Various discussion exists concerning ketone bodies (KB) for beneficial effects. In 2021, the American College of Cardiology (ACC) has presented the therapeutic potential of KB for cardiovascular (CV) disease. KB cover 10-15% of cardiac production of ATP, elevation of cardiac energetics, and reduction of cardiac remodeling, inflammation, and oxidative stress.
The patient was a 74-year-old female with type 2 diabetes mellitus (T2DM) treated on Humalog mix 25 twice a day. As social history, she has worked long years for growing and harvesting lotus roots. It gives physically heavy loading, which brings unstable glycemic daily control. She had to titrate minute regulation every time. For stable glucose variability, the treatment was changed to Xultophy, which is a specific combined agent of Insulin Degludec and Liraglutide (IDeg/Lira) once a day. Then, detailed glucose monitoring showed a better daily profile of blood glucose, irrespective of heavy or light work. It showed the bio-psycho-social benefit of Xultophy.
Diabetes and osteoporosis have been highly prevalent. Insulin therapy may increase risk of fracture. According to a cohort study (n=216,624), patients who changed to insulin therapy showed hazard ratio of fractures 1.5, with 1.6/1.8 of hip/vertebral fractures. Elevated hypoglycemic risk may be involved in greater episodes of falls with fractures.
Hyperuricemia is a clinical important problem and its prevalence has been increased. Latest topics are described. The guideline adequately managing gout was published from American College of Rheumatology (ACR). Various optimal uses of urate-lowering therapy (ULT) were presented. The cardiorenal effects of hyperuricemia have been investigated for years. Regarding the patients on chronic kidney disease (CKD) and high risk of progression, ULT with allopurinol did not show the decline in eGFR compared to the control. Recently, dotinurad that is a new selective urate reabsorption inhibitor (SURI) would be applied to medical practice. Low-dose dotinurad showed satisfactory pharmacological efficacy.
Reduces glucose (sugar) levels in your body by increasing the amount of sugar you pass in your urine Canagliflozin (Invokana®), Dapagliflozin (ForxigaTM), Empagliflozin (JardianceTM) • Canagliflozin 100 mg may be increased to 300 mg (Your dose may depend on your kidney function) • Dapagliflozin 5 mg may be increased to 10 mg • Empagliflozin 10 mg may be increased to 25 mg Take once a day as directed by your healthcare provider • Take it as soon as you remember • If more than 12 hours has passed since your missed dose, then skip the missed dose and take the next dose at the regularly prescribed time • Do not double your dose to
Objective: Pump size exterior artificial pancreas that will keep the glucose between 120 – 150mg/dl. Method: The whole project based on the idea that we should already know one insulin unit how much is able to go down the glucose and one glucagons unit how much is able to increase the glucose. Less than 120 mg/dl it uses glucagons. More than 150 mg/dl it uses insulin. The pump checks the glucose automatically for every 8 minutes. The pump (which is software decision) will choose between insulin or glucagons base in an internal database table with prerequisite glucose values and the insulin or glucagons units requiring for each glucose value (adaptive database table for each diabetic). The pump (the software) is able to choose how many insulin or glucagon units it should use (that is not based on what the diabetic will eat, but base on the current glucose level that received from the sensor which is located in the human body, needle and sensor are one piece). The insulin should have a work duration of 8 minutes and works instantly. Result: I choose 120 mg/dl as the lowest allowance glucose level as this level is secure for the diabetic (there is a time to prevent big hypoglycemia). Conclusion: This project offers to diabetics insulin injections freedom, hypoglycemia prevention, run emergency tests, ideally for all ages, endocrinologists will have the software to adapt the internal database table of the pump for each diabetic needs.
Adequate nutritional therapy and research have been crucial for diabetes and obesity. Recent topics include Calorie restriction (CR) and Low Carbohydrate Diet (LCD). It is rather difficult to calculate energy intake in person, and also to calculate the energy of the meal. There are some methods for investigating these factors, such as the total energy expenditure (TEE), physical-activity-related energy expenditure (PAEE), metabolic equivalent (MET) values, and the doubly-labeled water (DLW) method. Multi factors would be involved in the study. Further investigation would be expected for the determination of an appropriate amount of energy intake and meal energy in the future.
This research utilizing the data from the California Health Interview Survey (CHIS) (2017) reports on the factors that are linked to childhood obesity among Hispanic/Latinx communities in California with the purpose to determine the causes of the increase in childhood obesity among these two communities. The Statistical Package for Social Sciences (SPSS) was used to determine the significance of the factors that most affect the rate of childhood obesity among Hispanic/Latinx children. The data from CHIS was also utilized to derive categories related to the socioeconomic factors. Frequency tests and a chi-square test on data related to childhood obesity showed that there is a high level of significant differences among the factors that were used in relation to childhood obesity. Overall, it was concluded that there is a significant relationship between childhood obesity and factors that include income, environmental conditions, parent’s education, quality of meals, and physical activity.
