Diabetic Individuals Research Articles

Mathematical model for understanding the relationship between diabetes and novel coronavirus

A new model is proposed to explore interactions between diabetes and novel coronavirus. The model accounted for both the omicron variant and variants varying from omicron. The model investigated compartments such as hospitalization, diabetes, co-infection, omicron variant, and quarantine. Additionally, the impact of different vaccination doses is assessed. Sensitivity analysis is carried out to determine disease prevalence and control options, emphasizing the significance of knowing epidemics and their characteristics. The model is validated using actual data from Japan. The parameters are fitted with the help of ”Least Square Curve Fitting” method to describe the dynamic behavior of the proposed model. Simulation results and theoretical findings demonstrate the dynamic behavior of novel coronavirus and diabetes mellitus (DM). Biological illustrations that illustrate impact of model parameters are evaluated. Furthermore, effect of vaccine efficacy and vaccination rates for the vaccine’s first, second, and booster doses is conducted. The impact of various preventive measures, such as hospitalization rate, quarantine or self-isolation rate, vaccine dose-1, dose-2, and booster dose, is considered for diabetic individuals in contact with symptomatic or asymptomatic COVID-19 infectious people in the proposed model. The findings demonstrate the significance of vaccine doses on people with diabetes and individuals infectious with omicron variant. The proposed work helps with subsequent prevention efforts and the design of a vaccination policy to mitigate the effect of the novel coronavirus.

Exploring the diverse therapeutic benefits of metformin: from anti-cancer to anti-inflammation and PCOS management

Background: Metformin is widely prescribed for type 2 diabetes mellitus and is recognized for its therapeutic benefits beyond glycemic control. This review summarizes current data on metformin's diverse roles in various therapeutic contexts, including treating polycystic ovarian syndrome (PCOS), anti-inflammatory effects, and cancer prevention. Method: This comprehensive examination highlights the multifaceted applications of metformin in modern medicine and its potential to enhance the treatment of inflammatory diseases, cancer, and reproductive disorders. Results and Discussion: Metformin's anti-inflammatory properties may benefit autoimmune disorders, neurological diseases, and cardiovascular illnesses. In women with PCOS, metformin aids in restoring menstrual regularity, inducing ovulation, and improving reproductive outcomes by enhancing insulin sensitivity, modulating ovarian function, and reducing hyperandrogenism. Additionally, emerging evidence suggests that metformin may reduce cancer incidence and mortality in diabetic individuals by modulating cellular metabolism, inducing apoptosis, and inhibiting tumor cell proliferation. Conclusion: Our review suggests promising evidence for metformin's role in cancer prevention, reducing inflammation, and managing PCOS. However, further research is required to identify patient subgroups that will benefit most from metformin therapy, elucidate its mechanisms of action, and optimize dosing regimens.

Hyperglycemia in Orthopaedic Trauma Patients: Implications, Management, and Future Directions

Physiologic stress-induced hyperglycemia (SIH) significantly impacts patient outcomes in both non-diabetic and diabetic individuals following orthopaedic trauma. This review synthesizes current literature on SIH's effects, highlighting its association with increased surgical site infections (SSI), extended hospital stays, wound complications, nonunion, need for revision surgery, and mortality. Non-diabetic patients with SIH face worse outcomes compared to euglycemic patients, including a higher risk of deep infections and systemic complications. Diabetic patients experience exacerbated hyperglycemia during trauma, leading to poor wound healing and heightened infection risk. Effective glycemic control, through preoperative optimization, intraoperative monitoring, and postoperative management, is crucial for improving outcomes. Special considerations are discussed for the geriatric population, who are particularly vulnerable to SIH-induced morbidity and mortality. Future directions emphasize developing tailored glycemia management algorithms, utilizing continuous monitoring systems, and fostering multidisciplinary collaboration to optimize care for orthopaedic trauma patients.

