Serum C-peptide Levels Research Articles

Impact of angiotensin receptor neprilysin inhibitor on serum C-peptide levels in patients with type 2 diabetes

Impact of angiotensin receptor neprilysin inhibitor on serum C-peptide levels in patients with type 2 diabetes

Synergistic Effects of Aerobic Exercise and Moringa Oleifera Supplementation on Glycemic Control and Metabolic Health in Type 2 Diabetes Patients: A Randomized Controlled Trial

Background: The action of aerobic exercise and Moringa Oleifera supplementation on type 2 diabetes mellitus (T2DM) have been individually documented, but their combination remains unclear. This study evaluates the synergistic effects of a 12-week aerobic exercise program and Moringa supplementation on metabolic and inflammatory markers in T2DM patients. Methods: A total of 120 T2DM patients were randomly assigned to four groups: control, aerobic exercise, moringa supplementation (250mg/kg/day), and a combination. BMI, blood glucose, serum insulin, serum C-peptide, renal function tests, HbA1c, adiponectin, IL-6, and lipid profile, were assessed before and after the intervention. Blood glucose levels were monitored weekly. Results: All intervention groups showed significant improvements in HbA1c levels compared to the control group, with the combination group demonstrating the greatest reduction. Blood glucose levels decreased significantly in the exercise and combination groups, with the aerobic exercise group outperforming moringa alone. Serum insulin levels significantly decreased in the moringa and combination groups, while serum C-peptide levels decreased in all groups. Lipid profile improvements were noted in all intervention groups, with the combination treatment showing superior results in reducing total cholesterol and BMI. Both adiponectin levels increased and IL-6 levels decreased significantly in all intervention groups, particularly in the combination group. Renal function tests showed no adverse changes, with a significant reduction in BUN levels observed only in the combination group. Conclusion: The combination of aerobic exercise and moringa supplementation provides a synergistic therapeutic effect, significantly improving glycemic control, lipid profile, adiponectin levels in T2DM patients.

Association of Maternal Short Sleep Duration With Neurodevelopmental Delay in Offspring: A Prospective Cohort Study.

To investigate how short sleep duration (SSD) during pregnancy is related to neurodevelopmental delays in offspring, we aimed to inform pregnancy sleep guidelines and promote maternal health and child development. To identify the associations between SSD during pregnancy and offspring neurodevelopmental delay and to determine whether fetal glucose metabolism plays a role in SSD and neurodevelopmental delays. This cohort study followed 7059 mother-child pairs from the Maternal & Infants Health in Hefei cohort, and collected sleep data during pregnancy via the Pittsburgh Sleep Quality Index at weeks 24 to 28 and 32 to 36. Neurodevelopmental outcomes from 6 to 36 months postpartum were assessed via the Denver Developmental Screening Test-II and the Gesell Development Diagnosis Scale. Cox proportional hazard regression was used to analyze the link between maternal SSD and neurodevelopmental delay risk. Mediation analysis was used to evaluate the role of cord blood serum C-peptide levels. Three hospitals and children's health centers in Hefei were involved. The stratified analysis revealed a significant association between mothers with SSD during midpregnancy and neurodevelopmental delay in boys (adjusted HR 2.05, 95% CI 1.29, 3.25). Cord blood marker analysis revealed a positive relationship between cord blood serum C-peptide levels and neurodevelopmental delay in offspring (RR 0.04, 95% CI 0.00, 0.08). The proportion of the association between SSD and neurodevelopmental delay mediated by cord blood C-peptide was 11.05%. Maternal SSD during pregnancy was continuously associated with an increased incidence of neurodevelopmental delay with sex differences among offspring. This association may be mediated in part by increased higher levels of cord C-peptide.

Clinical Profile, Risk Factors, and Complications in Young-Onset Type 2 Diabetes Mellitus.

