Treatment Of Diabetic Patients Research Articles

AWD-stacking: An enhanced ensemble learning model for predicting glucose levels.

Accurate prediction of blood glucose levels is essential for type 1 diabetes optimizing insulin therapy and minimizing complications in patients with type 1 diabetes. Using ensemble learning algorithms is a promising approach. In this regard, this study proposes an improved stacking ensemble learning algorithm for predicting blood glucose level, in which three improved long short-term memory network models are used as the base model, and an improved nearest neighbor propagation clustering algorithm is adaptively weighted to this ensemble model. The OhioT1DM dataset is used to train and evaluate the performance of the proposed model. This study evaluated the performance of the proposed model using the Root Mean Square Error (RMSE), Mean Absolute Error (MAE), and Matthews Correlation Coefficient (MCC) as the evaluation metrics. The experimental results demonstrate that the proposed model achieves an RMSE of 1.425 mg/dL, MAE of 0.721 mg/dL, and MCC of 0.982 mg/dL for a 30-minute prediction horizon(PH), RMSE of 3.212 mg/dL, MAE of 1.605 mg/dL, and MCC of 0.950 mg/dL for a 45-minute PH; and RMSE of 6.346 mg/dL, MAE of 3.232 mg/dL, and MCC of 0.930 mg/dL for a 60-minute PH. Compared with the best non-ensemble model StackLSTM, the RMSE and MAE were improved by up to 27.92% and 65.32%, respectively. Clarke Error Grid Analysis and critical difference diagram revealed that the model errors were within 10%. The model proposed in this study exhibits state-of-the-art predictive performance, making it suitable for clinical decision-making and of significant importance for the effective treatment of diabetes in patients.

Hyperglycaemia is a causal risk factor for upper limb pathologies.

Diabetes (regardless of type) and obesity are associated with a range of musculoskeletal disorders. The causal mechanisms driving these associations are unknown for many upper limb pathologies. We used genetic techniques to test the causal link between glycemia, obesity and musculoskeletal conditions. In the UK Biobank's unrelated European cohort (N = 379 708) we performed mendelian randomisation (MR) analyses to test for a causal effect of long-term high glycaemia and adiposity on four musculoskeletal pathologies: frozen shoulder, Dupuytren's disease, carpal tunnel syndrome and trigger finger. We also performed single-gene MR using rare variants in the GCK gene. Using MR, we found evidence that long-term high glycaemia has a causal role in the aetiology of upper limb conditions. A 10-mmol/mol increase in genetically predicted haemoglobin A1C (HbA1c) was associated with frozen shoulder: odds ratio (OR) = 1.50 [95% confidence interval (CI), 1.20-1.88], Dupuytren's disease: OR = 1.17 (95% CI, 1.01-1.35), trigger finger: OR = 1.30 (95% CI, 1.09-1.55) and carpal tunnel syndrome: OR = 1.20 (95% CI, 1.09-1.33). Carriers of GCK mutations have increased odds of frozen shoulder: OR = 7.16 (95% CI, 2.93-17.51) and carpal tunnel syndrome: OR = 2.86 (95% CI, 1.50-5.44) but not Dupuytren's disease or trigger finger. We found evidence that an increase in genetically predicted body mass index (BMI) of 5 kg/m2 was associated with carpal tunnel syndrome: OR = 1.13 (95% CI, 1.10-1.16) and associated negatively with Dupuytren's disease: OR = 0.94 (95% CI, 0.90-0.98), but no evidence of association with frozen shoulder or trigger finger. Trigger finger (OR 1.96 (95% CI, 1.42-2.69) P = 3.6e-05) and carpal tunnel syndrome [OR 1.63 (95% CI, 1.36-1.95) P = 8.5e-08] are associated with genetically predicted unfavourable adiposity increase of one standard deviation of body fat. Our study consistently demonstrates a causal role of long-term high glycaemia in the aetiology of upper limb musculoskeletal conditions. Clinicians treating diabetes patients should be aware of these complications in clinic, specifically those managing the care of GCK mutation carriers. Upper limb musculoskeletal conditions should be considered diabetes complications.

Epidemiology and Management of Hypertension and Diabetes Mellitus in Patients with Mild Autonomous Cortisol Secretion: A Review.

