Diabetes Symptoms Research Articles

Single-cell RNA sequencing reveals the effects of hederasaponin C in the treatment of diabetic nephropathy

There is great demand for the development of novel efficient therapeutic strategies or preventative measures to alleviate the life-threatening complications of type 2 diabetes. Hederasaponin C (PB5), a natural product, has been reported to exhibit significant therapeutic effects in various diseases; however, the possible effects and mechanism underlying PB5 in reducing diabetic renal complications have not been comprehensively reported. Here, we investigated the response of murine diabetic models to PB5 treatment using single-cell RNA-sequencing (scRNA-seq) and proteomics. Our findings revealed the dynamic transcriptional changes of renal cells in response to diabetic nephropathy. PB5 alleviated inflammatory injury by partially reducing pathophysiologic processes. In addition, we observed severe glomerular lesions and functional deficiencies, including GBM thickening and podocyte dysfunction, during the progression of diabetes, which were likewise attenuated by PB5. These results provide insight into how PB5 treatment improves diabetic symptoms and possibly serves as a novel protective measure and therapeutic strategy in the treatment of type 2 diabetes.

The knowledge and practice of Saudi type-2 diabetic patients regarding lifestyle habits in Riyadh City

Objectives: To estimate the level of knowledge and practice in type-2 diabetic patients, regarding the effect of lifestyle habits. Also, to estimate the knowledge of diabetic smokers toward smoking cessation benefits and its relation in decreasing diabetic complications, and to estimate the ratio between men and women about the knowledge and practice regarding the effect of lifestyle habits. Methods: A cross-sectional study was conducted using a structured questionnaire amongst 332 type-2 diabetic patients observed at the outpatient clinics in 5 hospitals across Riyadh city. Baseline characteristics of the participants were obtained and their knowledge and practice regarding lifestyle modification were assessed. Results: Out of 332 participants, almost 84.6% of participants knew that physical exercise improves diabetic symptoms but unfortunately 49.4% did not exercise at all. It was also found that almost 45.1% of participants did not know about the effect of cigarette smoking/alcohol consumption on the progression of diabetes, and 50% of active smokers had no awareness about its effect on the progression of the disease. Also, 13.6% of participants did not know about the effect of diet on the progression of type-2 diabetes. Conclusion: Despite the high level of awareness among the patients regarding its effects on lifestyles in type-2 diabetes mellitus patients, there was a lack of routine physical activity.

Dose-dependent effects of xylooligosaccharides on glycemic regulation with L. rhamnosus CCFM1060 in diabetic mice.

Dietary intervention with the probiotic Lactobacillus rhamnosus CCFM1060 has been proved to be effective on glycemic regulation in diabetic mice. Therefore characterization of the potential symbiotic effect of prebiotic xylooligosaccharides (XOS) with L. rhamnosus CCFM1060 would be desirable. In this study, we evaluated any dose-dependent relationship between XOS and L. rhamnosus CCFM1060, and the potential impact on glycemic regulation. Diabetic mice were randomly assigned to receive 5 × 109 CFU mL-1L. rhamnosus CCFM1060, 5 × 109 CFU mL-1L. rhamnosus CCFM1060 with 250 mg kg-1 XOS (L-LXOS), or 5 × 109 CFU mL-1L. rhamnosus CCFM1060 with 500 mg kg-1 XOS (L-HXOS) for 7 weeks. In addition to characterization of the host metabolism, the intestinal microbiota were analyzed using 16S rRNA gene sequencing. The results showed that L. rhamnosus alone and L-LXOS intervention significantly alleviated diabetes symptoms and increased the populations of short-chain fatty acid (SCFA)-producing bacteria. The intake of L-HXOS had an adverse effect on glucose metabolism, causing increased insulin resistance and inflammation. Although a significant increase in the relative abundance of Bifidobacterium was observed in the L-HXOS group, the abundance of SCFA-producing bacteria, such as Romboutsia and Clostrudium sensu stricto 1, decreased. KEGG pathway analysis revealed that the adverse effects of L-HXOS intervention might be attributed to the metabolic pathways involved in amino acid, cofactor, and vitamin metabolism. This study revealed that L. rhamnosus CCFM1060 combined with different doses of XOS exerted dose-dependent effects on glucose metabolism. Therefore, the type and dose of prebiotics should be carefully evaluated when developing individualized symbiotic formula.

