Diabetes Prevention Research Articles

Community-engaged Systems for Population Health Improvement: A Novel Approach to Improve Diabetes Outcomes in Rural Communities

BackgroundApproaches to prevent and manage diabetes at a community population level are hindered because current strategies are not aligned with the structure and function of a community system. We describe a community-driven process based on local data and rapid prototyping as an alternative approach to create diabetes prevention and care management solutions appropriate for each community. We report on the process and provide baseline data for a 3-year case study initiative to improve diabetes outcomes in two rural Nebraska communities.MethodsWe developed an iterative design process based on the assumption that decentralized decision-making using local data feedback and monitoring will lead to the innovation of local sustainable solutions. Coalitions act as community innovation hubs and meet monthly to work through a facilitated design process. Six core diabetes measures will be tracked over the course of the project using the electronic health record from community clinics as a proxy for the entire community.ResultsBaseline data indicate two-thirds of the population in both communities are at risk for prediabetes based on age and body mass index. However, only a fraction (35% and 12%) of those at risk have been screened. This information led both coalitions to focus on improving screening rates in their communities.DiscussionIn order to move a complex system towards an optimal state (e.g., improved diabetes outcomes), stakeholders must have access to continuous feedback of accurate, pertinent information in order to make informed decisions. Conventional approaches of implementing evidence-based interventions do not facilitate this process.

Examining the Impact of a Behavior Modification Program on Disease Prevention Behaviors among Individuals at Risk of Diabetes: A Quasi-Experimental Investigation.

This study aimed to develop and test a behavior modification intervention to prevent type 2 diabetes (T2DM) among at-risk individuals. The primary goal was to compare diabetes prevention behaviors and fasting blood sugar levels between the intervention and comparison groups. This study utilizes a quasi-experimental design to develop a behavior modification intervention for preventing diabetes. It involves two groups, each with pre- and post-intervention assessments, comprising 60 at-risk individuals equally divided into intervention and comparison groups. The 8-week intervention includes components like risk assessment, dietary skill enhancement, exercise, stress management, and social media platforms (data recording training, follow-up visits, reminders, and visual aids). Data collection includes self-administered questionnaires and blood sugar level measurements. Statistical analysis involved paired t-tests for within-group comparisons and independent t-tests for between-group differences. The findings showed that the intervention group achieved significantly higher average scores in nutrition, exercise, and stress management, and had significantly lower average blood sugar levels compared to the comparison group. These results suggest that healthcare providers and policymakers should develop community health programs and public health policies that incorporate integrative care, leverage social media platforms, and foster collaboration with other health professionals to improve outcomes for individuals at risk of T2DM.

Real-world impacts from a decade of Quality Enhancement Research Initiative-partnered projects to translate the Diabetes Prevention Program in the Veterans Health Administration.

To describe the impacts of four Veterans Health Administration (VA) Quality Enhancement Research Initiative (QUERI) projects implementing an evidence-based lifestyle intervention known as the Diabetes Prevention Program (DPP). 2012-2024 VA administrative and survey data. This is a summary of findings and impacts from four effectiveness-implementation projects focused on in-person and/or online DPP across VA sites. Patient demographics, participation data, and key findings and impacts were summarized across reports from the VA Diabetes-Mellitus Quality Enhancement Research Initiative (QUERI-DM) Diabetes Prevention Program (VA DPP) Trial, QUERI-DM Online DPP Trial, the Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) QUERI DPP Project, and EMPOWER 2.0 QUERI Program. Between 2012 and 2024, four VA QUERI studies enrolled 963 Veterans in DPP across 16 VA sites. All participants had overweight/obesity with one additional risk factor for type 2 diabetes (i.e., prediabetes, elevated risk score, or history of gestational diabetes) and 56% (N = 536) were women. In addition to enhancing the reach of and engagement in diabetes prevention services among Veterans, these projects resulted in three key impacts as follows: (1) informing the national redesign of VA MOVE! including recommendations to increase the number of MOVE! sessions and revise guidelines across 150+ VA sites, (2) enhancing the national evidence base to support online DPP delivery options with citations in national care guidelines outside VA, and (3) demonstrating the importance of gender-tailoring of preventive care services by and for women Veterans to enhance engagement in preventive services. Over the past decade, the evolution of VA QUERI DPP projects increased the reach of and engagement in diabetes prevention services among Veterans, including women Veterans who have been harder to engage in lifestyle change programs in VA, and resulted in three key impacts informing type 2 diabetes and obesity prevention efforts within and outside of VA.

