Trace elements play a vital role in maintaining metabolic health by regulating glucose metabolism, enhancing insulin sensitivity, and supporting antioxidant defense. Moreover, they act as protective shields against toxic metal-induced oxidative stress, where even slight imbalances can shift the body from metabolic harmony to diabetes progression. This prospective case-control study was conducted at the Department of Biochemistry in collaboration with the Department of General Medicine at the North Indian Tertiary Care Centre. This study included 473 newly diagnosed type 2 diabetic patients (T2DM) and 303 controls. Serum toxic and trace elements were analyzed using inductively coupled plasma mass spectrometry. HbA1c was measured using ion-exchange high-performance liquid chromatography, while fasting serum insulin and glucose levels were measured using Cobas 6000, Roche Diagnostics to calculate insulin resistance and beta-cell dysfunction. Toxic elements (Nickel and Arsenic) and trace elements (Selenium, Molybdenum, Chromium, and Copper) were significantly elevated, while Manganese (Mn) was significantly reduced in the T2DM group compared to the controls (p < 0.0001, respectively). Nickel (Ni) and arsenic (As) were independently associated with HbA1c and insulin resistance in multivariate analysis. Among the trace elements, only Mn remained independently but was negatively associated with HbA1c. With β-cell function as the outcome, As remained negatively associated, and Mn remained positively associated. Gaussian process classifier and Bayesian kernel machine regression analysis further verified that Mn antagonizes diabetes risk associated with Ni and As exposures. Targeting trace element homeostasis, particularly enhancing Mn status, may open new avenues for the prevention and therapeutic intervention of T2DM.

This study aimed to assess the efficacy and hypoglycemia safety of tirzepatide as an add-on to basal insulin in people with inadequate glycemic control, across subgroups of baseline age, type2 diabetes (T2D) duration, HbA1c, and basal insulin dosage using pooled data from the SURPASS-5 and -6 studies. This exploratory post hoc analysis compared data from 1072 participants treated with tirzepatide as an add-on to basal insulin in SURPASS-5 and SURPASS-6. In SURPASS-5, tirzepatide was compared against placebo, while in SURPASS-6, it was compared with insulin lispro. Insulins were titrated to the target in both trials. Subgroups were divided by baseline HbA1c (≤ 8.5% and > 8.5%), age (< 65years and ≥ 65years), duration of T2D (< 10years and ≥ 10years), and insulin glargine dose (< 50IU/day and ≥ 50IU/day). At the primary endpoint, tirzepatide added to basal insulin glargine was associated with significant reductions in HbA1c, fasting serum glucose, and insulin glargine dose across all subgroups (P < 0.001), with no significant heterogeneity (all interaction P values > 0.1). Clinically significant hypoglycemia incidence rates were highest in younger participants with a baseline HbA1c above 8.5% and duration of T2D ≥ 10years. In this study, tirzepatide combined with basal insulin glargine was associated with reductions in HbA1c, fasting serum glucose, and insulin glargine dose from baseline, with a low incidence of hypoglycemia, regardless of baseline age, HbA1c, duration of T2D, or basal insulin dose. Trials were registered at ClinicalTrials.gov under the identifiers NCT04039503 (SURPASS-5) and NCT04537923 (SURPASS-6).

Background: Obesity is characterized by chronic low-grade systemic inflammation that contributes to metabolic dysfunction. Diet is a modifiable factor that can help reduce this inflammation. Nuts such as almonds are rich in unsaturated fats, and antioxidant and anti-inflammatory micronutrients, which may work synergistically to attenuate obesity-related inflammation. Hence, the objective of this study was to investigate whether daily almond consumption improves systemic inflammatory and immune markers in adults with obesity. Methods: In this randomized controlled parallel-arm trial (ClinicalTrials.gov ID NCT05530499), 69 adults (age 30-45 years) with obesity (BMI 30-45 kg/m2) were assigned to consume either 57 g/day of almonds (n = 38) or an isocaloric snack (cookie; n = 31) for six weeks. Fasting serum inflammatory cytokines, innate immune cell counts, body weight, serum glucose, insulin, lipid profile, and alpha-tocopherol were measured at baseline and week six. Dietary intake, compliance, palatability, acceptance, and appetite ratings were also assessed. Primary outcomes were analyzed using linear mixed models and baseline-adjusted linear models. Results: Subjective compliance was high in both groups, with greater acceptance of almonds (p < 0.05); however, serum alpha-tocopherol did not change. Almond consumption significantly decreased serum IL-6, TNF-α, and IFN-γ over 6 weeks compared with the cookie group (p < 0.05). No significant group differences were observed for innate immune cell counts, body weight, appetite ratings, blood pressure, or serum fasting glucose, insulin, total cholesterol (C), LDL-C, and triglycerides over six weeks. The almond group also increased intakes of monounsaturated fat, fiber, alpha-tocopherol, magnesium, zinc, and manganese, and improved diet quality indices relative to the cookie group (p < 0.05). Conclusions: Daily almond consumption for six weeks improved inflammatory cytokine profiles in adults with obesity, without changes in body weight under free-living conditions. These findings support recommending almonds as part of healthy dietary patterns to help attenuate obesity-related inflammation.

