Persistent Hyperglycemia Research Articles

Hyperglycemia in a NOD Mice Model of Type-I Diabetes Aggravates Collagenase-Induced Intracerebral Hemorrhagic Injury.

Intracerebral hemorrhage (ICH) is a severe type of stroke with high mortality. Persistent hyperglycemia following ICH is linked to deteriorated neurological functions and death. However, the exacerbating effect of hyperglycemia on ICH injury at the molecular level is still unclear. Therefore, this study explores the impact of diabetes on ICH injury using a non-obese diabetic (NOD) mouse model of type I diabetes mellitus. NOD and non-diabetic (non-obese resistant) mice subjected to ICH by intrastriatal injection of collagenase were sacrificed three days following the ICH. Brains were collected for hematoma volume measurement and immunohistochemistry. Neurobehavioral assays were conducted 24 h before ICH and then repeated at 24, 48 and 72 h following ICH. NOD mice showed increased hematoma volume and impairment in neurological function, as revealed by rotarod and grip strength analyses. Immunohistochemical staining showed reduced glial cell activation, as indicated by decreased GFAP and Iba1 staining. Furthermore, the expression of oxidative/nitrosative stress markers represented by 3-nitrotyrosine and inducible nitric oxide synthase was reduced in the diabetic group. Overall, our findings support the notion that hyperglycemia exacerbates ICH injury and worsens neurological function and that the mechanism of injury varies depending on the type of diabetes model used.

Unraveling the rationale and conducting a comprehensive assessment of AdipoRon (adiponectin receptor agonist) as a candidate drug for diabetic nephropathy and cardiomyopathy prevention and intervention-a systematic review.

Type 2 diabetes mellitus (T2DM) is a widespread chronic disease characterized by persistent hyperglycemia, leading to severe complications such as diabetic cardiomyopathy and nephropathy, significantly affecting patient health and quality of life. The complex mechanisms underlying these complications include chronic inflammation, oxidative stress, and metabolic dysregulation. Diabetic cardiomyopathy, marked by structural and functional heart abnormalities, and diabetic nephropathy, characterized by progressive kidney damage, are major contributors to the increased morbidity and mortality associated with T2DM. AdipoRon, a synthetic adiponectin receptor agonist, has shown potential in preclinical studies for mimicking the beneficial effects of endogenous adiponectin, reducing inflammation and oxidative stress, and improving lipid metabolism and mitochondrial function. This systematic review evaluates the therapeutic potential of AdipoRon, focusing on its impact on diabetic cardiomyopathy and nephropathy. Through a comprehensive literature search and analysis, we highlight AdipoRon's role in ameliorating cardiovascular and renal complications in various animal models and cellular systems. The findings underscore the urgent need for translational clinical studies to validate AdipoRon's efficacy and safety in human populations, aiming to advance this promising therapeutic approach from experimental models to clinical application, potentially offering new hope for improved management of diabetic complications.

The Role of Dietary Anthocyanins for Managing Diabetes Mellitus-Associated Complications.

Diabetes mellitus (DM) is an intricate metabolic disorder marked by persistent hyperglycemia, arising from disruptions in glucose metabolism, with two main forms, type 1 and type 2, involving distinct etiologies affecting β-cell destruction or insulin levels and sensitivity. The islets of Langerhans, particularly β-cells and α-cells, play a pivotal role in glucose regulation, and both DM types lead to severe complications, including retinopathy, nephropathy, and neuropathy. Plant-derived anthocyanins, rich in anti-inflammatory and antioxidant properties, show promise in mitigating DM-related complications, providing a potential avenue for prevention and treatment. Medicinal herbs, fruits, and vegetables, abundant in bioactive compounds like phenolics, offer diverse benefits, including glucose regulation and anti-inflammatory, antioxidant, anticancer, anti-mutagenic, and neuroprotective properties. Anthocyanins, a subgroup of polyphenols, exhibit diverse isoforms and biosynthesis involving glycosylation, making them potential natural replacements for synthetic food colorants. Clinical trials demonstrate the efficacy and safety of anthocyanins in controlling glucose, reducing oxidative stress, and enhancing insulin sensitivity in diabetic patients, emphasizing their therapeutic potential. Preclinical studies revealed their multifaceted mechanisms, positioning anthocyanins as promising bioactive compounds for managing diabetes and its associated complications, including retinopathy, nephropathy, and neuropathy.

