Non-diabetic Control Group Research Articles

Duplex ultrasound derived maximal systolic acceleration can be a reliable and rapid alternative to ankle brachial pressure indices for the diabetic population with lower extremity arterial disease; a prospective, observational cohort study.

Objectives: Ankle brachial pressure index (ABPI) is limited for diabetic patients. This can have costly impacts upon patient's quality of life along with healthcare budgets, with diabetic care equating to approximately 10% of NHS expenditure.11 We aimed to determine whether ultrasound waveform parameters are an alternative for quantifying lower extremity peripheral arterial disease (PAD) where ABPI is unreliable. Design: This was a prospective, observational study. Waveform parameters, systolic rise time (SRT), maximal systolic acceleration (AccMax) and peak systolic velocity (PSV) were recorded at ankle and compared to the ABPI and an aorta-ankle duplex ultrasound scan (DUS) as gold standard. Setting: Measurements were obtained by a Clinical Vascular Scientist at the Royal Free Hospital. Participants: Participants (≥18yrs) with known PAD, but without previous vascular intervention were allocated to non-diabetic control (n = 24) and diabetic test groups (n = 22). Outcome measures: The primary outcome measure was the correlation of novel ultrasound derived indices to PAD severity. The secondary outcome was the efficacy of this correlation in the diabetic population. Results: AccMax was most powerful in detecting PAD in both groups when compared to ABPI in the controls (r = 0.805; p < 0.01) and to DUS in control and test groups (r = −0.633 to −0.643; p < 0.01). In the test group, PSV did not consistently quantify PAD. SRT measurements were inconclusive throughout. Conclusion: AccMax is a rapid alternative tool for diagnosing PAD in diabetic patients. With further research, this simple test may prove useful for monitoring PAD progression in patients unsuitable for ABPI, reducing the need for lengthy repeat duplex scans.

Association of genetic polymorphism in Vitamin D receptor and Paraoxonase I genes with type II diabetes mellitus patients in rural South Western Maharashtra

Background: Type II diabetes mellitus (T2DM) is increasing at an alarming rate in urban as well as rural parts of India. Change in life-style, dietary habits, aging, environmental factors contribute to developing this disorder, T2DM is a polygenic disorder which involves large number of genes interacting with each other and the environment to manifest itself phenotypically. Aims and Objectives: In the present study, we investigated the association of Vitamin D receptor (VDR) and Paraoxonase I (PON I) gene polymorphisms with T2DM patients among rural population in South western Maharashtra. Materials and Methods: The study groups included healthy non-diabetic control group (n = 120), non-obese diabetic group (n = 120), obese diabetic group (n = 120) from the same geographical region. The single nucleotide polymorphisms (SNPs) amongst these groups were studied using Polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) for VDR and PON I genes. Results and Conclusion: Amongst the studied genes VDR SNP rs1544410 [OR 0.24 (0.1-0.63); P 0.005] and Paraoxonase I SNP rs854560 (OR 0.47 (0.26-0.84); P 0.015) had a protective effect against T2DM for non-obese individuals. Whereas only VDR SNP rs1544410 [OR 0.025 (0.003-0.91); P 0.001] had a protective effect in case of obese individuals. The findings suggest greater gene-gene interaction and gene-environment interactions influence the phenotypic outcomes of genetic polymorphisms.

Insulin Resistance in Type II Diabetes Mellitus Patients and Their First Degree Relatives- An Observational Study

Type II diabetes (T2DM) is caused by environmental, genetic, metabolic, and unknown variables. In diabetics, insulin resistance is the most of prolonged hyperglycemia. T2DM is induced by insulin resistance and cell dysfunction. The interaction of genetics and environment further complicates T2DM development. Insulin resistance and beta cell dysfunction are two of the most common Type 2 Diabetes Mellitus symptoms. A vicious triangle of cell failure (80% cell function) and insulin resistance in the muscles and liver causes major physiological issues. A group of diabetes patients (Group I), non-diabetic first-degree relatives of diabetic patients (Group II), and a non-diabetic healthy control group (Group III) were studied. The diabetes patients had the greatest systolic and diastolic blood pressures, followed by first degree relatives and healthy controls. We found that people with diabetes had higher fasting (FBS) and postprandial sugar, glycated haemoglobin (HbA1c) than diabetic offsprings and control group. Moreover, fasting insulin levels are higher in first degree relatives than in diabetes patients in the control group. The HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) levels of diabetics and their progeny do not differ much. The HOMA-IR measures insulin resistance severity. Common reference levels for HOMA-IR insulin resistance range from 0.7 - 2. Insulin resistance in diabetics and their first-degree relatives is evident from the results.

