Obese Type 2 Diabetes Mellitus Patients Research Articles

Decreasing malondialdehyde levels and body mass index of type II diabetes mellitus with obesity using cowpea sprout (Vigna unguiculata) yogurt

Hyperglycemia in diabetes is associated with obesity and increases the production of free radicals which is the beginning of the development of oxidative stress. This study aimed to determine the effect of cowpea sprout yogurt (CowpeaS-Yo) on body mass index (BMI) and malondialdehyde (MDA) levels in type-2 diabetes mellitus (T2DM) with obese patients. This study used a pretest-posttest control group design, with 20 women with T2DM with obesity, which was randomly divided into two groups of ten women in each group. Group I was given CowpeaS-Yo, while group II was given a placebo as a control, 200 mL/day, for 2 months. Before and after the intervention, the subject's weight and height were measured, and 1 mL of their blood sample was taken, to check their plasma MDA levels. Data were analyzed using a paired sample t-test. After two months of intervention, BMI decreased significantly from 28.53±2.27 to 24.56±2.55 kg/m2 (P = 0.002) in the group receiving CowpeaS-Yo, as well as decreased plasma MDA levels from 7.49±0.72 to 6.24±0.59 nmol/mL (P = 0.015) compared to the control group. In conclusion, CowpeaS-Yo was able to control body weight and improve the antioxidant status of T2DM in obese patients.

Correlation between obesity and serum 25-hydroxyvitamin D levels in patients with type 2 diabetes

[Objective] The paper analyzes the correlation of vitamin D level with obesity degree and serum 25-hydroxyvitamin D level in patients with type 2 diabetes mellitus (T2DM) through clinical case studies, which can provide clinical guidance for obese T2DM patients' weight control to lower their risk of developing metabolic illnesses. [Methods] A total of 249 patients with T2DM were chosen from among those hospitalized at Lanzhou University's First Hospital between April and September of 2023. The serum 25-hydroxyvitamin D level, body fat rate, fasting blood glucose, and fasting insulin of the subjects were detected, and 198 T2DM patients with low serum 25-hydroxyvitamin D levels were selected as the observation group. 51 T2DM patients with normal serum 25-hydroxyvitamin D levels were selected as the control group, and the correlation between type 2 diabetes mellitus and vitamin D levels and obesity was analyzed. [Results] Obesity and serum vitamin D insufficiency are associated with type 2 diabetes. Both vitamin D deficiency and obesity eventually lead to T2D, endocrine disorders, and other common diseases. [Conclusions] Low plasma 25-hydroxyvitamin D (25[OH]D) concentration and high BMI are correlated with an increased risk of diabetes.

Preoperative contributing factors and the remission of diabetes after metabolic surgery: the mediating role of preoperative triglyceride

Background and objectiveLimited understanding exists regarding the factors affecting the prognosis of surgical treatment for type 2 diabetes mellitus (T2DM), particularly in Chinese patients. In this study, we examined a cohort of early and intermediate obese T2DM patients to explore the potential impact of preoperative lipid metabolism in metabolic surgery on the postoperative remission of T2DM.MethodsParticipants with T2DM and obesity underwent metabolic surgery. Clinical data, including baseline body mass index, percentage of excess weight loss, and preoperative biochemical indicators, were collected and analyzed. A multidisciplinary team conducted patient follow-up. Remission was defined as sub-diabetic hyperglycemia (HbA1c < 48 mmol/mol, fasting glucose 100–125 mg/dl) without pharmacological intervention for at least 12 months.ResultsOver a median follow-up of 27 months, 96 T2DM patients with metabolic surgery were studied, with no laparotomies required. Among these patients, 61 (63.5%) achieved complete remission, and 85 (88.5%) experienced remission. In multivariable analysis models, preoperative fasting blood glucose (FBG) significantly correlated with all postoperative outcomes. Furthermore, mediation analysis indicated that preoperative triglycerides (TG) mediated 26.31% of the association between preoperative FBG and postoperative remission. Both preoperative FBG and TG were negatively associated with the postoperative remission of T2DM.ConclusionIn summary, our findings suggest that lower preoperative fasting glucose levels enhance the likelihood of postoperative T2DM remission. Moreover, preoperative TG could potentially play a mediating role in the postoperative remission of T2DM. Therefore, evaluating and managing fasting glucose and lipids before the procedure may aid in assessing the prognosis of metabolic surgery.Level of evidence Level III, designed cohort.

