Healthy Non-diabetic Individuals Research Articles

Study of Serum Ferritin and its relation with Glycemic control in Type 2 Diabetes Mellitus

Introduction: Type 2 diabetes mellitus is a common metabolic disorder. It has been hypothesized that, oxidative stress plays a major role in the etiology of the diabetic process, as well as in pathogenesis of various diabetic complications. Appreciating the role of catalytic Iron released by high serum Ferritin levels, in causation of oxidative stress and insulin resistance, we carried out this study to understand the relationship between the serum Ferritin and type 2 diabetes mellitus and we also studied glycated haemoglobin to know the correlation between glycemic control and serum Ferritin.Objectives: To compare the levels of serum Ferritin in patients with type 2 diabetes mellitus and non-diabetic healthy individuals. To know if any correlation exists between serum Ferritin and Glycated Hemoglobin in type 2 diabetes mellitus.Methods: The study was conducted at Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka from January 2012 to December 2012. The subjects of our study were fifty clinically diagnosed cases of type 2 diabetes mellitus and fifty non-diabetic healthy volunteers in the age group of 30 70 years who have satisfied the inclusion and exclusion criteria. Serum Ferritin levels and Glycated Hemoglobin were estimated by microplate immunoenzymo metric assay and ion exchange resin method respectively.Results: Serum Ferritin levels were significantly high in all cases compared to controls. There was moderate co-relation between serum Ferritin and Glycated Haemoblobin.Conclusion: The findings of the study project that, estimation of serum Ferritin may be useful in screening diabetics with poor glycemic control who are at high risk of developing complications. Thus serum Ferritin estimations in type 2 diabetes mellitus can be one of the adjuvant aids in investigations which guides in taking timely medical intervention and preventing further progression of disease.

Prevalence of Candida species in the buccal cavity of diabetic and non-diabetic individuals in and around Pondicherry

The aim of the present study was to determine the prevalence of Candida in the buccal cavity of diabetic and non-diabetic individuals in and around Pondicherry, India and to analyse the antifungal susceptibility profile of the selected isolates. A total of 400 buccal samples, 200 each from diabetic and non-diabetic healthy individuals were included in the study. Sabouraud's dextrose agar was used for isolation of Candida species. Identification was performed through microscopy, germ tube test, sugar fermentation test, sugar assimilation test and by using Hichrome agar. Distinct and phenotypically representative colonies were selected and subjected to ITS analysis. In vitro antifungal susceptibility testing for the isolated Candida species was performed using E-test. Results revealed that the prevalence of Candida species in diabetic individuals was higher when compared with non-diabetic healthy individuals. The most predominantly isolated species in diabetic and non-diabetic individuals from buccal cavity was Candida albicans. C.tropicalis was predominant among the non-albicans Candida isolated from both diabetic and non-diabetic individuals. Among denture wearers C.glabrata was predominant. In vitro antifungal susceptibility testing shows that ketoconazole, fluconazole and itraconazole were effective against the isolated Candida species. The rate of candidal carriage in diabetic individuals is higher. Different species of Candida are present in the oral cavity of diabetic individuals. There may be a positive correlation between glycemic control and candidal colonization. In vitro antifungal susceptibility testing of Candia species are required for proper management and treatment of candidal infections.

Effect of diabetic retinopathy on retinal nerve fiber layer thickness

Purpose The objective of this study was to assess the effect of diabetic retinopathy (DR) on the retinal nerve fiber layer (RNFL) thickness. Patients and methods This study included 30 diabetic patients having nonproliferative diabetic retinopathy (NPDR) without macular edema, 20 diabetic patients without DR, and 20 healthy nondiabetic age-matched individuals as a control group. In each patient one eye was included. Patients were evaluated for RNFL thickness by Heidelberg Spectralis optical coherence tomography. Results The global (G), the superior, and the temporal RNFL thickness in the diabetic patients without DR was significantly less than that of the control group and that of the patients with NPDR. However, there was no statistically significant difference between the patients with NPDR and the control group. It was noted that there was no statistically significant difference in the RNFL thickness of the inferior and nasal quadrants between the three studied groups. Conclusion Early retinal neurodegeneration can occur before retinal microvascular diabetic changes can be observed.