Background Young-onset type 2 diabetes mellitus (T2DM), defined as a diagnosis before the age of 45, is an increasingly common and aggressive form of diabetes. This population is at a heightened risk of developing complications earlier in life due to longer disease duration and often suboptimal glycemic control. Complications such as diabetic neuropathy, retinopathy, and nephropathy are significant concerns, leading to reduced quality of life and increased morbidity. Objective To investigate the clinical profile and risk factors associated with complications of young-onset T2DM and to analyze the correlation between the age of onset and other parameters and the development of these complications. Methods We conducted a cross-sectional study on young-onset T2DM patients (<45 years) to investigate the prevalence and associated factors of diabetic complications. Variables analyzed included age, gender, BMI, waist-hip ratio, duration of diabetes, age at diagnosis, proteinuria, and glycosuria, along with biochemical markers such as HbA1C (glycated hemoglobin), serum cholesterol, triglycerides, and C-peptide levels. Results The average age of participants in our study was 34.76 ± 6.91 years. The mean BMI was 26.68 ± 3.35, with a mean cholesterol level of 169.84 ± 55.64 and a mean triglyceride level of 205.79 ± 67.49. The average HbA1c level was 9.82 ± 2.44. Diabetic neuropathy was found to increase significantly with advancing age (p < 0.001), longer duration of diabetes (p < 0.001), higher mean levels of HbA1C (p < 0.001), serum cholesterol (p = 0.006), and serum triglycerides (p = 0.010), as well as with lower levels of serum C-peptide (p = 0.025). The severity of kidney damage showed a significant association with older age (p = 0.049), longer diabetes duration (p < 0.01), elevated mean levels of HbA1C (p = 0.0002), and serum cholesterol (p = 0.0310). Diabetic retinopathy increased significantly with advancing age (p < 0.001), longer diabetes duration (p < 0.001), higher mean levels of HbA1C (p < 0.001), and serum triglycerides (p = 0.013). Conclusion Young-onset T2DM is associated with significant risks for neuropathy, retinopathy, and nephropathy, particularly with increasing age and longer disease duration. Higher HbA1C, serum cholesterol, and triglyceride levels are prevalent among those with complications. These findings underscore the need for early intervention and targeted management strategies to mitigate complications in this high-risk population.

Stevens-Johnson Syndrome/Toxic epidermal necrolysis complicated with fulminant type 1 diabetes mellitus: a case report and literature review

BackgroundStevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening skin lesion triggered by hypersensitive drug reaction. They are characterized by extensive epidermal necrosis and skin exfoliation. Fulminant type 1 diabetes mellitus (FT1DM) is featured by a rapid-onset of hyperglycemia with ketoacidosis due to severely destroyed β-cell function. Fulminant type 1 diabetes mellitus as a sequela of SJS/TEN has rarely been reported.Case presentationWe present a 73-year-old female patient who developed SJS/TEN skin allergic reaction after taking carbamazepine and phenytoin for 35 days. Then, hyperglycemia and diabetic ketoacidosis occurred 20 days after discontinuation of antiepileptic drugs. A very low serum C-peptide level (8.79 pmol/l) and a near-normal glycosylated hemoglobin level met the diagnostic criteria for fulminant T1DM. Intravenous immunoglobulin (IVIG) and insulin were promptly administered, and the patient recovered finally.ConclusionsThis rare case indicates that monitoring blood glucose is necessary in SJS/TEN drug reaction, and comprehensive therapy with rehydration, insulin, antibiotics, and IVIG may improve the prognosis.

New Onset Diabetes After COVID 19 (NODAC) is predominantly due to exacerbated Insulin Resistance (IR) rather than beta cell dysfunction: Lessons from tertiary care hospital data during confluence of two epidemics.

