Improved Blood Glucose Levels Research Articles

Overexpression of PDX1 and NKX6.1 as a Treatment for Type 1 Diabetes: A Research Protocol

Introduction: Type 1 diabetes is an autoimmune disorder characterized by the destruction of pancreatic islet beta cells responsible for insulin production, leading to insulin deficiency. The PDX1 and NKX6-1 genes are essential to beta cell development and maturation in the pancreas. Based on previous studies, Pdx1 is downregulated in diabetics, and higher Nkx6.1 expression has been shown to induce high cell turnover. This proposal aims to investigate the potential therapeutic effects of gene therapy on streptozotocin-induced non-obese diabetic/severe-combined immunodeficient mice in treating Type 1 Diabetes. It is hypothesized that the use of gene therapy to overexpress PDX1 and NKX6-1 into the pancreas of experimental diabetic mice will result in increased beta cell production and improved glucose metabolism. Methods: Both male and female streptozotocin-induced non-obese diabetic/severe-combined immunodeficient experimental mice will receive human islets from individuals 32-55 years old. The PDX1 and NKX6-1 genes will be overexpressed in a shuttle vector and incorporated into the gutless adenovirus vector backbone through co-transfection using the Cre293/lox P cell line. Verification of successful vectors containing the gutless adenovirus coupled with a helper plasmid will be done using gel electrophoresis. Incubation with beta cells will stimulate the transduction process after which beta cells will be delivered into mice pancreas’ through endoscopic retrograde cholangiopancreatography. An intraperitoneal glucose tolerance test, pancreatic biopsy with immunohistochemical staining, and islet calculations will be done. Results: An intraperitoneal glucose tolerance test is expected to show improved blood glucose levels in experimental mice post-treatment, while a pancreatic biopsy with immunohistochemical staining and subsequent islet diameter and volume calculations are expected to depict an increase in the number of beta cells. Discussion: The experimental mice are anticipated to show an improvement in blood glucose levels and increased production of beta cells following treatment due to the overexpression of PDX1 and NKX6-1. The normal control mice and diabetic untreated mice are expected to show normal and high glucose levels, as well as normal and deficient beta cells respectively. Conclusion: This proposal may provide a better understanding of the pathophysiology in Type 1 Diabetes and pave a new path for its treatment.

A novel mechanism of imeglimin-mediated insulin secretion via the cADPR-TRP channel pathway.

ABSTRACTAims/IntroductionImeglimin is a novel oral hypoglycemic agent that improves blood glucose levels through multiple mechanisms of action including the enhancement of glucose‐stimulated insulin secretion (GSIS), however, the details of this mechanism have not been clarified. In the process of GSIS, activation of the transient receptor potential melastatin 2 (TRPM2) channel, a type of non‐selective cation channel (NSCCs) in β‐cells, promotes plasma membrane depolarization. The present study aimed to examine whether imeglimin potentiates GSIS via the TRPM2 channel in β‐cells.Materials and MethodsPancreatic islets were isolated by collagenase digestion from male wild‐type and TRPM2‐knockout (KO) mice. Insulin release and nicotinamide adenine dinucleotide (NAD+) production in islets were measured under static incubation. NSCC currents in mouse single β‐cells were measured by patch‐clamp experiments.ResultsBatch‐incubation studies showed that imeglimin enhanced GSIS at stimulatory 16.6 mM glucose, whereas it did not affect basal insulin levels at 2.8 mM glucose. Imeglimin increased the glucose‐induced production of NAD+, a precursor of cADPR, in islets and the insulinotropic effects of imeglimin were attenuated by a cADPR inhibitor 8‐Br‐cADPR. Furthermore, imeglimin increased NSCC current in β‐cells, and abolished this current in TRPM2‐KO mice. Imeglimin did not potentiate GSIS in the TRPM2‐KO islets, suggesting that imeglimin’s increase of NSCC currents through the TRPM2 channel is causally implicated in its insulin releasing effects.ConclusionsImeglimin may activate TRPM2 channels in β‐cells via the production of NAD+/cADPR, leading to the potentiation of GSIS. Developing approaches to stimulate cADPR‐TRPM2 signaling provides a potential therapeutic tool to treat type 2 diabetes.