Effective Health Screening Strategies for Overcoming Non-Communicable Diseases in Sambimulyo Village, Banyuwangi Regency

Non-communicable diseases (NCDs) are chronic conditions that cannot be transmitted from one person to another. These conditions do not usually cause symptoms at first, but over time they can progress and damage the affected organ, leading to complications or even death. A lack of public knowledge about NCDs is a major contributor to complications and deaths from these diseases. To address this issue, a series of activities have been organized as part of the Movement for the Control of Non-Communicable Diseases. These activities focus on understanding the definitions, risk factors, prevention methods, and symptoms of diabetes, hypertension, and hyperuricemia. This study used a descriptive observational method, collecting primary data from pre- and post-test responses and health test results. In the first intervention, information about NCDs was provided and participants’ knowledge was increased by 31.25%. The second intervention was a health screening, which included measuring blood pressure and blood sugar levels. Uric acid levels were also measured at five points in Sambimulyo Village, with 129 participants. The results showed that 41.1% had high blood pressure, 29.5% were classified as diabetic, and 18.8% had high uric acid levels. These activities increased public knowledge about NCDs, provided information about the community’s risk factors, and improved communication, education, and information about how to manage these conditions.

Genipin Attenuates Diabetic Cognitive Impairment by Reducing Lipid Accumulation and Promoting Mitochondrial Fusion via FABP4/Mfn1 Signaling in Microglia.

The present study was conducted to evaluate the effect of genipin (GEN) on the microglia of diabetic cognitive impairment and explore its potential mechanism. Diabetic mice were induced by STZ/HFD, while GEN was intragastrically and intraventricularly treated. The human microglia cell HMC3 was induced by LPS/HG/PA. As a result, GEN attenuated diabetic symptoms and diabetic cognitive impairment-related behavior in novel object recognition, Morris water maze and passive avoidance tests. GEN inhibited M1 microglia polarization, lipid accumulation, oxidative stress and promoted mitochondrial fusion via FABP4/Mfn1. FABP4 overexpression, Mfn1 overexpression, selective FABP4 inhibitor BMS, and Mfn1 SiRNA were employed for investigating the mechanism. The inhibitory effect of GEN on ROS may be associated with NOX2 signaling and the translocation of p47phox/p67phox to the cell membrane. With the ROS scavenger NAC, it was proved that ROS participated in GEN-mediated inflammation and lipid accumulation. GEN inhibited the phosphorylation and nucleus translocation of NF-κB. GEN inhibited the ubiquitination of Mfn1, which was mediated by the E3 ligase Hrd1. GEN also enhanced microglia phagocytosis. Molecular docking predicted that GEN may interact with FABP4 by hydrogen bond at the S53 and R78 residues. In conclusion, GEN attenuated diabetic cognitive impairment by inhibiting inflammation, lipid accumulation and promoting mitochondrial fusion via FABP4/Mfn1 signaling.

"I see salt everywhere": A qualitative examination of the utility of arts-based participatory workshops to study noncommunicable diseases in Tanzania and Malawi.

The burden of noncommunicable diseases (NCDs) including hypertension, diabetes, and cancer, is rising in Sub-Saharan African countries like Tanzania and Malawi. This increase reflects complex interactions between diverse social, environmental, biological, and political factors. To intervene successfully, new approaches are therefore needed to understand how local knowledges and attitudes towards common NCDs influence health behaviours. This study compares the utility of using a novel arts-based participatory method and more traditional focus groups to generate new understandings of local knowledges, attitudes, and behaviours towards NCDs and their risk factors. Single-gender arts-based participatory workshops and focus group discussions were conducted with local communities in Tanzania and Malawi. Thematic analysis compared workshop and focus group transcripts for depth of content and researcher-participant hierarchies. In addition, semiotic analysis examined the contribution of photographs of workshop activities to understanding participants' experiences and beliefs about NCD risk factors. The arts-based participatory workshops produced in-depth, vivid, emotive narratives of participants' beliefs about NCDs and their impact (e.g., "… it spreads all over your body and kills you-snake's poison is similar to diabetes poison"), while the focus groups provided more basic accounts (e.g., "diabetes is a fast killer"). The workshops also empowered participants to navigate activities with autonomy, revealing their almost overwhelmingly negative beliefs about NCDs. However, enabling participants to direct the focus of workshop activities led to challenges, including the perpetuation of stigma (e.g., comparing smells associated with diabetes symptoms with sewage). Semiotic analysis of workshop photographs provided little additional insight beyond that gained from the transcripts. Arts-based participatory workshops are promising as a novel method to inform development of culturally relevant approaches to NCD prevention in Tanzania and Malawi. Future research should incorporate more structured opportunities for participant reflection during the workshops to minimise harm from any emerging stigma.