This study evaluates a non-invasive and feasible nutritional strategy as a realistic intervention to prevent or mitigate T2DM in one-year-old female Wistar rats. This strategy is based on replacing a commercial pâté (CP) with a functional one, either a silicon-enriched commercial pâté (Si-CP), a reduced-fat pâté formulated with a biopolymeric emulsion (BP), or a silicon-enriched and reduced-fat biopolymeric pâté (Si-BP). After consumption of a high-saturated fat high-cholesterol diet, CP rats exhibited elevated fecal excretion, fasting serum glucose, insulin, and LDL cholesterol, and altered islet morphology. Versus the CP group, the Si-CP consumption group exhibited significantly reduced fecal output (1.17 ± 0.02 vs. 2.09 ± 0.44) and serum insulin (12.06 ± 7.89 vs. 20.74 ± 7.44), triglycerides (47.51 ± 4.46 vs. 58.24 ± 9.97), LDL cholesterol (34.63 ± 5.14 vs. 42.20 ± 4.98), and ghrelin (32.49 ± 24.66 vs. 78.35 ± 22.85). Although BP rats also exhibited some positive effects, Si-BP animals presented the most promising results. Compared to the CP group, Si-BP consumption significantly reduced fecal excretion (1.44 ± 0.24) and serum glucose (129.1 ± 10.40 vs. 154.9 ± 15.76), insulin (9.49 ± 6.06), triglycerides (46.91 ± 5.13), and estradiol (528.2 ± 45.00 vs. 634.4 ± 98.87), preserved islet circularity (0.88 ± 0.02 vs. 0.82 ± 0.01), and significantly increased tibia length (4.09 ± 0.12 vs. 3.95 ± 0.09) and wet weight (0.65 ± 0.07 vs. 0.56 ± 0.06). This study demonstrates the antidiabetic effects of silicon from diatomaceous earth (4 mg Si/kg body/day) incorporated into pâté in middle-aged female rats. Replacing CP with a functional alternative improved the health status of diabetic female rats, supporting its potential as an effective nutritional adjuvant.

A novel compound mixture mitigates hyperglycemia, insulin resistance, dyslipidemia, and oxidative stress in streptozotocin induced diabetic rats: A therapeutic drug lead for metabolic syndrome.