The prognostic role of remnant cholesterol in Asian menopausal women received percutaneous coronary intervention with acute coronary syndrome

BackgroundRemnant cholesterol (RC) exert a significant influence on atherosclerotic cardiovascular disease development. However, the prognostic implications of RC in menopausal women received percutaneous coronary intervention (PCI) who experiencing acute coronary syndrome (ACS) remain uncertain.MethodsRC was derived by subtracting the sum of high-density lipoprotein cholesterol and low-density lipoprotein cholesterol from the total cholesterol. Kaplan-Meier survival and Cox regression analysis were employed for assessing the correlation between continuous RC levels and composite and individual adverse events in Q1-Q4 quartiles. Receiver operator characteristic (ROC) curves, derived from Cox regression, were employed for analyzing the relationship between RC and both composite and individual adverse events.Results1505 consecutive menopausal women who underwent PCI and diagnosed with ACS were included. Kaplan-Meier survival analysis demonstrated a progressive reduction in composite adverse event survival rates across the four groups, observed in both the general population and among diabetic individuals, as RC values increased (Log-rank P < 0.001). The analysis of multivariate Cox regression indicated RC remained independently associated with both composite and individual adverse events. ROC analysis showed that RC enhanced the area under the curve both in total and diabetic populations for composite adverse events.ConclusionAmong menopausal women diagnosed with ACS who underwent PCI, heightened levels of RC were found to be independently correlated with an increased occurrence of adverse events.

Fusion protein of FGF21 and elastin-like peptide improves wound healing in diabetic mice via inflammation modulation, collagen synthesis, and vascular network formation

Chronic-healing skin wounds are a common complication in diabetic individuals. To alleviate patient suffering, there is a pressing demand for more effective strategies to expedite the repair of diabetic wounds. Fibroblast growth factor 21(FGF21) has been proven to accelerate wound healing, but its stability and ability to assist in the healing of diabetic ulcers have not met expectations. Therefore, we have fused FGF21 with an elastin-like peptide (ELP) to create a recombinant fusion protein (abbreviated as “ELF”) to increase the bioactivity and stability in vitro or in vivo. Our results demonstrated that ELF significantly improved the efficiency of FGF21 purification due to the inverse temperature responsive phase transition property of ELP. Meanwhile, the fusion strategy did not impair the structure of FGF21 or diminish its activity, as demonstrated by the highly similar secondary structure of ELF and FGF21, and their considerable inhibitory activity in the glucose consumption experiment of Huh-7 cells. An in vitro migration assay revealed that ELF promoted healing more effectively than either free FGF21 or ELP. Further in vivo study revealed the ability of ELF to improve skin wound healing quality, manifested by lower levels of inflammatory factors, more collagen formation and deposition, and the formation of robust vascular networks, though there was no significant difference in healing rate among the ELF, FGF21, and ELP groups. In conclusion, our study indicated that FGF21 and ELP fusion molecules could be developed as more efficient and cost-effective therapeutic strategies for diabetic wound healing.

Antioxidant, In Vitro Cytotoxicity, and Anti-diabetic Attributes of a Drug-Free Guar Gum Nanoformulation as a Novel Candidate for Diabetic Wound Healing.

The escalating intersection of diabetes and impaired wound healing poses a substantial societal burden, marked by an increasing prevalence of chronic wounds. Diabetic individuals struggle with hindered recovery, attributed to compromised blood circulation and diminished immune function, resulting in prolonged healing periods and elevated healthcare expenditures. To address this challenge, we report here a drug-free novel guar gum (GG)-based nano-formulation which is effective against diabetic wound healing. Nanoparticles with an average particle size of 32.4nm display stability with negative zeta potential. Differential scanning calorimetry (DSC) and Fourier transform infrared (FTIR) analysis reveal alterations in thermal properties and molecular structures induced by the nano-particulation process. In vitro studies highlight the antioxidant potential of GGNP through concentration-dependent free radical scavenging activity in DPPH and ABTS assays. The nanoformulation also exhibits inhibitory effects on α-glucosidase and α-amylase enzymes. Cell viability studies have indicated moderate cytotoxicity in L929 cells and significant proliferation and migration in HaCaT cells, suggesting a positive impact on skin cells. In vitro enzymatic activity assessments under hyperglycaemic conditions reveal the potential of GGNP to modulate glutathione-S-transferase (GST), superoxide dismutase (SOD), and catalase activities as well as decreasing lipid peroxidation (LPO) levels, showcasing an antioxidant response. These results suggest GGNP as a promising candidate in diabetic wound healing.

