Hyperglycemia In Diabetes Mellitus Research Articles

New Insights on the potential therapeutic effects of glibenclamide and Obeticholic acid against Alloxan-Induced diabetes mellitus in rat model

Diabetes mellitus (DM) represents a highly prevalent metabolic disorder across the globe. This study aimed to determine the ameliorative efficacy of glibenclamide (Gli) and obeticholic acid (OCA) against biochemical and pathological changes related to alloxan-induced diabetes. Twenty male Wistar rats were allocated into four groups; Control group, Diabetic group: received intraperitoneal injection of alloxan (120 mg/kg) for induction of diabetes, Diabetic + Gli group: Diabetic rats treated daily with oral Gli (5 mg/kg) and Diabetic + OCA group: Diabetic rats treated daily with oral OCA (10 mg/kg). All rats were subjected to 30 days treatments. Our results indicated that Gli successfully ameliorated hyperglycemia and dyslipidemia with a significant decline in serum pancreatic lipase activity and increased insulin level, while OCA had the same effect but without any enhancement in serum insulin levels. Additionally, the disturbances in liver function-related parameters and the evoked oxidative stress, interleukin(IL)-6 and IL-10 in the liver and pancreas were abrogated upon treatment with Gli and OCA. Furthermore, Gli and OCA increased AMP-activated protein kinase (P-AMPK), insulin receptor substrate 1 (IRS1), farnesoid X receptor (FXR), and glucagon-like peptide-1 receptor (GLP-1R) expressions and downregulated sterol regulatory element binding protein-1c mRNA expression. Besides, Gli and OCA have alleviated diabetes-induced histopathological distortions in hepatic and pancreatic tissues and enhanced the immunoexpression of insulin, and proliferating cell nuclear antigen with decreased immune reactivity of glucagon within pancreatic tissues. Gli and OCA decreased the immune reactivity of nuclear factor kappa B and increased the glycogen content of hepatic tissues. In conclusion, OCA is efficacious in the management of dyslipidemia and hyperglycemia of DM and its related oxidative stress.

A Probiotic Mixture Decreases Neuropathy and Oxidative Stress Markers in Diabetic Rats

Diabetic neuropathy (DN) is a type of nerve damage caused by long-term hyperglycemia in diabetes mellitus (DM). The gut microbiota alters in DM. Therefore, improvement of the gut flora may affect neuropathic pain and oxidative biomarkers' responsiveness to the probiotic treatment. The present study aimed to assess the effects of probiotic supplementation on neuropathic pain and oxidative stress biomarkers in diabetic rats’ serum. Forty-eight rats (200-250 g) were randomly divided into four groups (n = 12 per group) to examine the effects of the probiotics mixture as follows: the control group (CO), and the diabetic groups received 1 ml probiotics mixture (DP) containing <em>Lactobacillus rhamnosus</em>, <em>Lactobacillus acidophilus</em>, <em>Lactobacillus delbrueckii</em>, <em>Lactobacillus plantarum</em>, and <em>Bifidobacterium bifidum</em> (10<sup>9</sup> CFU of each), 100 mg/kg Gabapentin (DG), or normal saline (DM) daily. The study used animals with plasma glucose concentrations between 70 and 100 mg/dl. Behavioral tests, including mechanical allodynia, cold allodynia, and thermal hyperalgesia, were used to evaluate the pain on days 1, 4, 7, 14, and 21 of the study. After that, the serum's biochemical analysis was completed. Taking the probiotics mixture decreased mechanical and cold allodynia as well as thermal hyperalgesia. The probiotics group also showed significant reductions in lipid peroxidation levels and increases in total antioxidant capacity (TAC) and glutathione peroxidase (GPx) and superoxide dismutase (SOD) activities compared to the DM group. Our results showed that supplementation with the probiotics mixture could reduce pain-related behaviors in diabetic rats by enhancing the antioxidant capacity in their serum.

