Insulin Resistance In Type Research Articles

Physicochemical Characteristics and Antidiabetic Properties of the Polysaccharides from Pseudostellaria heterophylla.

This study aimed to investigate the Pseudostellaria heterophylla polysaccharides (PF40) physicochemical and antidiabetic characteristics. The ultraviolet–visible (UV) spectra, Fourier transform infrared radiation (FT-IR) spectra, nuclear magnetic resonance (NMR) spectra, zeta potential, surface characteristics, and conformational and thermal stability properties of PF40 were characterized. X-ray diffraction (XRD) and scanning electron microscopy (SEM), combined with Congo red test, revealed that PF40 powder has mainly existed in amorphous form with triple-helix conformation. The single-molecular structure of PF40 exhibited a multi-branched structure extending from the center to the periphery by scanning probe microscopy (SPM) scanning. The monosaccharide residue of PF40 was an α-pyranoid ring and exhibits good stability below 168 °C. Experimental studies on antidiabetic characteristics found that PF40 could significantly improve STZ-induced intestinal mucosal damage and reduce the apoptosis of villus epithelial cells. PF40 combined with metformin could significantly improve the symptoms of insulin resistance in type 2 diabetes mellitus (T2DM) rats, the molecular mechanism might be through inhibiting the expression of RORγ protein and increasing Foxp3 protein in the jejunum of T2DM rats, and then restoring the STZ-induced imbalance of T helper 17(Th17)/ regulatory T cells (Treg) cells, thereby maintaining intestinal immune homeostasis. Results identified in this study provided important information regarding the structure and antidiabetic characteristics of Pseudostellaria heterophylla polysaccharides, which can contribute to the development of Pseudostellaria heterophylla polysaccharides for industrial purposes in the future.

Prevalence of Insulin Resistance in Type 1 Diabetes Mellitus and Its Correlation with Metabolic Parameters: The Double Trouble.

The phenotype of type 1 diabetes mellitus has changed over the last few decades. Little attention has been paid to the presence of insulin resistance in individuals with type 1 diabetes mellitus. The appearance of insulin resistance in type 1 diabetes mellitus patients has been labeled as "double diabetes." This phenotype of double diabetes has been seen to have higher rate of microvascular as well as macrovascular complica- tions. The aim of the current study was to estimate the burden of insulin resistance in patients with type 1 diabetes mellitus and its correlation with various metabolic parameters and microvascular complications. It was a cross-sectional study in which a total of 95 type 1 diabetes mellitus patients (children/adolescents (<18 years) and adults ≥18 years) presenting to Endocrinology OPD were screened for the presence of insulin resistance using estimated glucose disposal rate. Estimated glucose disposal rate (mg/kg/min) was calculated as = 21.16- (0.09 ×WC) - (3.407×HTN) - (0.551×HbA1c [%]) where, WC is waist circumference (cm) and HTN is hypertension (1= yes, 0 = no). Based on previous studies, an estimated glucose disposal rate <8 was considered to have the presence of insulin resistance and double diabetes. Using an estimated glucose disposal rate <8 as the cut-off for the presence of insulin resistance, the overall prevalence was 16.8%. Prevalence was high in adults 12 (29.3%) compared to children/adolescents 4 (7.4%) which was statistically significant [χ2 = 7.95; P = .004]. In comparison of the anthropometric and metabolic parameters in those with an estimated glucose disposal rate <8 versus ≥8, there was a significant statistical difference. Those having an estimated glucose disposal rate <8 had higher age, longer duration of diabetes, and body mass index [P ≤ .05]. Also, they had poor glycemic control, higher blood pressure, triglycerides, low-density lipoproteins levels. Using Spearman correlation coefficient there was a statistically significant (P < .05) negative correlation between the estimated glucose disposal rate and various anthropo- metric as well as metabolic parameters. This study shows that with increasing duration of disease, insulin resistance (low estimated glucose disposal rate) could be a serious problem in type 1 diabetes mellitus patients, especially in those who are metabolically unhealthy. As insulin resistance could be a major contributing factor in the onset and progression of various vascular complications, evaluation of the presence of insulin resistance using estimated glucose disposal rate could be useful in recognizing individuals who would benefit the most from preventa- tive strategies.

