Non-diabetic Group Research Articles

Matrix metalloproteinase-1 and matrix metalloproteinase-9 are highly expressed in the joint capsule of diabetic frozen shoulder

BackgroundThe pathophysiology of frozen shoulder (FS) involves abnormal expressions of matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMPs) that lead capsular fibrosis. However, there has been little concern for why diabetic FS has more protracted fibrotic condition. The objective of this study was to compare the expression levels of MMPs and TIMPs in the joint capsule of patients with diabetic and non-diabetic FS. Materials and methodsSamples of capsular tissue were collected from 20 patients with FS (10 diabetic patients; diabetic group, and 10 non-diabetic patients; non-diabetic group) and 10 patients (control group) with chronic anterior shoulder instability. Quantitative real-time RT-PCR and Western blot analysis were performed to determine the expression levels of mRNA and protein for MMP-1, 3, 9, 13, 14, and TIMP-1, 2. ResultsThe results of quantitative real-time RT-PCR showed significantly higher expression levels of all MMPs and TIMP-1 and significantly lower expression levels of TIMP-2 in the joint capsule of patients in the diabetic or non-diabetic groups compared with the control group. Significantly higher expression levels of MMP-1, 9, 14, and TIMP-1 were detected in the diabetic group compared with the non-diabetic group. The results of Western blot analysis showed significantly higher levels of MMP-3, 13, 14, and TIMP-1 in the joint capsule of patients in the diabetic or non-diabetic groups compared with the control group. However, no significant differences of protein levels of them were observed between diabetic and non-diabetic groups. ConclusionsThe findings of this study demonstrate the potential involvement of MMP-1 and 9 in the pathophysiology of diabetic FS. These findings may be helpful in identification of therapeutic targets for development of novel treatments for this protracted chronic fibrosing condition.

Investigating the Influence of Antidiabetic Medications and Psychosocial Factors.

The relationship between type 2 diabetes mellitus (T2DM) and depression presents a significant area of medical concern, characterized by a higher incidence of depression among T2DM patients compared to the general population. This connection is not only evidenced in the prevalence of depressive symptoms in diabetic patients but also in the way these symptoms impact diabetes management. Furthermore, the influence of antidiabetic medications, especially sodium-glucose cotransporter-2 (SGLT2) inhibitors, on depression risk is a topic of ongoing research, with contrasting findings regarding the effects of drugs like metformin and pioglitazone. The aim of this study is to provide a comprehensive analysis of the relationship between T2DM and depression, focusing on the prevalence of depressive symptoms among diabetic patients, and the role of antidiabetic medications in modulating depression risk. Methods Utilizing data from the National Health and Nutrition Examination Survey (NHANES), we focused on individuals with T2DM. Depression status was assessed using the nine-item Patient Health Questionnaire (PHQ-9), a validated tool for evaluating depressive symptoms. Participants' depression status was categorized based on PHQ-9 composite scores. The analysis included demographic variables and the use of antidiabetic medications, with a focus on SGLT2 inhibitors. Logistic regression models adjusted for age, race/ethnicity, and BMI were employed. Results Our study involved 23,575 participants, of which 7,862 had T2DM. A significant difference in age and BMI was observed between diabetic and non-diabetic groups. Logistic regression analysis indicated that non-diabetic individuals had a significantly lower likelihood of depression compared to diabetic patients not on SGLT2 inhibitors. However, no statistically significant difference in depression levels was found between diabetic patients on SGLT2 inhibitors and those not on these medications. Conclusion These findings highlight the complex relationship between diabetes, antidiabetic medication, and depression. Notably, we found no significant impact of SGLT2 inhibitors on depression in diabetic patients, challenging previous assumptions about the role of specific antidiabetic drugs in mental health. We also revealed that older diabetic individuals reported fewer depressive symptoms, suggesting the influence of psychosocial factors and the need for age-specific depression management strategies. This research underscores the necessity of further studies to explore the nuanced effects of different antidiabetic medications on mental health outcomes, guiding toward more personalized treatment approaches for the mental health challenges in T2DM.

Comparison of acute glucose responses following combined arm and leg cycling in non and pre-diabetic males

