Type 2 Diabetes Mellitus Group Research Articles

A sex-disaggregated analysis of the prognostic value of lean type 2 diabetes mellitus in the adult population with acute myocardial infarction

BackgroundEmerging evidence has demonstrated the unfavourable cardiovascular risk of individuals with lean type 2 diabetes mellitus (T2DM). Our study aims to investigate the prognostic value of lean T2DM in patients with acute myocardial infarction (AMI), stratified by sex.MethodsThe study cohort examines the clinical characteristics and long-term outcomes of individuals with AMI, stratified by four phenotypes based on T2DM and lean body category—lean T2DM, non-lean T2DM, lean non-T2DM and non-lean non-T2DM. The primary outcome was long-term all-cause mortality. Cox regression model was constructed to investigate the associations of lean and non-lean T2DM phenotypes with mortality, adjusted for age, ethnicity, previous AMI, AMI type, chronic kidney disease, angiotensin converting enzyme inhibitor or angiotensin receptor blockers, beta-blockers, and smoking status.ResultsA cohort of 9545 AMI patients was examined, with a mean follow-up duration of 3.4 ± 2.4 years. Majority had the non-lean T2DM phenotype (40.4%), followed by non-lean non-T2DM (29.8%), lean non-T2DM (15.9%), and lean T2DM (13.9%). In the T2DM group, one-quarter was lean (N = 1324), while the vast majority (74.5%) was non-lean. Individuals with lean T2DM tended to be female and older. Patients with lean T2DM had the highest rates of heart failure (23.3%, p < 0.001), cardiogenic shock (9.1%, p = 0.036), and long-term all-cause mortality (32.6%, p < 0.001). Cox regression demonstrated that lean T2DM was an independent predictor of mortality (adjusted hazard ratio [aHR] 1.171, 95% CI 1.040–1.319, p = 0.009) after adjustment. The presence of higher mortality risk following AMI was present in males (aHR 1.201, 95% CI 1.037–1.391, p = 0.015), but not in females (aHR 1.066, 95% CI 0.869–1.308, p = 0.538).ConclusionsThe lean T2DM phenotype was present in one-quarter of the AMI cohort with T2DM. The lean T2DM phenotype was an independent predictor of long-term mortality following AMI, although this association was stronger in males than in females.

Integrating Ambulatory Care Pharmacists Into Value-Based Primary Care: A Scalable Solution to Chronic Disease.

Patients living with chronic diseases require more medical attention, including more visits to primary care. However, primary care providers are overburdened, and this specialty is attracting fewer new providers than before. Clinical pharmacists can augment these efforts by improving disease state control. In this cohort study, we aimed to demonstrate a retail pharmacy hired and trained clinical pharmacist within a value-based primary care clinic network can improve hypertension (HTN) and type 2 diabetes mellitus (T2DM) control. In this cohort study, a pharmacist, enabled by a collaborative drug therapy management agreement, prescribed and titrated therapies for HTN and T2DM. Primary outcomes were pre- to post-index changes in hemoglobinA1c, systolic, and diastolic blood pressure (BP) measures. The HTN cohort consisted of 43 patients and the T2DM cohort consisted of 125 patients. The difference-in-differences (β) in the HTN group was -10.2 mmHg (P < .01) for systolic BP and -2.0 mmHg (P = .42) for diastolic BP. The β in the T2DM group was -1.16% (P < .001). Statistically significant reductions in systolic BP and hemoglobinA1c were observed in the pharmacist-managed group compared with matched controls. These results demonstrate that pharmacist integration into a value based primary care clinic may improve measures of chronic disease associated with morbidity and mortality.