Prevalence of Type 2 Diabetes and Its Signs and Symptoms Among the Meiteis of Manipur, India

The rate of prevalence of Type 2 Diabetes (T2D) increases globally and the greatest rise over the years is observed in India. T2D is the most frequent type of diabetes, increasing susceptibility to different diseases. The present study tries to find out the overall prevalence and identify the sign and symptoms of diabetes among the Meiteis of Manipur. Fasting blood glucose level was randomly collected from 1026 participants (men: 517 and women: 509) using a glucometer from five valley districts of Manipur. An interview schedule consisting of personal information and data on signs and symptoms of diabetes was collected from the participant with prior informed consent. The present study shows that 34.40% has impaired fasting glucose (IFG), and the overall prevalence of T2D is 12.96%, indicating that one out of every ten Meitei individuals is affected by the disease. The prevalence of T2D is higher with an increase in chronological age. The presence of signs and symptoms of T2D was significantly higher among the diabetic patients than the normal individuals. Owing to a lack of awareness and knowledge, the incidence of newly diagnosed diabetes is higher than self-reported. Therefore, as a preventive measure, there is an urgent need for timely intervention through awareness and imparting knowledge about diabetes education among the people.

Public knowledge and awareness of diabetes mellitus, its risk factors, complications, and prevention methods among adults in Poland-A 2022 nationwide cross-sectional survey.

Regular monitoring of public awareness of diabetes is necessary to provide effective educational and preventive strategies. This study aimed to assess (1) public knowledge and awareness of diabetes among adults in Poland, as well as (2) to identify sociodemographic factors associated with public awareness of diabetes. This cross-sectional survey was carried out between 24 and 27 June 2022, on a non-probability random quota sample of 1,051 adults in Poland. The questionnaire included ten questions related to the awareness of risk factors, symptoms, and complications of diabetes. Among the respondents, 10.5% had diabetes and 43.8% declared that they have a history of diabetes in their family. Only 17.3% of respondents declared a good level of knowledge of diabetes. Out of 10 symptoms of diabetes analyzed in this study, high blood sugar (80.7%) and chronic fatigue (74.6%) were the most recognized. Out of 8 diabetes risk factors analyzed in this study, overweight/obesity (80.4%) and unhealthy diet (74.1%) were the most recognized diabetes risk factors, while only 22.7% of respondents indicated tobacco use. The diabetic foot was the most recognized diabetes complication (79.8%), but approximately half of the respondents indicated vision problems (56.9%), kidney damage (52.1%), or cardiovascular diseases (50.2%) as diabetes complications. Female gender, having higher education and having a family member with diabetes were the most im-portent factors associated (p < 0.05) with a higher level of awareness of diabetes. This study demonstrated insufficient public awareness of diabetes among adults in Poland. Gender and educational level were the most important factors significantly associated with the awareness of the selected aspects of diabetes, while self-reported financial situation and place of residence had none or marginal influence. The presented data manifest the importance of adopting a comprehensive education strategy regarding diabetes in Poland.

Xiaotangzhike Pill Attenuates the Progression of Diabetes In Vivo through the Mediation of the Akt/GSK-3β Axis.