Prolonged and chronic sedentary behavior contributes to negative metabolic health conditions. Recent research has shown that a single bout of combined arm and leg cycling (CALC) can improve acute glucose metabolism in non-diabetic college aged adults. If a short bout of CALC can improve glucose metabolism in individuals that are non-diabetic then one could hypothesize that a short bout of CALC may improve glucose metabolism in individuals that are pre-diabetic. We hypothesized that short bouts of CALC would result in a greater decrease in the 60-min total (tAUC) area under the curve in pre-diabetic compared to non-diabetic males. PURPOSE: To compare acute glucose responses following a short bout of CALC in non and pre-diabetic males. METHODS: College age males were recruited for this trial. Diabetes status was based upon a fasting blood glucose measurement taken after an overnight 12 hour fast. Participants completed three randomized experimental trials. Two of the experimental trials consisted of a 1-min (1M) or 5-min (5M) bout of CALC at a self-selected pace. The third trial was a non-exercise control (CON) trial. Immediately following both exercise trials and during the CON trial, participants completed a 60-min oral glucose tolerance test. A 2-way (diabetes status vs trial) repeated measures ANOVA was done to determine if there were any significant differences between the two groups and the three trials for the tAUC during the 60-min OGTT. RESULTS: A total of 18 college age males completed this study. Fasting blood glucose was 94.0 ± 3.7 and 108.1 ± 4.6 mg/dl for the non (n=8, 21.4 ± 2.4 yrs) and pre-diabetics (n = 10, 22.6 ± 3.9 yrs) participants respectively. There was a significant interaction between trials and diabetes status (p = 0.04) for tAUC. Follow-up analysis showed that within the pre-diabetic group, tAUC was significantly lower in the 5-min trial compared to the CON trial (113.7 ± 22.5 mg/dl, p > 0.001). Within the pre-diabetic group, the tAUC for the 1M trial was not significantly different from the CON or 5M trials. Within the non-diabetic group, there were no significant differences in tAUC between the three trials. CONCLUSIONS: The results of this study indicate that a 5M bout of CALC done at a self-selected pace may have the ability to acutely improve glucose metabolism in college age pre-diabetic males when compared to non-diabetic males. Supported by a SIUE Graduate School Research Grant for Graduate Students, the School of Education, Health, and Human Behavior Dean's Grant, and the Undergraduate Research and Creative Activities Program. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Neuroprotective Potential of Hygrophila auriculata Targeting Oxidative Stress-Mediated Deficits in Streptozotocin-Induced Sciatic Nerve Injury

Abstract Objective Diabetic neuropathy, a microvascular complication of diabetes, affects 50% of individuals. Addressing this challenge is challenging due to its poorly understood origin and existing therapeutic approaches. This study used a methanolic extract from Hygrophila auriculata (MEHA) to treat oxidative stress-induced sciatic nerve injury in diabetic rats. Materials and Methods A study was conducted to assess the nociceptive reflex after a single streptozotocin (STZ) (45 mg/kg intraperitoneal.) injection. The rats were divided into six groups (n = 6 rats per group). Group I nondiabetic (ND) rats received oral gavage of 1% carboxymethyl cellulose (CMC). The diabetic rats in groups II to VI were given 1% CMC, 100, 200, and 400 mg/kg of MEHA, and 180 mg/kg of metformin (MET). The freshly prepared 1% (w/v) CMC suspension of both MEHA and MET was administered over a 4-week period, commencing from the 28th day through the 56th day post-STZ injection. The impact of STZ-induced sciatic nerve injury was analyzed through the estimation of serum glucose and glycohemoglobin levels, paw withdrawal and tail-flick latencies, oxidative stress markers, and neural histoarchitecture. Results Diabetic (STZ) control group II showed significantly altered serum glucose and glycohemoglobin levels, a reduced paw withdrawal threshold, and reduced paw withdrawal and tail-flick latencies in contrast to ND group I. Furthermore, increased oxidative stress in the sciatic nerve correlates with a reduced nociceptive threshold and disrupted neural histoarchitecture in diabetic rats. These behavioral, biochemical, and molecular changes were markedly and dose-dependently reduced by MEHA and MET treatments. Conclusion The antioxidant efficacy of MEHA modulated oxidative stress in STZ-sensitized diabetic rats and corrected neuropathic pain by attenuating hyperglycemia.

A Retrospective Analysis of the Effects of Cardiac Rehabilitation on Health Markers and Performance Outcomes among Diabetic and Non-Diabetic Patients with Coronary Artery Bypass Grafting and Percutaneous Coronary Intervention.

The aim of this study was to investigate the effects of cardiac rehabilitation on health markers and performance outcomes among diabetic and nondiabetic patients with coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). One hundred and ninety-seven patients with PCI and CABG, who attended phase 2 cardiac rehabilitation, were included in the study. Patient data were separated by cardiac diagnosis, (PCI and CABG), diabetes category (diabetic and nondiabetic), number of sessions attended (12-24 or 25-36), and time (pre- to post-test). The Duke Activity Score Index and Patient Health Questionnaire-9 questionnaires and measurements for total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, and, if diabetic, A1c and fasting blood glucose, were taken at baseline and upon completion of the program. High-density lipoprotein (p < 0.001), diastolic blood pressure (p = 0.004), Duke Activity Score Index questionnaire (p < 0.001), Patient Health Questionnaire-9 (p < 0.001), and A1c (p = 0.003) significantly improved from pre- to post-testing. Total cholesterol (p < 0.001) and low-density lipoprotein (p < 0.001) for the 25-36 nondiabetic PCI group significantly decreased. Triglycerides decreased for all 12-24 session groups (p = 0.015). Fasting blood glucose significantly decreased (p = 0.037) for the 12-24 PCI group with diabetes. No significant interactions were found for systolic blood pressure and body weight. Cardiac rehabilitation resulted in significant improvements in the lipid panel, diastolic blood pressure, and questionnaire results, regardless of the number of sessions attended. However, no significant benefits for systolic blood pressure were observed.