To investigate determinants of new onset diabetes after COVID-19 (NODAC) and its recovery at 6 months. This was an observational follow up study conducted from August, 2020 to July, 2023, recruiting patients with preexisting DM and COVID 19 patients with no history of DM. Multivariate regression analysis was used to determine the factors responsible for severity of COVID 19 infection in preexisting DM group. Clinical, laboratory and glycometabolic parameters were estimated at baseline and 6 months in NODAC and euglycemic group to determine the factors responsible for NODAC and its persistence at 6 months. Of 1310 patients, 855 (65.3%) COVID 19 patients were further divided based on their glycemic status: preexisting DM (19%), NODAC (8.5%) and euglycemia (72.5%). Older age and male gender were independent risk factors for severe COVID 19 disease in patients with preexisting diabetes. Prevalence of NODAC in present study was 8.5%. Patients with NODAC had higher mean fasting blood glucose (FBG), random blood glucose (RBG) and HbA1c at baseline as compared to COVID with euglycemic group with no difference in serum C-peptide levels. Female gender, family history of DM, signs of insulin resistance, higher BMI, WHR, HbA1c, serum insulin levels, FBG and RBG predicted persistence of NODAC at 6 months. Preexisting DM is a risk factor for severe COVID 19 disease. Patients with NODAC have evidence of persistence insulin resistance on follow up, underscoring the need for long term glycemic monitoring.

Reference Standards for C-Peptide in Korean Population: A Korean Endocrine Hormone Reference Standard Data Center Study.

The Korean Endocrine Hormone Reference Standard Data Center (KEHRS DC) has created reference standards (RSs) for endocrine hormones since 2020. This study is the first of its kind, wherein the KEHRS DC established RSs for serum Cpeptide levels in a healthy Korean population. Healthy Korean adults were recruited from May 2021 to September 2023. After excluding participants according to our criteria, serum samples were collected; each participant could then choose between fasting glucose only or fasting glucose plus an oral glucose tolerance test (OGTT). If their sample showed high glucose (≥100 mg/dL) or hemoglobin A1c (HbA1c) (≥5.70%), their C-peptide levels were excluded from analyzing the RSs. A total of 1,532 participants were recruited; however, only the data of 1,050 participants were analyzed after excluding those whose samples showed hyperglycemia or high HbA1c. Post-30-minute OGTT data from 342 subjects and post-120-minute OGTT data from 351 subjects were used. The means±2 standard deviations and expanded uncertainties of fasting, post-30-minute and 120-minute OGTT C-peptide levels were 1.26±0.82 and 0.34-3.18, 4.74±3.57 and 1.14-8.33, and 4.85±3.58 and 1.25-8.34 ng/mL, respectively. Serum C-peptide levels correlated with obesity, serum glucose levels, and HbA1c levels. The RSs for serum C-peptide levels established in this study are expected to be useful in both clinical and related fields.

C-peptide Level in Patients With Uncontrolled Type 2 Diabetes Mellitus on Oral Anti-diabetic Drugs.

In the development and progression of type 2 diabetes mellitus, β-cell dysfunction occurs after insulin resistance. Despite poor glycaemic control, there is a practice of increasing the dose of oral anti-diabetics or adding more drugs to the regimen due to the common perception that low endogenous insulin secretion is related to type 1 diabetes mellitus only and patient'spoor compliance to injectables. Keeping this perspective in mind, this study was conducted to assess the prevalence of beta cell dysfunction by low serum C-peptide levels and its correlation with poor glycaemic control. A total of 134 patients with type 2 diabetes mellitus for more than 10 years on oral anti-diabetic drugs fulfilling our eligibility criteria were enrolled in our study. Blood samples for fasting blood sugar and fasting C-peptide level were taken before breakfast and uptake of anti-diabetic drugs. Correlation analysis was performed to evaluate the relationship between fasting C-peptide and glycaemic control with respect to glycated haemoglobin (HbA1c). Of the patients,19.40% had insufficient beta cell reserve serumlevels (C-peptide < 0.5 ng/ml), of which most of the patients (14/26 = 53.85%) had poor glycaemic control (HbA1c < 8.0%). Overall, there was a significant correlation between poor glycaemic control with respect to HbA1c and low serum C-peptide levels (p < 0.05). We found a significant association of beta cell dysfunction (low fasting C-peptide level) with the use of insulin secretagogue. The proportion of patients with C-peptide levels less than 0.5 ng/ml was lower in patients using sodium-glucose cotransporter-2 (SGLT-2) inhibitors as compared to insulin secretagogue. SGLT-2 inhibitors should be preferred over other anti-diabetic drugs as an add-on to existing metformin therapy. Insulin requirement must be assessed in patients who have long-term type 2 diabetes mellitus.

