To Type 2 Diabetes Mellitus Patients Research Articles

Association between vitamin D levels and insulin resistance in patients with type 2 diabetes mellitus

Background: Insulin resistance (IR) is a major contributor to type 2 diabetes mellitus (T2DM) and is associated with various metabolic disorders. Vitamin D deficiency (VDD) has been linked to an increased risk of T2DM, but the relationship between vitamin D status and IR in T2DM patients remains unclear. This study explores this association in a male population with T2DM in Baghdad, Iraq.Methods: A case-control study was conducted on 190 male participants: 40 healthy controls and 150 patients categorized into different groups; 40 diabetic patients, 55 with coronary artery disease (CAD) and T2DM (CAD+DM), and 55 with only CAD. Physicians diagnosed them, and they were evaluated by physical and full medical history. All the sample set parameters were measured in the fasting state for each group. The biochemical tests included body mass index (BMI), vitamin D levels, insulin levels, fasting tests glucose (FBG), and HbA1c were measured. Insulin resistance was calculated using the HOMA-IR model.Results: Vitamin D levels were significantly lower in all diabetic groups (DM, CAD+DM) compared to the control group (p<0.001). All diabetic patients had insulin resistance. BMI was significantly higher in the CAD and CAD+DM groups compared to controls (p<0.00001, p<0.004). FBG, HbA1c, insulin levels, and HOMA-IR were all significantly higher in diabetic patients compared to controls (p<0.001 for all). Furthermore, increased HbA1c, fasting insulin, and homeostatic model assessment for insulin resistance (HOMA-IR) were associated with CAD progression in T2DM patients (p < 0.001).Conclusion: This study suggests that vitamin D deficiency may contribute to insulin resistance in male T2DM patients in Baghdad, Iraq. Maintaining optimal vitamin D levels may be beneficial in diabetes management in this population. Incorporating vitamin D screening into routine check-ups for T2DM patients could aid in early detection and prevention of insulin resistance-associated complications.Keywords: Diabetes mellitus; Insulin resistance; Vitamin D; Coronary artery disease

Impact of bisphenol a on the levels of vascular calcification biomarkers in type 2 diabetes mellitus with vascular complications: A case-control study

Bisphenol A (BPA) is an endocrine disruptor present in polycarbonate plastics used in food containers and water bottles that resists insulin action and leads to type 2 diabetes mellitus (T2DM). However, there is scant research on the impact of BPA on T2DM-related vascular complications. Fetuin-A (FTA) and osteoprotegerin (OPG) are crucial markers for vascular calcification, which is the primary risk factor for developing vascular complications. This study aims to link external factor BPA levels with the vascular calcification markers FTA and OPG in diabetic subjects with and without vascular complications. Therefore, 120 study subjects were included and divided as control (n = 30), T2DM with cardiovascular diseases (CVD) (n = 30), T2DM with diabetic nephropathy (DN) (n = 30), and T2DM without vascular complications (n = 30). Serum and urinary FTA, OPG, and BPA levels were measured using an ELISA. FTA (AHSG) and OPG (TNFRSF11B) gene expression were analyzed using qPCR. Both serum (p < 0.001) and urinary BPA (p < 0.001) were found higher in T2DM with CVD and DN than T2DM without vascular complications and control. Also, T2DM with CVD and DN patients had lower serum and urinary FTA protein levels and increased serum and urinary OPG (p < 0.001) levels than T2DM without vascular complications and control. Moreover, FTA (AHSG) gene expression was negatively associated with serum BPA (p < 0.001) and urinary BPA (p < 0.01). Likewise, OPG (TNFRSF11B) gene expression was positively significant with serum BPA (p < 0.001) and urinary BPA (p < 0.01) in the study groups. These findings suggest that elevated blood and urinary BPA levels contribute to the severity of vascular complications in T2DM patients through vascular calcification.

