Management Of Metabolic Diseases Research Articles

A novel deep eutectic solvent-based green extraction and purification of DPP-IV inhibitory peptides from tilapia (Oreochromis niloticus) viscera hydrolysate

The use of green and low-cost techniques to produce bioactive peptides with anti-diabetic properties from protein-rich fish waste is a sustainable way to manage agro-fishery and food industrial waste. This study investigated a novel ultrasound (UL) assisted deep eutectic solvent (DES) based extraction approach to recover bioactive protein-rich extracts from tilapia fish viscera waste under optimized conditions (52.52% ultrasound amplitude, 1:4 DES molar ratio, 25 min extraction time). The aqueous two-phase system (ATPS) method successfully concentrated the crude proteins in the top phase and back-extracted proteins to the bottom phase with a high recovery yield. Hydrolysis by Alcalase produced tilapia viscera protein hydrolysate (TVPH) with low molecular weight (MW) peptides and low dipeptidyl peptidase (DPP)-IV half-maximal inhibitory concentration (IC50) value of 1.57 ±0.16 mg/mL. Notably, TVPH-3 fraction and TVPH-3-2 sub-fraction exhibited appreciable DPP-IV IC50 values of 1.36 ±0.08 mg/mL and 0.42 ±0.01 mg/mL, respectively. Ultrafiltration combined with RP-HPLC enriched the DPP-IV inhibitory concentration of the individual protein fractions. TVPH-3-2 sub-fraction contained hydrophobic amino acids and peptide sequences with typical DPP-IV inhibitory peptide sequence motifs. The results presented in this study indicate that tilapia viscera biomass is a potential source for protein recovery aided with a green extraction approach, and tilapia viscera protein-derived hydrolysates have potential applications as a potent functional food ingredient for the management of metabolic diseases like type-2 diabetes.

The Role of Fecal Microbiota Transplantation (FMT) in the Management of Metabolic Diseases in Humans: A Narrative Review.

The gut microbiota represents a complex ecosystem of trillions of microorganisms residing in the human gastrointestinal tract, which is known to interact with the host physiology and regulate multiple functions. Alterations in gut microbial composition, diversity, and function are referred to as dysbiosis. Dysbiosis has been associated with a variety of chronic diseases, including Clostridioides difficile infections, but also cardiometabolic diseases, including obesity, metabolic syndrome, and type 2 diabetes mellitus (T2DM). The implication of gut microbiota dysbiosis in the pathogenesis of both obesity and T2DM has paved the way to implementing novel therapeutic approaches for metabolic diseases through gut microbial reconfiguration. These interventions include probiotics, prebiotics, and synbiotics, while a more innovative approach has been fecal microbiota transplantation (FMT). FMT is a procedure that delivers healthy human donor stool to another individual through the gastrointestinal tract, aiming to restore gut microbiota balance. Several studies have investigated this approach as a potential tool to mitigate the adverse metabolic effects of gut microbiota aberrations associated with obesity and T2DM. The aim of the present review was to critically summarize the existing evidence regarding the clinical applications of FMT in the management of obesity and T2DM and provide an update on the potential of this method to remodel the entire host microbiota, leading thus to weight loss and sustained metabolic benefits. Safety issues, long-term efficacy, limitations, and pitfalls associated with FMT studies are further discussed, emphasizing the need for further research and standardization in certain methodological aspects in order to optimize metabolic outcomes.

Potential utilization of ferulic acid and its derivatives in the management of metabolic diseases and disorders: An insight into mechanisms

Metabolic diseases are abnormal conditions that impair the normal metabolic process, which involves converting food into energy at a cellular level, and cause difficulties like obesity and diabetes. The study aimed to investigate how ferulic acid (FA) and its derivatives could prevent different metabolic diseases and disorders and to understand the specific molecular mechanisms responsible for their therapeutic effects. Information regarding FA associations with metabolic diseases and disorders was compiled from different scientific search engines, including Science Direct, Wiley Online, PubMed, Scopus, Web of Science, Springer Link, and Google Scholar. This review revealed that FA exerts protective effects against metabolic diseases such as diabetes, diabetic retinopathy, neuropathy, nephropathy, cardiomyopathy, obesity, and diabetic hypertension, with beneficial effects on pancreatic cancer. Findings also indicated that FA improves insulin secretion by increasing Ca2+ influx through the L-type Ca2+ channel, thus aiding in diabetes management. Furthermore, FA regulates the activity of inflammatory cytokines (TNF-α, IL-18, and IL-1β) and antioxidant enzymes (CAT, SOD, and GSH-Px) and reduces oxidative stress and inflammation, which are common features of metabolic diseases. FA also affects various signaling pathways, including the MAPK/NF-κB pathways, which play an important role in the progression of diabetic neuropathy and other metabolic disorders. Additionally, FA regulates apoptosis markers (Bcl-2, Bax, and caspase-3) and exerts its protective effects on cellular destruction. In conclusion, FA and its derivatives may act as potential medications for the management of metabolic diseases.