Decreased sirtuin 1 in type 2 diabetes patients with abnormal BMD

IntroductionSirtuin 1, a class III histone deacetylase, plays a critical role in the pathophysiology of both diabetes mellitus and bone metabolism by promoting osteoblast differentiation and inhibiting osteoclast maturation. However, its exact impact on bone mineral density (BMD) and bone metabolism in type 2 diabetes mellitus (T2DM) remains unclear. This study investigates the relationship between Sirtuin 1 levels, BMD, and bone metabolism in newly diagnosed T2DM patients, specifically examining alterations in Sirtuin 1 levels in those with concomitant osteoporosis or osteopenia.MethodsA total of 69 newly diagnosed T2DM patients and 82 control subjects with normal glucose tolerance (NGT) were enrolled. Serum Sirtuin 1 levels and bone turnover markers, including osteocalcin (OC), procollagen type 1 N-terminal propeptide (P1NP), and β-C-terminal telopeptide of type I collagen (β-CTX), were measured using enzyme-linked immunosorbent assay (ELISA). BMD was assessed via dual-energy X-ray absorptiometry (DXA). Comparisons of these parameters were made between the T2DM and NGT groups.ResultsT2DM patients were further categorized into a normal BMD group (DMn) and an osteopenia or osteoporosis group (DMo), and differences in Sirtuin 1 levels between these subgroups were analyzed. Risk factors for osteoporosis/osteopenia in T2DM patients were also evaluated. Serum Sirtuin 1 levels were found to be significantly diminished in the T2DM group relative to the control group (P &amp;lt; 0.05), with no significant differences in lumbar spine BMD, OC, 25(OH)D, and β-CTX between groups (P &amp;gt; 0.05). Osteoporosis incidence was higher in T2DM subjects compared to controls (34.8% vs. 18.3%, P = 0.026). Subgroup analysis revealed that SIRT1 levels in T2DM patients with osteoporosis or osteopenia exhibited a significant reduction compared to those with normal BMD (P &amp;lt; 0.05). Logistic regression indicated that Sirtuin 1, age, HDL-C, P1NP, and β-CTX were independent risk factors for osteoporosis in T2DM patients.DiscussionIn conclusion, decreased serum Sirtuin 1 levels are associated with bone turnover markers in T2DM patients and may serve as an independent risk factor and potential biomarker for diagnosing bone metabolism disorders in newly diagnosed T2DM patients.

Do children with type 1 diabetes mellitus remain protected against hepatitis B?

Because patients with type 1 diabetes mellitus (T1DM) have persistent and profound limitations in immune functions, immune response to vaccines may diminish. The aim of our study was to compare the antibody to Hepatitis B surface antigen (anti-HBs) serologies of children with T1DM, at the time of T1DM diagnosis, who were vaccinated according to the vaccination schedule with the anti-HBs serologies of healthy children. And to investigate the relationship between anti-HBs levels and the accompanying variables of these patients. Anti-HBs and Hepatitis B surface antigen (HBs Ag) results of 214 children with T1DM and 210 healthy children were recorded retrospectively. Seropositivity rates for anti-HBs were compared between T1DM and control groups and the odds of seropositivity were examined. Clinical andlaboratory data of T1DM patients were investigated according to anti-HBs seropositivity. Anti-HBs seropositivity rates and titers in the T1DM group were significantly lower than those in the healthy group. According to anti-HBs status among T1DM patients; no difference was found in terms of gender, BMI, presence of comorbidities, presence of autoantibodies and lipid profiles. Diagnosis age and HbA1c levels of anti-HBs negative group were higher than anti-HBs positive group in patients diagnosed with T1DM. However, neither age nor HbA1c level was found to significantly change the odds of the seropositivity for anti-HBs in T1DM patients after adjustment. We recommend that children diagnosed with T1DM should have anti-HBs serology tested at the time of diagnosis and seronegative patients should have additional hepatitis B vaccination.

Effects of forced treadmill exercise on lipid and carbohydrate metabolism parameters in a mouse model of type 2 diabetes mellitus

Aim. To study the effect of forced treadmill exercise on lipid and carbohydrate metabolism parameters in liver and skeletal muscle tissues of mice with a model of type 2 diabetes mellitus, taking into account age and biological rhythm characteristics.Materials and methods. To create a model of type 2 diabetes mellitus (T2DM), a high-fat diet was used. Physical activity in the form of forced treadmill exercise was carried out for 4 weeks. Parameters of lipid and carbohydrate metabolism in muscle and liver tissues were determined by Western blotting.Results. A decrease in glycogen content in the muscles in T2DM was associated with activation of its breakdown rather than with its reduced synthesis. Significant and multidirectional changes were recorded in the content of glycogen phosphorylase in the liver and skeletal muscle tissues. These changes were significantly influenced by both the nature of diet and physical activity. The development of T2DM in mice was accompanied by a decrease in high-density lipoprotein (HDL) content in the liver along with an increase in low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL) levels. It is worth noting that physical activity provided partial normalization of the ratio of lipid fractions, despite the fact that the exercises were performed in the context of a high-fat diet. In the T2DM group, metabolic changes caused by both T2DM modeling and physical exercises were not only quantitative, but in some cases also qualitative. The effects of physical exercises performed at different times of the day on metabolic processes in the liver and muscle tissues varied significantly.Conclusion. Physical activity can help prevent not only metabolic disorders (obesity and insulin resistance), but also associated complications on the part of the liver and cardiovascular system.