Background: Authors and collaborators have continued medical practice in the Heisei Medical Welfare (HMW) group for long years for mainly two areas, extensive care for the elderly and diabetes research. From both of them, the current research was held on the daily profile of glucose and insulin for patients with type 2 diabetes mellitus (T2DM). Subjects and Methods: Cases were 6 T2DM patients in admission, with ages 67.5 ± 12.7 years, diabetes duration 9.5 years. Methods included a daily profile of glucose and insulin for seven times per day, Morbus (M) value, Meal Tolerance Test (MTT) using breakfast with 70g carbohydrate, insulinogenic index (IGI)-2 hours, various correlations among HbA1c, M value, Area Under the Curve (AUC) of glucose and insulin. Results: Cases showed average values of HbA1c 8.4 ± 0.7%, glucose 197 mg/dL, M value 111. Glucose and IRI levels increased during 0700-0900h with 154-258 mg/dL and 13.8-54.3 μU/ml. There was a significant correlation between Glucose-⊿AUC and M value (p<0.05). Discussion: Daily profile of glucose and insulin showed a similar manner, suggesting post-prandial glucose influence due to carbohydrate intake. When studied cases increase, significant correlations among M value, HbA1c and glucose-AUC seem to be found. This report hopefully becomes a reference for future diabetic research.
We know that Corona Virus develops in animals, birds and humans’ body. Now it is a pandemic and many people are dying with each passing day and the number of patients is increasing every hour. If we do not control it then it is dangerous for humanity. As we know the incubation period for COVID-19 is 1 to 14 days and it’s live in the environment for 12 to 14 hours. The only solution to the spread of the virus is by social distancing. As we know that it affects the person with low immunity so it is advised for all people to have a balanced diet, exercise daily and spend time in meditation for increasing immunity. I want to share a natural method to develop and increase the immunity power by the bile juice of animals, birds and we can try for corona virus too.
In this editorial, I would like to go through some philosophical aspects in conceptual formulations. Diabetes has been defined as part of metabolic syndrome. Diabetes is associated with insulin deficiency either in concentration or function. This is the classical and traditional picture associated with diabetes type 2. Diabetic complications are also associated with these concepts involving the metabolic points of view.
The world is facing a major epidemic of diabetes mellitus (DM) & available reports suggest that all these patients are at risk of developing diabetic foot ulcer (DFU). Approximately 50 – 60% of all DFUs can be classified as neuropathic. Signs or symptoms of vascular compromise are observed in 40 to 50% of all patients with the vast majority having neuro-ischemic ulcers, and only a minority of patients has purely ischemic ulcers. Diabetic foot infections are usually polymicrobial in nature, involving both aerobes and anaerobes, which can decay any part of the body especially the distal part of the lower leg. However, one of the hidden barriers to wound healing is the presence of biofilm in chronic DFUs. Biofilms are difficult to identify & diagnose, recalcitrant to topical antibiotics & can reoccur even after sharp debridement. More than 90% of chronic wounds are complicated with biofilms. Hence, early identification and management of diabetic foot infections becomes imperative in order to prevent complications & amputation. Debridement is considered to be the gold standard treatment approach for managing DFU manifested with necrotic tissue. However, biofilm can reform even after sharp debridement and can delay healing & recovery. Also, antibiotics & few antiseptics have limited role in managing DFUs complicated with biofilm. Until recently, Cadexomer iodine, a new generation iodine formulation with microbead technology has taken a different profile in wound care. It can effectively manage biofilm along with exudate & possesses superior desloughing action. Additionally, appropriate ways of offloading, dressings & use of newer treatment strategies like negative pressure wound therapy (NPWT), hyperbaric oxygen therapy (HBOT) and / or use of growth factors can ensure faster healing & early wound closure. Although, commendable efforts in recent years have been taken in the diagnosis and treatment of DFU, it still remains a major public health concern.
Congratulations on the inaugural issue of Diabetes Research: Open Access (DROA). Across the world, the necessity of medical practice and research concerning diabetes has been more emphasized. The significant role of this journal will be expected from now.
Diabetes mellitus (DM) is the seventh leading cause of death in the United States and the leading cause of death in the U.S. American Indian/Alaskan Natives (AI/ANs), who comprise only 2% of the total population. The AI/AN population has a high prevalence of DM in adults aged 20 years or older and is developing DM at a younger age than the general U.S. population. DM is a major risk factor for cardiovascular disease (CVD), and mortality from CVD is higher in AI/ANs than the general population, as is the prevalence of stroke and 1-year poststroke mortality for both genders when compared to non-Hispanic whites. A genome-wide scan found a number of chromosome linkages in the AI/AN population that suggest that genetic factors may contribute to their high risk of DM and CVD. Importantly, studies also suggest that in addition to race/ethnicity, cultural norms and historic conditions play important roles in the prevalence of DM and CVD in this population. Therefore, multiple factors should be taken into consideration when establishing prevention programs to decrease the prevalence of obesity, diabetes, and CVD incidence among adults and children in the AI/AN population. Prevention programs should focus on behavioral risk factors and lifestyle changes like encouraging smoking cessation, healthy diet, and increased physical activity while taking into consideration cultural, economic, and geographic factors.