MiR-322-5p is involved in regulating chondrocyte proliferation and differentiation in offspring’s growth plate of maternal gestational diabetes

Pregestational diabetes mellitus (PGDM) has an impact on fetal bone formation, but the underlying mechanism is still obscure. Although miRNAs have been extensively investigated throughout bone formation, their effects on fetal bone development caused by PGDM still need clarification. This study intends to examine the mechanism by which hyperglycemia impairs the bone formation of offspring via miR-322-5p (miR-322). In this study, miR-322 was selected by systemically screening utilizing bioinformatics and subsequent validation experiments. Using streptozotocin (STZ)-induced diabetic mice and ATDC5 cell lines, we found that miR-322 was abundantly expressed in the proliferative and hypertrophic zones of the growth plate, and its expression pattern was disturbed in the presence of hyperglycemia, suggesting that miR-322 is involved in the chondrocyte proliferation and differentiation in absence/presence of hyperglycemia. This observation was proved by manipulating miR-322 expression in ATDC5 cells by transfecting mimic and inhibitor of miR-322. Furthermore, Adamts5, Col12a1, and Cbx6 were identified as the potential target genes of miR-322, verified by the co-transfection of miR-322 inhibitor and the siRNAs, respectively. The evaluation criteria are the chondrocyte proliferation and differentiation and their relevant key gene expressions (proliferation: Sox9 and PthIh; differentiation: Runx2 and Col10a1) after manipulating the gene expressions in ATDC5 cells. This study revealed the regulative role miR-322 on chondrocyte proliferation and differentiation of growth plate by targeting Adamts5, Col12a1, and Cbx6 in hyperglycemia during pregnancy. This translational potential represents a promising avenue for advancing our understanding of bone-related complications in diabetic pregnancy and mitigating bone deficiencies in diabetic pregnant individuals, improving maternal and fetal outcomes.

Effect of 3-hydrazinylquinoxaline-2-thiol hydrogel on skin wound healing process in diabetic rats

Impaired wound healing in diabetic individuals creates huge social and financial burdens for both diabetic patients and the health system. Unfortunately, the current treatment has not resulted in consistently lower amputation rates. Quinoxalines are heterocyclic compounds with multiple important pharmacological properties. Their effect on wound healing have not been closely studied. In the current work, the wound healing effect of 3-hydrazinylquinoxaline-2-thiol hydrogel is tested topically in a full-thickness excision wound in streptozotocin-induced type 1 diabetic rats. We examined the wound closure rate, expression of inflammatory factors, growth factors in addition to the histological analysis. The results revealed a significant acceleration in wound closure in the treated group compared with the control experimental animals. Histological data demonstrated enhanced re-epithelialization and collagen disposition. The healing effect was additionally evaluated by the inhibition of the inflammatory response of interleukin (IL)—1β interleukin (IL)—6, tumor necrosis factor (TNF-α) and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) with a marked improvement of the transforming growth factor beta (TGFβ-1), antioxidant markers and collagen-1. In silico study indicated a favorable drug-like properties and toxicity profile. The present work showed that 3-hydrazinylquinoxaline-2-thiol holds great potential for the treatment of diabetic wounds.

Sports and diabetes - limitations resulting from the disease in people engaging in sports

Diabetes mellitus is a chronic condition that significantly impacts various aspects of daily life, including physical activity and sports participation. This article explores the limitations imposed by diabetes on individuals engaged in sports, examining both type 1 and type 2 diabetes. It discusses how the disease affects physical performance, endurance, and recovery, and highlights the need for careful management of blood glucose levels before, during, and after exercise. The potential risks of hypoglycemia and complications like diabetic neuropathy are addressed, alongside strategies for mitigating these risks through personalized exercise regimens, dietary adjustments, and continuous monitoring. Despite these challenges, the article emphasizes that with proper management and awareness, individuals with diabetes can safely engage in various forms of physical activity, often achieving high levels of performance. The discussion aims to provide athletes, coaches, and healthcare providers with insights into optimizing sports participation for diabetic individuals, promoting both safety and success in athletic endeavors.

