Metformin on Insulin, Glucagon, Oxidative Stress Markers and Pancreatic Tissue Histology in Streptozotocin-Induced Diabetic Rats

This study determined the effects of Metformin on plasma insulin, glucagon, oxidative stress status and histology of pancreas in diabetic rats. Grouping was carried out on 21 rats, and were assigned into 3 groups (n = 7 rats per group); non-DM, DM and DM+metformin (200 mg/kg). Diabetes Mellitus was induced and treatments were given daily by oral gavage for 4 weeks. Food intake, fasting blood glucose (FBG), glucagon, malondialdehyde and protein carbonyl were significantly higher while final body weight, insulin and total antioxidant capacity were significantly lower in Diabetes Mellitus group compared with non- Diabetes Mellitus group. There was significantly higher body weight, insulin level and total antioxidant capacity with significantly lower food intake, FBG, glucagon, malondialdehyde and protein carbonyl levels in Diabetes Mellitus +Metformin group compared with the Diabetes Mellitus group. Pancreatic tissue histology revealed islet cells regeneration in Diabetes Mellitus +Metformin group. This in vivo study provides evidence of the potential of antihyperglycemic and improved oxidants- antioxidant status which may be due to the oral hypoglycaemic nature or effects of metformin as seen in this study.

Non-invasive skin cholesterol testing: a potential proxy for LDL-C and apoB serum measurements

Background Lipid management is the first line of treatment for decreasing the incidence of cardiovascular events in patients with coronary heart disease (CHD), and a variety of indicators are used to evaluate lipid management. This work analyses the differences in LDL-C and apoB for lipid management evaluation, as well as explores the feasibility of skin cholesterol as a marker that can be measured non-invasively for lipid management. Methods The prospective study enrolled 121 patients who had been diagnosed with acute coronary syndrome (ACS) at the department of emergency medicine of the First Affiliated Hospital of the USTC from May 2020 to January 2021, and the patients were grouped into Group I (n=53) and Group II (n=68) according to whether they had comorbid hyperlipidemia and/or diabetes mellitus. All patients were administered 10 mg/day of rosuvastatin and observed for 12 weeks. Lipid management was assessed on the basis of LDL-C and apoB, and linear correlation models were employed to assess the relationship between changes in these well accepted markers to that of changes in skin cholesterol. Results Out of 121 patients with ACS, 53 patients (43.80 %) had combined hyperlipidemia and/or diabetes mellitus (Group I), while 68 patients (56.20 %) did not (Group II). Cardiovascular events occur at earlier ages in patients with CHD who are comorbid for hyperlipidemia and/or diabetes (P<0.05). LDL-C attainment rate is lower than apoB attainment rate with rosuvastatin therapy (P<0.05), which is mainly attributable to patients with low initial LDL-C. Skin cholesterol reduction correlated with LDL-C reduction. (r=0.501, P<0.001) and apoB reduction (r=0.538, P<0.001). Skin cholesterol reduction continued over all time points measured. Conclusions Examination of changes in apoB levels give patients with low initial LDL-C more informative data on lipid management than LDL-C readings. In addition, non-invasive skin cholesterol measurements may have the potential to be used independently for lipid management evaluation.

Association of Lower Extremity Vascular Disease, Coronary Artery, and Carotid Artery Atherosclerosis in Patients with Type 2 Diabetes Mellitus