Urinary NGAL is a Potential Biomarker for Early Renal Injury in Insulin Resistant Obese Non-diabetic Children

Objective:Neutrophil gelatinase-associated lipocalin (NGAL) is one of the new biomarkers for detecting acute renal injury. There are studies showing the relationship between NGAL and renal injury in obese children. The aim of this study was to investigate whether urinary levels of NGAL, kidney injury molecule-1, and serum cystatin C are increased in insulin resistance (IR) patients before the development of diabetes.Methods:Cross-sectional, case-controlled study that included non-diabetic obese children and adolescent patients with IR and a non-diabetic obese control group with no IR, who attended a tertiary center pediatric endocrinology outpatient clinic between 2016-2018. Those with diabetes mellitus and/or known renal disease were excluded. NGAL and creatinine (Cr) levels were evaluated in the morning spot urine from all participants. Serum renal function was evaluated.Results:Thirty-six control and 63 IR patients were included in the study, of whom 68 (68.7%) were girls. The mean age of all participants was 13.12±2.64 years and no statistically significant difference was found between the two groups in terms of age or gender distribution. Median (range) spot urinary NGAL (u-NGAL) values in the IR group were significantly higher at 26.35 (7.01-108.7) ng/mL than in the control group at 19.5 (3.45-88.14) ng/mL (p=0.018). NGAL/Cr ratio was also significantly higher in the IR group compared to the control group (p=0.018).Conclusion:Obese pediatric patients with IR were shown to have elevated levels of u-NGAL, a marker of renal injury. u-NGAL examination may show early renal injury before development of diabetes.

Clinical assessment of endovenous thermal ablation combined with concomitant phlebectomy for the treatment of lower limb varicose veins with or without poor glycemic control

BackgroundThis study aimed to investigate the clinical results of endovenous thermal ablation combined with stab phlebectomy for unilateral varicose veins based on diabetic management. MethodsThe study reviewed 501 patients who underwent endovenous thermal ablation combined with stab phlebectomy for unilateral varicose veins, including 337 nondiabetics (control group) and 164 diabetics. Diabetics with hemoglobin A1c ≥7% were classified as the poor glycemic control group, and hemoglobin A1c <7% as the good glycemic control group. Surgical outcomes were assessed by Venous Clinical Severity Score. The Chronic Venous disease quality of life Questionnaire was used to assess the quality of life. ResultsLower limb varicose veins can be treated successfully with endovenous thermal ablation combined with stab phlebectomy in patients with or without poor glycemic control, accompanied by a significant improvement in health status. For patients with initial varicose veins (preoperative Venous Clinical Severity Score <10), the results revealed satisfactory improvements in Venous Clinical Severity Score and quality of life among the control, poor glycemic control, and good glycemic control groups. Patients with advanced varicose veins (preoperative Venous Clinical Severity Score ≥10) also showed an obvious amelioration concerning venous symptoms and quality of life. However, the extent of improvement varied among the 3 groups. Patients subjected to advanced varicose veins with the condition of poor glycemic control exhibited a less desirable improvement in postoperative health conditions compared with the control and good glycemic control groups, especially in edema relief and ulcer healing. ConclusionEndovenous thermal ablation combined with stab phlebectomy is safe and effective in the treatment of varicose veins with or without poor glycemic control. Clinical attempts at hemoglobin A1c management may contribute to improved clinical outcomes in patients with advanced varicose veins.

The Effect of Gembili Starch (Dioscorea esculenta) and Eubacterium rectal Supplementation on Skeletal Muscle Peroxisome Proliferator-Activated Receptor γ Coactivator 1α (Pgc-1α) Expression in Diabetic Mice Models