Diabetes seriously threatens the health of people. Traditional Chinese medicine has been proven to inhibit the progression of diabetes. Meanwhile, the Xiaotangzhike pill (XTZK) was known to alleviate the symptom of diabetes. Thus, this research decided to investigate the mechanism underlying the impact of XTZK in diabetes remains unexplored. To assess the impact of XTZK in diabetes, in vivo model of diabetes was constructed. The contents of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) in the rats were tested by the commercial kits. In addition, Masson and hematoxylin and eosin (H&E) staining were applied for assessing the histological changes and fibrosis in the rats, respectively. Furthermore, a western blot was applied to assess the protein levels. Streptozotocin (STZ) significantly increased the levels of area under the curve (AUC), TG, TC, LDL-C, and decreased the contents of HDL-C in rats, while these phenomena were partially reversed by XTZK. In addition, STZ notably induced inflammatory infiltration and fibrosis in the liver tissues of rats, which was greatly restored by XTZK. The levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and malondialdehyde (MDA) in the serum of rats were notably upregulated by STZ, while the effect of STZ was markedly abolished by XTZK. Meanwhile, STZ-caused the upregulation of p-Smad2 and α-SMA in rats was restored by XTZK. Furthermore, XTZK notably inhibited the progression of Qi and Yin deficiency syndrome in diabetes through the mediation of the Akt/GSK-3β axis. The Xiaotangzhike pill attenuates the progression of diabetes through the mediation of the Akt/GSK-3β axis. Hence, our study might supply a novel insight into discovering new strategies against diabetes.

SYMPTOMS CONTRIBUTING TO SLEEP PROBLEMS IN OLDER ADULTS WITH TYPE 2 DIABETES

Abstract Sleep problems are common in older adults. Those with diabetes are more vulnerable to sleep disorders since diabetes-specific symptoms can interfere with sleep quality. Yet little is known which diabetes symptoms most strongly affect sleep in older adults. This study aimed to examine the associations between diabetes symptoms and sleep and to identity the symptoms that most strongly disrupt sleep in older adults in the United States. Diabetes symptoms were assessed using the Diabetes Symptom Checklist-Revised. Sleep impairment and sleep disturbance were self-reported using The Patient-Reported Outcomes Measurement Information System. Demographic (age, sex, race/ethnicity) and other variables (body mass index, depressive symptoms, diabetes duration, glycemic control) were also assessed. Multivariate regression analyses were used with standardized coefficients. A total of 82 adults aged ≥ 60 years were included (mean age = 68.32 ± 5.29 years, White 76.83%, female 56.1%). After controlling for demographic and other variables, increased hypoglycemia (β = .35), hyperglycemia (β = .38), fatigue (β = .65), cognitive (β = .48), and ophthalmologic (β = .25) symptoms and neurological pain (β = .42) significantly increased sleep impairment. Of these, fatigue was the strongest contributor to sleep impairment. Similarly, increased hyperglycemia symptoms (β = .30), fatigue (β = .34), and neurological pain (β = .37) significantly increased sleep disturbance while neurological pain was the strongest contributor. To improve sleep quality of older adults with diabetes, their diabetes symptoms should be comprehensively assessed, and potential contributor to poor sleep such as increased fatigue and neurological pain should be addressed.

Associations between diabetes-related symptoms, glycemic control, and health-related quality of life in adult Samoans