Female Type 1 Diabetic Akita Mice Demonstrate Increased Bladder Contractility via FP Receptor Activation due to NLRP3-Mediated Inflammation.

Diabetic bladder dysfunction (DBD) is driven in part by inflammation which dysregulates prostaglandin release in the bladder. Precise inflammatory mechanisms responsible for such dysregulation have been elusive. Since prostaglandins impact bladder contractility, elucidating these mechanisms may yield potential therapeutic targets for DBD. In female Type 1 diabetic Akita mice, inflammation mediated by the nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 (NLRP3) inflammasome is responsible for DBD. Here, we utilized female Akita mice crossbred with NLRP3 knock-out mice to determine how NLRP3-driven inflammation impacts prostaglandin release within the bladder and prostaglandin-mediated bladder contractions. Akita mice were crossbred with NLRP3-⁣/- mice to yield four groups of non-diabetics and diabetics with and without the NLRP3 gene. Females were aged to 30 weeks when Akitas typically exhibit DBD. Urothelia and detrusors were stretched ex vivo to release prostaglandins. Prostaglandin E2 (PGE2) and prostaglandin F2α (PGF2α) were quantified using enzyme linked immunosorbent assays (ELISA). In separate samples, ex vivo contractile force to PGE2 and PGF2α +/- the prostaglandin F (FP) receptor antagonist, AL8810, was measured. FP receptor protein expression was determined via western blotting. Stretch-induced PGE2 release increases in urothelia but decreases in detrusors of diabetics. However, PGE2-mediated bladder contractions are not impacted. Conversely, diabetics show no changes in PGF2α release, but PGF2α-mediated contractions increase significantly. This is likely due to signaling through the FP receptors as FP receptor antagonism prevents this increase and diabetics demonstrate a four-fold increase in FP receptor proteins. Without NLRP3-mediated inflammation, changes in prostaglandin release, contractility, and receptor expression do not occur. NLRP3-dependent inflammation dysregulates prostaglandin release and prostaglandin-mediated bladder contractions in diabetic female Akita mice via FP receptor upregulation.

In-shoe plantar pressure measurement technologies for the diabetic foot: A systematic review

IntroductionLoss of cutaneous protective sensation and high plantar pressures increase the risk for diabetic foot patients. Trauma and ulceration are imminent threats, making assessment and monitoring essential. This systematic review aims to identify systems and technologies for measuring in-shoe plantar pressures, focusing on the at-risk diabetic foot population. MethodsA systematic search was conducted across four electronic databases (Scopus, Web of Science, PubMed, Oxford Journals) using PRISMA methodology, covering articles published in English from 1979 to 2024. Only studies addressing systems or sensors exclusively measuring plantar pressures inside the shoe were included. ResultsA total of 87 studies using commercially available devices and 45 articles proposing new systems or sensors were reviewed. The prevailing market offerings consist mainly of instrumented insoles. Emerging technologies under development often feature configurations with four, six or eight resistive sensors strategically placed within removable insoles. Despite some variability due to the inherent heterogeneity of human gait, these devices assess plantar pressure, although they present significant differences between them in measurement results. Individuals with diabetic foot conditions appears exhibit elevated plantar pressures, with reported peak pressures reaching approximately 1000 kPa. The results also showed significant differences between the diabetic and non-diabetic groups. ConclusionInstrumented insoles, particularly those incorporating resistive sensor technology, dominate the field. Systems employing eight sensors at critical locations represent a pragmatic approach, although market options extend to systems with up to 960 sensors. Differences between devices can be a critical factor in measurement and highlights the importance of individualized patient assessment using consistent measurement devices.