Eccentric Exercise Decrease Blood Glucose Level and Improve Protein Level of Glucose Transporters in Diabetic Mice Muscle

Background: Previously, eccentric exercise improved on blood glucose level better than concentric andisometric exercise. The improvement of blood glucose level was resulted from higher glucose uptakeactivity, particularly at the muscles. Unfortunately here isn’t yet information whether it is facilitated byglucose transporter type 1 or glucose transporter type 4.Objectives: The aim of the present study was to investigate the effect of eccentric activity on glucosetransporter type 1 and glucose transporter type 4 in gastrocnemius muscle of streptozotocin-induced diabetesmellitus mice.Methods: Diabetic mice were grouped randomly into 4 groups (7 mice each group). Two groups wereobserved during fasting and others were observed during post prandial. Single bout of eccentric activity wasgiven by downhill running on 10o degree decline treadmill. The protein level of glucose transporters weremeasured using monoclonal antibody in ELISA protocol. Blood glucose level was measured on fasting andpost prandial using colorimetric protocol of EASY TOUCH app.Result: Glucose levels (fasting and post prandial) of eccentric group were significantly lower than isometricgroup. Consistently, protein level of glucose transporters (type 1 and type 4) were significantly higher thanisometric group. Type-4 glucose transporter level was higher than type-1 glucose transporter, found in calfmuscle.Conclusions: single bout of eccentric exercise on downhill running improve blood glucose level due to bothGLUT-1 and GLUT-4 protein levels improvement.

Evidence-based tailored nutrition educational intervention improves adherence to dietary guidelines, anthropometric measures and serum metabolic biomarkers in early-stage breast cancer patients: A prospective interventional study

PurposeThe impact of the adherence to dietary guidelines of early-stage breast cancer (EBC) patients on body composition changes during treatment is not entirely defined. This study aimed to evaluate the role of an evidence-based nutrition educational intervention, according to adherence to dietary guidelines, in EBC patients. MethodsThis prospective study included EBC patients, candidates for neoadjuvant/adjuvant therapy. Patients received an evidence-based tailored nutrition educational intervention. The adherence to dietary guidelines, anthropometric and dietary assessments, and blood glucose and lipid profile tests were evaluated at baseline and after a 12-months nutritional intervention. ResultsTwo hundred and forty-three patients were enrolled. At baseline, 38.3% and 23.9% of patients were overweight and obese, weight gain ≥5% (compared to 6-months before enrollment) and central obesity were observed in 47.3% and 52.7% of patients, respectively. Adherence to dietary guidelines was low (median Med-Diet score: 6 [IQR 4–8]). After the nutritional intervention (median follow-up: 22 months [range 12–45]), adherence to dietary guidelines significantly increased (median Med-Diet score: 12 [IQR 8–13]), p < 0.0001). High adherence to dietary guidelines (defines as Med-Diet score ≥10) significantly correlated with: 1) overall weight loss ≥5% (21.8% vs. 2.5%, p = 0.003); 2) median BMI drop (from 25.6 kg/m2 to 24.4 kg/m2, p = 0.003); 3) lower prevalence of central obesity (38.2% vs. 7.2%, p = 0.01); 4) improvement in blood glucose levels and lipid profile. ConclusionThis study suggests that an evidence-based tailored nutrition educational intervention during treatment for EBC significantly increases overall adherence to dietary guidelines, and it improves both anthropometric measures and serum metabolic biomarkers in patients with high adherence.

English

BACKGROUND Diabetic nephropathy (DN) is one of the commonest causes for end stage renal disease. Renal accumulation of lipids is one of the pathological finding seen in diabetic nephropathy. Diallyl disulphide (DADS), a principle component of garlic oil, is known for its hypolipidemic properties. Diaceto-dipropyl disulphide (DADPDS) is a structural analogue of DADS, and is more palatable and less toxic to diabetic rats. Hence this animal experiment study was undertaken to compare the hypolipidemic and antioxidant effects of DADS and DADPDS on diabetic rat renal tissue and to evaluate the better disulphide among the two that may be used as adjuvant drug in treating or preventing diabetic nephropathy. METHODS This was an animal experimental comparative study. 24 male albino rats were grouped (6 rats in each group) into normal, diabetic control, DADS and DADPDS treated diabetic rats. Diabetes was induced in albino rats by intraperitoneal injection of alloxan. DADS and DADPDS were fed by gastric intubation for 90 days. After stipulated time, kidneys were dissected out and its total lipids, cholesterol and phospholipid levels were estimated along with tissue thiobarbituric acid reactive substances (TBARS) levels. RESULTS Renal tissue total lipids, cholesterol and phospholipids were significantly decreased in DADS and moderately decreased in DADPDS treated diabetic kidneys, when compared to diabetic control rats. But TBARS levels were significantly decreased in DADPDS rat kidneys compared to DADS treated rat kidneys. CONCLUSIONS In this comparative study, we note that DADS has better lipid-lowering effect on renal tissue of alloxan diabetic rats compared to DADPDS. On the other hand, DADPDS has low renal toxic effects, as indicated by low TBARS levels and improvement in blood glucose levels, when compared to DADS treated diabetic rats. Hence, DADS can be used as an adjuvant drug, only in atherogenic diabetic patients without nephropathy and DADPDS can be used as an adjuvant drug in diabetic nephropathy patients. KEYWORDS Diallyl-Disulphide, Diallyl-Dipropyl Disulphide, Diabetic Nephropathy, Renal Lipids