Effect of various pharmacotherapy regimens on the state of carbohydrate metabolism in patients with urination disorders

Aim. To evaluate the efficacy and safety of various pharmacotherapy regimens in patients with urination disorders and type 2 diabetes mellitus during their preparation for surgery.Materials and methods. In total, 130 people (56 men and 74 women) aged from 18 to 81 years (average 65 years) were included in the research. All the patients were on standardized hypoglycemic therapy in combination with alpha1-blockers (doxazosin, terazosin) and vitamin-like drugs (alpha-lipoic acid, levocarnitine). Patients were divided into male and female subgroups, as well as into age subgroups, including under 65 years and over 65 years. Tabular methods of assessing the clinical symptoms of urinary disorders were used, along with instrumental, laboratory, and statistical methods (Mann-Whitney test, Spearman rank correlation coefficient).Results. The duration of therapy averaged 16± 2 months. The observation found that alpha1-blockers lead to a number of positive changes in the composition of carbohydrate metabolism, i.e., the level of serum glucose and insulin. In the general observation group, a significant decrease in blood glucose from 6.64 to 6.27 mmol/L, insulin from 18.07 to 14.03 mU/mL, and C-peptide from 3.67 to 2.98 ng/mL was detected. In the male subgroup, glucose levels decreased from 6.45 to 6.00 mmol/L, insulin from 18.92 to 13.99 mU/mL, and C-peptide from 3.76 to 2.97 ng/mL. In the female subgroup, blood glucose levels decreased from 6.98 to 6.77 mmol/L, insulin from 16.41 to 14.1 mU/mL, and C-peptide from 3.51 to 2.99 ng/mL. In the group of patients younger than 65 years of age, a decrease in glucose from 6.22 to 5.93 mmol/L, insulin from 17.87 to 14.36 mU/mL, and C-peptide from 3.49 to 3.01 ng/mL were also observed. In the group of patients older than 65 years of age, similar dynamics of the above parameters was established.Conclusions. The data obtained suggest that alpha1-blockers in combination with vitamin-like drugs contribute to reducing the level of serum glucose, insulin, and C-peptide during a long-term (at least 1 year) therapy, which may be promising in the correction of metabolic disorders during preparation of patients for surgery.

Production of alginate macrocapsule device for long-term normoglycaemia in the treatment of type 1 diabetes mellitus with pancreatic cell sheet engineering

Type 1 diabetes-mellitus (T1DM) is characterized by damage of beta cells in pancreatic islets. Cell-sheet engineering, one of the newest therapeutic approaches, has also been used to create functional islet systems by creating islet/beta cell-sheets and transferring these systems to areas that require minimally invasive intervention, such as extrahepatic areas. Since islets, beta cells, and pancreas transplants are allogeneic, immune problems such as tissue rejection occur after treatment, and patients become insulin dependent again. In this study, we aimed to design the most suitable cell-sheet treatment method and macrocapsule-device that could provide long-term normoglycemia in rats. Firstly, mesenchymal stem cells (MSCs) and beta cells were co-cultured in a temperature-responsive culture dish to obtain a cell-sheet and then the cell-sheets macroencapsulated using different concentrations of alginate. The mechanical properties and pore sizes of the macrocapsule-device were characterized. The viability and activity of cell-sheets in the macrocapsule were evaluated in vitro and in vivo. Fasting blood glucose levels, body weight, and serum insulin & C-peptide levels were evaluated after transplantation in diabetic-rats. After the transplantation, the blood glucose level at 225 mg dl–1 on the 10th day dropped to 168 mg dl–1 on the 15th day, and remained at the normoglycemic level for 210 days. In this study, an alginate macrocapsule-device was successfully developed to protect cell-sheets from immune attacks after transplantation. The results of our study provide the basis for future animal and human studies in which this method can be used to provide long-term cellular therapy in T1DM patients.