The motive of this article is to present the case study of patients to investigate the association between the ultrasonographic findings of lower extremity vascular disease (LEAD) and plaque formation. Secondly, to examine the association between the formation of coronary artery and carotid artery atherosclerosis in patients with type 2 diabetes mellitus. 124 patients with type 2 diabetes (64 males and 60 females with the age group 25-78 years) are considered for the research studies who have registered themselves in the Department of Endocrinology and Metabolism from April 2017 to February 2019. All participants have reported their clinical information regarding diabetes, alcohol consumption, smoking status, and medication. The blood samples from subjects are collected for measurement of HbA1c, total cholesterol, triglycerides, HDL-c, and LDL-c levels. Two-dimensional ultrasound has been used to measure the inner diameter, peak flow velocity, blood flow, and spectral width of the femoral artery, pop artery, anterior iliac artery, posterior tibial artery, and dorsal artery and to calculate the artery stenosis degree. Independent factors of atherosclerosis are determined by multivariate logistic regression analysis. The results are evaluated within the control group and it is found that there is no significant impact of gender, age, and body mass index ( P > 0.05 ) on the lower extremity vascular diseases. Those with smoking, alcohol consumption, hypertension, and dyslipidemia have higher positive rate ( P < 0.05 ). The type 2 diabetes mellitus group has higher diastolic blood pressure and lower triglyceride ( P < 0.05 ). Diastolic blood pressure, HbA1C, total cholesterol, HDL-c, and LDL-C are not remarkably dissimilar between the type 2 diabetes mellitus group and the control group ( P > 0.05 ). Compared with the control group, the type 2 diabetes mellitus group has higher frequency of lower extremity vascular diseases in the dorsal artery than in the pop artery ( P < 0.05 ). The blood flow of type 2 diabetes mellitus group is found to be lower than that of the control group, especially in the dorsal artery ( P < 0.05 ). The blood flow velocity of the dorsal artery is accelerated ( P < 0.01 ). Among 117 patients of type 2 diabetes mellitus (94.35%) with a certain degree of injury, there are 72 cases of type I carotid stenosis (58.06%), 30 cases of type II carotid stenosis (24.19%), and 15 cases of type III carotid stenosis (12.10%). Out of 108 subjects in the control group, there are 84 cases of type 0 carotid stenosis (77.78%), 19 cases of type I carotid stenosis (17.59%), 5 cases of type II carotid stenosis (4.63%), and 0 case of type III carotid stenosis (0.00%). Compared with the control group, carotid stenosis is more common in patients with type 2 diabetes mellitus ( P < 0.05 ). Age, smoking, duration of diseases, systolic blood pressure, and degree of carotid stenosis are found to be associated with atherosclerosis. The findings suggest that the color Doppler ultrasonography can give early warning when applied in patients with carotid and lower extremity vascular diseases to delay the incidence of diabetic macroangiopathy and to control the development of cerebral infarction, thus providing an important basis for clinical diagnosis and treatment.

Features of the acid-base balance of the prosthetic cavity in patients with diabetes mellitus

The number of patients with diabetes mellitus in the Russian Federation on January 1, 2019 is more than 4.5 million people, which is 3.12% of the population of the Russian Federation. Metabolic disorders in diabetes mellitus cause physicochemical changes, including a violation of acid-base balance (pH). Aim. To study the effect of diabetes mellitus and ocular prosthetics on the acid-base balance of the prosthetic cavity. Materials and methods. From 2018 to 2021 - 185 patients of both sexes from 21 to 80 years old (57.73±17.34 years old) were examined. 47 patients using an eye prosthesis and without diabetes mellitus (group I); 93 patients using an eye prosthesis with diabetes (group II), which were divided into two subgroups depending on the level of glycated hemoglobin (HbA1c): II-a subgroup - 47 patients with HbA1c up to 7.5%, II-b group – 46 patients with HbA1c more than 7.5%; 45 patients, without an eye prosthesis and without diabetes mellitus (group III). Results. In patients with an ocular prosthesis and without diabetes, a shift in pH to the side of acidosis was observed. In patients with an ocular prosthesis and with diabetes mellitus, the greatest shift in the pH of the conjunctival cavity to the side of acidosis, depending on the level of HbA1c (8-8.5 – in 25.8% of cases, 9-9.5 – in 43% of cases, and <10 – in 31.2% of cases). Conclusions. The presence of an ocular prosthesis in the conjunctival cavity leads to a shift in pH to the side of the alkaline side. The progression of the pH shift to the side of acidosis directly depends on the HbA1c level in patients, and the combination of two factors (the use of an ocular prosthesis in the conjunctival cavity and the presence of diabetes in the anamnesis) leads to an aggressive shift in the pH of the conjunctival cavity to the side of acidosis. Key words: acid-base balance, ocular prosthesis, diabetes mellitus.