Analysis of traditional Chinese medicine syndrome elements and clinical symptoms in prediabetes: A systematic review.

Prediabetes mellitus (PDM) and impaired glucose regulation precedes diabetes and serve as early warning signals. A 2018 Chinese epidemiological survey reported prediabetes at 25.5% prevalence and type 2 diabetes at 10.8%, respectively. Untreated carries one-third of the risk of diabetes progression. This study aimed to understand traditional Chinese medicine syndromes in PDM to guide clinical practice and diabetes prevention. We systematically searched the Chinese and English literature in PubMed, EMBASE, Sinomed, CNKI, VIP, Wanfang until March 31, 2023. We manually explored the Chinese prediabetes literature, trial registrations, and references, adhering to predefined criteria. The results were independently summarized by 2 researchers. Statistical analysis was performed using EXCEL, IBM SPSS 27.0, and IBM SPSS Modeler 18.0, with data mining techniques including association and cluster analysis. Analysis of 23 clinical trials (8943 patients) identified phlegm dampness syndrome as predominant, with qi deficiency, dampness, and phlegm as the principal pathogenic elements. Spleen syndrome elements dominated, with a priori correlation analysis favoring spleen dampness. The prevalent PDM clinical symptoms include amnesia, mental fatigue, limb fatigue, dizziness, and lumbar discomfort. Prediabetes is strongly associated with spleen dampness, highlighting its role. Common traditional Chinese medicine syndrome elements include qi deficiency, phlegm, and dampness. Clinical diagnosis and treatment should prioritize syndrome differentiation and emphasize spleen-focused approaches. Although limited research exists on prediabetes syndromes, further exploration of PDM and spleen dampness is crucial.

PROGNOSTIC VALUE OF IMMUNE PREDICTORS OF DIABETIC RETINOPATHY AGAINST THE BACKGROUND OF THE METABOLIC SYNDROME

Global statistics of recentyear sindicate a rapidin creasein the in cidence of diabetesamong the population. In thisregard, diabetic retinopathy, the main complication of diabeteson the part of the organ of vision, occupiesone of the leading placesamong the knowncauses o freducedvision and blindness, and the number of cases of visionlossas a result of this complication main tains a steady trend of constant growth. But the most significant and widespreadcause of visionlossin diabetesis pathology of the retina (diabetic retinopathy). The refore, itisrelevantto study immunological predictors for the purpose of time lydiagnosis, prevention of complications and prevention of the development of this disease. Thus, itisclear from the abovethatvariou schemokines and the irreceptors play animportantrolein the pathogenesis of diabetes in humans. The ypartici patein the autoimmune processin the islets of Langerhans of the pancreas, starting from the earlylatenttothe clinical stage of the disease, directing the flow of variousantigen-dependent effector cells from the blood totheinsulitis, whichsecrete a spectrum of pro-inflammatory cytokines, whichlead stoapoptosis and necrosisof β-cells. Atthesametime, inthefuture, in the distantstages of the development of diabetes, chemokines canparticipatein the occurrence of inflammatory complications characteristic of this disease, especiall ymicro- and macro angiopathy: retino- and nephropathy, atherosclerosis and cardiovascular diseases. The existence of such scientific information and fur the study of this issue open upnew wayst ocreate methods of targeted immunotherapy and prevention of diabetes and itscomplications by specific blockade of certainlinks of immunemechanism sinwhich chemokines and their receptors participate.

Heterogeneous Effects of Intensive Glycemic and Blood Pressure on Cardiovascular Events Among Diabetes by Living Arrangements.