Diabetes has been associated with vitamin D deficiency.
OBJECTIVE To evaluate the relationship between total and differential White Blood Cell (WBC) counts with time to transition to type 2 diabetes in Mexican Americans using prospective data from the Cameron County Hispanic Cohort (CCHC). RESULTS Multivariable Cox proportional hazards regression models revealed that obese Mexican-American cohort participants whose total WBC or granulocyte count increased over time had 1.39 and 1.35 times higher risk respectively of transition to type 2 diabetes when compared to overweight participants. The granulocyte or total WBC count in participants with BMI≥35 were significant risk factors for transition to type 2 diabetes. CONCLUSIONS Increased total WBC and WBC differential counts, particularly lymphocytes and granulocytes, are associated with risk of transition to type 2 diabetes in obese Mexican Americans, after adjusting for other potential confounders. Screening and monitoring the WBC counts, including lymphocytes and granulocytes can help with monitoring potential transition to type 2 diabetes.
Heart failure is the leading cause of death in diabetic patients. Recently we showed that apelin gene therapy attenuates heart failure following myocardial infarction. This study further explored the potential mechanisms by which apelin may reduce cardiac injury in Postmyocardial infarction (MI)) model of diabetes. Wild type and Sirt3 knockout (Sirt3 KO) mice were induced into diabetes by intra-peritoneal (i.p.) Streptozotocin (STZ). STZ mice were then subjected to MI followed by immediate intramyocardial injection with Adenovirus-apelin (Ad-apelin). Ad-apelin treatment resulted in over expression of apelin in the ischemic hearts of STZ mice. Apelin over expression led to a significant increase in Sirt3 expression. Apelin over expression significantly reduced gp91phox expression. This was accompanied by a significant reduction of reactive oxygen species formation. Ad-apelin treatment also dramatically reduced NF-κb-p65 expression in WT-STZ mice. Over expression of apelin further enhanced autophagy markers (LC3-II and beclin-1) expression in post-MI heart. Most intriguingly, knockout of Sirt3 in STZ mice abolished these beneficial effects of apelin treatment. In vitro, knockout of Sirt3 in EPCs significantly enhanced high glucose-induced ROS formation. Conversely, treatment of Sirt3 KO-EPCs with NADPH oxidase inhibitor led to two fold increase in LC3-II levels. Our studies demonstrate that apelin increases autophagy via up regulation of Sirt3 and suppression of ROS-NF-κb pathway in diabetic heart.
The highest prevalence of type 2 diabetes mellitus in developing countries occurs in the upper socio-economic group, but this has not been well documented in Indians. The age and sex standardized prevalence of diabetes in 1112 affluent adult Indian subjects was 21.1%. This is the highest prevalence of diabetes reported from India.
During the month of Ramadan, Muslims fast every day from dawn to sunset. In the healthy subject, this fasting does not have any harmful consequences on health. However, it can induce several complications for patients with diabetes. The aim of this review twofold: first, it seeks to give some clues about methodological aspect of research during Ramadan and to show the impact of various diabetes monitoring and treatment, including biochemical and clinical parameters, diet and caloric intake, drug intake when fasting. Second, it intends to determine whether or not Ramadan fasting induces complications in patients with types 1 and 2 diabetes and ultimately to elaborate some advice as to the management of fasting patients. Several studies have shown that Ramadan fasting did not alter biochemical parameters in patients with type 2 diabetes. However, other studies have shown that there is either an increase or a decrease in biochemical parameters during Ramadan. Ramadan fasting would be acceptable for patients with well-balanced type 2 diabetes who are conscious of their disease and compliant with their diet and drug intake. If patients with type 1 diabetes wish to fast, it is necessary to advise them to undertake control of their glycaemia several times a day. Patients with type 1 diabetes who will fast during Ramadan may be better managed with fast absorption insulin.
During the month of Ramadan, Muslims fast every day from dawn to sunset. In the healthy subject, this fasting does not have any harmful consequences on health. However, it can induce several complications for patients with diabetes. The aim of this review twofold: first, it seeks to give some clues about methodological aspect of research during Ramadan and to show the impact of various diabetes monitoring and treatment, including biochemical and clinical parameters, diet and caloric intake, drug intake when fasting. Second, it intends to determine whether or not Ramadan fasting induces complications in patients with types 1 and 2 diabetes and ultimately to elaborate some advice as to the management of fasting patients.