HUBUNGAN ANTARA DIABETES MELLITUS TIPE II DENGAN DERAJAT OSTEOARTHRITIS LUTUT

Osteoarthritis is a degenerative disease that cause damage to joint cartilage damage. Osteoarthritis affects 151,4 million people in the world, including 27,4 million in Southeast Asia. Osteoarthritis is a disease that is a burden on public health and the country. The prevalence of osteoarthritis is one in four people aged 50 years and individuals aged 65 years are more at risk of developing calcification of the knee joint. Risk factors such as type II Diabetes Mellitus are observed in one of osteoarthritis research. A hispanic study explained the prevalence of osteoarthritis patient are twice as much in diabetic patient than non-diabetic patient. A score of 6.5% of HbA1c test is required to diagnose diabetes. The goal of this study is to find out the connection of type 2 diabetes mellitus and knee osteoarthritis. This research uses observational analytic with cross sectional research design with a total of 45 patient from Orthopedic clinic of Al – Fauzan General Hospital in 2016 – 2019 and analyzed with chi square test. According to the result, the most group of age is elderly about 34 people (75,6%), the most group of gender is women about 34 people (75,6%), the most group of HbA1c is non-diabetes mellitus group about 30 people (66,7%), the most group of osteoarthritis stage is severe de (4) about 28 people (62,2%), and there is no connection between type II diabetes mellitus with the stage of knee osteoarthritis with p value of 0,828 (p > 0.05). this research shows no significant correlation between type II diabetes mellitus and the stage of knee osteoarthritis. Keywords : Knee Osteoarthritis; HbA1c; Type II Diabetes Mellitus AbstrakOsteoarthritis adalah penyakit degeneratif yang disebabkan kerusakan tulang rawan sendi. Osteoarthritis dialami 151,4 juta orang di dunia dan 27,4 juta orang di Asia Tenggara. Osteoarthritis merupakan penyakit yang menjadi beban kesehatan masyarakat dan negara. Prevalensi terjadinya osteoarthritis yaitu satu dari empat orang berusia 50 tahun dan individu berusia lebih dari 65 tahun beresiko mengalami pengapuran sendi lutut. Penelitian osteoarthritis mengamati faktor risiko terjadinya osteoarthritis seperti diabetes mellitus tipe 2. Studi Hispanik menjelaskan prevalensi penderita osteoarthritis dua kali lebih banyak terjadi pada penderita dengan diabetes dibandingkan penderita tanpa diabetes. Pemeriksaan HbA1c direkomendasikan untuk mendiagnosis diabetes, dengan batas nilai 6,5 %. Tujuan penelitian ini adalah untuk mengetahui hubungan antara diabetes mellitus tipe II dengan derajat osteoarthritis lutut. Penelitian ini menggunakan analitik observasional dengan desain penelitian potong lintang dengan jumlah sampel 45 pasien di Poli Orthopedi Rumah Sakit Umum Al – Fauzan tahun 2016 – 2019 dan dianalisa menggunakan uji kai kuadrat. Berdasarkan hasil penelitian, usia terbanyak adalah lansia yaitu 34 orang (75,6 %), jenis kelamin terbanyak adalah perempuan yaitu 34 orang (75,6 %), HbA1c terbanyak adalah non diabetes mellitus yaitu 30 orang (66,7 %), derajat osteoarthritis lutut terbanyak adalah derajat berat (4) yaitu 28 orang (62,2 %), dan tidak terdapat hubungan yang bermakna antara diabetes mellitus tipe II dengan derajat osteoarthritis lutut dengan nilai p sebesar 0,828 (p > 0,05). Penelitian ini menunjukan tidak terdapat hubungan yang bermakna antara diabetes mellitus tipe II dengan derajat osteoarthritis lutut

Significant abnormal glycemic variability increased the risk for arrhythmias in elderly type 2 diabetic patients

