Objective The coronavirus disease 2019 (COVID-19) pandemic has led to a global restriction of public behavior due to lockdowns in various major cities. Lifestyle changes and reduced rates of ...outpatient lifestyle guidance/consulting may have had some impact on glycemic control in patients with type 2 diabetes. This study analyzed the impact of changes in the frequency of nutritional guidance/consulting (NGC) during the COVID-19 pandemic on outpatient care for type 2 diabetes. Methods Among 785 patients, 67 who received regular NGC during the COVID-19 pandemic were assigned to the continuation group (CG), 143 whose NGC was discontinued after the pandemic were assigned to the discontinuation group (DG), and 575 who did not receive regular NGC regardless of the COVID-19 pandemic status were assigned to the irregular NGC group (IGG). The three groups were followed up for two years. Analyses among the three categories were performed using the chi-square test or an analysis of covariance. Results The number of diabetes medications after the declaration of the COVID-19 emergency did not markedly increase in the CG (2.0±1.4 to 2.1±1.5, p>0.05) but significantly increased from 2.2±1.4 to 2.6±1.4 in the DG (p<0.005) and from 2.2±1.4 to 2.4±1.4 in the IGG (p<0.005). The increase in HbA1c adjusted for confounders was unchanged at 0.12%±1.06% for the CG and -0.07%±1.29% for the IGG but was significantly increased at 0.19%±1.49% for the DG (p<0.05). Conclusion In patients with type 2 diabetes mellitus, regular nutritional guidance may be important for maintaining good glycemic control, even during the COVID-19 pandemic.
OBJECTIVES
The objective of this study is to assess the understanding of lifestyle modification in patients with Type 2 Diabetes Mellitus, including activity, diet, and weight loss (if obese), to ...explore the reasons which keep them away from adopting the recommended lifestyle modification and to evaluate the interpretation of common foods by Type 2 diabetics.
METHODOLOGY
This hospital-based cross-sectional study was conducted in the MTI - Khyber Teaching Hospital, Peshawar, from 1st October 2022 to 31st January 2023. A validated questionnaire recorded all the pertinent details regarding the demographic profile, presence of comorbid conditions, and comprehension of lifestyle changes like diet, physical activity, and attainment of normal body mass index (BMI). A p-value ≤0.05 was considered a test of significance in this study.
RESULTSThree hundred and five (305) Type 2 Diabetics, including 196 (64.3%) females and 109 (35.7%) males, were recruited with mean age and HbA1c as 58.52 ± 10.3 years and 9.15 ± 2.1 %, respectively. About 67.2% of patients were from urban areas, while 32.8 % belonged to rural settings. Almost 55% of participants were on oral antidiabetic agents, 34.4% were on insulin therapy, and 10.2% were taking both insulin and oral antidiabetics.
CONCLUSION
General attitudes and behaviors toward lifestyle modifications in T2DM patients are highlighted in this study. Although there is awareness regarding the positive impact, patients still need to transform this aspect into tangible changes in behavior. Although geographical and socioeconomic statuses were considered variables, they were not found to be determinants in compliance with lifestyle changes in T2DM in our settings.
Background: Diabetes mellitus DM is a systemic metabolic disease. It is characterized by increase blood glucose level over a prolonged period of time. Diabetes is due to either the pancreas is not ...producing enough insulin, or the cells of the body are not responding properly to the insulin produced.The Aim of the work: To measure the effect of diabetes type-II on corneal endothelial cells using specular microscopy versus normal individuals.Patients and Methods: This is a case-control study including 96-eye of 48-diabetic patients’ type-II from those attending the outpatient clinics of memorial institute of ophthalmology and Helwan University.Results: The results of the current study revealed that the diabetes mellitus may have some adverse effects on corneal endothelial cell parameters. We have found that Specular microscopy is the only investigative tool that measures all corneal endothelial parameters together CCT, CD, CV, HEX.Conclusion: The current study revealed that diabetes mellitus may have an adverse effect on different corneal endothelial cell parameters especially on cell density.
