Drugs For Treatment Of Diabetes Research Articles

Repurposing the Antidiabetic Drugs Glyburide, Gliquidone, and Glipizide in Combination with Benznidazole for Trypanosoma cruzi Infection.

Infection with the protozoan parasite Trypanosoma cruzi causes human Chagas disease. Benznidazole (BNZ) and nifurtimox are the current drugs for the treatment; however, they induce severe adverse side effects in patients; therefore, there is a need to improve the treatment effectiveness and efficiency of these drugs for its safer use. Background/Objective: Glyburide, glipizide, and gliquidone, hypoglycemic drugs for diabetes treatment, were previously predicted to bind to dihydrofolate reductase-thymidylate synthase from T. cruzi by in silico docking analysis; they also showed antiproliferative effects against T. cruzi epimastigotes, the stage of the insect vector. In the present study, the potential parasiticidal effect of these antidiabetic drugs was tested in monotherapy and bi-therapy with BNZ in human cells in vitro and in animals. Methods: Evaluation was performed in (a) a model of in vitro infection of T. cruzi trypomastigotes using human fibroblasts as host cells and (b) in mice infected with T. cruzi. Results: The antidiabetic drugs in monotherapy showed antiparasitic effects in preventing infection progression (trypomastigotes release), with an IC50 of 8.4-14.3 µM in comparison to that of BNZ (0.26 µM) in vitro. However, in bi-therapy, the presence of just 0.5 or 1 µM of the antidiabetics decreased the BNZ IC50 by 5-10 times to 0.03-0.05 µM. Remarkably, the antidiabetic drugs in monotherapy decreased the infection in mice by 40-60% in a similar extent to BNZ (80%). In addition, the combination of BNZ plus antidiabetics perturbed the antioxidant metabolites in epimastigotes. Conclusions: These results identified antidiabetics as potential drugs in combination therapy with BNZ to treat T. cruzi infection.

Application Of Xiaoke Pill in Treatment of Type 2 Diabetes Mellitus

As a metabolic chronic disease, the number of patients with diabetes and its fatality rate remain high. At present, many drugs have been developed for the prevention and treatment of diabetes, such as glibenclamide, insulin and other drugs in the clinical treatment of diabetes, has achieved very good therapeutic effects. However, there are research on the treatment of diabetes with traditional Chinese medicine (TCM). In this paper, through the dissolving analysis of Xiaoke Pill, the action mechanism and effect of the effective ingredients in Xiaoke pill for the treatment of diabetes were specifically analyzed, and it was found that the main ingredients in Xiaoke pill were effective for the treatment of diabetes, and could minimize the incidence of adverse consequences like hypoglycemia. Through the analysis and research of Xiaoke Pill, this paper hopes to provide theoretical help for TCM treatment of diabetes, and hope to increase the intensity of TCM treatment of diabetes.

Curcumin and Metformin Infinite Coordination Polymer Nanoparticles for Combined Therapy of Diabetic Mice via Intraperitoneal Injections.

Metformin (Met) is one of the most commonly prescribed first-line drugs for diabetes treatment. However, it has several issues, including low bioavailability, therapeutic platform, and side effects at high doses. In order to improve the therapeutic efficiency of Met, this study proposes a strategy of using Met and curcumin (Cur) to prepare Cur-Zn(II)-Met infinite coordination polymer nanoparticles (CM ICP NPs), and combining this with intraperitoneal injections, for the treatment of diabetic mice. Fourier transform infrared (FTIR) spectroscopy, X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM), nanoparticle analysis, cytotoxicity experiments, and mice experiments were used to investigate structure, properties, and application effects. The results showed that CM ICP NPs exhibit a high drug encapsulation rate (100%), good stability, and an absence of in vivo and in vitro toxicity. The blood glucose level of diabetic mice after treatment was reduced to 6.7 ± 0.65 mmol/L at the seventh week. In terms of therapeutic mechanism, it appears that Met and Cur can synergistically regulate blood glucose in mice from multiple paths. This study provides a promising method for the treatment of diabetes using Met and other drugs.