Heterogeneously elevated branched-chain/aromatic amino acids among new-onset type-2 diabetes mellitus patients are potentially skewed diabetes predictors.

The lack of specific predictors for type-2 diabetes mellitus (T2DM) severely impacts early intervention/prevention efforts. Elevated branched-chain amino acids (BCAAs: Isoleucine, leucine, valine) and aromatic amino acids (AAAs: Tyrosine, tryptophan, phenylalanine)) show high sensitivity and specificity in predicting diabetes in animals and predict T2DM 10-19 years before T2DM onset in clinical studies. However, improvement is needed to support its clinical utility. To evaluate the effects of body mass index (BMI) and sex on BCAAs/AAAs in new-onset T2DM individuals with varying body weight. Ninety-seven new-onset T2DM patients (< 12 mo) differing in BMI [normal weight (NW), n = 33, BMI = 22.23 ± 1.60; overweight, n = 42, BMI = 25.9 ± 1.07; obesity (OB), n = 22, BMI = 31.23 ± 2.31] from the First People's Hospital of Yunnan Province, Kunming, China, were studied. One-way and 2-way ANOVAs were conducted to determine the effects of BMI and sex on BCAAs/AAAs. Fasting serum AAAs, BCAAs, glutamate, and alanine were greater and high-density lipoprotein (HDL) was lower (P < 0.05, each) in OB-T2DM patients than in NW-T2DM patients, especially in male OB-T2DM patients. Arginine, histidine, leucine, methionine, and lysine were greater in male patients than in female patients. Moreover, histidine, alanine, glutamate, lysine, valine, methionine, leucine, isoleucine, tyrosine, phenylalanine, and tryptophan were significantly correlated with abdominal adiposity, body weight and BMI, whereas isoleucine, leucine and phenylalanine were negatively correlated with HDL. Heterogeneously elevated amino acids, especially BCAAs/AAAs, across new-onset T2DM patients in differing BMI categories revealed a potentially skewed prediction of T2DM development. The higher BCAA/AAA levels in obese T2DM patients would support T2DM prediction in obese individuals, whereas the lower levels of BCAAs/AAAs in NW-T2DM individuals may underestimate T2DM risk in NW individuals. This potentially skewed T2DM prediction should be considered when BCAAs/AAAs are to be used as the T2DM predictor.

Effect of laparoscopic mini-gastric bypass versus laparoscopic sleeve gastrectomy on hypertension and dyslipidemia in obese type 2 diabetes mellitus patients.

The aim of the research was to compare the effect of the laparoscopic mini-gastric bypass (LMGB) technique with the laparoscopic sleeve gastrectomy (LSG) technique in bariatric surgery on type 2 diabetes mellitus (T2DM), hypertension (HTN), and dyslipidemia in obese T2DM patients. A prospective, cross-sectional study, conducted in Surgery Department at Al-Mouwasat and Al-Assad University Hospitals in Damascus, and included T2DM obese patients who would undergo bariatric surgery using the LMGB or LSG technique. The research included two groups: the LSG group (92 patients, 60.9% female, age 44.6 year, BMI 41.85kg/m2) and the LMGB group (137 patients, 59.1% female, age 47.1 year, BMI 43kg/m2). Before surgery, the prevalence of HTN and dyslipidemia were similar in the two groups. After one year: T2DM improvement and remission rate in the LMGB group (13.9, 80.3%) were greater than in the LSG group (13, 62%), the difference was statistically significant. The HTN improvement and remission rate in the LMGB group (52.9, 41.4%) were greater than in the LSG group (47.5, 39%), the difference was not statistically significant. The dyslipidemia improvement rate was greater in LSG group (47.2 vs. 32.7%), while the dyslipidemia remission rate was greater in LMGB group (67.3 vs. 52.8%), the difference was statistically significant. The authors found that the LMGB technique was more effective than the LSG technique in controlling cardiovascular risk factors of obesity, T2DM, HTN, and dyslipidemia.