Machine learning-driven Raman spectroscopy: A novel approach to lipid profiling in diabetic kidney disease.

Diabetes mellitus is a chronic metabolic disease that increasingly affects people every year. It is known that with its progression and poor management, metabolic changes can lead to organ dysfunctions, including kidneys. The study aimed to combine Raman spectroscopy and biochemical lipid profiling, complemented by machine learning (ML) techniques to evaluate chemical composition changes in kidneys induced by Type 2 Diabetes mellitus (T2DM). Raman spectroscopy identified significant differences in lipid content and specific molecular vibrations, with the 1777 cm-1 band emerging as a potential spectroscopic marker for diabetic kidney damage. The integration of ML algorithms improved the analysis, providing high accuracy, selectivity, and specificity in detecting these changes. Moreover, lipids metabolic profiling revealed distinct variations in the concentration of 11 phosphatydylocholines and 9 acyl-alkylphosphatidylcholines glycerophospholipids. Importantly, the correlation between Raman data and lipids metabolic profiling differed for control and T2DM groups. This study underscores the combined power of Raman spectroscopy and ML in offering a low-cost, fast precise, and comprehensive approach to diagnosing and monitoring diabetic nephropathy, paving the way for improved clinical interventions. However, taking into account small number of data related to ethical committee approvals, the study should be verified on a larger number of cases.

Concentrations of trace metals in serum: Implications for type 2 diabetes mellitus and gender difference

Trace metals play a pivotal role in maintaining normal and healthy physiology due to their various metabolic functions in humans. This study was performed to identify the association between trace metals and type 2 diabetes mellitus (T2DM) through a comparative analysis of serum samples from both healthy controls and T2DM patients. Additionally, we aim to explore the potential connection between gender differences and the concentration of trace metals in T2DM patients. The study included 103 participants, comprising 53 healthy controls and 50 T2DM patients, with blood samples stored at Eulji University Hospital (Daejeon, Korea). Serum concentrations of copper (Cu), zinc (Zn), manganese (Mn), and selenium (Se) and chromium (Cr) levels were measured and statistically analyzed by t-tests and logistic regression after the outliers replaced by mean. In the overall participants, serum concentrations of Cu and Mn in T2DM group was significantly different compared to the control group (P &lt; 0.01). Logistic regression analysis indicated that Cu, Se and Mn concentration was significantly different in T2DM patients than in healthy controls in adjusted for age and sex. When examining trace metal concentrations by gender difference, Se were significantly lower in T2DM men (P &lt; 0.01), while T2DM women exhibited significantly higher levels of Zn, Se and Mn (P &lt; 0.05). Especially in women, logistic regression analysis indicated that Cu, Se and Mn concentration was significantly different in T2DM patients than in healthy control (adjusted for age OR of Cu, 0.92; 95 % CI 0.87 - 0.98, adjusted OR of Se, 3.04; 95 % CI, 1.71 - 5.34; adjusted OR of Mn, 4.50; 95 % CI, 2.09 - 9.68). This study showed that trace metal imbalances related to Se and Mn in patients with T2DM were particularly relevant in women. It highlights the significance of gender difference and suggests the potential benefits of regular monitoring of trace metal concentrations in the management of T2DM patients.

Type 2 diabetes mellitus: A cross-sectional analysis of glycemic controls and brain health outcomes

In this cross-sectional analysis, we explored how fluctuations in glycemic levels impact executive functions and psychosocial outcomes in patients with type 2 diabetes mellitus (T2DM). The goal was to understand the relationship between glycemic control and both neuropsychological and psychosocial health. We stratified participants into well-controlled and poorly controlled groups based on glycated hemoglobin (HbA1c) levels and variability, including a healthy control group for comparison. The study consisted of neuropsychological tests and psychosocial assessments. Results indicated that the poorly controlled T2DM group experienced significant executive dysfunction and scored lower on the Tower of London, Wisconsin Card Sorting, and Digit Span Tests, reflecting a broader impact on quality of life and resilience. These findings support the importance of maintaining stable glycemic levels for better executive and psychosocial outcomes and highlight the need for regular neuropsychological and psychosocial assessments in diabetes care.

CEBPA as a potential hub gene for cutaneous inflammation in type 2 diabetes mellitus.