BACKGROUND: Gembili or Dioscorea esculenta is a local food that is produced by several areas in Indonesia. Few studies have reported its health benefits for diabetes mellitus but a little is understood about its mechanism of action. PGC-1α is a transcriptional coactivator for genes that involved in energy metabolism and increased expression of this gene has previously been associated with improved insulin sensitivity. AIM: The objective of this study was to investigate the effect of Gembili starch and Gembili starch with butirogenic bacteria Eubacterium rectal on PGC-1α expression in skeletal muscle of diabetic mice. MATERIALS AND METHODS: Three months old male diabetic Wistar mice were divided into groups based on dietary supplement: Gembili starch only; Gembili starch with E. rectal; and E. rectal only. Positive (diabetic mice) and negative (non-diabetic) control groups were used in this study. After 4 weeks of supplementation, mice were sacrificed and muscle tissue was taken from musculus vastus latissimus. Plasma blood glucose was measured before and after intervention. PGC-1α expression was measured with immunohistochemistry and quantified by dividing cells that produce PGC-1α with total cells. RESULTS: Plasma blood glucose was reduced after invention in group that received Gembili starch only (p &lt; 0.001); Gembili starch with E. rectal (p &lt; 0.001); and E. rectal only (p &lt; 0.001). The protein expression of PGC-1α in diabetic mice receiving Gembili starch only was significantly higher compared to control (p &lt; 0.05). CONCLUSION: This study shown that Gembili starch supplementation was able to improve glucose control in diabetic mice and this effect was obtained perhaps through PGC-1α activation. Further study is needed to investigate the effect of Gembili starch supplementation on fat metabolism.

Antidiabetic and Antioxidant Activities of the Twigs of Andrograhis paniculata on Streptozotocin-Induced Diabetic Male Rats

Background: Diabetes is associated with chronic hyperglycaemia, long-term damage, dysfunction, and organ failure. This study aims to evaluate the antidiabetic activity of the twigs of Andrographis paniculata and its toxicological markers on Streptozotocin (STZ)-induced diabetic Albino rats. Methods: A total of thirty rats were randomly divided into five groups of six animals each. Non-diabetic animals were treated with distilled water as non-diabetic sham control group 1, while diabetic animals (group 2, 3, 4 and 5) were treated with 60 mg/kg bw STZ intravenous (iv) and 100 mg/kg body weight (bwt) of metformin orally for group 2, distilled water for group 3, and 250 and 500 mg/kg bwt of Andrograhis paniculata (A. paniculata) for groups 4 and 5, respectively. The animals were dosed for 28 days, after which they were sacrificed. Liver and kidney function tests as well as livid profile tests were used as the biomarkers of toxicological assessment. Fasting blood glucose was carried out weekly. Oral Glucose Tolerance Test (OGTT) was conducted on the 28th day of the antidiabetic assessment. Results: A. paniculata groups 4 and 5 were significant at different doses (p &lt; 0.05) in reducing the blood glucose level in comparison with metformin. There were significant changes in total and direct bilirubin, total protein, potassium, triglyceride and inorganic phosphorus in 500 mg/kg bwt of the treated group in comparison with the metformin and diabetic group groups. A. paniculata at 500 mg/kg bwt is most effective for its antidiabetic and organ protecting effects.

Altered Prevalence of Pulp Diagnoses in Diabetes Mellitus Patients: A Retrospective Study

IntroductionDiabetes mellitus (DM) is a complex multisystemic disorder that affects an estimated 21 million Americans. No studies have evaluated the association of DM with the prevalence of each pulpal diagnosis. The objective of this study was to compare the prevalence of each pulp diagnosis including symptomatic irreversible pulpitis (SIP), asymptomatic irreversible pulpitis, reversible pulpitis, normal pulp, and pulp necrosis (PN) in DM patients against a nondiabetic control group. MethodsA retrospective chart review was approved by Rutgers University Institutional Review Board. The prevalence of the diagnoses SIP, asymptomatic irreversible pulpitis, reversible pulpitis, normal pulp, and PN was calculated from AxiUm (Exan software, Las Vegas, NV) electronic health records at Rutgers School of Dental Medicine. The chi-square test was used to see the relationship between the 2 categoric variables. Second, binary logistic regression analyses were performed for each group. ResultsA total of 2979 teeth were diagnosed with a pulp condition between April 2013 and November 2018. The total tooth number of DM patients was 682, whereas the tooth number of nondiabetic patients was 2297. In the subgroup of patients younger than 40 years old, SIP was notably more prevalent in DM patients. In addition, the prevalence of PN in elderly DM patients (60–69 years old) was significantly higher than in the control group. ConclusionsThe prevalence of SIP in DM patients was significantly higher compared with the control group (<40 years old), suggesting the possibility that DM could hypersensitize the subgroup of patients younger than 40 years old to pulpitis pain.