BackgroundAccurate assessment of insulin resistance, sensitivity and β-cell function is essential for early detection and management of metabolic disorders. However, reference intervals (RIs) commonly used in Nepal have been adapted from Western populations, which may not accurately reflect local physiological characteristics. Thus, this study aimed to establish population-specific RIs for fasting insulin and key insulin-related indices using a direct priori method in healthy adults from Gandaki Province, Nepal.MethodThis cross-sectional study recruited 135 healthy adults (20–69 years, body mass index 18.5–24.9 kg/m²) representing different districts of Gandaki Province, Nepal. Fasting blood samples were analysed for glucose, insulin and lipids using standardised assays. Insulin was measured using the chemiluminescence immunoassay method. Nineteen different insulin-derived indices (Homeostasis Model Assessment 1 of Insulin Resistance (HOMA1-IR), Homeostasis Model Assessment 2 of Insulin Resistance (HOMA2-IR), Homeostasis Model Assessment for Triglycerides, Fasting Insulin to Glucose Ratio, Fasting Insulin Resistance Index, Metabolic Score for Insulin Resistance (METS-IR), InsuTAG, HOMA1-%S, HOMA2-%S, Quantitative Insulin Sensitivity Check Index (QUICKI), McAuley, Bennett, Raynaud, Glucose-to-Insulin Ratio, Fasting Insulin Sensitivity Index, Single Point Insulin Sensitivity Estimator (SPISE), reciprocal insulin, HOMA1-%B and HOMA2-%B) were calculated. Non-parametric 95% double-sided RIs (2.5th–97.5th percentiles) were established following outlier removal per Clinical and Laboratory Standards Institute-International Federation of Clinical Chemistry and Laboratory Medicine EP28-A3c guidelines.ResultsThe RI for fasting insulin was 2.63–14.56 µIU/mL (median 7.69 µIU/mL). Among the 19 mathematically correlated insulin-derived indices which are calculated from core measurements (fasting serum insulin and glucose), consistent patterns emerged across functional categories. Insulin resistance indices (HOMA1-IR: 0.56–3.50; HOMA2-IR: 0.30–1.70; METS-IR: 25.14–38.94) exhibited concordant right-skewed distributions with elevated upper limits. Conversely, insulin sensitivity indices (QUICKI: 0.32–0.42; HOMA2-%S: 58.83–233.20; SPISE: 5.75–10.86) demonstrated inverse, left-skewed patterns. Beta-cell function indices (HOMA1-%B: 0.54–322.21; HOMA2-%β: 40.74–159.52) also exhibited right skewed characteristics and revealed wide interindividual variability, reflecting preserved pancreatic reserve despite varying insulin resistance. Composite indices incorporating lipid parameters showed broader ranges, capturing additional metabolic heterogeneity.ConclusionThis is the first study to define the RIs of fasting insulin and a spectrum of insulin derived indices in a Nepalese population. These findings offer a valuable framework for early detection and management of metabolic disorders in South Asian populations.

Type 2 Diabetes Mellitus (T2DM), a growing metabolic disease that is expected to affect 693 million people by 2045. Hyperglycemia is associated with defect in ionic metabolism, particularly potassium (K+). The current study aimed to explore correlation between serum potassium levels and hyperglycemia, as well as other complication in patients with T2DM . This study included 100 T2DM patients (50 males and 50 females) , aged 40-75 years . A control groups was matched with patient in both age and numbers of participants . Total serum potassium and fasting serum glucose levels were determined using ready-made solutions for the Quantitative determination of potassium ion (IVD). The results revealed significantly lower serum potassium levels in T2DM patients compared with healthy controls (3.493±0.0389 mmol/L vs. 4.268±0.05 mmol/L; P= 0.0001). Female patients showed significantly lower serum potassium levels than controls (4.236±0.069 mmol/L vs. 3.502±0.065 mmol/L; p= 0.0001).Similarly, male patients exhibited significantly lower serum potassium levels compared with controls (3.484±0.043 mmol/L vs. 4.30±0.073 mmol/L; p=0.0001). Additionally , a strong negative correlation was observed between serum glucose levels and potassium concentration in patients, with a regression value of 0.88 and high statistical significance (p&lt;0.001). Conclusion: our finding has explored the a strong negative correlation between elevated glucose levels and decreased in potassium concentration in T2DM patients.

Background: Hypertension and diabetes mellitus frequently coexist, affecting millions worldwide. The choice of antihypertensive medication may influence glycemic control, making the metabolic effects of these agents clinically significant. Amlodipine, a widely prescribed dihydropyridine calcium channel blocker, has demonstrated potential glycemic benefits beyond its blood pressure-lowering effects. Objective: This study examines the impact of amlodipine therapy on glycemic parameters in hypertensive patients, including those with and without pre-existing diabetes mellitus. Methods: A comprehensive literature review was conducted analyzing recent clinical studies, randomized controlled trials, and observational research examining the relationship between amlodipine use and glycemic outcomes, including HbA1c levels, fasting plasma glucose, and incidence of new-onset diabetes. Results: Evidence demonstrates that amlodipine therapy is associated with improved glycemic control in hypertensive patients with diabetes, with reductions in HbA1c levels of 0.39% compared to standard diabetes therapy alone. Additionally, amlodipine significantly reduces the risk of new-onset diabetes by 34% compared to beta-blocker therapy. Calcium channel blockers, particularly amlodipine, show a neutral to beneficial effect on glucose metabolism, with average reductions in fasting serum glucose of 5-10 mg/dL. Conclusion: Amlodipine represents a favorable antihypertensive choice for patients with diabetes or those at risk for developing diabetes. Its neutral to beneficial effects on glycemic parameters, combined with effective blood pressure control, make it an optimal therapeutic option in the management of hypertensive patients with metabolic concerns.