Correlation between TCF7L2 gene expression and certain biochemical parameters in type 2 diabetes mellitus

ObjectivesThe transcription factor 7-like 2 gene (TCF7L2) is associated with a predisposition to type 2 diabetes mellitus (T2DM) in different ethnic populations. This article investigated the relationship between TCF7L2 gene expression and several biochemical indexes among different age categories of T2DM in a sample of the Iraqi population. MethodsOne hundred and fifty blood samples were collected from three groups: young T2DM (10–35 years), old T2DM (40–80 years), and healthy control (10–65 years) groups. Both sexes were enrolled. qPCR was performed to explore the expression of the TCF7L2 gene. Biochemical tests were performed to assess hemoglobin A1C (HbA1c), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels. The body mass index (BMI) was calculated. The results were statistically analyzed. ResultsPatients with T2DM had higher BMI, TG, and LDL, and lower HDL than the control group. There was a strong positive correlation between hemoglobin A1C (HbA1c) and BMI, TG, and LDL and a negative correlation between HbA1c and HDL. Expression of the TCF7L2 gene showed a significant difference between old and young patients by 1.68- and 0.207-fold, respectively. These results showed that old patients had higher gene expression than young patients. ConclusionTCF7L2 gene expression was affected by age, with higher expression in old T2DM patients. This may influence beta cell functions and insulin secretion.

Adipocytokines as Predictors of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Development in Type 2 Diabetes Mellitus Patients.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common chronic liver condition. Due to pathophysiological processes, MASLD's relation to type 2 diabetes mellitus (T2DM) is still unclear, especially when the role of adipocytokines is taken into consideration. This study aims to examine the potential predictive value of adiponectin and resistin for MASLD in T2DM. In a two-year study, 71 T2DM patients were categorized into MASLD-T2DM and non-MASLD-T2DM groups according to MASLD development. Serum samples were tested for resistin, adiponectin, high-density lipoprotein cholesterol, fasting glucose, and triglycerides. An appropriate equation is used to calculate the adiponectin/resistin (A/R) index. The optimal cut-off values for differentiating MASLD patients from non-MASLD patients were determined using receiver operating characteristic (ROC) curves and the corresponding areas under the curve (AUC). To predict the onset of MASLD in patients with T2DM, a logistic regression analysis was performed. There were significant differences in adiponectin (p<0.001), resistin (p<0.001), and A/R index (p<0.001) between T2DM individuals with and without MASLD. The ROC curve for resistin produced an AUC of 0.997 (p<0.001) with a sensitivity of 96.1% and a specificity of 100% for the cut-off point of 253.15. Adiponectin (OR, 0.054; 95% CI, 0.011-0.268; p<0.001) and resistin (OR, 1.745; 95% CI, 1.195-2,548; p=0.004) were found to be independent predictors for MASLD by logistic regression analysis. This study confirms the potential of adiponectin and resistin as predictors of MASLD development in T2DM.

Therapeutic Fasting and Vitamin D Levels: A New Dimension in Type 2 Diabetes Mellitus Prevention and Management—A Brief Report

Abstract Introduction Studies link hypovitaminosis D to be significantly associated with poor glycemic control, heightened inflammation, and risk of complications. Studies recommend fasting or calorie restriction as a useful measure to achieve diabetic reversal. The present study explores if therapeutic fasting is associated with improvement in the vitamin D levels and other clinical outcomes related to type 2 diabetes mellitus (T2DM). Methods This observational study included 26 T2DM patients exposed to a 10-day medically supervised fasting (≈ 500–1000 Kcal/day) in a complementary medicine facility. Levels of vitamin D, B12, fasting blood sugar (FBS), blood pressure, anthropometric measures, World Health Organization Quality of Life, disease perception (Brief Illness Perception Questionnaire), and self-reported vitality were measured at the baseline and the 10th day. Results Significant improvement in the levels of vitamin D (p = 0.000), B12 (p = 0.03), and reduction in FBS levels (p = 0.001), blood pressure, body mass index, waist and hip circumference (p ≤ 0.05), and improvement in quality of life, vitality, and disease perception (p &lt; 0.001) were observed by the end of 10th day. FBS shared a negative correlation with vitamin D levels (males r = –0.1, females r = –0.48). Conclusion The present findings provide insights into the probable mechanisms by which therapeutic fasting modulates the progression of T2DM. Nevertheless, large-scale randomized controlled trials are warranted to validate the present findings.

Comparative Effectiveness of Oral Hypoglycemic Agents for Glycemic Control and Glycemic Variability in Patients with Type 2 Diabetes Mellitus: Using Flash Glucose Monitoring.