Correlation of HbA1c with Various Hematological Parameters in Patients of Type 2 Diabetes Mellitus in a Tertiary Health Care Centre in North India: A Comparative Cross-Sectional Study

Introduction: Diabetes has become one of the leading Global health Emergencies and is ranked among the top 10 causes of mortality worldwide. Diabetes mellitus causes a wide range of complications including micro and macrovascular complications like microangiopathy, retinopathy, nephropathy, neuropathy and diabetic foot. HbA1c is considered as the Standard of Care for monitoring type 2 Diabetes Mellitus. We aim to evaluate the common hematological parameters along with inflammatory parameters like neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in patients of type 2 diabetes mellitus. Methods: This was an observational laboratory based cross sectional study in which cases were included from 1st November 2023 to 31st December 2023. Two hundred and thirteen cases were divided into two groups (Diabetic and Non-Diabetic group) based on HbA1c levels and exclusion criteria. All cases were assessed for RBC count, TLC, DLC, Hb, RDW, Hct, NLR and PLR. Data was analysed using IBM SPSS v 29.0.2.0 (20) software and Microsoft Excel. A p value of less than 0.05 was considered statistically significant. Results: The mean age of diabetic and non-diabetic groups were 52.9 years and 50.6 years respectively (p &gt; 0.05) with sex ratio of 1:2.1 and 1:1.7 respectively. There were significant differences in the means of the two groups for hematocrit levels, WBC count, neutrophil count, and NLR with p values of 0.001, 0.018, &lt; 0.001 and &lt; 0.001 respectively. There was no significant difference in the means for other parameters. Conclusion: The study results are consistent with the significant role of inflammation in etiopathogenesis of type 2 diabetes with significant increase in the levels of hematocrit, WBC count, neutrophils and NLR in patients with poor glycemic control. Furthermore, NLR being an easy and cost-effective tool along with its high association with microangiopathic complications, it needs to evaluated meticulously for assessing the prognosis in patients of type 2 diabetes mellitus.

Hepatogenous Diabetes as Compared to Type-2 Diabetes Mellitus and Non-diabetes in Patients With Liver Cirrhosis: Magnitude, Characteristics, and Implications

AimHepatogenous diabetes (HD) is frequently underestimated among cirrhosis patients. The current study assessed the magnitude, clinical characteristics, and implications of HD in cirrhosis patients as compared to the patients with type-2 diabetes mellitus (T2DM) and non-diabetes (ND) cirrhosis. MethodsIn a prospective observational study, 338 consecutive eligible cirrhosis patients were screened for diabetes mellitus. A 2-hour oral glucose tolerance test (OGTT) was used to detect HD. The clinical characteristics, complications, and outcomes were ascertained and compared amongst HD, T2DM, and ND patients. ResultsIn the final study cohort of 316 patients, the proportion of HD, T2DM and ND was 22.5% (n=71), 26.3% (n=83), and 51.3% (n=162), respectively. HD was the predominant form of diabetes (68.9%) in Child-Pugh class-C cirrhosis. The majority (73%) of HD patients had abnormal OGTT without fasting hyperglycaemia. A lower cut-off of 98.5 mg/dl for fasting blood glucose had a modest sensitivity (72%) and specificity (75%) for predicting HD. In comparison to T2DM patients, HD patients were younger, leaner, and had more advanced cirrhosis. In comparison to ND patients, HD patients were leaner but had higher glycemic indices, serum cholesterol, and arterial ammonia levels. During a median follow-up period of 12 (03-21) months, the frequency of hepatic encephalopathy and variceal haemorrhage were higher in HD and T2DM patients compared to that in the ND group. ConclusionsHD is prevalent in about one fifth of cirrhosis patients. It differs from T2DM and ND in a number of ways, and has association with complications of cirrhosis.

Assessment of subclinical left ventricular systolic and diastolic dysfunction in patients with type 2 diabetes mellitus under follow-up at Tikur Anbessa specialized hospital, Ethiopia: a case-control study

BackgroundIndividuals with diabetes mellitus are at increased risk of cardiovascular diseases, which in turn are the most common cause of morbidity and mortality in the diabetic population. A peculiar feature of cardiovascular diseases in this population is that they can have significant cardiac disease while remaining asymptomatic. There is a paucity of data regarding subclinical cardiac imaging features among diabetic adults in Africa, particularly in Ethiopia. This study was conducted to compare the magnitude and spectrum of left ventricular systolic and diastolic dysfunction among asymptomatic type 2 diabetic adults versus a normotensive, non-diabetic control group and to evaluate the determinants of left ventricular diastolic and systolic dysfunction.MethodsThis was a case-control study conducted at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. A standard transthoracic echocardiography was done for all study participants with type 2 diabetes mellitus and their normotensive and non-diabetic controls. Structured questionnaires were used to collect demographic and clinical characteristics and laboratory test results. Statistical analysis was done using the SPSS 25.0 software. The data was summarized using descriptive statistics. Bivariate and multivariate analysis was performed to determine the association between variables and echocardiographic parameters. The strength of statistical association was measured by adjusted odds ratios and 95% confidence intervals, with significant differences taken at p < 0.05.ResultsWe analyzed age- and sex-matched 100 participants in the study (diabetic) group and 200 individuals in the control group. Left ventricular systolic and diastolic dysfunction were significantly more prevalent among diabetic adults than their sex and age matched controls. Among diabetic individuals, ages of 60 years and above, dyslipidemia, use of Metformin and Glibenclamide, high serum triglyceride level, presence of neuropathy and use of statins correlated significantly with the presence of left ventricular diastolic dysfunction. Chronic kidney disease and neuropathy were determinants of left ventricular systolic dysfunction.ConclusionLeft ventricular systolic and diastolic dysfunction were significantly more prevalent among diabetic patients than their sex- and age-matched controls in our study. We recommend early screening for subclinical left ventricular dysfunction, especially in the elderly and in those with chronic kidney disease, dyslipidemia, and microvascular complications such as neuropathy.