The role of inflammation in the development of type 2 diabetes mellitus (T2DM) related skin complications necessitates further investigation. This study aims to explore the correlation between inflammation and cutaneous alterations in T2DM, enhancing comprehension of underlying mechanism involved. Utilizing bioinformatics, the GSE38396 and GSE92724 datasets were employed to identify differentially expressed genes (DEGs) and potential hub genes in T2DM-related skin inflammation. Subsequently, gene functional enrichment analysis was employed for functional annotation. Finally, we validated the regulatory impact of hub gene on inflammation during high glucose incubation using the in vitro model. A comprehensive analysis identified 742 DEGs, including 9 hub genes and 4 potential biomarkers. Compared to the CON group, the expression of M2 macrophages was significantly upregulated in the T2DM group, while resting dendritic cells and eosinophils showed notable decreases, indicating a significant correlation with CEBPA. Furthermore, functional enrichment analysis revealed significant enrichment of DEGs in pathways linked to immunity and diabetes pathogenesis. Interestingly, overexpression of CEBPA demonstrated anti-inflammatory effects under hyperglycemic conditions, while silencing CEBPA expression appeared to worsen inflammation. CEBPA emerges as a potential hub gene for skin inflammation in T2DM, shedding light on the underlying mechanisms of this condition.

Investigating metabolic characteristics of type 2 diabetes mellitus-related cognitive dysfunction and correlating therapeutic effects of Di Dang Tang in animal models.

Di Dang Tang is a classic formula from Shang Han Lun, originally used to treat conditions such as blood stasis and heat accumulation. It is widely applied in the treatment of diabetes and its complications, but its effects on Type 2 Diabetes Mellitus-related Cognitive Dysfunction (T2DM-CD) remain unclear. The study aimed to investigate the metabolic characteristics of patients with T2DM-CD. Additionally, it sought to evaluate the effects of Di Dang Tang on cognitive function in T2DM-CD model rats by targeting the metabolic pathways identified in the clinical analysis, exploring the underlying mechanisms through animal experiments. Fasting venous serum was collected from patients with Type 2 Diabetes Mellitus (T2DM) to detect metabolism-related products, and KEGG annotation analysis was performed. Separately, thirty rats were randomly divided using a random number table method, with six rats selected as the blank control group. Twenty-four successfully modeled rats were then randomly divided into the model group and three Di Dang Tang groups (low, medium, and high doses). After administering the medication, the relevant indicators in the rats were assessed. Clinical metabolomics detected 32 key differential metabolites between the T2DM-CD and the blank control groups. Between the T2DM-CD and T2DM groups, 29 key differential metabolites were identified. In animal experiments, blood glucose levels in the model group were significantly higher compared to the blank control group at the same time points, whereas the high dose groups of Di Dang Tang exhibited reduced blood glucose levels at weeks 6 and 8 relative to the model group. In the Morris water maze test, the model group had longer escape latencies than the blank control group. The medium and high dose groups of Di Dang Tang showed shorter latencies. Additionally, compared to the model group, the Di Dang Tang groups spent more time and covered more distance in the target quadrant but had reduced average proximity and fewer platform entries. HE staining observation of the hippocampal CA1 area showed no apparent pathological changes in the blank group, obvious pathological damage in the model group, and no significant pathological changes in the medium and high dose groups of Di Dang Tang. Compared to the blank control group, the model group showed significant increases in the levels of Arachidonic Acid (AA), Ceramide (Cer), Glutamate (Glu), TNF- α, IL-1β, TG, and LDL-C, and a significant decrease in HDL-C levels. Compared to the model group, the groups of Di Dang Tang significantly modulated the levels of the above indicators. In Western Blot (WB) assays, compared to the blank control group, the model group rats exhibited significantly higher levels of cPLA2, PKC, ERK, and JNK , and significantly lower levels of claudin-5, NMDA, CaMKII, CREB, and BDNF. The Di Dang Tang groups significantly altered the levels of the above indicators compared to the model group. Amino acid metabolism, sphingolipid signaling pathways, glycerophospholipid metabolism, and various signaling pathways play significant roles in the pathogenesis of T2DM-CD. Di Dang Tang can improve learning and memory abilities in T2DM model rats and ameliorate cognitive impairments, potentially by regulating metabolic levels and inflammatory responses.

