Elevated Blood Glucose Levels Research Articles

The Association of the Neutrophil-Lymphocyte Ratio With Diabetes Mellitus and Diabetic Foot Ulcer: A Review Article

Introduction: Diabetes mellitus (DM) is inappropriately elevated blood glucose levels. Diabetic foot ulcer (DFU) is the most common complication of diabetes mellitus. Many research studies was found that neutrophil lymphocyte ratio (NLR) have positive correlation with HBA1C, blood glucose, and outcome of diabetic foot ulcer. Methods: The literature searches using online databases such as PubMed, ScienceDirect Elsevier, and Google Schoolar. Result: After doing an online search, we found 39 articles were relevant for this review topic. Analysis: Many research studies have found increased HbA1C (≥6,5) and increased blood glucose (random blood glucose ≥ 200mg/dL and/or fasting blood glucose ≥126 mg/dL) in patients with diabetes mellitus have a positive correlation with increased NLR. And there was increased NLR values in patients with diabetic foot ulcer and NLR values was higher (NLR≥6) in non-healing ulcers than in healing ulcers. Conclusion: NLR can be used as screening tool for determining evaluation of diabetes mellitus and as screening tool for determining outcome of diabetic foot ulcers.

Rare, late onset of immune checkpoint inhibitor-induced type 1 diabetes mellitus in a patient with small-cell lung cancer treated with serplulimab: a case report and review of the literature

BackgroundAs a newly approved immune checkpoint inhibitor in China, serplulimab has been widely used in the immunotherapy of tumors. However, the immune-related adverse events of immune checkpoint inhibitors should not be ignored. Although immune checkpoint inhibitor-induced type 1 diabetes mellitus is a rare complication, it may cause diabetic ketoacidosis and endanger the lives of patients.Case presentationThis case report describes a 55-year-old male of Han nationality from China diagnosed with small-cell lung cancer with multiple metastases who experienced an adverse event of type 1 diabetes mellitus 68 weeks after receiving serplulimab therapy. The patient presented with typical symptoms of diabetic ketoacidosis, including severe thirst, nausea, vomiting, deep respirations, and stupor. Despite the absence of diabetes-related autoantibodies, the patient had extremely low levels of insulin and C-peptide release. Other potential causes of diabetes were ruled out, confirming the condition as serplulimab-induced immune checkpoint inhibitor-induced type 1 diabetes mellitus. After aggressive treatment to correct diabetic ketoacidosis, the patient’s blood glucose levels stabilized and symptoms of diabetes improved significantly, although long-term insulin maintenance therapy was necessary.ConclusionThis case highlights a rare, late-onset adverse event of immune checkpoint inhibitor-induced type 1 diabetes mellitus that may be overlooked during treatment with serplulimab. The monitoring of blood glucose levels and early signs and symptoms of diabetes cannot be relaxed at the late stage of treatment, even if patients do not have elevated blood glucose levels before and during the middle stage of treatment.

Integrated Management for Patients with Diabetes Mellitus: A Literature Review

Background: Many factors contribute to DM, such as age, heredity, high-calorie meals, an unhealthy lifestyle, obesity, and stress. Inadequate glycemic control contributes to elevated blood glucose levels and potential complications. However, many people of DM had unmet proper DM management regularly due to many factors.Objective: This study reviewed published articles about integrated management for people with DM through three databases.Methods: We identified 1902 articles, and 13 articles were selected for full-text analysis.Results: We found that in integrated DM management for patients with DM, they highly recommend to monitoring their blood glucose, doing exercise, dietary plan, coping strategy, and continuous health education were the most effective DM management strategies to lowering HbA1c levels.Conclusion: Nurses as healthcare providers should engage with people with DM to ensure they have good knowledge and understanding of how to maintain their disease.

