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Diabetes mellitus - Top 30 Publications

Berberine regulates type 2 diabetes mellitus related with insulin resistance.

Insulin resistance (IR) is defined as a series of clinical manifestations for diminished effectiveness of insulin in lowering blood sugar levels caused by decreased sensitivity to insulin of liver, muscle and adipose tissue. IR is the major contributor to the etiology and pathogenesis of type 2 diabetes mellitus (T2DM). Berberine, a traditional Chinese herb extract, has been shown to be safe and effective in lowering blood sugar, alleviating insulin resistance and moderating type 2 diabetes mellitus and its complications. The bioavailability of berberine is extremely low, suggesting that it may play a role in lowering blood sugar and lipid by regulating intestinal flora. Intestinal microbiota may serve as a new potential target for berberine treatment of type 2 diabetes mellitus.

Cerebral microangiopathy of diabetes.

Diabetes mellitus, a kind of chronic metabolic disease, has become one of major threats to human health with an increasing incidence. As a basic pathology of chronic complications related to diabetes mellitus, cerebral microangiopathy is mainly found in patients with Alzheimer's disease and lacunar infarction, and becomes one of the main reasons of death and disability in diabetic patients. The pathogenesis of cerebral microangiopathy is complicated, involving such signal pathways as metabolic abnormalities of polyol, saccharification hyperactivity, oxidative stress, abnormal transport of amyloid-β across blood-brain barrier and protein kinase C activation. Treatment targeting at related pathogenesis may bring a new hope to prevention and delay of the occurrence and development of cerebral microangiopathy of diabetes mellitus. Currently, pathogenesis, diagnosis and therapies for cerebral microangiopathy of diabetes mellitus have become hot topics in medical studies. This article reviews pathogenesis, clinical diagnosis and treatment for cerebral microangiopathy of diabetes mellitus, in order to provide new ideas for the prevention and treatment of cerebral microangiopathy of diabetes mellitus.

Effect of AP102, a subtype 2 and 5 specific somatostatin analog, on glucose metabolism in rats.

Somatostatin analogs are widely used to treat conditions associated with hormonal hypersecretion such as acromegaly and metastatic neuroendocrine tumors. First generation somatostatin analogs, such as octreotide and lanreotide, have high affinity for somatostatin receptor subtype 2 (SSTR2), but have incomplete efficacy in many patients. Pasireotide targets multiple SSTRs, having the highest affinity for SSTR5, but causes hyperglycemia and diabetes mellitus in preclinical and clinical studies. AP102 is a new somatostatin analogs with high affinity at both SSTR2 and SSTR5. We aimed to characterize the effects of AP102 vs. pasireotide on random and dynamic glucose levels, glucoregulatory hormone concentrations and growth axis measures in healthy Sprague-Dawley rats.

Immigration to Israel during childhood is associated with diabetes at adolescence: a study of 2.7 million adolescents.

Immigration studies can shed light on diabetes pathogenesis and risk factors. To this end, we investigated the association between age at immigration and diabetes occurrence at adolescence among immigrants to Israel.

CDKAL1 rs7756992 is associated with diabetic retinopathy in a Chinese population with type 2 diabetes.

Diabetic retinopathy (DR) is a major microvascular complication of diabetes. Susceptibility genes for type 2 diabetes may also impact the susceptibility of DR. This case-control study investigated the effects of 88 type 2 diabetes susceptibility loci on DR in a Chinese population with type 2 diabetes performed in two stages. In stage 1, 88 SNPs were genotyped in 1,251 patients with type 2 diabetes, and we found that ADAMTS9-AS2 rs4607103, WFS1 rs10010131, CDKAL1 rs7756992, VPS26A rs1802295 and IDE-KIF11-HHEX rs1111875 were significantly associated with DR. The association between CDKAL1 rs7756992 and DR remained significant after Bonferroni correction for multiple comparisons (corrected P = 0.0492). Then, the effect of rs7756992 on DR were analysed in two independent cohorts for replication in stage 2. Cohort (1) consisted of 380 patients with DR and 613 patients with diabetes for ≥5 years but without DR. Cohort (2) consisted of 545 patients with DR and 929 patients with diabetes for ≥5 years but without DR. A meta-analysis combining the results of stage 1 and 2 revealed a significant association between rs7756992 and DR, with the minor allele A conferring a lower risk of DR (OR 0.824, 95% CI 0.743-0.914, P = 2.46 × 10(-4)).

Fifteen-year mortality trends in Poland analysed with the use of standard expected years of life lost, 2000-2014.