Apolipoprotein E gene polymorphism, blood lipids and clinical-biochemical values in gallstone disease with T2DM women

Aim. To study the clinical-biochemical parameters, APOE gene polymorphism in women with gallstone disease (GSD) with/without type 2 diabetes mellitus (T2DM). Materials and methods. In the open, single-stage, single-center, observational, cross-sectional, uncontrolled case-series study, 137 women with GSD were examined, including 71 patients with GSD and T2DM (Group 1), 66 patients – GSD without T2DM (Group 2) comparable age and BMI. The inspection included clinical examination, biochemical blood tests, including lipid profile, APOE gene polymorphism identification by PCR. Results. In group 1 met more often than in group 2 pain in the right hypochondrium (97.2 % vs. 86.4 %), in the left hypochondrium (42.3 % vs. 22.7 %), belching (88.7 % vs. 59.1 %), heartburn (78.9 % vs. 50.0 %), bitterness in the mouth (87.3 % vs. 57.6 %), stool disorders (83.1 % vs. 48.5 %, p &lt; 0.05 in all cases). In group 1 were significantly higher than in group 2, TG (1.9 [1.5; 2.6] vs. 1.4 [1.0; 2.0] mmol/l), atherogenic coefficient (AC) (3.9 [3.1; 4.5] vs. 3.4 [2.5; 4.4] units), HDL-C – significantly lower (1.1 [1.0; 1.3] vs. 1.2 [1.1; 1.6] mmol/l). HypoHDL-C (69.0 % vs. 45.5 %) and hyperTG (66. 2% vs. 36.4 %) significantly more often observed in group 1. Systolic (140,0 [130,0; 150,0] and 130,0 [120,0; 130,0] mmHg, р &lt; 0,001), diastolic blood pressure (SBP, DBP) (90,0 [80,0; 90,0] and 80,0 [80,0; 90,0] mmHg, р &lt; 0,001), in group 1 higher than in group 2. APOE gene alleles frequency in group 1 and 2 is similar. There were no differences in the lipidogram in carriers of different alleles of the APOE gene in group 1. Conclusions. The presence of GSD and T2DM in group 1, both with cholecystolithiasis and after cholecystectomy, is associated with more conspicuous gastroenterological symptoms, lipid metabolism disorders, SBP, DBP increase, compared to group 2. There were no differences in the frequency of the alleles of the AРOE in groups 1 and 2, as well as in the lipidogram of carriers of different alleles of the AРOE in group 1.

Effects of Acute Aerobic Exercise on Skeletal Muscle and Liver Glucose Metabolism in Male Rodents with Type 1 Diabetes.

Aerobic exercise (AE) is associated with a significant hypoglycemia risk in individuals with type 1 diabetes mellitus (T1DM). However, the mechanisms in the liver and skeletal muscle governing exercise-induced hypoglycemia in T1DM are poorly understood. This study examined the effects of a 60-minute bout of AE on hepatic and muscle glucose metabolism in T1DM rats. Nineteen male Sprague-Dawley rats were divided into sedentary (SC; n=5) and T1DM (DSC; n=14) groups. T1DM rats were subcategorized into pre-exercise (DPRE; n=6) and post-exercise (DPOST; n=8). DPOST were sacrificed immediately after 60-minute of AE. Results demonstrate that DPOST animals experienced reductions in BG following 30 and 60 minutes of AE compared to pre-exercise. Both DPRE and DPOST animals exhibited lower hepatic glycogen content, while muscle glycogen did not differ, suggesting impaired glycogenolysis in T1DM. Hepatic glycogen-6-phosphatase content, and muscle and hepatic protein kinase B phosphorylation were significantly greater in DPOST animals, suggesting elevated gluconeogenesis and insulin stimulation during exercise. Glycogen phosphorylase activity did not differ between groups. These data suggest that drops in BG during AE in T1DM were due to lower glycogen levels in the liver and muscle and a lack of muscle glycogen utilization; leading to a reliance on gluconeogenesis and BG.

Evaluation of ACE I/D and ATIR A1166C variants in patients with diabetes mellitus with and without peripheral neuropathy in Turkish patients

Objective Type 2 Diabetes Mellitus (T2DM) can lead to long-term vascular complications such as diabetic peripheral neuropathy (DPN). This study aimed to investigate the role of angiotensin-converting enzyme (ACE) insertion (I)/deletion (D) and angiotensin II type 1 receptor (AT1R) A1166C variants in the predisposition to T2DM in the Turkish population and their association with DPN. Methods The study included 90 T2DM patients (42 with DPN) and 50 healthy individuals. ACE I/D and ATIR A1166C gene regions were analyzed for the variant. Both the general genotype distribution of these variants and the observed genotype ratios were examined separately. Results In the T2DM group, the proportion of individuals with the AA genotype of the AT1R A1166C variant was lower than in the control group, and the proportion of individuals with the AC genotype was higher. There was no significant difference in the genotype distribution between the groups for the ACE I/D variant. There was no significant difference in the genotype distribution of the ACE I/D and ATIR A1166C variants in patients with and without DPN. Conclusion In the Turkish population, no significant difference was observed in the overall genotype distribution of ACE I/D and AT1R A1166C variants between T2DM patients and healthy individuals, whereas the AC genotype of the AT1R A1166C variant was more frequent in T2DM patients, and the AA genotype was less frequent. For both variants, no significant difference was observed in the genotype distribution between T2DM patients with and without DPN.