Docosahexaenoic Acid Ester of Phloridzin Reduces Inflammation and Insulin Resistance via AMPK.

Docosahexaenoic acid-acylated phloridzin (PZ-DHA), a novel polyphenol fatty acid ester derivative, is synthesized through an acylation reaction of phloridzin (PZ) and docosahexaenoic acid (DHA). PZ-DHA is more stable than DHA and exhibits higher cellular uptake and bioavailability than PZ. The study aims to investigate the effects of PZ-DHA on insulin resistance in the skeletal muscle and the related mechanisms; we used palmitic acid (PA)-treated C2C12 myotubes as an insulin resistance model. We found that PZ-DHA increased the activity of AMP-activated protein kinase (AMPK) and improved glucose uptake and mitochondrial function in an AMPK-dependent manner in untreated C2C12 myotubes. PZ-DHA treatment of the myotubes reversed PA-induced insulin resistance; this was indicated by increases in glucose uptake and the expression of membrane glucose transporter 4 (Glut4) and phosphorylated Akt. Moreover, PZ-DHA treatment reversed PA-induced inflammation and oxidative stress. These effects of PZ-DHA were mediated by AMPK. Furthermore, the increase in AMPK activity, improvement in insulin resistance, and decrease in inflammatory and oxidative responses after PZ-DHA treatment diminished upon co-treatment with a liver kinase B1 (LKB1) inhibitor, suggesting that PZ-DHA improved AMPK activity by regulating its upstream kinase, LKB1. The effects of PZ-DHA on insulin resistance in C2C12 myotubes may be mediated by the LKB1- AMPK signaling pathway. Hence, PZ-DHA is a promising therapeutic agent for insulin resistance in type 2 diabetes.

Efficacy and Safety of Nutrient Supplements for Glycaemic Control and Insulin Resistance in Type 2 Diabetes: An Umbrella Review and Hierarchical Evidence Synthesis.

Background: Nutrient supplements are widely used for type 2 diabetes (T2D), yet evidence-based guidance for clinicians is lacking. Methods: We searched the four electronic databases from November 2015–December 2021. The most recent, most comprehensive, high-ranked systematic reviews, meta-analyses, and/or umbrella reviews of randomised controlled trials in adults with T2D were included. Data were extracted on study characteristics, aggregate outcome measures per group (glycaemic control, measures of insulin sensitivity and secretion), adverse events, and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessments. Quality was assessed using A Measurement Tool to Assess Systematic Reviews Version 2.0 (AMSTAR 2). Results: Twelve meta-analyses and one umbrella review were included. There was very low certainty evidence that chromium, Vitamin C, and omega-3 polyunsaturated fatty acids (Ω-3 PUFAs) were superior to placebo for the primary outcome of glycated hemoglobin (HbA1c) (Mean Difference/MD −0.54, −0.54 and ES −0.27, respectively). Probiotics were superior to placebo for HbA1c (Weighted Mean Difference/WMD −0.43%). There was very low certainty evidence that Vitamin D was superior to placebo for lowering HbA1c in trials of <6 months (MD −0.17%). Magnesium, zinc, Vitamin C, probiotics, and polyphenols were superior to placebo for FBG. Vitamin D was superior to placebo for insulin resistance. Data on safety was limited. Conclusions: Future research should identify who may benefit from nutrient supplementation, safety, and optimal regimens and formulations.