Pharmacokinetics and pharmacodynamics of insulin glargine–insulin glulisine basal-bolus and twice-daily premixed analog insulin in type 1 diabetes mellitus patients during three standardized meals

AimsTo evaluate the pharmacokinetics and pharmacodynamics of basal insulin glargine with mealtime insulin glulisine or twice daily 75/25 premixed neutral protamine insulin lispro and insulin lispro in individuals with type 1 diabetes during three standardized meals over a 24 hour duration and compare to physiologic insulin and glucose responses in healthy non-diabetic individuals. MethodsTwelve healthy (4 male/8 female) and thirteen individuals with type 1 diabetes (8 male/5 female) were studied during three sequential standardized meals. Individuals with type 1 diabetes received either glargine and glulisine injected 5 minutes subcutaneously before each meal or premixed insulin lispro injected 5 minutes before breakfast and dinner in a randomized fashion separated by eight weeks. ResultsThe incremental systemic insulin AUC, maximal insulin concentration, and rate of rise of systemic insulin (0–30 minutes) during all three meal intervals were similar between glargine/glulisine and healthy controls. Incremental glucose AUC with glargine/glulisine was similar to controls at lunch and dinner. With premix 75/25 insulin, insulin AUC was lower and incremental glucose AUC was greater at lunch compared to the healthy and glargine/glulisine. Hypoglycemic events before lunch were greater with premix insulin group than with glargine/glulisine (p < 0.0001). ConclusionsGlargine/glulisine pharmacokinetics in type 1 diabetes can closely approximate physiologic insulin responses in healthy individuals during a day in which three standardized meals are consumed. Additionally, when glulisine is dosed only five minutes pre-meal, systemic insulin concentration rises as rapidly as prandial endogenous insulin levels. This present study compared glargine and glulisine administered in an approximate 50/50 proportion. Future studies of alternate meal times, meal content and differing premixed insulin preparations are indicated.

Conjunctival Flora in Diabetic and Nondiabetic Individuals.

Objectives:To evaluate the conjunctival bacterial flora in diabetic patients and nondiabetic subjects.Materials and Methods:Fifty-three diabetic patients and 43 nondiabetic healthy individuals were included in the study. A specimen was taken from each participant for the study by rubbing a sterile cotton-tipped swab on the inferior palpebral conjunctiva of the right eye. Samples were incubated in blood agar, chocolate agar, eosin methylene-blue lactose sucrose agar and sabouraud 4% dextrose agar. Isolated microorganisms were identified using routine microbiological methods.Results:Rates for bacterial isolations were determined as 38.5% in diabetic patients and 34.9% in nondiabetic controls. Staphylococcus aureus was isolated in 30% of cases in the diabetic patient group, while 20% tested positive for Escherichia coli, 10% for coagulase-negative Staphylococcus, 10% for Klebsiella pneumoniae and 30% for multiple bacteria. In the non-diabetic group, 53.3% of patients were positive for Staphylococcus aureus while coagulase-negative Staphylococcus was isolated in 26.7%, Klebsiella pneumoniae in 6.7% and multiple bacteria in 13.3% of patients. Although there was no statistically significant difference in the number of isolated bacteria between the diabetic and nondiabetic groups, gram-negative bacterial colonization was significantly higher in diabetic patients (χ2=0.129, p=0.719 and χ2=5.60, p=0.018, respectively).Conclusion:Gram-negative bacteria are more common in the conjunctival flora of diabetic patients. This should be considered by clinicians when treating ocular infections in diabetic patients.

