Body mass index (BMI) and breast cancer biomarkers such as resistin, leptin adiponectin, monocyte chemoattractant protein-1 (MCP-1) and homeostasis model assessment of insulin resistance (HOMA-IR) are highly associated with each other. The report has focused the inter-relationship between BMI and breast cancer biomarkers based on probabilistic modeling. It has been shown that mean BMI is positively associated with leptin (P<0.0001) and MCP-1 (P=0.0002), while it is negatively associated with adiponectin (P=0.0003), HOMA-IR (P<0.0001), and it is higher for healthy women (P=0.0116) than breast cancer women. In addition, variance of BMI is negatively associated with resistin (P=0.1450). On the other hand, mean MCP-1 is positively associated with BMI (P<0.0001). Mean resistin is positively associated with the interaction effect of BMI and leptin (BMI*Leptin) (P=0.0415), while its variance is positively associated with BMI (P=0.0942), and it is negatively associated with BMI*Adiponectin (P=0.1518). Leptin is positively associated with BMI (P<0.0001). Also adiponectin is negatively associated with BMI (P<0.0001), BMI*Leptin (P=0.1729), while it is positively associated with Age*BMI (P=0.0017) and BMI*Resistin (P=0.0615). It can be concluded that BMI and breast cancer biomarkers are strongly associated with each other. Care should be taken on BMI for breast cancer women.
Background: Diabetic ketoacidosis (DKA) is an acute and life-threatening situation that accounts for the majority of diabetes related morbidity and mortality in children and adolescents who suffer from type 1 diabetes mellitus (T1DM). Diabetic ketoacidosis is the most severe endocrine emergency in pediatrics, which is characterized by hyperglycemia (>250 mg/dl or 14 moll/l), metabolic acidosis (venous pH < 7.3), with associated glucosuria, ketonuria, and ketonemia. Objective: To assess the precipitating factors, clinical presentation, and treatment outcome of diabetic ketoacidosis among diabetic patients in two tertiary hospital of Addis Ababa. Methods: A retrospective analysis was done on the case records of 175 children with diabetic ketoacidosis admitted to our hospital from January 2015 to April 2020. They were managed using a standard protocol including intravenous fluids and insulin infusion. Blood glucose, serum electrolytes, blood urea, and urinary ketones were monitored at regular intervals. The outcomes were assessed. The data was checked for its ’ completeness and entered into Epi version 4.6, and imported to SPSS version 25 software for analysis. The Associations between independent and dependent variables were analyzed using binary logistic regression models. Result: The median age at presentation was 8 years ’ ranges from < 6 months to ≤ 12 years with male to female ratio of 1:1.5. One hundred thirtyseven children (78.3%) were detected to have diabetes mellitus at the time of presentation. Dehydration, Polyuria with polydipsia was the commonest clinical presentation. The precipitating factor of DKA was newly diagnosed, omission of insulin and infection respectively (137, 78.3%, 33, 21.7% and 5,2.9%). There was mortality which accounts 6.9%. Conclusion and Recommendation: DKA were most prevalent in newly diagnosed TIDM cases. Newly diagnosed T1DM and insulin omission were the main factors associated with DKA. The age of presentation and clinical symptoms of studied subjects were similar to international studies. High frequency of DKA at presentation of T1DM requires careful attention to issues of early diagnosis before development of ketoacidosis and subsequently need prevention of DKA management complication. We recommend all the health facilities to give health education about the sign and symptoms of DM and the acute complications of DM.