Impact of female sex and type 2 diabetes mellitus on in-hospital mortality among patients with acute coronary syndrome: a retrospective cohort study between 2015-2022

Aim. This study aimed to assess the influence of female sex and type 2 diabetes mellitus (T2DM) on in-hospital mortality among patients diagnosed with acute coronary syndrome (ACS) in the emergency department during the period 20152022, while also exploring the association of relevant laboratory factors.Material and methods. An observational, analytical, retrospective cohort study was conducted, focusing on patients diagnosed with acute coronary syndrome who had high-density lipoprotein (HDL) values measured. The study included a total of 196 patients, divided into diabetes and non-diabetes groups, totaling 98 patients in each.Results. Among the 196 patients with acute coronary syndrome, 181 survived, and 15 succumbed until hospital discharge. Statistically significant associations were identified between female sex (relative risk (RR): 3.52, 95% confidential interval (CI): 1.25-9.92, p=0.017) and T2DM (RR: 4.05, 95% CI: 1.51-10.85, p=0.005) withan increased risk of mortality in acute coronary syndrome patients. Notably, high HDL values did not exhibit a statistically significant association (RR: 0.88, 95% CI: 0.33-2.33, p=0.789). Subsequent multivariate analysis reaffirmed the significant association, indicating a 20% increased risk of death in patients with T2DM and acute coronary syndrome (RR: 1.2, 95% CI: 0.15-2.25, p=0.025).Conclusion. The study concludes that while elevated HDL levels are not associated with increased in-hospital mortality in acute coronary syndrome patients, T2DM emerges as a noteworthy factor influencing this outcome.

Association of Apelin, Chemerin and Omentin Levels with Oxidative Stress Markers in Non-Diabetic and Induced Diabetic Rats

Abstract &#x0D; Oxidative stress has a significant impact on the etiology of type 1 diabetes mellitus (T1DM). However, associations of adipokines with oxidative stress biomarkers have yet to be investigated. Therefore, the present study aimed to investigate the estimation of serum apelin, chemerin, and omentin levels in induced TIDM and their correlations with oxidative stress markers. The study included sixty male albino rats divided into two groups. The first group (n = 30) was diabetic (TIDM induced with an intraperitoneal injection of 40mg/kg STZ). The non-diabetic control group was the second (n: 30). The enzyme-linked immunosorbent (ELISA) test was used to quantify the serum levels of apelin, chemerin, omentin and asymmetric dimethylarginine (ADMA). Furthermore, blood glucose, lipid profile triglyceride (TG), cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), liver enzymes (alanine aminotransferase (ALT) and aspartate transaminase (AST)), malondialdehyde (MDA) and nitric oxide (NO) parameters were evaluated. Rats with induced TIDM had significantly higher serum levels of apelin, chemerin, omentin, malondialdehyde MDA, ADMA, and NO compared to non-diabetics. According to the coefficient of correlation analysis, the results revealed a positive association between apelin and LDL, ALT, and MDA and a negative correlation between apelin and AST: ALT. In addition, no correlation was found between apelin and serum levels of glucose, cholesterol, HDL, LDL: HDL TG, TG: HDL, VLDL, AST, creatinine, uric acid, albumin, NO, and ADMA. LDL, ALT, and MDA. Serum chemerin level correlated positively with LD: HDL and ADMA. Also, the plasma level of omentin showed a significant and positive correlation with both TG: HDL and MDA values. In conclusion, the results of this study introduced apelin and chemerin as potential biomarkers for the early detection of diabetes. Elevated serum apelin levels in induced T1DM could provide compensatory action for low insulin levels. While, apelin, chemerin and omentin’s positive correlations with MDA level suggest the potential roles of these adipokines in diabetes-induced complications caused by oxidative stress.

A Comparative Study of Central Foveal Thickness in Nondiabetics Versus Diabetics Without Retinopathy Using Spectralis OCT

Abstract Purpose: To compare the central foveal thickness (CFT) in diabetics without retinopathy versus nondiabetics using optical coherence tomography (OCT). Methods: The study was done as a comparative cross-sectional study among two groups with 30 subjects in each group. Group A was of diabetics without retinopathy and Group B was of nondiabetics. Patients with diabetic retinopathy, diabetic macular edema, other macular diseases, history of laser treatment, intra vitreal injections, chronic glaucoma, previous eye surgeries, and hypertension were excluded from the study. CFT of the two groups was measured using OCT. Results: All the data were analyzed with a statistical software package SPSS version 16.0. The mean CFT in the diabetics without retinopathy group was found to be 225.97 ± 21.20 µm, and in nondiabetic group it was 234.57 ± 34.68 µms. Conclusion: The study showed that CFT was slightly lower in diabetics without retinopathy when compared to nondiabetics, but the value was not statistically significant (P-value: 0.091).

