Form Of Diabetes Mellitus Research Articles

Immunological Implications in Diabetes: A Review on Various Diseases and Conditions

Abstract:: Diabetes Mellitus (DM) is a long-term metabolic condition that has significant social, health, and economic consequences. There are various forms of diabetes mellitus, but the two most common varieties are type I and type II. Insulin-dependent diabetes (IDDM) is one of the most wellknown autoimmune illnesses that cause insulin insufficiency and hyperglycemia by either damaging or destroying Langerhans' beta cells. Available scientific data evidenced the greatest genetic contribution of Human Leukocyte Antigen class II in the IDDM. Hyperglycemia and individual components of the insulin resistance (metabolic) syndrome put people with type II diabetes at increased risk for microvascular consequences (retinopathy, nephropathy, and neuropathy) as well as macrovascular issues (cardiovascular comorbidities). A number of pathophysiological abnormalities, including obesity, poor diet, and physical inactivity, as well as genetic variables, are involved in the disturbed glucose homeostasis associated with type II diabetes. Diseases like lipid abnormalities contribute to the progression of diabetes, whereas obesity and its related medical disorders (such as hypertension, diabetes, insulin resistance, and sleep apnea syndrome) are eventually linked to an elevated cardiovascular risk. Diabetes raises the incidence, intensity, and duration of peri-densities in people with diabetes compared to healthy persons, making it a risk factor for periodontal disease. Diabetes conditions in patients concurrently also increase the progression or risk of other diseases, i.e., cardiovascular- related diseases (hypertension, oxidative stress, hyperlipidemia), nervous system-related diseases, and COVID-19, by increasing the overall infection rate. There is widespread evidence that correlates the direct connection between diabetes and other diseases, including immunity disorders, CVS disorders, etc. This review provides a correlation between diabetes and another disease with an overall impact on the progression of cardiovascular diseases, neurological diseases, COVID-19, and periodontal diseases. This current review focuses on the collation of some plants that show antidiabetic activity, including plant part, family, chemical constituent, mechanism of action, and chemical used for extraction. Studies on the role, causes, clinical management, prevention, and treatment of diabetes heavily rely on epidemiological evidence. This review also explains different factors responsible for diabetes, like genetic factors, environmental factors, and viral infections.

The effect of the new coronavirus infection on the human pancreas

The aim of the study - is to study the effect of a new coronavirus infection on the human pancreas. Research materials. An analysis for blood α-amylase, as well as ultrasound of the abdominal cavity, namely the pancreas, was carried out. This study involved 20 patients, 10 had a concomitant disease in the form of diabetes mellitus and 10 without it. The results of the research. During the research, all patients had relatively the same dynamics of pancreatic lesions, without any pronounced manifestations of pancreatitis. The shift of analyses in favor of this pathology indicates more to the glucocorticosteroid therapy that patients received in the treatment of covid-19 coronavirus infection. Only one of the 20 patients studied had a classic manifestation of pancreatitis. Conclusions. Acute pancreatitis is a rare complication of COVID-19, and it is not often associated with this infection. Nevertheless, acute pancreatitis with SARS-CoV-2 infection is considered to have a higher risk of severe course and poor clinical outcomes, including the risk of organ dysfunction and higher inpatient mortality compared to patients with acute pancreatitis negative for SARS-CoV-2.

Detection of mtDNA Mutations Using the Amplification Refractory Mutation System-Polymerase Chain Reaction Method in Type II Diabetes Mellitus Patients in Publich Health Center Poasia

Background: Diabetes Mellitus (DM) is a heterogeneous disease caused by hereditary and ecological factors. One form of diabetes mellitus that is related to genetic factors is type 2 DM. type 2 diabetec melitus caused by dysfunction of insulin secretion, due to the presence of inhibition in the production of Adenosine Triphosphate (ATP) necessary in the process of its secretion by cells β glands of the pancreas. The dysfunction is related to the mutation of A to G at the 3243rd nucleotide position of the mitochondrial DNA tRNA gene. The purpose of the study was to find out whether there was a heteroplasmic mtDNA mutation in the genes of respondents to type 2 diabetes mellitus using the ARMS-PCR method. Methods: The type of research used is descriptive research, the sample used in this study is a blood sample in respondents of type 2 diabetes mellitus. The method chosen in this study is the Amplification Refractory Mutation System (ARMS)-PCR Method which is a PCR application that uses a specific primer. Results: According to this study, 20 of the 20 samples evaluated using the ARMS-PCR method were positive for the heteroplasmic A3243G mutation, which is defined by the presence of DNA bands measuring 200 bp on both tubes. These pathogenic mutations are inherited maternally and can cause a variety of disorders. Conclusion: After analyzing all samples, this study has concluded that they all contain hetero plasma mutations. The suggestions provided in this study are expected to be useful for future researchers who employ samples from other public health centers and hospitals.