The effect of gestational diabetes on the expression of mitochondrial fusion proteins in placental tissue.

Gestational diabetes mellitus (GDM) poses a risk factor for fetal mortality and morbidity by directly affecting the placenta and fetus. Mitochondria are dynamic organelles that play a key role in energy production and conversion in placental tissue. Mitochondrial fusion and fission proteins are important in terms of providing mitochondrial dynamics, the adaptation of the cell to different conditions, and maintaining the metabolic stability of the cells. Although GDM shares many features with Type 2 diabetes mellitus (T2DM), different effects of these conditions on the mother and the child suggest that GDM may have specific pathological effects on placental cells. The aim of this study is to investigate the expression of mitochondrial dynamics, and mitochondrial protein folding markers in placentas from GDM patients and women with pre-existing diabetes mellitus. Placentas were properly collected from women, who had pre-existing diabetes (Pre-DM), from women with gestational diabetes mellitus (GDM) and from healthy (non-diabetic) pregnant women. Levels of mitochondrial fusion markers were determined in these placentas by real time quantitative PCR and Western blot experiments. mRNA expressions and protein levels of mitochondrial fusion markers, mitofusin 1, mitofusin 2 (MFN1 and MFN2) and optical atrophy 1 (OPA1) proteins were found to be significantly lower in both Pre-DM placentas and those with GDM compared to healthy (non-diabetic) control group. Likewise, proteins involved in mitochondrial protein folding were also found to be significantly reduced compared to control group. Diabetes during pregnancy leads to processes that correlate with mitochondria dysfunction in placenta. Our results showed that mitochondrial fusion markers significantly decrease in placental tissue of women with GDM, compared to the healthy non-diabetic women. The decrease in mitochondrial fusion markers was more severe during GDM compared to the Pre-DM. Our results suggest that there may be differences in the pathophysiology of these conditions.

NOX1/4 Inhibitor GKT-137831 Improves Erectile Function in Diabetic Rats by ROS Reduction and Endothelial Nitric Oxide Synthase Reconstitution

BackgroundPrevious studies have shown that oxidative stress contributes to hyperglycemia-induced erectile dysfunction. A preferential direct inhibitor of NOX1 and NOX4, GKT-137831, exhibited a strong anti‑oxidative role via blockade of reactive oxygen species (ROS) generation in endothelial cells, but whether GKT-137831 could improve erectile function was not clear. AimOur study was designed to investigate the effect of NOX1/4 inhibition on improving diabetic erectile dysfunction (ED) in rats. MethodsWe used streptozotocin to induce type 1 diabetes mellitus (DM) in 32 male Sprague Dawley (SD) rats (8 weeks old). Eight weeks later, type 1 diabetes mellitus-induced erectile dysfunction (DMED) in rats was confirmed using an apomorphine test. Our study consisted of 3 groups: (i) nondiabetic control group (n = 8), (ii) DMED + vehicle group (DMED group; n = 8), and (iii) DMED + GKT-137831 group (n = 9); GKT-137831 was given as a once-daily intraperitoneal injection for 4 weeks. Cavernous nerve electrostimulation was used to evaluate erectile function. Western blot, ELISA, immunohistochemistry, and immunofluorescence were used to measure expression of specific proteins, and DHE fluorescent probe was performed to detect ROS level. OutcomesIntracavernous pressure (ICP), nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) signaling pathway, oxidative stress level, inflammatory response, corporal autophagy, and apoptosis were measured. ResultsErectile function in the DMED group was significantly impaired compared to the nondiabetic control group, whereas this impairment was improved with GKT-137831 treatment by 70%. Similarly, endothelial function and overactivated oxidative stress in the corpus cavernosum (CC) of the DMED + GKT-137831 group were improved. The DMED group showed serious inflammatory responses and excessive autophagy, which were inhibited by GKT-137831 treatment in the DMED + GKT-137831 group. Clinical TranslationOur study showed improvement in erectile function with GKT-137831 in a diabetic rat ED model. Strength and LimitationsThis study suggested for the first time that GKT-137831, an NOX1/4 inhibitor undergoing clinical trials, is effective in improving erectile function in rats with type 1 DMED. However, we only investigated GKT-137831 treatment of streptozotocin-induced type 1 diabetic rats, and therapeutic evidence in other types of diabetes is lacking. ConclusionGKT-137831 improves erectile function by 70% in type 1 DMED rats and constitutes a promising compound for the treatment of type 1 DMED, likely by inhibition of overactivated oxidative stress, down-regulation of proinflammatory factors, and amelioration of excessive autophagy and endothelial function.B Zhou, Y Chen, H Yuan, et al. NOX1/4 Inhibitor GKT-137831 Improves Erectile Function in Diabetic Rats by ROS Reduction and Endothelial Nitric Oxide Synthase Reconstitution. J Sex Med 2021;18:1970–1983.