New insight on the role of liraglutide in alleviating dexamethasone-induced pancreatic cytotoxicity via improving redox status, autophagy flux, and PI3K/Akt/Nrf2 signaling.

Chronic glucocorticoids therapy is commonly complicated by steroid diabetes, although the underlying mechanisms are still elusive. Liraglutide, a glucagon-like peptide-1, was initially found to induce glycemic control and recently it was found to have many pleotropic effects; however, its role in pancreas remains unknown. The present study aims to estimate the protective role of liraglutide on dexamethasone-induced pancreatic cytotoxicity and hyperglycemia, highlighting the possible underlying biochemical, molecular, and cellular mechanisms. Twenty-eight male Wistar rats were involved in this study and were randomly divided into four groups. Group III and IV were treated with 1mg/kg dexamethasone daily for 10days. Group II and IV were treated with liraglutide in a dose of 0.8mg/kg per day for 2weeks. Pancreatic caspase-9, nuclear factor erythroid 2-related factor 2 (Nrf2), phospho-protein kinase-B (pAkt), and sequestrome 1 (p62) levels were assessed by immunoassay. Moreover, phosphoinositide 3-kinase (PI3K) expression by real-time PCR, microtubule-associated protein light chain 3 (LC3B) expression by immunohistochemistry, glycemic status, β-cell function by homoeostasis model assessment (HOMA) β index, and pancreatic redox status were assessed. Liraglutide improved blood glucose level, β-cell function, pancreatic caspase-9 level, redox status, and autophagy. Additionally, it increased pancreatic PI3K, pAkt, and Nrf2 levels. Moreover, preservation of pancreatic histological and the ultrastructural morphological features of β- and α-cells were observed. In conclusion, liraglutide protected against dexamethasone-induced pancreatic injury and hyperglycemia and decelerated the progression towards steroid diabetes via activating PI3K/Akt/Nrf2 signaling and autophagy flux pathways.

Effects of Baccharin Isolated from Brazilian Green Propolis on Adipocyte Differentiation and Hyperglycemia in ob/ob Diabetic Mice.

Propolis is a honeybee product with various biological activities, including antidiabetic effects. We previously reported that artepillin C, a prenylated cinnamic acid derivative isolated from Brazilian green propolis, acts as a peroxisome proliferator-activated receptor γ (PPARγ) ligand and promotes adipocyte differentiation. In this study, we examined the effect of baccharin, another major component of Brazilian green propolis, on adipocyte differentiation. The treatment of mouse 3T3-L1 preadipocytes with baccharin resulted in increased lipid accumulation, cellular triglyceride levels, glycerol-3-phosphate dehydrogenase activity, and glucose uptake. The mRNA expression levels of PPARγ and its target genes were also increased by baccharin treatment. Furthermore, baccharin enhanced PPARγ-dependent luciferase activity, suggesting that baccharin promotes adipocyte differentiation via PPARγ activation. In diabetic ob/ob mice, intraperitoneal administration of 50 mg/kg baccharin significantly improved blood glucose levels. Our results suggest that baccharin has a hypoglycemic effect on glucose metabolic disorders, such as type 2 diabetes mellitus.