Knowledge and Attitude of Medical Students about Insulin Resistance Symptoms, Effect, and Treatment

The inability of the target organs to react appropriately to the action of insulin is known as insulin resistance. Insulin resistance impairs insulin-mediated glucose absorption in the peripheral (skeletal muscle and adipose tissue), which results in increased blood sugar levels and increase insulin demand.
 Aim: This study aims to assess medical students' knowledge and attitudes on the signs, consequences, and treatments of insulin resistance.
 Patients and methods: There were 160 medical students at Tikrit University in all, male and female. The average age of students in the primary stages was 20 years, while that of students in the clinical stages was 23 years old. The current study, which was conducted in 2023 at Tikrit University College of Medicine (TUCOM), is cross-sectional in nature. All data presented statically as percentage.
 Results: There are three forms of diabetes mellitus, according to 43.75 percent of medical students. One of the complications of DM, according to (90.63 %) of them, is vision problems. Diet modification and exercise were preferable than oral hypoglycemic drugs and insulin therapy.
 Conclusions: The study found that (75%) of medical students recognized the link between type 2 DM and insulin resistance, with clinical students showed a higher level of awareness in comparison with preclinical students.

Analysis of the Determinants of Exercise Habits, Diet, and Heredity History with the Incidence of DM in Productive Age at Tirto 1 Health Center, Pekalongan Regency, Indonesia

Degenerative disease in the form of diabetes mellitus which spreads to the elderly because there is a decrease in the function of the body's organs. The industrial revolution 4.0 affects diet and lifestyles which are estimated to increase the risk of diabetes mellitus in productive age. This study aimed to determine the relationship between exercise habits, diet and hereditary history with the incidence of diabetes mellitus in productive age. The research was carried out in April - May 2023 on 51 respondents each with analysis techniques using the Chi – square test and logistic regression. The results of the study showed that there was no relationship between exercise habits (p =0.269, OR=3.267), there is a relationship between diet based on food ingredients including the variable carbohydrate consumption habits (p =0.001, OR = 6.3), and soft drinks (p = 0.031, OR = 5.976) which is a risk factor. While animal protein (p= 0.001, OR=0.001), vegetables (p=0.003, OR = 0.17), fruits (p= 0.003, OR = 0.26) is a protective factor. The results of the analysis of food ingredients that did not show any relationship with the incidence of diabetes mellitus (DM) in productive age included vegetable protein (p = 1,000, OR = 1,000), dairy (p = 1,000, OR=1,000), nuts (p = 0.454, OR=1.654) and snacks (p = 0.523, OR = 1.87) as well as family history (p = 0.029, OR=2.636). Apart from that, it was found that there was a relationship between hereditary factors and the incidence of DM in productive age and became a risk factor in the research. In conclusion, protein is the most dominant influencing variable and protective factor in this research.

The Relationship between Phthalates and Diabetes: A Review.

Since the beginning of their production, in the 1930s, phthalates have been widely used in the plastics industry to provide durability and elasticity to polymers that would otherwise be rigid, or as solvents in hygiene and cosmetic products. Taking into account their wide range of applications, it is easy to understand why their use has been increasing over the years, making them ubiquitous in the environment. This way, all living organisms are easily exposed to these compounds, which have already been classified as endocrine disruptor compounds (EDC), affecting hormone homeostasis. Along with this increase in phthalate-containing products, the incidence of several metabolic diseases has also been rising, namely diabetes. That said, and considering that factors such as obesity and genetics are not enough to explain this substantial increase, it has been proposed that the exposure to environmental contaminants may also be a risk factor for diabetes. Thus, the aim of this work is to review whether there is an association between the exposure to phthalates and the development of the several forms of diabetes mellitus, during pregnancy, childhood, and adulthood.