Analysis of antidiabetic drug utilization patterns in type 2 diabetes patients: a perspective on real-time prescribing practices

Background: Type 2 diabetes is a most common health problem associated with significant morbidity and mortality worldwide, evaluation of drug utilization pattern is very crucial and significant in order to promote the rational use of drugs in treatment of diabetes, and offer insights in to the actual patterns of drug use. The objective is to evaluate drug utilization pattern of antidiabetic drugs among type 2 diabetic patients at Integral Institute of Medical Science & Research. Methods: This is a prospective observational study involving 100 subjects conducted for a period of 6 months after approval by Institutional Ethics Committee (IEC) of Integral University at IIMS and R Hospital. Informed consent was obtained from all the participants. Data gathered was examined using descriptive statistics and compared to the standard guidelines. Drug utilization pattern was studied and evaluated to analyse the pattern of drug therapy among type 2 diabetics. Results: Antidiabetic drugs were given 198 times among the 100 participants, averaging 2 antidiabetic drugs per prescription, Insulin therapy (58.58%) and Metformin (20.20%) were the most prescribed medications, combination therapy was common, with 66% of patients particularly with Glimepiride (DPP4 Inhibitor) at 10.61%. Most prescriptions were given by generic name (55%) and 90% of the drugs prescribed were from the WHO essential medicines. Most patients were aged 51-60 years, with a nearly equal gender distribution. Conclusion: The study highlights the prescribing patterns and characteristic use of antidiabetic medications. These findings provide valuable insights into the current prescribing practices in type-2 DM treatment and can contribute to optimizing treatment strategies for better patient outcomes.

The screening of α-glucosidase inhibitory peptides from β-conglycinin and hypoglycemic mechanism in HepG2 cells and zebrafish larvae

Inhibition of carbohydrate digestive enzymes is a key focus across diverse fields, given the prominence of α-glucosidase inhibitors as preferred oral hypoglycaemic drugs for diabetes treatment. β-conglycinin is the most abundant functional protein in soy; however, it is unclear whether the peptides produced after its gastrointestinal digestion exhibit α-glucosidase inhibitory properties. Therefore, we examined the α-glucosidase inhibitory potential of soy peptides. Specifically, β-conglycinin was subjected to simulated gastrointestinal digestion by enzymatically cleaving it into 95 peptides with gastric, pancreatic and chymotrypsin enzymes. Eight soybean peptides were selected based on their predicted activity; absorption, distribution, metabolism, excretion and toxicity score; and molecular docking analysis. The results indicated that hydrogen bonding and electrostatic interactions play important roles in inhibiting α-glucosidase, with the tripeptide SGR exhibiting the greatest inhibitory effect (IC50=10.57μg/mL). In vitro studies revealed that SGR markedly improved glucose metabolism disorders in insulin-resistant HepG2 cells without affecting cell viability. Animal experiments revealed that SGR significantly improved blood glucose and decreased maltase activity in type 2 diabetic zebrafish larvae, but it did not result in the death of zebrafish larvae. Transcriptomic analysis revealed that SGR exerts its anti-diabetic and hypoglycaemic effects by attenuating the expression of several genes, including Slc2a1, Hsp70, Cpt2, Serpinf1, Sfrp2 and Ggt1a. These results suggest that SGR is a potential food-borne bioactive peptide for managing diabetes.

