Healthy Non-diabetic Subjects Research Articles

Vitamin D status in Type 2 Diabetes Mellitus in a Tertiary Level Hospital

Background: There is increasing evidence of a relationship between vitamin D status and type 2 diabetes. Diabetes has also been found to be associated with 25(OH)D (vitamin D) deficiency and the role of vitamin D has recently emerged, especially in preventing cardiovascular diseases and cancer. and insulin resistance. Objective: This study aimed to compare vitamin D deficiency between healthy and Type 2 Diabetes Mellitus (T2DM) patients. Methods: This cross-sectional study was conducted from July 2021 to June 2022 in the Department of Physiology, Rangpur Medical College, Rangpur. For this study, a total number of 100 subjects were selected among them 50 non-diabetic healthy subjects were included as control and 50 Type 2 Diabetes Mellitus patients were included as cases. The subjects of control were selected from the surrounding community of Rangpur district and subjects of cases were selected from Diabetic Association and from Outdoor of Endocrinology Department, Rangpur Medical College and Hospital, Rangpur. For statistical analysis, an independent sample t-test was performed by computer-based software SPSS-23.0 version for windows. Results: The mean vitamin D level was lower in the diabetic patients than in non-diabetic participants (14.1±8.3 ng/ml and 37.3±11.3, p<0.001). Conclusions: Early screening for serum vitamin D level is recommended for T2DM patients. Hence, it is crucial to promptly address any deficiencies in vitamin D levels. J Rang Med Col. March 2024; Vol. 9, No. 1: 77-81

Arterial involvement of lower limbs in peripheral artery disease - the difference between diabetics and non-diabetics.

To detect peripheral artery disease in diabetic and non-diabetic individuals. The case-control study was conducted from October 2018 to September 2019 at Ruth K.M. Pfau Civil Hospital, Karachi, and comprised diagnosed diabetic patients with random blood sugar ≥200mg/dl in group A, and healthy non-diabetic subjects in group B. Ankle brachial pressure index was measured and mean luminal diameters of lower limb arteries were compared using colour Doppler ultrasonography. Data was analysed using SPSS 21. Of the 82 subjects, 41(50%) were in each of the 2 groups. The sample had 42(51.2%) males and 30(48.8%) females with overall mean age of 53.9±5.07 years (range 44-60 years). There was significant difference in the ankle brachial pressure index values between the groups (p=0.004). There was also a significant difference in the mean luminal diameters of distal arteries (p=0.001), while there was no significant difference in proximal arteries (p>0.05). The diabetics were more prone to developing peripheral arterial disease than nondiabetics.

Implication of Low Plasma Arginine among Patients with Diabetic Foot Ulcer (DFU).

<b>Background and Objective:</b> Diabetic foot ulcer (DFU) is a well-recognized vascular complication of uncontrolled diabetes mellitus. Unless immediate measures are taken some patients end up with amputation. The hallmarks of DFU are hyperglycemia, neuropathy, ischemia and infection (Andrew). Recent studies confirmed the role of low serum arginine in the development of foot ulcer in diabetic patients. The current study aimed to investigate the relationship between low serum magnesium and diabetic foot ulcer and to identify the incidence of low plasma arginine levels in diabetic patients with DFU in Sudan. <b>Materials and Methods:</b> A total of 120 subjects were recruited in this study and were divided into three groups, namely, diabetic with foot ulcer (group-I), diabetic without foot ulcer (group-II) and non-diabetic healthy subjects (group-III). These subjects were investigated for FBS, HbA1c and serum arginine. Data were analysed using SPSS (28th release). <b>Results:</b> Analysis of the results obtained showed significantly marked reduced plasma arginine levels in group I than the other two groups where mean plasma arginine level was 12.08, 49.25 and 94.1 micromole/L, respectively. There was no statistical difference between the duration of diabetes and DFU in diabetic patients with DFU and diabetic patients without DFU, as well as levels of HbA1c (p-value 0.457, 0.89) respectively. <b>Conclusion:</b> The low serum arginine levels were significantly associated with foot ulcers in diabetic patients and play an important role in the development of diabetic foot ulcers.