Development of oral formulation of Lepidium seeds significantly decreases the high blood glucose levels in diabetic rats: in vitro formulation and in vivo antidiabetic performance

Background Lepidium sativum, Garden Cress (GC), seeds have a lot of natural molecules with a pronounced activity against different disorders. It was reported that GC seeds have the ability to lower the blood glucose level. Aim The aim of this work was to formulate GC seeds into oral tablets containing a fixed dose of the grounded seeds. Furthermore, the anti-diabetic performance of the prepared tablets was studied in the streptozotocin rats’ model in comparison with positive control metformin. Methods Micrometrics of GC grounded seeds with different excipients were investigated. Then, GC tablets were prepared via direct compression technique. GC tablets were characterized for their uniformity of dosage unit, friability, hardness, disintegration time, and in vitro release. The antidiabetic effect was studied in rats for a period of 28 days. Glycosylated hemoglobin, liver performance, and lipid levels include total cholesterol (TC), triglycerides (TGs), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were also estimated. In addition, histopathological study of liver and pancreas was also performed. Results Prosolv®EasyTab produced tablets with higher hardness, lower disintegration time, and fast release. GC tablets significantly lower the elevated blood glucose level. In addition, they have antihyperlipidemic activity, hepatocellular protective role and restore the histology of the liver and pancreas. Conclusion GC tablets could be a promising alternative formulation to control the high blood glucose level in diabetic rats rather than chemically derivatized drugs.

Effects of Nanoparticle-Mediated Dihydromyricetin to Diabetic Wounds: An In Vivo Study.

Diabetic wound is one of the serious complications of diabetes, and the wound is persistent and easily recurring, which seriously endangers the health and life of patients. How to effectively promote the healing of diabetic wounds has been a hot spot and difficult area of clinical research. Some previous studies have shown that dihydromyricetin has the effects of regulating blood glucose, controlling the severity, and inhibiting scarring. In the present study, we used polylactic-co-glycolic acid nanoparticles as a carrier to load dihydromyricetin to make drug-loaded nanoparticles and applied them dropwise (200 µL) to diabetic mice wounds by topical application to observe the healing and scar formation of diabetic wounds. We found that the healing rate of the diabetic mice was faster and the scar formation was less obvious. In addition, the elevated blood glucose level and weight loss of the mice in the treatment group were also reduced. Therefore, nanoparticle-mediated dihydromyricetin may be an effective treatment for diabetic wounds.

Current scientific evidence for why periodontitis should be included in diabetes management.

This Perspective provides a brief summary of the scientific evidence for the two-way links between periodontal diseases and hyperglycemia (diabetes mellitus [DM] and pre-DM). It delivers in a nutshell current scientific evidence for manifestations of hyperglycemia on periodontal health status and effects of periodontal diseases on blood glucose levels and in turn incidence, progression, and complications of diabetes. Of outmost importance is presentation of scientific evidence for the potential of routine periodontal treatment to lower blood glucose levels, providing a novel, economical tool in DM management. Non-surgical periodontal treatment ("deep cleaning") can be provided by dental hygienists or dentists in general dental offices, although severe cases should be referred to specialists. Such therapy can decrease the costs of DM care and other health care costs for people with DM. The great importance of a healthy oral cavity free of infection and subsequent inflammation - especially periodontitis that if untreated will cause loosening and eventually loss of affected teeth - has largely gone unnoticed by the medical community as the health care curricula are largely void of content regarding the bi-directional links between oral health and systemic health, despite elevation of blood glucose levels being an integral part of the general systemic inflammation response. The importance of keeping disease-free, natural teeth for proper biting and chewing, smiling, self-esteem, and pain avoidance cannot be overestimated. Medical and dental professionals are strongly encouraged to collaborate in patient-centered care for their mutual patients with - or at risk for - hyperglycemia.

