Lower Blood Glucose Research Articles

Activity Test of The Combination Papaya Leaf Extract (Carica papaya L.) and Soursop Leaf Extract (Annona mu-ricata L.) on Decreasing Blood Glucose Levels in Rats (Rattus norvegicus)

Diabetes mellitus (DM) is one of the most common health disorders and its prevalence rate is increasing every year. Natural compounds can be an alternative treatment for DM. Previous re-search reports for papaya leaves (Carica papaya L.) and soursop leaves (Annona muricata L.) showed activity in lowering blood glucose levels when used alone. Therefore, in this study, the two samples were combined to lower blood glucose levels. Both leaves were extracted using the decoction method. This study aims to identify secondary metabolite compounds in papaya leaf extract (Carica papaya L.) and soursop leaf extract (Annona muricata L.), then continued with determining the activity and effectiveness of lowering blood glucose levels. The results of the identification of secondary metabolite compounds showed several groups of compounds such as flavonoids, saponins and tannins. The combination of papaya leaf extract and soursop leaf extract showed a decrease in blood glucose levels. In more detail, EDPS 1:2 and EDPS 2:1 were statistically significant against negative controls. EDPS 1:2 showed the most effective percentage reduction in blood glucose levels at 22.72%

Perception of diet, dietary practices and sources of dietary information among people with type 2 diabetes followed up at a tertiary care outpatient clinic: a qualitative study

BackgroundDietary practices and beliefs among people living with diabetes in low-middle-income South-Asian countries are unique. Understanding them is paramount in supporting them to improve their clinical outcomes. This study aimed to understand the perception of diet, dietary practices, and sources of dietary information among Sri Lankan adults with type 2 diabetes.MethodsFocus group discussions (FGD) were conducted with the participation of adults with type 2 diabetes attending a Medical Clinic at a tertiary care hospital in Sri Lanka. Eligible participants were recruited between June to October 2022 through convenience sampling. FGDs were facilitated by two researchers using a semi-structured discussion guide developed for this study. Abridged transcripts were formulated using the notes and audio recordings. Data were analysed using Braun and Clarke’s six-step method for thematic analysis.ResultsAmong 38 participants included in five FGDs, the mean age was 59.9 (range: 39–76) years, 27 (71.1%) were females, and mean duration since the diagnosis of diabetes was 9.4 (range: 0–25) years. Five main themes were identified. (1) Diet in diabetes and composition of the meal; participants were aware of the importance of diet in diabetes and understood a healthy meal including the plate concept. (2) Individual components in the diet; many participants used ‘sugar’ to refer to ‘starch’ in the food. Participants considered rice superior to wheat flour-based products in diabetes. Finger millet products were believed to lower blood glucose. We observed beliefs on the glycaemic effects of specific varieties of yams, legumes and fruits. Some participants completely avoided sweets and starchy vegetables. (3) Utilisation of food labels; only a few participants referred to food labels. (4) Factors affecting the practice; external factors such as the recent economic crisis, family members’ influence, and availability affected their food choices. (5) Sources of information; some felt that ready access to information was limited.ConclusionsWe identified several misconceptions and undue dietary restrictions, minimal utilisation of food labels and information sources, and the impact of several external factors including economic restrictions. Understanding these dynamic patient and social factors would enable culturally acceptable dietary interventions by health professionals to improve patient outcomes.

Integrating Sglt-2 Inhibitors into the Clinical Management of Type 2 Diabetes Mellitus and Chronic Kidney Disease: Current Evidence and Future Outlook