Ultrasonographic Evaluation of Severity of Hepatic Steatosis in Type2 Diabetic Patients Treated with Oral Hypoglycemic Drug Metformin- Correlation with Serum C-Peptide and Triglyceride Level

Ultrasonographic Evaluation of Severity of Hepatic Steatosis in Type2 Diabetic Patients Treated with Oral Hypoglycemic Drug Metformin- Correlation with Serum C-Peptide and Triglyceride Level

Association of C- peptide Levels and Type 1 Diabetes in Urban and Rural areas of South India

Background Type 1 diabetes T1D presents as a severe chronic disorder affecting 5-10 of diabetes cases typically emerging earlier in life compared to type 2 diabetes T2D. Despite advancements the global incidence of T1D continues to rise posing significant short-term and long-term implications. Characterised by the destruction of pancreatic beta cells T1D results in absolute insulin deficiency with most cases attributed to autoimmune-mediated loss of beta cells type 1a and a minority stemming from idiopathic beta cell destruction or failure type 1b. Although traditionally perceived as predominant in children and adolescents T2D diagnoses in youth are increasingly prevalent.Methods This prospective study was conducted on thirty-one individuals diagnosed with T1D and seeking treatment at the KLES Diabetes Centre Belagavi Karnataka India. A single fasting blood sample approximately 10 mL was collected from each participant via peripheral venipuncture. According to the manufacturers instructions serum C-peptide levels were measured in all samples using a validated Chemiluminescent Immuno-Assay CLIA kit.Results The mean C-peptide levels were significantly higher 1.12 ngmL in participants with disease onset between 11 and 15 years than in those with onset between 0 and 5 years 0.57 ngmL. The participants had a mean disease duration of 6.93 years ranging from 3 to 15 years with 14 45.1 having a disease duration of 0-5 years 7 22.8 with 6ndash10 years and 10 32.2 with 11ndash15 years of type 1 diabetes.Conclusion This study investigated the relationship between C-peptide levels disease duration and age at onset in individuals with Type 1 Diabetes T1D. Our findings suggest a potential link between later diseaseonset 10-15 years and higher C-peptide levels which might indicate a slower disease progression in older individuals diagnosed with T1D.nbsp However a longer disease duration was positively correlated with a gradual decline in C-peptide levels.

Study of age, sex and body mass index wise variation in C-peptide level among urban population of Northern part of Bihar

Background: Different factors regulate the insulin level in blood. Earlier C-peptide was considered as by product of insulin biosynthesis and its role in body seems to be negligible. C-peptide at low physiological concentrations mimics the effects of insulin. However, in the presence of elevated level of insulin concentrations concomitant raised level of C-peptide may blunt peripheral effects of insulin age. This study was carried out to verify the age, sex, and BMI wise variation in level of C-peptide among apparently healthy individual and its contribution in fine-tuning of the tissue’s metabolism under different physiological conditions. Methods: This is a prospective cross-sectional observational study. Estimation of serum c-peptide level was done by solid phase direct sandwich enzyme linked immunosorbent assay (ELISA) kit method. Glucose is estimated by Glucose oxidase peroxidase (GOD-POD) end point colorimetric method and HbA1C was estimated by ion exchange resin method (kit method). Result: Serum C-peptide level is significantly high in advance age and males in compared to younger age and females respectively. The mean level of serum C-peptide is higher in higher body mass index (BMI) group compared to lower, but this difference is statistically insignificant. Conclusions: In normal subjects, the level of C-peptide shows positive correlation with age and BMI. Males have higher level of C-peptide in comparison to females. Apart from these variation C-peptide contributes to different biological effects.

