3B) through AMP-activated protein kinase/ mechanistic target of rapamycin (AMPK/mTOR) signaling pathway to ameliorate streptozotocin-induced pancreatic β-cell apoptosis and dysfunction

ABSTRACT Diabetes mellitus is a metabolic disease caused by defective insulin secretion and/or insulin action. And insulin is the main hormone released by the pancreatic β-cells. Diosgenin (DG) is a phytochemical with pharmacological activity that increases insulin secretion in streptozotocin (STZ)-induced pancreatic β-cells of diabetic rats. In this paper, we investigated the effect and mechanism of DG on cell apoptosis and dysfunction in STZ-induced pancreatic β-cells. Cell viability was detected by CCK-8, apoptosis by flow cytometry, and apoptosis-related protein expression by Western blot. Western blot and RT-qPCR were performed to detect the expression of related genes. The results showed that in STZ-induced INS-1 cells, DG could improve cell viability, inhibit apoptosis, attenuate oxidative stress levels and increase insulin secretion. Notably, PDE3B was highly expressed in STZ-induced INS-1 cells, while DG could significantly inhibit PDE3B expression in a dose-dependent manner. More importantly, overexpression PDE3B remarkably reversed the effect of DG on STZ-induced INS-1 cells. It is thus clear that DG might inhibit STZ-treated pancreatic β-cell apoptosis and reduce dysfunction via downregulating PDE3B, which provided a more reliable theoretical basis for the treatment of diabetes mellitus with DG.