Mild autonomous cortisol secretion (MACS) is associated with a higher cardiometabolic risk than that observed in patients with nonfunctioning adrenal adenomas and in the general population. In patients with MACS, the excess of glucocorticoids affects various metabolic pathways, leading to different manifestations of metabolic syndrome and other comorbidities. Hypertension and diabetes mellitus are two of the most common cardiometabolic comorbidities associated with MACS, reaching a prevalence of up to 80% and up to 40%, respectively. In addition, they are the comorbidities that experienced a greater improvement after adrenalectomy in patients with MACS. Hypertension pathogenesis is multifactorial, including the coexistence of comorbidities such as obesity or diabetes and the role of the different polymorphisms of the glucocorticoid receptor gene, among others. Glucocorticoid-induced diabetes mellitus is mainly related to the detrimental effects of glucocorticoids on insulin-dependent glucose uptake in peripheral tissues, gluconeogenesis and insulin secretion. There are no specific recommendations for hypertension and diabetes treatment in patients with MACS. Thus, considering the similar underlying pathogenesis of hypertension and diabetes mellitus in overt and mild hypercortisolism, our recommendation is to follow this general stepwise approach: surgically remove the adrenal culprit lesion to induce remission from hypercortisolism; control hypercortisolism with steroidogenesis inhibitors; and treat elevated blood pressure or high glucose levels using carefully selected anti-hypertensives and glucose-lowering medications if blood pressure and glucose levels remain uncontrolled, respectively. In this review, we summarize the epidemiology, physiopathology and management of diabetes mellitus and hypertension in patients with MACS.

Iontophoretically controlled insulin delivery via water-soluble conductive polymer PANI:PSS and thermoplastic polyurethane matrix.

Transdermal insulin delivery is an alternative route to deliver insulin through the body skin with the challenges to overcome the low drug skin permeability and high molecular weight. Polyaniline doped with poly(4-styrenesulfonic acid) (PANI:PSS), a conductive polymer with the high electrical conductivity, was synthesized and utilized as a drug carrier to improve the drug delivery capability from a porous thermoplastic polyurethane (TPU) matrix. The insulin was electrostatically attached to PANI:PSS based on the ion exchange between insulin and PSS. For the in vitro drug release of insulin loaded PANI:PSS relative to the pristine insulin alone, the amount of insulin released was improved to 84.70% with the time to equilibrium of 2h under the electrical field of 6V. For the ex vivo release-skin permeation, the amount insulin released and permeated became lower at 57.02% with time to equilibrium of 2h, due to the pig skin acting as a barrier for insulin permeation. The modified insulin transdermal delivery, with PANI:PSS as the drug carrier and drug enhancer relative to without, is shown here to influence the insulin release rate, amount, and duration, suitable to treat diabetes patients.

The use of GLP-1 analogues in the treatment of diabetes in patients with cardiovascular diseases. The expert opinion of the Working Group of Cardiovascular Pharmacotherapy of the Polish Cardiac Society.

The use of GLP-1 analogues in the treatment of diabetes in patients with cardiovascular diseases. The expert opinion of the Working Group of Cardiovascular Pharmacotherapy of the Polish Cardiac Society.

THE PHARMACOGNOSTIC STANDARDS, ANTIOXIDANT ACTIVITY, AND HEPATIC SAFETY PROFILE OF AN INDONESIAN ANTIDIABETIC POLYHERBAL FORMULATION

The excessive oxidative processes and the lack of cellular antioxidative mechanisms are significantly observed in diabetes. In addition, long-term medication required for the treatment might harm the hepatic tissues. This study evaluated the selected pharmacognostic characters, antioxidant activities, total phenolic content, and the hepatic safety of a polyherbal formulation containing seven plant constituents used by Klinik Wisata Kesehatan Jamu Kalibakung, Tegal, Indonesia, to treat diabetes patients. The pharmacognostic properties of the formulation were characterized according to the WHO quality control methods for herbal materials. The 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity (DPPH RSA), ferric reducing antioxidant power (FRAP), and total phenolic content (TPC) were evaluated as per the standard method. The effect of formulation on the hepatic HepG2 cells was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction assay. The pharmacognostic properties of the formulation specified as follow: foreign matters (1.32±0.05%), loss on drying (11.50±0.07%), total ash (5.68±0.07%), acid-insoluble ash (0.94±0.04%), water-soluble extractable (18.22±0.60%), and ethanol-soluble extractable (16.90±0.77%). The ethanol extract showed a superior DPPH RSA (960.70±2.58 mM Trolox equivalent (TE)/ g dry weight (DW)), FRAP (1112.69±8.39 mM TE/g DW), and TPC (1768.40±32.40 mg gallic acid equivalent (GAE)/g DW) over its water counterpart. However, the water extract was safer for HepG2 cells than the ethanol one, with the IC50 values of 218.25±14.03 and 40.24±3.53 µg/ml, respectively. This study set the pharmacognostic standards for an antidiabetic polyherbal formulation with excellent antioxidant activities, in which its traditional use as a decoction was safe for the hepatic cells.