Muscle strength in ostensibly healthy non-diabetic subjects

Background/purposeSarcopenia and decreased muscle strength (dynapenia) are emerging health issues. However, the study exploring muscle strength changes of both upper and lower limbs at the same time among all age groups is rare. This study aims to investigate the muscle strength and to establish a muscle strength norm of an ostensibly healthy non-diabetic Asian population. MethodsFrom 2018 June to 2020 March, subjects (aged from 20 to <80 years old) undergoing health checkup in Good Liver Medical Examination Center and National Taiwan University Hospital Geriatrics and Gerontology Department were enrolled. A battery of muscle power examinations including handgrip strength (HGS), five times sit-to-stand test (5TSTS), and one-leg standing test (OLST) were performed. ResultsA total of 183 participants was enrolled, consisting of 92 females and 91 males. The finding shows the strongest HGS, best 5TSTS, and the longest OLST of both genders appeared in the 20-29-year-old group. Age, gender, and palm length are significantly related to HGS, whereas age is the only factor affecting 5TSTS and OLST. It revealed a progressive decline during ageing process, especially after age 60. Finally, Z-score and T-score norms of these were established. ConclusionThese data will be useful as normal controls for muscle strength of specific disease groups. The application of the cutoffs from these data and their comparisons with the recommended cutoffs from various guidelines worth further exploration.

Salivary and crevicular fluid proinflammatory cytokines and advanced glycation end products in patients with different glycemic levels undergoing fixed orthodontic treatment.

To examine whether patients with different blood glycemic levels undergoing fixed orthodontic therapy demonstrate changes in the biochemical profiles of crevicular fluid and salivary advanced glycation end products (AGEs) and proinflammatory cytokine levels in comparison with nondiabetic healthy subjects. Prediabetic subjects, subjects with type 2 diabetes mellitus (T2DM), and subjects without a diabetes mellitus diagnosis undergoing fixed orthodontic therapy with MBT prescription brackets (0.022-inch brackets and 0.019 × 0.025-inch stainless steel archwires) were included in the study. The following clinical periodontal parameters were evaluated: (1) plaque score (PS), (2) probing depth (PD), (3) bleeding on probing (BOP), and (4) clinical attachment loss. Crevicular fluid and saliva specimens were collected during regular orthodontic visits. Salivary and crevicular fluid tumor necrosis factor alpha, interleukin-6, ghrelin, resistin, AGEs, and receptor activator of nuclear factor κΒ ligand were evaluated using a human magnetic Luminex multiplex assay. BOP scores were significantly higher among T2DM subjects (19.2%) than among nondiabetic subjects (11.2%) and prediabetic subjects (15.9%). Comparable values were demonstrated by all three study groups regarding PD scores and PSs. T2DM subjects demonstrated higher scores for gingival crevicular fluid (GCF) chemokines than nondiabetic and prediabetic subjects. A statistically significant difference was found in the levels of AGEs and resistin among the three study groups. The scores revealed for the levels of GCF resistin and AGEs versus periodontal BOP demonstrated a significant positive association by the Pearson correlation test. T2DM patients demonstrated significantly higher levels of GCF resistin and AGEs during fixed orthodontic therapy. Chronic hyperglycemic patients undergoing orthodontic therapy demonstrated a proinflammatory response.

Serum Iron Profile in Type 2 Diabetes Mellitus

Background: Type 2 diabetes Mellitus is a major growing health issue worldwide. There is a strong relation between iron parameters and type 2 diabetes mellitus. Iron metabolism can directly or indirectly affect the occurrence and development of type 2 diabetes. Objectives: To observe serum levels in Type 2 Diabetes Mellitus patients. Methods: This cross sectional study was conducted from to in the Department of Physiology, Rangpur Medical College, Rangpur. For this study, total number of 150 subjects were selected among them 75 non-diabetic healthy subjects were included in group-A and 75 Type 2 Diabetes Mellitus patients were included in group-B. The subjects of group-A were selected from surrounding community of Rangpur district and subjects of Group-B were selected from Diabetic Association and from Outdoor of Endocrinology Department, Rangpur Medical College and Hospital, Rangpur. For statistical analysis independent sample “t”test was performed by computer based software SPSS- 23.0 version for windows. Results: Mean serum free iron concentration in Group A and Group B were 12.29±3.1 μmol/l and 15.24±6.8 respectively. Mean TIBC in Group A and Group B were 68.06±7.3 μmol/l and 56.89 ± 8.6 respectively. Mean serum ferritin concentration were 131±12.90 mg/ml and 170.50±15.1 respectively. The difference between serum iron, TIBC and ferritin between Group A and Group B were highly significant ( p _ 001 ). Conclusion: The results obtained from this study suggests that serum iron and serum ferritin were increased and TIBC was decreased in T2DM patients as compared to healthy control. J Rang Med Col. September 2023; Vol. 8, No. 2: 40-43

Decreased plasma myonectin levels in female patients with type 2 diabetes mellitus and its correlation with lipid and glycemic parameters.