Distribution of the T cell element of the immune system in post-COVID patients with first identified hyperglycemia

Post-COVID syndrome combines many adverse outcomes with often new-onset conditions, including type 2 diabetes mellitus (DM). The relevance of the study is the insufficient data on T cell immunity in patients with hyperglycemia after COVID-19. The purpose of this study was to identify the characteristics of T cell immunity in individuals with post-COVID syndrome and newly diagnosed carbohydrate metabolism disorders (CDM) in the post-COVID period. The study included 100 patients (32 men and 68 women) aged from 38 to 70 years (mean age (M±m) was 59.40±8.80 years) with a verified post-COVID-19 condition. All patients were divided into three groups: group 1 – patients with concomitant newly diagnosed impaired glucose tolerance (IGT) in the post-COVID period (prior to SARS-CoV-2 infection, no increase in glycemia was detected according to primary medical documentation) (n = 30), group 2 – patients with concomitant newly diagnosed type 2 diabetes mellitus (n = 30), and group 3 – patients with the development of post-COVID syndrome without hyperglycemia (n = 40). During the study, the following parameters were determined: CD45+, CD3+ (T lymphocytes), CD45+, CD3+, CD4+ (helper inducers), CD45+, CD3+, CD8+ (cytotoxic T lymphocytes), CD45+, CD3+, CD4+, CD25+, CD127- (T regulatory cells), CD45+, CD3+, CD4+, CD25+ (T lymphocytes – early activation), CD45+, CD3+, HLA-DR+ (T lymphocytes – late activation). Infection with SARS-CoV-2 with the subsequent development of post-COVID syndrome and persistent hyperglycemia (IGT, type 2 diabetes) in the post-COVID period was accompanied by a higher level of the total number of T lymphocytes. A study of the T lymphocyte population revealed changes in the subpopulation composition. In the group of patients with CDM, a significant increase in T cytotoxic and T regulatory cells was noted. More pronounced changes in the subpopulation composition were identified in the group of patients with newly diagnosed type 2 diabetes in the post-COVID period: an increase in the relative and absolute numbers of T helper cells and T cells of late activation of lymphocytes. Disorders of carbohydrate metabolism associated with COVID-19 are accompanied by changes in the subpopulation composition of T lymphocytes. In individuals with newly diagnosed type 2 diabetes in the post-COVID period, hyperactivation of the T cell component of the immune system was revealed. Heterogeneous data were obtained in individuals with newly diagnosed impaired glucose tolerance, which requires further study of this group of patients.

Re-diagnosis of diabetes mellitus type 1 to maturity-onset diabetes of the young type 2 (MODY 2) in a 26-year-old male: a case report

Diabetes mellitus (DM) encompasses a spectrum of metabolic disorders characterized by hyperglycemia due to defects in insulin secretion, action, or both. Type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) are the most prevalent forms, whereas Maturity-Onset Diabetes of the Young (MODY) represents a monogenic subtype, often misdiagnosed due to its phenotypic overlap. This case study highlights a 26-year-old male initially diagnosed with T1DM at age 12, managed with insulin therapy. Upon admission, despite stable glycemic control and preserved C-peptide secretion, genetic testing revealed MODY 2 due to a variant in the GCK gene. Unlike T1DM and T2DM, MODY 2 is characterized by mild, persistent hyperglycemia with a low risk of complications, emphasizing the importance of genetic diagnosis for tailored management and family counseling. This case underscores the critical role of genetic evaluation in accurately diagnosing and managing atypical diabetes presentations.