Peripheral Heating With Negative Pressure at the Feet Increases Blood Flow at the Popliteal, Brachial, and Carotid Arteries

The prevalence of diabetes continues to increase with half (53%) of American adults having some form of diabetes mellitus as of 2020. Novel therapies could help prevent and manage diabetes and its complications. Applying heat with negative pressure (HNP) to the extremities decreases postprandial blood glucose through unknown mechanisms. Increased blood flow to peripheral tissues during HNP may facilitate greater disposal of blood glucose. Objective: Examine the effects of HNP on arterial blood flow in the popliteal, brachial, and carotid arteries. Hypothesis: HNP will increase popliteal but not brachial or carotid blood flow. Methods: Heat (42°C) and negative pressure (-75mmHg) were applied to the soles of both feet and from the feet to calves, respectively. An ultrasound doppler (Philips CX50, USA) was used to measure time-averaged mean velocity (TAMV) and vessel cross-sectional area (CSA) in the left or right popliteal, brachial, and carotid arteries before and during HNP. Body composition was determined via bioelectrical impedance analysis (Inbody 770, Korea). Blood volume flow (BF) was calculated as the product of TAMV and CSA (BF = TAMV✕CSA). Data are presented as mean (SD) and analyzed with a 2(time) by 3(site) repeated measures ANOVA and follow-up paired t-tests. Results: Participants (N=7; 5 males) demographics are as follows: age: 25(7) years; height: 179(7) cm; BMI: 25.0 (3.4) kg/m2; body fat: 19 (7) %. There was no interaction [F(2,17)=0.56, p=.58] but were significant main effects for both time [F(1,17)=14.05, p=.002] and site [F(2,17)=33.99, p<.001]. During HNP, popliteal BF increased by 41% [3.4(1.9) to 4.8(2.6) ml/min, p=.008] with a 12% increase [0.36(.15) to 0.41(.16) cm 2 , p=.009] in CSA and 22% increase [9.4(4.5) to 11.5(4.3) cm/s, p=.015] in TAMV; brachial BF increased by 24% [3.1(1.2) to 3.9(1.3), p=.007] with a 4% increase [0.20(0.04) to 0.21(0.04) cm 2 , p=.008] in CSA and 19% increase [15.4(4.9) to 18.3(5.0) cm/s, p=.008] in TAMV; and carotid BF increased by 14% [11.8(3.1) to 13.4(3.1) ml/min, p=.11] with a 6% increase [0.37(.06) to 0.39(0.08) cm 2 , p=.14] in CSA and 8% increase [32.6(10.2) to 35.4(11.1) cm/s, p=.13] in TAMV. Percent changes in BF, CSA, and TAMV were often greater at the popliteal than the brachial (p=.14; p=.069; p=.57) and carotid (p=.11; p=.11; p=.18) arteries with smaller differences between brachial and carotid arteries (p=.56; p=.33; p=.25). Conclusions: HNP applied to the feet and calves increased BF in the popliteal, brachial, and carotid arteries through changes in both TAMV and CSA. Increases in BF were greatest at the popliteal artery. Whether increases in blood flow are a result of increased cardiac output or at the expense of blood flow elsewhere is unknown. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Impact of Comorbidity of Bronchial Asthma and Type 2 Diabetes Mellitus on the Expression and Functional Activity of TLR2 and TLR4 Receptors

Epidemiological data indicate the active progression of various forms of diabetes mellitus in patients with bronchial asthma (BA), but little is known about the mechanisms of comorbidity formation. TLR2 and TLR4 are involved in the progression of asthma and type 2 diabetes mellitus (T2DM). These receptors are involved in the inflammatory response to Gram(+) and Gram(-) bacteria, respectively, so changes in their expression may affect the predisposition of patients to bacteremia. The aim of this study was to analyze the expression and functional activity of toll-like receptor 2 and 4 (TLR2 and TLR4) on peripheral blood cells of patients with BA, T2DM, and BA + T2DM. The expression of TLR2 and TLR4 was analyzed by flow cytometry. Whole blood samples were incubated with lipopolysaccharides from E. coli (LPS) and lipoteichoic acid from S. pyogenes (LTA). The concentration of cytokines and soluble blood proteins was determined by ELISA. Patients with comorbid diseases showed a statistically significant increase in TLR2 expression on both monocytes and neutrophils compared with healthy donors and patients with BA. We found increased expression of TLR4 on the surface of blood monocytes from patients compared to donors. The activation of blood cells of patients and donors with LPS or LTA led to an increase in the expression of "fast" pro-inflammatory cytokines (TNF-α, IL-6). In patients with BA, the average production of TNF-α in response to endotoxin was two times higher than in other studied groups. The reactions of blood cells in patients with T2DM and BA + T2DM did not differ significantly. The expression and functional activity of TLR2 and TLR4 on the blood cells of patients with comorbid disease were similar to those only in patients with T2DM. The greatest increase in the synthesis of the pro-inflammatory cytokine TNF-α in response to LPS and LTA was observed in patients with BA, which can lead to an inadequate response to bacteremia.