Association of obstructive sleep apnea symptoms with all-cause mortality and cause-specific mortality in adults with or without diabetes: A cohort study based on the NHANES.

The association between obstructive sleep apnea syndrome (OSAS) and mortality has not been extensively researched among individuals with varying diabetic status. This study aimed to compare the relationship of OSAS with all-cause and cause-specific mortality in US individuals with or without diabetes based on data from the National Health and Nutrition Examination Survey (NHANES). The study included participants from the NHANES 2005-2008 and 2015-2018 cycles with follow-up information. OSAS data (OSAS.MAP10) was estimated from the questionnaire. Hazard ratios (HRs) and the 95% confidence interval (CI) of OSAS for mortality were calculated by Cox regression analysis in populations with different diabetes status. The relationships between OSAS and mortality risk were examined using survival curves and restricted cubic spline curves. A total of 13 761 participants with 7.68 ± 0.042 follow-up years were included. In the nondiabetic group, OSAS.MAP10 was positively associated with all-cause, cardiovascular, and cancer mortality. In individuals with prediabetes, OSAS.MAP10 was positively related to all-cause mortality (HR 1.11 [95% CI: 1.03-1.20]) and cardiovascular mortality (HR 1.17 [95% CI: 1.03-1.33]). The relationship between OSAS.MAP10 and the risk of all-cause mortality and cancer mortality exhibited L-shaped curves in diabetes patients (both with nonlinear p values <.01). Further threshold effect analysis revealed that OSAS was positively related to death risk when OSAS.MAP10 exceeded the threshold scores. The relationship between OSAS and mortality differed among participants with or without diabetes. Individualized clinical treatment plans should be developed in clinical practice to reduce the risk of death for patients with different metabolic conditions.

LncRNA ANRIL Promotes Glucose Metabolism and Proliferation of Colon Cancer in a High-Glucose Environment and is Associated with Worse Outcome in Diabetic Colon Cancer Patients.

The potential involvement of type 2 diabetes mellitus (T2DM) as a risk factor for colon cancer (CC) has been previously reported. Epigenetic changes, such as deregulation of long non-coding RNA (lncRNA) and microRNA (miR), have been linked to the advancement of CC; however, the effects of high glucose levels on their deregulation and, in turn, colon cancer remain unexplored. Fifty patients had a dual diagnosis of CC and T2DM, and 60 patients with CC without diabetes mellitus were included in the study. qRT-PCR was used to examine the expression of lncRNA ANRIL and miR-186-5p in tissue samples. ANRIL, miR-186-5p, and their downstream target genes HIF-1α, PFK, HK, Bcl-2, and Bax were also determined in CC cell lines under various glucose conditions. Glucose uptake, lactate production and cells proliferation were estimated in CC cell lines. A significant upregulation of ANRIL expression levels (p<0.001) and a significant downregulation of miR-186-5p expression (p<0.001) in diabetic colon cancer specimens compared to those in non-diabetic colon cancer group were observed. MiR-186-5p expression levels were inversely correlated with ANRIL expression levels, blood glucose levels and HbA1c%. Concerning in vitro model, a significant upregulation of ANRIL, downregulation of miR-186-5p, upregulation of HIF-1α, glycolytic enzymes and activation of antiapoptotic pathway was detected in higher glucose concentrations than lower one. There was a significant increase of glucose uptake, lactate accumulation and proliferation of the Caco2 and SW620 cell lines in a dose dependent manner of glucose concentrations. Moreover, a significant positive correlation between glucose uptake and ANRIL expression was shown. A high-glucose environment can increase the tumor-promoting effect of ANRIL. ANRIL can promote glucose metabolism and colon cancer proliferation by downregulating miR-186-5p with subsequent upregulation of glycolysis enzymes expression and inhibition of apoptosis.

Unveiling the Role of PAR 1: A Crucial Link with Inflammation in Diabetic Subjects with COVID-19.