The Therapeutic Potential of the Specific Intestinal Microbiome (SIM) Diet on Metabolic Diseases.

Exploring the intricate crosstalk between dietary prebiotics and the specific intestinal microbiome (SIM) is intriguing in explaining the mechanisms of current successful dietary interventions, including the Mediterranean diet and high-fiber diet. This knowledge forms a robust basis for developing a new natural food therapy. The SIM diet can be measured and evaluated to establish a reliable basis for the management of metabolic diseases, such as diabetes, metabolic (dysfunction)-associated fatty liver disease (MAFLD), obesity, and metabolic cardiovascular disease. This review aims to delve into the existing body of research to shed light on the promising developments of possible dietary prebiotics in this field and explore the implications for clinical practice. The exciting part is the crosstalk of diet, microbiota, and gut-organ interactions facilitated by producing short-chain fatty acids, bile acids, and subsequent metabolite production. These metabolic-related microorganisms include Butyricicoccus, Akkermansia, and Phascolarctobacterium. The SIM diet, rather than supplementation, holds the promise of significant health consequences via the prolonged reaction with the gut microbiome. Most importantly, the literature consistently reports no adverse effects, providing a strong foundation for the safety of this dietary therapy.

Does glucose-dependent insulinotropic polypeptide receptor blockade as well as agonism have a role to play in management of obesity and diabetes?

Recent approval of the dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, tirzepatide, for the management of type 2 diabetes mellitus (T2DM) has reinvigorated interest in exploitation of GIP receptor (GIPR) pathways as a means of metabolic disease management. However, debate has long surrounded the use of the GIPR as a therapeutic target and whether agonism or antagonism is of most benefit in management of obesity/diabetes. This controversy appears to be partly resolved by the success of tirzepatide. However, emerging studies indicate that prolonged GIPR agonism may desensitise the GIPR to essentially induce receptor antagonism, with this phenomenon suggested to be more pronounced in the human than rodent setting. Thus, deliberation continues to rage in relation to benefits of GIPR agonism vs antagonism. That said, as with GIPR agonism, it is clear that the metabolic advantages of sustained GIPR antagonism in obesity and obesity-driven forms of diabetes can be enhanced by concurrent GLP-1 receptor (GLP-1R) activation. This narrative review discusses various approaches of pharmacological GIPR antagonism including small molecule, peptide, monoclonal antibody and peptide-antibody conjugates, indicating stage of development and significance to the field. Taken together, there is little doubt that interesting times lie ahead for GIPR agonism and antagonism, either alone or when combined with GLP-1R agonists, as a therapeutic intervention for the management of obesity and associated metabolic disease.

NPYR modulation: Potential for the next major advance in obesity and type 2 diabetes management?

The approval of the glucagon-like peptide 1 (GLP-1) mimetics semaglutide and liraglutide for management of obesity, independent of type 2 diabetes (T2DM), has initiated a resurgence of interest in gut-hormone derived peptide therapies for the management of metabolic diseases, but side-effect profile is a concern for these medicines. However, the recent approval of tirzepatide for obesity and T2DM, a glucose-dependent insulinotropic polypeptide (GIP), GLP-1 receptor co-agonist peptide therapy, may provide a somewhat more tolerable option. Despite this, an increasing number of non-incretin alternative peptides are in development for obesity, and it stands to reason that other hormones will take to the limelight in the coming years, such as peptides from the neuropeptide Y family. This narrative review outlines the therapeutic promise of the neuropeptide Y family of peptides, comprising of the 36 amino acid polypeptides neuropeptide Y (NPY), peptide tyrosine-tyrosine (PYY) and pancreatic polypeptide (PP), as well as their derivatives. This family of peptides exerts a number of metabolically relevant effects such as appetite regulation and can influence pancreatic beta-cell survival. Although some of these actions still require full translation to the human setting, potential therapeutic application in obesity and type 2 diabetes is conceivable. However, like GLP-1 and GIP, the endogenous NPY, PYY and PP peptide forms are subject to rapid in vivo degradation and inactivation by the serine peptidase, dipeptidyl-peptidase 4 (DPP-4), and hence require structural modification to prolong circulating half-life. Numerous protective modification strategies are discussed in this regard herein, alongside related impact on biological activity profile and therapeutic promise.