Association of leptin with insulin resistance in type 2 diabetes mellitus

Introduction: Type 2 Diabetes mellitus (T2DM) is a chronic disease that is characterized by impaired glucose metabolism and insulin resistance. Leptin is a 16-kDa protein hormone, which is secreted by adipocytes. Plasma Leptin concentration increases in proportion to body fat mass and regulate food intake and energy expenditure to maintain body fat stores. Leptin binds with a leptin receptor (LEPR) that is located on pancreatic beta cells to regulate insulin secretion. Materials and Methods: This is a prospective and case-control study was conducted in the Department of Biochemistry at Great Eastern Medical School and hospital over a period of 1 year. After the inclusion of participants in the study, their demographics such as age, BMI, gender, and smoking history were noted in self-structured questionnaires. Their blood was drawn and sent to the laboratory for Lipid profile levels, insulin resistance and leptin levels. The serum levels of Leptin were measured using a radioimmunoassay (RIA). Results: The probable association between Leptin and Insulin resistance in type 2 diabetes mellitus. 60 recent onset (&lt;5 years) diabetics and age-sex matched 60 non-diabetic controls were assessed for physical and chemical parameters.

Body composition and insulin resistance in type 1 Diabetes Mellitus

Body composition and insulin resistance in type 1 Diabetes Mellitus

Association between of polymorphism rs1801133 in MTHFR gene and diabetes mellitus type II for Iraqi patients

Diabetes mellitus (DM) is a clinical syndrome caused by metabolic problems. Recently, researchers have recently concentrated their efforts on identifying additional risk variables, like as homocysteine (Hcy), a non-independent vascular risk factor linked to insulin resistance in type 2 diabetes mellitus (T2DM). Aimed our current study to association between of polymorphism rs1801133 in MTHFR gene and diabetes mellitus type II for Iraqi patients. Samples of blood were collected from Iraqi with T2DM (50 patenits) from auditors to specialized laboratories and consulting clinics in Baquba District / Diyala Governorate, Iraq, as well as 21 healthy participants, and their ages ranged (35-54 years). Genotyping was performed by PCR/SNP (specific primers), risk score for T2DM was determined by Hardy-Weinberg equilibrium (HWE). (HWE) was analyzed in T2DM patients and healthy participants, and it was discovered that the MTHFR (rs1801133) genotypes were in agreement with the equilibrium, with no clear differences (p&gt;1.020-0.298) between the observed and expected genotype frequencies. When rs1801133 genotype and allele frequencies were compared in T2DM patients and healthy participants, it was shown that there were no significant differences in these frequencies.

T194 Peripheral blood Smad7 and miR-181b-5p possibly regulate insulin resistance in type 2 diabetes

T194 Peripheral blood Smad7 and miR-181b-5p possibly regulate insulin resistance in type 2 diabetes

IDF21-0069 Beta-cell function and insulin resistance of type 2 diabetes patients on maximum doses of sulphonylurea-metformin