Scope
The present study aims to assess the antidiabetic effect of Lactobacillus paracasei strain NL41 and its potential mechanisms in rats with type 2 diabetes mellitus (T2DM) induced by a high‐fat ...diet and low‐dose streptozotocin administration (HFD/STZ).
Methods and results
Eighteen Sprague–Dawley (SD) rats are randomly assigned to three groups: one control, one HFD/STZ model, and one HFD/STZ‐Lactobacillus protection group with administration of strain NL41 for 12 weeks. Blood is collected for biochemical parameters analysis and tissue samples for histological analysis. Treatment with strain NL41 results in excellent blood glucose regulation and significantly decreases insulin resistance, and HbA1c, glucagon, and leptin levels, accompanied by remarkable improvement of dyslipidemia and oxidative stress status in the animals. Islets of Langerhans, liver, and kidney are significantly protected in the NL41‐treated rats compared to the HFD/STZ‐T2DM model rats. Histochemistry shows that strain NL41 inhibits beta‐cell loss and alpha‐cell expansion, indicating pancreatic islets as the targeted tissues for the primary ameliorative effect of the probiotic strain on HFD/STZ‐T2DM rats. Crosstalk between the gut–liver and liver–pancreas endocrine axes is discussed.
Conclusion
Probiotic strain NL41 prevents HFD/STZ‐T2DM by decreasing insulin resistance and oxidative stress status, and protecting beta‐cell function.
The antidiabetic effect of probiotic Lactobacillus paracasei NL41 and its potential mechanisms in rats with T2DM induced by HFD/STZ are focused on. Treatment with NL41 significantly decreases insulin resistance, protects pancreatic islets function, and remarkably improves dyslipidemia and oxidative stress, which can be a potential probiotic for the primary prevention of T2DM.
As a key regulator of the unfolded protein response, the transcription factor XBP1 activates genes in protein secretory pathways and is required for the development of certain secretory cells. To ...elucidate the function of XBP1 in pancreatic β-cells, we generated β-cell-specific XBP1 mutant mice. Xbp1 f/f ;RIP-cre mice displayed modest hyperglycemia and glucose intolerance resulting from decreased insulin secretion from β-cells. Ablation of XBP1 markedly decreased the number of insulin granules in β-cells, impaired proinsulin processing, increased the serum proinsulin: insulin ratio, blunted glucose-stimulated insulin secretion, and inhibited cell proliferation. Notably, XBP1 deficiency not only compromised the endoplasmic reticulum stress response in β-cells but also caused constitutive hyperactivation of its upstream activator, IRE1α, which could degrade a subset of mRNAs encoding proinsulin-processing enzymes. Hence, the combined effects of XBP1 deficiency on the canonical unfolded protein response and its negative feedback activation of IRE1α caused β-cell dysfunction in XBP1 mutant mice. These results demonstrate that IRE1α has dual and opposing roles in β-cells, and that a precisely regulated feedback circuit involving IRE1α and its product XBP1s is required to achieve optimal insulin secretion and glucose control.
The global prevalence of prediabetes and type 2 diabetes (T2D) is increasing, and it is contributing to the susceptibility to diabetes and its related epidemic in offspring. Although the impacts of ...paternal impaired fasting blood glucose and glucose intolerance on the metabolism of offspring have been well established, the exact molecular and mechanistic basis that mediates these impacts remains largely unclear. Here we show that paternal prediabetes increases the susceptibility to diabetes in offspring through gametic epigenetic alterations. In our findings, paternal prediabetes led to glucose intolerance and insulin resistance in offspring. Relative to controls, offspring of prediabetic fathers exhibited altered gene expression patterns in the pancreatic islets, with down-regulation of several genes involved in glucose metabolism and insulin signaling pathways. Epigenomic profiling of offspring pancreatic islets revealed numerous changes in cytosine methylation depending on paternal prediabetes, including reproducible changes in methylation over several insulin signaling genes. Paternal prediabetes altered overall methylome patterns in sperm, with a large portion of differentially methylated genes overlapping with that of pancreatic islets in offspring. Our study uniquely revealed that prediabetes can be inherited transgenerationally through the mammalian germ line by an epigenetic mechanism.