Markers of Oxidative Stress in the Saliva of Type 2 Diabetic Patients

Objective: Diabetes mellitus is associated with increased prevalence of oral diseases for which reactive oxygen species have been implicated. The saliva contains protective antioxidants which statutorily curtail these destructive oxygen molecules. A functional compromise of the antioxidants may precipitate oxidative stress leading to the increased oral disease susceptibility. However, salivary markers of oxidative stress have not been sufficiently studied in the diabetics. Methods: A total of 166 adults were recruited for this study. They comprised of 95 Type 2 diabetic patients and 71 healthy non-diabetic controls. About 3 ml of unstimulated saliva samples were collected from participants and processed, levels of salivary H2O2, NO and MDA were measured using spectrophotometry method and compared between the two groups. Data was analysed using t-test, logistic regression and receiver operating characteristics (ROC) with statistical significance set at p&lt;0.05. Results: Salivary H2O2 (p=0.024) and NO (p=0.002) were significantly higher in the diabetic patients when compared to the healthy non-diabetic control group. Binary logistic regression showed that patients with Type 2 diabetic mellitus are more likely to have elevated salivary H2O2 (OR= 1.013; p=0.025) and NO (OR=1.016; p=0.003) levels. ROC analysis showed statistically significant performance of salivary NO levels in distinguishing between T2DM patients and healthy controls. Conclusions: Higher levels of oxidative stress markers including salivary H2O2 and NO in the diabetic groups could be a pointer to the characteristic high prevalence of oral diseases in diabetes mellitus, given that oxidative stress predisposes to disease vulnerability. This calls for increased attention to oral health in diabetes management to minimise co-morbidity.

Magnesium sulfate improves insulin resistance in high fat diet induced diabetic parents and their offspring

In the present study, first, the role of high-fat diet (HFD) in insulin resistance (IR) in offspring with diabetic and non-diabetic parents, and then the effect of magnesium sulfate (Mg) administration on improved IR in HFD diabetic parents, and their offspring were investigated. Induction of diabetes was carried out by eating HFD and a low dose of streptozotocin (STZ). Diabetic rats were divided into three groups: diabetic control (DC), insulin, and Mg-treated (Mg). The non-diabetic control (NDC) group received a normal diet. Their offspring were fed on a regular diet for four months. Blood glucose and body weight of all animals were measured weekly, and IPGTT, urine volume, and water intake were measured monthly. In both parents and their offspring, the hyperinsulinemic euglycemic clamp was conducted, and blood samples were obtained. In all groups, the expression of IRS1, Akt and GLUT4 genes in muscle was measured. The HFD-fed rats exhibited a significant increase in blood glucose, body weight and IPGTT. In diabetic parents and their offspring, Mg or insulin therapy lowered blood glucose, IPGTT, and HbA1c relative to the DC group. They also increased GIR in parents and their offspring. Compared to the DC group, the expression of IRS1, Akt and GLUT4 genes was increased in both parents. Mg had positive effects on the expression of IRS1, Akt and GLUT4 genes in Mg treated offspring and reduced IR in them. As a result, magnesium may have beneficial effects on IR by increasing the expression of IRS1, Akt and GLUT4 genes.

Application of Topical Sucralfate and Topical Platelet-Rich Plasma Improves Wound Healing in Diabetic Ulcer Rats Wound Model.