The aim of the study is an evaluation of years of life lost by inhabitants of Poland according to the most important causes of mortality and identification of trends in the period 2000-2014. The study material included a database which contained information gathered from 5,601,568 death certificates of inhabitants of Poland. In order to calculate years of life lost, the SEYLLp index (Standard Expected Years of Life Lost per living person) was applied. We also calculated AAPC (Average Annual Percentage Change). The SEYLLp index (per 10,000 population) in Poland decreased from 2503.4 in 2000 to 2193.2 in 2014 among males (AAPC = -0.8%, p < 0.05) and from 1430.2 in 2000 to 1269.4 in 2014 among females (AAPC = -0.6%, p < 0.05). In 2014, the top 5 causes of years of life lost were: cardiovascular diseases (721.4 per 10,000 males and 475.6 per 10,000 females), malignant tumours (575.5 and 418.3), unintentional injuries (202.2 and 46.8), intentional injuries (114.6 and 16.3) and digestive diseases (120.2 and 58.3). Due to negative trends, there is a need to implement preventative measures, aimed at reducing mortality caused by respiratory infections in both males and females, malignant tumours in females and diabetes mellitus and intentional injuries in males.

Twenty-four-hour rhythmicity of circulating metabolites: effect of body mass and type 2 diabetes.

Metabolic profiling of individuals with type 2 diabetes mellitus (T2DM) has previously been limited to single-time-point samples, ignoring time-of-day variation. Here, we tested our hypothesis that body mass and T2DM affect daily rhythmicity and concentrations of circulating metabolites across a 24-h day in 3 age-matched, male groups-lean, overweight/obese (OW/OB), and OW/OB with T2DM-in controlled laboratory conditions, which were not confounded by large meals. By using targeted liquid chromatography/mass spectrometry metabolomics, we quantified 130 plasma metabolites every 2 h over 24 h, and we show that average metabolite concentrations were significantly altered by increased body mass (90 of 130) and T2DM (56 of 130). Thirty-eight percent of metabolites exhibited daily rhythms in at least 1 study group, and where a metabolite was rhythmic in >1 group, its peak time was comparable. The optimal time of day was assessed to provide discriminating biomarkers. This differed between metabolite classes and study groups-for example, phospholipids showed maximal difference at 5:00 AM (lean vs. OW/OB) and at 5:00 PM (OW/OB vs. T2DM). Metabolites that were identified with both robust 24-h rhythms and significant concentration differences between study groups emphasize the importance of controlling the time of day for diagnosis and biomarker discovery, offering a significant improvement over current single sampling.-Isherwood, C. M., Van der Veen, D. R., Johnston, J. D., Skene, D. J. Twenty-four-hour rhythmicity of circulating metabolites: effect of body mass and type 2 diabetes.

A computational model of 1,5-AG dynamics during pregnancy.

The importance of 1,5-anhydroglucitol (1,5-AG) as an intermediate biomarker for diabetic pregnancy is multi-fold: (1) it serves as a reliable indicator of moderate-level glycemic control, especially during early gestation; (2) it has been associated with increased risk of diabetes, independent of HbA1c and fasting glucose; and (3) it is an independent risk factor for the development of eclampsia during pregnancy. However, the clinical use of this biomarker during pregnancy has been underutilized due to physiological changes in glomerular filtration rate, plasma volume, and other hemodynamic parameters which have been hypothesized to bias gestational serum 1,5-AG concentrations. Here, we develop an in-silico model of gestational 1,5-AG by combining pre-existing physiological data in the literature with a two-compartment mathematical model, building off of a previous kinetic model described by Stickle and Turk (1997) Am. J. Physiol., 273, E821. Our model quantitatively characterizes how renal and hemodynamic factors impact measured 1,5-AG during normal pregnancy and during pregnancy with gestational diabetes and diabetes mellitus. During both normal and diabetic pregnancy, we find that a simple two-compartment model of 1,5-AG kinetics, with all parameters but reabsorption fraction adjusted for time in pregnancy, efficiently models 1,5-AG kinetics throughout the first two trimesters. Allowing reabsorption fraction to decrease after 25 weeks permits parameters closer to expected physiological values during the last trimester. Our quantitative model of 1,5-AG confirms the involvement of hypothesized renal and hemodynamic mechanisms during pregnancy, clarifying the expected trends in 1,5-AG to aid clinical interpretation. Further research and data may elucidate biological changes during the third trimester that account for the drop in 1,5-AG concentrations, and clarify physiological differences between diabetes subtypes during pregnancy.

