Shortage Of Insulin Research Articles

The Effect of Sungkai (Peronema canescens Jack) Leaf Extract on Malondialdehyde Levels in Diabetic Rats Model

The chronic illness known as diabetes mellitus is typified by elevated blood glucose levels brought on by an insulin shortage, or hyperglycemia. Oxidative stress is caused by hyperglycemia, which also deactivates the antioxidant system and causes reactive oxygen species (ROS) to build up. Lipid peroxidation is brought on by this stress, and malondialdehyde (MDA) is one of the by-products. This study used a diabetic rat model to examine how sungkai leaf extract affected MDA levels. This study used 30 rats in six groups: negative control (NC), positive control (PC) with alloxan induction, diabetes control (DC) with glibenclamide, and administration of sungkai (Peronema canescens Jack) leaf extract T1 (Dose 150 mg/kgBW), T2 (Dose 300 mg/kgBW), and T3 (Dose 600 mg/kgBW) for 30 days. The study was experimental and used a post-test-only control group design. The TBARS method was used to measure MDA levels. The One-way ANOVA test and the Bonferroni Post Hoc test were used to evaluate the data. According to the findings, MDA levels were considerably lowered by the sungkai leaf extract. It can be concluded that sungkai leaf extract lowers MDA levels in a model of diabetic rats. Keywords: Diabetes Mellitus, Hyperglycemia, Malondialdehyde, Peronema canescens Jack.

An assessment of the factors contributing to the unavailability of drugs at outpatient pharmacy of tertiary care hospital: an observational study.

Throughout history and up until the present, there has been a medicine shortage. In the early 1920s, there was a shortage of insulin, which is when drug scarcity first appeared in the records. Drug shortages are now more prevalent globally than they were back then.The goal of this essay is to pinpoint the key components that make up a definition for medication shortages and to pinpoint the circumstances that should be considered when reporting drug shortages in databases. Understanding the factors that led certain organizations to create their own definition of a medicine shortage was crucial for achieving these goals.The pharmaceutical regulatory environment can be connected to several reasons why there are medication shortages, including parallel trading, quality standards, and business choices to halt or reduce manufacturing. The many rules governing medicine shortages have not yet been the subject of a thorough investigation. This protocol's objective is to analyze the pertinent legislative and regulatory frameworks in the European pharmaceutical system that affect medication shortages. The objectives of the study will be the non-availability of drugs at an outpatient pharmacy and to analyze the reason of non-availability of drugs. An observational study will be adopted in this study. It includes a collection of data from the patient coming to the outpatient pharmacy of AVBRH Sawangi (Meghe) Wardha. It can lead to delayed treatment for patients seeking alternative medication. It can also lead to increased healthcare costs if patients seek alternative treatments that are more expensive or require additional medical care. The unavailability of drugs can also lead to frustration and anxiety for patients who need medication to manage their health condition. It can also negatively impact the reputation of the hospital.

Evaluation of serum electrolyte abnormalities in type II diabetic patients presenting in Gulab Devi hospital, Lahore

Background: The hallmark of diabetes mellitus (DM) is hyperglycemia brought on by an absolute or relative insulin shortage. Globally, the prevalence of DM is a major cause for worry. The International Diabetes Federation estimates that 26.7% of Pakistan's adult population would have diabetes in 2022, totalling over 33,000,000 cases 1. Patients with diabetes are more likely to experience electrolyte imbalances, which may be caused by an imbalance in the distribution of electrolytes. Electrolytes play a vital role in the maintenance of blood acid-base balance, composition of body fluids, blood clotting, muscle and nerve conduction. Impaired electrolytes balance in diabetics may lead to micro and macrovascular complications. Aims and objectives: The objective of this study is to investigate disturbances in serum electrolytes including Sodium (Na+), Potassium (K+) and Chloride (Cl) in Type II diabetics. Methodology: This has been a descriptive cross-sectional study where random sampling technique was used. 3cc clotted blood samples of 100 Type II diabetic patients were collected from diabetic OPD and medicine wards of Gulab Devi Chest Hospital Lahore and processed in the Pathology lab of Gulab Devi Educational Complex. Results: Out of 100 samples of type II diabetic patients, there were 65 patients in which serum sodium levels were decreased. Serum potassium and serum chloride were slightly increased in some patients. Conclusion: In this study, serum sodium levels were significantly decreased in type II diabetic patients, while no significant alteration was observed in serum potassium and chloride levels. Serum electrolytes should be routinely measured in diabetics to prevent complications.