Evaluation of Achilles Tendon in Type 2 Diabetes Mellitus Patients Using Sonoelastography

Abstract Background Diabetes mellitus is an endocrine disease associated with several metabolic disorders and long-term complications. Achilles tendon is the largest and strongest tendon in the human body playing a crucial role in foot biomechanics. Hyperglycaemia in Diabetes Mellitus aids the deposition of glycosylated end products in most tissues including the Achilles tendon, which in turn alters its structure and function. Objectives The study aims to investigate the differences in Achilles tendon thickness and stiffness in people with and without type 2 diabetes mellitus. Patients and Methods This is a case control study, where the Achilles tendons of 20 type 2 DM patients and 21 non-diabetic controls were examined for the thickness and stiffness. Achilles tendon thickness was measured using B-mode ultrasonography while its stiffness was evaluated by compression elastography. Results This study included 20 type 2 DM patients (40 Achilles tendons), and 21 non-diabetic controls (42 Achilles tendons). The Achilles tendon thickness was significantly higher in the diabetic group with a mean thickness of 4.23 ± 0.95 mm, compared to 3.06 ± 0.83 mm in the control group (p < 0.01). A statistically significant difference of the Achilles tendon stiffness was also established. The diabetic group showed a greater percentage of soft tendons (47.5%) compared to the control group (16.7%). The diabetic group also showed a smaller percentage of hard tendons (52.5%) compared to the control group (83.3%) (p < 0.05). Conclusion Achilles tendons of type 2 DM patients are both thicker and softer than their non-diabetic counterparts.

Effects of insonification on repairing the renal injury of diabetic nephropathy rats

IntroductionProlonged hyperglycemia in diabetes mellitus can result in the development of diabetic nephropathy (DN) and increase the susceptibility to kidney failure. Low-intensity pulsed ultrasound (LIPUS) is a non-invasive modality that...

In vitro and in vivo evaluation of isoxsuprine loaded invasomes for efficient treatment of diabetes‐accelerated atherosclerosis

Hyperglycemia in diabetes mellitus exacerbates vascular disarray in atherosclerosis by damaging endothelial cells and vascular smooth muscles. It's a major contributor to deaths from cardiovascular disease. Isoxsuprine (IXS) is an oral beta-adrenergic agonist that improves arterial blood flow due to its vasodilatation effect and boosts insulin secretion. However, oral IXS has low efficacy, low bioavailability and patient incompliance due to its high dose frequency, short biological half-life and fast clearance. The goal of this research was to develop a nasal formulation of IXS-loaded invasomes to sustain IXS's release and improve its permeation and efficacy as a potential diabetes-accelerated atherosclerosis treatment. Different IXS-loaded invasomes formulations were developed using design expert software to study the effects of ethanol, phospholipid, and cineole concentrations. Based on the desirability index, the formulation with 1 % ethanol, 0.5 % cineole, and 2.48 % phospholipid was chosen as the optimum formulation. The optimum IXS-loaded invasomes formulation showed an encapsulation efficiency of 72.03 % and a particle size of 210.26 nm. Production of nasal IXS-loaded invasomes formulation increased the permeation of IXS with a ratio of 2.25 and sustained its release. The optimum IXS-loaded invasomes formulation was non-cytotoxic and showed a good binding mode with serum proteins. When optimum IXS-loaded invasomes formulation was evaluated in vivo against a rat model of experimental diabetes and atherosclerosis, it showed anti-diabetic and anti-atherosclerotic effects. It substantially increased the levels of HDL by 45.11 % and substantially decreased the levels of glucose, LDL, triglycerides, and cholesterol by 41.35 %, 89.76 %, 51.01 %, and 60.18 %, respectively. Histopathology also showed that atherosclerotic lesions got improved in rats given optimum IXS-loaded invasomes formulation. In conclusion, nasal administration of IXS-loaded invasomes could be a potential diabetes-accelerated atherosclerosis treatment.

DAUN UNDIS DAN JAHE MENINGKATKAN PERTAHANAN ANTIOKSIDAN PADA PANKREAS TIKUS DIABETES : STUDI IMUNOHISTOKIMIA

Hyperglycemia in diabetes mellitus results in stress oxidative condition. This study aims to analyze the antioxidant defence in pancreatic experimental-diabetic rats treated with a combined extract of Cajanus cajan leaves and ginger, using an immunohistochemical technique for copper, zinc – superoxide dismutase (Cu,Zn-SOD). A total of 25 male Sprague Dawley rats were used in this study. The rats were randomly divided into five groups; normal control group (NC), diabetic group (DM), two groups DM treated with a different dose combination of Cajanus cajan leaf extract and ginger extract (DME and DMF), and DM treated with glibenclamide (DMG). This study used 110 mg/kg BW alloxan induction to obtain diabetic conditions, and the treatments of the extract were conducted for 28 days. The pancreatic tissues were processed using the paraffin standard method and an immunohistochemical technique using monoclonal antibody Cu,Zn-SOD. The results showed that a combination of Cajanus cajan leaf extract and ginger extract lowered the level of blood glucose, increased body weight, and increased the level of Cu,Zn-SOD content in pancreatic tissues of experimental-diabetic rats. This study concluded that combining Cajanus cajan leaf extract and ginger extract increased antioxidant defence in pancreatic organs of experimental-diabetic rats.