Okra (Abelmoschus esculentus L. moench) fruit powder standardized in flavonoids improves glycemic control and metabolic memory in acute and chronic hyperglycemia

Type 2 diabetes mellitus (T2DM) is a chronic disease with high global prevalence characterized by persistent hyperglycemia. Elevated blood glucose levels are associated with constant oxidative stress and increased protein glycation, establishing a metabolic memory state. Therefore, the efficacy of the Okra (Abelmoschus esculentus L. moench) Fruit Powder Standardized in Flavonoids (OFP-SF) was evaluated in glucose homeostasis, oxidative stress, and metabolic memory, using zebrafish models of acute and chronic hyperglycemia. The OFP-SF was produced from dried fresh fruits and subsequently subjected to characterization regarding its antioxidant potential and chemical composition. Finally, the product was standardized to contain 1.6% flavonoids. In acute hyperglycemia, OFP-SF at doses of 125 μg and 250 μg demonstrated the ability to normalize blood glucose levels, reaching levels of 94.56 ± 5.9 mg/dL and 76.88 ± 8.9 mg/dL, respectively, when administered prior to glucose overload. The same doses were tested in a chronic hyperglycemia model, where after a seven-day treatment, animals receiving 125 and 250 μg of OFP-SF exhibited glycemic values of 73.45 ± 15.67 mg/dL and 33.96 ± 5.31 mg/dL, respectively, comparable to those observed in the Control group (49.48 ± 2.77 mg/dL). Furthermore, OFP-SF was able to mitigate metabolic memory by reducing oxidative stress and protein glycation in the brain, liver, and eye tissues of hyperglycemic zebrafish. These findings provide a basis for developing new products that utilize the phytochemical potential of A. esculentus fruits for the prevention and adjunctive treatment of T2DM.

A Novel Immunodeficient Hyperglycemic Mouse Carrying the Ins1 Akita Mutation for Xenogeneic Islet Cell Transplantation.

For patients who have difficulty controlling blood glucose even with insulin administration, xenogeneic islet cells, including human stem cell-derived pancreatic islets (hSC-islet) and porcine islets, have garnered attention as potential solutions to challenges associated with donor shortages. For the development of diabetes treatment modalities that use cell transplantation therapy, it is essential to evaluate the efficacy and safety of transplanted cells using experimental animals over the long term. We developed permanent diabetic immune-deficient mice by introducing the Akita (C96Y) mutation into the rodent-specific Insulin1 gene of NOD/Shi-scid IL2rγcnull (NOG) mice (Ins1C96Y/C96Y NOG). Their body weight, nonfasting blood glucose, and survival were measured from 4 wk of age. Insulin sensitivity was assessed via tolerance tests. To elucidate the utility of these mice in xenotransplantation experiments, we transplanted hSC-islet cells or porcine islets under the kidney capsules of these mice. All male and female homozygous mice exhibited persistent severe hyperglycemia associated with β-cell depletion as early as 4 wk of age and exhibited normal insulin sensitivity. These mice could be stably engrafted with hSC-islets, and the mice that received porcine islet grafts promptly exhibited lowered blood glucose levels, maintaining blood glucose levels below the normal glucose range for at least 52 wk posttransplantation. The Ins1C96Y/C96Y NOG mouse model provides an effective platform to assess both the efficacy and safety of long-term xenograft engraftment without the interference of their immune responses. This study is expected to contribute essential basic information for the clinical application of islet cell transplantation.

Glucometrics utilisation in an urban teaching hospital in ireland: current practice and future aims.