This study aimed to investigate the association between dietary supplement use and regression from pre-diabetes (Pre-DM) to normal glucose regulation (NGR) in a well-characterized population-based cohort. A total of 2,174 adults with Pre-DM (mean age 51.9 ± 14.2 y; 48.6% men) were enrolled from the Tehran Lipid and Glucose Study (2009-2011) and followed up to 2015-2018. Baseline dietary supplement use was assessed via structured interviewer-administered questionnaires and verified when possible with supplement containers, medication lists, or written records. Participants reporting any supplement, including vitamins and minerals, were classified as users. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for regression to NGR. The overall mean fasting serum glucose (FSG) and 2-hour serum glucose (2h-SG) levels over time were compared between supplement users and non-users using repeated measures analysis of variance (ANOVA). Over a median of 6 years of follow-up, 44.2% of participants regressed to NGR. Calcium supplementation was associated with a 25% lower probability of regression (HR = 0.75, 95% CI = 0.59-0.96). Iron supplementation was associated with a 45% higher likelihood of regression to NGR (HR = 1.45, 95% CI = 1.05-2.02). Participants who reported taking iron supplements had a significantly lower mean FSG compared with non-users (99.7 vs. 104mg/dL, P = 0.003), while mean 2h-SG concentrations were slightly lower in this group (133 vs. 139mg/dL, P = 0.09). Use of iron supplement may increase, whereas use of Ca supplement may decrease the likelihood of regression from Pre-DM to NGR.

The aim of the study is to evaluate the effects of 12-week high-intensity interval training (HIIT) on body composition, metabolic hormones, insulin resistance, lipid profile, inflammation, and oxidative stress markers in adolescents with obesity. Thirty-two (female = 19; male = 13) adolescent volunteers with obesity were divided into two groups: training and control. Participants underwent health checks with resting electrocardiogram (ECG) and blood pressure monitoring. Anthropometric measurements, body composition components, and biochemical tests were performed in pre and post-tests of all participants. Serum fasting glucose, insulin, total cholesterol, triglyceride, high and low-density lipoproteins, leptin, adiponectin, High-Sensitivity C-Reactive Protein (hs-CRP), Tumor Necrosis Factor-alpha (TNF-α), Interleukin-6 (IL-6), hs-CRP, TNF-alpha, IL-6, prooxidant, and antioxidant parameters were analyzed biochemically. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was calculated. The training group participated in a HIIT program for 12 weeks, 3 days a week, for a total of 36 sessions, after 3 weeks of pre-adaptation studies. Heart rate was monitored with a heart rate monitor. The control group was not included in any exercise program during this period. The mean age of the adolescents with obesity included in the study was 15.28 ± 2.93 years and Body Mass Index (BMI) was 33.21 ± 4.98 kg/m2. Group, sex, and time interaction effects showed that HOMA-IR and triglyceride levels had reduced in the HIIT group (p < 0.001). The group-time interaction effect was observed in the parameters related to body composition, metabolism, inflammation, and pro-oxidant status (p < 0.05). BMI, waist and hip circumferences, body fat (%), insulin, glucose, total cholesterol, LDL, triglyceride, and leptin were decreased in the HIIT group (p < 0.05). While lean mass, muscle mass, body water and adiponectin were increased in the HIIT intervention group (p < 0.05). The inflammation parameters (hs-CRP, TNF-α, and IL-6), and pro-oxidant indicator Advanced Glycation End Products (AGEs) were decreased in the HIIT group. A 12-week HIIT program in adolescents with obesity has positive effects on body composition, metabolic parameters, inflammation, and oxidative stress markers. These benefits may contribute to healthy growth and developmental processes. HIIT represents a time-efficient, practical, and effective strategy to mitigate obesity-related metabolic and inflammatory disturbances while strengthening antioxidant defenses.