Introduction: Ensuring the quality of pharmaceutical services in hospitals is an integral aspect of providing quality of health care. In this regard, it has long been proven that the adoption of the concept of pharmaceutical care is essential to improve the quality of pharmaceutical services. Hence, this study aimed to assess type 2 diabetes mellitus patients’ satisfaction with pharmacy services in Wollega University Referral Hospital, West Ethiopia. Methods: Descriptive cross-sectional study design was employed from May to June 2019. Data were collected using both close and open-ended questionnaires from the sample of type 2 diabetes mellitus patients. The collected data were analyzed using Statistical Package for Social Science version 20 and Descriptive data were explained by frequency and percentage. Results: From a total of 195 study participants, 124 (64%) were satisfied with pharmacy service. Patients who were satisfied with pharmacy services reported possible reasons like availability of the prescribed drugs, affordability, and notice of information on the drug package that is not taken with foods. However, patients were dissatisfied with other pharmacy related factors like the reflection of negative attitude from the pharmacists and withholding information on what to do during the occurrences of adverse effects. About two thirds (67.8%) patients agreed with the availability of prescribed medicines. None of the patients had negative attitude toward the pharmacists. About 43.1% of the patients strongly disagreed with unclear instruction of taking medicines. Conclusion: The patients’ satisfaction level with pharmacy service was affected by different pharmacy service-related factors. The management of Wollega University Referral Hospital has to establish and activate information centers to sufficiently provide drug information for the patients and motivate pharmacists morally and financially.
Our aim was to check the suitability of the human intestine for the delivery of the re-combinant proteins in humans. The prospective applications of said technology are huge, since travel in the outer Space to locate new planets for the relocation of the over crowded Earth will face the need for the crew vaccination from the pathological microorganisms, found in these outer Space locations. We invented the technology to treat Diabetes II and his chronic anemia in the adult volunteer as the draft of said new applications of said in vivo technology. The strain of lactobacilli from normal human intestinal microflora was isolated, genetically engineered and then returned back for the adhesion back to the host intestinal epithelium of the volunteer. The volunteer was cured from his Diabetes II and chronic anemia. We discuss the potential applications of said technology for the in vivo expression of the vaccines for the crews of the outer space long range travel missions coming soon.
Long-term hyperglycemia can impair renal microvessels and lead to diabetic nephropathy (DN). Early treatment can delay or prevent its progression. Efficacy of monoclonal antibody (mAb) therapies for human diseases can often be tested only in nonhuman primates (NHPs) but no other species due to lack of human mAb cross-reactivity. To test if DN in NHPs is similar to the human disease, this study analyzed the blood and urine biochemistry data from a large pool (n=129) of cynomolgus monkeys (Macacafascicularis). Compared with the normoglycemic monkeys, the diabetic animals were significantly aged and showed significantly higher levels of blood glucose, HbA1c, TC, TG, LDL and ALT. DN monkeys (n=47) significantly increased urine (24h) volume, glucose, albumin, total protein, bilirubin and albumin/creatinine ratio (ACR). The data showed significant correlations between age and 24h-urine glucose (p<0.05) and between age and urine creatinine (negative, p<0.05). Plasma glucose correlated well with 24h-urine volume, glucose, albumin, total protein, creatinine, and ACR (p<0.01). Treatment with the angiotensin II antagonist losartan significantly improved proteinuria in DN monkeys, which is consistent with the clinical observations in nephropathy patients. Our data indicate that DN in NHPs can be a highly valuable translational model for studying pathophysiological mechanisms and novel therapies of human nephropathy.
Our aim was to find the efficient cure of Diabetes II in vivo. The selective medium was constructed to ensure, that only bifidobacteria would be isolated from the feces of the volunteer. The additonal work was needed to find the conditions of maintenance of the isolated cultures to ensure the adhesion of said cultures back to the intestinal epithelium of the host organism. The isolated strains of bifidobacteria were tested on their belonging to the species Bifidobacterium breve, which has been used prior to us as the probiotic. The recombinant strain of B. breve was constructed as we did that before using the genome tailoring technology. We reached the success with the complete cure of Diabetes II in the volunteer. We have proposed our technology for expression of the recombinant proteins for the future use, for instance, for the long term outer space missions, where the crew would be vaccinated by the same technology, if they feel they would need to do so during the discovery of the new planets, suitable for the relocation of the overcrowded Earth population there. We also propose our technology for use for any recombinant protein expression in the human body when that would be needed for a variety of clinical applications: use of the human intestine as the gate as the entry to the human body for delivery of the recombinant proteins. The application of our described technology economic value would be around $327 billion or above that these days.