Objective and Background: The prevalence of type 2 diabetes mellitus (T2DM) is steadily increasing globally. A significant complication of T2DM is diabetic kidney disease, which contributes to increased morbidity and mortality. Sodium-Glucose Co-Transporter-2 (SGLT-2) inhibitors are a class of oral antidiabetic agents that effectively lower blood glucose levels and provide protective benefits for kidney health. Methods: A comprehensive review of studies was conducted focusing on the use of SGLT-2 inhibitors in patients with T2DM, including those with chronic kidney disease (CKD), defined as a glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m², or urine albumin/creatinine ratio ≥ 30 mg alb/g creatinine. The studies evaluated clinical outcomes such as cardiovascular events, kidney disease progression, and mortality. Results: Research findings demonstrate that SGLT-2 inhibitors significantly reduce the risk of hospitalization due to heart failure, myocardial infarction, and stroke. Additionally, these medications lower the incidence of cardiovascular-related and all-cause mortality. Renal-specific benefits include slowing the progression of albuminuria, reducing the decline in GFR, lowering the need for renal replacement therapy, and decreasing kidney-related deaths.

Effect of 3-Nitrooxypropanol Combined with Different Feed Additives on Growth Performance, Carcass Traits, Enteric Methane Emissions, and Physiological Responses in Feedlot Beef Cattle Fed a High-Concentrate Finishing Diet

The objective of this study was to evaluate the effect of 3-nitrooxypropanol (3-NOP) in combination with different feed additives on growth performance, carcass traits, meat quality, enteric methane (CH4) emissions, nutrient intake and digestibility, and blood parameters in feedlot beef cattle. In experiment (Exp.) 1, one hundred sixty-eight Nellore bulls (initial bodyweight (BW) 410 ± 8 kg) were allocated to 24 pens in a completely randomized block design. In Exp. 2, thirty Nellore bulls (initial BW 410 ± 3 kg) were allocated to a collective pen as one group, and treatments were allocated in a completely randomized design. Three treatments were applied: Control (CTL): monensin sodium (26 mg/kg of dry matter, DM); M3NOP: CTL with 3-NOP (100 mg/kg DM); and Combo: 3-NOP (100 mg/kg DM) with essential oils (100 mg/kg DM), 25-Hydroxy-Vitamin-D3 (0.10 mg/kg DM), organic chromium (4 mg/kg DM), and zinc (60 mg/kg DM). In Exp. 1, bulls in the Combo group had greater (p < 0.01) dry matter intake (DMI) at d 28 compared to the CTL and M3NOP groups. During d 0 to 102, bulls’ final BW and average daily gain (ADG) were greater (p ≤ 0.03) for the Combo group compared to the CTL. The bulls in the Combo and M3NOP groups had better (p < 0.01) feed conversion (FC) and feed efficiency (FE) compared to the CTL. Hot carcass weight (HCW), carcass ADG, and carcass yield were greater (p ≤ 0.05) for bulls in the Combo group compared to the CTL and M3NOP groups. The bulls in the Combo group had greater (p = 0.01) dressing compared to the M3NOP group. Combo bulls had better (p = 0.02) biological efficiency compared to the CTL. The bulls in the Combo group had lower (p < 0.01) carcass pH compared to the CTL and M3NOP groups. In Exp. 2, bulls in the Combo group had greater (p = 0.04) DMI at d 28 compared to the CTL and had greater (p < 0.01) DMI at d 102 compared to the CTL and M3NOP groups. The bulls in the Combo group had greater (p = 0.04) HCW compared to the CTL and M3NOP groups and carcass ADG was greater (p = 0.04) for bulls in the Combo group compared to the M3NOP group. The bulls in the Combo and M3NOP groups had lower (p < 0.01) CH4 production (38.8%, g/d), yield (41.1%, g/kg DMI), and intensity (40.8%, g/kg carcass ADG) and higher (p < 0.01) H2 emissions (291%, g/d) compared to the CTL. Combo bulls had lower (p < 0.01) blood glucose and insulin, and higher nutrient intake and digestibility (p ≤ 0.05) compared to the CTL and M3NOP groups. Combining 3-NOP with different feed additives improved FC and FE, and reduced enteric CH4 emissions. Combo treatment improved growth performance, carcass traits, nutrient intake, and digestibility, and improved glucose and insulin responses in feedlot beef cattle on a high-concentrate finishing diet.