Dysglycaemia in hospitalised patients is associated with poorer clinical outcomes, including cardiovascular events, longer hospital stays, and increased risk of mortality. Therefore, glucose monitoring is necessary to achieve best outcomes. This audit assesses use of point-of-care (POC) blood glucose (BG) testing in Tallaght University Hospital (TUH) over an 8-day period. It evaluates compliance with international and TUH glucose monitoring protocols and determines frequency of diabetes team consultations for inpatient adults. Data from an 8-day period (12/03/2023-19/03/2023) were extracted from the TUH COBAS-IT system and analysed. Invalid tests were excluded. Hyperglycaemia was defined as ≥ 10mmol/L and hypoglycaemia as ≤ 3.9mmol/L. Persistent hyperglycaemia was defined as two BG results of ≥ 10mmol/L. A chart review was conducted on adult patients with persistent hyperglycaemia to assess for HbA1C results, diabetes diagnosis, and diabetes consult. 3,530 valid tests were included and analysed. 674 individual patients had tests done. 1,165 tests (33.00%) were hyperglycaemic and 75 (2.12%) were hypoglycaemic. 68.25% of adults with persistent hyperglycaemia had an HbA1C test performed or documented within three months. 42.71% of inpatient adults with persistent hyperglycaemia and a known diabetes diagnosis received a consult from the diabetes team. Increased adherence to hospital protocols for testing HbA1C in adults with persistent hyperglycaemia could improve treatment and clinical outcomes. Increased diabetes team consultation could facilitate appropriate treatment and improve patient outcomes in persistently hyperglycaemic adult patient populations.

Fermented Ananas comosus and Carica papaya harbour putative probiotic Limosilactobacillus fermentum and Lacticaseibacillus paracasei strains with inhibitory activity against α-glucosidase and α-amylase

Diabetes mellitus (DM) is the condition represented by persistent hyperglycaemia, owing to the altered glucose metabolism. The current research aims to assess the capabilities of strains of lactic acid bacteria (LAB) that were obtained from fermented Ananas comosus (A. comosus) and Carica papaya (C. papaya) (non-dairy sources) as probiotics for the prevention of DM. The capacity of the strains to endure or survive extreme conditions was evaluated using bile tolerance using oxgall at varying concentrations, hydrophobicity, coaggregation ability, adhesion ability, and hemolytic activity, and their survival rate in gastric and intestinal juices. The LAB strains demonstrated the following results: phenol (>7 Log CFU/mL), acid-bile conditions (6.53–7.11 Log CFU/mL), gastric and intestinal juice tolerance (6.18–7.33 Log CFU/mL), thereby fulfilling the requirements to be a prospective probiotic agent. The LAB strains showed characteristics of cell surface hydrophobicity (≥ 40 %), autoaggregation (≥ 70 %), and coaggregation (≤ 48 %). Furthermore, they demonstrated antioxidant activity (≥ 59 %) as well as the ability to lower blood sugar levels by inhibiting α-glucosidase (≤ 57 %) and α-amylase (≤ 64 %). The development of antidiabetic probiotics from fermented papaya and pineapple has several potential uses. These probiotics may be used as functional foods or supplements to improve glycemic control in individuals with DM. They may also be used as adjunct therapies to conventional diabetes treatments to enhance their efficacy. The results of this research may pave way for creating probiotic products that function as food additives or supplements, with the aim of enhancing health and preventing long-term illnesses like diabetes. Additionally, probiotics have been proven to boost intestinal health, regulate the immune system, and decrease inflammation.

Investigation of Glycated hemoglobin (HbA1C) and Serum Ferritin Levels in Diabetic Patients with Poor Glycemic Control in Benin City, Edo State, Nigeria

Aim/ Objective: Uncontrolled diabetes mellitus is a metabolic disorder characterized by persistent hyperglycaemia and associated complications. Assessing ferritin and glycated haemoglobin (HbA1c) levels in diabetic patients can provide valuable insights into the management and progression of the disease. This study was aimed at assessing the ferritin and HbA1c levels in patients with uncontrolled diabetes mellitus and evaluate the clinical implications of these assessments. Methodology: This was a case-control study, comprising of 60 consenting participants including 30 uncontrolled diabetes patients, 15 controlled diabetic patients, and 15 non-diabetic with no history of the disease serving as controls. Ferritin levels were measured using enzyme-linked immunosorbent assay (ELISA), and HbA1c levels were also determined using modified enzymatic reaction. Demographic and clinical data, including age, gender, diabetes duration, and medication history, were collected via questionnaires. Results: Analysis of variance (post-hoc) indicated significantly (p < 0.001) higher FBS, HbA1c and ferritin in patients with uncontrolled diabetes compared with the non-diabetic individuals. In contrast, there was no significant difference (p = 0.973) in mean ferritin between patients with controlled diabetes and those with uncontrolled diabetes. In the entire study population, there was a significant relationship between ferritin and FBS (p = 0.001) and HbA1c (p < 0.001) level. Conclusion: In this study, the levels of FBS, HbA1c and ferritin were higher among the uncontrolled diabetes patients. This suggests the need to include ferritin in the panel of assay when screening for diabetes mellitus and when monitoring the progression of the disease.