Aim&#x0D; The prevalence of Type 2 diabetes in Samoa has increased substantially over the last 30 years. Identifying common symptoms in those living with diabetes may be instrumental in directing those at risk to seek early evaluation, diagnosis, and treatment. Additionally, identifying associations between diabetes experiences and health-related quality of life is useful for understanding the lived experience of having diabetes in this setting. Here we present the first description of diabetes-related symptoms in an adult cohort of Samoans with diabetes and prediabetes and describe associations between symptom presence and sex, glycemic control (HbA1c ≥ 8.0%), and health-related quality of life (HRQL). We also assessed whether reported symptoms were independently associated, when adjusting for other factors, with increased odds of having diabetes.&#x0D; METHODS&#x0D; Analyses were conducted on n = 123 adult Samoan participants selectively sampled from the observational cohort Soifua Manuia study, and who were living with either prediabetes or diabetes. Participants completed a series of anthropometric, biochemical, and questionnaire measures including the Revised Diabetes Symptoms Checklist (DSC-R) questionnaire between 2017-2019. Differences in symptom presence by sex, diabetes status (prediabetes vs. diabetes), glycemic control (HbA1c &lt; or ≥ 8.0%), and HRQL were assessed using Independent Sample T-tests, Mann Whitney U tests and Chi-square tests of association. Multivariate logistic regression was used to assess which symptoms, when controlling for other factors, were associated with increased odds of having diabetes.&#x0D; RESULTS&#x0D; In a small sample of adult Samoans, we observed high symptom burdens among those with prediabetes and diabetes, and sex differences in the reported impact of diabetes symptoms on health-related quality of life. We identified three specific symptoms – frequent urination, difficulty thinking clearly, and chest/heart pains – that may be useful indicators of diabetes in this setting.&#x0D; DISCUSSION&#x0D; A high prevalence of symptoms was observed among those with prediabetes and among those with diabetes. It is recommended that individuals experiencing any of the measured symptoms seek early evaluation and engage in diabetes self-care behaviors to prevent diabetes-related complications and/or progression to diabetes among those in the early stages of the disease.

Wolfram syndrome 1b mutation suppresses Mauthner-cell axon regeneration via ER stress signal pathway

Wolfram Syndrome (WS) is a fatal human inherited disease with symptoms of diabetes, vision decreasing, and neurodegeneration caused by mutations in the endoplasmic reticulum (ER)-resident protein WFS1. WFS1 has been reported to play an important role in glucose metabolism. However, the role of WFS1 in axonal regeneration in the central nervous system has so far remained elusive. Herein, we established a model of the wfs1b globally deficient zebrafish line. wfs1b deficiency severely impeded the Mauthner-cell (M-cell) axon regeneration, which was partly dependent on the ER stress response. The administration of ER stress inhibitor 4-Phenylbutyric acid (4-PBA) promoted M-cell axon regeneration in wfs1b−/− zebrafish larvae, while the ER stress activator Tunicamycin (TM) inhibited M-cell axon regeneration in wfs1b+/+ zebrafish larvae. Moreover, complementation of wfs1b at the single-cell level stimulated M-cell axon regeneration in the wfs1b−/− zebrafish larvae. Altogether, our results revealed that wfs1b promotes M-cell axon regeneration through the ER stress signal pathway and provide new evidence for a therapeutic target for WS and axon degeneration.

Depressive symptoms mediate the longitudinal association between diabetes and subjective cognitive decline. Findings from a semirural multi-ethnic older population in Malaysia

The potential role of psychological distress as the pathway linking diabetes and subjective cognitive decline (SCD) is still unclear. This study aims to investigate whether depressive symptoms mediate the relationship between diabetes and SCD in older adults. Baseline data from 3428 adults (55–94 years) of the South East Asia Community Observatory (SEACO), Malaysia were utilized. Subjective cognitive complaints (SCC) were recorded at baseline and five years later. Mediation analyses with non-parametric bootstrapping methods were employed. A proportion of 20% of participants without SCC at baseline reported a decline in SCC after 5 years of follow-up. Known diabetes (β = −0.13, SE = 0.05, p = 0.02) and depressive symptoms (ß = −0.18, SE = 0.05, p = 0.001) were independently associated with SCD. Previously diagnosed diabetes was associated with depressive symptoms at baseline (ß = 0.04, SE = 0.02, p = 0.01), and greater SCD at follow-up (β = −0.19, SE = 0.06, p = 0.001). Mediation analyses revealed that 9% of the association between diabetes and SCD was attributable to an indirect effect through depressive symptoms (ß = −0.01, 95% CI 0.02–0.001, p < 0.0001). This study provides further evidence of the detrimental effects of diabetes and depression on subjective cognitive decline. Our findings also suggest that depression is an important pathway linking previously diagnosed diabetes with subjective cognitive decline in older adulthood.