Effect of sorghum flour-containing pasta on postprandial glycemia, appetite and energy intake in healthy individuals.

In vitro studies suggest that incorporating sorghum flour into staple foods including pasta reduces their starch digestibility and hence may suppress postprandial blood glucose levels, appetite and energy intake; however, these effects in humans have yet to be reported. Therefore, this study investigated the effect of red and white sorghum-containing pasta on blood glucose response, appetite and energy intake in humans. In a randomised crossover design, healthy individuals (n = 20) consumed the following three iso-caloric test meals (each providing 50 g available carbohydrates) as breakfast: control pasta (CP) made from100% durum wheat; 30% red sorghum pasta (RSP) and; 30% white sorghum pasta (WSP). Blood glucose and subjective appetite were measured postprandially for 2 and 3 h, respectively. Energy intakes from ad libitum lunch consumed 3 h after breakfast and for the remainder of the day were also measured. Incremental areas under or over the curves (iAUCs/iAOCs) for blood glucose and appetite parameters were calculated. The RSP meal resulted in significantly lower blood glucose response (-0.35 ± 0.09 mmol/l; 95% CI: -0.61 ~ -0.09; P = 0.005) and glucose iAUC over 120 min (-36.11 ± 10.53 mmol/l × min; 95% CI: -67.11 ~ -5.11; P = 0.017) compared to CP meal. Compared to CP meal, the RSP meal resulted in significantly higher satiety iAUC (1219.46 ± 383.26 mm × min; 95% 91.18 ~ 2347.75; P = 0.029), lower hunger iAOC (-1410.47 ± 349.14 mm x min; 95% CI: -2438.30 ~ -382.63; P = 0.004) and lower prospective food intake iAOC (-1645.73 ± 324.14 mm x min; 95% CI: -2599.97 ~ -691.49; P < 0.001). Energy intake at ad libitum lunch was significantly lower after the RSP meal than after the CP meal (-794.17 ± 163.25 kJ; 95% CI: -1274.77 ~ -313.57; P = 0.001). The results indicate that red sorghum addition into pasta provides a product inducing reduced glycemia, favourably changed appetite parameters and decreased subsequent energy intake.

Administration of a diabetes-specific formula can improve postprandial glycemic control and delay insulin use in gestational diabetes mellitus: a randomized controlled trial from two centers

Background and AimsThere have been limited studies on the application of a diabetes-specific formula in gestational diabetes mellitus (GDM), the role of which has not been well studied. We explored the effect of a diabetes-specific formula on blood glucose levels, insulin use and pregnancy outcomes in GDM patients. MethodsIn this randomized controlled study, 112 GDM patients were randomly assigned to the intervention group (56) and the control group (56). Both groups received individualized dietary counseling. The intervention group consumed a soy-protein-based, high-monounsaturated-fatty-acid, and multi-fiber diabetes-specific formula as milk replacement for breakfast and an extra meal after dinner. All participants were followed up every two weeks until delivery. The blood glucose levels, insulin use and pregnancy outcomes between the groups were compared. ResultsCompared to the control group, the intervention group had significantly lower 2h postprandial blood glucose levels after breakfast (5.84±0.56 vs. 6.15±0.44mmol/L, p=0.008), and exhibited higher postprandial time in range values (83.80% vs. 78.95%, p=0.045). The intervention group used insulin later (33 vs. 28 weeks, p=0.015) and for fewer days (36 vs 78 days, p=0.024), but no differences in the proportion, dose or frequency of insulin use between the groups. There were no significant differences in pregnancy outcomes between the groups. ConclusionsThe diabetes-specific formula significantly decreased postprandial blood glucose levels and improved postprandial glycemic control in GDM patients. Moreover, it delayed the initiation of insulin use and reduced the duration of insulin therapy. Our findings may offer a potential new approach for achieving better personalized blood glucose control in GDM patients. Registration number of Clinical TrialNCT03957603 (registered at ClinicalTrials.gov).