Nesfatin-1 and nesfatin-1-like peptide attenuate hepatocyte lipid accumulation and nucleobindin-1 disruption modulates lipid metabolic pathways.

Nesfatin-1 (NESF-1) has been shown to modulate lipid metabolism. We have identified a nesfatin-1-like-peptide (NLP) processed from a related precursor nucleobindin 1 (NUCB1). Here we determined if NLP, like NESF-1, regulates lipid accumulation in vitro, and tested if the disruption ofnucb1 gene affects hepatic lipid metabolism genes in mice. Hepatocytes (HepG2/C3A cells) express NLP and NESF-1 and both peptides significantly reduced lipogenic enzyme mRNAs and enhanced beta-oxidation enzyme mRNAs. Lipid contents in oleic acid induced HepG2/C3A cells were attenuated by NESF-1 and NLP. The inhibitory effect on cellular lipid content was blocked by compound C, an inhibitor of AMPK. The disruption of nucb1 gene affected lipid metabolism-related enzyme mRNAs, endogenous nucb2 mRNA and AMPK phosphorylation. The lipid-lowering effects identified here highlights the potential of nucleobindins and peptides processed from them to address lipid disorders, and its possible benefits in metabolic disease management.

Phytochemicals, Herbal Extracts, and Dietary Supplements for Metabolic Disease Management.

Comprehensive and effective care techniques have become essential due to the global epidemic dimensions of metabolic disorders, including diabetes, obesity, and cardiovascular ailments. Recent research highlights the potential of dietary supplements, herbal extracts, and phytochemicals in treating metabolic diseases. This abstract conveys the current state of the science in this field by highlighting these findings' underlying mechanisms and potential therapeutic applications. Plant-based diets contain naturally occurring bioactive molecules termed phytochemicals, which have shown promise in treating various metabolic illnesses. Examples include curcumin, flavonoids, and polyphenols' insulin-sensitizing, antioxidant, and antiinflammatory properties. Herbal extracts, derived from ancient medicinal herbs, have been used by people for years to treat a wide range of ailments. Recent studies have shown the efficacy of these strategies in improving lipid profiles, glucose metabolism, and overall cardiovascular health. Omega-3 fatty acids, vitamins, and minerals are just a few of the numerous nutritional supplements that are critical to metabolic health. These vitamins improve insulin sensitivity, regulate blood sugar, and decrease inflammation. Probiotics and prebiotics also affect the gut flora, which significantly affects metabolic function. These natural medicines' ability to treat metabolic diseases either by themselves or in combination with conventional medical interventions. However, when using it therapeutically, one must consider the differences in doses, individual responses, and bioavailability. The article concludes that phytochemicals, plant extracts, and food supplements offer a promising avenue for the management of metabolic illnesses. Comprehensive research, including clinical studies, is needed to ascertain their safety and efficacy characteristics. When added to treatment strategies, these natural therapies could be helpful supplements that improve overall health and the quality of life among individuals with metabolic diseases. Naringenin, a citrus flavonoid, can potentially prevent kidney injury in hyperuricemia by reducing uric acid, inflammation, apoptosis, DNA damage, and activating antioxidants. Further research and professional consultation are essential. Factors contributing to metabolic diseases, current approaches to management nutritional approaches for managing obesityassociated metabolic impairments in the liver and small intestine, and nutritional approaches for managing obesity-associated metabolic dysregulation are also explained briefly.