Gender Disparities in the Association Between Educational Attainment and Cardiovascular-Kidney-Metabolic Syndrome: Cross-Sectional Study.

Cardiovascular-kidney-metabolic (CKM) health is affected by social determinants of health, especially education. CKM syndrome has not been evaluated in Chinese population, and the association of education with CKM syndrome in different sexes and its intertwined relation with lifestyles have not been explored. We aimed to explore the association between educational attainment and the prevalence of CKM syndrome stages in middle-aged and older Chinese men and women as well as the potential role of health behavior based on Life's Essential 8 construct. This study used data from the nationwide, community-based REACTION (Risk Evaluation of Cancers in Chinese diabetic individuals: a longitudinal study). A total of 132,085 participants with complete information to determine CKM syndrome stage and education level were included. Educational attainment was assessed by the self-reported highest educational level achieved by the participants and recategorized as low (elementary school or no formal education) or high (middle school, high school, technical school/college, or above). CKM syndrome was ascertained and classified into 5 stages according to the American Heart Association presidential advisory released in 2023. Among 132,085 participants (mean age 56.95, SD 9.19 years; n=86,675, 65.62% women) included, most had moderate-risk CKM syndrome (stages 1 and 2), and a lower proportion were at higher risk of CKM (stages 3 and 4). Along the CKM continuum, low education was associated with 34% increased odds of moderate-risk CKM syndrome for women (odds ratio 1.36, 95% CI 1.23-1.49) with a significant sex disparity, but was positively correlated with high-risk CKM for both sexes. The association between low education and high-risk CKM was more evident in women with poor health behavior but not in men, which was also interactive with and partly mediated by behavior. Low education was associated with adverse CKM health for both sexes but was especially detrimental to women. Such sex-specific educational disparity was closely correlated with health behavior but could not be completely attenuated by behavior modification. These findings highlight the disadvantage faced by women in CKM health ascribed to low education, underscoring the need for public health support to address this inequality.

From Evaluation to Prediction: Analysis of Diabetic Autonomic Neuropathy Using Sudoscan and Artificial Intelligence

A dangerous side effect of diabetes that can significantly lower quality of life and raise the death rate of diabetic individuals is diabetic autonomic neuropathy. It is essential to identify and anticipate this disease early on for prompt intervention and care. This study aims to predict this diabetic complication using Sudoscan and artificial intelligence. In this study, 172 individuals with type 1 or type 2 diabetes mellitus provided clinical and demographic information. Sudoscan was used to evaluate the subjects’ sudomotor dysfunction. Statistical methods were used to link various electrochemical skin conductance values with risk factors for neuropathy such as age, BMI, age of diabetes, or biochemical values such as cholesterol and triglycerides. Different machine-learning algorithms were used to predict the risk of diabetic autonomic neuropathy based on the collected data. The accuracy achieved with Logistic Regression is 92.6%, and with the Random Forest model is 96.3%. Lazzy Classifiers also show that six classifiers have a high performance of 97%. Thus, the use of machine learning algorithms in this field of metabolic diseases offers new perceptions for diagnosis, treatment, and prevention, and improves the quality of life of diabetic patients by reducing the incidence of complications related to this disease.

The influence of diabetes on sleep-derived cardiorespiratory features of the finger pulse wave signal – The population-based SCAPIS study