Anti-Diabetic Effects of &lt;i&gt;Cordyceps Militaris&lt;/i&gt; Extract on Weight, Blood Glucose, and Insulin Resistance in Diabetic Model Mice

Objectives: This study investigates the anti-diabetic effects of &lt;i&gt;Cordyceps militaris&lt;/i&gt; extract on diabetic model mice (db/db mouse).Methods: Diabetic mice (db/db) were compared to normal control group (NC). The positive control group received Metformin (Met), while other groups received &lt;i&gt;Cordyceps militaris&lt;/i&gt; extract, including &lt;i&gt;ARA301_L&lt;/i&gt;. Body weight, fasting blood glucose levels (FBGL), oral glucose tolerance tests (OGTT), insulin tolerance tests (ITT), blood lipid profiles, and tissue analysis were conducted.Results: Diabetic mice showed significantly higher body weight compared to normal mice. The positive control group maintained stable weight over 56 days, while the &lt;i&gt;Cordyceps militaris&lt;/i&gt; extract groups showed slight weight decreases, with a marked reduction in the &lt;i&gt;ARA301_L&lt;/i&gt; group. FBGLs were significantly lower in treated groups than in control groups. OGTT indicated better glucose regulation in treated groups, though differences among them were not significant. ITT showed lower blood glucose levels in treated groups, indicating improved insulin resistance. Blood lipid profiles revealed significant reductions in total cholesterol (TC) and AST in the &lt;i&gt;ARA301_L&lt;/i&gt; group. Liver tissue analysis showed decreased expression of lipid metabolism and inflammation-related genes, particularly PPAR&lt;i&gt;γ&lt;/i&gt; and SREBP-1c. Muscle and adipose tissues displayed increased GLUT4 protein and reduced inflammatory gene expression.Conclusions: &lt;i&gt;Cordyceps militaris&lt;/i&gt; extract has more positive effects than metformin on body weight, insulin resistance, sugar metabolism, fatty liver, and inflammation in diabetic mice. It also has a similar positive effect as metformin on blood lipid concentration and liver damage. This suggests the potential of diabetes management in &lt;i&gt;Cordyceps militaris&lt;/i&gt; extract.

SGLT2 Inhibitors in Cardiovascular Medicine: Panacea or Pandora's Box?

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are antidiabetic agents that effectively lower blood glucose levels in patients with Type 2 Diabetes Mellitus (T2DM). Beyond their glycemic control properties, SGLT2 inhibitors have demonstrated significant cardiovascular benefits, including reductions in major adverse cardiovascular events. However, the limitations of the pivotal trials investigating these outcomes have not been fully explored. This letter aims to critically assess the major randomized clinical trials that evaluated the cardiovascular effects of SGLT2 inhibitors, highlighting both their strengths and limitations.

A sensitive red/far-red photoswitch for controllable gene therapy in mouse models of metabolic diseases

Red light optogenetic systems are in high demand for the precise control of gene expression for gene- and cell-based therapies. Here, we report a red/far-red light-inducible photoswitch (REDLIP) system based on the chimeric photosensory protein FnBphP (Fn-REDLIP) or PnBphP (Pn-REDLIP) and their interaction partner LDB3, which enables efficient dynamic regulation of gene expression with a timescale of seconds without exogenous administration of a chromophore in mammals. We use the REDLIP system to establish the REDLIP-mediated CRISPR-dCas9 (REDLIPcas) system, enabling optogenetic activation of endogenous target genes in mammalian cells and mice. The REDLIP system is small enough to support packaging into adeno-associated viruses (AAVs), facilitating its therapeutic application. Demonstrating its capacity to treat metabolic diseases, we show that an AAV-delivered Fn-REDLIP system achieved optogenetic control of insulin expression to effectively lower blood glucose levels in type 1 diabetes model mice and control an anti-obesity therapeutic protein (thymic stromal lymphopoietin, TSLP) to reduce body weight in obesity model mice. REDLIP is a compact and sensitive optogenetic tool for reversible and non-invasive control that can facilitate basic biological and biomedical research.