Effect of denosumab on glucose metabolism in postmenopausal osteoporotic women with prediabetes: a study protocol for a 12-month multicenter, open-label, randomized controlled trial

BackgroundParticipants with prediabetes are at a high risk of developing type 2 diabetes (T2D). Recent studies have suggested that blocking the receptor activator of nuclear factor-κB ligand (RANKL) may improve glucose metabolism and delay the development of T2D. However, the effect of denosumab, a fully human monoclonal antibody that inhibits RANKL, on glycemic parameters in the prediabetes population is uncertain. We aim to examine the effect of denosumab on glucose metabolism in postmenopausal women with osteoporosis and prediabetes.MethodsThis is a 12-month multicenter, open-label, randomized controlled trial involving postmenopausal women who have been diagnosed with both osteoporosis and prediabetes. Osteoporosis is defined by the World Health Organization (WHO) as a bone mineral density T score of ≤ − 2.5, as measured by dual-energy X-ray absorptiometry (DXA). Prediabetes is defined as (i) a fasting plasma glucose level of 100–125 mg/dL, (ii) a 2-hour plasma glucose level of 140–199 mg/dL, or (iii) a glycosylated hemoglobin A1c (HbA1c) level of 5.7–6.4%. A total of 346 eligible subjects will be randomly assigned in a 1:1 ratio to receive either subcutaneous denosumab 60 mg every 6 months or oral alendronate 70 mg every week for 12 months. The primary outcome is the change in HbA1c levels from baseline to 12 months. Secondary outcomes include changes in fasting and 2-hour blood glucose levels, serum insulin levels, C-peptide levels, and insulin sensitivity from baseline to 12 months, and the incidence of T2D at the end of the study. Follow-up visits will be scheduled at 3, 6, 9, and 12 months.DiscussionThis study aims to provide evidence on the efficacy of denosumab on glucose metabolism in postmenopausal women with osteoporosis and prediabetes. The results derived from this clinical trial may provide insight into the potential of denosumab in preventing T2D in high-risk populations.Trial registrationThis study had been registered in the Chinese Clinical Trials Registry. Registration number: ChiCTR2300070789 on April 23, 2023. https://www.chictr.org.cn.

A novel model for predicting diabetes remission after bariatric surgery based on the measurement of C-peptide and creatinine in serum: A pilot study

Background and aimsBariatric surgery is effective for treating type 2 diabetes (T2D) in patients with obesity, although a significant proportion of these patients do not achieve diabetes remission after the surgery even after significant weight loss and metabolic improvement. C-peptide is a valuable marker of beta cell function and insulin secretion, but renal function must be considered when interpreting measurements in patients with T2D. The study aims to investigate the association of serum levels of C-peptide adjusted for creatinine with diabetes remission and glycemic target achievement after bariatric surgery in patients with obesity and T2D. Methods and resultsProspective data from a cohort of 84 patients with obesity and T2D submitted to Roux-en-Y gastric bypass (RYGB) were collected at baseline and at least a 6-month follow up. A multivariate binomial regression model showed that Ln(C-peptide/creatinine) and age were significantly associated with 6-month T2D remission. The area under the curve for the receiver operating characteristic analysis (AUROC) to predict remission was 0.87, and more accurate than the AUROC based on C-peptide levels alone (0.75). The same model was also able to predict achieving an HbA1c target of 7 % (53 mmol/mol) (AUROC 0.96). ConclusionIn conclusion, Ln(C-peptide/creatinine) ratio could be a useful tool in predicting T2D remission and target achievement after RYGB surgery, providing a more accurate reflection of beta cell function in bariatric patients.