The effect of squalene on cellular energy and inflammation in type 2 diabetes patients

Background: Squalene is a 30-carbon ring hydrocarbon in the triterpene class. Squalene as a bioactive compound has been shown to have several health benefits specifically in the reduction of diabetic symptoms, including anti-inflammatory effects.Objective: The purpose of the study was to examine effect of squalene on specific parameters regarding energy production and inflammation in those with type 2 diabetes mellitus. These parameters included ATP, NAD/NADH, CoQ10, NFκB, IκB-alpha, IκK-alpha, and IκK-beta.Methods: 150 volunteers were selected for this study split into 5 groups. Group 1 contained 30 healthy participants and served as the control. The remaining 120 participants were split into 4 groups containing 30 volunteers each. All the participants in groups 2, 3, 4, and 5 have type 2 diabetes mellitus. Group 2 did not receive any squalene while group 3, group 4, and group 5 all received an oral supplementation of squalene at 200 mg/day, 400 mg/day and 600 mg/day respectively. Participants were prescribed to take the oral supplementation of squalene for a total of 84 days. Blood samples were taken on days 1, 14, 28, 56, and 84 in five time periods. For all participants ATP, NAD/NADH, CoQ10, NFκB, IκB-α, IκK-α and IκK-β levels of all groups were evaluated.Results: Throughout the 84 days there was a statistically significant difference when comparing the healthy group and the diabetic groups in reducing ATP, NAD/NADH and CoQ10 (P &lt; 0.05) and increasing NFκB, IκB-α, IκK-α and IκK-β (P &lt; 0.05). When compared, participants in groups 3, 4, and 5 also showed a statistically significant in the changes of ATP, NFκB, IκB-α, IκK-α and IκK-β levels.Conclusions: Squalene as a bioactive compound can play an important role in reducing inflammatory mediators and increases energy production.Keywords: squalene, diabetes mellitus, ATP production, NAD/NADH, Reactive oxygen species (ROS), CoQ10, NFκB, IkB-α, IκK-α, IκK-β

The effect of squalene on cellular energy and inflammation in type 2 diabetes patients

Background: Squalene is a 30-carbon ring hydrocarbon in the triterpene class. Squalene as a bioactive compound has been shown to have several health benefits specifically in the reduction of diabetic symptoms, including anti-inflammatory effects.Objective: The purpose of the study was to examine effect of squalene on specific parameters regarding energy production and inflammation in those with type 2 diabetes mellitus. These parameters included ATP, NAD/NADH, CoQ10, NFκB, IκB-alpha, IκK-alpha, and IκK-beta.Methods: 150 volunteers were selected for this study split into 5 groups. Group 1 contained 30 healthy participants and served as the control. The remaining 120 participants were split into 4 groups containing 30 volunteers each. All the participants in groups 2, 3, 4, and 5 have type 2 diabetes mellitus. Group 2 did not receive any squalene while group 3, group 4, and group 5 all received an oral supplementation of squalene at 200 mg/day, 400 mg/day and 600 mg/day respectively. Participants were prescribed to take the oral supplementation of squalene for a total of 84 days. Blood samples were taken on days 1, 14, 28, 56, and 84 in five time periods. For all participants ATP, NAD/NADH, CoQ10, NFκB, IκB-α, IκK-α and IκK-β levels of all groups were evaluated.Results: Throughout the 84 days there was a statistically significant difference when comparing the healthy group and the diabetic groups in reducing ATP, NAD/NADH and CoQ10 (P &lt; 0.05) and increasing NFκB, IκB-α, IκK-α and IκK-β (P &lt; 0.05). When compared, participants in groups 3, 4, and 5 also showed a statistically significant in the changes of ATP, NFκB, IκB-α, IκK-α and IκK-β levels.Conclusions: Squalene as a bioactive compound can play an important role in reducing inflammatory mediators and increases energy production.Keywords: squalene, diabetes mellitus, ATP production, NAD/NADH, Reactive oxygen species (ROS), CoQ10, NFκB, IkB-α, IκK-α, IκK-β

The effect of education of patients with type 2 diabetes at risk of covid-19 on symptoms and some metabolic outcomes: A randomized controlled study