Inflammation is a distinguished clinical manifestation of COVID-19 and type 2 diabetes mellitus (T2DM), often associated with inflammatory dysfunctions, insulin resistance, metabolic dysregulation, and other complications. The present study aims to test the hypothesis that serum concentrations of PAR-1 levels differ between COVID-19 diabetic patients (T2DM) and non-diabetic COVID-19 patients and determine their association with different biochemical parameters and inflammatory biomarkers. T2DM patients with COVID-19 (n = 50) with glycated hemoglobin (HbA1c) levels of (9.23 ± 1.66) and non-diabetic COVID-19 patients (n = 50) with HbA1c levels (4.39 ± 0.57) were recruited in this study. The serum PAR-1 levels (ELISA method) were determined in both groups and correlated with parameters such as age, BMI, inflammatory markers including CRP, interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), D-dimer, homocysteine, and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Demographic variables such as BMI (29.21 ± 3.52 vs. controls 21.30 ± 2.11) and HbA1c (9.23 ± 1.66 vs. controls 4.39 ± 0.57) were found to be statistically elevated in COVID-19 T2DM patients compared to non-diabetic COVID-19 patients. The concentrations of several inflammatory biomarkers and PAR-1 were remarkably increased in the COVID-19 T2DM group when compared with the non-diabetic COVID-19 group. The univariate analysis revealed that increased serum PAR-1 estimations were positively correlated with enhanced HbA1c, BMI, inflammatory cytokines, D-dimer, homocysteine, and NT-proBNP. The findings in the current study suggest that increased levels of serum PAR-1 in the bloodstream could potentially serve as an independent biomarker of inflammation in COVID-19 patients with T2DM.

Follicle-Stimulating Hormone and Diabetes in Postmenopausal Women: A Systematic Review and Meta-Analysis.

The co-occurrence of hormonal changes during menopause and the risk of cardio-metabolic disorders has been well studied. We explored the association of circulating levels of follicle-stimulating hormone (FSH) with diabetes (DM) among postmenopausal women. In this systematic review and meta-analysis, the search was performed in PubMed, Scopus, Web of Sciences, Epistemonikos, and Cochrane Library up to September 2023. Risk of bias was assessed by Newcastle-Ottawa Quality Assessment Scale. Pooled estimates of mean differences in FSH levels were compared between postmenopausal women with and without DM. Correlations between FSH and fasting blood glucose (FBG)/insulin/homeostatic model assessment for insulin resistance (HOMA-IR) as well as pooled effect sizes with their 95% CIs for risk of DM were calculated. In this study, 14 articles, including 7878 postmenopausal women, met eligibility criteria. Most of the included studies had a low/moderate risk of bias. Women with DM had significantly lower FSH levels than those without DM (standardized mean difference [SMD] -0.751 [95% CI, -1.129 to -.372], I2 = 82.46%, n = 1416). The pooled effect size for diabetes was 0.861 (95% CI, 0.740-1.001; I2 = 80.11%). The pooled risk estimate for DM based on the categorical FSH levels (high vs low) was (HR = 0.550; 95% CI, 0.356-0.850, I2 = 0). The significant inverse correlation was found between FSH levels and glycemic parameters: FBG (r= -0.285 [95% CI -0.441 to -0.113]; n = 1229), HOMA-IR (r = -0.241[-0.378 to -0.0924]; n = 1229) and insulin (r = -0.337 [-0.434 to -0.232]; n = 959)]. There were no statistically significant differences between estradiol levels among diabetic and nondiabetic groups; however, the SMD for luteinizing hormone was similar to that reported for FSH. The available data indicated an indirect association between FSH levels and glucose disturbances among postmenopausal women, notwithstanding heterogeneity among included studies, and the complexity of various influential factors needs to be considered. Further efforts should be made to clarify the underlying mechanisms.

Blood glucose level affects iodine-123 labeled MIBG uptake in the lung

The aim of this study was to evaluate the correlation of blood glucose and the metaiodobenzylguanidine (MIBG) uptake in lung and compare the difference between the lung uptake of MIBG in diabetic and non-diabetic patients. Patients who underwent iodine-123 MIBG whole-body scan (WBS) in the Department of Nuclear Medicine Seoul National University Hospital between January 2014 and July 2022 were recruited and analyzed. Semi-quantitative analysis of the mean value of lung-to-mediastinum ratio (LMR) was performed. Correlation was analyzed with Pearson correlation test and mean difference was analyzed with independent t-test. There were 36 patients in diabetic group and 57 patients in non-diabetic group with mean age of 56 &amp;plusmn; 14.1 and 52 &amp;plusmn; 14.6 years, respectively. The mean 24-h LMRs in diabetic and non-diabetic groups were 1.38 &amp;plusmn; 0.20 and 1.17 &amp;plusmn; 0.14, respectively. Fasting glucose showed a mean value of 136 &amp;plusmn; 37.7 and 96 &amp;plusmn; 8.2 mg/dL, respectively. There was a significant positive correlation in diabetic (r = 0.397; P = 0.016) and non-diabetic groups (r = 0.579; P &lt;0.001) with significant mean difference (0.21; P &lt;0.001). In conclusion, lung uptake of MIBG is positively correlated with blood sugar level, with diabetic patients displaying higher lung uptake of MIBG compared with non-diabetic patients. In addition, higher lung uptake of MIBG is evident in patients with higher fasting glucose level and even in non-diabetic patients. Thus, in the situations where MIBG therapy is required, the radiation dose to the lungs must be carefully adjusted for patients with high blood sugar level.