Effects of insulin glargine U300 versus insulin degludec U100 on glycemic variability, hypoglycemia, and diet evaluated by continuous glucose monitoring in type 1 diabetes: a retrospective cross-sectional study.

The impacts of insulin degludec U100 (Deg-100) and insulin glargine U300 (Gla-300) on glycemic variability (GV) in patients with type 1 diabetes, as well as the impact of major nutrient components on GV in these patients, remain unclear. This was an observational, cross-sectional, retrospective study. Type 1 diabetes mellitus patients treated with either Deg-100 or Gla-300 as basal insulin were enrolled. After the participants underwent continuous glucose monitoring, GV indices and major nutrient components were analyzed. Forty patients with type 1 diabetes were enrolled, and 20 participants used Deg-100, and 20 used Gla-300. There was no significant difference in major nutrient components between the two groups. Better GV indices of standard deviation, coefficient of variation, mean amplitude of glycemic excursion, AUCn, M-value, CONGA1, CONGA2, and CONGA4 were noted in the Gla-300 group versus Deg-100 group. Compared with patients who received once-daily injection in the morning (QD), Deg-100 administration once daily at bedtime (HS) yielded a higher low blood glucose index during both day and nocturnal periods, indicating a higher risk of hypoglycemic events. By contrast, there were significantly lower levels of CONGA1, CONGA2, and CONGA4 during insulin Gla-300 QD administration than during HS administration, indicating a lower GV of a short interval. In this real-world study involving type 1 diabetes patients, Gla-300 appears to offer more stable glucose variability than Deg-100. Administering once-daily injections could lower the risk of hypoglycemia in the Deg-100 group and minimize GV in the Gla-300 group compared to bedtime injections.

Inter-temporal dynamic joint learning model considering intra- and inter-day mutable correlations for blood glucose level prediction

Accurate and low clinical risk blood glucose level (BGL) prediction plays an important role in blood glucose management of type 1 diabetes (T1D). Due to the diurnal variation in physiological regulation and the influence of external life events, blood glucose patterns change over time and events within a day. The fact that humans have an inherent biological cycle of approximately one day and an individual has similar responses to the same life events leading to day-to-day similarities in blood glucose trajectories. However, the daily schedules are not entirely same under free-living conditions so that similar glycemic patterns may occur at different periods on each day. Thus, the mutable intra-day and inter-day temporal correlations in multi-day BGL data challenge the BGL prediction. To this end, we propose an inter-temporal dynamic joint learning method, named as iTDJL. Firstly, considering the variability of the association between days in the free-living, we design a discovery strategy based on discrete cross-correlation to dynamically select the highly correlated series slices from previous days. Then, based on the multi-head self-attention mechanism, the intra-day and inter-day attention layers are developed and connected in sequence to capture the correlation relationships between different time spans that varies with input. Finally, the future multi-step predictions are obtained through a multi-layer perception layer. We evaluate the iTDJL model on the real-world OhioT1DM dataset. Compared to other advanced methods, the iTDJL produces more reliable BGL predictions without requiring meal announcement and other lifestyle information from the patients under free-living conditions. Our proposed method may promote the T1D management, such as clinical decision support assisting insulin injection and abnormal glucose warning.