PurposeOne of the most serious and devastating complications of diabetes mellitus is diabetic ulcers. They are difficult to treat and often result in limb loss. Topical sucralfate and platelet-rich plasma have the potential to improve the healing outcomes of chronic ulcers, including diabetic ulcers. This research aims to determine the effectiveness of sucralfate and platelet-rich plasma therapy for the improvement of diabetic ulcer wound healing.Patients and MethodsNinety Wistar rats were used in this study and were classified into five groups. Four of the five groups were diabetic induced and were treated with topical sucralfate only, platelet-rich plasma only, combination of topical sucralfate and platelet-rich plasma, and diabetic control group which received standard therapy only. The non-diabetic control group did not receive any therapy. We observed macrophage amount, platelet-derived growth factor, vascular endothelial growth factor, and hypoxia-inducible factor as a biomarker. Rats were terminated after 7th and 14th days and were subjected to immunohistochemistry staining and examination.ResultsWe found that topical sucralfate and platelet-rich plasma increase macrophage levels, vascular endothelial growth factor expression and platelet-derived growth factor expression in diabetic wound cells. We also found a reduction in hypoxia inducible factor-1α expression. Combination of topical sucralfate and platelet-rich plasma for 14 days gave the most significant improvement in terms of wound healing compared to topical sucralfate or platelet-rich plasma alone.ConclusionThe combination of topical sucralfate and platelet-rich plasma therapy results in the best improvement in diabetic ulcer wound healing compared to sucralfate or platelet-rich plasma monotherapy or conventional wound healing therapy.

The Role of Insulin Level on the Biofilm-Forming Capacity in Diabetes-Related Urinary Tract Infection

Background: Type 2 diabetes mellitus (T2DM) is more prone to get infections and the most common infection is urinary tract infection (UTI), most of the causative agents are related to biofilms, biofilm-forming capacity affected by host factors such as glucose and others. Aims: The objective of this research was to see how insulin affects the biofilm-forming capacity that most common pathogens associated with diabetic patients in different isolates. Materials and Methods: The objective was investigated by comparing the amounts of serum insulin in UTI patients to those without UTI whether the patients with T2DM or nondiabetic. The study was conducted on 40 T2DM patients divided into 20 patients with UTI and 20 without UTI, and 40 nondiabetic control subjects 20 with UTI and 20 patients without UTI. Serum insulin levels were detected by using enzyme-linked immunosorbent assay kit. Results: The mean concentration of serum insulin was a highly significant increase in T2DM in comparison to the nondiabetic control group. Pseudomonas auroginosa was the strongest biofilm producer isolate. Conclusion: In conclusion, insulin's direct effect was elevated the capability of biofilm formation. This contributes to a better knowledge of the causes of frequent bacterial infections in diabetics.

Downregulation of interleukin-10 receptor (IL-10R) along with low serum IL-10 levels in newly diagnosed type 2 diabetes mellitus patients

Type 2 diabetes mellitus (T2DM) is a metabolic disorder in which ageing, altered lifestyle, genetic, and environmental factors contribute to producing insulin resistance in target tissues, leading to hyperglycaemia. Previous studies have reported lower levels of Interleukin-10 (IL-10), an anti-inflammatory cytokine in T2DM patients. However, the knowledge regarding its receptor (IL-10R) expression changes in T2DM is unknown. This study aimed to correlate levels of IL-10 with its receptor expression in newly diagnosed T2DM cases and compare the findings with that of a non-diabetic control group. 35 newly diagnosed T2DM and 35 non-diabetic controls were recruited after obtaining due informed consent. Venous blood was taken under aseptic conditions. Biochemical parameters were analyzed in an autoanalyzer. Serum levels of IL-10 were estimated using ELISA, and IL-10R expression was estimated using RT-PCR by TaqMan Advanced gene expression assay. Serum levels of IL-10 were significantly lowered in T2DM patients (10.93 (8.62) pg/ml) compared with non-diabetic controls (14.52 (9.71) pg/ml) (p < 0.015). IL-10R expression was significantly downregulated in T2DM patients with a fold change of 0.18 (p < 0.018). Our study suggests that the expression of IL-10R is downregulated along with low serum levels of IL-10 in newly diagnosed Type 2 diabetes mellitus patients.