Diabetes and prediabetes are some of the most serious social and medical issues of the present day. It is fitting to identify a distinct category of women aged 40 to 60 who have diabetes mellitus (DM) or prediabetes to discover new biomarkers related to DM diagnosis. As this age group is predominantly overweight, which is considered a risk factor for several health issues, it is one of the most serious social and medical problems today that interferes with the physiological and metabolic lipid profile, as well as other proteins linked to metabolic effects.The objective: to examine F-box and WD repeat domain-containing protein 7 (FBXW7) levels in relation to total fatty acids (TFAs) in women with type 2 DM (T2DM) in order to investigate their potential interaction.Materials and methods. The current study included 124 women who were divided into three groups: G1 included 31 patients with prediabetes, G2 – 65 women with T2DM; G3 (control) consisted of 28 women without pathology. The level of FBXW7 and TFAs were determined using enzyme-linked immune sorbent assay. The level of fasting serum glucose and lipid profile were determined using spectrophotometer, and the level of HbA1c – by a fully auto technique.Results. Serum levels of FBXW7 were significantly higher in women with prediabetes compared to both the G2 and G3, possibly due to tissue damage which is associated with the onset of DM. TFAs concentrations revealed distinct patterns across the groups, G3 had the highest concentration. These findings indicate a gradient in fatty acid levels, with G3 showing significantly higher concentrations. Cluster analysis showed that 90% of the data were homogenized in cluster 1, where the distributions of parameters matched the original data distribution. In contrast, cluster 2 displayed different distributions. Furthermore, TFAs was identified as a more significant predictor than FBXW7 in diabetic patients.Conclusions. These results highlight the importance of TFAs and FBXW7in the diagnosis and progression of DM women with obesity.

Currently, there is no doubt that type 2 diabetes mellitus (T2DM) is associated with local and systemic manifestations of meta-inflammation, which is considered as one of the variants of low-grade inflammation. Aim of the study was to develop and test a scale for assessing chronic systemic meta-inflammation in patients with prediabetes and T2DM based on a comparative analysis of inflammation biomarker levels. Material and methods . Two groups of patients were studied: prediabetes (n = 26, fasting serum glucose level of 6.1–6.9 mmol/L and/or postprandial glycemia 7.8–11.0 mmol/L, and glycated hemoglobin content &lt;6.5 %) and T2DM (n = 63). The control group consisted of blood donors (n = 89). To verify meta-inflammation, an integral criterion was used, including blood plasma content of C-reactive protein, cytokines (IL-6, IL-8, TNFα), cortisol, D-dimers. Results and discussion . Systemic meta-inflammation developed in 57.7 % of patients with prediabetes and in 74.6 % patients with T2DM, but was not detected in the control group. At the same time, in 7.7 and 19 % cases with prediabetes and T2DM, respectively, meta-inflammation in intensity can be characterized as systemic hyperinflammation, when the levels of individual proinflammatory cytokines increased by ten folds relative to the upper normal limit. Conclusions . Systemic meta-inflammation develops in most, but not all patients with prediabetes and T2DM. In some patients, however, its intensity goes beyond low-grade inflammation and is rather characterized as systemic hyperinflammation, with its characteristic “cytokine storm” phenomenon.

Triglyceride-glucose (TyG) index has emerged as a reliable surrogate marker for insulin resistance and an early indicator of metabolic dysfunction. However, its association with inflammatory markers and adipokine dysregulation in patients with metabolic syndrome (MetS) remains poorly understood. This study aimed to investigate the association of the TyG index with inflammatory biomarkers and adipokine profiles in adults diagnosed with MetS. This cross-sectional study included 190 adults (aged 20-50 years) with metabolic syndrome (MetS), recruited from primary healthcare centers in Iran. We collected anthropometric and biochemical data, and calculated the TyG index, classifying participants into quartiles based on their TyG values. Fasting serum glucose (FSG), insulin, and lipid profiles were measured. Insulin resistance was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). In addition, inflammatory markers including tumor necrosis factor alpha (TNF-α), Interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP) long with serum levels of adipokines including leptin, adiponectin, resistin, visfatin, vaspin, and omentin-1 were measured using standardized assays. Higher TyG quartiles were associated with increased levels of insulin, HOMA-IR, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), TNF-α, leptin, and resistin, and decreased levels of adiponectin (all p < 0.05). There were no significant differences in high-density lipoprotein cholesterol (HDL-c), IL-6, hs-CRP, visfatin, vaspin, or omentin-1. These associations remained significant even after adjusting for age, sex, body mass index (BMI), smoking status, and physical activity. Our findings suggest that the TyG index reflects not only insulin resistance and atherogenic dyslipidemia, but also low-grade inflammation and adipokine imbalance in patients with MetS. Due to its simplicity and cost-effectiveness, the TyG index could be a useful tool for early metabolic risk assessment and identifying adipose tissue dysfunction.