Incretin mimetics for the management of diabetes and associated comorbidities: An overview

Type 2 diabetes mellitus is commonly associated with various comorbidities that aggravate the disease&amp;rsquo;s overall impact on health. The most prevalent comorbidities of diabetes include obesity, dyslipidemia, hypertension, cardiovascular conditions, and kidney diseases. Incretin mimetics, also known as glucagon-like peptide-1 receptor agonists, mimic incretin hormones to stimulate insulin release in response to food intake. These medications help lower blood glucose by increasing insulin production, reducing glucagon secretion, slowing stomach emptying, and promoting satiety. A key advantage of incretin mimetics is their ability to reduce blood glucose levels without causing hypoglycemia, making them a safer option for many patients. They also promote weight loss, which is particularly beneficial for patients with both obesity and diabetes. Incretin mimetics are typically administered once or twice daily and are often used in combination with other treatments such as metformin or insulin. Evidence suggests that these drugs may reduce the risk of heart attack and stroke, an important consideration given the heightened cardiovascular risk in patients with diabetes. Additionally, incretin mimetics may help preserve pancreatic beta-cell function, potentially slowing the progression of diabetes. However, these drugs are costly and may be unaffordable for low-income individuals. Commonly reported side effects include nausea, vomiting, and diarrhea, which tend to decrease over time. While there have been reports of pancreatitis, current research indicates that incretin mimetics do not increase the risk of pancreatic cancer. Educating patients on proper use and potential side effects is crucial to ensure safe and effective treatment with incretin mimetics.

Association between gestational diabetes mellitus diagnostic criteria and adverse pregnancy outcomes—a systematic review and meta-analysis of adjusted effect sizes from studies using current diagnostic criteria

ObjectivesTo quantify the association between Gestational Diabetes Mellitus (GDM) and adverse pregnancy outcomes and primarily compare the associations between diagnostic criteria following the International Association of Diabetes and Pregnancy Study...

Breaking up sitting enhances neurocognitive function which is associated with improved postprandial glucose regulation in healthy adults: A randomized crossover study

Background and aimsThe glucose-centric hypothesis postulates that glycemic control may influence cognition. While research has examined the effects of breaking up sitting on blood glucose and inhibitory control, few studies have integrated these data and employed event-related potential (ERP) measures to delve into the neuroelectric processes. This study aimed to investigate the effects of breaking up sitting on postprandial blood glucose response, inhibitory control, and P3 component. MethodsEighteen healthy male participants [25 ± 4 years, 23.5 ± 3.2 kg/m² (mean ± SD)] were subjected to 3.5 h uninterrupted sitting (SIT) or with 3 min walking at 6.4 km/h every 30 minutes (ACTIVE) trials in a randomized crossover design. The Stroop task was administered to assess inhibitory control before and after SIT and ACTIVE trials, and electroencephalography was employed to derive stimulus-elicited P3 component. Finger prick blood glucose levels were collected at baseline, 0.5 h, 1 h, and 3.5 h during the trials. ResultsWhile no significant differences were found in inhibitory control performances between trials, greater P3 amplitude was found in the ACTIVE trial relative to the SIT trial (p = .041). Lower postprandial blood glucose iAUC was found in ACTIVE trial compared to SIT trial (p = .028), and this was correlated with the elevation of P3 amplitude (r = – .521, p = .023). ConclusionBreaking up sitting acutely facilitates neuroelectric indices of attentional processing, which is associated with the optimal postprandial blood glucose control.

Heat-treated brown rice starch structure and effect on short-chain fatty acids and mouse intestinal microbiota

Rice with high resistant starch (RS) exhibits the potential to improve glucose metabolism, insulin sensitivity. In this study, using two rice varieties—Samgwang, a medium-amylose rice, and Dodamssal, a high-amylose rice containing RS—we analyzed the composition and molecular structural characteristics of brown rice and its starch and the effects on fasting blood glucose levels, fecal short-chain fatty acid (SCFA), and gut microbiota after 8 weeks of consumption in mice. The amylose content of heat-treated Samgwang (HS) and -Dodamssal (HD) was 21.0 ± 0.2 and 47.5 ± 0.3 %, respectively, while RS contents were 0.8 ± 0.0 and 14.7 ± 1.0 %. HD exhibited a C-type starch crystallinity with a lower proportion of short chains and a higher proportion of long chains compared to HS. HD-fed mice exhibited lower fasting blood glucose levels and the highest SCFA levels in their feces. They also had the highest abundance of Ruminococcus bromii, an RS-degrading bacterium, the highest positive correlation with Faecalicatena fissicatena (r = 0.9), and the highest negative correlation with Lachnoclostridium scindens and Lawsonibacter asaccharolyticus (r = −0.8). Overall, HD consumption can improve glucose metabolism by increasing intestinal SCFA production and can serve as a prebiotic dietary ingredient to improve obesity and diabetes.