Effects of hydroethanolic garlic extract on oxidative stress, lipolysis, and glycogenesis in high-fat diet-fed Drosophila melanogaster

Introduction: Metabolic syndrome is multifaceted health condition associated with metabolism, which leads to the accumulation of oxidation products and impairment of the antioxidant system. Medicinal, edible plant alternatives are being sought to prevent the predisposing factors of metabolic syndrome, one of which is obesity. We studied the effects of hydroethanolic garlic extract (HGE) on oxidative stress, lipolysis, and glycogenesis in high-fat diet-fed Drosophila melanogaster. Methods: The HGE was processed and antioxidant assays (in vitro and in vivo) coupled with metabolic biomarkers were assayed following standard procedures. Results: HGE inhibited ABTS (2,2’-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid), hydroxyl, and hydrogen peroxide radicals in high-fat-fed D. melanogaster. The HGE also reduced the activity of superoxide dismutase and increased catalase activity significantly. The HGE promoted lipolysis and glycogenesis by reducing cholesterol, triglycerides, and total sugar concentrations while glycogen content was increased. Conclusion: Our results revealed that HGE improved the antioxidant defense system and promoted lipolysis and glycogenesis in metabolic deranged D. melanogaster. This suggests the therapeutic usefulness of garlic in the management of metabolic diseases.

Methanolic Extract of Ricinus Communis ameliorated cardiovascular dysfunction in dichlorvos-exposed rats.

Cardiovascular diseases are the leading causes of death globally resulting in 17-19 million death every year. The search for an effective medicine to manage cardiovascular disorder without any side effect has led to the use of traditional based medicine. 75% of the world's population has been reported to depend on traditional medicine as their basic form of health care and this has resulted to the use of herbal medicine in the treatment and management of metabolic diseases. The study evaluated the effect of methanolic extract of Ricinus communis on DDVP-induced cardiotoxicity in male Wistar rats. Thirty-two (32) male Wistar rats were randomly divided into four groups of eight (8) rats each. Group A served as control rats, received 10mL/Kg of dimethyl sulfoxide (DMSO) and distilled water solution (vehicle) for six weeks. Group B served as DDVP-induced rats and were exposed to DDVP (15 minutes daily) for 3 weeks without any treatment. Group C rats received DDVP as in group B and then administered 300mg/kg of R. communis extract for 42days. While Group D rats were administered 300mg/kg of R. communis extract daily, for 6 weeks in addition to normal feed and water. Exposure to DDVP caused significant cardiac dysfunction evidence by alteration in cardiovascular variables and electrocardiac function, compromised lipid profile and reduced antioxidant enzymes. However, treatment with methanolic extract of Ricinus communis improved antioxidant defense system, attenuate hemodynamic impairment and left ventricular dysfunction, as well as inhibit lipid peroxidation and prevent hyperlipidemia in rats. In addition, histopathology observation showed that Ricinus communis extract was able to regenerate the myocardial injury caused by exposure to dichlorvos. In conclusion, Ricinus communis exhibited cardioprotective properties and may be a potential remedy for cardiovascular diseases with low risk of toxicity.

Long-Term Management of Patients with Mild Urea Cycle Disorders Identified through the Newborn Screening: An Expert Opinion for Clinical Practice.

Urea cycle disorders (UCDs) are a group of rare inborn errors of metabolism caused by a deficiency in one of the six enzymes or one of the two transporters involved in the urea cycle. Current guidelines suggest that early diagnosis and treatment of mild UCDs may improve survival and prevent decompensation and neurocognitive impairment. Nevertheless, clinical studies are very difficult to carry out in this setting due to the rarity of the diseases, and high-level evidence is scant and insufficient to draw conclusions and provide clinical guidelines. With the early introduction of newborn screening, the Italian healthcare organization fostered an advancement in expertise in metabolic disease management and screening programs, by allocating resources, and favoring the expansion of newborn screening. A group of experts operating in Italian centers decided to share their experience and provide advice for the management of mild UCDs in clinical practice. A consensus was reached by the Estimate-Talk-Estimate (ETE) method. Five items were identified, and statements for each item were agreed. Briefly, the panel advised completing the diagnosis by expanded newborn screening (ENS) with biochemical and genetic confirmation and by following up with the patient during the first year of life, with a routine laboratory and metabolic profile as well as with clinical observation. Early initiation of therapy is advised and should be followed by therapy adjustment once the diagnostic profile is completed. The therapy should be based on a low-protein diet and nitrogen scavengers. The long-term follow-up is based on growth and nutritional assessment, clinical and neurocognitive evaluation, and laboratory and instrumental parameter monitoring.