Background: The sulphonylurea-metformin dual therapy is common among type 2 diabetes (T2D) patients before they are escalated to insulin, particularly in developing countries. Although oral therapy often has better acceptance among patients than injectables, the duration of which patients can remain on insulin secretagogues such as sulphonylureas depends on their pancreatic beta-cell function. Aim: In this study, we sought to investigate the factors associated with pancreatic beta-cell function and insulin resistance of type 2 diabetes patients on maximal sulphonylurea-metformin therapy. Method: Using a prospective multicentre design, patients meeting the inclusion criteria which were age 18 years and above, T2D for ≥ 1 year, treatment with maximum doses sulfonylurea-metformin combination for ≥ 1 year, and good adherence to treatment were recruited between September 2014 and March 2016, from seven out-patient clinics across Malaysia and followed up for 12 months. Exclusion criteria were renal impairment (eGFR < 30 ml/min/1.73m2), treatment with other antidiabetic agents, and comorbidities that could potentially confound glycemic parameters. Blood samples were taken at baseline for fasting insulin and fasting c-peptide which were used to construct the homeostatic model assessment of beta-cell function (HOMA2-%B) and insulin resistance (HOMA2-IR). Results: A total of 401 subjects were included in the final analysis of which 44.4% were males. At baseline, their median HbA1c was 8.0% (7.2 – 9.3) (64.0 [55.0 – 78.0] mmol/mol). They also had a median duration of diabetes of 10.0 years (8.0 – 16.0). The median HOMA2-%B was 54.3% (35.2 – 80.1) while the median HOMA2-IR was 2.2 (1.5 – 3.0). A significant positive correlation was observed between BMI and HOMA2-%B (r=0.232, P<0.001). Majority of the subjects who presented with a HOMA2-%B > 50.0% had a diabetes duration of ≤ 10 years. A higher number of subjects who were taking gliclazide modified release (71.3%) had HOMA2-%B level > 50.0% followed by immediate release gliclazide (60.5%) although there were no significant differences among the different types of sulphonylureas in HOMA2-%B level (P=0.054). Increased BMI was significantly associated with increased HOMA2-IR (r=0.236, P<0.001) and there was also a significant positive correlation between waist circumference and HOMA2-IR of subjects (r=0.551, P<0.001). More than two-thirds (65.3%) of subjects failed to achieve the target HbA1c of < 7.0% (53 mmol/mol) at 12 months from baseline. Discussion: The attainment of target HbA1c among T2D patients on maximal sulphonylurea-metformin therapy is difficult despite them having higher pancreatic beta-cell function because they were also more obese and had increased insulin resistance. As sulphonylureas also induce weight increment which contributes to insulin resistance, monitoring the bodyweight of T2D patients upon sulphonylurea initiation is important to prevent excessive weight increase and failure to sulphonylurea therapy. Choosing gliclazide modified release over other sulphonylureas may preserve patients' beta-cell function better. Early combination with a third oral glucose-lowering agent instead of maximizing the dose of the sulphonylurea in sulphonylurea-metformin regimen can be considered when target glucose is not met. This would also probably delay the need to start patients on insulin therapy.

FGF21: A Novel Regulator of Glucose and Lipid Metabolism and Whole-Body Energy Balance.

Fibroblast growth factor (FGF) 21 is a recently recognized metabolic regulator that evokes interest due to its beneficial action of maintaining whole-body energy balance and protecting the liver from excessive triglyceride production and storage. Together with FGF19 and FGF23, FGF21 belongs to the FGF family with hormone-like activity. Serum FGF21 is generated primarily in the liver under nutritional stress stimuli like prolonged fasting or the lipotoxic diet, but also during increased mitochondrial and endoplasmic reticulum stress. FGF21 exerts its endocrine action in the central nervous system and adipose tissue. Acting in the ventromedial hypothalamus, FGF21 diminishes simple sugar intake. In adipose tissue, FGF21 promotes glucose utilization and increases energy expenditure by enhancing adipose tissue insulin sensitivity and brown adipose tissue thermogenesis. Therefore, FGF21 favors glucose consumption for heat production instead of energy storage. Furthermore, FGF21 specifically acts in the liver, where it protects hepatocytes from metabolic stress caused by lipid overload. FGF21 stimulates hepatic fatty acid oxidation and reduces lipid flux into the liver by increasing peripheral lipoprotein catabolism and reducing adipocyte lipolysis. Paradoxically, and despite its beneficial action, FGF21 is elevated in insulin resistance states, that is, fatty liver, obesity, and type 2 diabetes.

IDF21-0684 Comparing glucose response according to the OGTT and MMT in PCOS and non-PCOS groups: 2nd-hour-value sufficient or not?