Blood glucose and blood pressure lowering effect of diets supplemented with whole unripe plantain flour and effects on altered biomolecules in diabetic/hypertensive rats

Blood glucose and blood pressure lowering effect of diets supplemented with whole unripe plantain flour and effects on altered biomolecules in diabetic/hypertensive rats

The Effect Combining Snakehead Fish Extract, Meniran, and Temulawak on Glycemic Status and Pancreatic Histopathology in High-Fat Diet Diabetic Rats

Diabetes mellitus is a metabolic disorder characterized by hyperglycemia, frequently associated with obesity, dyslipidemia, hypertension, and cardiovascular complications, particularly in type 2 diabetes mellitus (DM). In Indonesia, traditional medicine is often favored for its safety and cost-effectiveness compared to synthetic drugs. This study involved 25 male Wistar rats, which were divided into five groups: a control group, an alloxan and high-fat diet group, a pioglitazone group, a plant extract group, and a combination group. Obesity was induced over 27 days through a high-fat diet, followed by the administration of alloxan to elevate blood glucose levels. Glucose measurements were taken at specified intervals, with HbA1c assessed on day 26, and pancreatic histopathology was analyzed post-study. The Kruskal-Wallis test revealed significant differences in weight gain (p = 0.016) and blood glucose levels (p = 0.003) among the groups. Although no significant difference was observed in blood glucose reduction (p = 0.05), the combination group exhibited the most substantial decrease. One-way ANOVA results demonstrated that the combination of the extract and pioglitazone significantly reduced HbA1c levels (p &lt; 0.001), with the second group showing the highest levels and the fourth group displaying the most pronounced reduction. Histopathological analysis indicated damage to the islets of Langerhans in both the pioglitazone and extract groups. The combination of snakehead fish extract, meniran, temulawak, and pioglitazone effectively lowers blood glucose and HbA1c levels; however, it does not appear to ameliorate islet damage, likely due to oxidative stress resulting from the treatments

Effects of metformin supplementation in high-carbohydrate diets on growth performance, glucose metabolism, intestinal flora, and PI3K/AKT signaling pathway of hybrid grouper (Epinephelus fuscoguttatus♀×Epinephelus lanceolatu♂)

Metformin, or 1,1-dimethylbiguanide, is a hypoglycemic drug that lowers blood glucose by reducing glycogen synthesis and increasing glucose uptake in peripheral tissues. Six diets with iso-nitrogenous and iso-lipid compositions were prepared, including a positive control (20 % carbohydrate, PC) and a negative control (30 % carbohydrate, T0). The experimental diets contained 0.2 % (T2), 0.4 % (T4), 0.6 % (T6), and 0.8 % (T8) metformin based on the negative control diet. A total of 540 hybrid groupers, with consistent size and health conditions, were randomly assigned to six groups. Each group contained 30 fish, with three replicates per group, and they were fed for eight weeks. The high-carbohydrate diet reduced weight gain, digestive enzyme activities and specific growth rates (P>0.05), while significantly increasing hepatosomatic indices (P<0.05). Metformin supplementation reduced both hepatosomatic and viscerosomatic indices (P<0.05). The high-carbohydrate diet led to increased levels of glucose, triglycerides, low-density lipoprotein, hepatic fructose 1,6-bisphosphatase, and glucose-6-phosphatase in the serum (P<0.05). In contrast, metformin supplementation significantly lowered glucose, insulin, triglycerides, and low-density lipoprotein levels (P<0.05), while enhancing the activities of hepatic glucokinase, phosphofructokinase-1, and pyruvate kinase (P<0.05). It significantly reduced the activities of PEPCK and G6Pase and downregulated the expression of ir, pi3k, pdk, ampkα1, and gs in fish on high-carbohydrate diets, while metformin supplementation upregulated the expression of ir, pi3k, pdk, ampkα1, and gs genes compared to the T0 group (P<0.05). In terms of microbiota, a high-carbohydrate diet increased pathogenic bacteria like Proteobacteria and Photobacterium, while metformin boosted beneficial bacteria such as Firmicutes and Brevibacillus. Overall, the high-carbohydrate diet impaired growth and insulin sensitivity, while metformin improved glucose metabolism, promoted beneficial bacteria, and supported intestinal health.