The study aimed to compare the effectiveness of oral hypoglycemic agents (OHAs) as monotherapy, dual and quadruple therapy for glycemic control (GC) and glycemic variability (GV) in patients with type-2 diabetes (T2DM) using flash glucose monitoring system (FGM). Diabetes management largely relies on HbA1c monitoring. Glycemic variability (GV) has been an evolving glycemic target for preventing complications related to type 2 diabetes mellitus (T2DM). The purpose of the study was to compare glycemic control (GC) measures and glycemic variability (GV) measures among study groups and to study the relationships between GC and GV indices. Retrospectively, FGM data were collected from 50 T2DM patients. The patients were classified based on prescribed number of OHAs as monotherapy [group 1: dipeptidyl peptidase- 4 (DPP-4) inhibitors (n=10), group 2: sodium-glucose co-transporter-2 (SGLT2) inhibitors (n=10), group 3: sulphonylureas (n=10), group 4: dual therapy (n=10), and group 5: quadruple therapy (n=10)]. Measures of GC and GV were evaluated. Significant differences between study groups were observed in GC and GV measurements. The SGLT2 inhibitors monotherapy group demonstrated optimal GC [eA1c (%): 6.5 ± 2.2; MBG: 140.80 ± 63.94; TIR: 60.60 ± 19.96] and GV (SD: 42.38 ± 34.57; CV: 27.85 ± 6.68; MAGE: 96.76 ± 52.47; MODD: 33.96 ± 22.91) in comparison to other study groups. On using Pearson correlation analysis, mean blood glucose (MBG) and mean amplitude of glycemic excursion (MAGE) showed moderate correlation (r = 0.742)(r2 = 0.551), depicting distinct glucose variabilities at the same mean blood glucose levels. The monotherapy group of SGLT2 inhibitors demonstrated glucose-lowering effects with reduced glycemic variability. Hence, optimum glycemic control is associated with decreased glycemic variability.

Characterization of 16S rRNA of the gut microbiome in long-tailed macaque (Macaca fascicularis) with spontaneous type 2 diabetes mellitus

Abstract. Ramadhanty PW, Saepuloh U, Suparto IH, Darusman HS. 2023. Characterization of 16S rRNA of the gut microbiome in long-tailed macaque (Macaca fascicularis) with spontaneous type 2 diabetes mellitus. Biodiversitas 24: 6191-6199. The gut microbiota in the body is very complex and varied. It is known to influence human health. Imbalance (dysbiosis) of the gut microbiota can lead to type 2 diabetes mellitus (T2DM) and become a new feature in the development of the disease. Several human studies have compared the bacterial community in T2DM and non-T2DM patients. Until now, research on gut microbiota associated with T2DM in non-human primate animal models is still rare. T2DM can be developed by long-tailed macaque with clinical features similar to humans, which provides important information about the relationship between gut microbiota and T2DM. This study aims to characterize full-length 16S rRNA genes to obtain gut microbiota profiles in long-tailed macaques with and without spontaneous T2DM. The characterization was carried out using a metagenomic approach targeted at the full-length 16S rRNA gene with Nanopore technology (GridION) as one of the third-generation sequencing. The sample used was rectal swabs from adult male long-tailed macaques in the spontaneous T2DM group (n=3) and non-T2DM group (n=3). An increase in the alpha diversity, Firmicutes phylum, Oscillibacter genus, Oscillibacter valericigenes, and Oscillibacter ruminantium species, as well as a decrease in the Proteobacteria phylum were found in the T2DM group. The Firmicutes/Bacteroidetes ratio was also increased in the T2DM group compared to the non-T2DM group, which indicates dysbiosis. Based on these results, the metagenomic marker of the gut microbiome T2DM was obtained in long-tailed macaque primates, similar to humans with T2DM.

Bisphenol A accelerates the vascular complications in patients with Type 2 diabetes mellitus through vascular calcification-a molecular approach.

