Healthy Non-diabetic Individuals Research Articles

Objective audiometric evaluation of individuals with type 2 diabetes mellitus: A cross-sectional survey in South West Nigeria

Aims: Diabetes mellitus affects more than 450 million people around the world. The relationship between diabetes and sensorineural hearing loss has been an area of interest. The aim of this study is to evaluate hearing loss, among type 2 diabetes diagnosed in the endocrinology unit of a private tertiary health facility in South West Nigeria. Methods: This was a hospital-based cross-sectional study carried out among type 2 diabetic patients and normal healthy non-diabetic individuals as control. A total of 120 participants were recruited for the test and control. Otoacoustic emission and auditory steady-state response audiometry were carried out on all the participants. Result: The total number of study participants was 120 (60 for test and control) with an age range of 30–79 years for the test and 20–80 years for the control. Otoacoustic emission showed passes for both ears, 61.7% pass in both ears for the test group and 76.7% pass in both ears for the control group. 21.7% of the test and control were referred for both ears. 16.6% of the test group was referred in one ear compared to 1.7% in the control group. Auditory steady-state response (ASSR) audiometry showed mild to profound hearing loss in all test groups while in the control group 20% had normal hearing. Moderate to moderately severe hearing loss in at least one ear was 38.4% in the test ear compared to 16.7% in the control group. Conclusion: Hearing loss is an established complication of type 2 diabetes. Therefore, it is necessary to incorporate regular hearing screening for patients with diabetes for early detection, counseling, and rehabilitation for those with disabling hearing loss.

Metabolic consequences on platelet parameters: Mean platelet volume and platelet distribution width in type 2 diabetes mellitus

Background: Diabetes mellitus encompasses metabolic disorders marked by chronic hyperglycemia, leading to various complications. It is considered a prothrombotic state associated with increased platelet reactivity. Parameters such as mean platelet volume (MPV) and platelet distribution width (PDW), which are indicative of platelet size, enzymatic activity, and prothrombotic risk, can be readily assessed during routine hematological analysis, facilitating early detection of this prothrombotic state. Aims and Objectives: The study aimed to investigate the varied alterations in platelet parameters in type 2 diabetes mellitus (T2DM) patients and tried to elucidate these parameters’ predictive role in diabetes complications. Materials and Methods: This prospective cross-sectional study was conducted between February 2022 and February 2024, involving 100 patients with T2DM and 100 healthy non-diabetic individuals. MPV, PDW, fasting blood glucose (FBS), and glycated hemoglobin (HbA1c) levels were measured and analyzed. Statistical analysis was carried out using the Student’s t-test, Mann–Whitney U-test, Chi-square test, and Spearman’s correlation tests in the Statistical Package for the Social Sciences software (version 21.0). Results: Most of the patients were in the age group of 40–70 years with male predominance. In comparing the 100 diabetics and 100 non-diabetics groups, MPV and PDW levels were notably higher in diabetics (11.46±1.75 vs. 9.40±1.02 fl, 21±2.57 vs. 16.72±1.48%) with statistical significance (P<0.01). Similarly, FBS and HbA1C levels were elevated among diabetics (179.38±70.25 vs. 90.64±5.93, 7.83±2.24 vs. 5.02±0.64) along with a positive correlation between platelet indices (MPV and PDW) and FBS, HbA1c levels in patients with T2DM. In addition, diabetic patients with complications exhibit significantly higher MPV, PDW, FBS, and HbA1c levels compared to those without complications. Conclusion: MPV and PDW levels show significant alterations in T2DM patients, with consistently elevated values, especially in those with complications. This underscores their potential importance as key indicators alongside glycemic indices such as FBS and HbA1c, in monitoring diabetes progression and anticipating associated complications.

The Role of Nitric Oxide, Lipocalin-2, and Proinflammatory Cytokines on Proteinuria and Insulin Resistance in Type 2 Diabetes Mellitus Subgroups.