Outcomes of phacoemulsification on the corneal endothelium in diabetic versus non-diabetic patients: a prospective non-randomized controlled interventional study

Background: Cataract surgery in patients with diabetes is indicated either to improve visual acuity or to allow assessment and treatment of fundus changes. We aimed to document the effects of phacoemulsification on the corneal endothelium in patients with or without diabetes.&#x0D; Methods: This comparative, prospective, non-randomized controlled interventional study was conducted in patients with visually significant immature senile cataracts in the ophthalmology department at Sohag University Hospital between January 2018 and December 2020. The following data were recorded: corrected distance visual acuity, keratometry readings, refraction, slit lamp examination results, and biometry data. Changes in corneal parameters were documented preoperatively and at 1, 3, and 6 months postoperatively using specular microscopy.&#x0D; Results: Sixty-four eyes of 64 patients with visually significant senile cataracts were included (32 eyes in the diabetic group and 32 eyes in the non-diabetic control group). We found greater mean endothelial cell loss in the non-diabetic group (179 cells/mm2; 6.4%) than in the diabetic group (134 cells/mm2; 4.8%) at 3 months postoperatively, yet the difference was not significant. The difference could be explained by the higher mean cumulative dissipated energy (CDE) used in the non-diabetic group (5.37 J) than in the diabetic group (4.68 J), although the difference was also not significant. Moreover, we found significantly higher coefficient of variation (CV) in the non-diabetic group than in the diabetic group at 1, 3, and 6 months postoperatively (P = 0.03, P = 0.02, and P = 0.008, respectively).&#x0D; Conclusions: Endothelial cell density was directly related to the CDE of phacoemulsification and not to diabetes. CV was significantly higher in the non-diabetic group than in the diabetic group. Future studies with a larger sample size, longer follow-up, and more diabetic subgroups with different levels of glycemic control are warranted to verify our conclusions.&#x0D; &#x0D; How to cite this article: Mahmoud A, Moussa I, Abozaid M, Iqbal M. Outcomes of phacoemulsification on the corneal endothelium in diabetic versus non-diabetic patients: a prospective non-randomized controlled interventional study. Med Hypothesis Discov Innov Optom. 2021 Spring; 2(1): 1-7. DOI: https://doi.org/10.51329/mehdioptometry119&#x0D;

Accelerative Wound-Healing Effect of Aqueous Anthocephalus Cadamba Leaf Extract in a Diabetic Rat Model.

Impaired wound healing is a major concern in diabetic patients due to unregulated chronic hyperglycemia which further may lead to ulcer, gangrene, and its complications. The present study unveils the accelerative effect of aqueous Anthocephalus cadamba leaf extract on wound healing in diabetic rats. Diabetes was induced in 30 Sprague Dawley female rats by using streptozotocin (except control group I) at the dose of 60 mg/kg intraperitoneally. Diabetic rats were randomized in 3 groups viz. diabetic control group (II), diabetes + Kadam plant leaf extract group (III), and diabetes + 5% povidone-iodine solution group (IV). Surgically sterile wound of 1.77 cm2 was created on the dorsal area of anaesthetized rats. The experimental parameters were assessed by hematobiochemical, histopathological, and western blot techniques. The A cadamba extract treatment group (III) (D + KPLE) showed a significant increase in the percentage of wound closure (82%) at day 21 as compared to the diabetic control group (42%), nondiabetic control group (I) (49%), and povidone-iodine treatment group (75%) group (IV). The findings of the present study suggest that the (D + KPLE) group (III) exhibited marked epithelial regeneration, neovascularization, collagen deposition, and fibroblast proliferation along with higher expression of vascular endothelial growth factor as compared to the diabetic control group (II), which was confirmed by histopathological examination and western blot analysis. The present study suggests that the topical application of aqueous A cadamba leaf extract exhibits accelerative wound-healing properties in diabetic rats.

Genetic predisposition in the 2\u2032-5\u2032A pathway in the development of type 1 diabetes: potential contribution to dysregulation of innate antiviral immunity