Innate immunity in diabetic nephropathy: Pathogenic mechanisms and therapeutic targets

AbstractDiabetic nephropathy (DN) represents a prevalent chronic microvascular complication of diabetes mellitus (DM) and is a major cause of end‐stage renal disease. The anfractuous surrounding of DN pathogenesis and the intricate nature of this metabolic disorder often pose challenges in both the diagnosis and treatment of DN compared to other kidney diseases. Hyperglycaemia in DM predispose vulnerable renal cells into microenvironmental disequilibrium and thereby results in innate immunocytes infiltration including neutrophils, macrophages, myeloid‐derived suppressor cells, dendritic cells, and so forth. These immune cells play dual roles in kidney injury and closely correlated with the degree of proteinuria in DN patients. Additionally, innate immune signaling cascades, initiated by altered metabolic and hemodynamic in diabetic context, are crucial in instigating and perpetuating renal inflammation, which detrimentally contribute to DN pathogenesis. As such, anti‐inflammatory therapies, particularly those targeting innate immunity, hold renoprotective promise in DN. In this article, we reviewed the origin and feature of the above four prominent kidney innate immune cells, analyze their pathogenic role in DN, and discuss potential targeted‐therapeutic strategies, aiming to enhance the current understanding of renal innate immunity and hence help to discover promising therapeutic approaches for DN.

Er:YAG Laser Alleviates Inflammaging in Diabetes-Associated Periodontitis via Activation CTBP1-AS2/miR-155/SIRT1 Axis.

Periodontitis is a significant health concern for individuals with diabetes mellitus (DM), characterized by inflammation and periodontium loss. Hyperglycaemia in DM exacerbates susceptibility to periodontitis by inducing inflammaging in the host immune system. The use of erbium-doped yttrium-aluminum-garnet laser (ErL) in periodontitis treatment has gained attention, but its impact on diabetic-associated periodontitis (DP) and underlying mechanisms remain unclear. In this study, we simulated DP by exposing human periodontal ligament fibroblasts (PDLFs) to advanced glycation end products (AGEs) and lipopolysaccharides from P. gingivalis (Pg-LPS). Subsequently, we evaluated the impact of ErL on the cells' wound healing and assessed their inflammaging markers. ErL treatment promoted wound healing and suppressed inflammaging activities, including cell senescence, IL-6 secretion, and p65 phosphorylation. Moreover, the laser-targeted cells were observed to have upregulated expression of CTBP1-AS2, which, when overexpressed, enhanced wound healing ability and repressed inflammaging. Moreover, bioinformatic analysis revealed that CTBP1-AS2 acted as a sponge for miR155 and upregulated SIRT1. In conclusion, ErL demonstrated the ability to improve wound healing and mitigate inflammaging in diabetic periodontal tissue through the CTBP1-AS2/miR-155/SIRT1 axis. Targeting this axis could represent a promising therapeutic approach for preventing periodontitis in individuals with DM.

The potential of Myrmecodia pendans in preventing complications of diabetes mellitus as an antidiabetic and antihyperlipidemic agent.

Hyperglycemia in diabetes mellitus (DM) can lead to dyslipidemia, which is a risk factor for macrovascular complications such as heart disease and stroke. Aside from administering antidiabetic medications, DM treatment can also be achieved through the use of natural components, such as Myrmecodia pendans, commonly known as the ant nest plant (ANP). This study aimed to investigate the impact of administering the ANP on the lipid profile of Wistar rats. A group of 20 rats was divided into two categories: 6 rats served as healthy controls (H), while the remaining 14 rats were subjected to a high-lipid diet and streptozotocin to generate a model of type 2 diabetes mellitus (T2DM). The diabetic rats were divided into two groups: the DM group consisted of rats that did not receive any treatment, while the ANP group was administered the herb orally. The results revealed significant variations in triglyceride, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) levels among the three groups (p < 0.05). The post hoc test revealed disparities in triglyceride and LDL between those in the DM group and the ANP group (p < 0.05). Myrmecodia pendans demonstrated the ability to decrease triglyceride and LDL, while increasing HDL levels in rats with T2DM.