Environmental pollutant Bisphenol A (BPA) strongly interacts with insulin resistance, which leads to type 2 diabetes mellitus (T2DM). Uncontrolled glucose levels in both blood and urine develops vascular complications in T2DM patients. However, glucose-controlled diabetic patients are also affected by vascular complications due to vascular calcification, and there is a lack of clinically relevant data on BPA levels available in patients with T2DM-associated vascular complications due to vascular calcification. Therefore, we measured BPA levels in T2DM-associated vascular complications and correlated systemic BPA levels with vascular calcification-related gene expression. This study included 120 participants with T2DM and its associated vascular complications. Serum and urinary BPA were estimated using an ELISA kit, and gene expression of the study participants in peripheral blood mononuclear cells (PBMCs) was studied with quantitative real-time PCR. Serum and urinary BPA levels were higher in T2DM and its associated vascular complications with CVD and DN patients compared to control. Both Serum and urinary BPA had higher significance with Sirt1 (p < 0.001, p < 0.001), Runx2 (p < 0.01, p < 0.001) and IL-1beta (p < 0.001, p < 0.02) gene expression in the study groups, but, TNF-alpha significant with Serum BPA (p < 0.04), not urinary BPA (p < 0.31). BPA levels were positively correlated with lower Sirt1 and increased Runx2 in T2DM-associated vascular complications patients. Also, higher expression of IL-1beta and TNF-alpha was observed in T2DM-associated vascular complications patients. Our study is the first to associate BPA levels with vascular calcification in patients with T2DM and its associated vascular complications.

Detection of differentially expressed circulating micro-RNA among Indians with Type 2 Diabetes using a global expression profile and systematic analysis

Introduction and Aim: In recent years research on molecular mechanisms leading to Type 2 Diabetes Mellitus (T2DM) has discovered the promising role of microRNA (miRNA) as an early biomarker for the diagnosis of the clinical state. However, there is a lack of data from the Indian population exploring the global expression of circulating miRNA using precise and sensitive methods. The aim was to identify and quantify the circulating miRNAs from biological samples of T2DM and healthy controls using the Nanostring nCounter Platform. Material and Methods: The miRNA analysis was performed using the NanoString nCounter platform. The T2DM patients within a duration of 5 to 15 years without any complications were recruited. The healthy controls were identified without any chronic diseases. The NanoString nCounter platform probes were used to detect the newly discovered miRNAs in the chosen panel of nearly 800 miRNAs. Results: Our analysis has identified many unique miRNAs that are not reported earlier such as miR -25-3p, miR451a, miR365a, miR-129-2, miR-1271, miR572, and others. Conclusion: Identification of differential patterns of circulating miRNAs could offer optimistic chances for managing T2DM diagnostically and prognostically. The specific expansion of the miRNAs to know the intercommunication among miRNAs and other genes involved in the development of T2DM must be further explored to uncover the potential role in clinical practice.

Metabolites Potentially Derived from Gut Microbiota Associated with Podocyte, Proximal Tubule, and Renal and Cerebrovascular Endothelial Damage in Early Diabetic Kidney Disease in T2DM Patients.

Complications due to type 2 diabetes mellitus (T2DM) such as diabetic kidney disease (DKD) and cerebral small vessel disease (CSVD) have a powerful impact on mortality and morbidity. Our current diagnostic markers have become outdated as T2DM-related complications continue to develop. The aim of the investigation was to point out the relationship between previously selected metabolites which are potentially derived from gut microbiota and indicators of endothelial, proximal tubule (PT), and podocyte dysfunction, and neurosonological indices. The study participants were 20 healthy controls and 90 T2DM patients divided into three stages: normoalbuminuria, microalbuminuria, and macroalbuminuria. Serum and urine metabolites were determined by untargeted and targeted metabolomic techniques. The markers of endothelial, PT and podocyte dysfunction were assessed by ELISA technique, and the neurosonological indices were provided by an ultrasound device with high resolution (MYLAB 8-ESAOTE Italy). The descriptive statistical analysis was followed by univariable and multivariable linear regression analyses. In conclusion, in serum, arginine (sArg), butenoylcarnitine (sBCA), and indoxyl sulfate (sIS) expressed a biomarker potential in terms of renal endothelial dysfunction and carotid atherosclerosis, whereas sorbitol (sSorb) may be a potential biomarker of blood-brain barrier (BBB) dysfunction. In urine, BCA and IS were associated with markers of podocyte damage, whereas PCS correlated with markers of PT dysfunction.

Association Between Circulating Levels of C1q/TNF-Related Protein-9 and Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis.