Molecular and metabolic mechanisms of type 1 and type 2 diabetes mellitus, laboratory diagnostics

Diabetes mellitus is a widespread disease in the world, despite advances in understanding the molecular mechanisms of the development of multifactorial processes associated with this nosology. The review material is devoted to modern ideas about the immunogenetic causes of diabetes, changes in metabolism in the violation of carbohydrate metabolism, types of the disease and the principles of laboratory diagnostics in accordance with modern WHO criteria. Information on the molecular causes of functional insulin deficiency is presented. The biochemical aspects of hyperglycemia as the main mechanism of organ and tissue damage resulting from protein glycosylation are considered. The article describes the metabolic pathways of disorders of carbohydrate, lipid, protein, water-salt metabolism, leading to the occurrence of glucosuria, polyuria, polydipsia, ketonuria, ketoacidosis and other complications of diabetes mellitus. Knowledge of the modern concept of the development of various forms of diabetes mellitus from the point of view of biochemistry of pathogenesis, molecular medicine will be useful for doctors of all specialties and in clinical laboratory diagnostics.

Drug repurposing for the treatment of Type 2 Diabetes and Gestational Diabetes Mellitus

Currently, repurposing an existing medicine for treatment of a different disease is a good and lucrative choice because of the long and time-consuming research and development process of new drugs and the high attrition rate. The utilization of low-risk chemicals, lower overall research costs, and shorter development timelines are all contributing to its growth and appeal. Ideal repurposed medication candidates have been found using a variety of date- and experimental-driven methodologies. However, there are a number of technological and legislative issues that must be addressed. Type 2 and gestational diabetes mellitus are both forms of diabetes mellitus, although gestational diabetes mellitus is a transitory condition that can lead to type 2 diabetes in the future. About 90% to 95% of diabetic people have type 2 diabetes, which is the most common form of the disease. Currently medications used for the treatment of these two diabetes is basically Metformin which often regarded as first line of treatment for Diabetes, but it is not affective too much and just control the condition. In order to identify a more effective therapy for Type 2 diabetes and gestational diabetes, we are going to use the Drug repurposing approach to look at novel pharmaceuticals and treatments and alternative combinations of current drugs. Medicine repurposing strategies and their usage in the search for a better drug or combination of drugs for the treatment of Type 2 Diabetes and Gestational Diabetes have been addressed in this review article.

Transcriptomic analysis of patients with clinical suspicion of maturity-onset diabetes of the young (MODY) with a negative genetic diagnosis

BackgroundDiagnosis of mature-onset diabetes of the young (MODY), a non-autoimmune monogenic form of diabetes mellitus, is confirmed by genetic testing. However, a positive genetic diagnosis is achieved in only around 50% of patients with clinical characteristics of this disease.ResultsWe evaluated the diagnostic utility of transcriptomic analysis in patients with clinical suspicion of MODY but a negative genetic diagnosis. Using Nanostring nCounter technology, we conducted transcriptomic analysis of 19 MODY-associated genes in peripheral blood samples from 19 patients and 8 healthy controls. Normalized gene expression was compared between patients and controls and correlated with each patient’s biochemical and clinical variables. Z-scores were calculated to identify significant changes in gene expression in patients versus controls. Only 7 of the genes analyzed were detected in peripheral blood. HADH expression was significantly lower in patients versus controls. Among patients with suspected MODY, GLIS3 expression was higher in obese versus normal-weight patients, and in patients aged < 25 versus > 25 years at diabetes onset. Significant alteration with respect to controls of any gene was observed in 57.9% of patients.ConclusionsAlthough blood does not seem to be a suitable sample for transcriptomic analysis of patients with suspected MODY, in our study, we detected expression alterations in some of the genes studied in almost 58% of patients. That opens the door for future studies that can clarify the molecular cause of the clinic of these patients and thus be able to maintain a more specific follow-up and treatment in each case.