Effect of Swimming Exercise on Levels of Blood Glucose, Adiponectin, Glucose-6-Phosphatase and Lipid Profile in Diabetic Wistar Rats

Diabetes mellitus is a chronic metabolic condition that causes persistent hyperglycemia due to insulin action or secretion. Regular physical exercise has been reported to improve glycemia and lipid profile in diabetes. However, literature is scare on the effects of swimming exercise on the serum levels of adiponectin and glucose 6 phosphatase in Wister rats with diabetes This study therefore, investigated the effects of swimming exercise on adiponectin, glucose 6-phosphatase and lipid profile in male Wistar rats with streptozotocin-induced diabetes. This study was carried out on 25 male Wistar rats grouped into five groups (n=5/group): group 1=control, group 2=diabetes, group 3=diabetes treated with metformin, group 4=non-diabetes and swimming exercise, group 5=diabetes and swimming exercise. Animals in groups 2, 3, and 5 were induced with Streptozotocin (STZ) 50 mg/kg intraperitoneally. After 72 hours of diabetes induction, animals with a blood glucose level of ≥ 200 mg/dl were confirmed diabetics and used for the study. Group 3 animals were treated with metformin 200mg/kg giving orally for 28 days. Animals in groups 4 and 5 were subjected to swimming exercises for 5-10 minutes during the first week until they could swim freely for 30 minutes. The animals were then allowed to swim 5 days per week for 28 days. Swimming exercise for 28 days significantly reduced blood glucose, glucose-6-phosphatase (G6Ppase), Lactate dehydrogenase (LDH), Total cholesterol (TC), and Low-density lipoprotein (LDL) levels but caused significant increase in adiponectin and High-density lipoprotein (HDL) levels in diabetic rats compared with untreated diabetic rats. There was a significant decrease in triglyceride (TG) of diabetic animals caused by swimming for 28 days. This study demonstrated that swimming exercise for 28 days may help lower glucose level and improve insulin sensitivity by increasing adiponectin level and decreasing G6Pase activity in diabetic rats. Also, swimming exercise may help improve lipid profile in diabetic rats.

Effects of kaempherol-3-rhamnoside on metabolic enzymes and AMPK in the liver tissue of STZ-induced diabetes in mice

Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia. It involves disturbances in carbohydrate, fat, and protein metabolism due to defects in insulin secretion, insulin action, or both. Novel therapeutic approaches are continuously being explored to enhance metabolic control and prevent complications associated with the disease. This study investigates the therapeutic potential of kaempherol-3-rhamnoside, a flavonoid, in managing diabetes by modulating the AMP-activated protein kinase (AMPK) pathway and improving metabolic enzyme activities in streptozotocin (STZ) -induced diabetic mice. Diabetic mice were treated with varying doses of kaempherol-3-rhamnoside and/or insulin over a 28-day period. Glycolytic and gluconeogenesis enzyme activities in the liver, fasting blood glucose levels, serum insulin levels, lipid profiles and oxidative stress markers were assessed. Treatment with kaempherol-3-rhamnoside significantly improved glycolytic enzyme activities, reduced fasting blood glucose, and enhanced insulin levels compared to diabetic controls. The compound also normalized lipid profiles and reduced oxidative stress in the liver, suggesting its potential in reversing diabetic dyslipidemia and oxidative damage. Furthermore, kaempherol-3-rhamnoside activated the AMPK pathway, indicating a mechanism through which it could exert its effects. Kaempherol-3-rhamnoside exhibits promising antidiabetic properties, potentially through AMPK pathway activation and metabolic enzyme modulation. These findings support its potential use as an adjunct therapy for diabetes management. Further clinical studies are warranted to validate these results in human subjects.

