Background:Central Nervous System (CNS) abnormalities with insulin resistance and mediated by developmental exposures to ethanol can be avoided or remediated by consumption of dietary soy, which has insulin-sensitizing as well as antioxidant effects. However, choline supplementation has been shown to diminish Fetal Alcohol Spectrum Disorder (FASD) pathologies, and dietary soy contains abundant choline. This study was designed to determine if the therapeutic effects of soy were mediated by or independent of choline. Methods:Human PNET2 cells exposed to 0 mM or 100 mM ethanol for 48 hours were seeded into 96-well or 12-well plates and treated with vehicle, choline chloride (75 μM), or 1 μM Daidzein+1 μM Genistein (D+G) for 24 h. The cells were then analyzed for viability (Hoechst 33342), mitochondrial function (MTT), and GAPDH, Tau, Acetyl Cholinesterase (AChE), Choline Acetyl Transferase (ChAT), and Aspartyl-Asparaginyl-β-Hydroxylase (ASPH) immunoreactivity. Results:Choline and D+G significantly increased MTT activity (mitochondrial function) corrected for cell number relative to vehicle in control and ethanol-exposed cultures. Both choline and D+G prevented the ethanol-induced inhibition of GAPDH and ChAT and increased cellular accumulations of Tau. However, D+G significantly increased ASPH expression relative to vehicle and Choline. Conclusion:Choline and D+G differentially modulated the expression of neuronal proteins, mitochondrial function, and ASPH. Importantly, the prominently increased expression of ASPH by D+G corresponds with the insulin-sensitizer actions of soy isoflavones since ASPH is an insulin-responsive molecule. The findings further suggest that dietary soy may be more effective than choline for reducing ethanol-impaired neuronal migration linked to ASPH inhibition in FASD.
This entry outlines various components of diabetes mellitus, including etiology, health complications, risk factors, preventative measures, associated psychosocial factors, and issues related to the management and treatment of diabetes. Specifically, we provide a definition of both type 1 and type 2 diabetes, including symptomology, health consequences, prevalence rates, and demographics of vulnerable populations. A description of less common types of diabetes, including gestational, cystic fibrosis-related, and monogenic diabetes, is also incorporated. We review both behavioural and psychological risk factors of diabetes, including smoking, sedentary behaviours, and the role of depression and anxiety. Additional risk factors for diabetes that may cluster with poor health behaviours are described, including excess weight and poor dietary habits. Furthermore, we delineate effective evidenced-based prevention strategies that have been evaluated and that emphasise both behavioural lifestyle interventions, as well as pharmacological treatments. Specifically, previous studies indicate that engaging in physical activity and eating a healthy diet are protective against diabetes. We address the role of anxiety, eating disorders, and socioeconomic status as important psychosocial factors that have been associated with poor management of diabetes. Differences in diabetes complications among ethnic/minority populations are presented. We also delineate the role of family and friends and the importance of providing social support and autonomous support in the treatment and management of diabetes. Multiple approaches for improving treatment adherence are discussed, including the importance of self-regulation and self-monitoring. Interventions are summarised that highlight the importance of behavioural lifestyle interventions and pharmacological interventions for managing and preventing the progression of diabetes.
Objective: Accurate and reliable blood glucose monitoring devices (BGMDs) are required for adequate self-monitoring and management for people suffering from diabetes mellitus. To ensure a high level of safety for patients and users of in vitro diagnostic devices, an updated In Vitro Diagnostic Regulation (IVDR 2017/746) has been published, including new safety and performance prerequisites. However, BGMD accuracy may be limited by certain ‘real-life’ environmental factors, which should be respected in the performance evaluation. Methods: The temperature-and humidity-dependent performance of 4 different BGMD using up to 440 capillary blood samples was determined. BGMDs with associated test strips were stored at 15°C, 25°C and 35°C resp. at a relative humidity of 40% and 80% in order to imitate potential ‘real-life’ performance settings. Glucose measurements were compared to blood glucose values determined using standardized Laboratory equipment and were analyzed based on the ISO 15197:2013 system accuracy criteria. Results: Two out of three BGMDs provided consistent results across temperature ranges based on the medical threshold of a mean glucose change less than 15 mg/dl, although blood glucose difference of up to 96 mg/dl was found at an individual patient level after pairwise temperature comparison. For one device up to 31.2% of patients’ values were outside the defined limits when comparing 15o C to 35o C. Changes in humidity levels did not significantly influence the mean values across the BGMDs, although high deviations were observed at patients’ individual glucose levels. Conclusion: Moderate temperature and humidity changes can affect the accuracy of point-ofcare devices to a profound extent at an individual patient level. These ‘real-life’ environmental factors need to be included in the performance evaluation as required in the IVDR 2017/746 in order to provide a solid testing system for novel point-of-care-devices.