Nitric oxide (NO) is a bioactive signaling molecule that mediates various physiological and biological processes. Type 2 diabetes mellitus (T2DM) can be categorized into several subgroups according to fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels. Few studies have closely examined the effect of NO and lipocalin-2 on albuminuria and insulin resistance in T2DM subgroups. This study investigated the role of NO, lipocalin-2, and proinflammatory cytokines on the development of proteinuria and insulin resistance in patients with T2DM subgroups. A total of 256 subjects, including 191 patients with T2DM and 65 non-diabetic healthy individuals, were evaluated. NO metabolites (NOx), lipocalin-2, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) levels were measured. Patients with T2DM were classified into three subgroups: patients with FPG-defined diabetes (PG-DM), those with HbA1c-defined diabetes (HA-DM), and those who met the criteria for both FPG and HbA1c (PG/HA-DM). The albumin-to-creatinine ratio (ACR) and the homeostasis model assessment of β-cell function (HOMA-B) and insulin resistance (HOMA-IR) were calculated. NOx, lipocalin-2, and TNF-α levels were significantly higher in patients with T2DM than in healthy individuals. Patients with PG/HA-DM had significantly higher NOx levels than those with PG-DM or HA-DM. Of the patients with high NOx levels, patients with lipocalin-2 elevation exhibited higher ACR and HOMA-IR than those without lipocalin-2 elevation. NOx was positively correlated with lipocalin-2, ACR, HOMA-IR, and TNF-α but not with HOMA-B and IL-6. The upper quartile of NOx levels led to a 1.2-fold increase in the risk of albuminuria (odds ratio: 1.215; 95% CI: 1.012-2.418; p < 0.001). NO plays a crucial role in proteinuria and insulin resistance by collaborating with lipocalin-2 and TNF-α, showing significantly higher levels in patients with PG/HA-DM than in those with PG-DM or HA-DM.

A Study of the Mean Platelet Volume and Plasma Fibrinogen in Type Two Diabetes Mellitus Patients Versus Healthy Controls and Their Role as Early Markers of Diabetic Microvascular Complications.

Background Mean platelet volume (MPV) is considered an emerging biological marker of platelet function and activity. Higher MPV has been scientifically linked to diabetes mellitus, metabolic syndrome, stroke, and coronary artery disease. Plasma fibrinogen is a circulating glycoprotein, serving as an acute inflammatory marker ultimately leading to enhanced atherogenic plaque formation. We conducted this study to evaluate the crucial role of MPV and plasma fibrinogen, which showed elevated levels in diabetes mellitus patients compared to non-diabetic healthy individuals. This study also elaborates on the pivotal role that MPV and plasma fibrinogen levels play in the pathogenesis of microvascular complications, which progress and eventually lead to mortality in patients with type 2 diabetes mellitus. Methodology This study is a single-center hospital-based study including120 type 2 diabetes mellitus patients and 120 healthy non-diabetic individuals. It is across-sectional and observational study. The study wasconductedover a period of one and a half years in a medical college and hospital in a semi-urban locality in Western Maharashtra, India. We obtained informed written consent from the patients. All patients underwent thorough clinical assessment, and data were collectedusing proformas, which were latertabulated and entered in Microsoft Excel sheets. Later, the statistical data analysis was performed.Plasma fibrinogen was performed by photo-optical clot detection. MPV was analyzed by coulter principle in the central laboratory department of the parent institute. Patients above 18 years with cases of type 2 diabetes mellitus with or without any related complications, while the controls are healthy non-diabetic individuals attending the outpatient and inpatient departments of General Medicine. We excluded patients under the age of 18 years, those diagnosed with type 1 diabetes mellitus, hematological conditions associated with anemia and abnormal platelet counts, pregnant females, any acute or chronic infections, patients currently on antiplatelet medication and other drugs affecting the platelets, and all critical patients. Results The majority of patients in our study were in the age group of 41-50 years, with 49.2% having one or more microvascular complications of diabetes mellitus. In our study, out of 120 cases, 3.3% and 23.3% had raised MPV and fibrinogen levels, respectively, above the normal range. When compared with males and females, there was no statistically significant difference in the mean value of MPV and fibrinogen. On the t-test (p < 0.05), there was a statistically significant difference in the mean value of MPV and fibrinogen level between diabetics with and without microvascular complications. The t-test (p < 0.05) showed that there was a statistically significant difference among cases in the mean values of MPV and plasma fibrinogen in relation to retinopathy, nephropathy, and neuropathy, which are all microvascular complications of diabetes. Conclusion The study reveals higher levels of MPV and fibrinogen in diabetic patients compared to non-diabetic healthy individuals. In addition,higher levels of MPV and fibrinogen were present in patients with microvascular complications, correlated with age and diabetes duration.

