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.