SAT447 Gaps In Care: Endocrine-disrupting Chemicals And Metabolic Disease Management Guidelines

Abstract Disclosure: M. Obeid: None. A. Majid: None. R.M. Sargis: None. In recent decades, global rates of obesity, diabetes, and non-alcoholic fatty liver disease have increased substantially, imposing significant morbidity and mortality on patients and severe economic strain on healthcare systems. Discussions of modifiable risk factors responsible for metabolic dysfunction have classically centered upon the role of excess energy intake and insufficient energy expenditure. Consequently, clinical practice guidelines have largely focused upon these factors when addressing disease risk and treatment. In recent years, however, new metabolic risk factors have emerged, including exposure to endocrine-disrupting chemicals (EDCs). Because exposure to EDCs is potentially modifiable through individual action and/or public policy, we sought to understand how practice guidelines for metabolic disorders have incorporated this new knowledge into clinical care. To accomplish this, we searched PubMed for the years 2007 to 2022 for European, Asian, and American clinical practice guidelines related to obesity, diabetes, non-alcoholic fatty, dyslipidemia, chronic kidney disease, and cardiovascular disease. Each guideline was then searched by two reviewers for 83 terms related to environmental factors linked to metabolic dysfunction. Environment-related statements were then adjudicated by three reviewers for relevance. Select guidelines for non-metabolic disorders linked to environmental factors were similarly reviewed for comparison, including asthma, chronic obstructive pulmonary disease (COPD), and obstetrics/gynecology guidelines. In total, 68 guidelines and statements were systematically reviewed. While environmental risk reduction was partially addressed in COPD, asthma, and cardiovascular guidelines, those focused on obesity, diabetes, and non-alcoholic fatty liver disease did not address the contribution of EDCs or other ambient environmental factors. Across all guidelines only air pollution received substantive attention, leaving other EDCs nearly entirely neglected. A clear but inadequately considered component of the social and structural determinants of health, environmental exposures have emerged as modifiable risk factors for multiple metabolic disorders. While further work is needed, future clinical practice guidelines should incorporate clinical interventions, research initiatives, and policy recommendations to address the impact of poor environments on human metabolic health. Presentation: Saturday, June 17, 2023

Anti-Dyslipidemic and Anti-Diabetic Properties of Corosolic Acid: A Narrative Review

Corosolic acid (CA), a natural compound derived from the Banaba tree (Lagerstroemia speciosa), has attracted attention for its potential therapeutic properties in the management of metabolic diseases. This narrative review aims to summarize the current evidence on the anti-dyslipidemic, anti-diabetic, and anti-inflammatory effects of CA and to understand the pharmacokinetics and molecular mechanisms through the analysis of preclinical and clinical studies.

Relationship between Perceived Stress, Obesity, and Hypertension in Korean Adults and Older Adults.

Perceived stress has a significant effect on metabolic diseases, including obesity and hypertension. However, the association between stress levels, obesity, and hypertension according to age and sex is not fully understood. Therefore, this study investigated the relationship between stress levels and obesity and hypertension in Korean adults and older adults. We analyzed data from the 2015 survey of the Korea National Physical Fitness Project conducted by the Korea Institute of Sports Science and the Korea Ministry of Culture, Sports, and Tourism. Of the 3457 participants, 2829 were adults (20-64 years old) and 628 were older adults (≥65 years old). The correlation between obesity and hypertension according to the degree of perceived stress (low, medium, and high) was analyzed using the chi-square test. Binary logistic regression analysis was used to investigate the influence of perceived stress levels on obesity and hypertension. Age, body mass index (BMI), blood pressure, exercise frequency, smoking, breakfast, and sleeping hours were included as covariates. In adult males, perceived stress levels, age, and diastolic blood pressure were found to have a significant impact on obesity rates, whereas age and breakfast had a significant effect on hypertension rates. In adult females, age and systolic blood pressure were found to significantly influence obesity rates, whereas age, BMI, and exercise frequency had a significant impact on hypertension rates. In older adult females, perceived stress levels and systolic blood pressure were found to significantly impact obesity rates, and sleep duration influenced the rates of hypertension. The effect of perceived stress level on obesity and hypertension rates was less pronounced in the elderly population than in the adult population. This study revealed age and sex differences in the relationship between perceived stress, obesity, and hypertension among Koreans. These findings contribute to a better understanding of the complex relationship between perceived stress and metabolic disorders and emphasize the need for a deeper understanding of the specific factors involved in the prevention and management of metabolic diseases.