Effectiveness of seasonal influenza vaccination in patients with diabetes: protocol for a nested case-control study.

Seasonal influenza vaccination (SIV) is recommended for people with diabetes, but its effectiveness has not been demonstrated. All of the available studies are observational and marred with the healthy vaccine bias, that is, bias resulting from the generally better health behaviours practised by people who choose to be vaccinated against influenza, compared with those who do not. This protocol is intended to study the effectiveness of SIV in people with treated diabetes and simultaneously to control for bias.

Hyperglycemia is associated with increased bone mineral density and decreased trabecular bone score in elderly Japanese men: The Fujiwara-kyo osteoporosis risk in men (FORMEN) study.

Patients with type 2 diabetes mellitus (T2DM) have an increased fracture risk despite having higher areal bone mineral density (aBMD). This study aimed to clarify the association between glycemic and insulin resistance status and bone microarchitecture, and whether pentosidine and bone turnover markers play any roles in the association.

Hyperglycemia in Young Adults Seen in the Emergency Department: A Health Records Review.

Patients with diabetes who are in emerging adulthood, defined as the life stage between 18 and 29 years of age, have unique challenges in managing their illness and are at risk for acute complications and loss to follow up. This study's objective was to describe emergency department (ED) utilization because of hyperglycemia in emerging adults with diabetes and to characterize 30-day outcomes, including return visits and admission for hyperglycemia. This was a health-records review of emerging adults presenting over a 1-year period to 4 tertiary care EDs; the patients had known histories of diabetes and final diagnoses of hyperglycemia, diabetic ketoacidosis or hyperosmolar hyperglycemia. Research personnel collected data concerning patients' characteristics, treatments and dispositions and determined whether the patients returned to the ED because of hyperglycemia within 30 days. Descriptive statistics were used to summarize the data where appropriate. There were 160 ED encounters for hyperglycemia, representing 91 unique emerging-adult patients. Mean (SD) age was 23 (3.6) years, and 52.7% were female; 80 (87.9%) had known type 1 diabetes, and 11 (12.1%) had type 2 diabetes. Of 160 visits, 84 (52.5%) resulted in hospital admission; 54 (33.8%) returned to the ED because of hyperglycemia within 30 days of their initial encounters and 20 (12.5%) were admitted on the subsequent visit. We characterized ED use and 30-day outcomes of emerging adults with diabetes and hyperglycemia. Future research should focus on earlier identification of those at higher risk for recurrent ED visits or admission and on the efficacy of interventions to prevent these adverse outcomes.

Contribution of serum FGF21 level to the identification of left ventricular systolic dysfunction and cardiac death.

The relationship between fibroblast growth factor 21 (FGF21) and cardiovascular disease has been well established in recent studies. This study aimed to investigate the relationship between FGF21 and left ventricular systolic dysfunction and cardiac death.

Impact of novel palmitoylated prolactin-releasing peptide analogs on metabolic changes in mice with diet-induced obesity.

Analogs of anorexigenic neuropeptides, such as prolactin-releasing peptide (PrRP), have a potential as new anti-obesity drugs. In our previous study, palmitic acid attached to the N-terminus of PrRP enabled its central anorexigenic effects after peripheral administration. In this study, two linkers, γ-glutamic acid at Lys11 and a short, modified polyethylene glycol at the N-terminal Ser and/or Lys11, were applied for the palmitoylation of PrRP31 to improve its bioavailability. These analogs had a high affinity and activation ability to the PrRP receptor GPR10 and the neuropeptide FF2 receptor, as well as short-term anorexigenic effect similar to PrRP palmitoylated at the N-terminus. Two-week treatment with analogs that were palmitoylated through linkers to Lys11 (analogs 1 and 2), but not with analog modified both at the N-terminus and Lys11 (analog 3) decreased body and liver weights, insulin, leptin, triglyceride, cholesterol and free fatty acid plasma levels in a mouse model of diet-induced obesity. Moreover, the expression of uncoupling protein-1 was increased in brown fat suggesting an increase in energy expenditure. In addition, treatment with analogs 1 and 2 but not analog 3 significantly decreased urinary concentrations of 1-methylnicotinamide and its oxidation products N-methyl-2-pyridone-5-carboxamide and N-methyl-4-pyridone-3-carboxamide, as shown by NMR-based metabolomics. This observation confirmed the previously reported increase in nicotinamide derivatives in obesity and type 2 diabetes mellitus and the effectiveness of analogs 1 and 2 in the treatment of these disorders.

