Diabetes Mellitus Control Group Research Articles

Aged garlic extract preserves beta-cell functioning via modulation of nuclear factor kappa-B (NF-κB)/Toll-like receptor (TLR)-4 and sarco endoplasmic reticulum calcium ATPase (SERCA)/Ca2+ in diabetes mellitus

BackgroundPeripheral insulin resistance and compromised insulin secretion from pancreatic β-cells are significant factors and pathogenic hallmarks of diabetes mellitus (DM). NF-κβ/TLR-4 and SERCA/Ca2+ pathways have been identified as potential pathways regulating insulin synthesis by preserving pancreatic β-cell functioning. The current study aimed to evaluate the therapeutic effect of aged garlic extract (AGE) against DM in a streptozotocin (STZ)-induced rat model with particular emphasis on pancreatic β-cell functioning.MethodsAGE was characterized by gas chromatography-mass spectrometry (GC-MS), Fourier-transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM) to evaluate its physio-chemical characteristics followed by in-vitro anti-diabetic and antioxidant potential. This was followed by the induction of DM in laboratory animals for investigating the therapeutic action of AGE by evaluating the role of NF-κβ/TLR-4 and the SERCA/Ca2+ pathway. The parameters assessed in the present experimental setup encompassed antioxidant parameters, metabolic indicators, insulin concentration, intracellular calcium levels, apoptotic markers (CCK-8 and Caspase Glo-8), and protein expression (P-62 and APACHE-II).ResultsAGE characterization by SEM, GC-MS, and X-ray diffraction (XRD) revealed the presence of phenylalanine, alliin, S-allylmercaptocysteine (SAMC), tryptophan, 1-methyl-1,2,3,4-tetrahydro-β-carboline-3-carboxylic acid as major bioactive constituents of AGE. Metabolic studies, including intraperitoneal glucose tolerance test (IPGTT), revealed significantly lower blood glucose levels in the AGE group compared to the disease control group. In contrast, the intraperitoneal insulin tolerance test (ITT) exhibited no significant difference in insulin sensitivity between the AGE supplementation group and the DM control group. Interestingly, AGE was found to have no significant effect on fasting glucose and serum insulin levels. In contrast, AGE supplementation was found to cause significant hypoglycaemia in postprandial blood glucose and insulin levels. Importantly, AGE causes restoration of intracellular Ca2+ levels by modulation of SERCA/Ca2 functioning and inhibition NF-κB/TLR-4 pathway. AGE was found to interact with and inhibit the DR-5/ caspase-8/3 apoptotic complex. Furthermore, microscopic studies revealed degeneration and apoptotic changes in pancreatic β-cells of the DM control group, while supplementation of AGE resulted in inhibition of apoptotic pathway and regeneration of pancreatic β-cells.ConclusionThe current study suggests that AGE enhance glucose homeostasis by exerting their effects on pancreatic β-cells, without ameliorating peripheral sensitivity. Moreover, AGEs promote an increase in β-cell mass by mitigating the apoptosis of pancreatic β-cells. These findings suggest that AGE could aid in developing a viable alternative therapy for diabetes mellitus (DM).

Differential Effects of n-3 and n-6 Polyunsaturated Fatty Acids on Placental and Embryonic Growth and Development in Diabetic Pregnant Mice.

The present study aimed to investigate the differential effects of n-3 and n-6 polyunsaturated fatty acids (PUFAs) on placental and embryonic development. Pregnant mice were assigned to five groups: healthy control (HC), diabetes mellitus control (DMC), diabetes + low-dose n-3 PUFA (Ln-3), diabetes + high-dose n-3 PUFA (Hn-3), and diabetes + n-6 PUFA (n-6). On E12.5d, the Hn-3 group, but not the n-6 group, had a higher placenta weight. The weight ratio of embryo to placenta in the n-6 group was significantly lower than in the Hn-3 group but higher than in the DMC group. The Hn-3 group had significantly higher protein levels of VEGF, IGF-1, and IGFBP3, while the n-6 group had lower VEGF than the DMC group. Compared with the DMC group, embryonic Cer-16:0 was significantly higher in the Hn-3 group, while embryonic PC (36:6), PC (38:7), and PE (40:7) were significantly lower in the n-6 group. The embryo and placenta weights were positively correlated with placental VEGF, IGFBP3, and embryonic Cer-16:0, and they were negatively correlated with embryonic PC (36:6) and PE (40:7). The weight ratio of embryo to placenta was negatively correlated with embryonic PC (36:6). In addition, embryonic Cer-16:0 was positively correlated with placental VEGF and IGFBP3. In conclusion, n-3 PUFA and n-6 PUFA improved placental and embryonic growth through different mechanisms.