According to growing research, C1q/TNF-Related Protein-9 (CTRP9) appears to be linked to type 2 diabetes mellitus (T2DM). But the literature on circulating levels of CTRP9 in patients with T2DM has been contradictory. This is a systematic review and meta-analysis to reassess the circulating level of CTRP9 in patients with T2DM, with and without complications. Relevant studies published until October 31, 2021, were identified from the PubMed, Embase, Web of Science, Cochrane Library, WanFang, CNKI, VIP, and CBM databases. Participants with age ≥18 years with clinically diagnosed T2DM were included. Sex and diabetes complications were not restricted. The data were extracted by 2 reviewers independently using a standard data collection form. Analysis demonstrated significantly lower circulating levels of CTRP9 in patients with T2DM than in patients without diabetes (standardized mean difference [SMD] = -1.36; 95% CI -1.78 to -0.93; P < .001), I2 = 97.5%, P < .001). Furthermore, the circulating level of CTRP9 in patients with T2DM-related complications was lower than that in patients with T2DM without complications, regardless of macrovascular complications or microvascular complications (SMD = -1.062; 95% CI -1.466 to -0.658; P < .001, I2 = 91.3%, P < .001). Subgroup analyses revealed that factors such as body mass index, T2DM duration, and fasting blood glucose were the sources of heterogeneity (P = .047, P = .034, and P = .07, respectively). The present systematic review and meta-analysis found CTRP9 levels were lower in T2DM patients with or without complications. However, since this was a meta-analysis of most observational studies, these findings still need to be verified by further studies with a large sample size.

Subclinical atherosclerosis in primary Sjögren's syndrome: comparable risk with diabetes mellitus.

It has been found that the risk of subclinical atherosclerosis in some connective tissue diseases (CTDs) was equivalent to type 2 diabetes mellitus (T2DM). There is no clinical study focusing on the differences of subclinical atherosclerosis between primary Sjögren's syndrome (pSS) and T2DM. Our aim is to investigate the prevalence of subclinical atherosclerosis in pSS patients, compare the differences in subclinical atherosclerosis between pSS and T2DM patients, and determine the risk factors of subclinical atherosclerosis. A retrospective case-control study of 96 patients with pSS, 96 age- and sex-matched T2DM patients and healthy individuals underwent evaluation, including clinical data and carotid ultrasound examination. Univariate and multivariate models were used to explore the related factors of carotid intima-media thickness (IMT) and carotid plaque. Increased IMT scores were detected in patients with pSS and T2DM compared to controls. The percentages of carotid IMT were detected in 91.7% of pSS and 93.8% of T2DM patients versus 81.3% in the controls. Carotid plaques were detected in 82.3%, 82.3% and 66.7% of pSS, T2DM, and controls, respectively. Age and the presence of pSS and T2DM emerged as risk factors for IMT (adjusted OR = 1.25, 4.40, and 9.92, respectively). In addition, age, total cholesterol, and the presence of pSS and T2DM emerged as risk factors for carotid plaque (adjusted OR = 1.14, 1.50, 4.18, and 3.79, respectively). The prevalence of subclinical atherosclerosis in pSS patients was increased, which was comparable to that in T2DM patients. The presence of pSS is associated with subclinical atherosclerosis. Key Points • The prevalence of subclinical atherosclerosis is higher in primary Sjögren' s syndrome. • The risk of subclinical atherosclerosis is similar in primary Sjögren's syndrome and diabetes mellitus patients. • Advanced age was an independent predictor of carotid IMT and plaque formation in primary Sjögren's syndrome. • Primary Sjögren's syndrome and diabetes mellitus are associated with atherosclerosis.

Identification of FGF13 as a Potential Biomarker and Target for Diagnosis of Impaired Glucose Tolerance.