Revealing health and socioeconomic realities among individuals with sickle cell trait through case studies from remote areas of India

There is a widespread misperception that sickle cell trait (SCT) is not a major health issue, since people with SCT do not normally exhibit apparent symptoms like those found with sickle cell disease (SCD). Therefore, SCT individuals are often neglected, as SCT is assumed to be a benign condition. However, in the present study, growing evidence has linked SCT to severe health risks. This study aims to comprehensively examine the clinical and socioeconomic aspects of SCT individuals in Koraput district of Odisha, India. A total of 9 individuals with specific, uncommon comorbidities and social issues were selected for a detailed case study during the SCT screening program, which involved 1132 individuals aged 30 years and above from scheduled tribe (ST) and scheduled caste (SC) categories, unrelated up to the 1st cousin. Physiological measurements such as weight, height, blood pressure, fasting blood sugar, and haemoglobin levels were recorded. Mental health and quality of life (QOL) were assessed using the Beck Depression Inventory (BDI) and WHOQOL-BREF tools. In-depth interviews were conducted to explore socioeconomic factors. Case studies revealed various comorbidities and social issues among SCT individuals. These included priapism, anaemia, hypotension, low blood glucose, decreased BMI, reduced SpO2 levels, retinopathy, paralysis, social barriers affecting marriage prospects, diagnosis stigma and depression, neonatal deaths, clinical negligence, consanguineous marriages leading to offspring with SCD. Additionally, the economic burden associated with healthcare expenditures was evident. The study highlights the need for awareness and comprehensive support systems for individuals with SCT, particularly in marginalized communities.

Non‐lethal sonodynamic therapy inhibits high glucose and palmitate‐induced macrophage inflammasome activation through mtROS‐DRP1‐mitophagy pathway

AbstractObesity plays a crucial role in the development and progression of type 2 diabetes mellitus (T2DM) by causing excessive release of free fatty acid from adipose tissue, which in turn leads to systemic infiltration of macrophages. In individuals with T2DM, the infiltration of macrophages into pancreatic islets results in islet inflammation that impairs beta cell function, as evidenced by increased apoptosis and decreased glucose‐stimulated insulin secretion. The present study aimed to investigate the effects of non‐lethal sonodynamic therapy (NL‐SDT) on bone marrow‐derived macrophages (BMDMs) exposed to high glucose and palmitic acid (HG/PA). These findings indicate that NL‐SDT facilitates the expression of DRP1 through the transient production of mitochondrial ROS, which subsequently promotes mitophagy. This mitophagy was shown to limit the activation of the NLRP3 inflammasome and the secretion of IL‐1β in BMDMs exposed to HG/PA. In co‐culture experiments, beta cells exhibited significant dysfunction when interacting with HG/PA‐treated BMDMs. However, this dysfunction was markedly alleviated when the BMDMs had undergone NL‐SDT treatment. Moreover, NL‐SDT was found to lower blood glucose levels and elevate serum insulin concentrations in db/db mice. Furthermore, NL‐SDT effectively reduced the infiltration of F4/80‐positive macrophages and the expression of CASP1 within islets. These findings provide fundamental insights into the mechanisms through which NL‐SDT may serve as a promising approach for the treatment of T2DM.