Myonectin is a novel myokine which has significant implications on diabetes. This study aimed to investigate plasma myonectin levels in patients with type 2 diabetes mellitus (T2DM), and their correlation with body composition, lipid and glycemic parameters. The study participants included 40 diabetic and 33 non-diabetic healthy adult Saudi females matched for their BMI and age. Body composition was assessed by bioelectrical impedance analysis. Fasting blood samples were used to investigate plasma myonectin levels by ELISA, along with lipid and glycemic parameters. We found that plasma myonectin levels were significantly decreased in diabetic patients (40.90±4.13 ng/ml, p<0.05) compared to non-diabetic participants (59.58±4.41). Diabetic patients with poor glycemic parameters had significantly decreased myonectin levels (35.18±4.03 ng/ml p<0.05) compared to non-diabetic healthy subjects. There was no significant difference in myonectin levels between diabetic patients with good glycemic control (55.76±8.09 ng/ml p>0.05) and non-diabetic healthy participants. Pearson correlation analysis indicated a significant negative correlation with fasting blood sugar (R=-0.366, p=0.001), HbA1c (R=-0.406, p<0.0001), triglycerides (R=-0.264, p=0.024), insulin (R=-0.278, p=0.017), and HOMA-IR (R=-0.409, p<0.0001). Our findings highlight an important aspect of myonectin in the pathophysiology of T2DM. They also show that myonectin has the potential to be a useful biomarker and therapeutic target in T2DM.

Ischemia-Modified Albumin (IMA) for early detection of myocardial ischemia in acute coronary syndrome with type 2 diabetes mellitus: a case control study

Abstract Introduction: Evaluation of the patients who present to the hospital with a complaint of chest pain or other signs suggestive of acute coronary syndrome (ACS) is time-consuming, expensive, and difficult. Most of the biochemical markers are negative in early phase acute myocardial ischemia. Recent literature reports have shown more interest in a new biochemical marker which is Ischemia-modified albumin for the detection of myocardial injury. Objective: to estimate the level of ischemia-modified albumin (IMA) as a risk factor for cardiovascular disease in diabetes mellitus patients. Materials and methods: A case-control study was undertaken with sixty Type-2 diabetic patients as cases and sixty non-diabetic healthy subjects as controls. Demographic data (sex, age), an ECG and Biochemical data were collected. Blood for IMA and HbA1C levels was collected within two hours of arrival, and IMA risk marker testing was performed before any heparin/thrombolytic treatment was started. Controlled and uncontrolled diabetic patients were determined by the level of their HBA1c and comparison with the means of IMA level in their serum. Results: The IMA was significantly increased in diabetic patients compared to healthy controls, with cut off value (0.92 IU/L), and there is also a significant increase in IMA level in uncontrolled diabetic patients (Mean ± SD; 240.55 + 52.5) that presented with acute chest pain and have signs and symptoms of cardiac ischemia when compared with the well-controlled diabetic patients(Mean ± SD; 159.8 ± 60.4). Conclusion: Ischemic Modified Albumin (IMA) level was elevated significantly in uncontrolled diabetic patients with early signs of early myocardial ischemia. Additionally, IMA estimation may improve our ability to identify ischaemic patients who are missed by current diagnostic strategies, or more confidently rule out patients who do not have ACS.

Antithyroid antibody (TPO-Ab) Status in Type 2 Diabetic Patients

Background: Presence of thyroid peroxidase antibody (TPO-Ab) in type 2 diabetic patients is a risk factor for future development of thyroid dysfunction.Objective: To observe thyroid antibody status in type 2 diabetic patients.Materials &amp; Methods: This cross sectional study was carried out in the Department of Physiology, Sir Salimullah Medical College, Dhaka from July 2016 to June 2017. Total 60 subjects including male and female, age ranged from 40 to 60 years were included in this study, among them 30 were non-diabetic subjects and 30 were type 2 diabetic patients.Results: In this study, mean serum TPO-Ab level was significantly (&lt;0.01) higher in diabetic subjects in comparison to that of apparently healthy non-diabetic subjects and mean serum TPO-Ab level was higher in uncontrolled diabetic subjects in comparison to that of controlled diabetic subjects but the difference is not statistically significant. However, On the other hand, among the diabetic patients 6.67% had positive TPO-Ab whereas, among the uncontrolled diabetic patients 11.76% had positive TPO-Ab. There was no correlation between TPO-Ab and HbA1c.Conclusion: The present study reveals that TPO-Ab may present in type 2 diabetic patients. KYAMC Journal Vol. 14, No. 01, April 2023: 35-38