Clinical Effectiveness of Intravenous Exenatide Infusion in Perioperative Glycemic Control after Coronary Artery Bypass Graft Surgery: A Phase II/III Randomized Trial.

We aimed to assess the clinical effectiveness of intravenous exenatide compared to insulin in perioperative blood glucose control in coronary artery bypass grafting surgery patients.

Emphysematous infections of the urinary tract - an audit of 20 patients with review of literature.

Emphysematous infection of the urinary tract is a rapidly progressive, necrotizing infection which results into collection of gas and subsequent destruction of the tissues. Although very rare among general population, such necrotizing infection is common, particularly among those with compromised immune status. With the rising trend of people afflicted with diabetes mellitus globally, this fulminating infection may pose a serious threat to the medical fraternity. A high index of suspicion and abdominal CT scan usually helps to establish the diagnosis at an early stage and thereby facilitating aggressive antimicrobial therapy and percutaneous drainage where indicated. Although, extirpation of infected renal unit was the treatment of choice earlier, with the advent of modern imaging, endourological procedures and broad spectrum antibiotics, majority of such patients can be treated with minimal morbidity and mortality even with salvaging of the renal units. We present here the outcome of management of 20 cases with varied spectrum of emphysematous infection.

The potential of signal peptide peptidase as a therapeutic target for hepatitis C.

Chronic infection with hepatitis C virus (HCV) causes liver steatosis, cirrhosis, metabolic syndrome with inflammation, and eventually leads to hepatocellular carcinoma. HCV core protein is a well-known capsid protein and pathogenic factor related to lipid accumulation, type 2 diabetes mellitus, and carcinogenesis. Cleavage of the C-terminal transmembrane region by signal peptide peptidase (SPP) is required for maturation of the core protein. Areas covered: Herein, this review details the general aspects of the structure, lifecycle, pathogenesis, and maturation of the HCV core protein, the function of SPP, and clinically available direct-acting antivirals (DAAs). SPP is classified into a group of GXGD-type intramembrane proteases including presenilin-1, which is a component of γ-secretase complex. Several SPP inhibitors were previously identified from γ-secretase inhibitors, but have not yet been improved based on specificity to SPP. Finally, the author discusses the potential of SPP inhibitors for hepatitis C therapy. Expert Opinion: Currently available DAAs therapies are limited because of different viral genotypes and underlying conditions in each patient. DAA-resistant viruses have also been reported. Development of SPP-selective inhibitors may improve current HCV therapies by decreasing in the emergence of DAA-resistant viruses irrespective of viral genotype.

A survey of non-communicable diseases and their risk factors among university employees: a single institutional study.

The incidence of non-communicable diseases (NCDs) is rising globally, with its attendant morbidity and mortality, especially in developing countries. This study evaluated the prevalence of NCDs and their risk factors among members of a university community.

Significance of Resveratrol in Clinical Management of Chronic Diseases.

Resveratrol could be beneficial to health and provides protection against a wide array of pathologies and age-associated problems, as evident from preclinical studies. However, a comparison of animal and human studies reveals that this dietary polyphenol cannot protect against metabolic diseases and their associated complications. The clinical outcomes are affected by many factors such as sample size. This article not only presents a comprehensive review of the current advances concerning the dose, the extent of absorption, interaction and toxicity of resveratrol in human studies, but also describes its therapeutic effects against several chronic diseases such as diabetes mellitus, obesity, cardiovascular diseases, cancer and aging and the related diseases.

T- Regulatory Cell subsets in Children with Type 1 Diabetes Mellitus: Relation to Control of The Disease.

Type 1 diabetes mellitus described as a chronic metabolic disorder characterized by aggressive immune β-cell destruction. There are numbers of varied immune mechanisms for sustaining self-tolerance in opposition to the autoimmune disorders. A recessive tolerance accomplished by thymic gland via a negative assortment of different clones while a dominant tolerance accomplished by the regulatory T cells (Treg) in the periphery. Treg (CD4+CD25+FOXP3+) are subsets of T cells which have an essential role in maintaining tolerance.

A 12-week pilot study of acceptance of a computer-based chronic disease self-monitoring system among patients with type 2 diabetes mellitus and/or hypertension.