Towards an integrated type 1 diabetes management in low-resource settings: barriers faced by patients and their caregivers in healthcare facilities in Ghana

Background In Low-Middle-Income Countries (LMICs), young people living with Type 1 Diabetes Mellitus (T1DM) face structural barriers which undermine adequate T1DM management and lead to poor health outcomes. However, research on the barriers faced by young people living with T1DM have mostly focused on patient factors, neglecting concerns regarding plausible barriers that may exist at the point of healthcare service delivery.Objective This study sought to explore barriers faced by young people living with T1DM and their caregivers at the point of healthcare service delivery.MethodsData were drawn from a qualitative research in southern Ghana. The research was underpinned by a phenomenological study design. Data were collected from 28 young people living with T1DM, 12 caregivers, and six healthcare providers using semi-structured interview guides. The data were collected at home, hospital, and support group centres via face-to-face interviews, telephone interviews, and videoconferencing. Thematic and framework analyses were done using CAQDAS (QSR NVivo 14).ResultsEight key barriers were identified. These were: shortage of insulin and management logistics; healthcare provider knowledge gaps; lack of T1DM care continuity; poor healthcare provider-caregiver interactions; lack of specialists’ care; sharing of physical space with adult patients; long waiting time; and outdated treatment plans. The multiple barriers identified suggest the need for an integrated model of T1DM to improve its care delivery in low-resource settings. We adapted the Chronic Care Model (CCM) to develop an Integrated Healthcare for T1DM management in low-resource settings.ConclusionYoung people living with T1DM, and their caregivers encountered multiple healthcare barriers in both in-patient and outpatient healthcare facilities. The results highlight important intervention areas which must be addressed/improved to optimise T1DM care, as well as call for the implementation of a proposed integrated approach to T1DM care in low-resource settings.

Serological characterization of Coxsackievirus B in type 1 diabetes mellitus (T1DM) patients in Basrah city- Iraq

Background: Type 1 diabetes mellitus (T1DM) is a chronic autoimmune illness that causes severe insulin shortage and hyperglycemia. Pancreatic cells may be destroyed by enteroviral (EV) infection either directly or by inducing an inflammatory response in the pancreatic islets that brings autoreactive T lymphocytes to the site of inflammation. Aim of study: investigate whether coxsackievirus group B (CVB) strains are associated with the onset of islet autoimmunity and T1DM. Objective: Serum samples were collected from newly diagnosed patients of type 1 diabetes mellitus who were attending the endocrinology centers at Al-Mawani general hospital and Al-Fayhaa teaching hospital from October 2022 to May 2023. A total of 168 children of both sexes, comprising 86 (51.1%) patients as a patient group. Results and discussion: Showed that there were no significant differences (p≤ 0.871) between patients and control according to age range however, the results showed elevated IgM titers in patients (15.14±2.43) in comparison with the control (8.66±1.56) with highly significant differences (p< 0.000). The age group (11-17) had the highest percentage (57.58%) of positive CVB-IgM patients which was 19 children of the total 33 infected children, while other age groups had 7 patients each (21.21%). Conclusion: Females were significantly more susceptible to T1DM than males. The age group (11-17) significantly more susceptible to T1DM than other age groups. Serological methods were more favorable than molecular methods in diagnosing the Coxsackievirus B. Elevated titers of IgG or IgM in patients in comparison with the control.