Evaluation of the Neuroprotective Action of <i>Azadirachta indica</i> Leaves Extract in Streptozotocin-induced Diabetic Rodent Model

Among the most common and painful consequences of diabetes mellitus, Diabetic Peripheral Neuropathy (DPN) is one of the most common. For DPN management, a variety of techniques have been used, ranging from traditional medicines to alternative approaches. Natural compounds are also the focus of research to explore the possible treatment by replacing or combining with the existing therapies. Different neurological changes in diabetic neuropathy and the effect of the Azadirachta indica (neem) extract were assessed with nerve conduction velocity, and biochemical and histological analysis in Streptozotocin-induced diabetic mellitus. The therapeutic effect of the extract was evaluated with doses 100, 200 and 500mg/kg body weight for 4 weeks after induction of diabetes. The protective effect was evaluated by treating the animals with hydroalcoholic extract of neem leaves in 500mg/kg dose before the induction of diabetes and post-treatment with the standard drug Metformin (500mg/kg). Both resulted in a significant reduction in blood glucose, additionally, 500mg/kg body weight dose revealed the signs of neuroprotection in diabetic rats. Neem leaf extract appears to be promising for future investigations, which might contribute to the emergence of new drugs for diabetes treatment and diabetic neuropathy either alone or in combination with conventional therapies.

Unraveling Light-Activated Insulin Action in Regulating Blood Glucose: New Photoactivatable Insight as a Novel Modality in Diabetes Management.

Diabetes, particularly type 2 diabetes (T2D), is the main component of metabolic syndrome. It is highly prevalent and has drastically increased with sedentary lifestyles, notably behaviors linked to ease of access and minimal physical activity. Central to this condition is insulin, which plays a pivotal role in regulating glucose levels in the body by aiding glucose uptake and storage in cells, and what happens to diabetes? In diabetes, there is a disruption and malfunction in insulin regulation. Despite numerous efforts, effectively addressing diabetes remains a challenge. This article explores the potential of photoactivatable drugs in diabetes treatment, with a focus on light-activated insulin. We discuss its advantages and significant implications. This article is expected to enrich the existing literature substantially, offering a comprehensive analysis of potential strategies for improving diabetes management. With its minimal physical intrusion, light-activated insulin promises to improve patient comfort and treatment adherence. It offers precise regulation and localized impact, potentially mitigating the risks associated with conventional diabetes treatments. Additionally, light-activated insulin is capable of explicitly targeting RNA and epigenetic factors. This innovative approach may pave the way for more personalized and effective diabetes treatments, addressing not only the symptoms but also the underlying biological causes of the disease. The advancement of light-activated insulin could revolutionize diabetes management. This study represents a pioneering introduction to this novel modality for diabetes management.

Phytoconstituents of Terminalia catappa linn fruits extract exhibit promising antidiabetic activities against α-amylase and α-glucosidase in vitro and in silico

Phytoconstituents of Terminalia catappa linn fruits extract exhibit promising antidiabetic activities against α-amylase and α-glucosidase in vitro and in silico

Sex-specific impact of GCKR rs1260326 polymorphism on metabolic traits in an older Japanese population: the Bunkyo Health Study.

Metabolic syndrome involves health problems influenced by aging and genetics. The glucokinase regulatory protein (GCKR) rs1260326 polymorphism (Leu446) is associated with metabolic traits. This study explores the impact of the GCKR rs1260326 polymorphism on metabolic traits in older Japanese with focusing on sex-specific differences. This cross-sectional study from the Bunkyo Health Study in Tokyo, Japan, examined 883 participants aged 65-84 years. Participants were excluded with diabetes, or on drug treatment for diabetes or dyslipidemia. The GCKR P446L polymorphism was analyzed and compared their characteristics of physical activity, dietary intake, body composition, and metabolic parameters. Study participants with GCKR rs1260326 genotypes (C/C 20.7%, C/T 47.6%, T/T 31.7%) had a median age of 72 years, and 60.4% were women. Men with the T/T genotype, as compared to the C/C genotype, had a lower body weight, body mass index (BMI), and skeletal mass index. This genotype also associated with lower fasting insulin, homeostasis model assessment of insulin resistance index (HOMA-IR), and higher Matsuda index, but not after adjustment for age, BMI, and physical activity. In contrast, women with the T/T genotype, compared to the C/C genotype, showed higher C-reactive protein, fibroblast growth factor 21, and Matsuda index. They also had lower fasting insulin, insulin area under the curve, and HOMA-IR; with these associations being independent of age, BMI, and physical activity. The GCKR rs1260326 genotype-affected metabolic traits differentially by sex in older Japanese. This highlights the need to consider sex differences in GCKR-related metabolic outcomes.