Bioactivity-guided isolation of a bioactive compound with α-glucosidase inhibitory activity from the leaves extract of Sauropus androgynus

Naturally-derived antidiabetic medications have been explored as alternatives to the current widely-used drugs which can cause mild to severe side effects. Sauropus androgynus has been traditionally utilized to treat diabetes patients. In this report, a flavonoid glycoside, astragalin (1), was isolated from the leaves extract of S. androgynus using bioassay-guided isolation approach. Enrichment processes using macroporous resins resulted in two enriched fractions with 1 contents of 0.083% and 0.054% for PAD610 and PAD900 fractions, respectively. Compound 1 showed a higher α-glucosidase inhibitory (IC50 = 55.03 ± 0.61 μg/mL) than that of acarbose. In vitro assay for antioxidant and α-glucosidase inhibitory activities showed the greatest inhibition by PAD 610 fractions which has 98.912% and 83.268%, respectively. These findings have shown promising results for further studies on S. androgynus as a potential herbal drug, particularly for the treatment of diabetes.

Amyloid Fibrillation of Insulin: Amelioration Strategies and Implications for Translation.

Insulin is a therapeutically relevant molecule with use in treating diabetes patients. Unfortunately, it undergoes a range of untoward and often unpredictable physical transformations due to alterations in its biochemical environment, including pH, ionic strength, temperature, agitation, and exposure to hydrophobic surfaces. The transformations are prevalent in its physiologically active monomeric form, while the zinc cation-coordinated hexamer, although physiologically inactive, is stable and less susceptible to fibrillation. The resultant molecular reconfiguration, including unfolding, misfolding, and hydrophobic interactions, often results in agglomeration, amyloid fibrillogenesis, and precipitation. As a result, a part of the dose is lost, causing a compromised therapeutic efficacy. Besides, the amyloid fibrils form insoluble deposits, trigger immunologic reactions, and harbor cytotoxic potential. The physical transformations also hold back a successful translation of non-parenteral insulin formulations, in addition to challenges related to encapsulation, chemical modification, purification, storage, and dosing. This review revisits the mechanisms and challenges that drive such physical transformations in insulin, with an emphasis on the observed amyloid fibrillation, and presents a critique of the current amelioration strategies before prioritizing some future research objectives.

Iontophoresis of basal insulin controlled delivery based on thermoplastic polyurethane

Insulin is globally required to treat diabetes patients by an injection into the subcutaneous tissue, the fat layer under the skin, but this may cause pain or discomfort to patients. To avoid these issues, insulin delivery through a transdermal patch is an alternative choice for sustained insulin delivery. The porous thermoplastic polyurethane (TPU) was successfully fabricated as the drug matrix via solvent casting and a particulate leaching technique by using Triton X-100 as a porogen. The pore size of the porous TPU matrices increased with increasing Triton X-100 content, whereas the porosity was not visible in the dense TPU. The in-vitro drug release and in-vitro skin permeation were investigated by using Franz diffusion cells and insulin as the model drug. The experiment was carried out under the effects of pore sizes, pHs, and electric fields. The insulin released amount depended on the matrix pore size and electric field strength. The higher insulin released amount and higher insulin diffusion coefficient were obtained mainly due to the electro-repulsive force between the drug and the electrode. Pig skin was used as the membrane to mimic human skin. The lower insulin permeation amounts and lower insulin diffusion coefficients were obtained as the pig skin possessed a stratum corneum layer acting as an insulin barrier. Both the amount and diffusion coefficient were enhanced under an applied electric field. Therefore, the porous TPU matrix has been shown here to have potential as an insulin matrix for the transdermal patch under iontophoresis.