Fingerprinting hyperglycemia using predictive modelling approach based on low-cost routine CBC and CRP diagnostics

Hyperglycemia is an outcome of dysregulated glucose homeostasis in the human body and may induce chronic elevation of blood glucose levels. Lifestyle factors such as overnutrition, physical inactivity, and psychosocials coupled with systemic low-grade inflammation have a strong negative impact on glucose homeostasis, in particular, insulin sensitivity. Together, these factors contribute to the pathophysiology of diabetes (DM) and expanding landscape of its prevalence regionally and globally. The rapid rise in the prevalence of type 2 diabetes, therefore, underscores the need for its early diagnosis and treatment. In this work, we have evaluated the discriminatory capacity of different diagnostic markers including inflammatory biomolecules and RBC (Red Blood Cell) indices in predicting the risk of hyperglycemia and borderline hyperglycemia. For that, 208,137 clinical diagnostic entries obtained over five years from Chugtai Labs, Pakistan, were retrospectively evaluated. The dataset included HbA1c (n = 142,011), complete blood count (CBC, n = 84,263), fasting blood glucose (FBG, n = 35,363), and C-reactive protein (CRP, n = 9035) tests. Our results provide four glycemic predictive models for two cohorts HbA1c and FBG) each having an overall predictive accuracy of more than 80% (p-value < 0.0001). Next, multivariate analysis (MANOVA) followed by univariate analysis (ANOVA) was employed to identify predictors with significant discriminatory capacity for different levels of glycemia. We show that the interplay between inflammation, hyperglycemic-induced derangements in RBC indices, and altered glucose homeostasis could be employed for prognosticating hyperglycemic outcomes. Our results then conclude a glycemic predictor with high sensitivity and specificity, employing inflammatory markers coupled with RBC indices, to predict glycemic outcomes (ROC p-value < 0.0001). Taken together, this study outlines a predictor of glycemic outcomes which could assist as a prophylactic intervention in predicting the early onset of hyperglycemia and borderline hyperglycemia.

An in silico analysis of the interaction of marine sponge-derived bioactive compounds with type 2 diabetes mellitus targets DPP-4 and PTP1B

Type 2 diabetes is a medical condition involving elevated blood glucose levels resulting from impaired or improper insulin utilization. As the number of type 2 diabetes cases increases each year, there is an urgent need to develop novel drugs having new targets and/or complementing existing therapeutic protocols. In this regard, marine sponge-derived compounds hold great potential due to their potent biological activity and structural diversity. In this study, a small library of 50 marine sponge-derived compounds were examined for their activity towards type 2 diabetes targets, namely dipeptidyl peptidase-4 (DPP-4) and protein tyrosine phosphatase 1B (PTP1B). The compounds were first subjected to molecular docking on protein models based on their respective co-crystal structures to assess binding free energies (BFE) and conformations. Clustering analysis yielded BFE that ranged from 24.54 kcal/mol to −9.97 kcal/mol for DPP-4, and from −4.98 kcal/mol to −8.67 kcal/mol for PTP1B. Interaction analysis on the top ten compounds with the most negative BFE towards each protein target showed similar intermolecular interactions and key interacting residues as in the previously solved co-crystal structure. These compounds were subjected to absorption, distribution, metabolism, excretion, and toxicity (ADMET) profiling to characterize drug-likeness and combining the results from these analyses, (S)-6’-debromohamacanthin B was identified as a potential multi-target inhibitor of DPP-4 and PTP1B, having favorable protein interaction, no Lipinski violations, good gastrointestinal (GI) tract absorption, blood-brain barrier (BBB) penetration, and no predicted toxicity. Finally, the interaction of (S)-6’-debromohamacanthin B with the two proteins was validated using molecular dynamics simulations over 100 ns through RMSD, radius of gyration, PCA, and molecular mechanics Poisson-Boltzmann surface area (MMPBSA) confirming favorable interactions with the respective proteins. Communicated by Ramaswamy H. Sarma

Mathematical Analysis of Fractional Diabetes Model via an Efficient Computational Technique