Evaluation of submandibular and parotid salivary glands by ultrasonography in patients with diabetes.

Microvascular complications of diabetes mellitus (DM) include oral manifestations and complications, including xerostomia, reduced salivary flow, susceptibility to infection, periodontal disease and salivary gland enlargement. The present study aims to evaluate B-mode ultrasonography (USG) parameters such as size, volume and echogenicity of the submandibular and parotid salivary glands on both sides, shear-wave elastography (SWE) value and colour Doppler properties in patients with DM and healthy control groups. In total, 160 right and left submandibular glands and 160 right and left parotid glands of 80 patients, 40 patients (20 type 1 DM, 20 type 2 DM) and 40 healthy control group, between the ages of 18-70 were examined by USG. Echogenicity, parenchyma internal structure, margin and dimensional measurements (antero-posterior length, supero-inferior length, medio-lateral length and volume) and colour Doppler with 'ML 6-15-D Matrix Array (4-15 MHz)' probe, shear-wave elastography '9L-D (2-8 MHz)' probe was investigated. Statistically significant difference was observed in echogenicity in the right submandibular gland, echogenicity in the right parotid gland, margin characteristics, parenchymal homogeneity and colour Doppler characteristics between the type 1 DM, type 2 DM and control groups (p < .05). It was observed that the size, volume and SWE values of both submandibular and parotid glands were higher in the DM patient group than in the control group. Higher values were observed in type 2 DM compared to type 1 DM in the patient group. USG is an effective imaging technique in investigating the effects of diabetes on the submandibular and parotid salivary glands.

Toxicological Assessment and Anti-diabetic Effects of Combined Extract of Chirata, Fenugreek and Sesame on Regulating TNF-α, TGF-β and Oxidative Stress in Streptozotocin Induced Diabetic Rats.

Swertia chirayita, Trigonella foenum-gracum and Sesamum indicum are used as traditional medicines to treat diabetes mellitus. A collection of metabolic illnesses known as diabetes mellitus (DM) involves chronic hyperglycemia caused by flaws in insulin secretion, function, or both. Innate immunity and inflammation both play important roles in the etiology of diabetes- related microvascular problems. This study aims to examine the anti-diabetic effects and the acute toxicity of combined extract (1:1:1) of Swertia chirayita, Trigonella foenum-gracum and Sesamum indicum. To address the demand for higher effectiveness and safety, the current effort aims to construct anti-diabetic preparations containing methanolic extract from herbal medications. The OECD 423 method was used to investigate acute toxicity in rats. Rats were used as test subjects, and rats were given a 35 mg/kg BW injection of streptozotocin to develop diabetes. The diabetic control group was given Glibenclamide 0.25 mg/kg BW, while the experimental group's diabetic rats received 125 mg/kg BW and 250 mg/kg BW of a combined methanolic extract of all plants. Among the measurements looked at were acute oral toxicity, behavioral changes, body weight, serum glucose levels, lipid profiles, oxidative stress, renal function tests, and inflammatory mediators. All the rat groups' histopathologies of the kidney, liver, and stomach were compared. The data were evaluated using analysis of variance, and a post hoc test was then carried out. The combined extracts' medium lethal doses (LD50) were higher than 2000 mg/kg, indicating that they are not poisonous under the conditions that can be observed. Streptozotocin-induced diabetic rats' elevated blood glucose was found to be considerably lower (p 0.01) in the treated group of rats. In the treated group of rats, it was discovered that the damage and disarray in the cells typical of Streptozotocin-induced DM had been repaired. The treated group of rats returned to normal levels of the lipid profile, hyperglycemia, decreased serum protein and liver glycogen, increased liver function, and kidney function markers seen in the rats of the DM control group. The evaluated combined methanolic extract can be considered safe for use in rats. Combining methanolic extract from all selected medicinal plants (Swertia chirayita, Trigonella foenum-gracum and Sesamum indicum) has a potential anti-diabetic effect and can be safely developed as an alternative medicine.

Spectral computed tomography parameters could be surrogate imaging markers to detect early perfusion changes in diabetic kidneys.