Stroke Risk Factors of Stroke Patients in China: A Nationwide Community-Based Cross-Sectional Study.

Background: Stroke is the leading cause of death in China, and its burdens are rapidly increasing. The prevalence and control of stroke risk factors among stroke patients in China are unknown. Objective: We investigated the stroke risk factors of stroke patients in China. Design: We examined stroke risk factors in 6580 stroke patients aged 18 years or older in the China National Chronic Diseases and Nutrition Surveillance of Adults (2015–2017). With regard to the basic characteristics of the study participants, categorical variables were described as frequency (percent). The chi-square test was used to analyze the difference between men and women. The multivariate logistic regression model was used in the multivariate analysis. Results: Among the 6580 stroke patients, hypertension was the most common stroke risk factor identified in most cases (78.51%), followed by overweight or obesity (61.58%), dyslipidemia (54.38%), smoking (24.04%), diabetes (21.75%), family history of stroke (17.43%), lack of exercise (16.35%), and atrial fibrillation (4.47%). Drinking stroke patients had a lower rate of hypertension, diabetes, and dyslipidemia. Patients with hyperuricemia had a higher rate of hypertension and dyslipidemia than no-hyperuricemia patients. The hypertension awareness, treatment, and control rates among hypertension stroke patients were 73.62%, 70.19%, and 17.79%, respectively. The diabetes awareness, treatment, and control rates among diabetes patients were 69.74%, 65.83%, and 34.59%, respectively. The dyslipidemia awareness, treatment, and control rates among dyslipidemia patients were 42.37%, 29.4%, and 20.07%, respectively. Among treated hypertension patients, the rates of taking medicine as medically advised, controlled diet, increased exercise, and blood pressure monitoring were 91.31%, 58.88%, 45.78%, and 73.99%, respectively. Among treated diabetes patients, the rates of oral antidiabetic medications, insulin injection, diet control, and blood glucose monitoring were 78.24%, 34.71%, 85.77%, and 78.24%, respectively. Among treated dyslipidemic patients, the rate of taking medicine as medical advice, controlled diet, increased exercise, and regular blood lipid monitoring was 80.61%, 77.57%, 56.46%, and 40.3%, respectively. Conclusions: The most common risk factors for community stroke patients in China are hypertension, dyslipidemia, and overweight or obesity. The stroke community patients’ suboptimal awareness and treatment of hypertension, and suboptimal awareness, treatment, and control of diabetes, and dyslipidemia are significant problems in China.

Role of Dipeptidyl Dipeptidase 4 Inhibitors in the Management of Diabetic Foot.

Background: Patients with diabetes mellitus face difficulties in wound healing. It is important to explore therapeutic options for diabetic complications such as ulcers. This study evaluates the role of dipeptidyl dipeptidase 4 inhibitors (DPP4i) in the management of diabetic foot. Methods: Literature search was conducted in electronic databases (Google Scholar, Ovid, PubMed, Science Direct, and Springer) and studies were selected for inclusion if they reported the incidence rate of diabetic foot ulcer during DPP4i treatment or evaluated the effect of DPP4i on wound healing. Incidence rates of foot ulcer, amputation and peripheral vascular disease were pooled to achieve overall estimates. Meta-analyses of odds ratios were performed to evaluate the risk of foot ulcer, amputation, and peripheral vascular disease with DPP4i, and to examine the effect of DPP4i treatment on ulcer healing. Results: Ten studies (532354 DPP4i and 2092010 non-DPP4i treated diabetes patients) were included. Incidence rates of foot ulcer, amputation, and peripheral vascular disease were 3.80 [95% confidence interval (CI): 0.22, 7.39], 0.82 [95%CI: 0.60, 1.05], and 22.33 [95%CI: 9.14, 35.53] per 1000 person-years respectively in patients treated with DPP4i and 3.60 [95%CI: 1.77, 5.39], 0.76 [95%CI: 0.58, 0.94], and 20.9 [95%CI: 16.04, 25.81] per 1000 person-years respectively in patients treated with non-DPP4i drugs. Risk of ulcer or amputation with DPP4i was not consistent across studies. Odds of non-healing of ulcer were significantly lower with DPP4i in comparison with controls (odds ratio: 0.27 [95%CI: 0.10, 0.71]; p = 0.008). Conclusion: Incidence rates of diabetic foot and amputation are found to be similar with DPP4i and non-DPP4i drugs. DPP4i improved wound healing of diabetic foot in 3-month randomized trials.