Diabetes is referred to a chronic metabolic disease signalized by elevated levels of blood glucose (also known as blood sugar level), which results over time in serious damage to the heart, blood vessels, eyes, kidneys, and nerves in the body. A mathematical assessment of the diabetes model using the Caputo fractional order derivative operator is given in this research paper. The concept of a Caputo fractional order derivative is a novel class of non-integer order derivative that has many applications in real-life scenarios. The proposed model is represented by a set of fractional ordinary differential equations. The authors employed the Sumudu Transform Homotopy Perturbation Method (STHPM) for finding the series solutions of the model being studied. By giving various numerical values to the respective model parameters, graphical analysis is also performed. It is observed in the numerical discussion that a decrease in both fractional order and leads to decrease in the number of diabetic people.

Evaluation of Phytochemical and Antidiabetic Potentials of Aqueous, Ethanol, and Acetone Crude Extracts of Plectranthus Neochilus Leaves on Alloxan Induced Diabetic Wistar Rats.

Diabetes mellitus is a metabolic disorder which leads to abnormally high blood glucose level (hyperglycemia). This research work is aimed at evaluating the antidiabetic potentials of aqueous, ethanol and acetone extracts of plectranthus neochilus leaves on alloxan induced diabetic wistar rats. Materials and Methods: The experimental rats were induced and made diabetic by single intra-peritoneal administration of Alloxan monohydrate at a dose rate of 150 mg/kg dissolved in 0.9% freshly prepared normal saline at pH 5.5. Sixty-five adult (male) albino rats weighing 160-200g were used for this study. The Animals were divided into 12 groups of 5 rats each namely: A: Normal control, B: Diabetic control 150kg/body weight of alloxan, C: Diabetic + 1000mg/kg body weight of Standard drug (Metformin), D: Diabetic + 250mg/kg body weight of aqueous extract, E: Diabetic + 500mg/kg body weight of aqueous extract, F: Diabetic + 1000mg/kg body weight of aqueous extract, G: Diabetic + 250mg/kg body weight ethanol extract, H: Diabetic + 500mg/kg body weight of ethanol extract, I: Diabetic + 1000mg/kg body weight of ethanol extract, J: Diabetic + 250mg/kg body weight of acetone extract, K: Diabetic + 500mg/kg body weight of acetone extract, L: Diabetic + 1000mg/kg body weight of acetone extract. The extracts were administered orally for a duration of 28days at doses of (250, 500, and 1000 mg/kg body weight). Results: Treatment with extracts significantly reduced (p&lt;0.05) elevated blood glucose level associated with alloxan induced diabetic (27.85±0.95) rats in the aqueous extract (5.90±0.10), ethanol extract (10.15±4.35) but no significant ameliorative effect with the acetone extract (23.35±2.82) at dosage of 1000mg/kg body weight. The aqueous extract significantly reduced (p&lt;0.05) elevated blood glucose level more when compared to the normal control (5.85±0.05) rats as when compared to the ethanol and acetone extracts at dose 1000mg/kg body weight. Conclusion: The blood glucose data obtained using Alloxan hyperglycaemic rats clearly shows that the crude aqueous extract has better anti-diabetic effect at dose of 1000mg/kg, followed by the ethanol extract and then the acetone extract in the 28 days of treatment, the ameliorative effect is also dose dependent. Thus, the leaves caused significant and consistent reductions in diabetic drug-induced hyperglycaemia in albino rats.

Management of Prediabtes (An Increased Risk of Type 2 Diabetes) with Life Style Modifications