Insulin regulates human pancreatic endocrine cell differentiation in vitro

ObjectiveThe consequences of mutations in genes associated with monogenic forms of diabetes on human pancreas development cannot be studied in a time-resolved fashion in vivo. More specifically, if recessive mutations in the insulin gene influence human pancreatic endocrine lineage formation is still an unresolved question. MethodsTo model the extremely reduced insulin levels in patients with recessive insulin gene mutations, we generated a novel knock-in H2B-Cherry reporter human induced pluripotent stem cell (iPSC) line expressing no insulin upon differentiation to stem cell-derived (SC-) β cells in vitro. Differentiation of iPSCs into the pancreatic and endocrine lineage, combined with immunostaining, Western blotting and proteomics analysis phenotypically characterized the insulin gene deficiency in SC-islets. Furthermore, we leveraged FACS analysis and confocal microscopy to explore the impact of insulin shortage on human endocrine cell induction, composition, differentiation and proliferation. ResultsInterestingly, insulin-deficient SC-islets exhibited low insulin receptor (IR) signaling when stimulated with glucose but displayed increased IR sensitivity upon treatment with exogenous insulin. Furthermore, insulin shortage did not alter neurogenin-3 (NGN3)-mediated endocrine lineage induction. Nevertheless, lack of insulin skewed the SC-islet cell composition with an increased number in SC-β cell formation at the expense of SC-α cells. Finally, insulin deficiency reduced the rate of SC-β cell proliferation but had no impact on the expansion of SC-α cells. ConclusionsUsing iPSC disease modelling, we provide first evidence of insulin function in human pancreatic endocrine lineage formation. These findings help to better understand the phenotypic impact of recessive insulin gene mutations during pancreas development and shed light on insulin gene function beside its physiological role in blood glucose regulation.

Genetic lineage tracing identifies adaptive mechanisms of pancreatic islet β cells in various mouse models of diabetes with distinct age of initiation.

During the pathogenesis of type 1 diabetes (T1D) and type 2 diabetes (T2D), pancreatic islets, especially the β cells, face significant challenges. These insulin-producing cells adopt a regeneration strategy to compensate for the shortage of insulin, but the exact mechanism needs to be defined. High-fat diet (HFD) and streptozotocin (STZ) treatment are well-established models to study islet damage in T2D and T1D respectively. Therefore, we applied these two diabetic mouse models, triggered at different ages, to pursue the cell fate transition of islet β cells. Cre-LoxP systems were used to generate islet cell type-specific (α, β, or δ) green fluorescent protein (GFP)-labeled mice for genetic lineage tracing, thereinto β-cell GFP-labeled mice were tamoxifen induced. Single-cell RNA sequencing (scRNA-seq) was used to investigate the evolutionary trajectories and molecular mechanisms of the GFP-labeled β cells in STZ-treated mice. STZ-induced diabetes caused extensive dedifferentiation of β cells and some of which transdifferentiated into a or δ cells in both youth- and adulthood-initiated mice while this phenomenon was barely observed in HFD models. β cells in HFD mice were expanded via self-replication rather than via transdifferentiation from α or δ cells, in contrast, α or δ cells were induced to transdifferentiate into β cells in STZ-treated mice (both youth- and adulthood-initiated). In addition to the re-dedifferentiation of β cells, it is also highly likely that these "α or δ" cells transdifferentiated from pre-existing β cells could also re-trans-differentiate into insulin-producing β cells and be beneficial to islet recovery. The analysis of ScRNA-seq revealed that several pathways including mitochondrial function, chromatin modification, and remodeling are crucial in the dynamic transition of β cells. Our findings shed light on how islet β cells overcome the deficit of insulin and the molecular mechanism of islet recovery in T1D and T2D pathogenesis.

Enhancing insulin supply chain resilience: A critical importance for diabetes management