Adherence to Treatment of Diabetes in Patients Suffering from Co-Morbid Depression

Objective: The objective of this study was to explore the adherence to diabetic management in patients with co-morbid depression presenting in Diabetes Management Centre, Services Hospital Lahore and to compare it with adherence to treatment of diabetes in patients not suffering from co-morbid depression. Method: The sample (N=94) was all diabetic patients with either type 1 or type 2 diabetes and presenting at outpatient department, Diabetes Management Centre, Services Hospital Lahore and who are suffering from depression according to DSM-5 Criteria. Cross-sectional study designed was being used. Result: A one-way anova was used. Results showed that there was a significant difference in adherence to treatment between diabetic patient with co-morbid depression and diabetic patient without co-morbid depression at p<.05 for four groups [F (3, 88) =6.108, P=0.001). A Tukey post hoc test revealed that adherence of diabetic patient with no depression (97.43± 14.69) had statistically significant different than diabetic patient with mild depression (77.85± 21.76, p = .002) and moderate depress diabetic patient (80.43±28.20, p = .027). There was no statistically significant difference between diabetic patient without depression and with severe depression (90.27± 21.38, p = .922). Conclusion: The study concluded that diabetic patient without co-morbid depression are better adhered to treatment than those with comorbid depression diabetic patient. The impact of demographic factors should explore in future study. Keywords: Adherence, diabetes, co-morbid depression

A STUDY OF THE EFFECT OF TIME RESTRICTED MEAL INTAKE ON ANTHROPOMETRIC AND BIOCHEMICAL PARAMETERS IN PATIENTS OF TYPE 2 DIABETES

Objective: 1. To study effect of time restricted meal intake on anthropometric and biochemical parameters in Type 2 diabetes patients. 2. To study if time restricted meal intake can act as an adjunct along with the standard conventional treatment of diabetes in patients of Type 2 diabetes mellitus. Design and method: 384 Type 2 diabetes patients enrolled from OPD Endocrinology, King George's Medical University were randomly divided based on whether the patients consented to having early dinner TRM (time restricted meal) group (192 patients) or not (control group) (192 patients). Follow up was done at 6 and 12 months for anthropometric measurement, height, weight, waist hip ratio, neck size, fasting, post prandial blood sugar, HbA1c, serum urea, serum creatinine and lipid profile. The patient was given a clear understanding about chronomedicine. A single intervention was done - timing of dinner was at or around 7 pm in the evening for TRM group. Both groups were given standard conventional treatment of diabetes. Result: 65% of TRM group, 40 % (non- TRM) had normal HbA1c after 12 months. BMI, Hip size, systolic blood pressure, HbA1c, blood sugar (fasting and post- prandial) were significantly different (p < 0.05) in TRM Group as compared to the p value of control group. p value <0.0167 observed in values of blood sugar (fasting) in TRM Group, p value < 0.8113 in control group. Blood sugar (post- prandial) in TRM Group a p value <0.0001 (highly significant), control group p value<0.6938. Hip size (TRM Group) p value < 0.0012 (Significant) (Difference between means=2.762 ± 1.261). BMI (TRM Group) p value = 0.0030, significant. Neck Size (TRM Group) p value= 0.9697, not significant. Waist Size (TRM Group)p value= 0.2832, not significant. Hip Size (TRM Group) p value = 0.0012, significant, correlation coefficient=0.8380. Systolic Blood Pressure (TRM Group) p value = 0.0211, significant. Diastolic Blood Pressure (TRM Group) p value = 0.536, not significant. Results: One of the first studies which has been undertaken in Indian diabetics, although the initial data obtained is encouraging yet further study is required to corroborate results.

The Safety of Pharmacological and Surgical Treatment of Diabetes in Patients with Diabetic Retinopathy-A Review.