Research Advances in Fusion Protein-Based Drugs for Diabetes Treatment.

Diabetes mellitus (DM) is a chronic metabolic disease characterized by elevated blood glucose levels, resulting in multi-organ dysfunction and various complications. Fusion proteins can form multifunctional complexes by combining the target proteins with partner proteins. It has significant advantages in improving the performance of the target proteins, extending their biological half-life, and enhancing patient drug compliance. Fusion protein-based drugs have emerged as promising new drugs in diabetes therapeutics. However, there has not been a systematic review of fusion protein-based drugs for diabetes therapeutics. Hence, we conducted a comprehensive review of published literature on diabetic fusion protein-based drugs for diabetes, with a primary focus on immunoglobulin G (IgG) fragment crystallizable (Fc) region, albumin, and transferrin (TF). This review aims to provide a reference for the subsequent development and clinical application of fusion protein-based drugs in diabetes therapeutics.

Edukasi pengetahuan masyarakat dalam pemanfaatan daun insulin di Desa Jambi Kecil Kabupaten Muaro Jambi

The insulin plant (Tithonia diversifolia (Hemsl.) A. Gray) is a flowering plant with orange-colored flowers that belongs to the Asteraceae family. It can be cultivated as an ornamental plant in gardens or green spaces and used in traditional medicine. The benefits and potential of this plant are numerous, including its use as green manure, pest, and disease control, fodder for livestock, soil and water conservation, and its potential in traditional treatments for urinary tract infections, digestive issues, and diabetes management. This community service aims to enhance public knowledge regarding using insulin plant leaves as crude drugs for diabetes treatment. The method employed involves conducting informational sessions through lectures followed by a question-and-answer session. The results show the community learned about using insulin plants as a diabetes remedy. The community's knowledge about using insulin plants as a traditional remedy as a decoction for diabetes treatment increased to 100%.

Development and Identification of Novel α-Glucosidase Inhibitory Peptides from Mulberry Leaves.

The mulberry leaf is a botanical resource that possesses a substantial quantity of protein. In this study, alcalase hydrolysis conditions of mulberry leaf protein were optimized using the response surface method. The results showed that the optimum conditions were as follows: substrate protein concentration was 0.5% (w/v), enzymatic hydrolysis temperature was 53.0 °C, enzymatic hydrolysis time was 4.7 h, enzyme amount was 17,800 U/g, and pH was 10.5. Then mulberry leaf peptides were separated by ultrafiltration according to molecular weight. Peptides (<3 kDa) were screened and subsequently identified using LC-MS/MS after the evaluation of α-glucosidase inhibition across various fractions. Three novel potential bioactive peptides RWPFFAFM (1101.32 Da), AAGRLPGY (803.91 Da), and VVRDFHNA (957.04 Da) with the lowest average docking energy were screened for molecular dynamics simulation to examine their binding stability with enzymes in a 37 °C simulated human environment. Finally, they were prepared by solid phase synthesis for in vitro verification. The former two peptides exhibited better IC50 values (1.299 mM and 1.319 mM, respectively). These results suggest that the α-glucosidase inhibitory peptides from mulberry leaf protein are potential functional foods or drugs for diabetes treatment, but further in vivo studies are needed to identify the bioavailability and toxicity.

The Severity of COVID-19 in Diabetes Patients.