Electrochemical skin conductances values and clinical factors affecting sudomotor dysfunction in patients with prediabetes, type 1 diabetes, and type 2 diabetes: A single center experience

Background and aimSudomotor dysfunction is linked to small fibers damage. We investigated sudomotor dysfunction in a large group of participants with diabetes, prediabetes, and nondiabetic healthy subjects. This study aimed to complete knowledge on sudomotor dysfunction in this population, especially regarding the threshold values for the electrochemical skin conductance (ESC) and factors affecting it. Materials and methodsA total of 690 volunteers in four groups were included in the study (type 1 [T1DG]: n = 80, 61.3% women; type 2 diabetes [T2DG]: n = 438, 63.5% women; prediabetes [Pre-DG]: n = 88, 80.7% women; healthy control [HC-G]: n = 84, 67.5% women). All subjects were investigated for clinical diabetic peripheral polyneuropathy and sudomotor dysfunction. The characteristics of participants obtained from outpatient records were evaluated. We used the Sudoscan device to measure ESC which was normalized for BMI, to improve the discriminative capability of the method. ResultsDiabetic polyneuropathy was found in 17.5% of T1DG, 27.4% of T1DG, and 10.2% of Pre-DG. The mean ESC/BMI was lower in subgroups with diabetic polyneuropathy than those without. Mean ESC/BMI was lowest in T2DG and highest in HC-G but comparable in T1DG and Pre-DG. We accepted the “mean ESC/BMI-1 SD” in the HC-G as the threshold for sudomotor dysfunction. Accordingly, the prevalence of sudomotor dysfunction was 18.8%, 44.3%, 59.1%, and 15% in T1DG, T2DG, Pre-DG, and HC-G, respectively. In T2DG, sudomotor dysfunction was found in 66.7% of persons with retinopathy, of which 56.3% had clinical diabetic polyneuropathy. The prevalence of sudomotor dysfunction in subjects with peripheral artery disease, chronic kidney disease, cardiovascular disease, and hypertension was 46.7%, 47.4%, 43.4%, and 50%, respectively, and 42.9%, 38.9%, 45.5%, and 37.3% of whom in the same order detected with clinical diabetic polyneuropathy. Considering the entire group, a logistic regression model demonstrated that the variables associated with SMD were: retinopathy (OR: 2.969; 95% CI: 1.723, 5.114), female gender (OR: 1.952; 95% CI: 1.287, 2.962), and e-GFR (OR: 0.989; 95% CI: 0.981, 0.998). Since the rate of complications was very low in T1DG, excluding this group, a new model similarly revealed that retinopathy and female gender were associated with SMD, however, the association with e-GFR was disappeared. ConclusionThe prevalence of sudomotor dysfunction is high when established peripheral polyneuropathy was present in diabetes. Even though, sudomotor dysfunction can also occur before clinical polyneuropathy in both types of diabetes (T1DG: 18.8%, T2DG 44.3%), prediabetes (59.1%), and nondiabetic healthy subjects (15%). The variables associated with sudomotor dysfunction were retinopathy and female sex. Normalization of ESC for BMI would be a beneficial approach. However, before this method is included in the routine screening programs for diabetic polyneuropathy, large-scale and prospective studies are required to reach a consensus on the pathological threshold values.

Glycemia is associated with subclinical atherosclerosis through renal function in nondiabetic apparently healthy adults: a mediation analysis.

The causative associations between glycemia and early alterations in renal and vascular function remain unclear. To examine the interplay among glycemia, renal function, and markers of subclinical atherosclerosis in apparently healthy subjects. Nondiabetic (30-60 years old) individuals (n = 205) without chronic kidney disease or cardiovascular disease were consecutively recruited from a cardiovascular prevention clinic. All subjects underwent arterial stiffness assessment by measuring the carotid-femoral pulse wave velocity (cfPWV). Glomerular filtration rate (GFR) was estimated by CKD-EPI equation. Study procedures were identical in the two visits (median follow-up 66 months). We employed structural equation modeling (SEM) analysis to investigate the directionality of associations. Baseline fasting plasma glucose (FPG) was independently and inversely associated with GFR (p = 0.008). GFR was significantly associated with cfPWV (p < 0.001) at baseline. By SEM analysis decreasing baseline GFR directly correlated with increasing cfPWV (p = 0.003) whereas FPG correlated with cfPWV indirectly through GFR (mediation) (P = 0.032). FPG did not mediate the effect of GFR on cfPWV (P = 0.768). SEM analysis of longitudinal data revealed bidirectional correlations between changes in FPG and GFR (P < 0.001). Alterations in GFR were directly related to changes in cfPWV (p < 0.001) whereas FPG only indirectly correlated with cfPWV through GFR changes (P = 0.002). In apparently healthy nondiabetic subjects, the association between baseline or longitudinal glycemia levels and arterial stiffening was indirect, consistently mediated by renal function status. These findings provide the first clinical evidence supporting the directionality between kidney function and glycemia in nondiabetic subjects leading to vascular dysfunction. In apparently healthy nondiabetic subjects, without cardiovascular disease or chronic kidney disease, the association between baseline or longitudinal glycemia levels and arterial stiffening was indirect, consistently mediated by renal function status.