Although living alone versus with others is a key social element for cardiovascular prevention in diabetes, evidence is lacking about whether the benefit of intensive glycemic and blood pressure (BP) control differs by living arrangements. We thus aim to investigate heterogeneity in the joint effect of intensive glycemic and BP control on cardiovascular events by living arrangements among participants with diabetes. This study included 4731 participants with diabetes in the ACCORD-BP (Action to Control Cardiovascular Risk in Diabetes-Blood Pressure) trial. They were randomized into 4 study arms, each with glycated hemoglobin target (intensive, <6.0% versus standard, 7.0-7.9%) and systolic BP target (intensive, <120 mm Hg versus standard <140 mm Hg). Cox proportional hazard models were used to estimate the joint effect of intensive glycemic and BP control on the composite cardiovascular outcome according to living arrangements. At a mean follow-up of 4.7 years, the cardiovascular outcome was observed in 445 (9.4%) participants. Among participants living with others, intensive treatment for both glycemia and BP showed decreased risk of cardiovascular events compared with standard treatment (hazard ratio [HR], 0.68 [95% CI, 0.51-0.92]). However, this association was not found among participants living alone (HR, 0.96 [95% CI, 0.58-1.59]). P for interaction between intensive glycemic and BP control was 0.53 among participants living with others and 0.009 among those living alone (P value for 3-way interaction including living arrangements was 0.049). We found benefits of combining intensive glycemic and BP control for cardiovascular outcomes among participants living with others but not among those living alone. Our study highlights the critical role of living arrangements in intensive care among patients with diabetes.

A deep neural network prediction method for diabetes based on Kendall's correlation coefficient and attention mechanism.

Diabetes is a chronic disease, which is characterized by abnormally high blood sugar levels. It may affect various organs and tissues, and even lead to life-threatening complications. Accurate prediction of diabetes can significantly reduce its incidence. However, the current prediction methods struggle to accurately capture the essential characteristics of nonlinear data, and the black-box nature of these methods hampers its clinical application. To address these challenges, we propose KCCAM_DNN, a diabetes prediction method that integrates Kendall's correlation coefficient and an attention mechanism within a deep neural network. In the KCCAM_DNN, Kendall's correlation coefficient is initially employed for feature selection, which effectively filters out key features influencing diabetes prediction. For missing values in the data, polynomial regression is utilized for imputation, ensuring data completeness. Subsequently, we construct a deep neural network (KCCAM_DNN) based on the self-attention mechanism, which assigns greater weight to crucial features affecting diabetes and enhances the model's predictive performance. Finally, we employ the SHAP model to analyze the impact of each feature on diabetes prediction, augmenting the model's interpretability. Experimental results show that KCCAM_DNN exhibits superior performance on both PIMA Indian and LMCH diabetes datasets, achieving test accuracies of 99.090% and 99.333%, respectively, approximately 2% higher than the best existing method. These results suggest that KCCAM_DNN is proficient in diabetes prediction, providing a foundation for informed decision-making in the diagnosis and prevention of diabetes.

Study to Determine the Barriers in the Implementation of the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke in Satara District, Maharashtra: A Stakeholder’s Perspective

Abstract Background: The Government of India started the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS) in 2009, which was implemented in Satara district since 2014. To identify gaps and difficulties in the implementation of this program, the present study was planned with the following objective. Objectives: The objective of this study was to determine the barriers in the implementation of the NPCDCS program from a stakeholder’s perspective. Methodology: This facility-based cross-sectional study was conducted in different health facilities (30), and 96 staff working for the NPCDCS program were interviewed using a pretested and semi-structured questionnaire. Informed consent was drawn from stakeholders. The study was approved by the Institutional Ethics Committee. Statistical analysis was carried out using the SPSS version 20. Results: While 96 responders were interviewed, with a mean age of 36.55 years, 82.3% were women among them. The majority of them were working as ASHA (39.6%). Among them 73 (76.0%) had more than 3 years of program experience; however, most of them had contractual jobs, 64 (87.7%). Among perceived barriers satisfaction with the number of staff provided for the program, 60 (62.5%), satisfaction with the training of human resources, 47 (41.7%), and supply of medicine to facility, 38 (39.6%), were predominant. Conclusion: For effective implementation of NPCDCS, focusing on the supply of good-quality medicine in ample quantity is a must; lack of which will definitely push the beneficiaries away. Providing repetitive essential training to the program health workers will improve program staff performance. Increasing the number of staff provided for the program will help stakeholders to give more time toward this program, particularly to improve service delivery and ensure program success.

Diabetes Mellitus as a Risk Factor for Tuberculosis: A Community Based Case Control Study.