Association between preoperative persistent hyperglycemia and postoperative delirium in geriatric hip fracture patients

BackgroundThe management of preoperative blood glucose levels in reducing the incidence of postoperative delirium (POD) remains controversial. This study aims to investigate the impact of preoperative persistent hyperglycemia on POD in geriatric patients with hip fractures.MethodsThis retrospective cohort study analyzed medical records of patients who underwent hip fracture surgery at a tertiary medical institution between January 2013 and November 2023. Patients were categorized based on preoperative hyperglycemia (hyperglycemia defined as ≥ 6.1mmol/L), clinical classification of hyperglycemia, and percentile thresholds. Multivariate logistic regression and propensity score matching analysis (PSM) were employed to assess the association between different levels of preoperative glucose and POD. Subgroup analysis was conducted to explore potential interactions.ResultsA total of 1440 patients were included in this study, with an incidence rate of POD at 19.1% (275/1440). Utilizing multiple logistic analysis, we found that patients with hyperglycemia had a 1.65-fold increased risk of experiencing POD compared to those with normal preoperative glucose levels (95% CI: 1.17–2.32). Moreover, a significant upward trend was discerned in both the strength of association and the predicted probability of POD with higher preoperative glucose levels. PSM did not alter this trend, even after meticulous adjustments for potential confounding factors. Additionally, when treating preoperative glucose levels as a continuous variable, we observed a 6% increase in the risk of POD (95% CI: 1-12%) with each 1mmol/L elevation in preoperative glucose levels.ConclusionsThere exists a clear linear dose-response relationship between preoperative blood glucose levels and the risk of POD. Higher preoperative hyperglycemia was associated with a greater risk of POD.Clinical trial numberNCT06473324.

Genetic Polymorphisms of Carnosine Synthase -1(ATPGD1) and Serum Carnosine Levels in Relation to Cardiovascular Diseases in Iraqi Type 2 Diabetics

Diabetes mellitus (DM) is a metabolic disorder specified by persistent hyperglycemia that occurs when β-cell insulin production became unable to control blood glucose with deterioration of response for insulin. The consequent development of DM complications with increased risk for many diseases caused by damaged variety of biological systems, including blood vessels, eyes, kidneys, heart, and nerves. Carnosine is a natural dipeptide (β-alanyl-L-histidine) expressed in both the central nervous system and periphery, it occurs in several tissues most notably in muscle where they represent an appreciable fraction of the total water-soluble nitrogen-containing compounds. Carnosine is synthesized by a cytosolic amino acid ligase, carnosine synthase-1 (CARNS1; also known as ATP-grasp domain–containing protein 1, ATPGD1; EC 6.3.2.11).Several biological and physiological functions have been attributed to carnosine, such as being an anti-inflammatory and antioxidant agent, antiglycating actions, and as a modulator of mitochondrial metabolism. Carnosine level in human serum is affected by several enzymes like carnosine synthase-1 (responsible of carnosine synthesis),thus any genetic polymorphisms in these enzymes could have an impact on enzymes levels and therefore serum carnosine level with consequent increased risk for many diseases. This study was aimed to estimate the occurrence of Carnosine synthase -1 SNP (rs 1790733) on chromosom11 (intron –variant) in Iraqi type 2 diabetics with and without cardio vascular diseases and it’s correlation with serum levels of carnosine & carnosine synthase-1 and their association with CVD as T2DM complication. To achieve this aim Enzyme Linked Immunosorbent Assay (ELISA) specific kits were used to estimate serum levels of carnosine & carnosine synthase-1. High resolution melt technique (HRM) was applied for detecting gene polymorphism of carnosine synthase-1 gene (ATPGD1). The results showed that gene polymorphism of SNP (rs1790733) increased the chance of CVD in T2DM patients by 84.5% by its effect to decrease the mean of serum levels of carnosine by decreased carnosine synthase-1 level that may correlate to development of CVD in T2DM patients.