Cardiorespiratory dynamics of type 2 diabetes mellitus: An extensive view of breathing and fitness challenges in a diabetes prevalent population.

Diabetes mellitus (DM) is well known for related micro and macrovascular complications. Uncontrolled hyperglycemia in diabetes mellitus leads to endothelial dysfunction, inflammation, microvascular impairment, myocardial dysfunction, and skeletal muscle changes which affect multiple organ systems. This study was designed to take an extensive view of cardiorespiratory dynamics in patients with type 2 DM. One hundred healthy controls (HC) and 100 DM patients were enrolled. We measured and compared the breathing patterns (spirometry), VO2 max levels (heart rate ratio method) and self-reported fitness level (international fitness scale) of individuals with and without diabetes. Data was analyzed in SPSS v.22 and GraphPad Prism v8.0. We observed restrictive spirometry patterns (FVC <80%) in 22% of DM as compared to 2% in HC (p = 0.021). There was low mean VO2 max in DM as compared to HC(32.03 ± 5.36 vs 41.91 ± 7.98 ml/kg/min; p value <0.001). When evaluating physical fitness on self-reported IFiS scale, 90% of the HC report average, good, or very good fitness levels. In contrast, only 45% of the DM shared this pattern, with a 53% proportion perceiving their fitness as poor or very poor (p = <0.05). Restrictive respiratory pattern, low VO2 max and fitness level were significantly associated with HbA1c and long-standing DM. This study shows decreased pulmonary functions, decreased cardiorespiratory fitness (VO2 max) and IFiS scale variables in diabetic population as compared to healthy controls which are also associated with glycemic levels and long-standing DM. Screening for pulmonary functions can aid optimum management in this population.

Olive oil increase catalase activity and gluthatione peroxidase level in hyperglycemic rats

Background: Diabetes mellitus is the most common endocrine disease globally. Hyperglycemia in diabetes mellitus is known to trigger oxidative stress. The activity of glutathione peroxidase (GSH-Px) is decreased in diabetic conditions. Catalase activity acts as a defense system to prevent the formation of free radicals (oxidants) in the human body. Objective: This study aimed to determine the effectiveness of olive oil antioxidants on catalase activity and GSH-Px levels in hyperglycemic rats. Methods: Adult male Wistar rats were randomized into three groups (n: 8): untreated control (Control), alloxan-induced untreated (Alloxan), and alloxan-induced treatment (Treatment) of olive oil at 25 mL/day for 14 days. Catalase activities were measured using the spectrophotometry method, and GSH-Px levels were analyzed using an enzyme-linked immunosorbent assay (ELISA). Results: Administration of olive oil increased catalase activity compared to the untreated group in alloxan-induced rats. The average level of glutathione peroxidase was higher in the treatment group than in alloxan-induced rats. Conclusion: Antioxidants in olive oil increased catalase activity and glutathione peroxidase levels in alloxan-induced hyperglycemic rats.

Nano Drug Delivery System with Resveratrol as Promising Novel Adjuvant Therapy for Diabetic Non-Healing Wounds: A Literature Review

Diabetes mellitus (DM) is a metabolic disease characterized by increased blood sugar levels (hyperglycemia) and is associated with impaired function of β cells. The uncontrolled and prolonged hyperglycemia in DM can cause complications. One of the most common is diabetic non-healing wounds, the leading cause of disability in people with diabetes, therefore adjuvant therapy is needed. Compounds from natural ingredients are currently getting the spotlight in recent studies conducted to prove their effect on non-healing wounds, such as Resveratrol (RSV). This review aims to discuss the potential of RSV as a novel adjuvant therapy and its delivery system strategy in the case of diabetic non-healing wounds. We conducted an extensive search from three online scientific databases such as ScienceDirect, ResearchGate, and PubMed on February-March 2023. Keywords used are "resveratrol", "diabetic wound healing", and "diabetes mellitus". As a result, 86 studies were reviewed, and only 79 selected studies met all inclusion criteria. The formulation of RSV nanoparticles in oral drug delivery systems and topical administration has shown promise to overcome the limitations of RSV as adjuvant therapy in diabetic non-healing wounds. The best option that we found through this literature review is the nano-oral drug delivery system as it could minimize drug metabolism in the gastrointestinal tract, therefore the drug bioavailability and drug concentration on the target site could be maximized, even though the systemic side effects might occur.