Comparative Analysis of Lifestyle Practices Between Diabetic Patients and Healthy Non-diabetic Individuals in the Saudi Population.

The burden of diabetes mellitus in Saudi Arabia is considerable, with high prevalence rates affecting the population's health and healthcare resources. This situation necessitates attention from healthcare policymakers. The study aims to compare lifestyle practices between diabetic and non-diabetic individuals in Saudi Arabia to inform targeted health interventions. The primary aim is to compare lifestyle practices, including dietary habits, physical activity levels, and smoking habits, between diabetic and non-diabetic individuals in Saudi Arabia. A 12-month cross-sectional study was conducted in Riyadh, Saudi Arabia. A total of 424 participants, evenly distributed across age, gender, and socioeconomic status, were enrolled. A total of 424 participants, balanced for age, gender, and socioeconomic status, were recruited. Data were collected via structured interviews employing a validated questionnaire. The King Fahad Medical City IRB approved the study. Informed consent was obtained from all participants. The study found that diabetic individuals were more likely to be older, male, and sedentary (p < 0.001). They were also at a higher likelihood of being current smokers (p = 0.002) and consuming whole grains regularly. Non-diabetic individuals consumed more fruits and fast food and had more flexible meal schedules (p < 0.001). Both groups had similar levels of regular vegetable consumption. A significantly lower proportion of diabetics (40 individuals; 20%) engaged in moderate physical activity three to four days a week compared to non-diabetics (80 individuals; 36%), which was highly significant (p < 0.001). The study identified critical differences in lifestyle practices between diabetic and non-diabetic individuals in Saudi Arabia. These findings underscore the need for tailored health interventions to address the rising diabetes rates and promote healthier lifestyle practices among the Saudi population.

Compromised Differentiation Potential of Diabetic Dental Pulp Stem Cells

Abstract Background Dental pulp-derived mesenchymal stem cells (DPSCs) are documented to be a promising source for the treatment of a diverse spectrum of diseases including type 2 diabetes mellitus (T2DM). However, alterations in the characteristics of DPSCs from the T2DM patients are still unclear. Objective The purpose of this study was to compare the characteristics of dental pulp stem cells obtained from diabetic and nondiabetic healthy individuals. Methods Dental pulp stem cells from nondiabetic (ND-DPSCs) and diabetic (D-DPSCs) were isolated by the explant culture method. Both cells were expanded in identical culture conditions and subsequently differentiated into osteogenic, chondrogenic, and adipogenic conditions. D-DPSCs and ND-DPSCs were characterized for a panel of MSCs-specific surface markers. Senescence associated with β-galactosidase was performed. In addition, we also performed an in vivo chick embryo yolk sac membrane assay for angiogenesis. Results Findings of this study showed that diabetes mellitus affected the osteogenic and chondrogenic differentiation, while adipogenic differentiation was significantly higher in D-DPSCs as compared to ND-DPSCs. Clonogenic ability and angiogenic potential of ND-DPSCs is higher than D-DPSCs despite similar surface marker expressions. Conclusion Diabetes affects the stemness of D-DPSCs in terms of clonogenic, osteogenic, and chondrogenic differentiation and angiogenic potential, reflecting the adverse effects of hyperglycemia even on dental pulp stem cells.