Continuum of sensory profiles in diabetes mellitus patients with and without neuropathy and pain.

Quantitative sensory testing (QST) assesses the functional integrity of small and large nerve fibre afferents and central somatosensory pathways; QST was assumed to provide insight into the mechanisms of neuropathy. We analysed QST profiles and phenotypes in patients with diabetes mellitus to study whether these could differentiate patients with and without pain and neuropathy. A standardized QST protocol was performed and 'loss and gain of function' abnormalities were analysed in four groups of subjects: diabetic patients with painful (pDSPN; n=220) and non-painful distal symmetric polyneuropathy (nDSPN; n=219), diabetic patients without neuropathy (DM; n=23) and healthy non-diabetic subjects (n=37). Based on the QST findings, diabetic subjects were further stratified into four predefined prototypic phenotypes: sensory loss (SL), thermal hyperalgesia (TH), mechanical hyperalgesia (MH) and healthy individuals. Patients in the pDSPN group showed the greatest hyposensitivity ('loss of function'), and DM patients showed the lowest, with statistically significant increases in thermal, thermal pain, mechanical and mechanical pain sensory thresholds. Accordingly, the frequency of the SL phenotype was significantly higher in the pDSPN subgroup (41.8%), than expected (p &lt; 0.0042). The proportion of 'gain of function' abnormalities was low in both pDSPN and nDSPN patients without significant differences. There is a continuum in the sensory profiles of diabetic patients, with a more pronounced sensory loss in pDSPN group probably reflecting somatosensory nerve fibre degeneration. An analysis of 'gain of function' abnormalities (allodynia, hyperalgesia) did not offer a key to understanding the pathophysiology of spontaneous diabetic peripheral neuropathic pain. This article, using quantitative sensory testing profiles in large cohorts of diabetic patients with and without polyneuropathy and pain, presents a continuum in the sensory profiles of diabetic patients, with more pronounced 'loss of function' abnormalities in painful polyneuropathy patients. Painful diabetic polyneuropathy probably represents a 'more progressed' type of neuropathy with more pronounced somatosensory nerve fibre degeneration. The proportion of 'gain of function' sensory abnormalities was low, and these offer limited understanding of pathophysiological mechanisms of spontaneous neuropathic pain.

Optical Coherence Tomography Angiography Findings after Acute Intraocular Pressure Elevation in Patients with Diabetes Mellitus versus Healthy Subjects.

Purpose To assess the changes in optic nerve head and macular microvascular networks after acute intraocular pressure (IOP) rise in healthy eyes versus the eyes of diabetic patients.MethodsIn this prospective, interventional, comparative study, 24 eyes of 24 adults including 12 eyes of healthy nondiabetic subjects and 12 eyes with mild or moderate non-proliferative diabetic retinopathy (NPDR) were enrolled. IOP elevation was induced by a suction cup attached to the conjunctiva. IOP and optical coherence tomography angiographic (OCTA) images of the optic disc and macula were obtained before and immediately after the IOP rise.ResultsBaseline and post-suction IOPs were not significantly different between the two groups (all P 0.05). The mean IOP elevation was 13.93 3.41 mmHg among all eyes and was statistically significant as compared to the baseline in both groups (both P 0.05). After IOP elevation, healthy eyes demonstrated a reduction in the vessel density in the whole image deep and superficial capillary plexuses and parafoveal deep capillary plexus (DCP) (all P 0.05). In diabetic retinopathy, foveal vessel density at DCP decreased significantly following IOP rise (P = 0.003). In both groups, inside disc vessel density decreased significantly after IOP rise (both P 0.05), however, no significant change was observed in peripapillary vessel density (both P 0.05).ConclusionAcute rise of IOP may induce different levels of microvascular changes in healthy and diabetic eyes. Optic disc microvasculature originating from the posterior ciliary artery may be more susceptible to IOP elevation than that of retinal microvasculature.