Exploring the Barriers and Enablers to Implementing a 16-Week Low-Carbohydrate Diet for Patients With Diabetic Cardiomyopathy.

Cardiac dysfunction in patients with diabetes, referred to as diabetic cardiomyopathy, is primarily precipitated by dysregulations in glucose and lipid metabolism. Diet and lifestyle changes are considered crucial for successful heart failure and diabetes management and are often difficult to achieve. Low-carbohydrate diets (LCDs) have gained popularity for the management of metabolic diseases. Although quantitative research in this field is evolving, little is known about the personal experience of patients with diabetic cardiomyopathy on specific diets. The aim of this qualitative study was to identify enablers and barriers of patients with diabetic cardiomyopathy who engage in an LCD. It further explored patients' perception of dietary education and dietary support received while in hospital. Participants who previously consented to a 16-week LCD trial were invited to share their experiences. Nine patients agreed to be interviewed. Semistructured interviews and a focus group interview were conducted, which were transcribed verbatim. Data were analyzed by using the 6-step approach for thematic analysis. Four themes were identified: (1) nutrition literacy (2) disease-related health benefits, (3) balancing commitments, and (4) availability of resources and support. Improvements in disease-related symptoms acted as strong enablers to engage in an LCD. Barriers such as access to resources and time constraints were identified. These challenges may be overcome with efficient communication and ongoing dietary support. More research exploring the experience of patients with diabetic cardiomyopathy on an LCD are warranted.

Abstract #1406876: Use of Continuous Glucose Monitoring in Conjunction with the GluCare Health Care Model in Patients with Prediabetes

Prediabetes is a state which increases the risk of type 2 diabetes. Continuous Glucose Monitoring (CGM) provides data for glycaemic variability (GV) as a coefficient of variation (CV). GluCare Health is a hybrid, data-driven approach in the management of metabolic diseases and combines in-clinic treatment with Continuous Metabolic Monitoring (CMM) through wearables, so patients are in continuous contact with their care team in the cloud. This team consists of physicians, educators, nurses, dietitians, and coaches, and provides real-time support when the patient needs it most, not just during their clinical visits. Patients were also encouraged to log their meals via a picture using a connected app. Previous studies have shown improvement in models utilizing digital biomarker tracking in chronic diseases as diabetes and obesity and GluCare Health showed a relevant reduction in HbA1C in a population with diabetes in 2021. All patients visited a GluCare Center located in Dubai, UAE at the initial visit and were tested for HbA1C, fasting blood glucose (FBG) and provided with CGMs and other wearables. We retrospectively evaluated patients with prediabetes between 18-65 ages who wore CGMs for at least 2 weeks and compared the GV between the first and second weeks. All patients received feedback via a cause-and-effect approach primarily on nutritional choices which included advice from the team regarding glucose patterns-peaks and how to manage them. Change in glycaemic variability according to CGM device and gender is also evaluated. 26 patients who wore CGM were evaluated.10 patients were female and 16 patients were male. The mean age was 45.6. Mean HbA1C was 5.5%. Mean FBG was 103mg/dL (89-110),15 patients wore DEXCOM G6 and 11 patients wore Freestyle Libre. In the whole group, mean CV was 15.7% in the first week and 13.97% in the second week. There was a significant improvement in GV in the whole group (p< 0.01). CV decreased from 17.07% to 14.77% in DEXCOM G6 group which was statistically significant (p= 0.03) and 13.84% to 12.90% in Freestyle Libre group which could not reach significance (p= 0.06). CV significantly decreased from 15.16% to 13.59% in females (p=0.01) and from 15.74% to 14.0% (p= 0.06) in males which could not reach significance. This study showed GV can be improved in patients with prediabetes who used CGM devices along with the GluCare Health’s CMM. A continuous model of monitoring along with increased engagement in conjunction with CGM use, can be a better approach to tackling prediabetes, prevent progression to diabetes and improve glucose hemostasis, in comparison to episodic or usual care.