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive aged women, that is a leading risk factor for insulin resistance syndrome and type 2 diabetes. Aim: İn this study, glucose tolerance was examined in PCOS and non-PCOS groups with 75 g of Glucose Tolerance Test (GTT) and Mixed Meal Tolerance Test (MMT) and the glucose levels change in the first two hours was evaluated comparatively. Method: MMT was applied to 69 women out of 131 patients diagnosed with PCOS, and the remaining 62 women underwent GTT. MMT was applied to 21 of the women with diagnosed non-PCOS , and GTT was applied to 19 of them .Fasting glucose levels and the first 30, 60, 90, 120, 180, 240 minutes of postprandial glucose levels were measured in these 4 groups, then finding values were compared within these 4 groups. Results: WHO-ADA consensus determines glucose intolerance when the second-hour value of the GTT is between 140 and 199 mg/dl. According this criteria, the PCOS (+) GTT applied-group and MMT applied-group was found as 9% and 9.8% respectively. In the non-PCOS group, there was no glucose intolerance case according to the results of the MMT and GTT. If WHO-ADA consensus defineds glucose intolerance as postprandial glucose levels between 140 and 199 mg/dl in the first two hours, in the PCOS (+) group GTT applied-group and MMT applied-group, the highest glucose levels was found in the first 30 min and approximately half of the cases were determined as glucose intolerance. In the non-PCOS group according to the first 30 min of the GTT 10% of cases who have glucose levels between 140 and 199 mg/dl. There was no patient was found with glucose intolerance in the non-PCOS MMT applied-group. In the PCOS (+) GTT applied group, glucose intolerance rate according to the 60th minute was found as 26.2% while 90th minute was 24.6%. In the PCOS (+) MMT applied group, the rates of 60th minute and 90th minute were found as 19.4% and 14.9%. In the non-PCOS group according to criteria of WHO-ADA, the glucose levels were not found between 140 and 199 mg/dl in any cases in other hours. Discussion: When the second-hour values were taken as criteria, the rate of glucose intolerance was found as approximately 10%. However when we evaluate the values of the first 2 h (30th, 60th, 90th, 120th minutes) approximately 50% of the cases were determined as glucose intolerance with the glucose level between 140 and 199 mg/dl. Accordingly, WHO-ADA criteria overlook almost 40% of the PCOS (+) patients with glucose intolerance.

Lipid Variability and Diabetes Mellitus

Diabetic dyslipidemia is characterized by hypertriglyceridemia, low HDL (high-density lipoprotein)-cholesterol, elevated LDL (low-density lipoprotein)-cholesterol, and predominance of small dense LDL particles caused by insulin resistance in type 2 diabetes or insulin deficiency in type 1 diabetes. Dyslipidemia is a major risk factor for atherosclerotic cardiovascular disease in diabetes, and lowering lipid levels can reduce its morbidity and mortality. Current guidelines for dyslipidemia management recommend that the LDL-C goal be lower than 55~100 mg/dL depending on the underlying risk factors. However, higher visit-to-visit variability in cholesterol levels might be an independent predictor of major adverse cardiovascular events and poor renal outcomes in diabetes. In this review, we focused on clinical implications of lipid variability in diabetes.

A Study on the Blood Sugar Improvement Effect and Safety of &lt;italic&gt;Galgunhwangryunhwanggum-tang&lt;/italic&gt; for Type 2 Diabetes without Complications: A Systemic Review and Meta-Analysis

Objectives: The purpose of this study is to assess the antidiabetic effect and safety of Galgunhwangryunhwanggum-tang for type 2 diabetes without complications by analyzing related research.Methods: For a systematic review and meta-analysis, we searched for the antidiabetic effect and safety of Galgunhwangryunhwanggum-tang for type 2 diabetes without complications in 10 databases up to September 2021. Only randomized controlled trials were chosen.Results: In the treatment effectiveness analysis and meta-analysis, Galgunhwangryunhwanggum-tang had significant improvement effects on fasting plasma glucose level, 2-hour postprandial glucose level, glycated hemoglobin, fasting insulin, and homeostasis model assessment for insulin resistance compared to the control group when treated in parallel with oral glycemic drugs.Conclusion: Galgunhwangryunhwanggum-tang is effective in improving blood sugar and insulin resistance in type 2 diabetes patients without complications and can especially be considered in parallel treatment with oral hypoglycemic drugs. A large-scale randomized controlled clinical trial is required to complement the limitations presented in this study in the future.