88-OR: Discordance between Glucose Management Indicator (GMI) and A1C in Well-Controlled Type 1 Diabetes (T1D) and Nondiabetic Population

Glucose management indicator (GMI) was developed using a linear regression formula to estimate A1C from mean glucose. The study population that was used to develop and validate GMI had a mean A1C of 7.3 ± 0.8%. Therefore, we hypothesize that GMI may overestimate A1C in those with A1C &amp;lt;6.5%. Non-pregnant adults (≥18 years) with T1D for ≥2 years and using Dexcom G6 for ≥6 months from Barbara Davis Center for Diabetes (n=93, 40.6 ± 12.6 years, female 58.4%, A1C 5.9 ± 0.4%) and subjects from “Glucose Sensor Profile in Healthy Non-diabetic Subjects” study (N=153, 31.2± 21.0 years, female 66.0%, A1C 5.1 ± 0.3%) were included. All participants used Dexcom G6 continuous glucose monitor (CGM) . Up to days (healthy participants) and 15 days (T1D patients) of CGM data was compared with laboratory A1C. Discordance in GMI and A1C is presented by A1C &amp;lt;5.7% (healthy participants) and A1C between 5.7-6.4% (T1D patients) . The degree of discordance between GMI and A1C was higher in those with A1C&amp;lt;6.5% compared to original GMI development cohort [Figure 1A]. The differences between A1C and GMI were largely negative in both A1C categories (A1C &amp;lt;5.7% and A1C of 5.7-6.4%) . On average, GMI was 0.59% higher in the A1C &amp;lt; 5.7% group and 0.49% higher in the A1C 5.7 - 6.4% group (both p &amp;lt; 0.0001) [Figure 1B and 1C]. The current GMI formula may overestimate A1C and may need to be re-assessed for those with A1C &amp;lt;6.5%. Disclosure V.Shah: Advisory Panel; Medscape, Sanofi, Consultant; Dexcom, Inc., Research Support; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk. T.B.Vigers: None. L.Pyle: None. S.Dubose: None. P.Calhoun: None. R.M.Bergenstal: Advisory Panel; Hygieia, Medtronic, Roche Diabetes Care, Zealand Pharma A/S, Consultant; Abbott Diabetes, Ascensia Diabetes Care, Bigfoot Biomedical, Inc., CeQur SA, Dexcom, Inc., Eli Lilly and Company, Novo Nordisk, Onduo LLC, Sanofi, United HealthCare Services, Inc., Research Support; Abbott Diabetes, Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Medtronic, Novo Nordisk, Sanofi.

Effect of type 2 diabetes on A disintegrin and metalloprotease 10.

BackgroundAs a type 1 transmembrane protein, a disintegrin and metalloprotease 10 (ADAM10) is responsible for the cleavage of a variety of cell surface molecules and has been implicated in the pathogenesis of Alzheimer disease, atherosclerosis, and inflammatory and neoplastic disorders. It has been suggested that systemic ADAM10 concentration may potentially be used as a prognostic biomarker. Since high glucose can upregulate ADAM10 expression in vitro, we investigated whether serum levels of ADAM10 and its substrate, the lectin‐like oxidized low‐density lipoprotein receptor 1 (LOX‐1), can be influenced by type 2 diabetes.MethodsA total of 1091 individuals with type 2 diabetes and 358 age‐matched healthy control subjects were recruited. Serum concentrations of ADAM10 and the soluble form of LOX‐1 (sLOX‐1) released by cleavage of LOX‐1 by ADAM were measured by enzyme‐linked immunosorbent assay kits (ELISA).ResultsSerum ADAM10 was increased in subjects with diabetes compared with control (40.5 ng/mL [22.3‐65.7] vs 10.3 ng/mL [7.0‐17.9], respectively; P < .01); the highest levels were seen in insulin‐treated subjects. On multiple linear regression analysis, glycosylated hemoglobin, age, body mass index, and insulin use were independent determinants of ADAM10 level. The increase in serum ADAM10 levels in diabetes was accompanied by changes in serum sLOX‐1. Subjects with diabetes had higher serum sLOX‐1 than the control (110 pg/mL [89‐153] vs 104 pg/mL [85‐138], respectively; P < .01), and there was a significant correlation between serum ADAM10 and sLOX‐1 (r = 0.26, P < .01).ConclusionsSerum concentration of ADAM10 is increased in type 2 diabetes and is associated with glycemia and insulin therapy, which may potentially affect the specificity of systemic ADAM10 level as a biomarker.