Kidney microvasculopathy is the baseline pathophysiological feature of diabetic kidney disease (DKD). We aimed to evaluate the spectral computed tomography (CT) parameters for detecting renal perfusion changes among diabetic patients. From August 2020 to June 2022, 34 patients (age, 57.7±10.7 years; male, 20) clinically diagnosed with type 2 diabetes mellitus (DM) and 19 DM-free individuals (age, 48.1±16.9 years; male, 12) were selected for analysis. The series participants formed the DM group and control group, respectively. Spectral parameters, including effective atomic number (Zeff), iodine density (ID), normalized iodine density (NID) and the slope of the energy spectrum curves (λ), between the 2 groups were analyzed using independent samples t-test. Receiver operator characteristic (ROC) curves were used to evaluate the diagnostic performance of spectral parameters for detecting renal perfusion changes. The results indicate that in both cortical and medullary phases, the values of Zeff, ID, NID, and λ40-70 for the renal cortex of the DM group were significantly higher than those in the control group (P<0.05). In the cortex phase, the diagnostic efficacy of cortical spectral CT parameters discriminating DM patients from controls was as follows: the area under ROC curve (AUC) of ID value was 0.816 [95% confidence interval (CI): 0.679-0.921] at the optimal cutoff value 4.14, the AUC of Zeff value was 0.800 (95% CI: 0.668-0.901) at the optimal cutoff value 9.26, the AUC of λ40-70 value was 0.822 (95% CI: 0.675-0.918) at the optimal cutoff value 8.26, and the AUC of NID value was 0.851 (95% CI: 0.684-0.926) at the optimal cutoff value 0.37. In medullary phase: the AUC of ID value was 0.769 (95% CI: 0.617-0.846) at the optimal cutoff value 5.08, the AUC of Zeff value was 0.763 (95% CI: 0.614-0.837) at the optimal cutoff value 9.58, the AUC of λ40-70 value was 0.766 (95% CI: 0.617-0.839) at the optimal cutoff value 10.07, and the AUC of NID value was 0.79 (95% CI: 0.623-0.855) at the optimal cutoff value 1.37. Spectral CT could serve as an alternative protocol for the early identification of kidney injury in diabetic patients.

Diffusion‐weighted magnetic resonance imaging of parotid glands in diabetes mellitus: A preliminary study

AbstractObjectiveThis retrospective study aimed to assess the parotid glands in diabetes mellitus (DM) using diffusion‐weighted magnetic resonance imaging (DW‐MRI).MethodsWe investigated 54 patients aged between 38 and 83 years, with DM (DM group) and without DM (control group), who underwent magnetic resonance imaging (MRI) in the facility between November 2006 and January 2021. We calculated the median apparent diffusion coefficients (ADCs) of the parotid glands in the control group and DM group. These groups were compared using the Mann–Whitney U tests. A receiver operating characteristic (ROC) curve analysis was performed to assess the ability of the ADC to predict DM. Statistical significance was set at p &lt; 0.05.ResultsThe median ADCs of parotid grands in the control group and DM group were 0.83 × 10−3 mm2/s and 0.74 × 10−3 mm2/s, respectively (p &lt; 0.01). ROC analysis revealed a cut‐off ADC value of 0.81 to distinguish between the control and DM group. Sensitivity, specificity, accuracy, and area under the ROC curve were 0.7, 0.67, 0.69, and 0.71, respectively.ConclusionThe ADC was significantly higher in DM groups than in the control group. This suggests that DW‐MRI may be able to quantitatively distinguish parotid glands between normal and DM patients.

The Effect of Shrimp Shell (Litopenaeus vannamei) Extract on Testicular Parameters of Streptozotocin-induced Diabetic Rats

Diabetes mellitus (DM) is a chronic metabolic disorder that has become a major health problem worldwide. Reproductive dysfunction is one of the main complications of DM, particularly in men. However, as is known, shrimp shell extract contains nutrients, such as astaxanthin, that affect reproductive traits. The present study aimed to evaluate the effect of shrimp shell extract on the volume, weight, and histological features of the testes of a DM rat model. Fifteen adult male rats were randomly divided into three groups. Group A (n = 5) was a healthy control group, group B (n = 5) was a DM control group, and group C (n = 5) was a DM group treated with shrimp shell extract. Rats in groups B and C were treated with streptozotocin to induce DM. Rats in group C were given shrimp shell extract at 25 mg/kg body weight for 30 consecutive days after DM induction. Testicles were collected and submitted to dimension, weight, and histological examinations. The testicle volume and weight of rats in group C were significantly higher and heavier, respectively, than rats in group B and did not differ from rats in group A. The seminiferous tubule diameter of rats in group C was significantly larger than rats in group B and did not differ from rats in group A. Rats in group B had a lower testicle volume and lighter testicle weight as well as a shorter seminiferous tubule diameter than rats in groups A and C. In conclusion, shrimp shell extract could improve male fertility parameters in a DM rat model. However, the mechanism of action needs to be studied further.