The award should motivate individuals to strive to realize their fullest potential which could, in turn, be beneficial to the field as a whole. Epic works are not only a testament to the individual’s efforts, but they also have the potential to change the whole world as they can lead to the formulation of better policies and or a new mindset.
Global diabetes market is expected to grow at a CAGR of 7.6% percent for the forecasted period of 2018-2023. The market is segmented on the basis of type of diabetes, drugs class and diabetic devices. Diabetic drugs have the highest market share amongst drugs and devices and are also expected to have the highest growth rate with a CAGR of 8.9%. Some of the top selling diabetic drugs include Lantus (Sanofi), Januvia (Merck And Co), Humalog (Eli Lily And Co), Novorapid (Novo Nordisk), Levemir (Novo Nordisk), Victoza (Novo Nordisk), Janumet (Merck And Co.), Novolog (Novo Nordisk), Humalin (Eli Lily And Co.) And Galvus (Novartis). With the diabetic population expected to cross the 350 million market by 2030 the market is expected to show strong growth rate.
Objective: The enormous burden of chronic venous disease among the general population is often overlooked, especially in the context of multi-morbidity. The aim of this study was to assess comorbidity of the pathologically-related conditions chronic venous disease and diabetes mellitus (DM). Methods: Data were derived from a quantitative market-research survey of physicians in Brazil, Mexico, Turkey, Bulgaria, Switzerland and Egypt (June-July 2019). Generalists and specialist with 3–30 years in practice; ≥ 10 chronic venous insufficiency (CVI) patients per week; and ≥ 1 CVI patient receiving pharmacotherapy were eligible. Interviews assessed practice details, patient population and anonymised data from one patient each treated for CVI, CVI and DM, and CVI and DM with microvascular complications (DmVC). Results: Over half of patients (53%) with CVI had comorbid DM. DM was likely to be diagnosed first followed by CVI (mean gap 5.3 years) and finally DmVC (mean gap 3.4 years). Patients being treated for CVI alone were diagnosed at an earlier CEAP stage (C2: 34.5%) than those being treated CVI+DM (C2: 24.8%) or CVI+DmVC (C2: 17.8%). A large minority (25.0– 29.3%) of patients self–medicated when presenting with CVI symptoms. Compression with pharmacotherapy was the most common initial treatment in all groups (39.3–42.3%). Most patients in all groups received initial diagnosis and treatment by non–specialists (54.4– 55.4%). Conclusion: There is a substantial unmet therapeutic need in CVI patients and those with comorbid DM are more likely to be untreated for longer. Earlier specialist intervention may improve care in this population.
Diabetes mellitus is the most common metabolic disease with neuropathy as its most common complication. In the present study, the effects of oral hypoglycaemic drugs (metformin, pioglitazone and rosiglitazone) on the morphology of the sciatic nerve were investigated. Forty male Wistar rats (140 g) divided into 5 groups control, diabetic, and 3 experimental groups (n=8) were used for the study. The 3 experimental groups were rendered diabetic by intraperitoneal injection of alloxan (150 mg/kg body weight) and subsequently treated with metformin (150 mg/kg/d), pioglitazone (3 mg/kg/d) and rosiglitazone (10 mg/kg/d) respectively. At 28 days of treatment, sciatic nerve morphology was studied by the Bielschosky’s Silver Nitrate (BSN) and Luxol Fast Blue (LFB) techniques. Blood glucose levels were monitored and recorded throughout the experiment. In the diabetic rats with oral hypoglycaemic interventions, blood glucose was not significantly different (P>0.05) from the control at 28 days of treatment. The body weight of Rosiglitazone-treated rats showed significant increase when compared with the control and other oral hypoglycaemic drug-treated rats. The axon and myelin fibers showed relatively strong affinity for BSN and LFB in the control and oral hypoglycaemic drugtreated diabetic rats contrary to the weak affinity for the stains in the untreated diabetic rats. These results suggest that oral hypoglycaemic drugs exerted positive effects on the treatment and improvement of sciatic nerve morphology of alloxan-induced diabetic rats.