Role of the voltage-gated proton channel Hv1 in insulin secretion, glucose homeostasis, and obesity

Diabetes is characterized by an absolutely inadequate insulin secretion (type 1 diabetes mellitus) or a relative deficit in insulin secretion due to insulin resistance (type 2 diabetes mellitus), both of which result in elevated blood glucose. Understanding the molecular mechanisms underlying the pathophysiology of diabetes could lead to the development of new therapeutic approaches. The voltage-gated proton channel Hv1 is an ion channel with specific selectivity for protons, which is regulated by membrane potential and intracellular pH. Recently, our studies showed that Hv1 is expressed in β cells of the endocrine pancreas. Knockout of Hv1 reduces insulin secretion and results in hyperglycemia and glucose intolerance, but not insulin resistance. Furthermore, knockout of Hv1 leads to diet-induced obesity due to inflammation and hepatic steatosis. Increasing evidence suggests that Hv1 plays a pivotal role in glucose homeostasis and lipid metabolism. This review aims to summarize advances made so far in our understanding of the roles of Hv1 in the regulation of insulin secretion in β cells, glucose homeostasis, and obesity.

Elevated Serum Retinol Binding Protein 4 is Associated with the Risk of Diabetic Cardiomyopathy.

Retinol binding protein 4 (RBP4), a biomarker for insulin resistance in type 2 diabetes (DM), is increased in heart failure. This case-control study aims to determine the association between serum RBP4 levels and diabetic cardiomyopathy (DCM). Demographic and clinical data were obtained from 245 DM patients and 102 non-diabetic controls. RBP4 levels were measured using ELISA. The association between RBP4 and DCM was evaluated using multivariate logistic regression and restricted cubic splines (RCS) in DM patients. We showed that serum RBP4 levels were higher in DCM patients than in DM patients without DCM or the controls. Multivariate analysis adjusted by age, gender, body mass index, diabetes duration, left ventricular ejection fraction, insulin treatment, triglycerides, low-density lipoprotein cholesterol, estimated glomerular filtration rate, diabetic retinopathy, diabetic nephropathy, diabetic neuropathy and log N-terminal proBNP showed a significant association between RBP4 and DCM (highest vs. lowest tertile OR 16.87, 95% CI: 6.58, 43.23, p 0.001). RCS displayed a positive linear correlation between RBP4 levels and the risk of DCM in diabetes (p = 0.004). Adding RBP4 to a basic risk model for DCM improved the reclassification (Net reclassification index: 87.86%, 95% CI: 64.4%, 111.32%, p 0.001). The positive association between serum RBP4 and DCM suggested the role of RBP4 as a potential diagnostic biomarker for distinguishing DCM in patients with DM.

Effect of Zinc as an Add-On to Metformin Therapy on Glycemic control, Serum Insulin, and C-peptide Levels and Insulin Resistance in Type 2 Diabetes Mellitus Patient

Type 2 diabetes mellitus (T2DM) is an insidious disorder that may progress asymptomatically, leading to secondary complications. Diabetics were found to have a significantly lower zinc level. This study aims to assess the effects of zinc supplementation for eight weeks on glycemic control, serum insulin level, serum C-peptide level, and insulin resistance. Zinc plus metformin using group had a significant decrease in fasting blood glucose level and glycated hemoglobin, as well as a significant increase in serum insulin and C-peptide levels, but no effect on insulin resistance compared to zinc-free metformin group. Comparing the two groups at the end of the study, the combined effect of zinc plus metformin was highly important versus metformin only except for C-peptide and insulin resistance. Zinc levels were significantly elevated and returned to normal in the interventional group, while in the control group, levels were rather decreased.

Assessment of the Relationship Between CD34 Antigen and Vitamin D Level and Insulin Resistance in Patients With Type 2 Diabetes.