Prediabetes, characterized by elevated blood glucose levels that are below the diagnostic threshold for diabetes, poses a significant health challenge worldwide due to its association with an increased risk of developing type 2 diabetes mellitus. This abstract explores the crucial role of lifestyle modifications in the effective management of prediabetes, emphasizing a holistic approach to prevent or delay the progression to overt diabetes. The primary focus of this review is on lifestyle interventions, including dietary changes, regular physical activity, and weight management, as key strategies to address the underlying factors contributing to insulin resistance and impaired glucose metabolism. Evidence from clinical studies underscores the efficacy of these interventions in improving insulin sensitivity, promoting weight loss, and stabilizing blood glucose levels among individuals with prediabetes. Furthermore, the abstract highlights the importance of personalized and sustainable lifestyle modifications, considering individual preferences, cultural influences, and socioeconomic factors. Behavioral interventions, such as motivational coaching and support groups, are discussed as essential components to facilitate long-term adherence to healthy lifestyle practices. In conclusion, this article advocates for a comprehensive and patient-centered approach to managing prediabetes, with a strong emphasis on lifestyle modifications. By empowering individuals with prediabetes to make sustainable changes in their daily habits, there is a promising avenue to curb the progression to type 2 diabetes and improve overall health outcomes.

Socioeconomic gradient of lean diabetes in India: Evidence from National Family Health Survey, 2019-21.

Diabetes is a global public health challenge, particularly in India, affecting millions. Among diabetic patients, lean type 2 diabetes is a severe subtype with higher microvascular complication risks. While studies on the prevalence, variations and risk factors of diabetes are increasingly available, there has been limited research on the prevalence, variations, and socioeconomic disparities of lean diabetes in India. This study used NFHS-5 microdata, and lean diabetes is defined as those with a BMI level of under 25 and random blood glucose levels of over 200 or under diabetic medication. Descriptive and multivariate analyses were conducted to understand lean diabetes variations and related factors. Socioeconomic disparities were measured using concentration curves and the concentration index. The study unveiled important insights into lean diabetes in India. 8.2% of men and 6.0% of women had elevated blood glucose levels, indicating a significant diabetes burden. Notably, 2.9% of men and 2.4% of women were diagnosed with lean diabetes. Among type 2 diabetics, 52.56% of males and 43.57% of females had lean type 2 diabetes. Lean diabetes prevalence varied from 11.6% in the poorest quintile to 1.1% in the richest. The odds of lean type 2 diabetes among those in the poorest quintile was 6.7 compared to the richest quintile. The concentration index of lean type 2 diabetes was -0.42 for men and -0.39 for women, suggesting a disproportionate impact on lower socioeconomic groups. This study advances our understanding of the complex interplay between socioeconomic factors and lean type 2 diabetes in India. To address the rising burden of lean diabetes among lower socioeconomic strata, policymakers and healthcare professionals must prioritise initiatives enhancing healthcare access, promoting healthy lifestyles, and ensuring effective diabetes management. By addressing socioeconomic disparities and implementing interventions for vulnerable populations, India can reduce diabetes-related mortality and enhance its citizens' overall health.

Early detection of diabetic foot ulcer using IoT and ML

This study explores the critical realm of Diabetic Foot Ulcers (DFUs) and proposes an innovative approach for early detection using Internet of Things (IoT) and Machine Learning (ML). A chronic metabolic condition with elevated blood glucose levels is called diabetes mellitus. A foot ulcer is an open wound that is typically located beneath the feet. It can be shallow and less severe, occurring just below the skin's surface, or it can be deep and expose the bones, tendons, and joints. However, diabetes patients may be able to avoid complications from diabetic foot ulcers if early prophylaxis is practiced. One of the complications that this condition is frequently linked to is diabetic foot ulcers. Focusing on Diabetes Mellitus, the chronic metabolic condition leading to DFUs, the study introduces a wearable shoe prototype equipped with temperature and pressure sensors. This IoT-enabled device facilitates daily foot evaluation at home, allowing for timely identification of early symptoms and severity monitoring. By integrating ML algorithms, the real-time ulcer detection system aims to prevent complications, reduce amputations, and enhance proactive diabetic care.