Management of Type 1 Diabetes in Children in the Outpatient Setting.

Management of Type 1 Diabetes in Children in the Outpatient Setting.

Role of the SARS-CoV-2 virus in the appearance of new onset type 1 diabetes mellitus in children in Gran Canaria, Spain.

It has been hypothesized that SARS-CoV-2 may play a role in the development of different forms of diabetes mellitus (DM). The Canary Islands have the highest incidence of type 1 DM (T1DM) reported in Spain(30-35/100,000 children under 14 years/year). In 2020-2021 we observed the highest incidence so far on the island of Gran Canaria, as a result of which we decided to evaluate the possible role of COVID-19 in the increased number of onsets. We examined the presence of IgG antibodies against SARS-CoV-2 in children with new onset T1DM between October 2020 and August 2021. We compared recent T1DM incidence with that of the previous 10 years. Forty-two patients were diagnosed with T1DM (48.1/100,000 patients/year), representing a nonsignificant 25.7% increase from the expected incidence. Of the 33patients who consented to the study, 32 presented negative IgG values, with only one patient reflecting undiagnosed past infection. Forty-four percent of patients presented with ketoacidosis at onset, which was similar to previous years. We conclude that there is no direct relationship between the increased incidence of T1DM and SARS-CoV-2 in the region. The COVID-19 pandemic did not result in an increased severity of T1DM presentation.

Sepsis rates after template prostate biopsy with single-dose prophylactic antibiotic.

IntroductionUrosepsis is a significant risk associated with prostate biopsy. Resistance of microorganisms to antibiotics is a challenging issue for clinicians in everyday practice. In the current study, we investigated the rates of sepsis and hospital admissions following transperineal (TP) prostate biopsies using a single dose of gentamicin.Material and methodsData for consecutive patients who underwent TP prostate biopsies (March 2019–March 2020) were included. Patients received a single-dose of prophylactic gentamicin 120 mg IV and had skin preparation with antiseptic povidone-iodine or chlorhexidine solution prior to the procedure. Patient’s electronic records were reviewed for rates of sepsis and readmission to hospital within 7 days following TP prostate biopsy.ResultsA total of 365 consecutive patients were included in the study. After exclusion of non-eligible patients, 280 patients were included in final analysis. The median age was 67 years (32–83), the median prostate-specific antigen (PSA) level was 8.5 ng/ml (0.2–58), and the median prostate size was 44 cc (10–188). Approximately 58% of patients had one or more comorbidities in the form of diabetes mellitus (DM), hypertension, asthma, chronic kidney disease, or ischemic heart disease. Adenocarcinoma was found in 71.7% of patients. None of the 280 patients developed sepsis. Urinary tract infection (UTI) occurred in 2.8% of patients with E.coli, none of them required hospital readmission.ConclusionsOur single centre experience showed a 0% sepsis rate after TP prostate biopsy with single prophylactic dose of gentamicin. Future randomized controlled trials (RCTs) should explore the possibility of performing these procedures without antibiotic prophylaxis in order to reduce the unnecessary use of antibiotics.

Don't forget me in amidst of COVID-19 pandemic: A case series and review of literature on steroid associated psychiatric manifestations

There is a sudden upsurge in the use of steroids due to the ongoing COVID-19 pandemic, especially in patients with severe or critical COVID-19 infection. There are reports of excessive use of steroids, both in terms of use in patients who do not require the same and use in doses higher than the recommended. There are reports of the emergence of different adverse outcomes of excessive steroid use in the form of diabetes mellitus and a higher incidence of mucormycosis. However, little attention has been paid to the mental health impact of the use of steroids. This review attempts to evaluate the existing data in terms of incidence of psychiatric side effects of steroids, and the risk factors for steroid associated psychiatric manifestations. Additionally, an attempt is made to discuss the pathogenesis of steroid-associated psychiatric side effects and why it is likely that the incidence of psychiatric side effects may be more in patients with COVID-19 infection. There is a need to improve the awareness about the psychiatric side effects of steroids, both among the physicians and mental health professionals, as in any patient presenting with new-onset psychiatric symptoms while having COVID-19 infection or during the post-COVID-19 infection phase, a possibility of steroid associated side effect needs to be considered.