Prevention of diabetes in the general population can help reduce the incidence of tuberculosis. Hence it is necessary to document that diabetes is strongly associated with tuberculosis as a risk factor. To study if diabetes is associated with tuberculosis compared to controls. A community based case-control study was carried out. 215 newly diagnosed cases of tuberculosis on treatment for not more than three months were selected randomly from the randomly selected tuberculosis unit. 215 neighbourhood controls were selected. They were matched for the age group of ± 10 years and sex. Fasting blood sugar (FBS) was estimated using a glucometer. Tobacco chewing, residence and family history of TB were significantly more in cases (P < 0.05). Mean BMI was significantly lower in cases compared to controls. The proportion of TB cases among the known cases of diabetes was 67% compared to 33% in controls, which was statistically significant. Mean FBS was significantly higher in cases compared to controls (P < 0.05). The odds of cases being diabetic was 2.456 times more than those of controls. On binary logistic regression, diabetes was an independent risk factor for tuberculosis. Other independent risk factors were tobacco chewing, and family history of TB. Family history of tuberculosis, and tobacco chewing were positively associated with tuberculosis whereas body mass index was negatively associated with tuberculosis. Diabetes was significantly associated with tuberculosis.

Whole Foods for Prediabetes: Feasibility and Acceptability of a Dietary Guidelines-Based Intervention for Type 2 Diabetes Prevention in Families

Whole Foods for Prediabetes: Feasibility and Acceptability of a Dietary Guidelines-Based Intervention for Type 2 Diabetes Prevention in Families

Educational Model and Prevention on Prediabetes: A Systematic Review.

Prediabetes is a reversible condition before the onset of Type 2 Diabetes Mellitus. Untreated condition of prediabetes will develop into diabetes and its complications. The prevalence of prediabetes has been emerging worldwide and has a considerable socioeconomic impact. The current study reviews the roles of early detection, educational models, life modification, and prophylaxis of individuals with prediabetes in preventing the progression of prediabetes into Type 2 Diabetes Mellitus and complications in the future. This study included published articles from several electronic databases. The obtained articles were limited to March 2023. Articles that were not open access and not in Indonesian or English were excluded. The protocol for this study used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020. Of 39627 articles, 39601 were excluded due to duplication and did not meet the eligibility criteria. At the final, there were 26 articles that were eligible for systematic review. Prevention of the development of prediabetes into diabetes is essential. A comprehensive understanding and training on intensive lifestyle modification protocols from local and national experts in diabetes prevention through digital-based education models and linguistically and culturally approach can be considered. Intensive lifestyle modification and pharmacological approaches may improve the outcome. Regular monitoring of glycemic control is also important for early diagnosis of diabetes, especially in patients with special conditions.

Challenges in Type 2 Diabetes Prevention among Senior High School Students: A Qualitative Study.

Schools, a place where students spend much more time than home, play an important role in preventing the nation's future generation from type 2 diabetes mellitus (T2DM). This study aimed to explore challenges in T2DM prevention among senior high school students. The study was conducted in Riau Province, Indonesia, from June to August 2023 using a qualitative content analysis. 31 respondents, determined by data saturation, were recruited using purposeful sampling. They were public senior high schools' principals, vice principals, school health services staff, school canteen tenants, students, parents, and primary health care personnel in six districts. Data were collected through semi-structured face-to-face interviews and document review. Graneheim and Lundman's content analysis method was used to analyze the data in Nvivo version 11 software. The Lincoln and Guba Qualitative research criteria for trustworthiness were used to ensure the rigor of the study. The main concepts obtained from the data were classified into three themes entitled, "Nonoptimal existing diabetes prevention programs in schools", "Inadequate knowledge of school community on T2DM", and "Inadequate policies to prevent diabetes in schools". An evidence-based, well-organized, and systematic school-based diabetes prevention program is fundamental to help overcome challenges and prevent future T2DM incidence. It requires relevant stakeholders' high level of awareness, strong collaborations with the school community, and effective school policies.

The Role of Screening, Risk Factors, and Early Intervention in Preventing Diabetes in the Obese Population: A Systematic Review.