Present study was aimed to evaluate the anti-diabetic efficacy of Ficus glomerata in Alloxan monohydrate induced albino rats. Oral administration of fresh Ficus glomerataleaves (2 - 4 g/day) for 60 days shows significant blood glucose lowering effect in experimental alloxan induced diabetic rats. These diabetic rats blood glucose level became normal when fed with Ficus glomerata leaves. It is amply revealed that fresh Ficus glomerata indica leaves possessed anti-diabetic properties. The results suggest that statistically significant anti-diabetic potential in alloxan monohydrate induced diabetic rats. The Ficus glomerata leaves to be almost similar effect like insulin treatment in alloxan monohydrate administered animal model. From the present investigation it appeared that Ficus glomerata leaves might have some ingredients to increase the output of insulin by binding to the receptors of the Beta cells of the Langerhans located in the pancreas. Once they bind to the Sulphonyl urea receptors, the K+ -ATP channels are probably closed and therefore the membrane is depolarized and insulin production is stimulated.
COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in late December 2019 in Wuhan, China, and has spread to become a pandemic with over 100 million confirmed cases and still growing. The infectious nature and hence, high hospitalization rates and intensive care admissions are resulting in high mortality rates. Alarmingly, COVID-19 infection and virus-induced respiratory dysfunction poses a serious threat to patients with chronic illnesses such as diabetes, Asthma, COPD and obesity. COVID-19 patients with diabetes show higher complication and mortality rate than patients without diabetes. Transient non-severe increased insulin requirement in patients hospitalized for medical conditions such as sepsis or myocardial infarction is a well-known phenomenon. However, extremely high-dose insulin requirement remains a very rarely reported entity, but this showed up in COVID-19 positive cases. Here, we report the case of transitory moderate increase in insulin requirement in a type 1 diabetic (T1D) patient who was previously well controlled in the absences of any medical conditions known to be a causative factor. We collected the data and compared total insulin daily requirement against pre-meal glycemia and blood gas results to reflect insulin resistance and multiple DKA events related to trials of multiple oral hypoglycemic agents and GLP1 analogue as potential target for intervention in addition to insulin therapy and low carb diet.
Background: To investigate the relationship between glycated haemoglobin (HbA1c) and the lipid profile in patients of type-2 diabetes. Methods: The study has been conducted on 32 patients of type 2 diabetes. These are patients diagnosed with Type 2 diabetes of age group between 30 and 70 years. Blood samples were collected after 12 hours of fasting where blood samples were drawn before and after a meal from the patients to measure levels of the sugar and lipids. Various biochemical assays were carried out including fasting plasma glucose (FPG), PPBG, HbA1c and lipid profile, along with the patient’s age, and gender. The method that has been used for doing these investigations is Kit Spinreact. Results: The study found that the participants have an increase in FBG, PPBG, HbA1C, TC, TG, VLDL-C and LDL-C, with a decrease in HDL-C concentrations in type 2 diabetic patients. The result showed a correlation of HbA1c with other variables. The HbA1c significantly correlated with FBG (r=0.531, P=0.000), PPBG (r= 0.699, P=0.000), Total Cholesterol (r= 0.339, P=0.006), Triglycerides (r=0.357, P=0.004), Low-density Lipoprotein (r=0.269, P=0.031) and Very low-density Lipoprotein (r=0.364, P=0.003) where it was not correlated with HDL (r=-0.182, P=0.149). Conclusion: The HbA1c was significantly associated with all variables (lipid profile) except HDL which did not reach the significant level. These findings suggest that HbA1c level can be used as a good parameter for predicting the lipid profile of type 2 diabetic patients.