Генетична основа ендокринної патології

Метою наведеного огляду був аналіз даних літератури щодо молекулярно-генетичної основи та діагностики ендокринної патології. Проведено огляд наукової літератури за ключовими словами «гени», «ендокринні хвороби», «молекулярна діагностика», «прогормони», «ядерні рецептори і фактори транс­крипції» з використанням пошукової системи PubMed. Беручи до уваги дослідження, проведені в останні 10 років, проаналізовані тези 144 статей. Більш детально вивчено результати дослідження, висвітлені у 32 статтях. Серед наведених нозологій — різні спадкові форми гіпопітуїтаризму, порушення біосинтезу стероїдних гормонів, порушення формування статі, моногенні форми цукрового діабету (ЦД) та інші захворювання. Виділено патологію, що пов’язана з мутацією генів, які кодують білкові прогормони, рецептори, ферменти біосинтезу стероїдів, молекули внутрішньоклітинного сигналінгу, транспортні білки, іонні канали, фактори транскрипції. Серед ендокринних захворювань, асоційованих із дефектами генів, які кодують білкові прогормони, найбільш поширеними є дефекти гена GH1; серед захворювань, асоційованих із дефектами генів, які кодують ферменти, найбільш поширеними є дефекти гена CYP21A2 (21-гідроксилази). Частіше мутації генів, які кодують білки, що відносяться до класу рецепторів, пов’язані із G-білком (G-protein coupled receptors). Більшість мутацій, пов’язаних із МЕН-2А, зосереджено в багатому цистеїном регіоні рецептора Ret. Відомо більше 70 моногенних синдромів, при яких відзначається клінічно виражена толерантність до глюкози і діагностується та чи інша форма ЦД, також виявлений ЦД, зумовлений мутацією мітохондріального гена (мутація tRNALeu, UUR). Самою частою з усіх моногенних форм є ожиріння, спричинене мутацією гена рецептора меланокортину 4-го типу (MC4R). У хворих на вроджений гіпотиреоз підвищена частота алелей HLA (Bw44, Aw24, B18) та описані мутації в генах TITF1, TITF2, FOXE1, PAX8 (транскрипційні маркери нормального онтогенезу щитоподібної залози).

Глікемічний скринінг і вторинні порушення вуглеводного обміну при ендокринній патології

Причиною поганого глікемічного контролю при цукровому діабеті може бути надлишкова секреція контрінсулярних гормонів при різних ендокринопатіях. А отже, глікемічний скринінг і скринінг ендокринних захворювань, які супроводжуються порушеннями вуглеводного обміну, повинні проводитися паралельно.

Anti-hyperglyceamic Effects of Psidium guajava LINN Crude Leaf Extracts and Fractions in Alloxan-induced Diabetic Mice

In Nigeria, rural inhabitants often resort to herbal remedies and dietary control for the treatment and management of various forms of diabetes mellitus. This study was conducted to provide the rationale for the use of Psidium guajava leaves as a potent traditional anti-diabetic remedy. The crude leaf extracts of n-hexane, methanol, and ethyl acetate of Psidium guajava were separately prepared by cold maceration. Then, ethyl acetate crude extract of Psidium guajava leaves was fractionated by column chromatography to yield ethyl acetate bulked fractions: EF-I (1-75), EF-II (76-150), and EF-III (151-250). The n-hexane, ethyl acetate, and methanol crude leaf extracts and ethyl acetate bulked fractions (EF-I, EF-II and EF-III) were evaluated for anti-diabetic activity in alloxan-induced diabetic mice. The blood sugar levels of treated and untreated alloxan-induced diabetic mice were assayed as indices of anti-diabetic effect. The phytochemical constituents of both crude extracts and ethyl acetate fractions of Psidium guajava leaves and the mean lethal dose (LD50) of ethyl acetate crude leaf extract of Psidium guajava were determined. The mean lethal dose (LD50) of ethyl acetate crude leaf extract was calculated to be 1500mg/kg b.w. The results indicated that oral administration of ethyl acetate, n-hexane, methanol crude extracts, and ethyl acetate bulked fractions of Psidium guajava leaves at a dose of 100mg/kg b.w on treated groups exhibited much significant[p&lt;0.001, p&lt;0.01and p&lt;0.05]anti-hyperglyceamic effect by ameliorating high blood sugar levels of alloxan-induced diabetic treated mice, while EF-II and EF-III showed non-significant[p&gt;0.05] anti-hyperglyceamic activity for the reduction in blood sugar levels compared with the negative and positive control groups. The anti-diabetic potency of the crude leaf extracts and ethyl acetate fractions were in the order; EC&gt;HC&gt;MC&gt;EF-I&gt;EF-II&gt;EF-III. The results of phytochemical screening of the crude extracts and ethyl acetate bulked fractions showed the presence of tannins, flavonoids, saponins, alkaloids, terpenoids, glycosides, and steroids while reducing sugar was absent. The results from this study gives credence to the use of Psidium guajava as an anti-diabetic agent in the management of diabetes mellitus.