With its rising global prevalence, diabetes has become one of the most significant and challenging health problems afflicting the world's population today. The increasing burden of diabetes and its associated complications calls for immediate action for prevention which primarily includes addressing the risk factors.The most significant risk factor for the onset of diabetes is obesity. Obesity and diabetes rates have been rising simultaneously, posing a threat to patient mortality and driving up community healthcare costs. A weight loss of five percent or more of total body weight has been shown to improve the quality of life, reduce the need for pharmacological therapy for diabetes, and enhance glycemic control. This level of weight loss can have significant health benefits, particularly for individuals with diabetes or at risk for developing diabetes. We aim to conduct this systematic review to assess diverse risk factors contributing to the incidence of diabetes among the obese population and determine various preventive strategies and recommendations in practice for the prevention of diabetes in this cohort. As a result, we included original studies that recruited the obese and diabetic populations and defined preventive measures for early intervention. Additionally, we included studies published in the last 10 years (2014-2024) only for the latest evidence. Studies including obese populations with cardiovascular diseases and neurological disorders were excluded. The Newcastle-Ottoman Castle assessment tool was utilized to assess the quality of the studies. We included nine studies that recruited 60,645 patients and were published between 2015 and 2022. Findings suggest that obesity alone is a significant contributor to the occurrence or onset of diabetes. At the same time, the presence of other risk factors, including hypertension, dyslipidemia, elevated triglycerides, or HDL and LDL levels, may further increase the risk of diabetes and its associated complications among the obese population. Preventive strategies emphasize early intervention through increasing awareness and educating communities about risk factors and lifestyle interventions, including the limitations of fast food diets for the prevention of diabetes and weight control. Since obesity is considered to be an independent risk factor for the development of diabetes, addressing and managing it is of critical importance clinically. Targeted early interventions, including screening for risk factors, health promotion, and education activities, can aid in the adaptation of healthier lifestyles, which can reduce the burden of these diseases significantly.

HLA Genotyping in Children With Celiac Disease Allows to Establish the Risk of Developing Type 1 Diabetes.

Celiac disease (CD) and type 1 diabetes (T1D) often co-occur and share genetic components in the human leukocyte antigen (HLA) class II region. We aimed to study the usefulness of HLA genotyping in predicting the risk of developing T1D in patients with CD and the temporal relationship between these diseases. A cohort of 1,886 Sardinian patients, including 822 with CD, 1,064 with T1D, and 627 controls, underwent HLA class II typing. Seventy-six of 822 patients with CD were also affected by T1D (CD-T1D), and their HLA genotypes were analyzed for specific HLA associations with CD, T1D, and controls. High-risk HLA-DQ genotypes, including HLA-DQ2.5/DQ8, -DQ2.5/DQ2.5, and -DQ2.5/DQ2.3, were strongly associated with CD-T1D with frequencies of 34.5%, 15.9%, and 18.8%, respectively. Conversely, certain HLA genotypes associated with CD seemed to confer protection against T1D development. Therefore, HLA genotyping allows for the identification of those patients with CD who might develop T1D. The frequency of patients with CD preceding T1D is higher in younger children than older ones, with implications for the early childhood approach to diabetes prevention. CD is a condition for future T1D development, and specific HLA genotypes can predict this risk. Early screening for celiac autoimmunity and subsequent HLA typing in CD children could help identify those at high risk of T1D, allowing for proactive interventions and immunotherapies to preserve β-cell function. These findings may support the re-evaluation of HLA typing in children with CD.

Metformin in diabetes management: expanding benefits. Review

We have conducted a narrative review based on a structured search strategy, focusing on the effects of metformin on the progression of non‑diabetic hyperglycemia to clinical type 2 diabetes mellitus. The principal trials that demonstrated a significantly lower incidence of diabetes in at‑risk populations randomized to metformin (mostly with impaired glucose tolerance) were published mainly from 1999 to 2012. Metformin reduced the 3‑year risk of diabetes by ‑31% in the randomized phase of the Diabetes Prevention Program (DPP), vs.‑ 58% for intensive lifestyle intervention. Metformin was most effective in younger, heavier subjects. Diminishing but still significant reductions in diabetes risk for subjects originally randomized to these groups were present in the trial’s epidemiological follow‑up, the DPP Outcomes Study (DPPOS) at 10 years (‑18 and ‑34%, respectively), 15 years (‑18 and ‑27%), and 22 years (‑18 and ‑25%). Long‑term weight loss was also seen in both groups, with better maintenance under metformin. Subgroup analyses from the DPP/DPPOS have shed important light on the actions of metformin, including a greater effect in women with prior gestational diabetes, and a reduction in coronary artery calcium in men that might suggest a cardioprotective effect. Improvements in long‑term clinical outcomes with metformin in people with non‑diabetic hyperglycemia («prediabetes») have yet to be demonstrated, but cardiovascular and microvascular benefits were seen for those in the DPPOS who did not vs. did develop diabetes mellitus. Multiple health economic analyses suggest that either metformin or intensive lifestyle intervention is cost‑effective in a community setting. Long‑term diabetes prevention with metformin is feasible and is supported in influential guidelines for selected groups of subjects. Future research will demonstrate whether intervention with metformin in people with non‑diabetic hyperglycemia will improve long‑term clinical outcomes.

