The incidence of diabetes is increasing steeply; the number of diabetics has doubled over the past three decades. Surprisingly, the knowledge of type 3c diabetes mellitus (T3cDM) is still unclear to ...the researchers, scientist and medical practitioners, leading towards erroneous diagnosis, which is sometimes misdiagnosed as type 1 diabetes mellitus (T1DM), or more frequently type 2 diabetes mellitus (T2DM). This review is aimed to outline recent information on the etiology, pathophysiology, diagnostic procedures, and therapeutic management of T3cDM patients.
The literature related to T3cDM was thoroughly searched from the public domains and reviewed extensively to construct this article. Further, existing literature related to the other forms of diabetes is reviewed for projecting the differences among the different forms of diabetes. Detailed and updated information related to epidemiological evidence, risk factors, symptoms, diagnosis, pathogenesis and management is structured in this review.
T3cDM is often misdiagnosed as T2DM due to the insufficient knowledge differentiating between T2DM and T3cDM. The pathogenesis of T3cDM is explained which is often linked to the history of chronic pancreatitis, pancreatic cancer. Inflammation, and fibrosis in pancreatic tissue lead to damage both endocrine and exocrine functions, thus leading to insulin/glucagon insufficiency and pancreatic enzyme deficiency.
Future advancements should be accompanied by the establishment of a quick diagnostic tool through the understanding of potential biomarkers of the disease and newer treatments for better control of the diseased condition.
Their limited solubility and lack of tumor selectivity limit the clinical usefulness of photosensitizers. Various nanostructures have been evaluated as delivery agents for photosensitizers in an ...attempt to overcome these obstacles, but these have typically been limited by premature clearance by the reticuloendothelial system (RES) and non-specific interactions with normal cells that result from their hydrophobic surfaces. In this study, we report our attempt to circumvent these problems by applying a low molecular weight chitosan (25 kDa) coating to a poly(lactic-co-glycolic acid)-diiodinated boron dipyrromethene (PLGA-I2BODIPY) nanoparticle-photosensitizer construct. This chitosan coating increased the hydrophilicity and decreased the charge of PLGA-I2 BODIPY nanoparticle surfaces without changing their size (average diameter 147 nm) or morphology. In comparison to the uncoated controls, the coated nanoparticles reduced the burst release of I2BODIPY, increased its predominantly lysosomal cellular uptake, and enhanced its photocytotoxicity in 4T1 murine and MDA-MB-231 human breast cancer cells. PLGA-Chitosan-I2BODIPY nanoparticles also showed reduced serum protein adsorption and macrophage uptake compared to the uncoated controls. In 4T1 tumor-bearing mice, the PLGA-Chitosan-I2BODIPY nanoparticles exhibited better tumor-targeting selectivity and significantly reduced accumulation in RES tissues, including the lymph nodes, spleen and liver (by 10.2-, 2.1- and 1.3-fold, respectively), and in non-tumorous organs, such as the skin and eyes (by 22.7- and 4-fold, respectively). The PLGA-Chitosan-I2BODIPY and PLGA-I2BODIPY nanoparticles also showed increased anticancer efficacy compared to free I2BODIPY. These results suggest that the low molecular weight chitosan (25 kDa) is a promising nanoparticle "stealth coating" that improves tumor selectivity.