Type 2 Diabetes Mellitus (T2DM) has developed into a significant cause of death and morbidity for millions of people worldwide. Antidiabetic drug toxicity concerns have shifted focus towards herbal remedies, which are both cost- was an effective and safe. Therefore, the objective of our study was to investigate the antidiabetic, antihyperlipidemic and antioxidant activities of a novel Polyherbal Formulation (PHF). To prepare the PHF, aqueous extracts of various plant parts namely Commiphora mukul, A$zadirachta indica antioxidant activities of a novel Polyherbal Formulation (PHF). The efficacy of the PHF was studied using various parts Gaertn, 2cimum sanctum / and Trigonella foenum-graecum / Curcuma longa /, ( mblica officinalis Gaertn, Gymnema sylvestre Retz, Momordica Momordica charantia /, Garcinia cambogia , High Fat Diet (HFD) and low dose streptozotocin (STZ-35 mg/kg) induced in rats. An Oral Glucose Tolerance Test (OGTT) was also performed in diabetic rats for assessment of pancreatic β-cell function. On other hand, the group of diabetic rat were fed with the dose is 50, 100 and 200 mg/kg of PHF along with the normal, diabetic and positive control (glibenclamide-0.6 mg/kg) group for 28 days. In addition, the biochemical parameters such aspartate many AminoTransferase (AST), Alkaline Phosphatase (ALP), alanine aminotransferase, and blood glucose and lipid were profile were estimated by auto-analyzer. Insulin, leptin and tumor necrosis factor alpha (TNF-α) are also examined by ELISA kit. The administration of 50, 100 and 200 mg/kg doses of PHF and glibenclamide (0.6 mg/kg), significantly (p<0.05) lower blood glucose level, Low-Density Lipoprotein Cholesterol (LDL-C), Very Low-Density Lipoprotein Cholesterol (VLDL-C), triglyceride, total cholesterol, glycated hemoglobin (HbA1c), TNF- α, leptin, ALT, AST, ALP, creatinine and urea as compared to diabetic control group. The levels of High-Density Lipoprotein Cholesterol (HDL-C), total protein and insulin were found to be significantly increase the compared with diabetic control group. Furthermore, the in vivo antioxidant enzymes such as CAT, SOD, GSH, GPx, and TBARS in liver and kidney tissues showed in significant (p<0.05) recovery in diabetic rats treated with the PHF.
Taking into consideration about current situation on COVID-19 Pandemic, Conference Series LLC Ltdwill be conducting a Webinar on “14th International Congress & Expo on Endocrine & Diabetic Complications” on November 09-10, 2020. The theme of the conference is “New recommendations and practical approaches in the treatment of endocrinal disorders and Management during COVID-19”. The webinar aims at providing a great scope for online interaction of Endocrinology Professionals, Diabetic Researchers, Academicians, industrialists, students and professors from around the globe on a single virtual platform.
Diabetes Mellitus is a metabolic disorder characterized by hyperglycemia and associated disturbances in carbohydrate, fat and protein metabolism because of absolute or relative insulin deficiency. Excess iron damages β-cells of pancreas due to oxidative stress contributing to pathogenesis of diabetes mellitus. Diabetes is a metabolic disorder characterized by hyper glycaemia & raised HbA1c. Serum Ferritin is an acute phase protein and it is a marker of iron stores in the body. The aim of this study is to establish a correlation between serum ferritin and glycated hemoglobin levels in type 2 diabetes mellitus patients. This study was done in the department of Medicine, Tertiary-level hospital, Dhaka, Bangladesh done from July-2019 to Jun-2020. The study comprised of total 100 subjects. Blood samples were analyzed for Ferritin, HBA1c and fasting plasma glucose. Serum ferritin was significantly higher in diabetic patients when compared with control group (p<0.001). Serum ferritin is positively correlated with HbA1c and also serum ferritin had a positive correlation with increasing duration of diabetes. Serum ferritin and HBA1c level were elevated in patients with type 2 diabetes mellitus when compared to healthy individuals and it indicates that serum ferritin can be used as a marker for glycemic control in diabetic patients.