Study objectivesAdvanced signal processing of photoplethysmographic data enables novel analyses which may improve the understanding of the pathogenesis of dysglycemia associated with sleep disorders. We aimed to identify sleep-related pulse wave characteristics in diabetic patients compared to normoglycemic individuals, independent of cardiovascular-related comorbidities. MethodsThis cross-sectional evaluation of the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) included overnight oximetry-derived pulse wave data from 3997 subjects (45 % males, age 50–64 years). Metabolic status was classified as normoglycemic (n = 3220), pre-diabetic (n = 544), or diabetic (n = 233). Nine validated pulse wave features proposed to influence cardiovascular risk were derived and compared between metabolic status groups. Logistic prediction models and genetic matching were applied to capture diabetes-related pulse wave characteristics during sleep. The model was controlled for anthropometrics, lifestyle, sleep apnea, and in the final adjustment even for cardiometabolic factors like dyslipidaemia, hypertension, and coronary artery calcification. ResultsPulse wave-derived parameters differed between normoglycemic and diabetic individuals in eight dimensions in unadjusted as well as in the partially adjusted model (anthropometric factors and sleep apnea, p ≤ 0.001). All covariates confirmed significant differences between normoglycemic and diabetic subjects (all p ≤ 0.001). Reduced cardio-respiratory coupling (respiratory-related pulse oscillations) (β = −0.010, p = 0.012), as well as increased vascular stiffness (shortened pulse propagation time (β = −0.015, p = 0.001), were independently associated with diabetes even when controlled for cardiometabolic factors. These results were confirmed through a matched cohort comparative analysis. ConclusionsPhotoplethysmographic pulse wave analysis during sleep can be utilized to capture multiple features of modified autonomic regulation and cardiovascular consequences in diabetic subjects. Dampened heart rate variability and increased vascular stiffness during sleep showed the strongest associations with diabetes.

High-fiber diet reduces bone formation but does not affect bone microarchitecture in type 2 diabetes individuals.

Bone fragility is a recognized complication of type 2 diabetes mellitus (T2DM), increasing patient morbidity. Thus, the development of an effective intervention to prevent diabetic bone fragility is urgently needed. As lifestyle intervention represents an effective option for diabetes management, it may have an impact on bone health. While studies have shown a beneficial effect of dietary fiber in T2DM management, its effect on bone health is still unclear. Thus, we investigated the impact of a high-fiber diet on bone and glucose control in men and women with T2DM. Forty-five T2DM patients (HbA1c: 6.5% ± 0.49%, age: 74 ± 7.29yr) scheduled for hip arthroplasty were randomly assigned to follow a high-fiber diet (38g/day) or to make no diet changes for 12wk. Interestingly, BMI decreased by 4% (p <.0001) and HbA1c by 3.4% (p <.0001) in the high-fiber diet group, but did not decrease in the control group. However, serum concentration of the bone formation marker procollagen type 1 amino-terminal propeptide (P1NP) decreased by 8.6 % in the high-fiber diet group (p =.0004), whereas it remained unchanged in the control group. In contrast, similar to the control group, serum concentration of the bone resorption marker C-terminal telopeptide of type I collagen (CTX) concentrations did not change in the high-fiber diet group. Bone microCT analysis revealed no changes in trabecular and cortical bone parameters between the high-fiber diet and control groups. Similarly, real-time (RT)-PCR analysis in bone tissue showed no changes in the gene expression of Wnt pathway-related genes (Sost, Dkk-1, Wnt10b, and Lef-1), bone formation markers (Runx2, Col1a1, and Ocn), and inflammatory cytokines (IL-6, IL-8, TNF-α, and IL-10) between the two groups. Our findings suggest that 12-wk high-fiber diet intervention improves metabolic outcomes in patients with T2DM. However, it may reduce bone formation without affecting bone microarchitecture or Wnt pathway regulation.

The Impact of Smoking and Hypertension on Cataract Development in Diabetic Patients

Background Cataracts are a leading cause of visual impairment and blindness globally, with a particularly high incidence in diabetic patients due to the complex interplay of metabolic dysregulation and hyperglycemia-induced oxidative stress. Diabetic cataract development is influenced by several modifiable risk factors including smoking and hypertension, which may exacerbate lens opacity through various biological mechanisms. This study aims to determine the effects of smoking and hypertension on cataract development in diabetic patients. Methods Conducted from December 2022 to November 2023, this cross-sectional study at a specialized diabetes and ophthalmology healthcare facility involved 60 diabetic patients. The participants were divided into two groups: those with cataracts (n=32) and those without (n=28). Data collection focused on demographics, smoking history, hypertension status, and cataract presence, using structured interviews and medical record reviews. Logistic regression was employed to analyze the association between cataracts and potential risk factors, adjusting for age, diabetes duration, and glycemic control. Results Age and genderfi were not significantly different between the two groups, with mean ages of 50.21±14.34 years in the cataract group and 49.41±12.15 years in the non-cataract group (P=0.087). The prevalence of smoking was similar between those with cataracts (14.3%) and without (15.6%), showing no significant association (P=0.885). Hypertension was more prevalent in the cataract group (71.4%) compared to the non-cataract group (53.1%), although this difference was not statistically significant (P=0.146). Logistic regression analysis indicated that smoking had a minimal effect on cataract development (OR=1.187; 95% CI=0.264-5.33; P=0.823), and while hypertension showed a stronger association (OR=2.277; 95% CI=0.749-6.92), it also lacked statistical significance (P=0.147). Conclusion Neither smoking nor hypertension showed significant associations with cataract development. These findings suggest that the influence of these factors on cataract progression may differ in diabetic individuals due to the complex interplay of metabolic and vascular changes associated with the condition.