Effects of noopept on ocular, pancreatic and renal histopathology in streptozotocin induced prepubertal diabetic rats

ABSTRACT Diabetes mellitus (DM) is a chronic disease at all ages including childhood and puberty. Failure to treat DM can cause retinopathy, nephropathy and neuropathy. Endocrine and metabolic changes during the pubertal period complicate management of DM. Noopept is a cognitive enhancer that exhibits antidiabetic properties. We investigated the effect of noopept on the histopathology of the cornea, retina, kidney and pancreas in pubertal diabetic rats. We allocated 60 prepubertal male rats randomly into six groups of 10: untreated control (C), DM control (DC), noopept control (NC), DM + noopept (D + N), DM + insulin (D + I) and DM + insulin + noopept (D + I + N). DM was induced by streptozotocin in the DC, D + N, D + I and D + I + N groups. Noopept was administered to the NC, D + N and D + I + N groups; insulin was administered to the D + I and D + I + N groups for 14 days. On day 18 of the experiment, animals were sacrificed and eyes, kidneys and pancreata were excised for histological investigation. Renal tubule diameter and corneal and retinal thickness were increased significantly in DC groups compared to the control group. The D + I, D + N and D + I + N groups exhibited fewer DM induced pathological changes than the DC group. The D + I + N group exhibited no significant differences in renal tubule diameter and corneal and retinal thickness compared to the DC group. Our findings suggest that noopept is protective against DM end organ complications in streptozotocin induced diabetic pubertal rats.

The Effect of Diabetes and Disease Duration on Disc Degeneration and ‎Subcutaneous Adipose Tissue Thickness

In this study, we aimed to determine whether the presence and duration of diabetes mellitus (DM) is ‎associated with changes in intervertebral disc degeneration, epiphyseal plaque degeneration, and ‎subcutaneous fat tissue thickness. Diabetic patients and non-diabetic participants (control group) who applied to the ‎internal medicine outpatient clinic between 2020-2022 and had lumbar spine magnetic resonance imaging ‎due to low back and/or leg pain were included the study. Disc degeneration, epiphyseal plaque ‎degeneration, and subcutaneous fat tissue thickness parameters of DM patients and control group were ‎reviewed retrospectively, and the results were statistically evaluated. There were 80 DM patients in the ‎patient group, 25 (31.3%) of these patients were male and 55 (68.8%) were female. There was a total of ‎‎121 participants in the control group, of which 39 (32.2%) were male and 82 (67.8%) were female. The ‎mean age of the patient group was 57.85±10.76 years, while the mean age of the control group was ‎‎54.23±13.09 years. There was no significant difference between the duration of DM and disc degeneration, ‎epiphyseal plaque degeneration, and subcutaneous adipose tissue thickness. However, there was a ‎significant difference between the control group and the DM patient group in terms of disc degeneration and ‎epiphyseal plaque degeneration (p=0.003 and p=0.017, respectively). This study reveals that patients with ‎diabetes have an increased susceptibility to disc degeneration and epiphyseal plaque degeneration, ‎regardless of disease duration. Control and treatment of diabetic disease will make an important contribution ‎to the prevention of secondary complications‎.

Effect of Phaleria Macrocarpa (Scheff.) Boerl Leaf Ethanol Extract on Serum IL-6 and TNF-α Levels in Diabetic Rats.

Hyperglycemia conditions in diabetes mellitus (DM) can turn on pro-inflammatory cytokines like IL-6 and TNF-α. These cytokines play a role in insulin resistance and the development of DM complications. People in Indonesia have used Phaleria macrocarpa to treat diabetes, but the leaf of this plant has not been studied to see if it can reduce inflammation. This study aims to analyze the effect of ethanolic extract of Phaleria macrocarpa leaves (EEPML) in serum IL-6 and TNF-α levels of diabetic rats. This study was an experiment with a post-test-only control group design. Thirty 8-week-old male Wistar rats were used in the study. They were split into six groups: K1 was the normal control group; K2 was the DM control group; K3, K4, and K5 were given EEPML at doses of 125, 250, and 500 mg/KgBW; and K6 was given metformin 45 mg/KgBW orally once a day for 14 days. A high-fat diet and a 30 mg/KgBWi.p injection of streptozotocin were used to make the diabetic rat model. ELISA method for measuring serum IL-6 and TNF-α levels. The Kruskal-Wallis and the Mann-Whitney test were used to examine the differences between the groups. There were significant differences between treatment groups in the mean levels of serum IL-6 (p=0.017), but there were no significant differences in the mean levels of serum TNF-α (p>0.05). Administration of Phaleria macrocarpa leaf ethanol extract 125 mg/KgBW reduced serum IL-6 levels but could not significantly reduce serum TNF-α levels in diabetic rats.