Early identification of pre-diabetes provides an opportunity for intervention and treatment to delay its progression to type 2 diabetes mellitus (T2DM). We aimed to identify the biomarkers of impaired glucose tolerance (IGT) through bioinformatics analysis. The GSE76896 dataset, including non-diabetic (ND), IGT, and T2DM clinical samples, was deeply analyzed to identify 309 Co-DEGs for IGT and T2DM. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses indicated that inflammatory responses and the PI3K-AKT signaling pathway are important patho-physiological features of IGT and T2DM. Protein-protein interaction (PPI) network analysis and cytoHubba technolgy identified seven hub genes: namely, CCL2, CXCL1, CXCL8, EDN1, FGF13, MMP1, and NGF. The expression and ROC curves of these hub genes were validated using the GSE38642 dataset. Through an immunofluorescence assay, we found that the expression of FGF13 in islets of mice in the HFD and T2DM groups was significantly lower than in the control group. Similarly, the level of FGF13 in the sera of IGT and T2DM patients was lower than that in the healthy group. Together, these results suggest that FGF13 can be treated as a novel biomarker of IGT, which may provide new targets for the diagnosis and treatment of pre-diabetes and T2DM.

Genetic variations of tumor necrosis factor-α and prostaglandin-endoperoxide synthase 2 genes among Egyptian patients with type 2 diabetes mellitus and diabetic nephropathy

ObjectivesThe current study aimed to determine whether genetic differences in the tumor necrosis factor-α (TNF-α) and prostaglandin-endoperoxide synthase 2 (PTG2) genes are linked to type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN). BackgroundDN is a major cause of chronic kidney disease (CKD). Unfortunately, the precise pathogenic mechanisms of DN are not completely understood. Recent data suggest a link between inflammatory cytokines and the chronic complications of T2DM. TNF-α and PTG2 are key mediators of inflammation. Subjects and methodsThis is a case-control study that includes 100 patients (group 1: 50 diabetic patients with diabetic nephropathy and group 2: 50 patients without diabetic nephropathy) and 50 age- and sex-matched healthy controls (group 3). Genotyping of TNF-α (rs3651525) and PTGS2 (rs689466) by real-time PCR was applied. ResultsTNF-α (rs3651525) and PTGS2 (rs689466) genotype frequency and allelic distribution are in Hardy-Weinberg equilibrium (HWE). When T2DM patients with nephropathy were compared to those without DN, regression analysis for the PTGS2 rs689466 and TNF-rs361525 single nucleotide polymorphisms (SNPs) demonstrated that none of the SNP genotypes showed a major risk factor for DN susceptibility. As regards TNF-α rs361525, GA and AA genotypes were significantly associated with a higher risk of T2DM when compared to GG, and A allele showed a 3.721-fold increased risk.TNF-α rs361525 AA genotype (OR, 10.980; 95% CI 1.385–87.066) and TNF-rs361525 GA genotype (OR, 3.050; 95% CI 1.315–7.0758) are the most substantially linked parameters with the risk of diabetes mellitus in univariate analysis.According to the multivariate analysis, the AA and GA genotypes of the SNP rs361525 significantly affect the development of diabetes mellitus. No remarkable association was found between the PTGS2 (rs689466) polymorphism and diabetes mellitus and diabetic nephropathy. ConclusionIn contrast to the lack of a significant correlation between PTGS2 (rs689466) and DM or DN, TNF-α rs361525 was connected to the possibility of developing diabetes mellitus in our study.

Cortisol Levels in the Peri-implant Sulcular Fluid of Type-2 Diabetic and Non-diabetic Patients with Peri-implantitis.

Cortisol levels (CL) in peri-implant sulcular fluid (PISF) samples in relation to type-2 diabetes mellitus (T2DM) and peri-implantitis remain unaddressed. It is hypothesi?sed that PISF CL are higher in patients with type-2 diabetes and peri-implantitis than in healthy patients without and with peri-implantitis. The aim was to assess the PISF CL of peri-implantitis patients without and with T2DM. Peri-implantitis patients with T2DM (group 1), T2DM patients without peri-implantitis (group 2), non-diabetic patients with peri-implantitis (group 3) and non-diabetic patients without peri-implantitis (group 4) were included. Demographics were recorded; and patients' medical and dental records were assessed. Peri-implant modified plaque-index (mPI), modified gingival index (mGI), and probing depth (PD) and crestal bone loss (CBL) were recorded. The PISF was collected and CL were determined. p < 0.01 was considered statistically significant. Each of the four groups included 16 subjects (n = 64) with no difference in mean age. In groups 1 and 2, the mean duration of T2DM was 10.5 ± 0.8 and 10.6 ± 0.4 years, respectively. Mean HbA1c levels (p < 0.01) were higher and clinicoradiographic parameters (p < 0.001) were worse in group 1 than in the other groups. The median PISF volume and mean CL were higher in groups 1 (p < 0.01) and 3 (p < 0.01) than groups 2 and 4. There was a statistically significant correlation between PD and CL in group 3 (p < 0.001). Cortisol levels in the PISF are higher in T2DM and non-diabetic patients with peri-implantitis than in healthy individuals with and without peri-implantitis. Hyperglycemia did not influence peri-implant clinicoradiographic parameters and CL in the present patient population.