1073 Roux-en-Y Gastric Bypass or Sleeve Gastrectomy Versus Medical Therapy in the Management of Obesity in Patients with Type 2 Diabetes Mellitus: Systematic Review and Meta-Analysis

Abstract Aim Bariatric Surgery has proven to be effective in achieving diabetic control in morbidly obese patients. Advances in Roux-En-Y Gastric Bypass (RYGB) and Sleeve gastrectomy procedures have influenced this majorly. This review aims to analyse the clinical outcomes by comparing the two procedures and medical therapy, in morbidly obese patients with Type 2 Diabetes Mellitus (T2DM). Method A systematic literature review was conducted in accordance to the PRISMA guidelines to identify relevant articles that compared RYGB, sleeve gastrectomy and medical therapy for obesity in diabetic patients. Primary outcomes included BMI and HbA1c. Results Seven studies were identified enrolling 900 patients. Participants were predominantly female (61.31%) with a mean follow up of 2.71 years. A greater reduction in BMI and HbA1c was noted with both procedures compared to medical therapy. Sleeve gastrectomy was better in reducing BMI than RYGB (SMD = 19.23 [15.61 – 22.84], p&amp;lt;0.01). HbA1c (SMD = -2.37 [-2.72 – -2.02], p&amp;lt;0.01) and Triglycerides (SMD = -0.87 [-1.65 – -0.08], p = 0.03) were statistically significantly in favour of RYGB. No differences were noted between the two procedures in other outcomes including fasting glucose, weight and Blood pressure. Both procedures compared to medical therapy were considered to be superior statistically across all outcomes measured. Conclusions Overall, the study shows the superiority of Bariatric surgery to medical therapy in managing T2DM in obese patients. No significant differences were noted between the types of bariatric surgery, however, there exists a need to perform studies with longer follow up and compare the feasibility of these procedures.

CORRELATION BETWEEN THYROID FUNCTION AND OBESITY IN TYPE 2 DIABETES INDIVIDUALS

Objectives: In the present study, it is aimed to investigate the prevalence of thyroid dysfunction and blood glucose parameters and their correlation in Type 2 diabetes mellitus (T2DM) obese patients. Methods: The present study was a cross-sectional and observational study conducted for a period of 1 year January 2020–January 2022. The patient demographic data, age, and gender were collected from the medical records. After an overnight fast, venous blood samples were collected in the morning for laboratory tests. Electrochemiluminescence immunoassays were used to assess serum free T3 (FT3), FT4, and thyroid stimulating hormone (TSH). Fasting blood glucose, postprandial blood glucose, and random sugar levels were measured using enzymatic method. Body mass index (BMI) was calculated as weight (kg) divided by squared height (m). Results: In the present study, the mean values of thyroid harmones T3, T4 between the obese and non-obese individuals showed that no much significant variations might be due to low sample size. However, the mean values of TSH values were significantly higher 8.7ng/dl for obese individuals than non-obese individuals. There was a significant positive correlation that was identified for thyroid parameters TSH between obese and non-obese T2DM patients. On the other hand, there was a significant influence of postprandial blood sugar, random blood sugar, hemoglobin A1C, and BMI in obese and non-obese T2DM patients and insignificant influence for thyroid parameters T3 and T4. However, the results also showed that there was a highly significant influence of THS levels in obese T2DM patients. Conclusion: The findings of the present investigation showed a high correlation between thyroid function, mainly TSH levels, and Type 2 diabetes, particularly in obese persons.

Comparison of therapeutic effect of metformin hydrochloride/vildagliptin and liraglutide on type 2 diabetes mellitus in obese patients

To evaluate the therapeutic effects of two therapeutic strategies based on metformin hydrochloride/vildagliptin and liraglutide on type 2 diabetes mellitus (T2DM) in obese patients. We retrospectively collected the clinical data of 107 obese patients (BMI>25 kg/m2) with T2DM treated in Second Affiliated Hospital of Wannan Medical College (Wuhu, China) during 2019-2021, including 53 patients treated continuously with metformin hydrochloride/vildagliptin and 54 with liraglutide for 3 months. The changes in BMI, waist circumference, fasting blood glucose (FBG), postprandial blood glucose, HbA1C, fasting C-peptide, postprandial C-peptide, fasting insulin and postprandial insulin of the patients after treatment were compared between the two groups. In both of the groups, the patients all showed significant reductions of BMI, waist circumference, FBG, postprandial blood glucose and HbA1C (all P < 0.05) with improved fasting and postprandial C-peptide levels after the treatments (P < 0.05). The two treatment regimens showed comparable blood glucoselowering effects, but liraglutide produced better effect in reducing waist circumference (P < 0.01). Neither of two regimens obviously affected insulin level of the patients (P>0.05). Both metformin hydrochloride/vildagliptin and liraglutide have good therapeutic effects on T2DM in obese patients and can achieve good blood glucose and weight control, but liraglutide has a better effect for weight control.