Correlation of Fasting and Postprandial Blood Glucose with Hba1c in monitoring Glycemic Control of Diabetic Patients in FCT Abuja, Nigeria

Achieving glycemic control or reduction of hyperglycemia would significantly decrease most of the complications associated with hyperglycemia in diabetes mellitus. It has been stated that measurement of glycosylated hemoglobin (HbA1C) remains the gold standard for the assessment of glycemic control; there is no consensus whether the Fasting or Postprandial is a better predictor of glycemic control in poor resource setting where HbA1C is not easily accessed or available. The aim of this research is to determine fasting and postprandial plasma glucose and their correlation with HbA1C in glycemic control. A cross sectional case control study was carried out from January, 2023 to July, 2023; a total of 203 participants were recruited into the study. Fasting blood glucose (FBG), 2 hours post prandial blood glucose (2HPBG) were determined in all the subjects using the enzymatic glucose oxidase method for glucose estimation according to the instruction of the manufacturer, while HbA1C was determined using Boroaffinity Chromatographic method according to the instruction of the manufacturer. Statistical data analysis was carried out using SPSS software (Version 25.0, IBM Corp., Armonk, New York USA), and p&lt;0.001 were defined as statistically significant; the correlation between the parameters was carried out using Pearson’s correlation. Both the FBG and the 2HPBG showed positive correlation with HbA1C in the diabetic and control subjects; however, the level of correlation varies. The correlation of FBG and 2HPBG with HbA1C is directly proportional to the concentration of blood glucose level. The FBG for the control and the subjects are 7.40±1.59 and 143.67±5.01, with HbA1C of 4.45±0.05; 6.26±1.47 respectively. The 2HPBG for the control and the subjects are 120.70±1.75 and 192.92±7.05, with HbA1C of 5.56±0.07; 7.82±0.22 respectively. The FBG correlation to HbA1C is r= 0.875, p&lt;0.001; while 2HPBG is r= 0.908, NEWPORT INTERNATIONAL JOURNAL OF PUBLIC HEALTH AND PHARMACY (NIJPP) Volume 4 Issue 2 2023 OPEN ACCESS ©NIJPP ONLINE ISSN: 2992-5479 Publications 2023 PRINT ISSN: 2992-605X Page | 10 p&lt;0.001. The study showed positive correlation of FBG and 2HPBG with HbA1C, since HbA1C is the value of the percentage concentration of glucose at a given period of time; FBG, 2HPBG and HbA1C can be used to evaluate the degree of glycemic control in diabetic patients’ management, in order to minimize or avoid diabetic complications. Keywords: FBG, PBG, Diabetes, HbA1C, Correlation, Complications

Bioprospecting of Sea Anemones (Cnidaria, Anthozoa, Actiniaria) for β-Defensin-like α-Amylase Inhibitors.

Diabetes mellitus is one of the most serious diseases of our century. The drugs used are limited or have serious side effects. The search for new sources of compounds for effective treatment is relevant. Magnificamide, a peptide inhibitor of mammalian α-amylases, isolated from the venom of sea anemone Heteractis magnifica, can be used for the control of postprandial hyperglycemia in diabetes mellitus. Using the RACE approach, seven isoforms of magnificamide were detected in H. magnifica tentacles. The exon-intron structure of magnificamide genes was first established, and intron retention in the mature peptide-encoding region was revealed. Additionally, an α-amylase inhibitory domain was discovered in the mucins of some sea anemones. According to phylogenetics, sea anemones diverge into two groups depending on the presence of β-defensin-like α-amylase inhibitors and/or mucin-inhibitory domains. It is assumed that the intron retention phenomenon leads to additional diversity in the isoforms of inhibitors and allows for its neofunctionalization in sea anemone tentacles. Bioprospecting of sea anemones of the order Actiniaria for β-defensin-like α-amylase inhibitors revealed a diversity of inhibitory sequences that represents a starting point for the design of effective glucose-lowering drugs.

Implementing a Novel Machine Learning System for Nutrition Education in Diabetes Mellitus Nutritional Clinic: Predicting 1-Year Blood Glucose Control.