Diabetes, a chronic metabolic disorder affecting millions worldwide, relies heavily on a stable and efficient supply chain for insulin, a life-saving hormone. However, the insulin supply chain faces multifaceted challenges that can disrupt access to this essential medication. In the realm of diabetes management, a novel and devastating occurrence has emerged—a severe shortage of insulin. This case report revolves around a singular clinical encounter that showcases a series of remarkable and uncommon aspects, which can enrich the knowledge of healthcare professionals. The patient’s condition presented several unique features, providing a learning opportunity that transcends the typical clinical scenarios seen in diabetes management. The findings surrounding the unavailability of insulin, the dire consequences it has on patients, and the clinical course and prognosis of an individual patient closely related to previous challenges. The shortage of insulin, though not a new challenge, has now reached unparalleled levels, resulting in life-threatening situations for those dependent on this vital hormone. This case report delves into a unique scenario where an individual patient’s health dramatically deteriorated due to the insulin scarcity, highlighting the urgency for comprehensive solutions and international cooperation to ensure access to this life-saving medication. This case report manuscript reviews the importance of enhancing the resistance and resilience of the insulin supply chain to ensure uninterrupted access to insulin for people with diabetes. We discuss the current challenges, their impact on diabetes management, and propose strategies to mitigate these issues. Strengthening the insulin supply chain is essential for the well-being of those living with diabetes, highlighting its significance for healthcare systems globally.

An assessment of the factors contributing to the unavailability of drugs at outpatient pharmacy of tertiary care hospital: an observational study

Introduction Throughout history and up until the present, there has been a medicine shortage. In the early 1920s, there was a shortage of insulin, which is when drug scarcity first appeared in the records. Drug shortages are now more prevalent globally than they were back then. The goal of this essay is to pinpoint the key components that make up a definition for medication shortages and to pinpoint the circumstances that should be considered when reporting drug shortages in databases. Understanding the factors that led certain organizations to create their own definition of a medicine shortage was crucial for achieving these goals. The pharmaceutical regulatory environment can be connected to several reasons why there are medication shortages, including parallel trading, quality standards, and business choices to halt or reduce manufacturing. The many rules governing medicine shortages have not yet been the subject of a thorough investigation. This protocol’s objective is to analyze the pertinent legislative and regulatory frameworks in the European pharmaceutical system that affect medication shortages. The objectives of the study will be the non–availability of drugs at an outpatient pharmacy and to analyze the reason of non–availability of drugs. Methods An observational study will be adopted in this study. It includes a collection of data from the patient coming to the outpatient pharmacy of AVBRH Sawangi (Meghe) Wardha. Expected result It can lead to delayed treatment for patients seeking alternative medication. It can also lead to increased healthcare costs if patients seek alternative treatments that are more expensive or require additional medical care. The unavailability of drugs can also lead to frustration and anxiety for patients who need medication to manage their health condition. It can also negatively impact the reputation of the hospital.

Insulin Resistance in relation to Hypertension and Dyslipidaemia among Men Clinically Diagnosed with Type 2 Diabetes.

Pathophysiologically, type 2 diabetes can result from insulin resistance or insulin insufficiency alone. It is unclear whether relative insulin shortage or pronounced insulin resistance is linked to poor cardiometabolic problems like obesity. Therefore, the objective of this study was to evaluate the relationship between insulin resistance (IR), hypertension, and dyslipidaemia, in men with type 2 diabetes mellitus. One hundred and twenty-one (121) type 2 diabetic men participated in this cross-sectional study, which was conducted between September 2018 and September 2019. Sociodemographic information was collected using a self-designed questionnaire. Anthropometric data were also taken and blood samples collected for estimation of insulin, glucose, and lipid concentrations. HOMA-IR was calculated from the fasting insulin and glucose values, and a HOMA - IR ≥ 2 was considered to indicate insulin resistance. Of the 121 participants, 39.7% were classified as insulin-resistant. Levels of total cholesterol (4.82 ± 1.2 mmol/L; p = 0.007 vs. 4.25 ± 1.1 mmol/L), LDL cholesterol (3.17 ± 0.9 mmol/L; p = 0.001 vs. 2.52 ± 0.8 mmol/L), and TC/HDL-C ratio (3.93 ± 0.9; p = 0.042 vs. 3.58 ± 0.9) and the prevalence of abnormal LDL-C (14.6%; p = 0.015 vs. 2.7%) and elevated BP (83.3%; p = 0.048 vs. 67.1%) were higher in the insulin-resistant group. LDL cholesterol (AUC = 0.670; p = 0.001) better classified subjects as being insulin-resistant compared to other lipid markers. The odds of insulin resistance in dyslipidaemia were not statistically significant after adjusting for obesity. The link between insulin resistance and dyslipidaemia and hypertension in male diabetics may thus be mediated by obesity.