ObjectiveType 2 diabetes is one of the most common chronic diseases worldwide. It also has a high risk of morbidity and mortality in the covid 19 pandemic. Due to pandemic measures, disruptions have emerged in the care treatments of patients with type 2 diabetes. The present study aimed to determine the effects of telehealth monitoring and patient training on the symptoms and metabolic outcomes in the patients with type 2 diabetes who are at risk of COVID-19. MethodologyThe current study is in the design of a single-blind randomized controlled trial. Patients were randomized into intervention group (n=41) and control group (n = 44). The patients in the intervention group received diabetes training once a week for the first 4 weeks and every other week for weeks 5–12. No training was given to the control group. The data was collected using the socio-demographic information form, the questionnaire of diabetes treatment, the form of metabolic control variables, and the Diabetes Symptoms Checklist. The data was analyzed with Chi-square, independent samples t-test, and paired sample t-test. ResultsThe mean age of the patients in the control group was 56.86 ± 9.40, and the mean age of those in the intervention group was 54.12 ± 8.32. After the training, a statistically significant difference was found between the checklist averages of the groups in the subscale of hyperglycemia. However, a statistically significant difference was found between the subscales of neurology, cardiology, cognition, hyperglycemia, and the total checklist averages in the intervention group before and after the training (p < 0.05). In the control group, there was a statistically significant difference between the subscale of hyperglycemia and the total checklist averages at the beginning and 3 months later (p < 0.05). ConclusionIt has been determined that the disease training given to the patients with diabetes via telehealth monitoring during the COVID-19 process has a positive effect on the diabetes control of the patients. Health education through telehealth methods can be an effective and cost-effective strategy to support patients with diabetes.

Serum neuron-specific enolase as a biomarker in diagnosing diabetic peripheral neuropathy: A cross-sectional study

Background: Diabetic peripheral neuropathy remains asymptomatic until the late stages. Hence, a need exists for a reliable and sensitive biomarker for the early diagnosis of diabetic peripheral neuropathy. Aims and Objectives: This study aimed to evaluate serum neuron-specific enolase (NSE) reliability as a biomarker in diagnosing diabetic peripheral neuropathy. Materials and Methods: In the department of biochemistry and internal medicine, a cross-sectional study was conducted at Government Villupuram Medical College from May 2018 to January 2020. One hundred diabetes patients with peripheral neuropathy were compared with 100 patients without peripheral neuropathy. A diabetic neuropathy symptom (DNS) questionnaire and diabetic neuropathy examination (DNE) score were used for diagnosis. In addition, vibration position sense and NSE values were compared between the two groups. For statistical analysis, R studio and coGuide were used. Results: Comparisons between groups were based on age, sex, and other baseline parameters. Statistically, significance was observed between the two groups in outcome parameters such as VPB (right), VPB (left), and DNS (P&lt;0.05). There was a weak positive correlation between NSE and DNS (rs value: 0.514, P&lt;0.001). On the other hand, there was a strong positive correlation between NSE and DNE (rs value: 0.937, P&lt;0.001). The NSE of 6.50 and above had a sensitivity of 53% (95%CI 42.76–63.06%) and specificity of 57% (95% CI 46.71–66.86%). Conclusion: NSE acts as a biomarker for diabetic peripheral neuropathy. Therefore, NSE can be used for the early diagnosis of diabetic peripheral neuropathy, thereby preventing a severe form of the disease.

The relationship between vitamin D deficiency and insulin resistance during pregnancy