Optimal cut-off points of anthropometric and body roundness indices associated with diabetes: Persian (Shahedieh) cohort study.

Diabetes is a chronic and concerning health condition that poses a significant public health challenge. Given that preventing, detecting early, and treating T2DM can enhance public health outcomes, the objective of this study was to identify the most effective obesity indices and determine their optimal cut-off points for predicting the risk of T2DM in an Iranian population. This study was conducted on 8,019 male and female participants aged between 35 and 70 years in the context of Shahedieh cohort study. The ROC curve analysis was utilized to determine the optimal cut-off point of each anthropometric index to predict diabetes in age-sex categories. The overall diabetes incidence in the study population was 2.5%, with 2.5% in men and 2.4% in women. In men, significant differences in most of the anthropometric indices were observed between diabetic individuals and healthy counterparts. This study found that for women 45-65, BMI and weight, and for men under 65 years, weight, WHR, BMI, WC, WHTR, AVI, and BRI are efficient T2DM predictors. The AUC of these indices varied from 0.593 (95% CI: 0.510-0.676) to 0.668 (95% CI: 0.586-0.750) in men, and from 0.587 (95% CI: 0.510-0.664) to 0.644 (95% CI: 0.535-0.754) in women. Anthropometric indices and body roundness are simple, inexpensive, and noninvasive means markers to predict the risk of diabetes. Our findings show that most of the studied indices had acceptable prediction power for men except for elderly. For women over 45 years old, weight and BMI are appropriate predictors. It seems that the approach of reducing diabetes incidence through early detection and primary prevention is achievable.

Role of Urinary Matrix Metalloproteinase-7 (MMP-7) as an Early Marker of Renal Dysfunction in Diabetic Individuals: A Cross-Sectional Study.

The matrix metalloproteinase 7(MMP-7) level gets heightened in the urine samples of diabetic individuals with impaired renal function. Renal biopsy is seldom offered because of its invasive nature. These concerns spurred the investigation of relationships between urine MMP-7 levels and the renal function of diabetic individuals. Studies exploring this aspect are scarce. We aimed to evaluate the glycemic and renal parameters of female and male individuals with or without type 2 diabetes mellitus (T2DM) or kidney disease. We also assessed the correlation of urine MMP-7 with various parameters. This prospective, analytical, cross-sectional study was conducted at Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, India, from February 2020 to January 2023. Female and male individuals 18-85 years of age diagnosed with either T2DM, hypertension, or kidney disease were assessed for their glycemic indices and renal parameters. Those with both renal disease and T2DMwere placed in group A. The diabetic individuals without kidney disease constituted group B. People in group C had neither kidney disease nor T2DM. Patients in group D had kidney disease but were not diabetics. The parameters of the male and female participants in each of the four groups were assessed and compared, including: age, body mass index (BMI), fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), serum urea, serum creatinine, estimated glomerular filtration rate (eGFR), urine albumin, urine creatinine, urine albumin-creatinine ratio (ACR), serum sodium, serum potassium, and urine MMP-7 levels. Furthermore, we correlated urine MMP-7 with all these traits. We used R software (version 4.4.0, Vienna, Austria) for data analysis. Two hundred eighty-seven (87.5%) of the 328 individuals we screened were eligible. Of them, group A had the maximum number (94) of participants, followed by B (75), C (65), and D (53). Males comprised 60.3% (n = 173) of the study population. The median age of the participants was 52.0 (44.0-61.1) years. The intergroup variations were statistically significant (p < 0.001) owing to their glycemic status and renal function. The gender-basis comparison of FBS and HbA1c yielded non-significant differences. On the contrary, assessment of the renal parameters revealed significant differences (p < 0.001) between females and males. The study population had a median urine MMP-7 level of 19.9 (1.1-50.5) µg/L. Significant associations with urine MMP-7 were found with serum creatinine (r = 0.91, p < 0.001), urine ACR (r = 0.86, p < 0.001), and eGFR (r = -0.84, p < 0.001). Our study portrayed that male diabetics, in comparison to female diabetics, had greater levels of urine ACR, urine MMP-7, eGFR, and serum creatinine. Moreover, urine ACR, eGFR, and serum creatinine strongly correlated with the urine MMP-7 level.