RP-HPLC Method Designed for Determining Charantin in its Capsule Dosage Form

Charantin, a steroidal saponin found in the plant Momordica charantia and functions like insulin. It is combined with natural insulin, increasing insulin release and inhibiting gluconeogenesis. Charantin improves blood glucose levels by enhancing glucose absorption and glycogen synthesis in the liver, muscles, and fat cells, according to a large body of research. The great majority of the time, it is taken in the form of a capsule. Because of the increased availability of these newly released formulations, a new way of calculating the amount of medications included in the formulations is now required. The current work's RP-HPLC technique is aimed to estimate Charantin as well as confirm that Charantin is being calculated. The proposed RP-HPLC technology for assessing Charantin in capsule dosage form was found to be precise, specific, accurate, quick, and cost-effective. Label Claims (also known as labelling claims) are representations of the actual product attributes as stated on the product label. The sample recoveries from all formulations were consistent with their respective Label Claims, and this method is suitable for routine analysis. It is suitable for normal laboratory analysis and may be used to control the quality of raw materials, formulations, dissolution tests, and bioequivalence studies for the same formulation.

Comparative effects of metformin and Cistus laurifolius L. extract in streptozotocin-induced diabetic rat model: oxidative, inflammatory, apoptotic, and histopathological analyzes.

Interest in phytochemical therapy methods in the treatment of diabetes is increasing day by day. Although the antidiabetic and antioxidant effects of Cistus laurifolius L. (CL) have been mentioned, the systemic effects remain unknown. The present study aims at evaluating the antidiabetic effects of the CL aqueous extract via metformin on streptozotocin (STZ)-induced diabetic rats. Forty male Wistar albino rats were divided into five groups of eight animals each: control, diabetic group (55mg/kg STZ), STZ+125mg/kg CL, STZ+250mg/kg CL, and STZ+100mg/kg metformin. The effects of CL and metformin on oxidative, apoptotic, and inflammatory pathways were comparatively investigated. In addition, nuclear factor-κB (NFκB), tumor necrosis factor-alpha (TNF-α), and interleukin (IL)-1β expressions analysis were carried out. CL treatment resulted in a significant improvement in blood glucose levels, lipid profile, pancreatic markers, and liver and kidney function tests. A 250mg/kg CL treatment decreased by 67.9%, 31.6%, 66.8%, 28.3%, and 31.4% in the total oxidant capacity, NFκB, TNF-α, IL-1β, caspase3, and cytochrome c levels, respectively, compared to the diabetic group. Additionally, CL treatments showed a dose-dependent reduction in NFκB, TNF-α, and IL-1β expression levels. A 250mg/kg CL treatment exhibited a greater increase (by 9.6%) in total antioxidant capacity than metformin. CL treatment provided histologically more improvement in the brain, heart, pancreas, spleen, liver, kidney, and testicular tissues compared to the metformin group. Our results suggest that the single treatment of CL aqueous extract at the low doses may have stronger short-term anti-diabetic effects than metformin. Therefore, further studies are needed regarding the long-term hypoglycemic effect or treatment of CL aqueous extract.

A Subsidized Healthy Food Prescription Program for Adults With Type 2 Diabetes Who Are Experiencing Food Insecurity: Protocol for a Randomized Controlled Trial

ObjectivesIt is vital for individuals with type 2 diabetes (T2DM) to adhere to a healthy dietary pattern to maintain optimal blood glucose levels and overall health. Increasing costs of healthy foods, however, are a barrier to maintaining healthful dietary patterns, particularly for individuals with T2DM who are experiencing food insecurity. Poor diet quality may result in difficulties maintaining optimal blood glucose levels, leading to higher rates of diabetes complications, and increased acute care usage and costs. Although the adverse impacts of food insecurity on maintaining optimal blood glucose levels are well documented, effective strategies to this among individuals with T2DM are lacking. One approach is providing subsidies to purchase healthy foods through subsidized healthy food prescription programs. These programs may help reduce food insecurity and improve diet quality, thereby improving blood glucose levels and reducing diabetes complications over time. MethodsA parallel group randomized controlled trial will examine the effectiveness of a subsidized healthy food prescription program compared to a healthy food prescription alone in improving average blood glucose levels (primary outcome), and other secondary outcomes among 404 adults who are experiencing food insecurity and persistent hyperglycemia. The subsidized healthy food prescription program consists of two core elements: 1) A one-time healthy food prescription pamphlet that outlines an evidence-based healthy dietary pattern; 2) A healthy food subsidy of $1.50/day/household member to purchase healthy foods in participating supermarkets for 6 months. At baseline and 6-month follow-up, participants will provide responses to sociodemographic and health-related items, and a variety of patient-reported outcomes. Biochemical and physical measurements will also be obtained. ResultsThe study’s theory of change posits that reducing food insecurity and improving diet quality will be key mediators in improving blood glucose levels, which may reduce diabetes complications, and healthcare usage and costs over time. ConclusionsThe results of this study will demonstrate if a subsidized healthy food prescription program results in meaningful changes in average blood glucose levels and other clinically relevant outcomes. Funding SourcesAlberta Innovates, Alberta Health Services.