Quercetin prevents rats from type 1 diabetic liver damage by inhibiting TGF-ꞵ/apelin gene expression

BackgroundHyperglycemia-induced oxidative stress is a significant contributor to diabetic complications, including hepatopathy. The current survey aimed to evaluate the ameliorative effect of quercetin (Q) on liver functional disorders and tissue damage developed by diabetes mellitus in rats. MethodsGrouping of 35 male Wistar rats was performed as follows: sham; sham + quercetin (sham + Q: quercetin, 50 mg/kg/day in 1 ml 1% DMSO for 6 weeks, by gavage); diabetic control (Diabetes: streptozotocin (STZ), 65 mg/kg, i.p.); diabetic + quercetin 1 (D + Q1: quercetin, 25 mg/kg/day in 1 ml 1% DMSO for 6 weeks, by gavage after STZ injection); and diabetic + quercetin 2 (D + Q2: quercetin, 50 mg/kg/day in 1 ml 1% DMSO for 6 weeks, by gavage after STZ injection). Body weight, food intake, and water intake were measured. Ultimately, the samples of plasma and urine, as well as tissue samples of the liver and pancreas were gathered for later assays. ResultsSTZ injection ended in elevated plasma blood glucose levels, decreased plasma insulin levels, liver dysfunction (increased activity levels of AST, ALT, and ALP, increased plasma levels of total bilirubin, cholesterol, LDL, triglyceride, decreased plasma levels of total protein, albumin and HDL), enhanced levels of malondialdehyde, diminished activities of antioxidant enzymes (superoxide dismutase, and catalase), reduced level of glutathione (GSH) increased gene expression levels of apelin and TGF-ꞵ, plus liver histological destruction. All these changes were diminished by quercetin. However, the measure of improvement in the D + Q2 group was higher than that of the D + Q1 group. ConclusionsQuercetin improved liver function after diabetes mellitus type 1, possibly due to reduced lipid peroxidation, increased antioxidant systems, and inhibiting the apelin/TGF-ꞵ signaling pathway.

Outcome of hospitalized patients with COVID-19 and predictors at the Buea Regional Hospital, South West region of Cameroon.

there is a paucity of data on the epidemiology of COVID-19 infection in Cameroon with a few studies limited to big urban cities. The objective of this study was to describe the clinical characteristics and outcomes of hospitalized patients with COVID-19 at the Buea Regional Hospital, in the South West region of Cameroon. this was a retrospective cross-sectional study. The medical records of hospitalized patients with COVID-19 were reviewed from 2020 to 2021. Hospitalized patients with laboratory-confirmed COVID-19 were included. Binary logistic regression was used to identify factors associated with mortality. two hundred and ten (210) patients were included in this cohort. There were 114 (54.7%) men. The mean age was 60±17.1 years. The common co-morbidities were hypertension (46.7%), diabetes mellitus (31%), and HIV infection (5.7%). The most common symptoms were dyspnea (93.3%), fatigue (93.8%), cough (77.6%), and fever (71.4%). The median oxygen saturation was 85% and the median respiratory rate was 24 cycles per minute. More than 80% had crackles on lung examination. Death occurred in 57 (27.1%) patients. In binary logistic regression, the factors independently associated with mortality were heart failure (aOR: 6.7, p=0.034), SBP < 100 mmHg (aOR: 8.1, p<0.001), RR > 24 cpm (aOR: 3, p=0.016), SaO2<90% (aOR: 6.2, p=0.031), blood glucose > 150mg/dL (aOR: 3.3, p=0.02), and CRP > 50 mg/L (aOR: 3.3, p=0.036). For every 1 mg/dL rise in blood glucose, the odds of death increased by 1% (p=0.011). For every 1 mg/L rise in the C-reactive protein (CRP), the odds of death increased by 1% (p=0.054). over half of hospitalized patients with laboratory-confirmed COVID-19 infection in the South West Region of Cameroon were males. Hypertension and diabetes were common co-morbidities. More than a quarter of these patients died. Furthermore, having heart failure, low systolic blood pressure (SBP), low oxygen saturation, elevated respiratory rate, high CRP and blood glucose levels on admission were associated with poor prognosis.