Assessment of DNA damage and mRNA/miRNA transcriptional expression profiles in hyperglycemic versus non-hyperglycemic patients with type 2 diabetes mellitus

The development of type 2 diabetes mellitus (T2D) is associated with a number of genetic and environmental factors. Hyperglycemia, a T2D hallmark, is related to several metabolic complications, comorbidities and increased DNA damage. However, the molecular alterations of a proper glucose control are still unclarified. In this study, we aimed to evaluate DNA damage (comet assay), as well as to compare the transcriptional expression (mRNA and miRNA analyzed by the microarray technique) displayed by peripheral blood mononuclear cells (PBMCs) from three distinct groups: hyperglycemic T2D patients (T2D-H, n=14), non-hyperglycemic T2D patients (T2D-N, n=15), and healthy non-diabetic individuals (n=16). The comet assay revealed significantly (p<0.05) higher levels of DNA damage in T2D-H group compared to both T2D-N and control groups, while a significant difference was not observed between the control and T2D-N groups. After bioinformatics analysis, the differentially expressed mRNAs were subjected to functional enrichment analysis (DAVID) and inflammatory response was among the enriched terms found when comparing T2D-N with controls and T2D-H with T2D-N. Concerning the gene set enrichment and gene set analyses, among the differentially expressed gene sets, three were of interest: regulation of DNA repair (T2D-H versus T2D-N), superoxide response (T2D-H versus control group), and response to endoplasmic reticulum stress (T2D-H versus control group). We also identified miRNAs related with T2D and hyperglycemia not yet associated with these conditions in the literature. Some of the differentially expressed mRNAs were among the predicted targets of the differentially expressed miRNAs. Our results showed the association of hyperglycemia with increased DNA damage and aberrant expression of miRNAs and genes related to several biological processes, such as inflammation, DNA repair, ROS production and antioxidant defense, highlighting the importance of proper glycemic control. Moreover, the transcriptional expression of miRNAs provided novel information for understanding the regulatory mechanisms involved in the T2D progression.

Glycated Albumin Levels in Relation to Dental Caries, Mutants Streptococci Lactobacilli and Salivary Status of Type 2 Diabetes Mellitus Patients

Background: Diabetes mellitus is one of the serious systemic diseases that may cause general systemic changes, which may be reflected in the oral cavity. The aims of this study were to assess the severity of dental caries, Mutans Streptococci and Lactobacilli in addition to the flow rate and pH among uncontrolled and controlled type 2 diabetic groups in comparison with non-diabetic control group. Materials and Methods: Study groups consisted of 25 uncontrolled diabetic patients (HbA1c >7), 25 controlled diabetic patients (HbA1c <7), in addition to 25 nondiabetic healthy looking individuals. Their age was (18-22) years from both genders. The diagnosis and recording of dental caries were according to the severity of dental caries lesion through the application of D1_4MFS and stimulated salivary samples were collected. The salivary flow rate and pH were estimated. Viable count of Mutans streptococci (on Mitis- Salivarius Bacitracin Agar) and Lactobacilli (on Rogosa) was determined. Results: The mean values of caries severity were recorded to be highest among study groups compared to the control with statistically highly significant difference (p<0.01). Lowest values of salivary pH and flow rate were among study groups compared to the control with highly significant difference (p<0.01). Concerning Mutans Streptococci and Lactobacilli were found that the mean values of them for uncontrolled diabetic group were highly significant higher than both mean values of controlled diabetic group and control group. Conclusion: Dental caries revealed higher percentage of occurrence and severity among uncontrolled diabetic group. Furthermore, there was significant influence of the diabetic and the poor metabolic control on the salivary flow rat, pH, Mutans streptococci and Lactobacilli that have an effect on caries occurrence and severity.

Effect of zinc supplementation on insulin secretion: interaction between zinc and SLC30A8 genotype in Old Order Amish.