Diabetes causes disorders in the performance of endothelial progenitor cells, and obesity and vitamin D deficiency are associated with endothelial dysfunction and cardiovascular disease. This case-control study investigated the relationship between serum CD34 antigen and vitamin D levels and insulin resistance in type 2 diabetes. The results showed that CD34 has a significant inverse relationship with BMI, A1C, fasting blood glucose, insulin resistance, and insulin levels and has a significant direct relationship with vitamin D levels. Both CD34 and vitamin D were found to be significantly associated with type 2 diabetes. The association between reduced CD34 and vitamin D levels with type 2 diabetes and increased insulin resistance suggests that these parameters may be helpful in assessing diabetes and predicting its complications.

Comparison of three indexes HOMA, QUICKI and TyG to evaluate insulin resistance in type 2 diabetic patients

Comparison of three indexes HOMA, QUICKI and TyG to evaluate insulin resistance in type 2 diabetic patients

Abstract 136: Video-based supervised exercise intervention successfully improves fitness in people with Type 2 diabetes: Outcomes from Diabefly® digital therapeutics platform

Background: Physical fitness is important in combating insulin resistance in type 2 diabetes. Supervised home-based exercise intervention can help in improving exercise adherence and reducing risk of injury leading to better diabetes management.Aims and Objectives: The study aims at the analysis of physical fitness in people with type 2 diabetes (PWD) following video-based supervised exercise prescription delivered as part of Diabefly® digital therapeutics program.Results: Over 90-days of program, 45 participants (mean age 45.33 ± 12.54 years, 42.2% females) received personalized home-based exercise plans based on their preliminary physical fitness assessment by qualified physiotherapists. The parameters assessed were: upper limb strength (1-min push-up test), lower limb strength (wall sit test), core strength (1-min sit-up test), flexibility (V-sit and reach test) and cardiorespiratory fitness (6-minute walk test (6MWT)) pre and post the program. Test performance was scored based on age and gender-based normative data. Statistical analysis demonstrated significant improvement in performance scores, 1-minute push-up test, wall sit test, 1-minute sit-up test, V-Sit and reach test and 6MWT by 40.17% (P<0.001), 36.61 % (P<0.001), 70.04% (P<0.001), 37.86 % (P< 0.001), and 249.25 % (P<0.001) and 7.24 % (P<0.05) respectively.Conclusion: The study demonstrates the effectiveness of video-call based exercise prescription leading to significant improvement in overall physical and cardiorespiratory fitness in PWD.

The Effects of C. lacerata on Insulin Resistance in Type 2 Diabetes Patients.

Background Several experimental studies have suggested beneficial effects of Ceriporia lacerata on glucose metabolism. However, there has been no human study assessing the effects of C. lacerata on glucose metabolism. Therefore, we investigated whether C. lacerata improves glucose control and insulin resistance in type 2 diabetes patients. Methods Ninety patients diagnosed with type 2 diabetes (T2DM) for more than 6 months were enrolled. Subjects were randomly divided into placebo (n = 45) or C. lacerata (n = 45) groups and then assigned to take placebo or C. lacerata capsules (500 mg/capsule) for a 12-week intervention period. Biochemical markers, including fasting glucose, 2-hour postprandial plasma glucose, and lipid profile levels, as well as insulin, c-peptide, and Hba1c, were measured. Furthermore, insulin sensitivity indices, such as HOMA-IR, HOMA-beta, and QUICKI, were assessed before and after the 12-week administration. Results Eighty-four patients completed the study. There were no significant differences in fasting, postprandial glucose, HbA1c, or lipid parameters. HOMA-IR and QUICKI indices were improved at week 12 in the C. lacerata group, especially in subjects with HOMA-IR of 1.8 or more (p < 0.05). Fasting, postprandial c-peptide, and insulin levels decreased at week 12 in the C. lacerata group (p < 0.05). These significant differences were not observed in the placebo group. Conclusion Twelve-week administration of C. lacerata in T2DM patients resulted in significant improvement in insulin resistance, especially in those with lower insulin sensitivity. A larger population study with a longer follow-up period and an effort to elucidate the mechanism is warranted to further assess the effects of C. lacerata on T2DM patients.