Exercise promotes longevity and ameliorates type 2 diabetes mellitus and insulin resistance. However, exercise also increases mitochondrial formation of presumably harmful reactive oxygen species ...(ROS). Antioxidants are widely used as supplements but whether they affect the health-promoting effects of exercise is unknown. We evaluated the effects of a combination of vitamin C (1000 mg/day) and vitamin E (400 IU/day) on insulin sensitivity as measured by glucose infusion rates (GIR) during a hyperinsulinemic, euglycemic clamp in previously untrained (n = 19) and pretrained (n = 20) healthy young men. Before and after a 4 week intervention of physical exercise, GIR was determined, and muscle biopsies for gene expression analyses as well as plasma samples were obtained to compare changes over baseline and potential influences of vitamins on exercise effects. Exercise increased parameters of insulin sensitivity (GIR and plasma adiponectin) only in the absence of antioxidants in both previously untrained (P < 0.001) and pretrained (P < 0.001) individuals. This was paralleled by increased expression of ROS-sensitive transcriptional regulators of insulin sensitivity and ROS defense capacity, peroxisomeproliferator-activated receptor gamma (PPARγ), and PPARγ coactivators PGC1α and PGC1β only in the absence of antioxidants (P< 0.001 for all). Molecular mediators of endogenous ROS defense (superoxide dismutases 1 and 2; glutathione peroxidase) were also induced by exercise, and this effect too was blocked by antioxidant supplementation. Consistent with the concept of mitohormesis, exercise-induced oxidative stress ameliorates insulin resistance and causes an adaptive response promoting endogenous antioxidant defense capacity. Supplementation with antioxidants may preclude these health-promoting effects of exercise in humans.
Aims To investigate the efficacy and tolerability of albiglutide, a weekly glucagon-like peptide-1 receptor agonist, when added to metformin and glimepiride in a triple therapy regimen in people with ...type 2 diabetes mellitus. Methods This was a 156-week, randomized, double-blind, parallel-group, multicentre study. In the present paper we describe the primary results, namely those at 52weeks. Adult participants (n=685) were randomly assigned to albiglutide (30mg/week), pioglitazone (30mg/day) or placebo. If needed, blinded uptitration of albiglutide (to 50mg/week) and pioglitazone (to 45mg/day) was allowed. The participant's current dose of metformin (>1500mg/day) was maintained throughout. The glimepiride dose (4mg/day), standardized before randomization, could be decreased if persistent hypoglycaemia occurred. Results The week 52 model-adjusted difference in change of glycated haemoglobin (primary endpoint) for albiglutide versus placebo was -0.87 95% confidence interval (CI) -1.07, -0.68%-units (p<0.001), and for albiglutide versus pioglitazone it was 0.25 (95% CI 0.10, 0.40)%-units; therefore, not non-inferior. In the albiglutide group only, fasting plasma glucose reduced rapidly in the first 2weeks. Confirmed hypoglycaemia occurred in 14% of participants on albiglutide, 25% on pioglitazone and 14% on placebo. The mean (± standard error) weight change was -0.42 (±0.2)kg with albiglutide, +4.4 (±0.2)kg (p<0.001) with pioglitazone, and -0.40 (±0.4)kg with placebo and serious adverse events occurred in 6.3, 9.0 and 6.1% of participants in the respective groups. Injection site reactions occurred in 13% of participants on albiglutide and resulted in treatment discontinuation for four participants (1.4%). Conclusions Albiglutide, as part of triple therapy, provided effective glucose-lowering and was generally well tolerated.
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