Comparison of Plasma Exosome Proteomes Between Obese and Non-Obese Patients with Type 2 Diabetes Mellitus.

Obesity is considered a promoter of type 2 diabetes mellitus (T2DM). However, the underlying mechanism remains unclear. This study aimed to identify plasma exosome differentially expressed proteins (DEPs) that are potentially involved in the development of obesity-related T2DM. Exosomes were isolated from the plasma of obese and non-obese T2DM patients (n = 10 for each group). A label-free quantitative mass spectrometry analysis was applied to identify plasma exosome DEPs in obese patients compared with non-obese patients, followed by bioinformatics analysis including GO annotation, KEGG analysis, subcellular localization prediction, transcription factor analysis, and protein-protein interaction (PPI) prediction. We identified 2 significantly upregulated proteins (C9 and PON1) and 5 significantly downregulated proteins (HPX, A1BG, CFHR1, ANG, and CALM) in obese patients compared with those in non-obese patients. KEGG analysis demonstrated that the insulin signaling pathway was one of the pathways that significantly correlated with the DEPs. The DEPs were primarily localized in the extracellular space (5 out of 7). HMG-box and NF-Y beta might regulate the transcription of the DEPs. C9, PON1, HPX, and CFHR1 were present in the PPI network. The plasma exosome DEPs are potentially responsible for the development of obesity-related T2DM possibly through the insulin signaling pathway and the interaction with other proteins. Our study may guide future research direction toward the pathogenesis of obesity-related T2DM.

Sphingolipidomic profile and HDL subfractions in obese dyslipidemic type 2 diabetic patients

PurposeThe aim of the study was to investigate changes in serum sphingolipid levels and high density lipoprotein (HDL) subtypes with relation to low-density lipoprotein cholesterol (LDL-C), non-HDL-C and triglyceride (TG) levels in type 2 diabetes mellitus (T2DM) patients. MethodsBlood was obtained from 60 patients with T2DM. Levels of sphingosine-1-phosphate (S1P), C16-C24 sphingomyelins (SMs), C16-C24 ceramides (CERs), and C16 CER-1 P were determined by LC-MS/MS. Serum concentrations of cholesterol ester transfer protein (CETP), lecithin-cholesterol acyltransferase (LCAT) and apolipoprotein A-1 (apoA-I) were analyzed by enzyme-linked immunosorbent assay (ELISA). HDL subfraction analysis was performed by Disc polyacrylamide gel electrophoresis. ResultsC16 SM, C24 SM, C24-C16 CER and C16 CER-1 P levels were significantly increased in T2DM patients with LDL-C above 160 mg/dL, compared to those with LDL-C below 100 mg/dL. A significant correlation was observed between C24:C16 SM, C24:C16 CER ratios and LDL-C, non HDL-C levels. Higher serum levels of C24 SM, C24-C18 CER and C24:C16 SM ratio was seen in obese T2DM patients (BMI>30) compared to those with BMI 27–30. Patients with fasting TG levels below 150 mg/dL had significantly increased HDL-large and significantly decreased HDL-small fractions compared to those with fasting TG levels above 150 mg/dL. ConclusionObese dyslipidemic T2DM patients had increased levels of serum sphingomyelins, ceramides and HDL-small fractions. The ratio of serum C24:C16 SM, C24:C16 CER and long chain CER levels may be used as diagnostic and prognostic indicators of dyslipidemia in T2DM.

PANCREATIC FAT CONTENT PLAYS AN IMPORTANT ROLE IN THE DEVELOPMENT OF TYPE 2 DIABETES MELLITUS SIMILAR TO THAT OF LIVER FAT CONTENT.