Potential of karamunting (Rhodomyrtus tomentosa) fraction against kidney damage in diabetic rats

Summary Introduction: Karamunting (Rhodomyrtus tomentosa) is Indonesian native plant that contains high anti-oxidant compounds with the potential to suppress oxidative stress activity in cells. This study is the first research to specifically explore the role of the karamunting fraction in protecting kidney damage due to the formation of AGEs in the renal glomerulus in diabetes mellitus. Objective: This study aims to assess the impact of karamunting on blood glucose profile, HbA1c, insulin profile and kidney condition (AGEs expression, TNF-α and kidney histology) in diabetic rats. Methods: The karamunting extraction process was carried out by maceration with ethanol. Induction of diabetes mellitus was carried out using streptozotocin. Thirty male rats (Rattus norvegicus), Wistar strain weighing between 200–250 grams were the subject in this study. HbA1c, insulin, TNF-α, AGEs levels were evaluated in the kidney tissue. Histological assessment of the kidney was carried out. Results: Karamunting can improve blood glucose levels in diabetic rats. This improvement in blood glucose levels causes an improvement in the level of HbA1c. Administration of karamunting fraction can prevent AGEs deposition in renal tissue, which in turn will inhibits the inflammation and prevents further damage of kidneys. Conclusion: Karamunting fraction can improve blood glucose regulation so that it can prevent further damage and complications of kidney organs in diabetic rats.

1163-P: Exercise as a Strategy to Decrease Pancreatic ß-Cell Senescence

Age increases the prevalence of type 2 diabetes (T2D) and insulin resistance (IR) accelerates the appearance of senescent β-cells, one of the hallmarks of aging. This suggests that senescence could contribute to the development of T2D and be a novel therapeutic target. In addition to improving blood glucose levels, exercise has been shown to attenuate all hallmarks of aging. However, the effects of exercise upon β-cell senescence remain to be determined. Our hypothesis is that exercise can decrease β-cell senescence and we aim to verify the effects of exercise upon senescence prevention and reversibility under control and IR conditions. Retired breeder male C57Bl/6 mice (6-8 months of age) were randomly assigned into groups (n=5/group): sedentary, exercised (treadmill running, 1 h, 5 times per week, for 2 weeks, at 17 cm/s and 5% incline) and IR (S961, 40nM/week for 2 weeks); exercise was performed at the same time, before or after IR to assess prevention and reversibility. ANOVA Brown-Forsythe and Welch were used to compare groups. Under control conditions, exercise decreased β-cell senescent markers (-58.1% p21Cip1 mRNA and -29% β-Galactosidase activity through FACS sorting), improved glucose tolerance (-13.6% in total area under the curve during intraperitoneal glucose tolerance test) and preserved suppression of basal insulin secretion when compared to sedentary (+39.3% insulin). Exercise performed before and during IR decreased mRNA levels of senescence marker and effector p16Ink4a by 41.7% and 80% respectively. Basal insulin secretion was decreased, and glucose-stimulated insulin secretion restored. When performed after IR, exercise decreased p16Ink4a mRNA by 62.4% and restored basal insulin secretion with no change in the stimulation index. In conclusion, exercise decreased the load of senescent cells in insulin resistant animals. Its effects were more effective before and during IR but it was also able to reverse some of the deleterious effects of IR converting it into a novel β-cell anti-aging strategy. Disclosure P. Carapeto: None. C. Aguayo-mazzucato: Consultant; Self; eGenesis. Funding Joslin Diabetes Center (to C.A-M.); Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (to P.C.)

Lactobacillus Sps in Reducing the Risk of Diabetes in High-Fat Diet-Induced Diabetic Mice by Modulating the Gut Microbiome and Inhibiting Key Digestive Enzymes Associated with Diabetes.