Stratification of diabetic kidney diseases via data-independent acquisition proteomics-based analysis of human kidney tissue specimens.

The aims of this study were to analyze the proteomic differences in renal tissues from patients with diabetes mellitus (DM) and diabetic kidney disease (DKD) and to select sensitive biomarkers for early identification of DKD progression. Pressure cycling technology-pulse data-independent acquisition mass spectrometry was employed to investigate protein alterations in 36 formalin-fixed paraffin-embedded specimens. Then, bioinformatics analysis was performed to identify important signaling pathways and key molecules. Finally, the target proteins were validated in 60 blood and 30 urine samples. A total of 52 up- and 311 down-regulated differential proteins were identified as differing among the advanced DKD samples, early DKD samples, and DM controls (adjusted p<0.05). These differentially expressed proteins were mainly involved in ion transport, apoptosis regulation, and the inflammatory response. UniProt database analysis showed that these proteins were mostly enriched in signaling pathways related to metabolism, apoptosis, and inflammation. NBR1 was significantly up-regulated in both early and advanced DKD, with fold changes (FCs) of 175 and 184, respectively (both p<0.01). In addition, VPS37A and ATG4B were significantly down-regulated with DKD progression, with FCs of 0.140 and 0.088, respectively, in advanced DKD and 0.533 and 0.192, respectively, in early DKD compared with the DM control group (both p<0.01). Bioinformatics analysis showed that NBR1, VPS37A, and ATG4B are closely related to autophagy. We also found that serum levels of the three proteins and urine levels of NBR1 decreased with disease progression. Moreover, there was a significant difference in serum VPS37A and ATG4B levels between patients with early and advanced DKD (both p<0.05). The immunohistochemistry assaay exhibited that the three proteins were expressed in renal tubular cells, and NBR1 was also expressed in the cystic wall of renal glomeruli. The increase in NBR1 expression and the decrease in ATG4B and VPS37 expression in renal tissue are closely related to inhibition of the autophagy pathway, which may contribute to DKD development or progression. These three proteins may serve as sensitive serum biomarkers for early identification of DKD progression.

Prevalence of female sexual dysfunction among diabetic females: a cross-sectional case controlled study

ABSTRACT Background Sexual relationships, sexual functions are all parts of the female sexual identity and which influence physiological, psychological, and reproductive functions of women. Aim of the work The study aimed to identify prevalence of Female Sexual Dysfunction (FSD) in women affected by type 1 and type 2 Diabetes Mellitus (DM) and to evaluate the impact of diabetes on female sexuality. Patient and Methods This cross-sectional study was carried out on 400 married females who were interviewed to answer Female Sexual Function Index (FSFI) questionnaire and were divided into two groups: the first group included 300 diabetes patients (134 patients with type 1 DM and 166 patients with type 2 DM), while the second included 100 women not diagnosed with diabetes who served as controls. Results Considering female sexual dysfunction (score < 26.55), there was statistically significant increase of patients with female sexual dysfunction (FSD) in Type 1 DM (50.7%) when compared to type 2 DM patients (28.9%) or control group (10.0%). Conclusion FSD is a significant health problem in premenopausal women complaining of DM. Females with type 1 DM were more affected than females with type 2 DM, who in turn were more affected than healthy controls. Long duration of the disease was the main risk factor for developing FSD.

Assessment the Role of Phagocytic Neutrophil Cells among Different Wagner’s Grades of Diabetic Foot Ulcers Infection