Comparative assessment of the corneal endothelium following phacoemulsification surgery in patients with type II diabetes and nondiabetes

Abstract: PURPOSE: The purpose is to assess the corneal endothelial changes after phacoemulsification surgery in diabetic patients and compare with those of nondiabetic subjects. METHODS: The study compared the corneal endothelial changes in diabetics and nondiabetics after phacoemulsification surgery. The study population included 40 patients with diabetes mellitus with good glycemic control and 40 nondiabetic patients who underwent uneventful phacoemulsification surgery. Central corneal endothelial cell density (ECD), central corneal thickness (CCT), and percentage of hexagonality percentage coefficient of variation (%CV) were measured preoperatively and postoperatively (at 4 and 12 weeks) using a specular microscope. RESULTS: Mean ECD loss (%) was measured as 9.85% and 8.41% at 4 weeks and 12 weeks postoperatively in the diabetic group while ECD loss percentage was 7.09% and 5.74% in the control group at the same time intervals, respectively. Furthermore, a significant difference was noted on comparing mean ECD measurements between the two groups at the postsurgical visits (4 weeks and 12 weeks). While the CCT was found to be similar in both diabetic and nondiabetic patients, increase was observed in the values of (%CV in both the groups at postoperative 4 weeks’ and 12 weeks’ follow-up. The values of both %CV and percentage hexagonality showed statistically significant differences between the diabetic and nondiabetic group before surgery and at 4 weeks’ and 12 weeks’ postoperative examinations. CONCLUSION: The patients with diabetes suffered greater endothelial damage despite good glycemic control as compared to nondiabetic patients which indicates the necessity of far more care to protect cornea endothelium in patients with diabetes.

Sexual Dysfunctions among Diabetic and Non-diabetic People Attending in Tribhuvan University Teaching Hospital, Kathmandu Nepal.

Sexual dysfunctions including erectile dysfunction among men, a widespread sexual health issue, pose challenges to sexual satisfaction. This cross-sectional study aimed to assess the prevalence and determinants of sexual dysfunctions in both diabetic and non-diabetic individuals aged 30-70. A study at Tribhuvan University Teaching Hospital in Kathmandu, Nepal, surveyed 350 participants (176 men, 174 women), aged 30-70, with 52.6% having diabetes. The structured interviews and validated questionnaires like IIEF-5 for men and FSFI-6 for women to assess the prevalence and factors associated with erectile dysfunction were used. Statistical tools were employed to measure the associations of different variables with Sexual dysfunctions. Overall, the prevalence of sexual dysfunction was 73.7% (95% CI: 72.4- 73.7) with higher rates in men 83.9% (95% CI: 83.1- 84.7) than women 63.6% (95% CI: 62.0 - 65.2). Individuals with diabetes experienced an 81.5% prevalence of sexual dysfunction (95% CI: 80.6-82.4), whereas non-diabetic individuals exhibited a 65.1% prevalence (95% CI: 63.5-66.7). In the diabetic male population, the prevalence of sexual dysfunction was 97.5% (95% CI: 97.4-97.6), while diabetic females had a prevalence of 68.9% (95% CI: 67.5-70.3). Among non-diabetic men, the percentage of erectile dysfunction was 72% (95% CI: 70.7-73.3), and among non-diabetic women, sexual dysfunction remained 56.2% (95% CI: 54.4-58.0). Among individuals with diabetes, those who used tobacco exhibited a sexual dysfunction prevalence of 93.8% (95% CI: 93.5-94.1), while non-tobacco users had a prevalence of 74.8% (95% CI: 73.6-76.0). In non-diabetic individuals, obesity was associated with a higher prevalence of sexual dysfunctions, reaching 84.6% (95% CI: 83.8-84.6). High blood pressure showed a strong association with sexual dysfunctions in both diabetic (83% with 95% CI: 81.9-83.4) and non-diabetic (70% with 95% CI: 67.7-70.1) groups. Individuals with diabetes for more than five years had a higher rate of sexual dysfunction as 87.8% (95% CI: 86.6-89.0) with 100% in men and 79% in women. However, there was no significant difference in the prevalence of sexual dysfunctions related to obesity and alcohol consumption between diabetics and non-diabetics. The research highlights a noteworthy association of sexual dysfunctions with individuals with diabetes, male sex, tobacco use, and hypertension. The observed high prevalence of sexual dysfunctions in both diabetic and non diabetic people is a public health concern, emphasizing the need for culturally tailored approaches to address the sexual health of the affected individuals.