Objectives:Influenza is a common and often underestimated viral infection that has been shown to trigger severe complications in high-risk patients and can lead to loss of blood glucose control in individuals with Type 2 diabetes (T2D). However, the long-term impact of influenza on this population has not been assessed very well. This study aims to examine the long-term burden of influenza infection among those with T2D, including impact on healthcare utilization and chronic diabetes-related complications. Methods:A retrospective cohort study was conducted using US commercial claims (2015-2018). T2D patients who had experienced an influenza infection were matched 1:5 with non-infected controls. The matched cohorts were followed for one year and compared at five different time periods (four quarters of 91 days, and at full-year) by healthcare utilization, including number of outpatient, Emergency Room (ER), and inpatient hospital visits and total medical expenses. Diabetes Complications Severity Index Score (DCSI) was used to measure diabetes complications at index date and after one year. Results: A total of 7,776 T2D patients with influenza were matched with 38,880 control patients. The cohort post-influenza infection had significantly higher total medical expenses, number of ER and outpatient visits in each time period, and increased numbers of hospitalizations in time periods Q1, Q3, and full-year. The influenza cohort also had significantly higher increase in DCSI after one year. Conclusion:The results from this study suggest that an influenza infection may have a significant long-term impact on T2D patient morbidity, including worsening of diabetes. When estimating the burden of influenza on this population and making treatment decisions, both short- and long-term impact should be considered.
I’m an African American psychologist living with type 2 diabetes. I have to admit that from the announcement of my diagnosis I was a difficult patient. With all of my education, I protested, I rebelled, I denied what was happening to me. I was angry at the medical profession. I was angry at my body. I was angry at the hand fate had dealt me. Looking back, I see now that I was grieving. It was essential that I accepted the fact that my lifestyle would never be the same because my body was in distress. I had to acknowledge the changes I needed to make were also the very changes my medical providers had been suggesting for years (e.g. work out a little more, try to cut out fast food, eat a healthier diet). That came in time, but what I needed most was a setting where I could vent, where I could be heard, where my anger would be validated as normal, where I could get beyond the shock and start partnering with my medical providers. Instead, I was told to make an appointment for a six-month check up to test my blood levels again and to use the time in between to see if I could manage my diabetes without medication I’m an African American psychologist living with type 2 diabetes. I have to admit that from the announcement of my diagnosis I was a difficult patient. With all of my education, I protested, I rebelled, I denied what was happening to me. I was angry at the medical profession. I was angry at my body. I was angry at the hand fate had dealt me. Looking back, I see now that I was grieving. It was essential that I accepted the fact that my lifestyle would never be the same because my body was in distress. I had to acknowledge the changes I needed to make were also the very changes my medical providers had been suggesting for years (e.g. work out a little more, try to cut out fast food, eat a healthier diet). That came in time, but what I needed most was a setting where I could vent, where I could be heard, where my anger would be validated as normal, where I could get beyond the shock and start partnering with my medical providers. Instead, I was told to make an appointment for a six-month checkup to test my blood levels again and to use the time in between to see if I could manage my diabetes without medication.
Introduction: Diabetes Mellitus is a metabolic disorder characterized by hyperglycaemia in which glucose is underutilized due to defects in insulin secretion, insulin action, or both. As of 2014, an estimated 387 million people had diabetes mellitus worldwide. Diabetes mellitus is a metabolic disorder characterized by hyperglycaemia in which glucose is underutilized due to defects in insulin secretion, insulin action, or both. As of 2014, an estimated 387 million people had diabetes mellitus worldwide. Objective: To encapsulate the definitions, classifications, prevalence, risk factors, diagnostics procedure, goal of management, lifestyle modifications, treatment, and complications of diabetic mellitus. Review: The authors used 89 different published articles for the accomplishment of this review article. Google search engine was used for accessing published articles from databases like Google Scholar, Research Gate, PubMed, NCBI, NDSS, PMID, PMCID, Cochrane Database and Clindamed international library. Findings: A role for excess glucagon cannot be underestimated; indeed, type 2 diabetes is an islet paracrinopathy in which the reciprocal relationship between the glucagon-secreting alpha cell and the insulin-secreting beta cell is lost, leading to hyperglucagonemia and hence the consequent hyperglycemia. Protease inhibitors may bind to as yet uncharacterized target proteins that regulate lipid metabolism, leading to elevated circulating fatty acids that could interfere with insulin signaling or enter the fatty acid cycle and compete with glucose cycle intermediates. Biguanides which reduce gluconeogenesis in the liver include metformin. The burden of diabetes is even higher in developing countries and in Ethiopia; systematic review result showed that prevalence of diabetes mellitus is between 2% and 6.5%. Conclusion: Diabetes is chronic disease occurred due to increased blood glucose level because of the body cannot produce at all or secrets in sufficient insulin hormone or not use it effectively. The common risk factors for occurrence of complications were gender, long duration with diabetes, poor and inadequate glycemic control, negative attitude towards diabetes, poor treatment adherence, and poor knowledge about the disease and its management.