Transdermal exposure to Chrome-III oxide resulting in intoxicaitons and morbidity in two tanning workers—a case report

Here, we report two cases of chrome-III oxide intoxications following transdermal exposure in tanning workers. A 58-year-old man (case 1) and his 41-year-old co-worker (case 2) were brought to our ED with unconsciousness six hours after accidental transdermal exposure to chrome-III oxide crystals (Tankrom® AB, Chrome-III oxide 25.5% and Schorlemmer Basicity 33%). Upon arrival, both patients presented with agitation and chemical burns affecting 11% (case 1) and 3% (case 2) of their total body surface area, respectively. Chemical burns were mainly distributed on injured skin. Initial arterial blood gas analysis revealed moderate (case 1, pH: 7.268) to mild acidosis (case 2, pH: 7.352). One of our patients (case 1) had significant respiratory depression. Laboratory results of case 1 and case 2 showed increased white blood cell counts, (16,630 mm3 and 19,950 mm3) and elevated blood glucose (178 mg/dL and 193 mg/dL), creatinine (1.33 mg/dL and 1.52 mg/dL), liver enzyme (aspartate aminotransferase/alanine aminotransferase of 416/322 U/L and 141/118 U/L) and creatine phosphokinase level (474 U/L and 566 U/L), respectively. Radiologic examinations revealed an orbital wall fracture and L2 compression fracture in case 1, while case 2 had a subdural hematoma, subarachnoid hemorrhage and scapular fracture and had to undergo an operation for external ventricular drainage. Both patients became alert on day three (case 1) and day six (case 2) and were discharged on day 27. We serially measured their serum and urinary chromium concentrations after hospital arrival. The calculated serum half-lives were 35.7 hours and 25.1 hours, and urinary half-lives were 2.3 hours and 2.5 hours in case 1 and case 2, respectively. We suggest that transdermal exposure to chrome-III oxide, especially to injured skin, may result in significant toxicity and morbidity. Therefore, it is essential to take necessary precautions and preventive measures to avoid transdermal exposure to chromium.

Restoring physiological parameters of the pancreas and kidney through treatment with a polymeric nano-formulation of C-peptide and lisofylline combination in diabetic nephropathy.

Diabetic nephropathy (DN) is a progressive kidney disorder that develops as a complication of diabetes due to long-term exposure to elevated blood glucose levels (BGLs). In this case, an intervention of therapeutic moieties is needed to target the specific elements involved in diabetes to prevent/delay the deterioration of kidney function. Therefore, the present study focused on designing and evaluating a potent nano-formulation of a combination of C-peptide (CPep) and the anti-diabetic drug lisofylline (LSF) to prevent streptozotocin (STZ)-induced DN. As a strategic intervention, an LSF-oleic acid prodrug (LSF-OA) was initially synthesized and further encapsulated in an in-house-synthesized cationic polymer [(mPEG-b-P(CB-{g-DMDP}-co-LA)); mPLM] to prepare polymeric nano-complexes of CPep via electrostatic interaction, possessing a size of 218.6 ± 14.4 nm and zeta potential of +5.2 mV together with stability for 30 days at 25 °C. mPLM-LSF-OA-CPep nanoparticles demonstrated hemocompatibility with RBCs and exhibited potent anti-oxidant activity by reducing nitrite levels, inducing the release of anti-oxidant GSH and protecting metabolically stressed rat kidneys and murine insulinoma cells from apoptosis. In vivo pharmacokinetics depicted an increase in t½ and mean residence time in rats, which further improved the BGL and renal conditions and reduced plasma IL-6 and TNF-α levels in the STZ-induced DN animal model when treated with mPLM-LSF-OA-CPep compared to free LSF and CPep. Moreover, an increase in the plasma insulin level and detection of proliferative marker cells in pancreatic islets suggested the regeneration of β-cells in diabetic animals.