Association of vitamin D deficiency and insufficiency with uncontrolled type 1 diabetes Mellitus among Saudi pediatric patients; a hospital-based retrospective study.

The association between 25-hydroxy-vitamin D [25(OH)D] levels and glycemic control in pediatric patients with type 1 diabetes mellitus (T1DM) is unclear. In this study, we aimed to investigate the association between 25(OH)D levels and glycemic control in Saudi pediatric patients' with T1DM in a region that is sunny year-round. A retrospective study was conducted in the Pediatric Department of King Saud Hospital in Unaizah, Saudi Arabia. A total of 218 children with T1DM were enrolled in the study and grouped according to their glycated hemoglobin (HbA1C) levels into the controlled T1DM (HbA1C ≤ 7.5%) and the uncontrolled T1DM (HbA1C > 7.5%). Their 25(OH)D levels and thyroid function were measured using standard methods. Of the 218 children in this study, 182 (83.5%) had uncontrolled T1DM, while only 36 (16.5%) had controlled T1DM. The median (interquartile range) of 25(OH)D levels was significantly lower in the uncontrolled T1DM group compared with the controlled group [45.4 (31.2-59.7) nmol/L vs. 56.1 (37.5-77.6) nmol/L; p = 0.007], respectively. Vitamin D deficiency (<50.0 nmol/L) and insufficiency (50-74 nmol/L) were detected in 55.0% and 31.1% of all the enrolled children, respectively. Vitamin D deficiency was detected in 86.6% of the uncontrolled T1DM patients and in 16.5% of the controlled T1DM patients (p = 0.012). The multivariable analysis showed that both vitamin D deficiency [adjusted odds ratio (aOR) = 2.92, p = 0.048] and insufficiency [aOR = 3.17, p = 0.042] were risk factors for uncontrolled diabetes. Vitamin D deficiency was highly prevalent in the studied group. Both vitamin D deficiency and insufficiency are associated with uncontrolled T1DM. Further study is needed.

The Relationship Between LRP-5 and LRP-6 Gene Mutations and Postmenopausal Type 2 Diabetes and Obesity

Background: Single nucleotide polymorphisms (SNPs) in the low-density lipoprotein receptor-related protein 5 (LRP5) and the low-density lipoprotein receptor-related protein 5 (LRP6) genes have been implicated in the pathogenesis of type 2 diabetes mellitus (T2DM) and obesity (OB). This study aimed to evaluate the polymorphisms in LRP5 and LRP6 genes in postmenopausal patients with T2DM and OB. Methods: Participants were categorized into the Non-T2DM group (n = 53) and the T2DM group (n = 89) based on glycemic levels. Baseline data and biochemical indices were collected, Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry, and SNPs at the LRP5 and LRP6 loci were assessed by time-of-flight mass spectrometry. Results: 1. There was a statistical difference in the distribution of genotypes (CC/CT) at locus rs4988331 (χ2 = 67.940, P = .000) and in the distribution of alleles (C/T) between the T2DM and non-T2DM groups (χ2 = 50.506, P = .000). Additionally, there were significant differences in the allele (G/A) at locus rs11054704, and both allele (G/T) and genotype (GG/GT) distributions at locus rs1181334 between the OB group and the normal weight group ( P &lt; .05). 2. OB was identified as a risk factor for T2DM in individuals with the wild-type at locus rs1181334, and the interaction between wild-type and mutant was significant ( P &lt; .05). 3. Multifactorial logistic regression analysis revealed that BMD (OR 3.755; 95% CI, 1.215-11.608) and triglyceride-glucose (TyG) index (OR 2.855; 95% CI, 1.361-5.986) were risk factors for T2DM in postmenopausal women, whereas alkaline phosphatase (ALP; OR 0.970; 95% CI, 0.945-0.995) and rs4988331 mutation (OR 0.018; 95% CI, 0.006-0.060) were protective factors. Conclusion: Mutations at the LRP5-rs4988331 locus, as well as the LRP6-rs11054704 and rs1181334 loci, may be associated with the development of T2DM and OB in postmenopausal women.