Relationships of intestinal microbiota metabolites with biomarkers of oxidative stress in type 2 diabetes mellitus. Review

The review is devoted to the analysis of modern data on the relationships between pathogenetic mechanisms in dysmetabolic conditions (metabolic syndrome, type 2 diabetes mellitus) and the functional activity of the intestinal microbiota, which produces low‑molecular compounds classified by biological effects into two types: 1) beneficial for maintaining metabolic homeostasis and antioxidant system in the body, such as short‑chain fatty acids (SCFAs), bile acids and 2) so‑called «dangerous» metabolites, including endotheliotoxic trimethylamine‑N‑oxide (TMAO) and endotoxemia factors lipopolysaccharides (LPS). The molecular mechanisms that mediate SCFAs effects as mediators of oxidative eustress and cytoprotection in various pathologies have been considered. In addition to the role of energy substrates, SCFAs play the role of ligands of G protein‑coupled membrane fatty acid receptors, the activation of which triggers nuclear erythroid 2‑related factor 2 (NRF2) signaling pathways. This transcription factor plays a crucial role in the response to cellular stress, suppressing the expression of inflammatory cytokine and chemokine genes and contributing to the maintenance of redox homeostasis under physiological conditions. The second type of microbial metabolites, on the contrary, corresponds to the definition of oxidative distress factors that exhibit cytotoxic properties, contributing to the processes of atherogenesis and chronic inflammation, especially under the conditions of a dysbiotic state. For example, it has been shown that TMAO can affect mitochondrial and lysosomal signaling pathways, thereby increasing the concentration of reactive oxygen species and malondialdehyde. In addition, TMAO modulates the expression of microRNAs, which promotes the expression of pro‑inflammatory interleukins and blood coagulation factors. Other toxic metabolites, LPS, have a high pro‑inflammatory potential, they increase the permeability of the intestinal mucosa and provoke inflammation and oxidative stress in various tissues of the body. Thus, there is a significant progress in the study of the molecular mechanisms of positive and negative effects of microbial metabolites, which argues for the importance of correcting the composition of the intestinal microbiota and monitoring its functional activity in the process of complex treatment of diabetes mellitus and prevention of the development of cardiometabolic complications associated with oxidative stress.

Does Health Coaching Reduce the Risk of Type 2 Diabetes?

Even with decades of medical advancements and the National Diabetes Prevention Program, the incidence obesity and type 2 diabetes mellitus (T2DM) continues to rise. This pilot study explored the effect of lifestyle coaching on weight and engagement in care among adults with or at risk for prediabetes. It used a virtual, group health coaching program called Aligning Nutrition, Exercise and Wellbeing (ANEW-AP), facilitated by board-certified health coaches. Weight loss varied, yet no participants gained weight, and overall engagement in care slightly increased.

Nanocurcumin-Based Sugar-Free Formulation: Development and Impact on Diabetes and Oxidative Stress Reduction.