Diabetic patients are significantly stimulated by COVID-19 infection. The dreadful risk of COVID-19 mortality may be affected. In order to preserve precious lives, it is essential to comprehend how diabetes and COVID-19 are related, as well as how to manage diabetes. We aimed to focus on the mechanism, impact, and drug treatment of diabetes in COVID-19 patients. A comprehensive scrutiny of the published literature in diverse pharmaceutical and medical databases such as Google Scholar, PubMed, Science Direct, DOAJ etc., were successfully conducted and classified accordingly. We discussed the severity of COVID-19 in diabetes patients. A patient with diabetes has a higher risk of COVID-19 mortality by influencing the development and prognosis of the disease. The recommended drugs for diabetes treatment in COVID-19 may reduce COVID-19 mortality. Metabolic syndrome diabetes is a risk factor enhancing the development and diagnosis of COVID-19. In order to treat diabetic patients who have COVID-19 infection, insulin is preferable over oral hypoglycemic medications.

Risk factors for drug-treated major adverse cardio-cerebrovascular events in patients on primary preventive statin therapy: A retrospective cohort study

We aim to identify risk factors of major adverse cardio-cerebrovascular events (MACCE) using a proxy of drug treatment for a MACCE after the start of statin therapy in the primary cardiovascular prevention group, taking drug dose, persistency and adherence into account. We conducted a retrospective inception cohort study using data from the University of Groningen prescription database IADB.nl, covering patients in the Northern part of the Netherlands. We identified adult starters on primary preventive statin therapy as patients without any statin or cardiovascular drug prescription in the two years before the first statin dispensing and used a weighted Cox proportional hazard model to estimate hazard ratios (HR) with their 95% confidence intervals (95%CI). Among 39,487 primary preventive statin starters, 23% received drug treatment for a MACCE within a median follow-up period of four years. Increasing age, male gender and presence of diabetes drug treatment were significantly associated with the outcome (HR: 1.03; 95%CI: 1.02-1.04; HR: 1.27; 95%CI: 1.12-1.44 and HR: 1.39; 95%CI: 1.24-1.56, respectively). If patients remained statin therapy persistent, adherence was no longer associated with drug treatment for a MACCE. In 23% of the statin therapy initiators, incident drug treatment for a MACCE occurred with a median of four years. To reduce event rates in this group, older patients, males and diabetes patients should be closely monitored. Non-adherence in the early stage of treatment should be avoided to prevent non-persistence.

Insulin-loaded nanoparticles based on acetylated cashew gum/chitosan complexes for oral administration and diabetes treatment

Insulin is one of the most important drugs in the clinical treatment of diabetes. There is growing interest in oral insulin administration as it mimics the physiological pathway and potentially reduces side effects associated with subcutaneous injection. In this study, a nanoparticulate system was developed using acetylated cashew gum (ACG) and chitosan by the polyelectrolyte complexation method, for oral administration of insulin. The nanoparticles were characterized by size, zeta potential and encapsulation efficiency (EE%). And they had a particle size of 460±11.0nm, PDI of 0.2±0.021, zeta potential of 30.6±0.48mV, and an EE% of 52.5%. Cytotoxicity assays were performed for HT-29 cell lines. It was observed that ACG and nanoparticles did not have a significant effect on cell viability, verifying their biocompatibility. Hypoglycemic effects of the formulation were analyzed in vivo, noting that the nanoparticles reduced blood glucose by 51.0% of baseline levels after 12h, not inducing signs of toxicity or death. Biochemical and hematological profiles were not clinically modified. Histological study indicated no signs of toxicity. Results showed that the nanostructured system presented itself as a potential vehicle for oral insulin release.

Symptoms of depression, perceived social support, and medical coping modes among middle-aged and elderly patients with type 2 diabetes.