Simple SummaryType 2 diabetes (T2D) is increasingly spreading across the globe. The disease is linked to a disruption of gut microbiome. Probiotics are essential gut microbiota modulators proven to restore microbiota changes, thereby conferring health to its host. This study aimed to use probiotics (lactobacilli) and their metabolites as natural anti-diabetic therapy through the modulation of gut microbiota and inhibit diabetes-causing enzymes. Lactobacillus-treated high-fat diet mice showed lower blood glucose levels and body weight. Interestingly, our study also proved that the lactobacilli altered gut microbiota composition by suppressing opportunistic bacteria that are highly associated with metabolic diseases. Our findings substantiate the use of probiotics as natural anti-diabetic therapeutics.Obesity caused by a high-fat diet (HFD) affects gut microbiota linked to the risk of type-2 diabetes (T2D). This study evaluates live cells and ethanolic extract (SEL) of Lactobacillus sakei Probio65 and Lactobacillus plantarum Probio-093 as natural anti-diabetic compounds. In-vitro anti-diabetic effects were determined based on the inhibition of α-glucosidase and α-amylase enzymes. The SEL of Probio65 and Probio-093 significantly retarded α-glucosidase and α-amylase enzymes (p < 0.05). Live Probio65 and Probio-093 inhibited α-glucosidase and α-amylase, respectively (p < 0.05). In mice fed with a 45% kcal high-fat diet (HFD), the SEL and live cells of both strains reduced body weight significantly compared to HFD control (p < 0.05). Probio-093 also improved blood glucose level compared to control (p < 0.05). The gut microbiota modulatory effects of lactobacilli on HFD-induced diabetic mice were analyzed with qPCR method. The SEL and live cells of both strains reduced phyla Deferribacteres compared to HFD control (p < 0.05). The SEL and live cells of Probio-093 promoted more Actinobacteria (phyla), Bifidobacterium, and Prevotella (genus) compared to control (p < 0.05). Both strains exerted metabolic-modulatory effects, with strain Probio-093 showing more prominent alteration in gut microbiota, substantiating the role of probiotics in gut microbiome modulations and anti-diabetic effect. Both lactobacilli are potential candidates to lessen obesity-linked T2D.

Magnitude and predictors of poor glycemic control among patients with diabetes attending public hospitals of Western Ethiopia.

BackgroundDiabetes is one of the most prevalent non-communicable diseases globally, which rapidly is increasing in developing countries. Ethiopia is also facing growing morbidity and mortality related to diabetes complications. Thus, dealing with glycemic control is essential for controlling the development of devastating acute and chronic complications related to diabetes. Therefore, this study aims to assess the magnitude and predictors of poor glycemic control among diabetic patients in western Ethiopia.MethodsThe cross-sectional study design was employed on a sample of 423 diabetic patients. A systematic random sampling method was employed. An interviewer-administered structured questionnaire was used. The data entered into Epi data version 3.1 and exported into Statistical Package for the Social Sciences window version 24 for analysis. All variables significant at p-<0.25 in bivariate were entered into multivariate analysis. The multivariable logistic regressions were used to determine predictors’ poor glycemic control by considering the Adjusted Odds Ratio at CI 95% and the significance level was set at p <0.05.ResultsThe magnitude of poor glycemic control was 64.1%. Being females (AOR = 1.684,95%CI = 1.066,2.662), duration of diabetes >8years (AOR = 2.552,95%CI = 1.397, 4.665), presence of diabetes complication (AOR = 2.806,95%CI = 1.594,4.941), negligence of blood glucose test at home (AOR = 1.720, 95%CI = 1.078, 2.743), poor self-care behavior (AOR = 1.787, 95%CI = 1.083,2.959) and poor self-efficacy (AOR = 1.934, 95%CI = 1.078,3.469) were significant predictors of poor glycemic control.ConclusionThe proportion of poor glycemic control was high which was nearly comparable to that reported from many countries. This could be due to factors that were significantly associated with poor glycemic control like lack of home blood glucose test, increased duration of diabetes, presence of diabetes complications, poor self-efficacy, and poor self-care behaviors. Each were significant independent predictors of poor glycemic control. Thus, we recommend patients with diabetes and health care providers enhancing self-monitoring practices, and preventing potential complications should be a priority concern to improve blood glucose levels. Further studies are also recommended to explore important factors which were not identified by the current study.

Five-Month Trial of Whole-Food Plant-Based Diet in a Patient With Coexisting Myasthenia Gravis and Lambert-Eaton Myasthenic Syndrome.