Silencing hsa_circ_0032449 inhibits the pancreatic differentiation of human embryonic stem cells via the hsa_miR-195-5p/CCND1/PI3K/AKT signaling pathway

Stem cell-derived β cells (SC-β cells) differentiated from stem cell-derived pancreatic progenitor (PP) cells are promising tools for enabling normal glucose control of islet transplants and have therapeutic potential for type 1 diabetes treatment. Pancreatic specification is essential for SC-β cell induction in vitro and low-quality PP cells may convert into derivatives of non-pancreatic lineages both in vivo and in vitro, impeding PP-derived β cell safety and differentiation efficiency. Circular RNA (circRNA) commonly determines the fate of stem cells by acting as competing endogenous RNA (ceRNA). Currently, the relationships between endogenous circRNA and pancreatic specification remain elusive. Herein, we used whole transcriptome sequencing analysis and functional experiments to reveal that deficiency of hsa_circ_0032449 resulted in posterior foregut-derived PP cells with a weakened the progenitor state with decreased expression of PDX1, NKX6.1 and CCND1. As differentiation processed into maturation, silencing of hsa_circ_0032449 suppressed PP cell development into functionally mature and glucose-responsive SC-β cells. These SC-β cells exhibited lower serum C-peptide levels compared with those of control groups in nude mice and had difficulties in reversing hyperglycemia in STZ-induced diabetic nude mice. Mechanistically, loss of hsa_circ_0032449 participated in PI3K-AKT signaling transduction by acting as a ceRNA to sponge miR-195-5p and by influencing the expression of the downstream target CCND1 at transcription and translation levels. Overall, our findings identified hsa_circ_0032449 as an essential PP cell-fate specification regulator, indicating a promising potential in clinical applications and basic research.

Bone marrow stem cell-derived β-cells: New issue for diabetes cell therapy

This investigation aimed to establish the promising role of insulin-producing cells (IPCs) growing from bone marrow-mesenchymal stem cells (BM-MSCs) in relieving hyperglycemia induced in rats. BM-MSCs were differentiated into IPCs using three different protocols. The efficiency of BM-MSCs differentiation into IPCs in vitro was confirmed by detecting IPCs specific gene expression (Foxa-2, PDX-1 and Ngn-3) and insulin release assay. The in vivo study design included 3 groups of male Wistar rats; negative control group, diabetic group and IPCs-transfused group (5 ×106 cells of the most functional IPCs/rat). One month after IPCs infusion, serum glucose, insulin, c-peptide and visfatin levels as well as pancreatic glucagon level were quantified. Gene expression analysis of pancreatic Foxa-2 and Sox-17, IGF-1 and FGF-10 was done. Additionally, histological investigation of pancreatic tissue sections was performed. Our data clarified that, the most functional IPCs are those generated from BM-MSCs using differentiation protocol 3 as indicated by the significant up-regulation of Foxa-2, PDX-1 and Ngn-3 gene expression levels. These findings were further emphasized by releasing of a significant amount of insulin in response to glucose load. The transplantation of the IPCs in diabetic rats elicited significant decline in serum glucose, visfatin and pancreatic glucagon levels along with significant rise in serum insulin and c-peptide levels. Moreover, it triggered significant up-regulation in the expression levels of pancreatic Foxa-2, Sox-17, IGF-1 and FGF-10 genes versus the untreated diabetic counterpart. The histopathological examination of pancreatic tissue almost assisted the biochemical and molecular genetic analyses. These results disclose that the cell therapy holds potential to develop a new cure for DM based on the capability of BM-MSCs to generate β-cell phenotype using specific protocol.

The impact of high-intensity interval training and alternate-day fasting on glucose metabolism in rats on a high-fat diet

Abstract The effect of lifestyle modifications in the form of exercise training and fasting intervention on glucose metabolism in subjects on a high-fat diet is not completely understood. The present study aimed to examine the effects of alternate-day fasting (ADF) and high-intensity interval training (HIIT) on serum levels of C-peptide, fructosamine, and glucose in rats under a high-fat diet. Twenty-eight male Wistar rats were initially fed a high-fat diet for 12 weeks, then randomised into the following four groups: HIIT, ADF, HIIT + ADF, and control (CON). The HIIT and ADF interventions were conducted 3 days per week for 6 weeks. The HIIT induced a significant reduction in serum fructosamine levels compared to other groups (), as well as there was a significant reduction in serum glucose levels compared to the ADF and HIIT + ADF groups (). ADF and HIIT + ADF did not cause any significant changes in fructosamine, glucose, and C-peptide serum levels compared to the CON group (). In subjects under a high-fat diet, HIIT but not ADF or HIIT + ADF may be associated with favourable improvements in glucose metabolism markers.