SLC30A8 encodes a zinc transporter in the beta cell; individuals with a common missense variant (rs13266634; R325W) in SLC30A8 demonstrate a lower early insulin response to glucose and an increased risk of type 2 diabetes. We hypothesised that zinc supplementation may improve insulin secretion in a genotype-dependent manner. We evaluated the early insulin response to glucose (using frequently sampled intravenous glucose tolerance testing) by R325W genotype before and after 14 days of supplementation with oral zinc acetate (50 mg elemental zinc) twice daily in healthy non-diabetic Amish individuals (N = 55). Individuals with RW/WW genotypes (n = 32) had the lowest insulin response to glucose at 5 and 10 min at baseline (vs RR homozygotes [n = 23]). After zinc supplementation, the RW/WW group experienced 15% and 14% increases in the insulin response to glucose at 5 and 10 min, respectively (p ≤ 0.04), and, compared with RR homozygotes, experienced a 26% (p = 0.04) increase in insulin at 5 min. We observed reciprocal decreases in proinsulin:insulin in the RW/WW (p = 0.002) vs RR group (p = 0.048), suggesting a genotype-specific improvement in insulin processing. Zinc supplementation appears to affect the early insulin response to glucose differentially by rs13266634 genotype and could be beneficial for diabetes prevention and/or treatment for some individuals based on SLC30A8 variation. ClinicalTrials.gov NCT00981448.

Hemodynamic responses during graded and constant-load plantar flexion exercise in middle-aged men and women with type 2 diabetes.

We tested the hypotheses that type 2 diabetes (T2D) impairs the 1) leg hemodynamic responses to an incremental intermittent plantar-flexion exercise and 2) dynamic responses of leg vascular conductance (LVC) during low-intensity (30% maximal voluntary contraction, MVC) and high-intensity (70% MVC) constant-load plantar-flexion exercise in the supine posture. Forty-four middle-aged individuals with T2D (14 women), and 35 healthy nondiabetic (ND) individuals (18 women) were tested. Leg blood flow (LBF) was measured between each contraction using venous occlusion plethysmography. During the incremental test peak force (Fpeak) relative to MVC was significantly reduced (P < 0.05) in men and women with T2D compared with their respective nondiabetic counterparts. Peak LBF and the slope of LBF relative to percentage Fpeak were also reduced (P < 0.05) in women with T2D compared with healthy women (peak blood flow, 460.6 ± 126.8 vs. 628.3 ± 347.7 ml/min; slope, 3.78 ± 1.74 vs. 5.85 ± 3.14 ml·min(-1)·%Fpeak (-1)) and in men with T2D compared with nondiabetic men (peak blood flow, 621.7 ± 241.3 vs. 721.2 ± 359.7 ml/min; slope, 5.75 ± 2.66 vs. 6.33 ± 3.63 ml·min(-1)·%Fpeak (-1)). During constant-load contractions at 30% MVC T2D did not affect the dynamic responses of LVC (LBF/MAP). However, at 70% MVC [completed by a subgroup of participants (20 with T2D, 6 women; 13 ND, 6 women)] the time constant of the second growth phase of LVC was longer and the amplitude of the first growth phase was lower (P < 0.05 for both) in men and women with T2D. The results suggest that the T2D-induced impairments in performance of the leg muscles are related to reductions in blood flow in both men and women.

A comparative study of oral candidal species carriage in patients with type1 and type2 diabetes mellitus.

Context:Diabetes mellitus can have profound effects upon the oral tissues especially in patients with poor glycemic control being prone to severe and/or recurrent infections particularly candidiasis. The main aim was to study the association between Type 1 and Type 2 diabetes mellitus and candidal carriage.Materials and Methods:The study design comprised of previously diagnosed 30 patients each with type 1 diabetes mellitus (Group A) and type 2 diabetes mellitus (Group B) and 30 age-, sex- and dental status-matched healthy non-diabetic individuals as controls (Group C). The saliva samples were collected and inoculated onto Sabouraud dextrose agar (SDA) and chromogenic agar culture medium. Candidal colony forming units per ml (CFU/ml) values were determined.Statistical Analysis:Data were analyzed by χ2 test, Mann-Whitney U-test, Spearman's rank correlation and Karl Pearson's correlation coefficient.Results:Data analysis showed statistically significant higher positive candidal growth in Group A and Group B when compared to Group C. The CFU/ml values were significantly higher in Groups A and B as compared with Group C. Significant positive correlation of CFU/ml with fasting blood sugar level and HbA1c% in both Groups A and B was seen. Oral signs and symptoms observed in diabetics were dry mouth, burning sensation, fissuring and atrophic changes of tongue and erythematous areas, which positively correlated with candidal load.Conclusion:The glycemic control status of the diabetic patients may directly influence candidal colonization. The quantitative and biochemical characterization allows better insight into the study of association of diabetes mellitus and candida.