Foot ulcers complications in diabetes mellitus (DM) patients are one of the significant medical problems. This study aimed to assessment the role of phagocytic neutrophil cells and its relationship with the incidence of diabetic foot ulcers (DFU) infection in diabetic patients. A case-control analytical study was conducted on 60 DM, DFU patients and healthy control group. Blood samples were collected for phagocytic activity testing and swabs samples of DFU were collected and processed for culture and antibiotics susceptibility testing after the ulcers classified according to Wagner’s grades system. Findings revealed that Gram-positive bacteria were the most prevalent in the DFU 57.1% with statistically significant relationship between the bacterial species and grades of Wagner’s classification. Wagner’s ulcers grade I and II were the most prevalence in DFU patients 30% for both. There was a weak negative correlation between phagocytic activity and grade ulcers classified. Amikacin and ciprofloxacin were the most effective antibiotics against bacterial isolates, whereas ampicillin, cefepime and cefadroxil were the most common resistance antibiotics of bacterial isolates. In conclusion, this is the first study carried out in Hadhramout, Yemen to assessment the phagocytic neutrophil cells and its role to fight the bacterial infection of diabetic foot ulcers. When the grade of ulcer increased, the bacterial resistance to antibiotics increased, and this was emphasis the correlation with prevalence of Gram-negative bacteria in the high grade of ulcers with high resistance of antibiotics. In contrast, the grade of ulcer increased, the efficiency of phagocytic neutrophil cells decreased.

Influence of one-day diabetes mellitus clinic management on blood glucose control and prognosis in patients with gestational diabetes mellitus

Objective To explore the influence of the one-day diabetes mellitus (DM) clinic management model on blood glucose control and prognosis in patients with gestational diabetes mellitus (GDM). Methods A total of 930 patients diagnosed with GDM by oral glucose tolerance test screening at 24–28 weeks of gestation were selected from those who underwent outpatient prenatal checkups at our hospital and were randomly divided into one-day DM clinic group (n = 509) and control group (n = 421). A one-day DM clinic intervention was conducted in the one-day DM clinic group, and individualized dietary interventions and exercise instruction were given in the control group. Results The compliance rates of fasting blood glucose and two-hour postprandial blood glucose (2-h PPBG) were higher in the one-day DM clinic group than in the control group (p < .05). The compliance rates of the oral glucose tolerance test and insulin release test were higher in the one-day DM clinic group than in the control group (p < .05). There existed statistically significant differences in fasting blood glucose before delivery, together with the difference between fasting blood glucose at enrollment and before delivery and the difference between glycated hemoglobin at enrollment and before delivery (p < .05). Conclusion The one-day diabetes mellitus clinic management model is more conducive to blood glucose control in patients with GDM and more conducive to the recovery of blood glucose and islet function in patients with GDM after delivery and to reduce the occurrence of adverse pregnancy outcomes.

Assessment the Role of Phagocytic Neutrophil Cells among Different Wagner’s Grades of Diabetic Foot Ulcers Infection

Foot ulcers complications in diabetes mellitus (DM) patients are one of the significant medical problems. This study aimed to assessment the role of phagocytic neutrophil cells and its relationship with the incidence of diabetic foot ulcers (DFU) infection in diabetic patients. A case-control analytical study was conducted on 60 DM, DFU patients and healthy control group. Blood samples were collected for phagocytic activity testing and swabs samples of DFU were collected and processed for culture and antibiotics susceptibility testing after the ulcers classified according to Wagner’s grades system. Findings revealed that Gram-positive bacteria were the most prevalent in the DFU 57.1% with statistically significant relationship between the bacterial species and grades of Wagner’s classification. Wagner’s ulcers grade I and II were the most prevalence in DFU patients 30% for both. There was a weak negative correlation between phagocytic activity and grade ulcers classified. Amikacin and ciprofloxacin were the most effective antibiotics against bacterial isolates, whereas ampicillin, cefepime and cefadroxil were the most common resistance antibiotics of bacterial isolates. In conclusion, this is the first study carried out in Hadhramout, Yemen to assessment the phagocytic neutrophil cells and its role to fight the bacterial infection of diabetic foot ulcers. When the grade of ulcer increased, the bacterial resistance to antibiotics increased, and this was emphasis the correlation with prevalence of Gram-negative bacteria in the high grade of ulcers with high resistance of antibiotics. In contrast, the grade of ulcer increased, the efficiency of phagocytic neutrophil cells decreased.