Objective: To understand the prevalence of depression in diabetes population, explore the relationship between diabetes and depression, and the impact of comprehensive psychological and behavioral intervention on depression related to diabetes and glucose metabolism. Methods: 71 middle-aged and elderly patients with type 2 diabetes were investigated and evaluated with Self Rating Depression Scale (SDS), Medical Coping Scale (MCWQ) and Social Support Scale (PSSS). Patients who met the research criteria were randomly divided into an experimental group and a control group. The number of effective cases in the two groups was 36 and 35 respectively. In addition to conventional diabetes drug treatment, the experimental group was supplemented with comprehensive psychological and behavioral intervention, while the control group was only given conventional treatment. The fasting blood glucose, 2-h postprandial blood glucose, body weight and depression index were measured before and after treatment in the two groups. Results: The prevalence of depression in patients with diabetes was as high as 60%, and that in the elderly control group was 5%; In type 2 diabetes population, depression is negatively related to the total score of social support and medical coping surface, and positively related to avoidance, blood sugar, women, course of disease, education level below junior high school, body mass index, and number of complications in medical coping; The fasting blood glucose, 2-h postprandial blood glucose, body mass index, and depression index of the two groups decreased, and the range and speed of decline in the experimental group were higher than those in the control group; There were significant differences between the two groups in fasting blood glucose, 2-h postprandial blood glucose and depression index; During the follow-up period, the blood glucose and depression index of the experimental group increased. Conclusion: Depression has a high prevalence rate in middle-aged and elderly people with type 2 diabetes, and has a negative impact on blood sugar control in diabetes patients; Psychological and behavioral comprehensive intervention can improve the glucose metabolism and depressive symptoms of middle-aged and elderly patients with type 2 diabetes.

CURRENT TRENDS AND AVAILABILITY OF INJECTABLE THERAPY IN PAKISTAN FOR MANAGEMENT OF DIABETES MELLITUS

Background: Diabetes is a metabolic disorder and is a growing healthcare problem in South Asian countries. The management guidelines provided by American Diabetes Association (ADA) have provided a thorough approach for the use of oral and injectable therapies. Current statistics indicate an increase in premature mortality, which poses a severe danger to global prosperity. Sulphonylureas, biguanides, alpha glucosidase inhibitors and thiazolidinediones are examples of recent generations of drugs that have been created as a result of scientific and technological developments and have a high efficacy in reducing hyperglycemia. Objectives: This communication aims to connote the trends and availability of injectable therapy in lower middle income countries. Methodology: We reviewed a number of studies (published between 2010-2020), a market survey for availability and the Drug Regulatory Authority of Pakistan official website for the registration status of newly registered injectable therapy for managing diabetes mellitus. Results: Novel classes of drugs that have been developed as potential targets for diabetes treatment drugs include Incretin mimics, Amylin analogues, GIP analogues, Peroxisome proliferator-activated receptors, and dipeptidyl peptidase-4 inhibitor. In Pakistan and other parts of the world, getting new insulin products in sufficient quantities has always been demanding. A list of imported insulin and GLP-1 products and their availability in lower middle income countries like Pakistan, India and Bangladesh is made so as to meet international standards. Conclusion: This short communicatiob shows the availability of Injectable therapy for management of diabetes in Pakistan.

Identification, measurement, and evaluation of blood concentrations of insulin glargine and insulin lispro by UPLC–MS–MS in a dead body suspected of insulin overdose

Insulin preparations, which are drug treatments for diabetes, cause fatal hypoglycemia when an overdose is administered. Cases of homicide and suicide using these preparations have been reported and are of great forensic interest. However, there are few reports assessing the postmortem concentration of insulin preparations, and it is often difficult to determine the cause of death. In the present study, we report a case of a suspected insulin glargine and insulin lispro overdose for suicide. A woman in her 30s had a history of mental illness and diabetes. The day before her death, she reported to her boyfriend that she had taken large doses of insulin preparations and prescription drugs. An autopsy revealed no fatal injuries or lesions. Drug screening tests revealed several prescription drugs, none of which showed toxic concentrations. Analysis using LC-MS/MS detected insulin glargine in the peripheral and cardiac blood at 429 μU/mL and 1362 μU/mL, respectively, whereas insulin lispro was detected in both the peripheral and cardiac blood at levels below the lower limit of quantification (LLOQ; <50 μU/mL). The cause of death was considered likely to be hypoglycemia caused by an overdose of insulin glargine. Insulin glargine is rapidly metabolized after subcutaneous administration and is rarely detected in the blood when used at therapeutic doses. There are no other reports on the quantification of insulin glargine parent compounds in postmortem samples, and this case provides important data on postmortem blood concentrations of insulin glargine intoxication.