Magnitude and mechanisms of glucose counterregulation following islet transplantation in patients with type 1 diabetes suffering from severe hypoglycaemic episodes

Pancreatic islet transplantation stabilises glycaemic control in type 1 diabetes mellitus patients with neuroglycopoenia, despite them not achieving insulin independence because of limited graft function. However, the extent and underlying metabolic pathways of restored glucose counterregulation are unknown. We therefore compared systemic glucose turnover, including lactate gluconeogenesis (GN) and muscle glucose uptake, in individuals with type 1 diabetes who were transplant recipients with partial graft function (T1DM/ITx(+)), matched non-transplanted individuals with type 1 diabetes (T1DM/ITx(-)) and matched healthy non-diabetic individuals. Participants (n = 12 in each group) underwent a euglycaemic and a hypoglycaemic (2.5-2.8 mmol/l) hyperinsulinaemic clamp (0.8 mU kg(-1) min(-1)) in a randomised crossover fashion. Systemic and skeletal muscle glucose and lactate kinetics were assessed using a combination of isotopic and forearm balance techniques. Whole-body glucose counterregulation, the difference in glucose infusion rates required to maintain the glycaemic goal between the hypoglycaemic and euglycaemic clamps, was improved in T1DM/ITx(+) (7.8 ± 1.3 μmol kg(-1) min(-1)) compared with T1DM/ITx(-) (0.3 ± 0.9 μmol kg(-1) min(-1)), but was ~45% lower than in controls (14.1 ± 2.1 μmol kg(-1) min(-1)). Increased endogenous glucose production (EGP) and decreased systemic glucose disposal accounted for 49% and 39% of glucose counterregulation in T1DM/ITx(+), respectively, compared with 60% and 36% in controls. Lactate GN increased in T1DM/ITx(+) (2.7 ± 0.4 μmol kg(-1) min(-1)) and controls (1.7 ± 0.5 μmol kg(-1) min(-1)), such that it accounted for 70% and 20% of the increased EGP, respectively. Skeletal muscle accounted for similar proportions of the decrease in systemic glucose disposal in controls (49%) and T1DM/ITx(+) (41%). Partial islet graft function improves hypoglycaemia counterregulation by increasing EGP, largely via lactate GN and decreasing systemic glucose disposal. This may explain the reduction in severe hypoglycaemic events in T1DM/ITx(+) individuals. ClinicalTrials.gov NCT01668485.

Evaluation of fasting plasma insulin concentration as an estimate of insulin action in nondiabetic individuals: comparison with the homeostasis model assessment of insulin resistance (HOMA-IR)