Background Little is known about whether the influence of glycemic variability on arrhythmia is related to age in type 2 diabetes mellitus (T2DM). Therefore, we aimed to compare the association between glycemic variability and arrhythmia in middle-aged and elderly T2DM patients. Methods A total of 107 patients were divided into two groups: elderly diabetes mellitus group (EDM, n = 73) and middle-aged diabetes mellitus group (MDM, n = 34). The main clinical data, continuous glucose monitoring (CGM) and dynamic ECG reports were collected. The parameters including standard deviation of blood glucose (SDBG), largest amplitude of glycemic excursions (LAGE), mean amplitude of glycemic excursions (MAGE), absolute means of daily differences (MODD), time in range (TIR), time below range (TBR), time above range (TAR), coefficient of variation (CV) were tested for glycemic variability evaluation. Results In terms of blood glucose fluctuations, MAGE (5.77 ± 2.16 mmol/L vs 4.63 ± 1.89 mmol/L, P = 0.026), SDBG (2.39 ± 1.00 mmol/L vs 2.00 ± 0.82 mmol/L, P = 0.048), LAGE (9.53 ± 3.37 mmol/L vs 7.84 ± 2.64 mmol/L, P = 0.011) was significantly higher in EDM group than those of MDM group. The incidences of atrial premature beat, couplets of atrial premature beat, atrial tachycardia and ventricular premature beat were significantly higher in EDM group compared with the MDM group (all P < 0.05). Among patients with hypoglycemia events, the incidences of atrial premature beat, couplets of atrial premature beat, atrial tachycardia and ventricular premature beat (all P < 0.05) were significantly higher in the EDM group than those in the MDM group. In EDM group, TIR was negatively correlated with atrial tachycardia in the MAGE1 layer and with atrial tachycardia and ventricular premature beat in the MAGE2 layer, TBR was significantly positively correlated with atrial tachycardia in the MAGE2 layer (all P < 0.05). In MDM group, TAR was positively correlated with ventricular premature beat and atrial tachycardia in the MAGE2 layer (all P < 0.05). Conclusions The study demonstrated the elderly patients had greater glycemic variability and were more prone to arrhythmias. Therefore, active control of blood glucose fluctuation in elderly patients will help to reduce the risk of severe arrhythmia.

The Role of Osteocalcin in Placenta Function in Gestational Diabetes Mellitus

Background: Evidence for osteocalcin role in glucose and energy metabolism is increasing. However, little is known about osteocalcin function in gestational diabetes mellitus. The aim of this study is to examine the associations between osteocalcin and gestational diabetes mellitus. Method: 36 patients with gestational diabetes mellitus and 40 normal glucose tolerance controls were recruited in the Maternal and Child Health Hospital Guangxi Zhuang Autonomous Region from May to August 2018. Total osteocalcin and biochemical indexes of maternal serum and umbilical vein serum were analyzed. Transcriptome of placenta were sequenced. Human trophoblast JAR cells were used for evaluated the affection of osteocalcin on trophoblast In vitro. There were no significant differences with maternal serum total osteocalcin levels between gestational diabetes mellitus and normal glucose tolerance groups. The gestational diabetes mellitus group has lower umbilical vein serum total osteocalcin (51.46 ng/mL ± 24.29 Vs 67.00 ng/mL ± 25.33, P = 0.008 ), lower adiponectin (1099.72 μg/L ± 102.65 Vs 1235.85 μg/L ± 94.63, P < 0.001), higher leptin (7.41 μg/L ± 0.28 Vs 6.02 μg/L ± 0.31, P ＜ 0.001). A significant relationship existed between umbilical vein serum total osteocalcin levels and leptin (r = -0.456, P = 0.007). Osteocalcin promote JAR trophoblast cells proliferation and HCG synthesis. 36 correlated gene modules of placental transcriptome were identified through weighted gene co-expression network analysis, 2 of them were associated with osteocalcin. Conclusion: lower osteocalcin in umbilical vein serum is associated with gestational diabetes mellitus, osteocalcin may regulate placenta function via adiponectin.

Self-reported psychological disorders among the mothers of children with an autism spectrum disorder, type 1 diabetes mellitus, and typically developed children.

Background: To assess the prevalence of symptoms of depression, anxiety, and stress among mothers of children with autism spectrum disorders (ASD), type 1 diabetes, and typical development (TD), in a geographical area where such data are lacking.Method: The study sample comprised a group of mothers of children with ASD (group 1; n=126), a group of mothers of children with diabetes mellitus (group 2; n=43), and a control group of mothers of children with TD (n=116).Results: On the DASS-21, both groups 1 and 2 had higher mean scores for depression (37.86), anxiety (4.58), and stress (29.81) than the control group (P=0.015). On the PSS-14, the mean score was higher in group 2 (28.63) than in group 1 (27.61) and the control group (25.87) (p=0.004). On the DASS 21, group 1 scored higher in the depression domain (p=0.046), whereas group 2 scored higher in the anxiety domain (p=0.034) and stress domain (p=0.009) than the TD group.Conclusion: Mothers of children with ASD should be assessed for the presence of depression following diagnosis. Mothers of children with type 1 diabetes require careful monitoring for the effects of anxiety and stress on their mental health and therefore their ability to cope with diabetes management plans.