Effectiveness of Hydroalcoholic Seed Extract of Securigera securidaca on Pancreatic Local Renin-Angiotensin System and Its Alternative Pathway in Streptozotocin-Induced Diabetic Animal Model.

Available data suggest inhibition of the pancreatic local-renin-angiotensin system (RAS) reduces tissue complications of diabetes. The purpose of the present study was to investigate the effect of hydroalcoholic seed extract of Securigera securidaca (S. securidaca) (HESS) on the pancreatic local-RAS and its alternative pathway. Three doses of HESS were orally administered to three groups of diabetic male Wistar rats, and the results were compared with both diabetic and healthy control groups. After 35 days of treatment, the groups were assessed for the levels of pancreatic local-RAS components, including renin, angiotensinogen, ACE, and Ang II, as well as ACE2 and Ang-(1-7) in the alternative pathway. The effect of herbal medicine treatment on tissue damage status was investigated by evaluating tissue levels of oxidative stress, proinflammatory and anti-inflammatory cytokines, and through histopathological examination of the pancreas. HESS showed a dose-dependent palliative effect on the tissue oxidative stress profile (P < 0.05) as well as the levels of pancreatic local-RAS components (P < 0.05), compared to diabetic control group. Considering the interrelationship between tissue oxidative stress and local-RAS activity, the moderating effect of HESS on this relationship could be attributed to the increase in total tissue antioxidant capacity (TAC) and pancreatic Ang-(1-7) concentration. Decrease in local-RAS activity was associated with decrease in the tissue levels of inflammatory cytokines (IL1, IL6, and TNFα) (P < 0.05) and increase in the levels of anti-inflammatory cytokine of IL-10 (P < 0.05). In addition, histological results were consistent with tissue biochemical results. Due to the reduction of local pancreatic RAS activity as well as oxidative stress and proinflammatory cytokines following treatment with HESS, S. securidaca seed can be proposed as a suitable herbal supplement in the drug-treatment of diabetes.

Effect of Dapagliflozin on Serum Uric Acid in Type 2 Diabetes Mellitus patients

Diabetes is one of the most common metabolic diseases, linked to hyperuricemia. Several studies have shown that high serum uric acid levels (SUA) are associated with an increased risk of diabetes. SGLT2 inhibitors (Sodium Glucose Cotransporter-2 Inhibitors) are a new drug for diabetes treatment. In addition to their ability to lower blood glucose, they have other benefits, including lowering serum uric acid levels. This study aimed to evaluate the effect of dapagliflozin, which is a selective inhibitor of SGLT2 Cotransporters present in the kidneys, on serum uric acid levels in patients with type 2 diabetes, compared with a control group. The study included 51 patients with type 2 diabetes, randomly selected from an endocrinology clinic, who started dapagliflozin treatment 5 and 10 mg at recruitment. The control group included 64 patients with type 2 diabetes treated with metformin. Patients were monitored for 3-6 months and serum uric acid levels were measured at baseline and after follow-up. 3 months after treatment, the mean concentration of uric acid in the dapagliflozin group was lower than that of the metformin group (4.58 vs. 5.24 mg/dl p = 0.0143). At 6 months follow-up, SUA levels decreased by 0.79 mg/dL and it was statistically significant (p = 0.0004), compared with control group where there was no statistically significant change in SUA levels. Statistically, there was no significant difference in uric acid levels between doses 5 and 10 mg. However, decreasing in SUA levels with dapagliflozin 5 mg was greater than that occurred with dapagliflozin 10 mg after 6 months of treatment. In conclusion, Dapagliflozin results in a decrease of SUA levels in patients with type 2 diabetes by increasing urinary excretion of uric acid induced by SGLT2 inhibitors.