Introduction: Nutritional intervention, such as a whole-food plant-based (WFPB) diet, is suggested to improve symptoms of autoimmune disorders. Its effects on neuromuscular junction (NMJ) diseases are less known. Case Description: A 56-year-old female with a combined myasthenia gravis and Lambert-Eaton myasthenic syndrome presented with persistent musculoskeletal weakness and pain, fatigue, and diminished concentration. Methods: A WFPB diet was implemented for 5 months in this case study. Functionality, biometrics, and quality of life were assessed at regular intervals via blood work, vital signs, and patient surveys. Results: After 10 weeks, 2 medications were de-prescribed due to improvement in blood glucose levels and blood pressure readings. Neuromuscular symptoms lessened as measured by the Myasthenia Gravis Illness Index. Weight loss of 18.7 pounds was achieved. No deterioration in physical activity was reported throughout the 5-month trial of WFPB diet. Discussion: Our results have implications that an individualized dietary strategy may be considered as one component of management of NMJ diseases. The effects of WFPB diet on NMJ diseases remain inconclusive.

Effect of Sitagliptin, Pioglitazone and Dapagliflozine on Myocardial Infarction Induced Experimentally in Diabetic Rats

Background: Diabetes is associated with both micro- and macrovascular complications. Aim of the study: The aim of the present study is to evaluate the prophylactic effect of Sitagliptin, Pioglitazone and Dapagliflozine on Isoprenaline (ISO) induced myocardial infarction in type II diabetic rats, regarding these parameters: lipid profile, blood glucose, kidney function, troponin, MDA, tumor necrosis factor-α, HR, ST elevation and histopathological changes of myocardium. Methods: Rats were classified into: Group I: control normal group. Group II: was not treated diabetic (diseased group). Group III: was treated with sitagliptin. Group IV: was treated with pioglitazone. Group V: was treated with dapagliflozine. Treated groups received drugs for 4 weeks. Results: Treated groups showed significant improvement in all parameters and improvement of the histopathology of the myocardium. A significant improvement in the parameters was seen in the treated groups at the end of the 4th week. Conclusion: Our study revealed that dapagliflozine produced more improvement in blood glucose level, and there was no significant difference between it and pioglitazone in improving lipid profile. Pioglitazone was superior in decreasing creatinine level, serum troponin, HR, ST elevation, MDA, TNFα and histopathological changes of myocardium. There was no significant difference between the three drugs regarding to their effect on blood urea. So our drugs ,mainly pioglitazone may have a prophylactic effect against MI in diabetic rats, this may be due to their antioxidant and anti-inflammatory effect through reduction of MDA and TNF α respectively, glycemic control and improvement of dyslipidemia.

Improvement of the therapeutic capacity of insulin-producing cells trans-differentiated from human liver cells using engineered cell sheet

BackgroundAlthough pancreatic islet transplantation therapy is ideal for diabetes patients, several hurdles have prevented it from becoming a standard treatment, including donor shortage and low engraftment efficacy. In this study, we prepared insulin-producing cells trans-differentiated from adult human liver cells as a new islet source. Also, cell sheet formation could improve differentiation efficiency and graft survival.MethodsLiver cells were expanded in vitro and trans-differentiated to IPCs using adenovirus vectors carrying human genes for PDX1, NEUROD1, and MAFA. IPCs were seeded on temperature-responsive culture dishes to form cell sheets. Differentiation efficiency was confirmed by ß cell-specific gene expression, insulin production, and immunohistochemistry. IPC suspension was injected by portal vein (PV), and IPC sheet was transplanted on the liver surface of the diabetic nude mouse. The therapeutic effect of IPC sheet was evaluated by comparing blood glucose control, weight gain, histological evaluation, and hepatotoxicity with IPC injection group. Also, cell biodistribution was assessed by in vivo/ex vivo fluorescence image tagging.ResultsInsulin gene expression and protein production were significantly increased on IPC sheets compared with those in IPCs cultured on conventional culture dishes. Transplanted IPC sheets displayed significantly higher engraftment efficiency and fewer transplanted cells in other organs than injected IPCs, and also lower liver toxicity, improved blood glucose levels, and weight gain. Immunohistochemical analyses of liver tissue revealed positive staining for PDX1 and insulin at 1, 2, and 4 weeks after IPC transplantation.ConclusionsIn conclusion, cell sheet formation enhanced the differentiation function and maturation of IPCs in vitro. Additionally, parameters for clinical application such as distribution, therapeutic efficacy, and toxicity were favorable. The cell sheet technique may be used with IPCs derived from various cell sources in clinical applications.