IntroductionVitamin D deficiency has been implicated in metabolic dysregulation, including insulin resistance and inflammation, commonly observed in patients with type 2 diabetes mellitus (T2DM) and obesity. Evidence on the metabolic impact of vitamin D supplementation in this population remains inconsistent.ObjectiveTo evaluate the effects of high-dose vitamin D3 supplementation on anthropometric and selected metabolic parameters in ambulatory obese patients with T2DM treated with metformin monotherapy.MethodsThis 12-week prospective cohort study included 200 patients with T2DM, allocated to a supplementation group (n = 100; vitamin D3 - 4,000 IU/day) or a control group (n = 100; no supplementation). Primary outcome was change in serum 25-hydroxyvitamin D [25(OH)D] concentration. Secondary outcomes included fasting serum glucose (FSG), glycated hemoglobin (HbA1c), blood pressure (BP), serum calcium, and body mass index (BMI). Predictors of failure to achieve target HbA1c ≤ 6.5% were identified using logistic regression.ResultsAfter 12 weeks, serum 25(OH)D significantly increased in the supplementation group compared with controls (Δ +23.7 vs +1.3 ng/mL; p < 0.001). FSG and HbA1c decreased significantly in the intervention group (Δ –0.4 mmol/L, p = 0.02; Δ –0.6%, p = 0.01, respectively), while no significant changes were observed in systolic or diastolic BP, serum calcium, or BMI. Logistic regression identified higher baseline FSG (OR 1.34, 95% CI 1.12–1.61), longer diabetes duration (OR 1.28, 95% CI 1.07–1.54), and higher BMI (OR 1.21, 95% CI 1.01–1.47) as independent predictors of suboptimal glycemic response.ConclusionsHigh-dose vitamin D3 supplementation significantly improved vitamin D status and was associated with modest improvements in glycemic control in obese patients with T2DM, without affecting blood pressure, calcium, or body weight. These findings support vitamin D repletion as a potential adjunctive strategy in diabetes management, while not allowing causal inference, and warrant further confirmation in randomized controlled trials with longer follow-up.

Abstract Background IBD is associated with complications of the metabolic syndrome including type 2 diabetes, ischemic vascular disease and metabolic associated steatotic liver disease (MASLD) 1. This may arise from shared environmental risk factors, such as diet, disease-related inflammation and the adverse effects of several medications used to treat IBD such as prednisone and Janus Kinase (JAK) inhibitors 2. The study of metabolomics allows the generation of a metabolic barcode of the current metabolic status of an individual, contributed to by the host interaction with their microbiome, environment and indicative of active disease states 3. Our study aimed to explore the relationships between plasma amino acid metabolomic profile and risk factors for metabolic diseases in individuals with IBD. Methods Fasting blood samples were collected, anthropometric measurements: weight, height, waist circumference (WC) and hip circumference recorded and body mass index (BMI) and waist-to-hip ratio (WHR) calculated. Fasting serum glucose, HbA1c, insulin level and lipid profile was measured. Dietary intake was recorded via a smartphone app (Easy Diet Diary) for 8 days and overall healthy eating score (HEIFA-2013 index) calculated 4. Twenty-two plasma amino acid levels were analyzed using Gas Chromatography-Mass Spectrometry (GC-MS). Correlations between fasting plasma amino acids and metabolic markers were evaluated via simple linear regression and p-values adjusted for false discovery rate (adj-p). Results Fifty-seven individuals with IBD in remission, 31 with Crohn’s Disease (CD) and 26 with Ulcerative Colitis (UC) participated. Significant correlations were found between measured anthropometric parameters and insulin and seven fasting plasma amino acids including glutamic acid and insulin (r 0.31, p &amp;lt; 0.01) and leucine and WC r 0.29, p &amp;lt; 0.01) (Table 1). There were no significant correlations between fasting glucose, fasting lipid profile, HbA1c, recorded dietary intake, including HEIFA-2013 score, nor individual dietary components and plasma amino acid levels. Conclusion Diet did not impact the plasma amino acid profile. Measurement of plasma amino acid profile may give insight into the overall metabolic health status of a patient with IBD. This knowledge may serve as a tool for personalised patient education on their metabolic risk status, prompt consideration of the addition of medical or surgical strategies for metabolic management and guide the safest selection of IBD treatment to minimise the impact on metabolic health profile and its associated complications.