Aims/hypothesisThe incidence of type 1 diabetes is increasing more rapidly than can be explained by genetic drift. Viruses may play an important role in the disease, as they seem to activate the 2′-5′-linked oligoadenylate (2′-5′A) pathway of the innate antiviral immune system. Our aim was to investigate this possibility.MethodsInnate antiviral immune pathways were searched for type 1 diabetes-associated polymorphisms using genome-wide association study data. SNPs within ±250kb flanking regions of the transcription start site of 64 genes were examined. These pathways were also investigated for type 1 diabetes-associated RNA expression profiles using laser-dissected islets from two to five tissue sections per donor from the Diabetes Virus Detection (DiViD) study and the network of Pancreatic Organ Donors (nPOD).ResultsWe found 27 novel SNPs in genes nominally associated with type 1 diabetes. Three of those SNPs were located upstream of the 2′-5′A pathway, namely SNP rs4767000 (p = 1.03 × 10−9, OR 1.123), rs1034687 (p = 2.16 × 10−7, OR 0.869) and rs739744 (p = 1.03 × 10−9, OR 1.123). We also identified a large group of dysregulated islet genes in relation to type 1 diabetes, of which two were novel. The most aberrant genes were a group of IFN-stimulated genes. Of those, the following distinct pathways were targeted by the dysregulation (compared with the non-diabetic control group): OAS1 increased by 111% (p < 1.00 × 10−4, 95% CI −0.43, −0.15); MX1 increased by 142% (p < 1.00 × 10−4, 95% CI −0.52, −0.22); and ISG15 increased by 197% (p = 2.00 × 10−4, 95% CI −0.68, −0.18).Conclusions/interpretationWe identified a genetic predisposition in the 2′-5′A pathway that potentially contributes to dysregulation of the innate antiviral immune system in type 1 diabetes. This study describes a potential role for the 2′-5′A pathway and other components of the innate antiviral immune system in beta cell autoimmunity.Graphical abstract

Decreased muscle-derived musclin by chronic resistance exercise is associated with improved insulin resistance in rats with type 2 diabetes.

Chronic resistance exercise induces improved hyperglycemia in patients with type 2 diabetes mellitus. Musclin, a muscle‐derived secretory factor, is involved in the induction of insulin resistance via the downregulation of the glucose transporter‐4 (GLUT‐4) signaling pathway in skeletal muscles. However, whether musclin affects the mechanism of resistance exercise remains unclear. This study aimed to clarify whether decreased muscle‐derived musclin secretion in chronic resistance exercise is involved in the improvement of insulin resistance via the GLUT‐4 signaling pathway in rats with type 2 diabetes. Male, 20‐week‐old, Otsuka Long‐Evans Tokushima Fatty (OLETF) rats, a type 2 diabetes model, were randomly divided into two groups: sedentary control (OLETF‐Con) and chronic resistance exercise (OLETF‐RT; climbing a ladder three times a week on alternate days for 8 weeks), whereas Long‐Evans Tokushima Otsuka rats were used as the nondiabetic sedentary control group. OLETF‐Con rats showed increased fasting glucose levels, decreased insulin sensitivity index (QUICKI), muscle GLUT‐4 translocation, and protein kinase B (Akt) phosphorylation, and concomitantly increased muscle musclin expression. In contrast, OLETF‐RT rats significantly reduced muscle musclin expression, improved hyperglycemia, and QUICKI through an accelerated muscle GLUT‐4/Akt signaling pathway. Moreover, chronic resistance exercise‐induced reduction of muscle musclin was correlated with changes in fasting glucose, QUICKI, GLUT‐4 translocation, and Akt phosphorylation. These findings suggest that the reduction in muscle‐derived musclin production by chronic resistance exercise may be involved in improved insulin resistance in rats with type 2 diabetes.

Cathinone: An alkaloid of Catha edulis (Khat) exacerbated hyperglycemia in diabetes-induced rats.

Cathinone, the main bioactive alkaloid of Catha edulis (khat), slightly increased the blood sugar levels of healthy animals, while its effect on blood sugar levels of diabetic animals has not yet been reported. This study investigated the in vitro inhibition of cathinone on α-amylase and α-glucosidase as well as its in vivo glycemic effects in diabetes-induced rats. Rats were fed on a high fat diet for five weeks, which then intraperitoneally injected with streptozotocin (30 mg/kg). Diabetic rats were distributed randomly into diabetic control (DC, n = 5), 10 mg/kg glibenclamide-treated group (DG, n = 5), and 1.6 mg/kg cathinone-treated group (CAD, n = 5). Additional healthy untreated rats (n = 5) served as a nondiabetic negative control group. Throughout the experiment, fasting blood sugar (FBS), caloric intake and body weight were recorded weekly. By the 28th day of treatment, rats were euthanized to obtain blood samples and pancreases. The results demonstrated that cathinone exerted a significantly less potent in vitro inhibition than α-acarbose against α-amylase and α-glucosidase. As compared to diabetic control group, cathinone significantly increased FBS of diabetic rats, while insulin levels of diabetic rats significantly decreased. In conclusion, cathinone was unable to induce a substantial in vitro inhibition on α-amylase and α-glucosidase, while it exacerbated the hyperglycemia of diabetes-induced rats.