The classical Biomarkers to Predict Diabetes Mellitus

Diabetes mellitus is metabolic disorders; depicted by elevated blood glucose levels ascribed to a futile, scanty or sojourns production of insulin. Enduring complications of the disease have been related to peripheral vascular problems, steering to cardiovascular diseases, stroke, diabetic retinopathy, nephropathy and foot. Precise monitoring of these complications and early therapy stages will allow improvement in prevention and treatment approaches. The availability of measurable, accurate and reproducible biomarkers allow the patient to receive timely enactment of personalized therapies and circumventing harmful blood sugar fluctuations that ultimately progress to life-threatening impediments. Profound knowledge of these biomarkers released by extracellular vesicles in metabolic diseases and other disease condition may guide the development of novel therapeutic approaches to restore the affected pathogenesis, rather than merely treating the symptoms. With advent of method that can isolate (ultracentrifugation, affinity-based capture, size exclusion chromatography/filtration, polymer precipitation) and characterize (protein quantification, transmission electron microscopy, atomic force microscopy, ELISA, nanoparticles tracking analysis, flow cytometry, western blot) from body fluids have become a major diagnostic and prognostic biomarkers not only in diabetes, in other conditions like cancer, neurodegradative disease.

Impact of butyric acid modification on the structural and functional properties of rice starch

Rice is a food with a high starch content, comprising over 75% of its composition. However, prolonged and excessive consumption of this cereal may lead to elevated blood glucose levels, which can increase the risk of obesity, type 2 diabetes, and cardiovascular disease. Butyric acid (BA), the primary energy source for colonic epithelial cells, exhibits the highest utilization rate among short-chain fatty acids, underscoring its importance for human health. In this study, rice starch butyrate (RSB) samples were synthesized using the aqueous phase process, with broken rice starch (RS) and butyric anhydride serving as the substrate. RSB samples with different degrees of substitution (DS) were produced by modulating the addition amount of butyric anhydride. The crystal structures, morphology of starch granules, pasting properties, thermal stability, and in vitro digestibilities of the RSB were investigated and compared with those of native rice starch. Fourier transform infrared (FTIR) spectroscopy confirmed the successful incorporation of butyryl into the starch molecules. With the increase in DS, the roughness of the RSB material's surface gradually increased, leading to the deterioration of the smooth structure on certain surfaces, which resulted in the appearance of cracks and collapses. Additionally, the crystallinity diminished from 24.77% to 7.41% with increasing DS. Concurrently, in vitro digestive characterisation revealed that the percentage of resistant starch increased from 24.33% to 47.72%. Thus, this study can provide a theoretical basis for the development of novel products of amyl butyrate.

Daphnetin ameliorates diabetic cardiomyopathy by regulating inflammation and endoplasmic reticulum stress-induced apoptosis.

Daphnetin has been demonstrated to exert beneficial effects on diabetes mellitus and renal complications. However, the role and molecular mechanism of daphnetin in diabetic cardiomyopathy (DCM) remain unclear. In this study, rats were injected with streptozotocin (STZ) to induce diabetes. The diabetic rats were then administered daphnetin (1 and 4 mg/kg) or dimethyl sulfoxide (DMSO) daily for 12 weeks. The results demonstrated that the diabetic rats exhibited elevated blood glucose levels, which were dose-dependently ameliorated by daphnetin. At 13 weeks following STZ injection, the rats exhibited typical diabetic signs, cardiac dysfunction, and evident pathological alterations in myocardial tissues. The administration of daphnetin to diabetic rats resulted in improvement in cardiac function, reductions in myocardial injury biomarkers, and the inhibition of myocardial fibrosis. Furthermore, daphnetin treatment suppressed inflammation and endoplasmic reticulum stress-induced apoptosis in a dose-dependent manner. Additionally, daphnetin exhibited partial blockade of the activation of mitogen-activated protein kinase pathways induced by diabetes. These findings indicate that daphnetin may be a promising therapeutic agent for the treatment of DCM.