Saponins from Momordica charantia exert hypoglycemic effect in diabetic mice by multiple pathways.

The antidiabetic activity of saponins extracted from Momordica charantia (MCS) on streptozotocin-induced diabetic mice was investigated in order to elucidate the mechanism of MCS for exerting hypoglycemic effects. Saponins were first extracted from M. charantia L. and their composition was analyzed. The diabetic Kunming mice were fed low-dose saponins from M. charantia L. and high-dose MCS, using normal mice and diabetic mice as controls. Body weight, blood glucose level, oral glucose tolerance, serum C-peptide level, hepatic antioxidant capacity, hepatic glycogen and hexokinase in liver tissues, serum blood lipid level, and alpha-glucosidase activity in small intestines were measured, and microstructure of pancreatic islet was analyzed. The results showed that the total content of seven triterpenoid compounds in MCS was 18.24 μg/mg, with Momordicoside K having the highest content at 11.66 μg/mg. Diabetic mice treated with MCS at 100 and 200 mg/kg body weight daily for 30 days showed a maximum glucose reduction (p < .05) of 12.63% and 26.47%, respectively. MCS significantly decreased levels of postprandial hyperglycemia, serum lipid, α-glucosidase activity, and liver malondialdehyde. Additionally, levels of serum C-peptide and liver glycogen, as well as hexokinase and antioxidant enzyme activity, were significantly increased compared to the diabetic control groups. Histopathological results showed that MCS markedly reduced degenerative changes in islet β-cells. It is concluded that MCS exerts antidiabetic effects by improved hypoglycemic, hypolipidemic, and antioxidant effects, increased hexokinase activity and glycogen synthesis, and enhanced reparative effects on the histological architecture and insulin secretion function of the pancreas.

Association between Serum C-peptide Level and Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients on Oral Anti-diabetic Drug

Background: Diabetic Nephropathy (DN) treatment focuses mostly on preventing or delaying disease development. The most recent research indicates that C-peptide may have a favourable biological effect on DN. In type 2 Diabetes Mellitus, the link between C-peptide level and DN is poorly understood (DM). The purpose of this study is to evaluate the relation between serum C-peptide and diabetic nephropathy in type 2 DM patients taking an oral anti diabetic medication. Methods: From July 2019 to June 2020, a cross-sectional observational study was done at the Department of Pharmacology and Therapeutics at Dhaka Medical College, Dhaka. A total of 63 randomly selected type 2 diabetes patients met the inclusion criteria. SPSS was used to collect, record, and evaluate biochemical values including FBG, 2hrs ABF, HbA1c, urine for microalbumin, serum creatinine, and serum C-peptide. Result: Among 63 study participants, 40 (63.5%) were female and 23 (36.5%) were male. Mean age of patients was 50.30±10.55 years. Mean duration of DM of total study subjects was 6.29±3.15 years. Out of total study subjects, 17.5% (11) had low serum C-peptide, 74.6% (47) had normal serum C-peptide and 7.9% (5) had high serum C-peptide level. Correlations of clinical and biochemical variables showed negative correlation between serum C-peptide level and microalbumin, DM duration, FBS, 2hrs ABF, HbA1c, creatinine. Mean urine albumin was higher in patients with low serum C-peptide level. The microalbumin level and the duration of DM of study subjects are significantly associated with serum C-peptide. Conclusion: In this study we have found that type 2 diabetic individuals with low serum C-peptide levels have a high frequency of diabetic nephropathy and that serum C-peptide levels are significantly associated with diabetic nephropathy. Bangladesh Journal of Medical Science Vol. 22 No. 04 October’23 Page : 768-772