Background: Over 3 million People in the UK live with Diabetes and over 500,000 of them are from Black Asian and minority Ethnic communities (BAME) communities. BAME communities develop Type 2 Diabetes at a younger age and are disproportionally at risk of complications. Objectives This pilot study aimed to demonstrate that using a picture based, culturally relevant, dietary-  booklet to provide dietary advice for newly diagnosed (BAME) people with Type 2 Diabetes, could enable healthcare professionals to improve the knowledge and understanding of Carbohydrates in BAME communities with Type 2 Diabetes. Method Questionnaire was administered before, and after the participant’s appointment with a Dietician to gauge participants knowledge of Carbohydrates. The newly designed booklets depicted foods commonly eaten by three specific communities prevalent in NW London those of the Gujarati, Caribbean and Pakistani communities. The Carbohydrate content of the foods in the booklets was represented as sugar spoons equivalents, to enable the participants to have a visual representation of the Carbohydrate content of their commonly eaten foods. Aim Using a simple method of sugar spoon equivalents and depicting culturally relevant, and specific foods would enable a better understanding of the carbohydrate content in food in these communities that could be used a tool to facilitate improved self-management of their Type 2 Diabetes. Results The participant's  ability to estimate the Carbohydrate content of foods, snacks and drinks pre and post the intervention showed consistent improvement, as did their confidence in estimating the carbohydrate content of foods.
The aim of the study is to evaluate the antidiabetic activity of aqueous peel extracts of selected fruits viz. Annona squamosa, Cucumis melo, Actinidia deliciosa, Malus pumila. Male wistar albino rats (180-200 g) divided into 12 groups including 1 control group. After induction of diabetes using alloxan, they were treated with selected extracts and polyherbal mixture. At the end of 28th day the animals were sacrificed; blood and pancreatic tissue samples were collected and analysed. All the selected fruit peel extracts and their polyherbal mixture shown significant reduction in the levels of blood glucose and serum lipids such as triglycerides, total cholesterol, LDL, VLDL but increase in HDL, insulin levels. The better action at lowest dose was shown by polyherbal mixture and Malus pumila extract followed by other peel extracts. Histopathological analysis of pancreatic tissue was in concurrence with the biochemical results These findings support that the selected fruit peel extracts and poly herbal mixture showed potent therapeutic effect on diabetes mellitus and can be a potent antidiabetic agent due to their ameliorating effects on damaged pancreas
To evaluate the medicinal impact of G. procumbens, this study designed to explore the anti-oxidant, anti-diabetic, anti-lipidemic, and enzyme activities of G. procumbens leaves extract. Alloxan induced diabetic mice used for anti-diabetic activity. Blood was collected and analyzed glucose level, lipid profile, hepatic performance, renal activity, and oxidative stress emblem with different hours (1-5 hours) and days (7th -28th days) interval using standards protocol. Bioactive compounds like alkaloid, tannin, phenol, flavonoid, and terpenoid were present in the extracts. Anti-oxidant activities were evaluated at concentration of 15, 20, 25, 30, 35, 40 and 45 μg/mL but aqueous extracts showed very significant free radical scavenging activity at concentration 40 and 45 μg/mL, (**p>0.001). Both the aqueous and ethanolic extracts (GPLAE-200 and GPLEE-200) exhibited a remarkable lowering of blood glucose level, compared to the control mice. Anti-diabetic results reveal that GPLEE-200 could be applicable for acute but GPLAE-200 for chronic treatment for diabetes mellitus. Aqueous extracts of G. procumbens have significant effects on cholesterol, triglycerides (TG), HDL and LDL level but GPLEE-200 have prominent effects on lowering LDL level. GPLAE-200 exhibit significant lowering effects of SGPT, SGOT, ALP (Alkaline phosphatase) and creatinine level. whereas; GPLEE-200 has prominent lowering effects on SGOT and creatininelevel. This study may suggest that treatment of the extracts was dose-dependent, and aqueous extract of G. procumbens could be a promising resource for better treatment of diabetes.