Type 2 diabetes mellitus (T2DM) is developed through the coexistence of β-cell dysfunction and insulin resistance. T2DM causes multiple complications, increase mortality and morbidity that make huge social and economic burden. Bangladesh is experiencing a rising prevalence of the disease, posing major challenges for health policy planners. Circulating ferritin concentrations may be related with the advanced risk of T2DM, regardless of iron status. Dysregulation of ferritin and glucose level may exert reciprocal effects. The goal of this study was conducted to evaluate and compare serum ferritin between type 2 diabetic patients and non diabetic apparently healthy groups. This cross-sectional analytical type of study was completed in the Biochemistry department of Mymensingh Medical College and samples were collected from the Endocrinology department of Mymensingh Medical College Hospital, Mymensingh, from July 2023 to June 2024. Through the purposive non-random sampling approach, total 132 study subjects were selected according to inclusion and exclusion criteria. Among them, 66 patients with type 2 diabetes mellitus, diagnosed according to ADA criteria, aged from 30 to 65 years of both male and female, were selected as Group I (Case). Another 66 non diabetic apparently healthy individuals of the same age and sex matched, were selected as Group II (Control). Informed written consents were taken. Baseline parameters were accumulated and recorded in pre-designed data collection sheets. Fasting serum glucose and serum ferritin levels were analysed, Mean±SD was used to express all values. Statistical analysis was done by using SPSS (statistical product and service solutions) version 26.0 windows package. By using Student's unpaired 't' test, quantitative continuous variables were compared between groups of study subjects and qualitative variables by Chi-square test. By using Pearson's correlation coefficient test correlations were done. Following comprehensive analysis, it was revealed that highly significant (p<0.001) raised of serum ferritin level in patient with T2DM (185.83±57.19μg/L) case group when compared with non diabetic (102.59±40.56μg/L) control group. Also showed that, highly significant positive correlations of fasting serum glucose with serum ferritin level in patients with T2DM (r=0.542, p<0.001). This study will provide fruitful information to the clinicians to advance their knowledge to overall management of T2DM. So, it is suggested timely evaluation and regular monitoring of serum ferritin in T2DM.

Type 2 diabetes mellitus (T2DM) is a common risk factor for atherosclerotic cardiovascular disease. Although in patients with coronary artery disease T2DM has a non-negligible prevalence, it is often overlooked. Due to its prognostic impact and the availability of pharmacological intervention, as sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1-RA), able to improve the prognosis, an early diagnosis is crucial. T2DM diagnosis is based on three evaluations: fasting serum glucose levels; glycate hemoglobin levels; and oral glucose tolerance test. In addition, it is important to know the clinical significance of stress-induced hyperglycemia, commonly found in patients with an acute cardiovascular event. As regards T2DM therapy, SGLT2i and GLP1-RA represent two pillars to reduce cardiovascular disease risk but, despite international guidelines, their use remains rather low in routine cardiovascular care. This review reports indications for an appropriate use of these treatments with an analysis of benefits and precautions to consider in clinical practice.