Impact of Humanitarian Crises on Diabetes Care in Iraq and Syria—IDF-MENA Region

This short review tried to discuss the factors that affect diabetes care during humanitarian crises after the political and military conflicts in post-2003 Iraq and post-2011 Syria. The pattern of the devastating effect of the conflicts on the suboptimal healthcare system and infrastructure is quite similar. Both countries’ long-term and continuous geopolitical instability and security concerns were barriers to applying any disaster preparedness plans. They had markedly exhausted diabetes care in these countries with similar mixed public and private healthcare systems. The influx of huge numbers of refugees with chronic diseases, especially diabetes, in the neighboring host countries created pressure on the healthcare systems. It urged some changes in the national policies with the needed help from the aid organizations to an extent. The internal displacement problem for huge nationals in their country exhausted the already exhausted healthcare facilities, with more burdens on the effective equal provision of diabetes-related medication and management tools. Still, diabetes care is not included as a vital part of the mitigation plans during crises in both countries, with the main concern the communicable rather than non-communicable diseases. Type 1 diabetes mellitus received less care during the crisis in both countries, with the insulin shortage being their major concern. The availability and affordability of diabetes medications in camp and non-camp settings were suboptimal and unsatisfactory. More active planning is needed to build a well-prepared healthcare system with diabetes care as an integral part.

A STUDY OF ASSOCIATION BETWEEN SENSORINEURAL HEARING LOSS AND TYPE 2 DIABETES MELLITUS IN PATIENTS WHOSE HbA1C>8% IN A TERTIARY CARE CENTRE.

Background: Diabetes mellitus is a metabolic disorder caused by a partial or complete shortage of insulin, which leads to elevated blood sugar levels and long-term vascular and neurological complications. One of the side effects of uncontrolled diabetes mellitus is sensory hearing loss. Sensorineural hearing loss has a signicant inuence on patients' quality of life because it is directly linked to physical, psychological, and cognitive dysfunction. Methods: ENT department at Sri Siddhartha Medical College in Tumkur did a prospective study over the course of 22 months that included 75 type 2 diabetic patients of both sexes between the ages of 30 and 65. All subjects have undergone FBS, PPBS, and HbA1c tests, followed by PTAto assess hearing loss. Age, gender, laterality, degree of hearing loss, length of DM, and HbA1c levels were compared with the occurrence of SNHL. Results: Of the 75 DM patients in our study, 64 (85.3%) had SNHL, while 11 individuals were normal. The majority of the patients, or 39 (52%), are between the ages of 51 and 65. The majority of patients (64%) are men aged 48. Males outnumbered females by a factor of 1.7:1. 4 patients (7%) have hearing loss in both ears, 34 (53%) only have hearing loss in the left ear, and 26 (40%) only have hearing loss in the right ear. The majority of patients, or 32 patients (51%) are in the group with mild hearing loss, followed by 19 patients (30%) with moderate hearing loss, 7 patients (10%) with moderately severe hearing loss, 4 patients (6%) with severe hearing loss, and 2 patients (3%) with profound hearing loss. patients who have diabetes.

Proteomic Changes to the Updated Discovery of Engineered Insulin and Its Analogs: Pros and Cons.

The destruction of β-cells of the pancreas leads to either insulin shortage or the complete absence of insulin, which in turn causes diabetes Mellitus. For treating diabetes, many trials have been conducted since the 19th century until now. In ancient times, insulin from an animal’s extract was taken to treat human beings. However, this resulted in some serious allergic reactions. Therefore, scientists and researchers have tried their best to find alternative ways for managing diabetes with progressive advancements in biotechnology. However, a lot of research trials have been conducted, and they discovered more progressed strategies and approaches to treat type I and II diabetes with satisfaction. Still, investigators are finding more appropriate ways to treat diabetes accurately. They formulated insulin analogs that mimic the naturally produced human insulin through recombinant DNA technology and devised many methods for appropriate delivery of insulin. This review will address the following questions: What is insulin preparation? How were these devised and what are the impacts (both positive and negative) of such insulin analogs against TIDM (type-I diabetes mellitus) and TIIDM (type-II diabetes mellitus)? This review article will also demonstrate approaches for the delivery of insulin analogs into the human body and some future directions for further improvement of insulin treatment.