IDF21-0124 Relationship between Serum Zinc Status and Diabetic Nephropathy in Algerian Patients with Type 2 Diabetes

Background: Diabetic nephropathy is a microvascular complication associated with diabetes that causes the kidneys to slowly deteriorate, leading to end-stage renal disease. Nephropathy associated with diabetes has been attributed to oxidative stress. Chronic zinc deficiency generally results in an increased sensitivity to the effects of oxidative stress. Zinc deficiency is often seen in diabetic patients. This alteration in zinc status appears to be involved in the development of microvascular complications of diabetes. Aim: The objective of this study will be to explore the relationship between zinc status and the progression of nephropathy in type 2 diabetes. Method: The study involved 80 normotensive diabetic patients with positive microalbuminuria and 60 healthy non-diabetic subjects of corresponding age. For all subjects, a serum zinc assay was performed on the ICE 3300 atomic absorption spectrometer from Thermo Fisher, a serum creatinine assay on Cobas 501 from Roche Diagnostic with evaluation of GFR, as well as a microalbuminuria assay. on the DCA Vantage from Siemens. Results: Serum zinc levels were low (p <0.001) in diabetic patients compared to non-diabetic control subjects. Elevated levels of microalbuminuria (p <0.001) were observed in diabetic patients with low serum zinc levels compared to those with normal serum zinc levels. Serum zinc level in diabetic patients was inversely correlated with serum creatinine (r = −0.51, p <0.001), microalbuminuria (r = −0.587, p <0.001) and positively with GFR (r = 0.24, p <0.01). Discussion: The results of our study support the observation that diabetes affects zinc status with a significant decrease in serum zinc levels at the onset of diabetic complications. During progression to the stages of diabetic nephropathy, morphological and structural changes occur in the glomerular and basal membrane of the kidneys, hyperfiltration, thickening of the glomerular basement membrane. All of these changes will cause albumin with trace metals to leak into the urine. Therefore, the hypozincemia seen in diabetics can be attributed to hyperzincuria. The results of this study are consistent with results reported by others.

Study of the association between GLIS3 rs10758593 and type 2 diabetes mellitus in Egyptian population

BackgroundGLIS3 (Gli-similar 3), a transcription factor, is involved in the maturation of pancreatic beta cells in fetal life, maintenance of cell mass as well as the control of insulin gene expression in adults. As a result, GLIS3 was reported as a susceptibility gene for type 1 diabetes, type 2 diabetes, and neonatal diabetes. Therefore, the goal of this study was to look into the association between the rs10758593 single nucleotide polymorphism (SNP) in the GLIS3 gene and T2DM in the Egyptian population.MethodsFrequencies of the rs10758593 (A/G) SNPs were determined in 100 T2DM patients (cases) and in 100 non-diabetic healthy subjects (controls) using real-time PCR.ResultsThe prevalence of the mutant genotypes, AA and AG, differed significantly between patients and controls. The AA genotype was more prevalent in the patients' group. The (AA) was found in 39% of the patients and 18% of the controls. While AG (heterozygous) genotype was found in 61% of the patients and 81% of the controls (p = 0.003). The AA genotype was significantly associated with T2DM. Moreover, The GLIS3 rs 10758593 mutation was found to be associated with the presence of diabetic retinopathy and nephropathy. In diabetic patients, a significant correlation between HbA1c with fasting glucose, fasting insulin, and HOMA-IR was found.ConclusionThe rs10758593 polymorphism of the GLIS3 gene was found to be significantly associated with T2DM in an Egyptian population sample. Additionally, significant association between GLIS3 rs 10758593 mutation and the glycemic control was found.

Oral lesions and periodontal status in diabetics and non-diabetics: A hospital based study.