Type 2 diabetes mellitus (T2DM) is a major health problem worldwide. Earlier studies have reported that pancreatic fat content (PFC) and liver fat content (LFC) are risk factors for T2DM. The aim of the present study was to demonstrate the relationship between PFC, LFC and T2DM. A total of 70 T2DM subjects and 30 non-diabetic volunteers who underwent Dixon-based magnetic resonance imaging (MRI) method at Yixing People's Hospital between December 2018 to December 2020 were included in the study. The three-point Dixon (3p-Dixon) method was used to measure the fat content in the pancreas and liver. Clinical indices including gender, age, body mass index (BMI), total cholesterol, triglyceride, glucose and C peptide levels were collected. The association between PFC, LFC, and OGTT-derived parameters was examined by Pearson and Spearman correlation analyses. T2DM subjects had higher PFC and LFC than those measured in the non-diabetic subjects (p <0.05). PFC and LFC were associated positively with OGTT-derived parameters such as insulin secretion, insulin resistance, and early- and late-phase insulin secretion in the male T2DM subjects(p <0.05), but not in the non-diabetic and female T2DM subjects. The relationship between PFC and OGTT-derived parameters was also more obvious than that for LFC in overweight and obese male patients with T2DM whose BMI was >24 kg/m2. PFC and LFC were both associated with β-cell dysfunction and insulin resistance in males with T2DM. The relationship between PFC and β-cell dysfunction and insulin resistance was more obvious than that observed for LFC in overweight and obese male T2DM patients. More attention should therefore be paid to PFC in clinical settings.

The Correlation of Nrf2 rs6721961 Variants with the Risk of Type 2 Diabetes Mellitus and Obesity in Kurdistan of Iraq

Background: Type 2 diabetes mellitus (T2DM) is an endocrine and metabolic disease that the interaction of genetic background with environmental factors could enhance its risk. The nuclear erythroid-2-related factor 2 (Nrf2) protects cells against oxidative damage and toxicity. Objectives: This study aimed to determine the possible correlation between the Nrf2 gene variants with the risk of T2DM and obesity in the Kurdistan of Iraq. Methods: This study was conducted on 250 individuals categorized into 4 groups: 67 obese T2DM patients (body mass index (BMI) ≥ 30 kg/m2), 65 normal BMI diabetic patients (BMI &lt; 25 kg/m2), 62 obese non-diabetics, and 56 normal BMI non-diabetic individuals. The Nrf2 rs6721961 variants were identified by polymerase chain reaction (PCR) technique followed by digestion with the restriction enzyme of NgoMIV. Results: In the obese T2DM group, the levels of waist, and wrist circumference were significantly more than those of obese non-diabetic controls. Total antioxidant capacity level was not significantly different comparing patients with their controls. The Nrf2 T allele significantly decreased the risk of T2DM in normal BMI patients. In addition, carrying the T allele significantly reduced the risk of obesity. Conclusions: According to the results, significantly higher levels of anthropometric parameters was detected in obese T2DM compared with obese non-diabetic controls. The T allele of Nrf2 decreased T2DM risk among patients with normal BMI and obesity risk among Kurdish residents of Iraq. The findings of our research can be used in the prevention and management of T2DM by improving lifestyle habits.

Impact of serum levels of vitamin D on lipid profiles, glycemic indices, and insulin resistance in obese type 2 diabetes patients: An observational study

Background: Diabetes patients have a higher chance of developing dyslipidemia and increased release of free fatty acids, which participate in developing insulin-resistant fat cells. On the other hand, vitamin D insufficiency is linked to the evolution of type 2 diabetes mellitus (T2DM). This study examines the impact of vitamin D serum levels on lipid profiles and insulin resistance concerning glycemic indices in obese T2DM patients. Methods: During the data collecting stage, 47 diabetes patients were chosen from the out-patient clinic. The control individuals were selected from the general population and were equivalent to the matching patients, with a total of 43 healthy participants. After an overnight fast, a venous blood sample was collected from each individual to test insulin and vitamin D3 levels using particular ELISA kits. In addition, by colorimetric test, serum was used to estimate total cholesterol, triglyceride, and high-density lipoprotein cholesterol. Aside from that, fasting serum glucose levels were measured (FSG). Results: Fasting serum glucose (FSG), homeostatic model assessment-insulin resistance (HOMA-IR), total cholesterol, and triglycerides, all of these values were significantly elevated in people with diabetes as compared to controls (p-value &lt;0.05) when the serum level of vitamin D was markedly low. In contrast, insulin and high-density lipoprotein values had decreased significantly in the diabetic population compared to controls (p-value &lt;0.05) and were not correlated to vitamin D levels. Conclusions: Diabetes patients had higher FSG, HOMA-IR, hemoglobin A1c (HbA1c), fasting insulin, triglycerides, total cholesterol to high-density lipoprotein cholesterol ratios (TC: HDL-C), triglyceride to high-density lipoprotein cholesterol ratios (TG: HDL-C), and low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratios (LDL-C: HDL). In obese diabetic individuals, vitamin D levels had a significant impact on total cholesterol, LDL-C, and the TC:HDL-C ratio.