Insulin-mediated glucose disposal varies severalfold in apparently healthy individuals, and approximately one-third of the most insulin resistant of these individuals is at increased risk to develop various adverse clinical syndromes. Since direct measurements of insulin sensitivity are not practical in a clinical setting, several surrogate estimates of insulin action have been proposed, including fasting plasma insulin (FPI) concentration and the homeostasis model assessment of insulin resistance (HOMA-IR) calculated by a formula employing fasting plasma glucose (FPG) and FPI concentrations. The objective of this study was to compare FPI as an estimate of insulin-mediated glucose disposal with values generated by HOMA-IR in 758 apparently healthy nondiabetic individuals. Measurements were made of FPG, FPI, triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) concentrations, and insulin-mediated glucose uptake was quantified by determining steady-state plasma glucose (SSPG) concentration during the insulin suppression test. FPI and HOMA-IR were highly correlated (r = 0.98, P < 0.001). The SSPG concentration also correlated to a similar degree (P < 0.001) with FPI (r = 0.60) and HOMA-IR (r = 0.64). Furthermore, the relationship between FPI and TG (r = 0.35) and HDL-C (r = -0.40) was comparable to that between HOMA-IR and TG (r = 0.39) and HDL-C (r = -0.41). In conclusion, FPI and HOMA-IR are highly correlated in nondiabetic individuals, with each estimate accounting for ~40% of the variability (variance) in a direct measure of insulin-mediated glucose disposal. Calculation of HOMA-IR does not provide a better surrogate estimate of insulin action, or of its associated dyslipidemia, than measurement of FPI.

Surgical Stress Induces an Amplified Inflammatory Response in Patients with Type 2 Diabetes

Background. Morbid obesity is believed to be an extreme of the metabolic spectrum. Moreover, diabetes is hypothesized to be associated with a chronic inflammatory state that is not observed in nondiabetic healthy individuals. We investigated the differences in expression of inflammatory cytokines induced by surgical stress between diabetic and nondiabetic individuals. Method. 39 morbidly obese patients undergoing laparoscopic Roux-en-Y gastric bypass (9 with type 2 diabetes mellitus) were compared with 8 nonobese euglycemic patients undergoing laparoscopic antireflux surgery. Cytokine levels for IL-6, IL-10, and IL-18 were measured 15 minutes before surgery and immediately after surgery. Results. IL-6 and IL-10 levels were elevated from baseline following surgery, but morbidly obese patients exhibited a much higher elevation than lean patients. Individuals with type 2 diabetes had the most pronounced IL-6 and IL-10 elevations. Baseline IL-18 levels were significantly higher in diabetic patients compared with nondiabetic or lean patients. However, IL-18 levels were not changed in response to surgery. Conclusions. Diabetes and morbid obesity are associated with augmented cytokine expression in response to surgical trauma that is several folds higher than in nonobese euglycemic patients. Diabetic patients exhibit a chronic elevation in IL-18 that is not changed by surgical stress.

Pattern of male sex hormones in type 2 diabetic patients in Nnewi, South Eastern Nigeria

Background: Type 2 diabetes mellitus has been shown to be associated with certain endocrine disorders in men. We therefore investigated the levels of male sex hormones in serum of patients with type 2 diabetes mellitus (DM2) and non-diabetic controls (NDMC) with a view to establishing the effect of diabetes mellitus on their endocrine system. Methods: One hundred and twenty five male type 2 diabetic subjects and 50 apparently healthy non-diabetic male individuals within the age of 32 - 70 years were recruited into this study. Fasting plasma glucose (FPG), male sex hormones (follicle stimulating hormone (FSH), prolactin, luteinizing hormone (LH), and testosterone), and body mass index (BMI) were determined. Results: The mean value of FPG, FSH and prolactin were significantly higher in diabetic subjects when compared with the NDMC, but there was no significant difference in the levels of LH and BMI. The level of testosterone was significantly lower in diabetics than in NDMC. There was no significant correlation between duration of diabetes and male sex hormones (FSH, LH, Prolactin and Testosterone). Results also showed that male sex hormones, BMI, FPG, are independent of age. Conclusion: This study revealed decreased levels of testosterone with insignificantly high levels of luteinizing hormone which is suggestive of abnormal feedback mechanism in the hypothalamic- pituitary-testicular axis of these diabetic men. The study also revealed a significant raised serum prolactin levels in type 2 diabetic patients without a definitive cause. We therefore, recommend further studies to elucidate the possible underlying mechanisms involved in these abnormalities so that correct strategies for treatment can be employed.