Diabetes mellitus, a chronic hyperglycemic disorder has been associated with several manifestations in the body including the oral cavity. The oral manifestations are of importance and may significantly contribute to the detection of undiagnosed diabetes. To find out the prevalence of oral diseases in type 1 and type 2 diabetics, to evaluate and compare the periodontal status of diabetics and non-diabetics. This was a cross sectional study conducted on 110 diabetic subjects of >5 years duration at the M.V. Hospital for Diabetes, Diabetes Research Centre, Chennai. One hundred apparently healthy non-diabetic subjects in the age group of 40-60 years were studied as control. The oral cavity was examined by using a mouth mirror and periodontal status was assessed by utilizing oral hygiene index - simplified (Greene and Vermillion), Miller's mobility index and Ramjford's periodontal disease index. Subjects with diabetes were found to have significant association with xerostomia (P < 0.003) and chronic periodontitis (P < 0.026). However, no significant association was found forleukoplakia, traumatic ulcer, frictional keratosis, smoker's melanosis, mucocele, aphthous ulcer, fissured tongue, lichen planus, parotid enlargement, parulis, chronic gingivitis, fibroma, and periodontal abscess. The study reaffirmed higher prevalence of xerostomia and periodontal disease among diabetic subjects. However, contrary to previous studies, no significant differences were found in the prevalence of traumatic ulcer, fissured tongue, lichen planus, and parotid enlargement.

Angiotensin(1–7) activates MAS-1 and upregulates CFTR to promote insulin secretion in pancreatic β-cells: the association with type 2 diabetes

ObjectiveThe beneficial effect of angiotensin(1–7) (Ang(1–7)), via the activation of its receptor, MAS-1, has been noted in diabetes treatment; however, how Ang(1–7) or MAS-1 affects insulin secretion remains elusive and whether the endogenous level of Ang(1–7) or MAS-1 is altered in diabetic individuals remains unexplored. We recently identified an important role of cystic fibrosis transmembrane conductance regulator (CFTR), a cAMP-activated Cl− channel, in the regulation of insulin secretion. Here, we tested the possible involvement of CFTR in mediating Ang(1–7)’s effect on insulin secretion and measured the level of Ang(1–7), MAS-1 as well as CFTR in the blood of individuals with or without type 2 diabetes.MethodsAng(1–7)/MAS-1/CFTR pathway was determined by specific inhibitors, gene manipulation, Western blotting as well as insulin ELISA in a pancreatic β-cell line, RINm5F. Human blood samples were collected from 333 individuals with (n = 197) and without (n = 136) type 2 diabetes. Ang(1–7), MAS-1 and CFTR levels in the human blood were determined by ELISA.ResultsIn RINm5F cells, Ang(1–7) induced intracellular cAMP increase, cAMP-response element binding protein (CREB) activation, enhanced CFTR expression and potentiated glucose-stimulated insulin secretion, which were abolished by a selective CFTR inhibitor, RNAi-knockdown of CFTR, or inhibition of MAS-1. In human subjects, the blood levels of MAS-1 and CFTR, but not Ang(1–7), were significantly higher in individuals with type 2 diabetes as compared to those in non-diabetic healthy subjects. In addition, blood levels of MAS-1 and CFTR were in significant positive correlation in type-2 diabetic but not non-diabetic subjects.ConclusionThese results suggested that MAS-1 and CFTR as key players in mediating Ang(1–7)-promoted insulin secretion in pancreatic β-cells; MAS-1 and CFTR are positively correlated and both upregulated in type 2 diabetes.

Comparison of Ultrasonographic Evaluation of Gallbladder Volume in Type II Diabetic Patients with Non-diabetic Healthy Subjects

Background: Measurement of increased gallbladder volume is necessary for the detection of pathology of gallbladder.&#x0D; Objective: The purpose of the present study was to find out the difference between ultrasonographically measured gall bladder volume in fasting and post prandial states of type II diabetic patients and non-diabetic control subjects.&#x0D; Methodology: This cross-sectional study, carried out department of Radiology and Imaging at Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) Hospital, Dhaka, Bangladesh from June 2013 to July 2014. The type II diabetic patients were selected as group A and the healthy individual with age and sex matched were selected as group B. An ultrasonographic evaluation of fasting gallbladder volume and 2 hours after meal was done in all the subjects using a 3.5 MHz transducer. Information was recorded in preformed data collection sheet.&#x0D; Results: There was statistically significant (p&lt;0.001) difference of mean fasting gall bladder volume between diabetic and non-diabetic subjects. The mean postprandial gall bladder volume of type II diabetic patients was significantly higher than that of the non-diabetic controls. By using Karl-Pearson coefficients of correlation it was found that gallbladder enlargement in type II diabetics, was significantly correlated with body mass index (p= 0.05) and systolic blood pressure (p= 0.05).&#x0D; Conclusions: Cholecystomegaly is found in type II diabetics in the present study to a significant degree which is also significantly correlated with body mass index and systolic blood pressure.&#x0D; Journal of Current and Advance Medical Research, July 2021;8(2):114-118