Type 2 diabetes mellitus in patients with acute ischemiс stroke is associated with a decrease in plasma glutathione levels

Ischemic stroke (IS) and type 2 diabetes mellitus are factors that affect the homeostasis of low-molecularweight aminothiols (cysteine, homocysteine, glutathione etc.). It has already been shown that IS in the acute period led to a decrease a level of reduced forms of aminothiols, but it is not clear whether type 2 diabetes mellitus has a noticeable effect there. Objective: to reveal the features of homeostasis of aminothiols in patients with type 2 diabetes mellitus in acute IS. Material and methods. The study involved 76 patients with primary middle cerebral artery IS in the first 10–24 hours after development of neurological symptoms. Group 1 included 15 patients with IS and type 2 diabetes mellitus, group 2 — 61 patients with IS and stress hyperglycemia. Their total plasma levels of cysteine, homocysteine, and glutathione, their reduced forms, and redox status were determined at admission (in the first 24 hours after IS). Results. There was a decrease in the level of total glutathione level (1.27 vs. 1.65 μM, p = 0.021), as well as its reduced form (0.03 vs. 0.04 μM, p = 0.007) in patients with IS and type 2 diabetes mellitus. Patients with type 2 diabetes mellitus who had a low redox status of homocysteine (0.65–1.2%) and glutathione (0.7–2.0%) were also characterized by a decrease in total glutathione level (p = 0.02; p = 0.03). Conclusion. Thus, type 2 diabetes mellitus is associated with a decrease in the level of total glutathione in acute IS. Probably, type 2 diabetes mellitus is characterized by a particular relationship between the metabolism of homocysteine, glutathione and glucose. Therefore, the search for homocysteine-dependent approaches to correct glutathione metabolism in type 2 diabetes mellitus may be of interest as an adjuvant therapy for IS.

Significant Abnormal Glycemic Variability Increased the Risk for Arrhythmias in Middle-Aged and Elderly Type 2 Diabetic Patients

Background: Little is known about whether the influence of glycemic variability on arrhythmia is related to age in type 2 diabetes mellitus (T2DM). Therefore, we aimed to compare the association between glycemic variability and arrhythmia in middle-aged and elderly T2DM patients. Methods: A total of 107 patients were divided into two groups: elderly diabetes mellitus group (EDM, n=73) and middle-aged diabetes mellitus group (MDM, n=34). The main clinical data, continuous glucose monitoring (CGM) and dynamic ECG reports were collected. The parameters including standard deviation (SDBG), largest amplitude of glycemic excursions (LAGE), mean amplitude of glycemic excursions (MAGE), absolute means of daily differences (MODD) were tested for glycemic variability evaluation. Results: In terms of blood glucose fluctuations, MAGE (5.77±2.16mmol/L vs 4.63 ±1.89mmol/L, P=0.026), SDBG (2.39±1.00mmol/L vs 2.00±0.82mmol/L, P=0.048), LAGE (9.53±3.37mmol/L vs 7.84±2.64 mmol/L, P=0.011) was significantly higher in EDM group than those of MDM group. The incidences of atrial premature beat, couplets of atrial premature beat, atrial tachycardia and ventricular premature beat were significantly higher in EDM group compared with the MDM group (all P<0.05). Among patients with hypoglycemia events, the incidences of atrial premature beat, couplets of atrial premature beat, atrial tachycardia and ventricular premature beat (all P<0.05) were significantly higher in the EDM group than those in the MDM group. Conclusions: The study demonstrated the elderly patients had greater glycemic variability and were more prone to arrhythmias. Therefore, active control of blood glucose fluctuation in elderly patients will help to reduce the risk of severe arrhythmia.