Background. Diabetes mellitus (DM) is a non-infectious pandemic of the modern world; it is estimated that in 2045 it will affect 10% of the world’s population. As the prevalence of diabetes increases, the problem of its complications, including diabetic retinopathy (DR), grows. DR is a highly specific neurovascular complication of diabetes that occurs in more than one third of DM patients and accounts for 80% of complete vision loss cases in the diabetic population. We are currently witnessing many groundbreaking studies on new pharmacological and surgical methods of treating diabetes. Aim. The aim of the study is to assess the safety of pharmacological and surgical treatment of DM in patients with DR. Material and methods. An analysis of the data on diabetes treatment methods currently available in the world literature and their impact on the occurrence and progression of DR. Results. A rapid decrease in glycaemia leads to an increased occurrence and progression of DR. Its greatest risk accompanies insulin therapy and sulfonylurea therapy. The lowest risk of DR occurs with the use of SGLT2 inhibitors; the use of DPP-4 inhibitors and GLP-1 analogues is also safe. Patients undergoing pancreatic islet transplants or bariatric surgeries require intensive monitoring of the state of the eye, both in the perioperative and postoperative period. Conclusions. It is of utmost importance to individualize therapy in diabetic patients, in order to gradually achieve treatment goals with the use of safe methods and minimize the risk of development and progression of DR.

Effectiveness and Safety of Hyperbaric Oxygen Therapy (HBOT) in Treating Diabetic Foot Ulcers (DFUs)

Abstract Introduction: Diabetic Foot Ulcers (DFUs) are one of the more dangerous complications of diabetes, contributing to morbidity, mortality, and major financial strain, potentially affecting patients’ quality of life. Therefore, an effective DFU treatment is needed to both heal and reduce severe consequences, such as amputation. Studies into effective multiple therapeutic interventions for DFUs indicate that Hyperbaric Oxygen Therapy (HBOT) may be a current alternative for treating patients presenting with DFUs. Here, we seek to determine whether HBOT is clinically effective in wound healing of DFUs and reducing associated high amputation levels. Further, it examines whether HBOT is a safe therapy for treating diabetes patients with foot ulcers. Methods: A comprehensive search strategy was applied to eight databases (CINAHL, Medline, EMBAS, PsycINFO, Joanna Brigg’s Institute (JBI), Ovid, Cochrane Library and PubMed) to obtain relevant Randomised Controlled Trials (RCTs). Stringent pre-defined inclusion and exclusion criteria were applied regarding eligibility of the retrieved studies. A manual search of the references contained in these studies was performed alongside a search of e-libraries and medical websites. Eight RCTs were included, shown in a PRISMA flow diagram; data were extracted using the JBI’s data extraction tool before being critically appraised using the JBI critical appraisal tool. Findings were then summarised and interpreted using narrative synthesis. Results: Three main themes emerged from the included studies: the effect of HBOT on ulcer healing, its effect on amputation rate, and HBOT safety (i.e., concerns about adverse events and oxidative stress). Most studies concluded that HBOT assists in size reduction and accelerates healing of DFUs. Conclusion: HBOT is an effective, safe treatment, as an additional therapy for standard wound care, for DFUs in the short term, if at least 20 sessions are completed. HBOT reduces the risk for severe consequences, not the consequences per se, i.e. infection. Further rigorous examination by larger, well-designed RCTs is required to investigate the relative efficacy and cost-effectiveness of HBOT.

Inovasi Kesehatan Terkini Sebagai Strategi Efektif Pada Manajemen Diabetes Di Masa Pandemi: Sebuah Tinjauan Literature

Diabetics are increasing every year in the world, including in Indonesia. The ministry of health has carried out a solution to control diabetes, but the role of nurses as educators is not yet clearly defined, especially using technological innovations via cell phones or the web. This article aims to describe the development of technological innovations in the perspective of treating diabetes patients based on remote care using cellphone or web technology that can be used in a new adaptation period. The method used is a narrative literature review. Smartphone or web technology offers great benefits for diabetic patient care, behavior modification and education. Interactive Diabetes Diary is proven to help improve this way and is very easy to use. Diabetes management via cell phone or web is one solution for the latest nursing care services in improving the health status of diabetes patients.