Background: Insulin resistance (IR) is a condition in which the tissues become less responsive to insulin. IR has been linked to many diseases including Type 2 Diabetes Mellitus (T2DM), pre-diabetes, and metabolic syndrome. The most commonly used tool of IR assessment is Homeostasis Model Assessment of insulin resistance (HOMA-IR). In Iraq, there is limited data on the reference interval of HOMA-IR. Objectives: To calculate the reference interval of HOMA-IR among a randomly screened sample of adult people in Nineveh Province, Northern Iraq. Methods: This is a cross-sectional study that finally involved 286 apparently healthy adults (≥25 years). Data were collected in the period from the 1st of September to the end of December 2024. Weight and height were measured and body mass index (BMI) was calculated for each participant. Fasting serum insulin and glucose were tested and used to calculate HOMA-IR. Results: The overall mean ±SD of HOMA-IR for the study population was 2.11±1.34. HOMA-IR 95% reference interval was calculated based on the 2.5th percentile and 97.5th percentile after removing outliers and was (0.53- 4.32). The participants were then divided according to BMI into 3 groups. For subjects with BMI below 25 Kg/m2 , the mean HOMA-IR was 1.62±1.2, and the 95% reference interval was (0.46-3.54). For Subjects with BMI from 25- 29.99 Kg/m2 , the mean HOMA-IR was 1.88±0.75 and the reference interval was (0.64-4.04), however, for subjects with BMI ≥ 30 Kg/m2 , the mean ±SD of HOMA-IR was 2.71±1.61 and the reference interval was established to be (0.49-4.75). Conclusions: The upper end of the reference interval in our study was a bit lower than previous studies in Iraq, and comparable to other studies in the region. Higher BMI is associated with increase in the mean HOMA-IR (p &lt; 0.000). The differences in the methods used to obtain HOMA-IR reference interval may lead to significantly different results.

To determine whether the triglycerides/glucose index (TyG-index), lipid accumulation product (LAP), and visceral adiposity index (VAI) would differ in young polycystic ovary syndrome (PCOS) patients when compared to the non-PCOS group, and to investigate the relationship between these markers and cardiovascular disease (CVD) risk in PCOS patients. One hundred and ninety two women with PCOS, and 148 age and body mass index (BMI) matched healthy women without PCOS were enrolled. Levels of serum androgens, sex hormones, lipids, fasting glucose, fasting insulin, and N-terminal pro-brain natriuretic peptide (Nt-probnp) were determined. The 75 g oral glucose tolerance test was performed. The Homeostatic Model Assessment-Insulin Resistance Index (HOMA-IR) and Matsuda insulin sensitivity index were calculated. Levels of TyG-index, LAP, and VAI were determined. TyG, LAP, and VAI were significantly higher in PCOS patients than in the control group (P = 0.001 vs. P = 0.001 vs. P = 0.001, resp.). HOMA-IR was significantly higher in PCOS patients and Matsuda ISI was significantly lower in PCOS patients (P = 0.001 vs. P = 0.001, resp.). Levels of Nt-probnp were significantly higher in PCOS patients (P = 0.001). Serum total testosterone and androstenedione levels had significant correlations with TyG, LAP, and VAI. Nt-probnp was significantly correlated with TyG, LAP, and VAI. LDL was positively correlated and HDL was negatively correlated with TyG-index, LAP, and VAI. PCOS patients have increased values of TyG-index, LAP, and VAI. TyG index, LAP, and VAI may indicate an increased risk of CVD and hyperandrogenism in PCOS patients.

Resistant starch, and specially retrograded starches (RS), have been suggested as useful biological molecules to improve the glucose management in diabetic conditions. However, the influence of the botanical origin in the RS biological capacities make necessary its evaluation, where RS from legumes have been paid less attention compared to other sources as cereals. A RS product obtained from creole Faba beans (Vicia faba L. creole), was evaluated for the first time as a material capable of improving glucose homeostasis in diabetic conditions. The RS ingredient investigated (with a reduced digestibility of 50%) was tested in a Wistar rat model with induced diabetes, fed with a 15 or 30% replacement of RS ingredient in the diet. Diverse nutritional and biomarkers were analysed. As a result of the reduced digestibility of the RS ingredient, diabetic animals fed with RS replacement (15% or 30%) showed attenuated postprandial hyperglycemia responses, reducing the hyperglycemic condition close to 29% compared to non-treated diabetic animals (24.56 ± 7.50 and 25.02 ± 3.54 vs. 34.65 ± 1.89 mmol/L, respectively). In addition, fasting serum glucose levels were significantly reduced (22%). Other biochemical parameters associated with glucose metabolism, such as glycosylated hemoglobin and AGEs levels, also improved. Furthermore, significant improvements in nutritional parameters (such as weight gain) and a lower insulin resistance index were determined. In contrast, no clear effects were observed in lipid metabolism and oxidative stress biomarkers in the treated group. The results of this research suggest that the retrograded starch from creole beans evaluated could be a potential functional food ingredient capable of enhancing glucose homeostasis in diabetic conditions.