The Effects of the New Therapeutic Treatments for Diabetes Mellitus on the Male Reproductive Axis.

One of the complications of chronic hyperglycemia and insulin resistance due to type 2 diabetes mellitus (T2DM) on the hypothalamic-pituitary-gonadal axis in men, is the high prevalence of hypogonadotropic hypogonadism, which has been recently defined as functional hypogonadism, characterized by low testosterone associated with inappropriately normal gonadotropin levels. Although the pathophysiology of this hormonal imbalance may be related to several factors, including glycemic control, concomitant sleep apnea, insulin resistance, the main role is determined by the degree of central or visceral obesity and the consequent inflammatory state. Several drugs have been developed to treat T2DM such as glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase 4 inhibitors, and sodium-glucose co-transporter 2 inhibitors. All appear to be effective in ameliorating blood glucose control, by lowering inflammation and body weight, and most seem to reduce the risk of micro- and macrovascular damage as a consequence of uncontrolled diabetes. A few studies have evaluated the impact of these drugs on gonadal function in T2DM patients with hypogonadism, with promising results. This review summarizes the main current knowledge of the effects of these new antidiabetic drugs on the hypothalamus–pituitary–gonadal axis, showing their potential future application in addition to glucose control in dysmetabolic male patients.

Prevalence of Cardiometabolic Syndrome and its Association With Body Shape Index and A Body Roundness Index Among Type 2 Diabetes Mellitus Patients: A Hospital-Based Cross-Sectional Study in a Ghanaian Population.

Cardiometabolic syndrome (MetS) is closely linked to type 2 diabetes mellitus (T2DM) and is the leading cause of diabetes complications. Anthropometric indices could be used as a cheap approach to identify MetS among T2DM patients. We determined the prevalence of MetS and its association with sociodemographic and anthropometric indices among T2DM patients in a tertiary hospital in the Ashanti region of Ghana. A comparative cross-sectional study was conducted among 241 T2DM outpatients attending the Komfo Anokye Teaching Hospital (KATH) and the Kumasi South Hospital for routine check-up. Sociodemographic characteristics, clinicobiochemical markers, namely, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), and glycated hemoglobin (HbA1C) were measured. Anthropometric indices, namely, body mass index (BMI), Conicity index (CI), body adiposity index (BAI), A body shape index (ABSI), body roundness index (BRI), Waist-to-hip ratio (WHR), and Waist-to-height ratio (WHtR) were computed based on either the Height, Weight, Waist circumference (WC) or Hip circumference (HC) of the patients. Metabolic syndrome (MetS) was classified using the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. Data entry and analysis were done using Excel 2016 and SPSS version 25.0 respectively. Of the 241 T2DM patients, 99 (41.1%) were males whereas 144 (58.9%) were females. The prevalence of cardiometabolic syndrome (MetS) was 42.7% with dyslipidemia and hypertension recording a prevalence of 6.6 and 36.1%, respectively. Being a female T2DM patient [aOR = 3.02, 95%CI (1.59-5.76), p = 0.001] and divorced [aOR = 4.05, 95%CI (1.22-13.43), p = 0.022] were the independent sociodemographic predictors of MetS among T2DM patients. The 4th quartile for ABSI and 2nd to 4th quartiles for BSI were associated with MetS on univariate logistic regression (p <0.05). Multivariate logistic regression identified the 3rd quartile (aOR = 25.15 (2.02-313.81), p = 0.012) and 4th quartile (aOR = 39.00, 95%CI (2.68-568.49), p = 0.007) for BRI as the independent predictors of MetS among T2DM. The prevalence of cardiometabolic syndrome is high among T2DM patients and this was influenced by female gender, being divorced, and increased BRI. Integration of BRI as part of routine assessment could be used as early indicator of cardiometabolic syndrome among T2DM patients.