Discriminating between diabetic and non-diabetic patient’s blood serum using near-infrared Raman spectroscopy

The current study demonstrates the utilization of Raman spectroscopy, employing a laser system emitting @ 785 nm, and multivariate analysis for the accurate assessment of diabetes (glucose) in human blood sera. Raman spectra of sera samples collected from 40 patients of both genders of different age groups were acquired in the spectral range of 600–1800 cm−1. For comparison, the Raman spectra of non-diabetic healthy individuals were also obtained in the same spectral range. Apparent variations were found in normal and pathological samples at peak positions of 700 cm−1, 750 cm−1, 879 cm−1, 950 cm−1, band at 1004 cm−1 to 1006 cm−1, 1048 cm−1, 1060 cm−1, 1082 cm−1, 1091 cm−1, 1170 cm−1, 1247 cm−1, 1330 cm−1, 1333 cm−1, 1367 cm−1, 1659 cm−1 and 1745 cm−1. These variations are most likely due to variations in the concentration of amino-acid methionine, glycosylated, tryptophan, polysaccharides, phenylalanine, glycogen, glucose, carbohydrates, carbohydrates (C–O–H), tyrosine, guanine, typical phospholipids, guanine, phospholipid, cholesterol band, and triglycerides (fatty acids) respectively. For highlighting the spectral differences between the two data sets principal component analysis was used. The observed variations in Raman peaks provide an in-depth biochemical fingerprint of the samples and can be used as a biomarker for medical diagnosis effectively at the mass level.

Impaired polymorphonuclear neutrophil functions in diabetics

Background and objectives: Polymorphonuclear neutrophils (PMN) are the first line of host resistance against infections. Diabetics are prone to both bacterial and fungal infections. The present study evaluated the phagocytic and killing activity of PMN in diabetics. Material and methods: Females aged 30 to 50 years with and without diabetes mellitus were enrolled. Functions of PMN were assessed by determining the phagocytic rate, phagocytic index and killing of C. albicans by PMN. Results: A total of 36 diabetic patients and 15 age matched non-diabetic healthy individuals were enrolled. Phagocytosis and killing of C. albicans by PMN were significantly (p&lt;0.05) lower in patients with diabetes mellitus compared to non-diabetic healthy individuals (86.5±14.6 vs. 94.5±4.2; 56.7±23.8 vs. 81.5±24.2). Conclusion: Phagocytic and killing functions of PMN were significantly reduced in patients with diabetes mellitus. IMC J Med Sci. 2024; 18(1):008. DOI: https://doi.org/10.55010/imcjms.18.008 *Correspondence:Tanzinah Nasrin, Microbiologist, Quality Control Laboratory, Department of Fisheries, Ministry of Fisheries and Livestock, Dhaka, Bangladesh. Email: tanzinahn8@gmail.com

Association of vascular endothelial growth factor a gene (VEGFA) polymorphisms, rs699947 and rs1570360, with diabetic retinopathy and altered VEGF secretion in the Pakistani patients with type 2 diabetes mellitus: a case-control study

Objective: To investigate the association of vascular endothelial growth factor A gene polymorphisms 2578C/A (rs699947) and 1154G/A (rs1570360) with type 2 diabetes mellitus, diabetic retinopathy and serum vascular endothelial growth factor levels in Pakistani patients. Method: The case-control study was conducted from Jan 2017 to Dec 2018 after approval from the ethics review board of Riphah International University, Islamabad, Pakistan, and comprised type 2 diabetes mellitus patients of either gender with diabetic retinopathy in group A, and without diabetic retinopathy in group B. Non-diabetic healthy individuals were enrolled in control group C. Genotyping was done by amplification refractory mutation system-polymerase chain reaction and serum vascular endothelial growth factor levels were measured using enzyme-linked immunosorbent assay. Data was analysed using SPSS 22. Results: Of the 450 subjects, 150(33.3%) were in each of the 3 groups. The mean age in group A was 58.16±9.42, in group B 56.25±8.5 years and in group C it was 55.90±10.90. The proportion of Punjabi ethnicity was significantly high in group B compared to other groups (p&lt;0.05). There was no significant association of rs699947 and rs1570360 genotypic and allelic frequencies in group B compared to group A. Further, rs699947 AA genotype was significantly associated with proliferative diabetic retinopathy compared to group A (p&lt;0.05). Minor allele A showed significant association in groups A and B compared to group C (p&lt;0.05). Significantly raised serum vascular endothelial growth factor levels were found in group B compared to group A (p&lt;0.05), and were associated with rs699947 and rs1570360 heterozygosity in group A (p&lt;0.05). Also, rs699947 genotype showed significant association with groups A and B in Punjabi and Pathan ethnicities (p&lt;0.05) and with Kashmiri ethnicity in group B (p&lt;0.05). Conclusion: There was a strong association of vascular endothelial growth factor 2578C/A (rs699947) gene polymorphism with proliferative diabetic retinopathy in type 2 diabetic Pakistani patients, suggesting its role in the pathogenesis of this condition. Key Words: Diabetic retinopathy, Polymorphisms, Type 2 diabetes mellitus, Vascular endothelial growth factor A gene.