Evaluation of selected trace elements in male type 2 diabetic patients in Nnewi, south eastern Nigeria

Background: There is accumulating evidence that the metabolism of several trace elements is altered in type 2 diabetic patients. Aims: We, therefore, investigated the levels of some of the trace elements in serum of male type 2 diabetic patients with a view to establishing their metabolic status in these subjects. Materials and Methods: One hundred and twenty-five male type 2 diabetic subjects and 50 apparently healthy non-diabetic male individuals within the age range of 32 - 70 years were recruited for this study. Fasting plasma glucose (FPG), trace elements (zinc, selenium, manganese and chromium), and body mass index (BMI) were determined. Results: The mean levels of Zn, Mn, Se and Cr were significantly lower in serum of type 2 diabetic patients when compared with non-diabetic controls (P 0.05). This study also observed a significant negative correlation between the serum levels of Trace Elements (Zn, Se, Cr and Mn) and the FPG in diabetic subjects. Conclusion: Consequently, the decrease in levels of trace elements may play a role in pathogenesis of diabetes mellitus considering their roles in glucose metabolism. Therefore, proper dietary control and mineral supplementation is advised.

Dental caries, Mutans Streptococci, Lactobacilli and salivary status of type1 diabetic mellitus patients aged 18-22 years in relation to Glycated Haemoglobin

diabetic mellitus is one of the serious systemic diseases that may cause general systemic changes, which may be reflected in the oral cavity. The aims of this study were to assess the severity of dental caries, Mutans Streptococci and Lactobacilli in addition to flow rate and pH among uncontrolled and controlled diabetic groups in comparison with non-diabetic control group. Materials and Methods: Study groups consisted of 25 uncontrolled diabetic patients (HbA1c > 7), 25 controlled diabetic patients (HbA1c ≤ 7), in addition to 25 non-diabetic healthy looking individuals. Their age was (18-22) years from both genders. The diagnosis and recording of dental caries was according to severity of dental caries lesion through the application of D1_4MFS (Manji et al, 1989) and stimulated salivary samples were collected. Salivary flow rate and pH were estimated. Viable count of mutans streptococci (on Mitis- Salivarius Bacitracin Agar) and lactobacilli (on Rogosa) was determined. Results: The mean values of caries-severi ty were recorded to be highest among study groups compared to the control with statistically highly significant difference (p<0.01). Lowest values of salivary pH and flow rate were among study groups compared to the control with highly significant difference (p<0.01). Concerning Mutans Streptococci and Lactobacilli were found that the mean values of them for uncontrolled diabetic group were highly significant higher than both mean values of controlled diabetic group and control group. Conclusion: Dental caries revealed higher percentage of occurrence and severity among uncontrolled diabetic group. Furthermore there was significant influence of the diabetic and the poor metabolic control on the salivary

Esophageal body motility in people with diabetes: Comparison with non-diabetic healthy individuals

AimsThe aim of this study was to compare esophageal motor characteristics between diabetics and healthy individuals. MethodsEsophageal manometry was performed in 34 type 2 diabetics and 32 healthy individuals. Waves were evaluated in the 3 thirds of the esophagus (P1=upper, P2=middle, and P3=distal). ResultsIn diabetics vs. controls, wave distribution was as follows: peristaltic waves, 83.5±22.2% vs. 96.3±4.4%, p<0.002; simultaneous waves, 3.26±5.8% vs. 0.53±1.3%, p<0.01; no transmitted waves, 10.62±20.7% vs. 2.75±3.0%, p<0.002; and retrograde waves, 2.68±4.0% vs. 0.31±1.1%, p<0.03. Wave amplitude was similar between groups. Average upstroke (mmHg/s) in diabetics vs. non-diabetics was P2, 33.8±13.9 vs. 40.2±17.7, p<0.03; and P3, 29.8±15.3 vs. 41.3±14.0, p<0.002. Conclusions(1) Simultaneous waves, no transmitted waves, and retrograde esophageal waves were significantly more frequent in diabetics. (2) Average upstroke was significantly lower within the middle and distal esophagus of diabetic individuals. (3) Wave amplitude was similar in both groups.