(1) Background: Persistent hyperglycemia in diabetes mellitus (DM) increases the risk of death and causes cardiovascular disease (CVD), resulting in significant social and economic costs. This study used a machine learning (ML) technique to build prediction models with the factors of lifestyle, medication compliance, and self-control in eating habits and then implemented a predictive system based on the best model to forecast whether blood glucose can be well-controlled within 1 year in diabetic patients attending a DM nutritional clinic. (2) Methods: Data were collected from outpatients aged 20 years or older with type 2 DM who received nutrition education in Chi Mei Medical Center. Multiple ML algorithms were used to build the predictive models. (3) Results: The predictive models achieved accuracies ranging from 0.611 to 0.690. The XGBoost model with the highest area under the curve (AUC) of 0.738 was regarded as the best and used for the predictive system implementation. SHAP analysis was performed to interpret the feature importance in the best model. The predictive system, evaluated by dietitians, received positive feedback as a beneficial tool for diabetes nutrition consultations. (4) Conclusions: The ML prediction model provides a promising approach for diabetes nutrition consultations to maintain good long-term blood glucose control, reduce diabetes-related complications, and enhance the quality of medical care.

Endothelial to mesenchymal cell transition in diabetic retinopathy: targets and therapeutics.

Diabetic retinopathy (DR) is a result of neurovacular insults from hyperglycemia in diabetes mellitus (DM), and it is one of the top causes of vision loss throughout the modern world. This review article explores the role endothelial to mesenchymal transition (EndMT) has on the pathogenesis of DR. EndMT contributes to the disruption of the blood-retinal barrier, vascular leakage, neovascularization, and fibrosis observed in DR. Risk factors and biomarkers associated with DR severity are discussed, highlighting the importance of early detection and targeted therapies. Current treatments primarily focus on anti-vascular endothelial growth factor (anti-VEGF) agents, corticosteroids, and laser photocoagulation. However, emerging therapeutic strategies aimed at inhibiting EndMT and its downstream effects show promise in preventing the development and progression of DR. Understanding the molecular and cellular mechanisms underlying EndMT in DR provides valuable insights into the disease process and offers potential options for the development of potential treatments.

Oxidative Stress in Streptozotocin-Induced Rats and The Role of Bajakah (Uncaria Sp.) as Antioxidants

Hyperglycemia in diabetes mellitus (DM) increases the production of reactive oxygen species (ROS). That condition causes a decrease in antioxidant defense activity in the body so that the body cannot fight free radicals and triggers diabetic macroangiopathy complications. One source of natural antioxidants is the Bajakah stem (Uncaria sp.). which has antioxidant and antihyperglycemic effects. so it is expected to inhibit oxidative damage in DM. This study aimed to determine the effect of the extract of bajakah stem on antihyperglycemic activity. the antioxidant enzyme activity of SOD. and MDA levels in streptozotocin-induced rats. This study used an experimental method consisting of 5 treatments: two control groups (NC. PC) and three treatment groups (P1. P2. P3). and five replications for 21 days. Antioxidant activity was measured by scavenging the activity of hydroxyl radicals. Furthermore. testing of antihyperglycemic and antioxidant activity using test animals (rats). divided into three doses. namely 100. 200. and 400 mg/kg BW. This study used one-way ANOVA and Duncan's mean difference test. Results showed that the ethanol extract of the bajakah stem (Uncaria sp.) contained alkaloids. flavonoids. tannins. saponins. triterpenoids. and steroids. The antioxidant activity test of the pirated extract obtained IC50 55.646 ppm. and a dose of 100 mg/kg BW had the best activity as antihyperglycemic. increased SOD enzyme activity. and decreased MDA levels

Study of Serum Apelin and Insulin Resistance in Type 2 Diabetes Mellitus Patients With or Without Obesity.