Vestibular evoked myogenic potentials and videonystagmography findings in type 2 diabetes mellitus patients with and without polyneuropathy

BackgroundVestibular impairment is a common pathology in patients with type 2 diabetes mellitus (DM) due to ischemia of the vestibular end organs and lysis of the myelin of the vestibular nerve. We aimed to evaluate function of the vestibular end organs and vestibular nerve in patients with type 2 DM with polyneuropathy and compare results to those of the patients without polyneuropathy.MethodThe participants consisted of three groups: thirty patients with type 2 diabetes mellitus without polyneuropathy (DM), thirty patients with type 2 diabetes mellitus with polyneuropathy (DPN), and thirty healthy non-diabetic individuals as the control group. Clinical examination, videonystagmography, cervical vestibular evoked myogenic potential(cVEMP), ocular vestibular evoked myogenic potential (oVEMP), Gans Sensory Organization Performance (SOP) test, and nerve conduction study were all performed on all groups.ResultsP1 and N1 cVEMP latencies and n1 and p1 oVEMP latencies were statistically significantly delayed in both the DM and DPN groups than the control. Also, amplitudes of P1-N1 and n1-p1 were statistically significantly lower in the DM and DPN groups than the control group. DPN patients had longer latencies and lower amplitude of the cVEMP and oVEMP response compared to diabetes patients without neuropathy. There was a statistically significant prevalence of BPPV in the DPN group compared to the control and DM groups. DPN included the following: 4 (13.3%) had vestibular pattern, 12 had polyneuropathic pattern, and 5 (16.7%) had vestibular and polyneuropathic pattern as regards the Gans Sensory Organization Performance (SOP) test.ConclusionVEMP is considered a promising objective tool in the assessment of the vestibular end organ disorders in patients with type 2 DM with and without polyneuropathy. Diabetics with prominent diabetic polyneuropathy showed higher vestibular impairment than diabetics without DPN, which may increase the risk of falling.

Correlation of Glycated Hemoglobin with Oxidative Stress in Type 2 Diabetes Mellitus

Type 2 diabetes mellitus (T2DM) has a heavy disease burden and is one of the leading causes of death worldwide. It is considered to be evolving from a complex and multifactorial metabolic disorder to an inflammatory condition. The strong link between hyperglycemia and oxidative stress has long been established. Oxidative stress leads to the generation of inflammatory mediators and reactive oxygen species, which results in an inflammatory state, which plays a key role in the pathogenesis of diabetic complications. We aimed to correlate the levels of Glycated Hemoglobin with Oxidative Stress.This cross-sectional study included 200 subjects, 100 were type 2 diabetic patients and 100 were healthy non-diabetic individuals. The data were analyzed using a t test. The results showed that as the Glycated Hb increased, the levels of FBS, MDA increased and Serum SOD, Glutathione and Catalase levels decreased. The results showed a positive correlation between HbA1c and fasting blood glucose (r = 0.417, p= 0.000) and MDA (r= 0.340, p=0.000). Whereas negative correlation was observed between HbA1c and other antioxidant parameters, SOD (r= 0.025, p=0.803) Catalase (r= 0.096, p= 0.342), Glutathione (r= -0.164, p= 0.103). It is hereby concluded for the present study that when glycated Hb increases the natural antioxidants that is SOD, catalase and glutathione decrease to combact the increased formation of ROS. Serum MDA, a marker of lipid peroxidation, increased with increased glycated Hb, and shows a positive correlation, indicating that lipid peroxidation increased, when glycation of Hb increased, thus depicting an increased chance of macrovascular complication in type 2 diabetics.