Dietary inflammation influences the prevalence of cardiovascular diseases in prediabetes and diabetes patients: findings from the National Health and Nutrition Examination Survey (NHANES 2001–2018)

Prediabetes is an early phase before diabetes. Diabetes and dietary inflammation are two crucial factors that are strongly associated with cardiovascular diseases (CVDs). Dietary interventions slowed the progression of diabetes and CVD. However, the associations between CVDs and dietary inflammation in different stages of pathoglycaemia have not been investigated. To explore the effect of a proinflammatory diet on CVD incidence at different stages of diabetes, NHANES (2001–2018) data were collected and analysed. A total of 3137 CVD patients with a comparable non-CVD group (n = 3137) were enrolled after propensity score matching (PSM) analysis. These patients were subsequently categorized into three subgroups: those with diabetes (n = 3043), those with prediabetes (n = 1099) and those with normoglycemia (n = 2132). The DII (Dietary inflammatory index) is a risk factor for CVD, both in overall individuals and in each subgroup of population-based information. In diabetic individuals, the odds ratios (ORs) (95% CIs) of CVD incidence for the DII were 1.10 (1.05, 1.15) and 1.08 (1.03, 1.13) according to the crude and adjusted models, respectively. For individuals with prediabetes, the ORs (95% CIs) of CVD risk for DII were 1.05 (0.97, 1.14) and 1.11 (1.01, 1.22) according to the crude and adjusted models, respectively. After adjusting for population-based information and hypertension status, the DII appeared to have the highest OR for individuals with prediabetes, and no significant association was found between the DII score and CVD risk in the normoglycemia group. Moreover, the OR of CVD for DII in the uncontrolled diabetes group was 1.06 (0.98, 1.16)*. These results suggest that the DII is more closely associated with the risk of CVDs in prediabetic and diabetic populations, and we should pay more attention to diet control before a person develops diabetes to prevent CVD progression.

Serum NT-proBNP levels in diabetes and its association with obesity, inflammation and glycemic status

Background: Type 2 diabetes mellitus (T2DM) patients are more prone to develop cardiovascular complications, and there is a dire need of a routine screening tool for risk assessment of heart failure (HF) in them. Aims and Objectives: The current study was conducted to estimate the levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations in subjects with and without T2DM and evaluate the association between NT-proBNP and body mass index (BMI), waist circumference as markers of obesity, hemoglobin A1c (HbA1c), plasma fasting blood sugar (FBS), plasma postprandial blood sugar (PPBS),duration of diabetes as markers of glycemic control and serum C-reactive protein (CRP),an inflammatory marker in diabetic subjects. Materials and Methods: A hospital-based cross-sectional non-interventional study was done with 82 non-diabetic healthy volunteers and 82 T2DM patients. Anthropometric measurements (waist circumference [WC] and body mass index [BMI]) were recorded, and blood was analyzed for serum NT-proBNP, C-reactive protein (CRP), plasma fasting blood sugar (FBS), postprandial blood sugar (PPBS), and hemoglobin A1c (HBA1c). Data collected were analyzed by statistical software with P&lt;0.05 as the significance level. Results: Serum NT-proBNP level was significantly higher in diabetic group (P&lt;0.001) compared to non-diabetic group statistically. Correlation analysis in diabetic subjects showed a significant positive correlation of NT-proBNP with CRP (ρ+0.576, P&lt;0.001), duration of diabetes (ρ+0.780, P&lt;0.001), plasma FBS (ρ+0.524, P=0.003), plasma PPBS (ρ+0.673, P=0.013), and HbA1c (ρ+0.571, P=0.001) but there was no statistically significant correlation of NT-proBNP with BMI or WC values although the correlation was negative for both. Conclusion: The present study provides a novel perspective that measuring serum NT-proBNP may help in the earlier identification of impending HF in diabetic individuals assisting in prompt intervention which may be further confirmed by larger studies.