Type 2 diabetes mellitus (T2DM) is a chronic disorder characterized by persistent hyperglycemia. Chronic hyperglycemia in diabetes mellitus can cause microvascular and macrovascular complications. Obesity is a major risk factor contributing to disease progression and complications of T2DM. Apelin is an adipokine having a compensatory role in reducing insulin resistance (IR)in morbidly obese individuals. This study was undertaken to find a correlation between Apelin, IR, and obesity. This case-control study included 180 participants, cases (n=90) having T2DM, and healthy controls (n=90). Further, the case and control groups were divided into group I (non-obese) and group II (obese) according to their body mass index (BMI) as per the Asia Pacific classification of BMI. Following obtainingconsent, anthropometrical measurements and blood parameters likeserum total lipid profile, fasting and postprandial glucose level, Apelin, and insulin were done,and results were analyzed statistically usingStatistical Package for the Social Sciences (SPSS) version 21(IBM Corp., Armonk, NY). A significantly higher Apelin level was observed in diabetes patients with obesity (265.16±11.0 pg/mL) as compared to non-obese (206.44±83.0 pg/mL). A positive correlation between serum Apelin levels and BMI was found (r=0.367, p=0.003). Homeostasis Model Assessment of IR (HOMA-IR) is increased in obese patients in comparison to the control group. A significant positive correlation between BMI and HOMA-IR (r=0.429, p=0.001) and Apelin and IR (r=0.742, p=0.000) was found in this study. On the basis of the finding of this study, we may conclude that Apelin has a role in improving insulin sensitivity in T2DM. Larger and multicentric studies are further required to discover the therapeutic role of Apelin in T2DM.

Effect of antioxidants on kidney damage repair in - diabetes-induced animal: a literature study

Diabetes mellitus is a disease characterized by hyperglycemia. Chronic hyperglycemia indiabetes mellitus can cause various complications, one of which is diabetic nephropathy,which affects the kidney. Chronic hyperglycemia causes an increase in free radicals and adecrease in antioxidant activity resulting in oxidative stress conditions. This study aims to determine kidney damage caused by oxidative stress and the role of antioxidants in reducingthis damage through literature studies. The literature used comes from Google search results such as PubMed, Google Scholar, ResearchGate, and ScienceDirect. From the search results, ten journals meeting the inclusion and exclusion criteria were selected for review and comparison so that a conclusion could be drawn. The results of this literature study have demonstrated that biochemical parameters, such as increased levels of creatinine, urea, malondialdehyde (MDA), and decreased antioxidant enzymes, as well as kidney histological parameters, such as changes in the shape of tubules, glomeruli, and increased kidney expression, are indicators of kidney damage caused by oxidative stress. The mechanism of antioxidants in reducing kidney damage is through DNA cutting, binding to phenolic OH groups, down-regulation of the oxidase expression of nitrogen oxides 4 nicotinamide adenine dinucleotide phosphate (Nox4 NADPH), antioxidant enzyme systems, activation of the activated protein kinase pathway - silent mating type information regulation 2 homolog 1- peroxisome proliferator-activated receptor-γ coactivator 1α (AMPK-SirT1- PGC-1 α), protein glycation reactions, and inhibition of protein 53 (P53) so that erythroid nuclear factor 2-related factor 2 (Nrf2) can activate antioxidant gene transcription.

Hyperglycemia-activated 11β-hydroxysteroid dehydrogenase type 1 increases endoplasmic reticulum stress and skin barrier dysfunction

The diabetes mellitus (DM) skin shows skin barrier dysfunction and skin lipid abnormality, similar to conditions induced by systemic or local glucocorticoid excess and aged skin. Inactive glucocorticoid (GC) is converted into active glucocorticoid by 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1). Hyperglycemia in DM and excessive GC are known to increase endoplasmic reticulum (ER) stress. We hypothesized that hyperglycemia affects systemic GC homeostasis and that the action of skin 11β-HSD1 and GC contributes to increased ER stress and barrier defects in DM. We compared 11β-HSD1, active GC, and ER stress between hyperglycemic and normoglycemic conditions in normal human keratinocytes and db/db mice. 11β-HSD1 and cortisol increased with time in keratinocyte culture under hyperglycemic conditions. 11β-HSD1 siRNA-transfected cells did not induce cortisol elevation in hyperglycemic condition. The production of 11β-HSD1 and cortisol was suppressed in cell culture treated with an ER stress-inhibitor. The 14-week-old db/db mice showed higher stratum corneum (SC) corticosterone, and skin 11β-HSD1 levels than 8-week-old db/db mice. Topical 11β-HSD1 inhibitor application in db/db mice decreased SC corticosterone levels and improved skin barrier function. Hyperglycemia in DM may affect systemic GC homeostasis, activate skin 11β-HSD1, and induce local GC excess, which increases ER stress and adversely affects skin barrier function.