Assessment of glycemic variability and lifestyle behaviors in healthy nondiabetic individuals according to the categories of body mass index.

There are limited data about the association between body mass index (BMI), glycemic variability (GV), and life-related factors in healthy nondiabetic adults. This cross-sectional study was carried out within our ethics committee-approved study called "Exploring the impact of nutrition advice on blood sugar and psychological status using continuous glucose monitoring (CGM) and wearable devices". Prediabetes was defined by the HbA1c level of 5.7-6.4% and /or fasting glucose level of 100-125 mg/dL. Glucose levels and daily steps were measured for 40 participants using Free Style Libre and Fitbit Inspire 2 under normal conditions for 14 days. Dietary intakes and eating behaviors were assessed using a brief-type self-administered dietary history questionnaire and a modified questionnaire from the Obesity Guidelines. All indices of GV were higher in the prediabetes group than in the healthy group, but a significant difference was observed only in mean amplitude of glycemic excursions (MAGE). In the multivariate analysis, only the presence of prediabetes showed a significant association with the risk of higher than median MAGE (Odds, 6.786; 95% CI, 1.596-28.858; P = 0.010). Additionally, the underweight (BMI < 18.5) group had significantly higher value in standard deviation (23.7 ± 3.5 vs 19.8 ± 3.7 mg/dL, P = 0.038) and coefficient variability (22.6 ± 4.6 vs 18.4 ± 3.2%, P = 0.015), compared to the normal group. This GV can be partially attributed to irregularity of eating habits. On the contrary, the overweight (BMI ≥ 25) group had the longest time above the 140 or 180 mg/dL range, which may be due to eating style and taking fewer steps (6394 ± 2337 vs 9749 ± 2408 steps, P = 0.013). Concurrent CGM with diet and activity monitoring could reduce postprandial hyperglycemia through assessment of diet and daily activity, especially in non- normal weight individuals.

Assessment of serum and salivary visfatin levels in newly diagnosed patients of type-II DM.

Type II diabetes mellitus (T2DM) is a metabolic disorder. It is thought to be an autoinflammatory disease, as inflammatory mediators are associated with the progression of the disease. Visfatin, an adipokine, is linked to insulin resistance. We aimed to study serum and salivary visfatin levels, at the time of diagnosis of T2DM, in middle-aged individuals, in the context of other diagnostic parameters like fasting blood sugar (FBS), postprandial blood sugar (PPBS), and glycated haemoglobin A1c (HbA1c). Thirty newly diagnosed T2DM (Group-I, T2DM) patients and 30 healthy nondiabetic individuals (Group-II, health controls [HC]) matched for age and sex were studied. In both the groups, we assessed serum and salivary visfatin levels, and serum high-sensitivity C-reactive protein (hs-CRP) levels. We also compared serum and salivary visfatin levels and serum hs-CRP levels between Group-I and Group-II individuals. The correlation between the groups was tested using Pearson's correlation. A P- value < 0.001 was considered to be statistically significant. The data was tabulated using software MS Excel and analysed using IBM Statistical Package for the Social Sciences (SPSS) Version 22.0. A positive correlation with a value of 0.8836 and a P value of 0.001 was noted between serum and salivary visfatin of Group-I. This is the first study in the Indian scenario to study the serum and salivary visfatin in newly diagnosed T2DM individuals. Serum visfatin and hs-CRP levels increased in T2DM, thus defining the link between visfatin, inflammation and T2DM, but we failed to notice a positive correlation.