The Effects of Vitamin K2 (Menaquinone-7) on the Leptin and Adiponectin Levels in Overweight/Obese Type 2 Diabetes Patients: A Randomized Clinical Trial

Background: Type 2 diabetes mellitus (T2DM) is a prevalent disease with metabolic consequences. Lower levels of adiponectin and higher levels of leptin were reported in T2DM. This study aimed to evaluate the effect of menaquinone-7 (MK-7) supplementation on adiponectin and leptin in overweight/obese T2DM patients. Methods: Sixty men and women with T2DM and 27 ≤ body mass index &lt; 35 kg/m2 , participated in this double-blind placebo-controlled randomized clinical trial for 12 weeks. The subjects were allocated into intervention (200 µg/day MK-7) or placebo groups. Three-day food records, anthropometrics and physical activity were assessed and fasting blood samples were collected at the pre- and post-intervention. Serum adiponectin, leptin, fasting blood sugar (FBS) and fasting insulin (FI) were measured and adiponectin to leptin ratio (A/L ratio) was calculated. Results: MK-7 decreased fasting blood sugar (P: 0.018) and fasting insulin (P: 0.012), according to a within group analysis of the 45 patients who finished the research. Fasting blood sugar (P: 0.024) and leptin levels (P: 0.032) were lower in the MK-7 group, but there were no significant changes between the groups in terms of adiponectin or the adiponectin to leptin (A/L) ratio. Conclusion: Current study showed that MK-7 supplementation could lead to significant reduction in leptin and FBS, but it has no effect on the adiponectin and A/L ratio in overweight/ obese T2DM patients.

Total Serum Testosterone Level in Obese Patients with Type -2 Diabetes Mellitus

Both obesity and type 2 diabetes mellitus (T2DM) are independently associated with reduced serum testosterone. The additive effect of obesity and T2DM on reducing testosterone levels need to be investigated. Their combined additive effects may place obese T2DM patients at higher risk of decreased testosterone and the associated increased morbidity and mortality. The aim of this study was to screen obese T2DM patients for biochemical hypogonadism regardless of the presence of overt clinical symptoms to consider testosterone replacement therapy. 152 adult male aged 40 to 68 years with T2DM were recruited through simple random sampling. The study participants were grouped based on their BMI into lean (n=48); overweight (n=57), obese (n=37) and morbidly obese (n=11). Total serum testosterone (TST), BMI and waist circumference (WC) were measured in all patients and luteinizing hormone (LH) was measured in 103 of them. Low TST was defined as TST&lt;9nmol/L and the normal range for LH was 1.7-11.2mIU/ml. Mean TST in lean T2DM patients was 15.61± 6.0 nmol/l. TST levels were significantly lower in obese and morbidly obese groups compared with the lean group (P=0.003 and 0.015 respectively). TST negatively correlated with BMI (r= -0.29, P&lt;0.001) and WC (r= -0.21, P&lt;0.009). Overall, 19.7% of T2DM patients had low TST. The prevalence of low TST increased from 14.9% in lean, to 21.1% in overweight, to 21.6% in obese, to 27.3% in morbidly obese T2DM patients, (P=0.74). LH was inappropriately normal in 95% (19/20) of patients with low TST. Obese T2DM patients had reduced TST levels and a higher prevalence of reduced TST compared to lean patients. TST negatively correlated with BMI and WC. Therefore, screening obese T2DM patients for testosterone deficiency should be considered.

Evaluation of the Clinical Efficacy of the Treatment of Overweight and Obesity in Type 2 Diabetes Mellitus by the Telemedicine Management System Based on the Internet of Things Technology.