Bacteroides uniformis Ameliorates Carbohydrate and Lipid Metabolism Disorders in Diabetic Mice by Regulating Bile Acid Metabolism via the Gut-Liver Axis.

Type 2 diabetes mellitus (T2DM) is a metabolic syndrome characterized by chronic inflammation, insulin resistance, and islet cell damage. The prevention of T2DM and its associated complications is an urgent public health issue that affects hundreds of millions of people globally. Numerous studies suggest that disturbances in gut metabolites are important driving forces for the pathogenesis of diabetes. However, the functions and mechanisms of action of most commensal bacteria in T2DM remain largely unknown. The quantification of bile acids (BAs) in fecal samples was performed using ultra-performance liquid chromatography-tandem mass spectrometer (UPLC-MS/MS). The anti-diabetic effects of Bacteroides uniformis (B. uniformis) and its metabolites cholic acid (CA) and chenodeoxycholic acid (CDCA) were assessed in T2DM mice induced by streptozocin (STZ) plus high-fat diet (HFD). We found that the abundance of B. uniformis in the feces and the contents of CA and CDCA were significantly downregulated in T2DM mice. B. uniformis was diminished in diabetic individuals and this bacterium was sufficient to promote the production of BAs. Colonization of B. uniformis and intragastric gavage of CA and CDCA effectively improved the disorder of glucose and lipid metabolism in T2DM mice by inhibiting gluconeogenesis and lipolysis in the liver. CA and CDCA improved hepatic glucose and lipid metabolism by acting on the Takeda G protein-coupled receptor 5 (TGR5)/adenosine monophosphate-activated protein kinase (AMPK) signaling pathway since knockdown of TGR5 minimized the benefit of CA and CDCA. Furthermore, we screened a natural product-vaccarin (VAC)-that exhibited anti-diabetic effects by promoting the growth of B. uniformis in vitro and in vivo. Gut microbiota pre-depletion abolished the favorable effects of VAC in diabetic mice. These data suggest that supplementation of B. uniformis may be a promising avenue to ameliorate T2DM by linking the gut and liver.

Effect of Verapamil on Glycemic Control in Type 2 Diabetic Hypertensive Patients in Saudi Arabia: A Quasi Experimental Study.

Type 2 diabetes is a common chronic disease that continues to increase in prevalence globally and is a major healthcare burden. Diabetes and hypertension frequently occur concurrently, and the use of antihypertensive agents is common in diabetic patients. One antihypertensive agent, verapamil, has tentatively shown potentially positive effects on glycemic control in assorted pre-clinical models. To evaluate the effect of verapamil on glycemic control in hypertensive type 2 diabetic patients. Type 2 diabetic hypertensive patients were recruited from King Fahad Medical City, Riyadh, KSA, to receive oral verapamil therapy. Blood pressure and glycometabolic parameters, including fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), C-peptide, and homeostatic model assessment insulin resistance (HOMA-IR), were monitored at baseline and after 6 months of verapamil therapy. Thirty-five patients (16 male, 19 female) with a mean age of 57.2 years were recruited. The use of verapamil was associated with non-significant decreases in HbA1c, FPG, C-peptide, and HOMA-IR. However, a sub-group of 17 participants showed a decrease in HbA1c that was ≥0.5%. Univariate logistic regression showed that baseline BMI, HOMA-IR, and C-peptide were significantly (P < 0.05) associated with HbA1c reductions of ≥0.5%. Verapamil is metabolically neutral and allows the stabilization of glycometabolic parameters in type 2 diabetic individuals. Additional research exploring the mechanism behind the variable response to verapamil therapy is warranted.