Association and treatment of diabetes in patients affected by Covid-19

In December 2019, a unique coronavirus infection, SARS-CoV-2, was first identified in the province of Wuhan in China. Since then, it spread rapidly all over the world and has been responsible for a large number of morbidity and mortality among humans. According to a latest study, Diabetes mellitus, heart diseases, Hypertension etc. are being considered important risk factors for the development of this infection and is also associated with unfavorable outcomes in these patients. There is little evidence concerning the trail back of these patients possibly because of a small number of participants and people who experienced primary composite outcomes (such as admission in the ICU, usage of machine-driven ventilation or even fatality of these patients). Until now, there are no academic findings that have proven independent prognostic value of diabetes on death in the novel Coronavirus patients. However, there are several conjectures linking Diabetes with the impact as well as progression of COVID-19 in these patients. The aim of this review is to acknowledge about the association amongst Diabetes and the novel Coronavirus and the result of the infection in such patients.

Anti-hyperglycemic activity of total ethanolic fruit extract of Faidherbia albida on Nicotinamide-Streptozotocin induced diabetic mice

Faidherbia albida is one of the plants that have been used traditionally throughout the world in the treatment of diabetes. In previous studies, various parts of the plant such as the methanolic root bark, aqueous seed and the aqueous stem bark extracts have been tested on alloxan induced diabetic rats for their anti-hyperglycemic activity. In the current study, the anti-hyperglycemic activity of total ethanolic extract of F. albida fruits was evaluated in nicotinamide-streptozotocin induced diabetic mice using glimepiride as a reference anti-diabetic drug. Total ethanolic fruit extract at 200mg/kg body weight significantly (p < 0.05) lowered the blood glucose levels of diabetic mice by (74%) within 4 hours of oral administration while the peak of the hypoglycemic effect of glimepiride (55.2%) occurred at 4th hour after oral administration. The results provided evidence that F. albida fruit extract is recommended to be used as a hypoglycemic drug in treating diabetes patients.

An Insight into Unani Hypoglycemic Drugs and Their Mechanism of Action.

Diabetes mellitus type-II is a major health problem characterized by hypoinsulinemia and insulin resistance, leading to hyperglycemia and its complications. In Unani medicine, it is known as ziyābetus. Several drugs are prescribed in Unani medicine as single and compound formulations for this disease. Most of these drugs have been studied on scientific parameters and shown significant activity in reducing the symptoms and complications of diabetes. Critical evaluation of Unani medicines for treating diabetes patients have been conducted. The aim of the study is to provide complete information on this subject with the action of the mechanism so that proper treatment should be done with prospective research. Unani literature was reviewed extensively via various search engines for the herbs, shrubs used for diabetes treatment. Ten drugs were selected for the present review. There is convincing evidence to suggest that the selected drugs have promising actions against diabetes and its complications. In addition, none of the studies has reported any adverse effects with the drugs. Also, there is evidence to suggest that the method of usage described in Unani medicine may reduce or eliminate adverse events, if any. Further, there is a great need to do more research on making medicine more effective. Besides, the review article is useful for treating patients effectively by advancing the research.

Changes of saliva microbiota in the onset and after the treatment of diabetes in patients with periodontitis.

The relationship between type 2 diabetes mellitus (T2DM) and oral microbiota is still insufficiently recognized. In the present study, we compared the salivary microbiome of nondiabetic individuals, treatment-naïve diabetic patients, and diabetic patients treated with metformin or a combination of insulin and other drugs. The α- and β-diversity demonstrated significant differences in the salivary microbiome between the nondiabetic people and patients with a history of diabetes, while little divergence was found among individuals with a history of diabetes. After characterizing the effects of periodontitis on the microbial composition of each group, the salivary microbiome of the treatment-naïve diabetic patient group was compared with that of nondiabetic people and the metformin/combined treatment groups. The results revealed changes in the contents of certain bacteria after both the onset and the treatment of diabetes; among these differential bacteria, Blautia_wexlerae, Lactobacillus_fermentum, Nocardia_coeliaca and Selenomonas_artemidis varied in all processes. A subsequent correlational analysis of the differential bacteria and clinical characteristics demonstrated that salivary microbes were related to drug treatment and certain pathological changes. Finally, the four common differential bacteria were employed for distinguishing the treatment-naïve diabetic patients from the nondiabetic people and the treated patients, with prediction accuracies of 83.3%, 75% and 75%, respectively.