Cytomorphometric analysis of exfoliative buccal cells in type II diabetic patients

Aim: To evaluate the quantitative and qualitative changes in cytological buccal smears of type II diabetic patients by using the parameters like nuclear area (NA), cytoplasmic area (CA), and cytoplasmic/nuclear ratio (C/N). Materials and Methods: The study was done in 40 known type II diabetic patients and 40 healthy individuals. Buccal smears were taken and subjected to Pap-stain. NA and CA of 20 integral cells in the smear were measured using Image Pro-Express Version 6.0 image analysis system by Media Cybernetics Inc., Bethesda, MD, USA. The C/N ratio was then calculated. For comparing cytomorphometric parameters (NA, CA, C/N ratio), t-test was used. Results: There was a statistically significant increase in average NA and significant decrease in the C/N ratio in diabetics when compared to non-diabetic healthy individuals. The average CA did not show any statistical difference between the two groups. The morphologic alteration seen in diabetic group was the presence of acute inflammation. Conclusion: Exfoliative cytology is an additional tool to aid in diagnosis of diabetes mellitus, apart from the regular standard tests.

Cadmium, lead, arsenic and selenium levels in patients with type 2 diabetes mellitus

There is accumulating evidence that the metabolism of several trace metals are altered in diabetes mellitus and these micronutrients might have specific roles in the pathogenesis and progression of the disease. The aim of this study was to investigate the level of toxic elements: lead (Pb), cadmium (Cd) and arsenic (As) levels in whole blood and selenium (Se) (an antioxidant element) in serum of patients with type 2 diabetes mellitus. Fifty diabetic patients and 40 apparently healthy non-diabetic individuals were recruited into this study. After an overnight fasting, blood was collected from each subject and blood/serum concentrations of these elements were measured by atomic absorption spectrophotometer after acid digestion. The mean value of Pb and Cd were significantly higher in the serum of diabetic patients when compared with the control (p 0.05). The serum concentration of Se was significantly lower in diabetic patients than in healthy control group (P < 0.01). Also, the concentration of the toxic elements showed positive correlation with fasting plasma glucose (Cd r = 0.378, Pb r = 0.425, p < 0.01) and inverse correlation with serum selenium (r = -0.599, p < 0.01). This study showed that, increased toxic metals are associated with diabetes mellitus. Thus, these elements may play a role in the development and pathogenesis of diabetes mellitus. In addition, depression in antioxidant concentration (especially, Se) may further aggravate this effect.

Association of plasma leptin levels and insulin resistance in diabetic women: a cross-sectional analysis in an Iranian population with different results in men and women

Objectives. The objective of this study was to assess the association of serum leptin levels with insulin resistance (IR), metabolic syndrome (MetS), lipid levels, and glucose control in an Iranian type 2 diabetic population.Findings. In this cross-sectional analysis, 132 type 2 diabetic patients (79 women) and 71 healthy non-diabetic and non-hypertensive individuals (40 women; as control subjects) were included. Homeostasis model assessment (HOMA) of insulin values ≥ 1.8 for females and 1.7 for males was regarded as the cut-point of IR. MetS was defined according to updated 2005 NCEP ATP III criteria. The leptin correlated with HOMA-IR values without adjustment (r = 0.24; p < 0.005) and with adjustment for sex and diabetes (r = 0.44; p < 0.005). Sex had significant effect on the BMI adjusted association of HOMA-IR (quintiles) and leptin (df = 4 F(12.7) = 3.5; p = 0.011). In diabetic women (but not men), leptin levels were different between those with and without IR (27.3 ± 1.9 vs. 18.2 ± 3.3; p < 0.05). BMI adjusted leptin values were different between subjects with and without MetS (22.2 ± 1.7 vs.14.8 ± 1.2; p < 0.001). No association was noticed between BMI-adjusted leptin with glycated hemoglobin or blood lipid levels.Conclusions. In this study, plasma leptin concentration correlated with IR independent of the effect of obesity in female but not male diabetic subjects.