3D Printed Hydrogel Microneedle Arrays for Interstitial Fluid Biomarker Extraction and Colorimetric Detection

To treat and manage chronic diseases, it is necessary to continuously monitor relevant biomarkers and modify treatment as the disease state changes. Compared to other bodily fluids, interstitial skin fluid (ISF) is a good choice for identifying biomarkers because it has a molecular composition most similar to blood plasma. Herein, a microneedle array (MNA) is presented to extract ISF painlessly and bloodlessly. The MNA is made of crosslinked poly(ethylene glycol) diacrylate (PEGDA), and an optimal balance of mechanical properties and absorption capability is suggested. Besides, the effect of needles' cross-section shape on skin penetration is studied. The MNA is integrated with a multiplexed sensor that provides a color change in a biomarker concentration-dependent manner based on the relevant reactions for colorimetric detection of pH and glucose biomarkers. The developed device enables diagnosis by visual inspection or quantitative red, green, and blue (RGB) analysis. The outcomes of this study show that MNA can successfully identify biomarkers in interstitial skin fluid in a matter of minutes. The home-based long-term monitoring and management of metabolic diseases will benefit from such practical and self-administrable biomarker detection.

Preparation and nutritional characterisation of protein concentrate prepared from foxtail millet (Setaria italica).

Plant-based protein sources as a sustainable alternative to animal sources are highly relevant for food and dietary supplements industries. Plant proteins are becoming popular as an eco-friendly source for meeting global protein requirements due to their importance in nutrition, management of metabolic diseases, biological activities, functionality in processed food products and their low carbon footprints. We applied biochemical protein extraction protocol and prepared protein concentrate from an underutilised cereal, foxtail millet, with plausible applications in foods and supplements. Herein efforts were utilised to obtain foxtail millet protein (FMP) concentrate by means of standardisation of processes of extraction cum isolation. The conditions including flour to solvent ratio, extraction-precipitation pH, dissolution time, etc. were optimised to significantly improve protein yield and recovery. The FMP concentrate prepared was also analysed for nutritional composition, bioactive compounds, amino acid content and digestion properties in comparison to packaged brown rice protein concentrate. The protein concentrate prepared was found to have high digestibility, rich in essential amino acids with good phenolic and flavonoid content, thereby making it a potential sensory and antioxidant additive for food/pharmaceutical applications.

Deoxyschizandrin ameliorates obesity and non-alcoholic fatty liver disease: Involvement of dual Farnesyl X receptor/G protein-coupled bile acid receptor 1 activation and leptin sensitization.

Natural dual farnesyl X receptor (FXR)/G protein-coupled bile acid receptor 1 (TGR5) activators have received little attention in the management of metabolic diseases. Deoxyschizandrin (DS), a natural lignan, occurs in S. chinensis fruit and has potent hepatoprotective effects, whereas its protective roles and mechanisms against obesity and non-alcoholic fatty liver disease (NAFLD) are largely elusive. Here, we identified DS as a dual FXR/TGR5 agonist using luciferase reporter and cyclic adenosine monophosphate(cAMP) assays. DS was orally or intracerebroventricularly administrated to high-fat diet-induced obesity (DIO) mice, and methionine and choline-deficient L-amino acid diet (MCD diet)-induced non-alcoholic steatohepatitis to evaluate its protective effects. Exogenous leptin treatment was employed to investigate the sensitization effect of DS on leptin. The molecular mechanism of DS was explored by Western blot, quantitative real-time PCR analysis, and ELISA. The results showed that DS activated FXR/TGR5 signaling and effectively reduced NAFLD in DIO and MCD diet-fed mice. DS countered obesity in DIO mice by promoting anorexia and energy expenditure and reversing leptin resistance, involving both peripheral and central TGR5 activation and leptin sensitization. Our findings indicate that DS may be a novel therapeutic approach for alleviating obesity and NAFLD through regulating FXR and TGR5 activities and leptin signaling.

Culinary Counselling in Chronic Care: The Pentad of Cs & Ps.

Diet and nutrition are an integral part of chronic metabolic disease management. Medical nutrition therapy (MNT) providers focus upon caloric and nutrient adequacy, but do not necessarily incorporate person-friendly recipes in their ambit. In this communication, we share a simple framework of culinary counseling. This supplements MNT, and enhances its value by encouraging adherence and persistence to prescribed therapy.