Objective To explore the application value of medical intelligent electronic system under the background of Internet of Things in the clinical study of the treatment of overweight/obesity in type 2 diabetes mellitus (T2DM) with empagliflozin combined with liraglutide; 50 overweight and obese adult T2DM patients in our hospital were randomly divided into the combined group and the control group, 25 cases in each group. The control group was treated with liraglutide alone, while the combined group was treated with empagliflozin on the basis of liraglutide. Based on the Internet of Things technology, with diabetes management as the core, the functions of information collection, transmission, and storage of T2DM patients are realized. Doctors pass the diabetes management plan to T2DM patients through the platform, supervise the implementation, and finally compare the clinical efficacy of the two groups. Results Compared with before treatment, the body mass index (BMI), fasting blood glucose (FPG), postprandial blood glucose (2hPG), glycosylated hemoglobin (HbAlc), islet beta cell secretion function index (HOMA-β), islet resistance index (HOMA-IR), total cholesterol (TC), and triglyceride (TG) in both groups decreased significantly after treatment. After combined treatment, systolic blood pressure (SBP), diastolic blood pressure (DBP), FPG, 2hPG, HbA1c, and HOMA-IR in the combined group were significantly lower than those in the control group (P < 0.05). Hypoglycemia occurred in both groups, with 2 cases in the control group and 4 cases in the combined group. Conclusion The telemedicine management system based on Internet of Things technology can improve patients' self-management ability and provide a new choice for individualized treatment of overweight/obesity T2DM patients. The combination therapy of empagliflozin and liraglutide can effectively reduce blood sugar, weight, blood pressure, blood lipid, and hypoglycemia and effectively improve insulin resistance and secretion function of islet β cells in T2DM patients.

Differential Association of Selected Adipocytokines, Adiponectin, Leptin, Resistin, Visfatin and Chemerin, with the Pathogenesis and Progression of Type 2 Diabetes Mellitus (T2DM) in the Asir Region of Saudi Arabia: A Case Control Study.

Background: Sedentary lifestyles, urbanization and improvements in socio-economic status have had serious effects on the burden of diabetes across the world. Diabetes is one of the 10 leading causes of death globally, and individuals with diabetes have a 2–3-fold increased risk of all-cause mortality. Adipose tissue is increasingly understood as a highly active endocrine gland that secretes many biologically active substances, including adipocytokines. However, the exact and discrete pathophysiological links between obesity and T2DM are not yet fully elucidated. Methods: In the current study, we present the association of five diverse adipocytokines, adiponectin, leptin, resistin, visfatin and chemerin, with T2DM in 87 patients (46 males and 41 females) with type 2 diabetes mellitus and 85 healthy controls (44 males and 41 females) from the Asir region of Saudi Arabia. The patients were divided into four groups: normal BMI, overweight, obese and severely obese. The baseline biochemical characteristics, including HbA1c and anthropometric lipid indices, such as BMI and waist–hip ratio, were determined by standard procedures, whereas the selected adipokine levels were assayed by ELISA. Results: The results showed significantly decreased levels of adiponectin in the T2DM patients compared to the control group, and the decrease was more pronounced in obese and severely obese T2DM patients. Serum leptin levels were significantly higher in the females compared to the males in the controls as well as all the four groups of T2DM patients. In the male T2DM patients, a progressive increase was observed in the leptin levels as the BMI increased, although these only reached significantly altered levels in the obese and severely obese patients. The serum leptin levels were significantly higher in the severely obese female patients compared to the controls, patients with normal BMI, and overweight patients. The leptin/adiponectin ratio was significantly higher in the obese and severely obese patients compared to the controls, patients with normal BMI, and overweight patients in both genders. The serum resistin levels did not show any significant differences between the males and females in thr controls or in the T2DM groups, irrespective of the BMI status of the T2DM patients. The visfatin levels did not reveal any significant gender-based differences, but significantly higher levels of visfatin were observed in the T2DM patients, irrespective of their level of obesity, although the higher values were observed in the obese and highly obese patients. Similarly, the serum chemerin levels in the controls, as well as in T2DM patients, did not show any significant gender-based differences. However, in the T2DM patients, the chemerin levels showed a progressive increase, with the increase in BMI reaching highly significant levels in the obese and severely obese patients, respectively. Conclusion: In summary, it is concluded that significantly altered concentrations of four adipokines, adiponectin, leptin, visfatin and chemerin, were found in the T2DM patient group compared to the controls, with more pronounced alterations observed in the obese and highly obese patients. Thus, it can be surmised that these four adipokines play a profound role in the onset, progression and associated complications of T2DM. In view of the relatively small sample size in our study, future prospective studies are needed on a large sample size to explore the in-depth relationship between adipokines and T2DM.