Inonotus obliquus (Chaga) against HFD/STZ-induced glucolipid metabolism disorders and abnormal renal functions by regulating NOS-cGMP-PDE5 signaling pathway

Our prior investigations have established that Inonotus obliquus (Chaga) possesses hypoglycemic effects. Persistent hyperglycemia is known to precipitate renal function abnormalities. The functionality of the kidneys is intricately linked to the levels of cyclic guanosine-3',5'-monophosphate (cGMP), which are influenced by the activities of nitric oxide synthase (NOS) and phosphodiesterase (PDE). Enhanced cGMP levels can be achieved either through the upregulation of NOS activity or the downregulation of PDE activity. The objective of the current study is to elucidate the effects of Chaga on disorders of glucolipid metabolism and renal abnormalities in rats with type 2 diabetes mellitus (T2DM), while concurrently examining the NOS-cGMP-PDE5 signaling pathway. A model of T2DM was developed in rats using a high-fat diet (HFD) combined with streptozotocin (STZ) administration, followed by treatment with Chaga extracts at doses of 50 and 100 mg·kg−1 for eight weeks. The findings revealed that Chaga not only mitigated metabolic dysfunctions, evidenced by improvements in fasting blood glucose, total cholesterol, triglycerides, and insulin resistance, but also ameliorated renal function markers, including serum creatinine, urine creatinine (UCr), blood urea nitrogen, 24-h urinary protein, and estimated creatinine clearance. Additionally, enhancements in glomerular volume, GBM thickness, podocyte foot process width (FPW), and the mRNA and protein expressions of podocyte markers, such as nephrin and wilms tumor-1, were observed. Chaga was found to elevate cGMP levels in both serum and kidney tissues by increasing mRNA and protein expressions of renal endothelial NOS and neural NOS, while simultaneously reducing the expressions of renal inducible NOS and PDE5. In summary, Chaga counteracts HFD/STZ-induced glucolipid metabolism and renal function disturbances by modulating the NOS-cGMP-PDE5 signaling pathway. This research supports the potential application of Chaga in the clinical prevention and treatment of T2DM and diabetic nephropathy (DN), with cGMP serving as a potential therapeutic target.

Comparison of Metabolic Changes after 6 Months of High-Carbohydrate Diet or High-Fat Diet with Low Dose Streptozotocin Injection in Rats.

We compared 2 models of metabolic syndrome in rats: high-fat diet (58% calories) with single streptozotocin injection at a dose of 25 mg/kg and replacement of water with 20% fructose solution. The model with fructose solution did not cause the main signs of metabolic syndrome over 24 weeks: concentrations of glucose, triglycerides, cholesterol, weight, and BP did not significantly differ from the control group (standard diet). At the same time, single streptozotocin administration was followed by the development of persistent hyperglycemia, hypertriglyceridemia, hypercholesterolemia, and signs of visceral obesity. High-fat diet combined with injection of streptozotocin in a low dose can be considered a more representative model of metabolic syndrome in humans.

The regulatory role of erythropoietin in diabetes mellitus: a focus on oxidative and glycemic statuses

Background and objectives. One of the leading causes of disability and death among the population is type 2 diabetes mellitus (T2DM), which is characterized by persistent hyperglycemia. The disease is associated with disorders including oxidative stress and resistance to insulin action, which are involved in the progression of other diabetic complications. Such complications strongly rationalize the need for advanced treatment strategies. Considering the antioxidant, and anti-inflammatory in addition to cytoprotective properties of erythropoietin (EPO), it may offer a new potential strategy for the management of these disorders in diabetic patients. This review aims to explore the effects of EPO on oxidative stress and insulin resistance and its impact on glucose metabolism to guide healthcare professionals to a novel approach for controlling diabetes complications. Materials and methods. This review was conducted by analyzing studies involved with oxidative stress, resistance to insulin, and glucose metabolism in T2DM published in Cochran Library, PubMed, and Google Scholar until February 2024. Results. EPO shows promising beneficial effects in the management of these diabetes-associated disorders. Conclusion. With this beneficial effect of EPO, it is considered a strong candidate and area of development for the creation of new choices in the management of diabetes.