Overview on Diabetes Mellitus

Diabetes mellitus is a group of diverse illnesses that often show hyperglycemia and glucose intolerance via insulin shortage, insulin impairment or both (Sicree et al., 2006). These difficulties occur due to disruptions in regulation systems controlling the storage and movement of metabolic fuels, including carbohydrate, lipid and protein catabolism and anabolism, induced by poor insulin production, insulin activity or both (Shillitoe, 1988; Votey and Peters, 2004). With more than 62 million diabetics already diagnosed in India, the situation of a potential pandemic is approaching fast.

Evaluation of Metabolic and Hydroelectrolytic Disturbances in Patients Diagnosed with Diabetic Ketoacidosis

Ketoacidosis is a life-threatening complication of diabetes mellitus, especially type 1 diabetic patients being predisposed to this condition. Ketoacidosis might occur also in other types of diabetes triggered by circumstances leading to shortage of insulin. The aim of the study was the assessment of metabolic, hydroelectrolytic disturbances and the relationship between different parameters in patients hospitalized with diabetic ketoacidosis. We evaluated the clinical state, parameters of blood-gas analyzer, biochemistry and hematology laboratory results of 32 patients admitted with diabetic ketoacidosis between January-November 2018 at the Department of Diabetology, Nutrition and Metabolic Diseases of the Emergency County Hospital in T�rgu Mureș. Demographic data, associated diseases, body mass index were also evaluated. The considered threshold of significance was 0.05. The distribution of type 1 and 2 diabetes was 40.6 and 46.9% in the studied group, 53.1% being male patients. Positive correlation could be observed between pH and base excess and between pH and bicarbonate values, while negative correlation could be found between triglyceridemia and body mass index (BMI). Severe hyperglycemia, very low pH values, glucosuria, ketonuria and electrolytic imbalances were very common in the studied patients. Pancreatitis, respiratory tract and urinary infections could be found in the background of ketoacidotic manifestations in the majority of the patients, dehydration occured in each of the cases. Many severe metabolic and hydroelectrolytic disturbances could be observed in the studied patients presenting diabetic ketoacidosis. Infectious diseases are the most common triggers of metabolic imbalance in diabetic patients.

A study to assess the knowledge of Karaya powder application on diabetic wound healing among diabetic mellitus patients

Diabetes mellitus is a serious debilitating longtime illness that grows in nearly 5% of the world’s peoples. People with this illness have a shortage of insulin or lessen capacity to use insulin; the hormone controlled blood glucose level. The study aims to assess the Karaya powder application among diabetic mellitus clients. The study was conducted in Mappedu village with 60 samples. The data was collected by using Structure interview questionnaires on Karaya powder. The result revealed that extract has significant effect increase knowledge on Karaya powder application on diabetic wound healing among diabetic clients.

Access to insulin: applying the concept of security of supply to medicines.

Security of supply of medicines is fundamental to ensure health for all. Furthermore, improving access to medicines is included in sustainable development goal 3. However, the concept of security of supply has mostly been applied to food, water and energy. Diversity of supply, vulnerability to disruption, expenditure, infrastructure, stability of exporting countries, ownership of production, price stability, access and equity, affordability, intellectual property, safety and reliability of supply, and countries’ capacity to adapt to market changes are all elements of security of supply. Based on these elements, we assessed security of supply for insulin, since access to insulin is a global problem. We found that three multinational companies, in Denmark, France and Germany, control 99% of the value of the global insulin market. Prices and affordability of insulin and access to it vary considerably between countries. Some countries are vulnerable to insulin shortage because they import insulin from only one source. Many countries spend large amounts of money on insulin and costs are increasing. Some countries lack an adequate infrastructure for procurement, supply chain management and distribution of insulin. Applying the security of supply concept to insulin showed that diversification of suppliers needs to be fostered. Global health actors should adopt a security of supply approach to identify medicines that are susceptible to supply issues and address this concern by strategic promotion of local production, strengthening regulatory harmonization, and adding local products to the World Health Organization’s programme on prequalification of medicines.