1505-P: CD44 Knockdown in Human Adipocytes—Effect on Adipocyte Proliferation and Differentiation

Introduction: eGWAS implicates the immune-cell receptor CD44 as the top candidate gene in the molecular pathogenesis of T2D1. We have shown that in human adipose tissue, CD44 expression is associated with inflammatory gene expression, M1 macrophage phenotype, and systemic insulin resistance2. Here we sought to determine whether CD44 directly impairs adipocyte function via siRNA knockdown in human preadipocytes with quantification of proliferation, differentiation, and gene expression. Methods: Abdominal subcutaneous adipose tissue was harvested from five healthy nondiabetic obese individuals during bariatric surgery. Preadipocytes were isolated via collagenase digestion and seeded at 1×10^4 cells/well and treated with siRNA-CD44 or mock condition (control) using siRNA Maxi Transfection Reagents (Invitrogen). Cell proliferation was assayed by MTS (Promega) on Days 1, 2, 3 post transfection. Differentiation was induced at confluence (as described3), and cells were harvested at days 3, 6, 12 after confluence for gene expression and at day 12 for oil red O staining (total lipid uptake) and immunofluorescence microscopy (% differentiation = bodipy/dapi*100). Results: CD44 knockdown decreased preadipocyte proliferation and increased adipocyte differentiation and lipid uptake. Conclusion: CD44 may contribute to human insulin resistance by impairing adipocyte differentiation and fat storage. Disclosure H.Chen: None. N.R.Saini: None. E.M.Ayhan: None. T.Mclaughlin: Board Member; January, Inc., Research Support; Merck &amp; Co., Inc., Stock/Shareholder; Eiger Bio. Funding National Institutes of Health (1R21AI159024-01A1)

Free Fatty Acids from Type 2 Diabetes Mellitus Serum Remodel Mesenchymal Stem Cell Lipids, Hindering Differentiation into Primordial Germ Cells.

Type 2 diabetes mellitus (T2DM) adversely affects the essential characteristics of adipose tissue-derived mesenchymal stem cells (AdMSCs). Given that T2DM is associated with an altered serum free fatty acid (FFA) profile, we examined whether diabetic serum FFAs influence the viability, differentiation, and fatty acid composition of the major lipid fractions of human AdMSCs in vitro. Serum FFAs were isolated from 7 diabetic and 10 healthy nondiabetic female individuals. AdMSCs were cultured and differentiated into primordial germ cell-like cells (PGCLCs) in the presence of either diabetic or nondiabetic FFAs. Cell viability was assessed using trypan blue staining. Cell differentiation was evaluated by measuring the PGCLC transcriptional markers Blimp1 and Stella. Lipid fractionation and fatty acid quantification were performed using thin-layer chromatography and gas-liquid chromatography, respectively. Both diabetic and nondiabetic FFAs significantly reduced the viability of PGCLCs. The gene expression of both differentiation markers was significantly lower in cells exposed to diabetic FFAs than in those treated with nondiabetic FFAs. Saturated fatty acids were significantly increased and linoleic acid was significantly decreased in the cellular phospholipid fraction after exposure to diabetic FFAs. In contrast, monounsaturated fatty acids were reduced and linoleic acid was elevated in the cellular triglyceride fraction in response to diabetic FFAs. Such an altered serum FFA profile in patients with T2DM reduces the proliferation and differentiation potential of AdMSCs, presumably due to the aberrant distribution of fatty acids into cell phospholipids and triglycerides.

Below Which Threshold of Glycemic Variability Is There a Minimal Risk of Hypoglycemia in People with Type 2 Diabetes?

Not applicable for a commentary.

Measures of optimal glucose “time in range” and variability using continuous glucose monitors in 4,805 healthy non-diabetic individuals is discriminatory of cardiovascular health risk

Measures of optimal glucose “time in range” and variability using continuous glucose monitors in 4,805 healthy non-diabetic individuals is discriminatory of cardiovascular health risk - Volume 81 Issue OCE1

The Role of Platelet Indices to Predict the Vascular Complication in Diabetic Patients in South Tamil Nadu