Higher Incidence of Diabetes in Asymptomatic Healthy Fatty Liver Patients of Bangladesh: Prompt Intervention can Avert Complications.

The strong association between type 2 diabetes mellitus (T2DM) and fatty liver is well known, and its nomenclature has even recently changed to metabolic dysfunction-associated steatotic liver disease (MASLD). Healthy MASLD patients are frequently overlooked and maltreated, especially in Bangladesh. In this present study, we tried to correlate T2DM burden in apparently healthy, incidentally diagnosed fatty liver patients on ultrasound. This cross-sectional study was done in Sheikh Hasina Medical College Hospital, Tangail, Bangladesh, from August 2022 to February 2023. A total of 92 patients with ultrasonological evidence of grade II fatty change in the liver were included and evaluated. Known T2DM, hypothyroidism, consumption of alcohol, HBV or HCV infection, Wilson's disease, autoimmune liver disease, hemochromatosis, and any other chronic liver or kidney disease patients were excluded. The patients were then assessed for the presence and absence of T2DM using OGTT (2 hours 75 gm glucose ≥ 11.1 mmol/L) and/or HbA1c (≥6.5%) as diagnostic criteria. Data was analyzed by SPSS, version 23. Out of 92 patients, 48 were male and 44 were female. A total of 50 patients (54.3%) were newly diagnosed with T2DM. Statistically significant differences were seen in the T2DM group and non-DM group for AST (50.33 IU vs 36.53 IU) and TG (270 mg/dL vs 189 mg/dL). Although no noteworthy differences were evident in mean age (41 years vs 38 years), ALT (58.9 IU vs 60.23 IU), and BMI (28.85 vs 29.29). In the present study, more than 54% of patients with grade II fatty liver were newly diagnosed with T2DM. They would later present with more advanced T2DM and related complications. Although a larger study is needed, physicians and healthcare workers in Bangladesh should be more concerned about treating MASLD patients with early diagnosis of T2DM, recommending prompt lifestyle interventions, and prescribing drugs if necessary. Gani ABMS, Mahmood AA, Alam AFMS, et al. Higher Incidence of Diabetes in Asymptomatic Healthy Fatty Liver Patients of Bangladesh: Prompt Intervention can Avert Complications. Euroasian J Hepato-Gastroenterol 2024;14(2):172-175.

Investigate the SOD-1 gene variants rs4817415 and Their Relationship with the Physiological Antioxidant Index in Patients with T2DM

Background and Aim: Type 2 diabetes mellitus (T2DM) is currently classified as a multi-gene hereditary metabolic disorder where the body fails to produce adequate insulin, resulting in irregular glucose regulation. Objectives: This research focuses on assessing the impact of SOD-1 gene variants rs4817415 and antioxidant index (AOI) in Iraqi individuals diagnosed with T2DM. Methods: A total of 90 participants, consisting of 45 individuals with T2DM and 45 healthy controls, were included in this study. The antioxidant index (TAO-C/MDA) was evaluated using the spectrophotometer method, while SOD-1 gene variants rs4817415 were analyzed through RT-RFLP. Results: The results of this study show that the T2DM and control groups had high statistically significant differences in TAO-C, MDA, and AOI levels (p-value &lt; 0.05). The duration of T2DM in participants was strongly negatively correlated with TAO-C levels (r = -0.654), and it was significantly positively correlated with MDA levels (r = 0.412). According to the study's current findings, the AC hetrozygote genotype implied a statistically significant effect on the risk of type 2 diabetes (T2DM), with a P-value of 0.000 and an OR of 3.19 (1.56–3.09). Additionally, we discovered that the CC genotype and T2DM were significantly correlated, with OR= 1.45 (0.45-3.88). Additionally, the data indicated that the T2DM and CONT groups had statistically different distributions of SOD-1 gene variations, specifically (OR=3.11(1.12-4.09) rs4817415 and its alleles. Conclusion: The findings suggest that the SOD-1 gene variants rs4817415 may serve as a risk factor for the onset of T2DM and contribute to further complications in affected individuals.

Knowledge, Attitudes, and Practice Regarding Physical Exercise in Type 2 Diabetic and Non-Diabetic Staff at a Tertiary Institution.