The elevated risk of sight-threatening cataract in diabetes with retinopathy: a retrospective population-based cohort study

BackgroundThe effect of diabetic retinopathy (DR) on the development of sight-threatening cataracts was assessed using the National Health Insurance Research Database of Taiwan.MethodsPatients diagnosed with diabetes mellitus (DM) and DR were enrolled in the study group. Age- and sex-matched DM individuals without DR and patients without DM served as the DM control group and non-DM control group, respectively, both with 1:4 ratios. The outcome was set as the performance of cataract surgery. Cox proportional hazard regression was used to calculate the adjusted hazard ratio (aHR) of DR considering multiple factors underlying cataract formation.ResultsA total of 3297 DR patients, 13,188 DM control patients and 13,188 non-DM control subjects were enrolled. The study group included 919 events of sight-threatening cataracts (27.87%), the DM control group included 1108 events (8.40%), and the non-DM control group included 957 events (7.26%). A multivariable analysis indicated that the study group presented a higher aHR of cataract surgery (2.93, 95% CI: 2.60–3.30) and a higher cumulative probability of cataract surgery than both the DM control and non-DM control groups (both log rank P < 0.001). In addition, both the proliferative DR (3.90, 95% CI: 3.42–4.45) and nonproliferative DR (2.35, 95% CI: 2.08–2.65) subgroups showed a higher aHR of cataract surgery than the DM control group.ConclusionThe presence of DR increases the risk of sight-threatening cataracts that warrant surgery, and the effect is prominent among patients with both proliferative DR and nonproliferative DR.

Саркопенія при цукровому діабеті 2-го типу (огляд і власні спостереження)

В огляді літератури подано визначення синдрому саркопенії (СП), його класифікація та етіологічні чинники. Основну увагу приділено зв’язку між СП і вуглеводним обміном, у тому числі між вмістом глікогену та чутливістю до інсуліну. Проаналізовано публікації, що стосуються механізмів впливу фізичного навантаження (короткочасного і тривалого) на вуглеводний обмін. Підкреслено, що сьогодні існує доказова база ролі скелетної мускулатури в підтримці глюкозного гомеостазу, і це обґрунтовує важливість фізичного навантаження в профілактиці цукрового діабету (ЦД) 2-го типу та моніторингу таких хворих. Власні спостереження проведені з метою порівняти частоту підвищення відсотка вмісту жирової тканини (ЖТ) та зниження — м’язової тканини в осіб із різним рівнем індексу маси тіла і вплив на ці показники наявності ЦД 2-го типу. Матеріали та методи. Проведено біоімпедансне дослідження 114 хворих на ЦД 2-го типу віком 52,3 ± 1,7 року й 110 осіб такого ж віку без ЦД 2-го типу (контрольна група). Результати. У всіх обстежених із надлишковою масою тіла (надлМТ) і ожирінням (Ож) виявлено перевищення вікових норм процентного вмісту ЖТ незалежно від наявності або відсутності ЦД 2-го типу. При нормальній масі тіла (нормМТ) у контрольній групі практично в половини обстежених (52,0 %) відзначалося підвищення питомої ваги ЖТ, а за наявності ЦД 2-го типу цей показник був вірогідно вищим (94,1 %). Це дає підставу припустити, що перевищення понад вікових норм процентного вмісту ЖТ в осіб із нормМТ можна розцінювати як фактор ризику ЦД 2-го типу. Частота зниження частки м’язової тканини в контрольній групі становила 8,0 % при нормМТ, 20,0 % — при надлМТ і 80,0 % — при Ож, що свідчить про важливість проблеми СП насамперед для осіб з Ож. На тлі ЦД 2-го типу ці показники були вірогідно вищими при нормМТ (41,2 %, р &lt; 0,02), вірогідно удвічі вищими — при надлМТ (40,0 %), але нижчими (невірогідно) — при Ож (61,1 %). Висновки. Проблема СП при ЦД 2-го типу актуальна для хворих із будь-яким індексом маси тіла.

Association of Type 2 Diabetes and Hepatic Encephalopathy in Chronic Liver Disease Patients.