Malnutrition in Acute Stroke: An Article Review

The prevalence of malnutrition after stroke varies widely. It is estimated about one-fifth of patients with acute stroke are malnourished on initial hospital admission, while the prevalence of malnutrition ranges from 6.1 to 62%. Energy requirements increase due to stress caused by stroke, while food intake decreases due to impaired ability to eat, so the body will use its fat and protein stores as fuel to produce glucose. Muscle and fat tissue undergo degradation due to the breakdown of amino acids to form energy. Systemic consequences occur after stroke, peripheral immunodepression in association with overstimulation of the autonomic and neuroendocrine systems. Damage to cerebral tissue can activates the hypothalamus-pituitary-adrenal axis, resulting in increased levels of glucocorticoid hormones, catecholamines, and glucagon, leading to hypermetabolism (increased energy use), hypercatabolism (increased protein breakdown), and persistent hyperglycemia. The prevalence of malnutrition increases with the length of stay and decreased functional improvement during rehabilitation. Malnourished patients with stroke experience a higher stress reaction, which increases the occurrence of peptic ulcers, and infections of the respiratory and urinary tracts, thus extending the length of stay and increasing mortality.

Naringenin - a potential nephroprotective agent for diabetic kidney disease: A comprehensive review of scientific evidence.

Diabetes mellitus (DM) is a chronic disease characterized by persistent hyperglycemia, which is a major contributing factor to chronic kidney disease (CKD), end-stage renal disease (ESRD), and cardiovascular-related deaths. There are several mechanisms leading to kidney injury, with hyperglycemia well known to stimulate oxidative stress, inflammation, tissue remodeling, and dysfunction in the vascular system and organs. Increased reactive oxygen species (ROS) decrease the bioavailability of vasodilators while increasing vasoconstrictors, resulting in an imbalance in vascular tone and the development of hypertension. Treatments for diabetes focus on controlling blood glucose levels, but due to the complexity of the disease, multiple drugs are often required to successfully delay the development of microvascular complications, including CKD. In this context, naringenin, a flavonoid found in citrus fruits, has demonstrated anti-inflammatory, anti-fibrotic, and antioxidant effects, suggesting its potential to protect the kidney from deleterious effects of diabetes. This review aims to summarize the scientific evidence of the effects of naringenin as a potential therapeutic option for diabetes-induced CKD.

Downregulation of Tnf-α and Cat Expression in a Wistar Rat Diabetic Model during Diabetes Onset.

Diabetes Mellitus (DM) is a metabolic disorder characterized by persistent hyperglycemia and/or insulin resistance. If left uncontrolled, it can lead to a combination of cardiac and renal alterations known as cardiorenal syndrome. Additionally, oxidative stress and inflammation contribute to tissue damage, thereby reducing the life expectancy of individuals with diabetes. The aim of this study was to identify early molecular markers associated with cardiorenal syndrome, oxidative stress, and inflammation, and to investigate their correlation with the duration of exposure to DM. An experimental DM model was employed using Wistar rats. The rats were divided into four groups: diabetic rats at 7 days (DM7), diabetic rats at 30 days (DM30), control sham at 7 days (CS7), and control sham at 30 days (CS30). Blood and brain tissue from the brainstem region were collected at 7 and 30 days after confirming DM induction. Gene expression analysis of Bnp, Anp, Cat, Gpx, Sod, Tnf-α, and Il-6 was performed. The analysis revealed lower expression values of Cat in the brainstem tissue of the DM7 group compared to the NDS7 group. Moreover, diabetic animals exhibited statistically lower levels of Tnf-α in their peripheral blood compared to the control animals. This study concluded that DM alters the oxidative balance in the brainstem after 7 days of DM induction, resulting in lower Cat expression levels. Although some genes did not show statistical differences after 30 days of DM induction, other genes exhibited no expression values, indicating possible gene silencing. The study identified an imbalance in the studied pathways and concluded that the organism undergoes a compensatory state in response to the initial metabolic alterations caused by DM.