Effects of dapagliflozin in combination with insulin on cytochrome P450 activities in a diabetes type 1 rat model.

Previous studies reported that diabetes alters the activities of hepatic cytochrome P450 (CYP) enzymes, which, in turn, affects the disposition of some drugs. We herein examined and compared the effects of the combination of dapagliflozin with a low insulin dose, a full dose of insulin alone, and dapagliflozin alone for 3 and 8 weeks on CYP activities in a diabetes type 1 rat model. We induced type 1 diabetes in rats using a single intraperitoneal injection of 60 mg/kg streptozotocin (STZ). Daily treatment with the full dose of insulin alone, dapagliflozin alone, or dapagliflozin in combination with a low dose of insulin was then initiated. STZ-induced rats developed marked hyperglycemia and altered CYP2E activities. Dapagliflozin in combination with a low dose of insulin stabilized hyperglycemia and CYP1A, 2D, 2E and 3A activities. However, dapagliflozin alone did not improve blood glucose levels or CYP activities. These results suggest that the effects of dapagliflozin in combination with a low dose of insulin are similar to those of a full dose of insulin, and stabilize CYP activities in type 1 diabetes.

Biochemical Effect of Nigella sativa (Black Cumin) on Glucose and Lipid Profile among Sudanese Diabetic Patients

Background: Diabetes mellitus (DM) is a common chronic disease; it is associated with alterations of blood glucose and lipid profile. Current evidence indicated beneficial effects of some medicinal herbs on metabolic parameters. Aim: The aim of this study was to investigate the effect of Nigella Sativa (NS) supplementation on blood glucose and lipid profile levels among type 2 DM Sudanese patients. Materials and Methods: the experimental study was conducted at Gezira state-Khartoum during the period from November 2019 to February 2020. Forty-five diabetic patients were randomly selected. Study population was classified into three groups; each contained 15 patients; glucose and lipid profile were estimated in all participants three times, the first one in day 0, the second after 15 days of daily intake of NS and the last sample after 30 days. Group 1 was given NS at concentration of 1 gram, and group 2 was given NS at concentration of 2 grams, while group 3 was given at concentration of 3 grams. Results: The included patients in the groups used NS with different dose, showed significant (P < 0.05) improvement with reference to blood glucose, while there was no significant improvement of lipid profile in all groups. Conclusion: Using regular NS can improve blood glucose level but has no effect on serum lipids. Concentration of two grams of NS has a better effect on blood glucose control.

EFFECT OF WALKING EXERCISE ON CONTROLLING BLOOD GLUCOSE LEVEL AND BODY MASS INDEX AMONG GESTATIONAL DIABETICWOMEN

Background: Gestational Diabetes Mellitus (GDM) is one of the most commonmedical health problems that may occur during pregnancy and may lead to a range ofshort and long-term maternal, fetal as well as neonatal complications. However, recentresearches have revealed that, walking exercise has been considered as a ‘gold standard’in controlling blood glucose level and body mass index among gestational diabeticwomen.Aim: The study was conducted to evaluate the effect of walking exercise oncontrolling blood glucose level and body mass index among gestational diabetic womenSubjects and method: A quasi-experimental study design was utilized at Antenatal Clinic ofObstetric and Gynecological Specialty Center at Mansoura University Hospitals,Mansoura city. A purposive sample conducted on 126 pregnant women diagnosed withgestational diabetes mellitus, The study sample was divided into two groups,interventiongroup (n= 63):practiced walking exercise in addition to routine antenatal care and controlgroup (n= 63): followed routine antenatal care only.Tools: Two tools were used to collectdata from participants as a structured interview schedule and maternal assessment record.Results:The current study resultsindicated that, there was a highly statistical significantreduction of body mass index and the mean random blood glucose levels at 34 & 37 weeks'of pregnancy after intervention in the walking exercise group than control group (p <0.001). ConclusionandRecommendations: This study showed that, pregnant women withgestational diabetes mellituswho practiced walking exercisehad improved blood glucoselevel and body mass index than those who did not. It is recommended that, pregnantwomen with gestational diabetes mellitusshould practice walking exercise duringpregnancy as one of the significant modalities to improve blood glucose level and bodymass index.