BackgroundHepatic encephalopathy (HE) is an important complication of hepatic cirrhosis and is an independent predictor of mortality in patients with cirrhosis. The prevalence of type 2 diabetes continues to increase at an alarming rate around the world, with even more people being affected by prediabetes. Diabetes leads to increased gastric transit and orocecal time, increased glutamase activity, and intestinal bacterial overgrowth, which may increase intestinal ammonia production. Thus, we speculated that diabetes mellitus (DM) might predispose cirrhotic patients to development and/or exacerbation of HE. The main purpose of this study is to determine the association of DM with severe HE in patients with chronic liver disease (CLD).MethodsThis case-control study (122 cases and 122 controls) was conducted for 6 months on patients who fulfilled the inclusion criteria and were selected from the Medical department, Abbasi Shaheed Hospital, Karachi, after taking informed consent. Demographic data were presented as simple descriptive statistics giving mean and standard deviation and qualitative variables were presented as frequency and percentages. Chi-square was applied and the odds ratio (OR) was calculated taking a p-value of ≤ 0.05 as statistically significant.ResultsOut of a total of 244 patients, 122 patients had CLD with DM (case group) and 122 participants had CLD without DM (control group). The mean and standard deviation of age in the case and control groups in our study was 43.29±3.79 and 45.49±5.40. The mean and standard deviation of the duration of disease in the case and control groups in our study was 3.18±1.22 and 3.72±1.36. Males were 53 (43.44%) and 56 (45.10%) in the case and control groups, whereas females were 69 (56.56%) and 66 (54.10%) in the case and control groups, respectively. Out of 122 patients in the case group, 73 (59.84%) and 49 (40.16%) patients developed and did not develop severe HE, respectively. Out of 122 patients in the control group, 50 (40.98%) and 72 (59.02%) patients developed and did not develop severe HE, respectively. Binary logistic regression analysis showed an association of severe HE with DM (p-value: 0.93, OR: 1.033, 95% CI: 0.586-1.599).ConclusionThis study demonstrates that HE is a common occurrence in CLD patients. There was not a direct relationship of DM with the severity of HE was observed. However, further research with larger sample size and involving a multicenter setting is warranted.

Diabetes mellitus aggravates ranolazine-induced ECG changes in rats.

Diabetes mellitus (DM) is known to affect the pharmacokinetics of drugs. In this study, we evaluated the effect of DM on the liver content of CYP 3A2 enzyme. We also explored the ECG changes after administration of ranolazine in non-DM and DM rats. First phase: 24 male Wistar rats were separated into 4 groups. The control group (n = 6) received normal saline and the DM groups (n = 18) were treated with a single dose (55mg/kg) of streptozocin (STZ; i.p. injection), then were held for 10, 20, and 30days, respectively. After study duration for each group, the liver CYP 3A2 protein content was determined using western blotting. Second phase: 48 male Wistar rats were classified into two groups of non-DM and DM; and each group was divided into 4 subgroups (n: 6). Experimental groups received oral doses of 20, 40, and 80mg/kg ranolazine. DM and non-DM control groups received normal saline. Treatment lasted for 28days, and then the ECG was recorded. Experimental DM induced by STZ caused a significant decrement in liver CYP3A2 protein content of rats on days 10 and 20 (P < 0.01), and 30 (P < 0.05) compared to the control animals. Significant increases in QT and corrected QT (QTc) intervals (P < 0.01), and bradycardia (P < 0.01) without any significant effect on PR and QRS intervals were observed in DM in comparison with non-DM groups after ranolazine treatment. In summary, DM induction in animals resulted in CYP 3A2 inhibition and the prolongation of QT and QTc interval as well as bradycardia after ranolazine treatment.

A New Silver Nano-Formulation of Cassia auriculata Flower Extract and its Anti-Diabetic Effects.

Treatment of diabetes mellitus (DM) using plant based drugs is advancing and getting much attention in recent years. Cassia auriculata L. is widely used in Indian folk medicine for the treatment of DM. Site-specific targeted plant drug delivery by metallic nanoparticles carriers is a new emerging procedure under research due to its enhanced bioavailability and reduced toxicity. This study was therefore aimed at biosynthesizing a new silver nanoparticle of Cassia auriculata L. flower extract and study its anti-diabetic efficiency in rats. The silver nanoparticles were biosynthesized using AgNO3 solution and characterized by spectroscopy, SEM and EDAX analyses. The acute toxicity of this nano-preparation (up to 2000 mg/kg b. wt) was analyzed in rats and the anti-diabetic efficiency (for 50 mg/kg.b.wt and 200 mg/kg.b.wt) was studied in Streptozotocin induced diabetic rats. The diabetic parameters such as; blood glucose, serum protein, liver glycogen, serum lipid profile, serum levels of creatinine, urea, ALT, AST and ALP were analyzed. The histology of the liver, kidney and pancreas was evaluated after staining with Haematoxylin and Eosin. The increased blood glucose in Streptozotocin induced diabetic rats was found to be significantly reduced (p<0.01) in the treated group of rats. The characteristic damage and disorganization in the cells of Streptozotocin induced DM was found to be recovered in the treated group of rats. The alterations in the lipid profile, hyperglycaemia, reduced serum protein and liver glycogen, enhanced liver function and kidney function markers observed in the rats of DM control group were normalized in the treated group of rats. The results of this study, proving an efficient anti-diabetic activity of the biosynthesized silver nanoparticles of Cassia auriculata L. flower extract, implies that this nano-preparation may be exploited as an alternative biopharmaceutical agent for treating DM.