Background. Vitamin D insufficiency is associated with metabolic complications during pregnancy, including insulin resistance. Physiological processes during pregnancy contribute to increased insulin resistance, which, in turn, is the main symptom of gestational diabetes. There is evidence that excessive weight gain during pregnancy negatively affects the concentration of 25-hydroxyvitamin D (25(OH)D). The aim of the study was to determine the effect of vitamin D insufficiency and deficiency during pregnancy on the occurrence of insulin resistance in the third trimester against the background of excessive weight gain. Materials and methods. The prospective study included 65 pregnant women with a gestation period of up to 20 weeks (on average 17 weeks). At the initial stage, a survey (body weight before pregnancy), and a clinical examination were conducted. Subsequent examinations were carried out in the second (20 weeks) and third (28 weeks) trimesters. Weight gain during pregnancy was calculated as the difference in body weight (between the third and second trimester) divided by the number of gestational weeks in that interval, following the Institute of Medicine guidelines. Gestational weight gain was classified as excessive, taking into account pre-pregnancy body mass index. Predicting the probability of insulin resistance (according to the HOMA-IR) was assessed by the dynamics of body weight gain. Results. Median 25(OH)D in the second and third trimesters of pregnancy was 23 and 24 ng/ml, respectively. Vitamin D insufficiency (25(OH)D &lt; 30 ng/ml) was observed in at least one of the trimesters in 47 (72.3%) pregnant women, while the permanent nature of vitamin D insufficiency was noted in 36 (55.4%) cases. Vitamin D deficiency was established in 8 (12.3%) pregnant women in the second trimester. Excessive weight gain during pregnancy was observed in 34 (52.3%) women. Insulin resistance was determined in 31 (47.7%) pregnant women in the third trimester. The median of immunoreactive insulin concentration and HOMA-IR was higher among women with vitamin D deficiency. Conclusion. Vitamin D insufficiency is associated with insulin resistance in the third trimester of pregnancy, which depends on excessive gestational weight gain.

Effects of empagliflozin on the expression of kisspeptin gene and reproductive system function in streptozotocin-induced diabetic male rats.

One of the main health concerns of diabetes is testicular dysfunction and impairment of reproductive function and sperm quality which can cause male infertility. kisspeptin is a hypothalamic neuropeptide hormone that is involved in the regulation of energy metabolism, gonadotrophin-releasing hormone (GnRH), and reproductive function. In the present study, the therapeutic effects of empagliflozin (sodium-glucose co-transporter 2 inhibitors) on kisspeptin expression along with reproductive function were investigated in diabetic male Wistar rats. Diabetes was induced by a single dose injection of 60 mg/kg streptozotocin. Empagliflozin in doses of 10 and 25 mg/kg body weight was used for 8 weeks. Serum samples, testis, epididymis, and pancreas tissues were collected at the end of the experiments. Lipid profiles, oxidative stress markers, blood hormones, expression of kisspeptin along with pathological alterations of the testis were assayed using real-time PCR, biochemical, and histological technics. Data have shown that empagliflozin improved hyperglycemia, reproductive impairment, oxidative stress condition, and histopathological alterations of pancreatic and testis tissues in diabetic animals. It improved the serum levels of sex hormones, insulin, leptin, and the expression of kisspeptin in the testes tissues. Spermatogenesis is also improved in treated animals. Data indicated that the administration of empagliflozin can ameliorate symptoms of diabetes. It probably has promising antidiabetic potential and may improve the male infertility of diabetic subjects. To our knowledge, this is the first experimental evidence for the potential impact of empagliflozin on kisspeptin expression in diabetic male rats.

Gut microbiota mediated hypoglycemic effect of Astragalus membranaceus polysaccharides in db/db mice.

Gut microbiota has been reported to be closely associated with Type-II diabetes. Restoration of disordered gut microbiota ecosystem has been developed into a therapeutic strategy and gradually applied on Type-II diabetes treatment with both western drugs and herbal polysaccharides. Although Astragalus membranaceus polysaccharides (AMP) have also been used to treat Type-II diabetes, no study investigated correlations between gut microbiota regulation and its hypoglycemic effect. In the present study, the role of gut microbiota on the hypoglycemic effect of AMP in db/db mice was investigated for the first time. Sixteen days treatment of AMP at the dosage of 600mg/kg in db/db mice not only alleviated its diabetic symptoms significantly but also restored its gut microbiota community with increased production of fecal short chain fatty acids (SCFA). Our further Pearson correlation analyses revealed that the relative abundance of two intestinal bacteria, Akkermansia and Faecalibaculum, were significantly positively correlated with the hypoglycemic effect of AMP as well as fecal SCFA production. It was also noted that treatment of AMP resulted in increased secretion of glucagon-like peptide-1 (GLP-1) in serum and enhanced intestinal integrity. Further mechanistic study revealed that the increased SCFA after AMP treatment could stimulate GLP-1 secretion and improve intestinal integrity via enhancing the expression of G protein-coupled receptors 41/43 and tight junction proteins (Occudin and ZO-1), respectively, leading to the alleviation of diabetic symptoms in db/db mice.