Background: Diabetic patients have larger young, more reactive and more agregable platelets. Platelet indices such as Mean Platelet Volume (MPV), Platelet Distribution Width (PDW) are the indicators of increased platelet activity and considered as potential markers for diabetic vascular complications. This study aimed to estimate and compare Platelet count, MPV and PDW between (1) Diabetics patient and Controls (2) Diabetics under glycaemic control and not under glycaemic control. Methodology: This cross sectional study was conducted at, Tirunelveli Medical College, Tamil Nadu, India, during August 2015 to September 2017. In this study 100 diabetic patients and 100 controls were included. Inclusion criteria for diabetics were FBS &gt; 126 mg/dl, PPBS &gt; 200 mg/dl, and age between 35-65 years. Exclusion criteria for diabetics were age less than 35 and greater than 65 years. The criteria for controls include normal FBS, PPBS levels, and age from 35-65 years and without any thromboembolic conditions. Results: Data analysis was done using SPSS 19.0. MPV was significantly increased in (a) diabetics than healthy controls (b) diabetics under glycaemic control than diabetics not under glycaemic control. PDW showed significant difference between (a) diabetics and non-diabetic controls, (b) diabetics under glycaemic control and not under glycaemic control. There was no significance of platelet count among group A and group B. P value &lt; 0.05 was considered significant. Conclusion: In this study MPV and PDW were significantly increased in diabetic patients than non-diabetic healthy individuals and higher in diabetic patients not under glycaemic control than the diabetic under glycaemic control.

Evaluation of vitamin-D, calcium, and phosphorus levels among diabetes mellitus type 2 in malwa belt of Punjab

Background: Type-2 diabetes mellitus (T2DM) or noninsulin-dependent diabetes is an endocrinological disease of impaired metabolism of carbohydrates. T2DM is increasing both nationally and worldwide at an alarming rate. In intermediary metabolism, including enzyme activities, electrical gradients and cellular function Vitamin D, calcium and phosphorus play an important role. Disturbances in the levels of Vitamin D, calcium, and phosphorus were found to be associated with T2DM. The present study is aimed to evaluate the levels of Vitamin D, calcium, and phosphorus levels in 300 patients, of which 150 were nondiabetic healthy individuals (control) and 150 were T2DM patients. Materials and Methods: A volume of 5 ml of the blood sample was taken after 12 h of overnight fasting by complete aseptic means from the antecubital vein with the sterilized disposable syringe for fasting plasma glucose (FPG), postprandial plasma glucose (PPPG), glycated hemoglobin, serum 25 hydroxy (OH) Vitamin D (25[OH]D), calcium, and phosphorus. Results: Of 150 type-2 diabetic and 150 nondiabetic group, there was a significant statistical difference between the diabetic and nondiabetic group for FPG (P < 0.001), PPPG (P < 0.001), 25(OH) D (P < 0.001), calcium (P < 0.001), and phosphorus (P < 0.001). 25(OH) D, calcium, and phosphorus levels were decreased in T2DM patients as compared to the control group. Conclusion: This study revealed that there is a significant decrease in the levels of Vitamin D, calcium, and phosphorus in Type-2 diabetic patients, which may be an important factor in the early onset of the disease in susceptible individuals.

Handgrip Strength in Patients With Type 2 Diabetes Mellitus

Background: Handgrip strength can be used to determine an individual's muscular strength objectively. It is a valid indicator of the disability index. Type 2 diabetes mellitus has a negative impact on skeletal muscles and handgrip strength. The goal of this study was to compare type 2 diabetic patients' handgrip strength to that of apparently healthy non-diabetic individuals. Materials and Method: This cross-sectional study was carried out in the Department of Physiology, Sylhet M.A.G Osmani Medical College in collaboration with Outpatient Department of Endocrinology, Sylhet M.A.G Osmani Medical College Hospital and Outpatient Department of Sylhet Diabetic Hospital during the period from January 2017 to December 2017. A total of 100 type 2 diabetic patients who had been diagnosed for at least 5 years were selected, as well as 100 age and sex matched apparently healthy non-diabetic controls. The Jamar Hydraulic Hand Dynamometer was used to measure the handgrip strength of all subjects. All the collected data were compiled and analyzed using the Statistical Package for Social Science (SPSS) Version 22.0. Results: The mean handgrip strength of the diabetics (60.62 ± 18.98 lb) was significantly lower than non-diabetics (74.80 ± 21.61 lb) (p&lt;0.001). A significant negative correlation was found between handgrip strength and duration of diabetes (r=–0.270, p=0.007). Conclusion: Handgrip strength is lowered in patients with type 2 diabetes compared to the non-diabetic group and correlates negatively with diabetes duration. Reduced handgrip strength may lead to the development of impairment in the future, resulting in decreased productivity.