The objective of this study is the development of innovative nanocurcumin-based formulations designed for the treatment and prevention of oxidative stress and diabetes. Nanocurcumin was obtained through a micronization process and subsequently encapsulated within biopolymers derived from corn starch and fenugreek mucilage, achieving encapsulation rates of 75% and 85%, respectively. Subsequently, the encapsulated nanocurcumin was utilized in the formulation of sugar-free syrups based on Stevia rebaudiana Bertoni. The stability of the resulting formulations was assessed by monitoring particle size distribution and zeta potential over a 25-day period. Dynamic light scattering (DLS) revealed a particle size of 119.9 nm for the fenugreek mucilage-based syrup (CURF) and 117 nm for the corn starch-based syrup (CURA), with polydispersity indices PDIs of 0.509 and 0.495, respectively. The dissolution rates of the encapsulated nanocurcumin were significantly enhanced, showing a 67% improvement in CURA and a 70% enhancement in CURF compared with crude curcumin (12.82%). Both formulations demonstrated excellent antioxidant activity, as evidenced by polyphenol quantification using the 2.2-diphenyl 1-pycrilhydrazyl (DPPH) assay. In the evaluation of antidiabetic activity conducted on Wistar rats, a substantial reduction in fasting blood sugar levels from 392 to 187 mg/mL was observed. The antioxidant properties of CURF in reducing oxidative stress were clearly demonstrated by a macroscopic observation of the rats' livers, including their color and appearance.

Use of technology in the dissemination of diabetes promotion and prevention programmes

Diabetes mellitus, a common endocrine pathology in these times of the 21st century, where many people of different etiological groups present it due to different risk factors. This pathology changes the life of the person, even more, if they do not carry out an adequate management of diabetes mellitus, because in the long term it increases the risks of presenting other chronic pathologies that can complicate the state of health and the prognosis of the individual's life. For this literature review research project: "Use of technology in the dissemination of diabetes promotion and prevention programmes" with the general objective: To promote the use of technology in the dissemination of diabetes promotion and prevention programmes; a qualitative and analytical approach was used, using databases such as google scholar, elsevier, pubmed, Taylor &amp; Francis, Scielo, etc. At the end of the research it was concluded that the application of technology in programmes for the promotion and prevention of Type 2 Diabetes Mellitus has had a positive impact on its use, allowing a greater possibility for the population to take part in the programmes and reduce their risk of developing Type 2 Diabetes Mellitus.

Rhodiosin from Rhodiola crenulata effectively alleviate postprandial hyperglycemia by inhibiting both the activity and production of α‑glucosidase

BackgroundEffective control of postprandial blood glucose (PBG) level is essential for the prevention and treatment of diabetes and its complications. Several flavonoids have attracted much attention due to their significant PBG-lowering effects. However, there is still a certain gap in the in vivo hypoglycemic activity of most flavonoids compared to first-line drugs available on the market, and are still lack of the PBG-lowering effects of 8-hydroxyflavones and their structure–activity relationship. PurposeEvaluate hypoglycemic effects of 8-hydroxyflavones from Rhodiola crenulata in vitro and in vivo, especially comparatively analyze the relationship between hypoglycemic effects and flavonoid configuration and reveal the possible mechanism of 8-hydroxyflavones in lowering hyperglycemia. MethodsStarch, maltose, sucrose, and glucose tolerance tests in both diabetic and normal mice were used to evaluate and compare the hypoglycemic effects of 8-hydroxyflavones rhodiosin (RHS), rhodionin (RHN), and herbacetin (HBT). Molecular docking, enzyme kinetics, and immunofluorescence analysis were used to research the possible hypoglycemic mechanisms of 8-hydroxyflavones. ResultsRHS (5 and 10 mg/kg) could efficiently decrease PBG levels in both normal and diabetes mice. Moreover, RHS, RHN, and HBT all had significant PBG-lowering effects in transgenic diabetes mice, and the effects were equivalent to or stronger than acarbose. Further mechanism research indicated that 8-hydroxyflavones achieved PBG-lowering effects by inhibiting both the activity and production of glycosidase. Notably, we have innovatively discovered that inhibiting the expression of glycosidases rather than just their activities may be a new target for hypoglycemic drugs. ConclusionWe have firstly comprehensively and systematically clarified PBG-lowering effects of 8-hydroxyflavones from Rhodiola crenulata, and revealed their structure-activity relationships and hypoglycemic mechanisms. The study demonstrated that the substitution of 8-hydroxy groups in flavonoids could significantly enhance their hypoglycemic effects, which were equivalent to or stronger than commercially available drug acarbose. 8-Hydroxyflavones could be used as therapeutic or health drugs with significant potential to reduce postprandial hyperglycemia.