Pilot toxicity studies using 200, 1000 and 3000 mg/kg doses of the aqueous extract of Sterculia tragacantha in albino rats did not produce significant (P< 0.05) adverse effects on haematological and biochemical parameters. Doses of the chloroform extract at 100 and 200 mg/kg caused inhibition of increase in paw volume at 1 hr (9.9%), 2 hrs (10.7%) and 3hrs (14.0%); whereas the 200mg/kg dose caused 1 hr (13.4), 2 hrs (16.4) and 3hrs (20.6%) inhibition in paw oedema.Evaluation of the n‐hexane extract of S. tragacantha produced 53.9 and 68.8% inhibition of writhing pain at 100 and 200 mag/kg doses respectively; the 100 and 200 mg/kg doses of the chloroform extract also produced 50 and 79.3% inhibition writhing pain respectively. Pooled chromatographic fractions of the chloroform extract with common Rf gave crystals which when tested at 25mg/kg dose gave a 35.4% inhibition of inflammation whereas the same dose produced 79.1% inhibition of writhing pain.Gas chromatographic mass spectrum analysis of the chloroform extract revealed the bioactive compounds to be n‐hexadecanoic acid, 9‐octadecanoic acid and n‐triacontane.It is concluded that the chloroform extract of S. tragacantha possesses anti‐inflammatory and analgesic properties which may account for the medicinal use.
Background. Depression is one of the most pressing public health problems and also highly prevalent comorbid condition among diabetes mellitus (DM) patients. Depression may impact lifestyle decisions and ability to poorly perform tasks which are risk factors for DM. For reducing the impact of depression among DM patients in developing countries, it is crucial to identify and assess associated risk factors of depression among DM patients, thereby designing effective management techniques. In line with this, the current study applies the Bayesian framework, which pools prior information and current data, to find factors associated with depression among DM patients. Methods. A hospital-based cross-sectional study was conducted at Adama Hospital and Medical College (AHMC) from March to April 2019. Data was entered into the Epi-data 3.1 then exported to the R software 3.4.4. Bayesian logistic regression models were fitted to the data using the Markov chain Monte Carlo (MCMC) algorithm. Estimates of model parameters including adjusted odds ratio (AOR) with 95% credible intervals (CI) were calculated. Results. A total of 359 adults with DM were included in the analysis. The prevalence of depression among diabetic patients was 9.22% (95% CI: 6.4% to 12.7%). Higher fasting blood sugar level (AOR=−1.012; HPD CI: (1.0020, 1.025)), having diabetic complication (AOR=0.1876; HPD CI: (0.0214, 0.671)), history of hospital admission (AOR=0.2865; HPD CI: (0.0711, 0.7318)), low medication adherence (AOR=29.29; HPD CI: (3.383, 92.26)), and taking both insulin and oral antidiabetic medication (AOR=24.46; HPD CI: (15.20, 49.37) were significantly and strongly associated with depression among DM patients. Conclusions. Prevalence of depression among diabetes patients in the catchment area of Adama Hospital, Ethiopia, was found to be very low. Higher fasting blood sugar level, diabetic complication, history of hospital admission, low medication adherence, and taking both insulin and oral antidiabetic medication were found to be strong predictors of prevalence of depression among DM patients. Based on the findings, we recommend that integrating screening and treating of depression, early detection and management of diabetic complication, and giving counseling to improve medication adherence is an effective approach for lowering the impact of depression on DM patients.