Análise dos pedidos de patente de insulina depositados no Brasil

Entre os medicamentos biotecnológicos, a insulina tem um papel extremamente significativo, pois no ranking mundial de medicamentos ocupa um lugar entre os mais comercializados e, no Brasil, é o insumo farmacêutico que gera mais gastos com importação. A insulina é um dos principais medicamentos utilizados para o diabetes, doença que acomete 415 milhões de pessoas e consome 12% das despesas mundiais de saúde. O objetivo do presente estudo consiste em analisar a atual situação no ranking de depósitos de pedidos de patente de insulina no Brasil. A busca dos documentos de patentes foi realizada utilizando a base de dados Orbit Intelligence®. Os resultados observados demonstram a ausência no Brasil de indústrias nacionais inovando, por meio de patentes, nessa área biotecnológica, deixando o país dependente de aquisição da insulina no mercado externo, o que pode acarretar um desabastecimento nacional. Dos três países estudados, somente os Estados Unidos apresenta índices de patenteamento que demonstram avanço e investimento em pesquisa e desenvolvimento. É necessário aumentar o investimento em P&D e criar políticas públicas que incentivem a inovação do estudo na área biotecnológica no Brasil.

Polydatin ameliorates diabetic cardiomyopathy via Sirt3 activation

BackgroundDiabetic cardiomyopathy is identified as cardiac ventricular dysfunction induced by an insulin shortage in diabetic patients. Our previous studies have shown that Polydatin (PD) alleviates cardiac dysfunction after myocardial infarction (MI) injury. Nevertheless, the mechanism by which PD regulates diabetic cardiomyopathy has not been reported. MethodsIn this study, we demonstrated the effects and described the mechanisms of PD in diabetic cardiomyopathy in both adult mouse hearts and neonatal mouse cardiomyocytes. We injected streptozotocin (STZ) to induce the DM model in wild-type (WT) and Sirt3 knockout (Sirt3−/−) mice. Mitochondrial bioenergetics in diabetic mice were detected by measuring citrate synthase activity and ATP content. The extent of autophagy regulation by PD was investigated by detecting the levels of Beclin 1, Atg5, LC3 and p62. ResultsCompared to the WT mouse hearts, hearts from the diabetic mice exhibited better cardiac function and a higher level of autophagy. Moreover, mitochondrial function in the diabetic mouse hearts was improved after PD treatment. However, PD treatment had no effect on the Sirt3 knockout diabetic mouse hearts. Additionally, PD increased autophagy flux in the cardiomyocytes that were cultured in high-glucose medium for 48 h. In addition, PD had no effects on the cardiomyocytes under high-glucose conditions when we down-regulated Sirt3. ConclusionsAltogether, PD attenuated cardiac dysfunction, increased autophagy flux and improved mitochondrial bioenergetics by up-regulating Sirt3 in the diabetic mice.

The Journey to Control

Diabetes mellitus (DM) is a lifelong metabolic disorder characterized by persistently increased serum glucose levels related to a shortage of insulin in the body (Meetoo & Allen, 2010). Research has found that individuals with a diagnosis of diabetes mellitus (DM) present to the hospital more often than individuals without DM. These hospital visits also tend to be lengthier and more serious in nature. Glycemic control is critical to avoid complications of inpatient hyperglycemia and to lower the risk of long-term complications associated with poor sugar control. Poor outcomes that have been associated with hyperglycemic patients staying in the hospital setting include increased rates of nosocomial infections, sepsis, and an increased length of stay. Strict glycemic control in the hospital that is modified daily according to each diabetic patients needs and clinical situation can significantly reduce the risks for these poor outcomes (Johnston & Van Horn, 2011). Also, patients who understand their disease are more likely to take ownership of their health care problems, understand their treatment options, modify their behaviors, and take their medications more regularly. Tight glycemic control will be tackled through the methods of a redesigned meal delivery program, accurate insulin administration, the implementation of the diabetes conversation map program, and by giving patients a diabetic workbook upon discharge.