The Effect of Orlistat Administration in Change of Glycemic Control and Weight Loss of Obesity or Overweight Patients with Type 2 Diabetes Mellitus

Hightlight:The effect of orlistat on glycemic control and weight loss in overweight or obese type 2 diabetes mellitus patients was determinedHbA1c and FPG level in overweight and obese type 2 diabetes mellitus patient can improved by orlistat as an adjuvant therapy. Abstract:Risk of Type 2 diabetes mellitus (T2DM) increases steadily with increasing overweight and obesity, and these two-health problems are emerging epidemics worldwide. Orlistat, a lipase inhibitor for weight loss drug, is often used in T2DM medication as adjuvant therapy, but effectiveness of the drug for improving glycemic control on T2DM patients is unclear. This study was to determine the effect of orlistat on glycemic control and weight loss in overweight or obese patients with T2DM. Term “Orlistat” AND “(obesity OR overweight)” AND “(HbA1c OR A1C)” AND “diabetes” were systematically searched in Pubmed and Science Direct web databases up to March 2021. Only randomized controlled study (RCT) methods studies were included in this study. Collected final samples were presented in a table with narrative review. There were 9 RCT studies with a total 2,175 subjects that met inclusion criteria. Of the sample, 360 mg/day orlistat as an adjuvant therapy, was administered to overweight or obese T2DM patients together with hypocaloric intake (8 studies) or without hypocaloric intake (1 study) intervention. They were examined for 12-52 weeks. From 2 short-term (12 weeks) studies, one study revealed that orlistat improved HbA1c and fasting plasma glucose (FPG) level significantly, while one study showed no significant effect compared to placebo. Seven other studies (long term observation) had found that orlistat significantly improved HbA1c and FPG level. All studies found that orlistat significantly reduced body weight. As an adjuvant therapy, Orlistat improved HbA1c and FPG level in overweight and obese T2DM patients.

Metformin: A Narrative Review of Its Potential Benefits for Cardiovascular Disease, Cancer and Dementia.

The biguanide metformin has been used as first-line therapy in type 2 diabetes mellitus (T2DM) treatment for several decades. In addition to its glucose-lowering properties and its prevention of weight gain, the landmark UK Prospective Diabetes Study (UKPDS) demonstrated cardioprotective properties in obese T2DM patients. Coupled with a favorable side effect profile and low cost, metformin has become the cornerstone in the treatment of T2DM worldwide. In addition, metformin is increasingly being investigated for its potential anticancer and neuroprotective properties both in T2DM patients and non-diabetic individuals. In the meantime, new drugs with powerful cardioprotective properties have been introduced and compete with metformin for its place in the treatment of T2DM. In this review we will discuss actual insights in the various working mechanisms of metformin and the evidence for its beneficial effects on (the prevention of) cardiovascular disease, cancer and dementia. In addition to observational evidence, emphasis is placed on randomized trials and recent meta-analyses to obtain an up-to-date overview of the use of metformin in clinical practice.

Predictor for cardiovascular risk in patients with type-2 diabetes mellitus

ObjectiveThelimited information available concerning the role of periostin associated with cardiovascular risk in patients with type 2 diabetes mellitus (T2DM). Therefore, this study aimed to find out the association between periostin level and inflammatory markers in patients with T2DM as well as in the acute coronary syndrome (ACS) patients. MethodsThis cross-sectional study randomly included a total of 210 participants, comprising T2DM (n = 130), ACS (n = 40), and healthy group (n = 40). All anthropometric measures and biochemical parameters, periostin level, high sensitivity C-reactive protein (hs-CRP), and white blood cell (WBC) count were estimated. Pearson's correlation and linear multiple regression analysis was performed to assess the correlation and association between periostin level and other variables. ResultsSerum periostin levels were significantly higher among obese T2DM and ACS patients as compared to control. Positive correlation was found between serum periostin levels and waist circumference (WC), body mass index (BMI), fasting plasma glucose (FPG), postprandial glucose (PPG), glycated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), hs-CRP, WBC count, while negative correlation was observed with high-density lipoprotein (HDL) (p < 0.05). After adjustment, regression analysis showed that BMI, HbA1c, TC, HDL, WBC and hs-CRP were independently related to serum periostin levels (p < 0.001). ConclusionThe evidence of current study suggested that periostin levels were significantly higher among patients with ACS and obese T2DM, and it is significantly associated with lipid profile, anthropometric measures and inflammatory biomarkers. Our results revealed that periodic estimation of the circulating serum periostin could be a biomarker to predict the risk of developing cardiovascular complications in patients with T2DM.However, lacking of follow-up it further creates room for the future investigation.