Ghrelin and Leptin and Their Relations with Insulin Resistance in Diabetes Mellitus Type 2 Patients

Ghrelin and leptin are hunger hormones related to type 2 diabetes mellitus (T2DM), and the pathogenesis of T2DM is the abnormality in insulin secretion and insulin resistance (IR). The aim of this study is to evaluate ghrelin and leptin concentrations in blood and to specify the relationship of these hormones as dependent variables with some biochemical and clinical measurements in T2DM patients. In this study, forty one T2DM and forty three non-diabetes mellitus (non-DM) subjects, aged between 40-60 years and with normal weight, were enrolled. Fasting serum ghrelin and leptin were estimated by enzyme-linked immunosorbent assay (ELISA). In our results ghrelin was significantly increased, and leptin was significantly decreased, in T2DM patients compared with non-DM subjects. Ghrelin was positively correlated with the fasting blood glucose (FBG) and IR, but inversely related to the insulin sensitivity (IS). Leptin was negatively correlated with mean arterial pressure (MAP), FBG, glycated hemoglobin (HbA1c), IR, low-density lipoprotein cholesterol, nitric oxide (NO), and alanine aminotransferase (ALT), as well as showed a linear correlation with IS and a strong dependence on sex. The area under the curve (AUC) value shows ghrelin and leptin as biomarkers for T2DM. In conclusion ghrelin and leptin hormones have predictive ability to predict T2DM, as they are significantly associated with IR, IS, free radicals, and lipid profile.

Assessment of the relationship of transcription factor 7-like 2 rs4506565 (T/A) variant with type 2 diabetes in Iraqi Arab patients

Researchers have consistently linked some TCF7L2 gene variations, such as rs7903146, rs12255372, and rs11255372, to Type 2 diabetes mellitus (T2DM) in numerous populations and ethnic groups. The goal of this study is to show if the TCF7L2 variations rs4506565 T/A is linked to T2DM in Iraqi Arab patients. For this purpose, a case-control study was conducted with 100 T2DM patients and 100 controls. The Tetra-Primer ARMS-PCR Technique was used to genotype TCF7L2 rs4506565 T/A, making use of newly-designed primers. The study concluded that the TCF7L2 gene polymorphism rs4506565 T/A shows no significant difference in genotypes in any of the codominant, dominant, over dominant, recessive, and additive models. The dominant model has a significance with age but no significance with other parameters.

GRB10 rs1800504 Polymorphism Is Associated With the Risk of Coronary Heart Disease in Patients With Type 2 Diabetes Mellitus.

Diabetic vascular complications are one of the main causes of death and disability. Previous studies have reported that genetic variation is associated with diabetic vascular complications. In this study, we aimed to investigate the association between GRB10 polymorphisms and susceptibility to type 2 diabetes mellitus (T2DM) vascular complications. Eight single nucleotide polymorphisms (SNPs) in the GRB10 gene were genotyped by MassARRAY system and 934 patients with type 2 diabetes mellitus (T2DM) were included for investigation. We found that GRB10 rs1800504 CC+CT genotypes were significantly associated with increased risk of coronary heart disease (CHD) compared with TT genotype (OR = 2.24; 95%CI: 1.36–3.70, p = 0.002). Consistently, levels of cholesterol (CHOL) (CC+CT vs. TT, 4.44 ± 1.25 vs. 4.10 ± 1.00 mmol/L; p = 0.009) and low density lipoprotein cholesterin (LDL-CH) (CC+CT vs. TT, 2.81 ± 1.07 vs. 2.53 ± 0.82 mmol/L; p = 0.01) in T2DM patients with TT genotype were significant lower than those of CC+CT genotypes. We further validated in MIHA cell that the total cholesterol (TC) level in GRB10-Mut was significantly reduced compared with GRB10-WT; p = 0.0005. Likewise, the reversed palmitic acid (PA) induced lipid droplet formation in GRB10-Mut was more effective than in GRB10-WT. These results suggest that rs1800504 of GRB10 variant may be associated with the blood lipids and then may also related to the risk of CHD in patients with T2DM.