Background/Aims: Nonalcoholic fatty liver disease (NAFLD) is believed to be the most common chronic liver disease. The present study aimed to evaluate the efficacy of the vildagliptin versus vildagliptin / metformin combination in the treatment of nonalcoholic fatty liver disease patients with type 2 diabetes mellitus (T 2DM). Methods: One hundred twenty patients, who were newly diagnosed with T 2DM, and proof of diagnosis of NAFLD, were enrolled in a twelve-month open label prospective parallel study. The patients were divided into two groups; Group 1 received vildagliptin in a dose of 50 mg twice daily and Group 2 received vildagliptin/metformin in a dose of 50 mg/ 1000 mg twice daily. Body mass index and fatty liver ultrasound grading were evaluated with the assay of HbA1c and serum levels of fasting and postprandial glucose, lipid profile, liver enzymes, fasting insulin, adiponectin, ferritin, and creatinine and blood urea with calculation of HOMA-IR before and after treatment. Results: There was a significant improvement in fatty liver ultrasound grading in both groups (p=0.001). Univariate and multivariate analysis showed that the improvement in NAFLD grading in both groups was affected by change in BMI, HbA1c, fasting insulin, HOMA-IR, triglycerides and adiponectin. After twelve months both groups showed significant decrease in BMI (p=0.001), fasting serum insulin (p<0.05 and p=0.001, respectively), HOMA-IR, HbA1c and triglycerides (p=0.001). However, adiponectin level increased significantly in both groups (p=0.001). Conclusion: Both vildagliptin or vildagliptin/metformin combination can improve fatty liver disease through their effect on BMI, serum levels of insulin, triglycerides, adiponectin and HOMA-IR.
Background: Medical Nutrition Therapy (MNT) plays a very important role in diabetes management if advised to the patient with proper counselling. Objective: The objective of this prospective study was to determine efficacy and safety of MNT in improving glycemic control in pre-diabetic and diabetic population as monotherapy and as added therapy with ongoing anti-diabetic drugs. Methods: Adult participants with Type 2 Diabetes Mellitus (T2DM) and pre-diabetics (HbA1c>6.0) were selected for the study. The MNT as Oral Nutrition Supplement was supplemented to their diet with and without concomitant medications. The primary endpoint was change in HbA1c, fasting and postprandial blood glucose. Secondary endpoints were change in lipid parameters such as cholesterol, high density lipids (HDL), low density lipids (LDL) and triglycerides. Mean change in the parameters were analysed using paired t-test with significance value of 5%. This was a 24-week, multi-centre, prospective, observational study. Results: A total of 313 patients completed the study until 24 weeks and a statistically significant reduction in HbA1c levels was seen from baseline to 12 weeks (8.6% to 7.7%; p<0.001) and at 24 weeks (8.6% to 7.1%: p<0.001), respectively, due to only MNT intake. Similar significant reduction in fasting glucose (167.4 to 119.4 mg/dL) and post-prandial glucose parameters (232.1 to 156.2 mg/dL) were also observed at both 12 and 24 weeks, respectively due to only MNT intake. The data showed that MNT is effective as both stand alone and as add-on food supplement to ongoing therapies and safe to consume. Conclusion: There was significant reduction in levels of hyperglycemic and lipid parameters in pre-diabetics and diabetics upon taking monotherapy or as an added therapy along with anti-diabetic drugs.
Millions of people die each year due to diabetes, it occurs in all groups of ages but there is no proper cure of this disease. There are so many causes of diabetes like poor life style, genetic factor, environmental pollutants and heavy metals etc. Heavy metals exposure is widespread and type 2 diabetes is reaching epidemic extent. Genetic variations can be considered as internal contributing factors in susceptibility of individuals to heavy metals and metalloids like cadmium, arsenic and related other toxicities. Polymorphism in different genes, which are directly/indirectly involving in the metabolism of arsenic, cadmium and other biological pollutants, may lead to accumulation of these pollutants in the body. It may lead to metabolic disorders such as type 2 diabetes. This study is designed to determine the effect of heavy metals as arsenic exposure as diabetogenic agents on the patients suffering from type 2 diabetes mellitus and it’s genetic and proteomic analysis against heavy metals. For this purpose, blood samples of diabetes patients will be collected from different areas of Pakistan. All base line hematology, physical, biochemical parameters from blood samples will be assessed by electrophoretic, chromatographic and mass spectrometric analysis. Genomic, Proteomic, Atomic Absorption analysis will be carried out by using advanced molecular biology techniques. In the present work, main focus on some of the most important heavy metals like arsenic exposure, their properties and effects that is documented and suspected risks on the human population. In this work, the main purpose is to determine the effect of arsenic exposure on type 2 diabetes mellitus, the expression of genes and proteins on human blood and help in early diagnosis, preventive and management of the disease.