One hundred years of insulin therapy.

At the time of its first clinical application 100 years ago, insulin was presented as the cure for people with diabetes mellitus. That transpired to be an overstatement, yet insulin has proven to be the lifesaver for people with type 1 diabetes mellitus and an essential therapy for many with type 2 diabetes mellitus or other forms of diabetes mellitus. Since its discovery, insulin (a molecule of only 51 amino acids) has been the subject of pharmaceutical research and development that has paved the way for other protein-based therapies. From purified animal-extracted insulin and human insulin produced by genetically modified organisms to a spectrum of insulin analogues, pharmaceutical laboratories have strived to tailor the preparations to the needs of patients. Nonetheless, overall glycaemic control often remains poor as exogenous insulin is still not able to mimic the physiological insulin profile. Circumventing subcutaneous administration and the design of analogues with profiles that mimic that of physiological insulin are ongoing areas of research. Novel concepts, such as once-weekly insulins or glucose-dependent and oral insulins, are on the horizon but their real-world effectiveness still needs to be proven. Until a true cure for type 1 diabetes mellitus is found and the therapeutic arsenal for other forms of diabetes mellitus is expanded, insulin will remain central in the treatment of many people living with diabetes mellitus.

Transient Neonatal Diabetes Mellitus with the Rare Association of Nonsuppurative Sialadenitis and Genetic Defects in 6q24

Background Transient neonatal diabetes mellitus (TNDM) is the most common cause of diabetes in the first week of life, with an overall incidence of 1 in 90,000 to 160,000 live births. TNDM occurs soon after birth and undergoes spontaneous remission during infancy; however, it may relapse to a permanent form of diabetes mellitus in childhood or adolescence. We report a case of TNDM due to hypomethylation on chromosome 6q24, associated with a rare clinical finding of nonsuppurative submandibular sialadenitis managed by subcutaneous insulin, and who underwent remission by three months of age. Case Presentation. We report a male neonate of Arab ancestry delivered by caesarean section at 37 weeks of gestation. He had intrauterine growth retardation with a birth weight of 2.099 kg. He presented with hyperglycemia on the first day of life, which was managed with parenteral insulin infusion. Blood glucose control was initially difficult to achieve due to difficulties in preparing such small doses of insulin and the significant variations in blood glucose concentrations, without ketosis. Blood tests revealed low serum insulin and C-peptide levels. Genetic analysis revealed multiple loci hypomethylation of the PLAGL1/HYMAI-DMR in the TNDM region in chromosome 6q24 and two pathogenic heterozygous variants in the ZFP57 gene. Segregation analysis showed that both parents were heterozygous carriers of familial ZFP57 variants. The clinical course was associated with bilateral nonsuppurative sialadenitis, which is extremely rare among newborns. Conclusion Sialadenitis is a well-known phenomenon that is rarely diagnosed in neonates. To the best of our knowledge, this is the first case report to describe the exceedingly rare association of nonsuppurative submandibular sialadenitis in a neonate with TNDM due to multiple loci hypomethylation of the PLAGL1/HYMAI-DMR in the TNDM region in 6q24 and heterozygous pathogenic variants in the ZFP57 gene.