Type 2 diabetes mellitus (T2DM) has become a global epidemic, where increasing urbanization encourages sedentary lifestyles. Persistent physical inactivity can lead to T2DM and increase the risk of T2DM in the general population. Therefore, the aim of this study was to explore the knowledge, attitudes, and practices (KAP) regarding exercise amongst T2DM and non-diabetic (ND) staff at a tertiary institution in KwaZulu Natal South Africa. A total of 166 responses were received: a total of 16 responses (9.6%) were T2DM, and 150 responses (90.0%) were non-diabetic (ND). The demographics included 66.3% females and 33.7% males who consented to taking part, 62.7% were black, 18.7% were Indian, 12% were white, 5.4% were colored, and 1.2% were other. A cross-sectional descriptive survey design, utilizing a modified validated online knowledge, attitudes, and practice questionnaire, was used to collect data. Descriptive statistics were used for the analysis: inferential statistics; the ordinal (1-5) Likert scale; t-tests; and chi-square tests. The level of statistical significance was set at p ≤ 0.05. No significant differences were found between the T2DM and ND groups except in their attitude towards exercise, which showed three items with significant differences. The ND group agreed significantly more than the T2DM group that they looked forward to exercising (p = 0.002), and even without company, they exercised regularly (p = 0.042). The T2DM group agreed significantly more with the statement that they had asked their doctor if there was medicine available to make them better without doing any exercise (p = 0.002). The overall KAP results of the current study found that both participants diagnosed with T2DM and those in the ND group know about exercise and have a good attitude toward exercise. However, both groups still have poor practice regarding physical activity.

Integrative Metagenomic Analyses Reveal Gut Microbiota-Derived Multiple Hits Connected to Development of Diabetes Mellitus.

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder associated with gut dysbiosis. To investigate the association between gut microbiota and T2DM in a Saudi Arabian population. We conducted a comparative analysis of fecal microbiota from 35 individuals, including both T2DM patients and healthy controls. 16S rRNA gene sequencing was employed to characterize the microbial community structure. Our findings revealed significant differences in microbial composition between the two groups. The T2DM group exhibited a higher abundance of Firmicutes and lower levels of Bacteroidetes compared to the healthy control group. At the genus level, T2DM patients showed a decrease in butyrate-producing bacteria such as Bacteroides and Akkermansia, while an increase in Ruminococcus and Prevotella was observed. Additionally, the T2DM group had a higher abundance of Faecalibacterium, Agathobacter, and Lachnospiraceae, along with a lower abundance of Bacteroides. These results suggest that alterations in gut microbiota composition may contribute to the development of T2DM in the Saudi Arabian population. Further large-scale studies are needed to validate these findings and explore potential therapeutic interventions targeting the gut microbiome.

Analysis of frequency changes in CD8+ regulatory T cell subsets in peripheral blood of individuals with type 1 diabetes

BackgroundThis study aims to examine the alterations and clinical significance of CD8+ regulatory T cell subsets in the peripheral blood of individuals with type 1 diabetes mellitus (T1DM).MethodsFrom January 2020 to December 2023, a study was conducted involving 40 individuals with T1DM, who visited the Department of Endocrinology at the First Affiliated Hospital of Nanjing Medical University (T1DM group). For comparison, 40 healthy individuals who underwent routine physical examinations at the same hospital during this period were selected as the control group. Peripheral blood mononuclear cells were isolated, and CD8+ T cells were labeled with CD3, CD25 and FoxP3 to analyze their subset frequencies using flow cytometry. The study examined differences in subset frequencies between the two groups and explored correlations between subset frequency, disease duration, and age of onset.ResultsThe frequencies of CD8+ CD25+, CD8+ FoxP3+, CD8+ CD25+ CD3+ and CD8+ FoxP3+ CD3+ subsets in peripheral blood mononuclear cells did not significantly differ between the healthy control group and the T1DM group (P > 0.05). In the T1DM group, the expression level of CD25 on CD8+ T cells showed no correlation with the age of onset or disease duration, and FoxP3 levels were also unrelated to the age of onset, with no statistical differences (P > 0.05). However, within the T1DM group, FoxP3 levels progressively decreased with longer disease duration, demonstrating a statistically significant negative correlation (Pearson r = -0.331, P < 0.05). In the T1DM group, the level of CD3+ CD8+ T cells expressed CD25, and there was no correlation between Foxp 3 level and age of onset, not statistically significant (P > 0.05), but the level of Foxp 3 in the T1DM group decreased with the duration of the disease, (Pearson r= − 0.363, P < 0.05).ConclusionThe levels of CD8+FoxP3+ regulatory T cells in peripheral blood mononuclear cells of patients with T1DM show a significant correlation with disease duration, suggesting that these cells may play a critical role in the progression of T1DM.