This study tested a structural model examining the effects of perceived usefulness, perceived ease of use, attitude, subjective norm, perceived behavioral control, health consciousness, and application-specific self-efficacy on the acceptance (i.e. behavioral intention and actual usage) of a computer-based chronic disease self-monitoring system among patients with type 2 diabetes mellitus and/or hypertension. The model was tested using partial least squares structural equation modeling, with 119 observations that were obtained by pooling data across three time points over a 12-week period. The results indicate that all of the seven constructs examined had a significant total effect on behavioral intention and explained 74 percent of the variance. Also, application-specific self-efficacy and behavioral intention had a significant total effect on actual usage and explained 17 percent of the variance. This study demonstrates that technology acceptance is determined by patient characteristics, technology attributes, and social influences. Applying the findings may increase the likelihood of acceptance.

Maximum home blood pressure is a useful indicator of diabetic nephropathy in patients with type 2 diabetes mellitus: KAMOGAWA-HBP study.

Maximum home systolic blood pressure has been shown to predict target organ damage. We aimed to clarify the association between maximum home systolic blood pressure and urine albumin to creatinine ratio, an indicator of early-phase diabetic nephropathy in patients with type 2 diabetes.

Maternal and neonatal outcomes of pregnancy at 39 weeks and beyond with mild gestational diabetes mellitus.

The purpose of this study was to retrospectively analyze maternal and neonatal outcomes in pregnant women with mild gestational diabetes mellitus at 39 weeks compared to 40 weeks.

The Antioxidant Effect of Curcumin on Cochlear Fibroblasts in Rat Models of Diabetes Mellitus.

The aim of this study was to investigate the potential of curcumin as an antioxidant to increase the expression of superoxide dismutase (SOD) in fibroblasts of the cochlear lateral wall in rat models of diabetes mellitus.

Bilateral ruptures of the extensor mechanism of the knee: A systematic review.

We conduct a systematic and qualitative review of the current literature to evaluate studies that described bilateral ruptures of the extensor mechanism of the knee.

Patients with atrial fibrillation and coronary artery disease - Double trouble.

Coronary artery disease (CAD) is the most common cardiovascular disease while atrial fibrillation (AF) is the most common cardiac arrhythmia. Both diseases share associated risk factors - hypertension, diabetes mellitus, sleep apnea, obesity and smoking. Moreover, inflammation plays a causative role in both diseases. The prevalence of CAD in patients with AF is from 17% to 46.5% while the prevalence of AF among patients with CAD is low and it is estimated from 0.2% to 5%. AF is a well-established factor of poor short- and long-term prognosis in patients with acute myocardial infarction (AMI) and is associated with a marked increase in overall mortality. The arrhythmia is common after cardiac surgeries and occurs in about 20 to 40% of patients after coronary artery bypass graft (CABG) surgery. It is predicted that between 5 and 15% of AF patients will require stenting at some point in their lives and will receive triple therapy with aspirin, clopidogrel or ticagrelor and oral anticoagulation (OAC). This requires careful consideration of antithrombotic therapy, balancing bleeding risk, stroke risk, and in-stent thrombosis with subsequent acute coronary syndromes. Co-prescription of OAC with antiplatelet therapy, in particular triple therapy, increases the absolute risk of major bleeding. In addition, major bleeding is associated with an up to 5-fold increased risk of death following an acute coronary syndrome. Coexistence of AF and CAD worsens the prognosis even in carefully treated patients.

Association of the hemoglobin A1c variability and the incidence of heart failure with preserved ejection fraction in patients with type 2 diabetes mellitus and arterial hypertension.

This study aimed to investigate the association between variability in hemoglobin A1c (HbA1c) and left ventricular (LV) diastolic function and incidence of symptomatic heart failure with preserved ejection fraction (HFpEF) in patients with type 2 diabetes mellitus (T2DM) and arterial hypertension.

Geometry as a Confounder When Assessing Ventricular Systolic Function: Comparison Between Ejection Fraction and Strain.

Preserved left ventricular (LV) ejection fraction (EF) and reduced myocardial strain are reported in patients with hypertrophic cardiomyopathy, ischemic heart disease, diabetes mellitus, and more.

Determination of Mean Glycated Haemoglobin in Healthy Adults of a Local Population.

To determine the mean hemoglobin HbA1C levels of disease-free adults in a local population and its optimum cutoff for the diagnosis of diabetes.

Patients With Diabetic Foot Disease Fear Major Lower-Extremity Amputation More Than Death.

The aim of this study was to identify the most-feared complications of diabetes mellitus (DM), comparing those with diabetic foot pathology with those without diabetic foot pathology.

Prevention, Detection, and Management of Diabetes in South Dakota.

Diabetes mellitus (DM) is increasing in prevalence nationwide and in South Dakota, with an especially high prevalence in its American Indian population. Screening is not recommended for type 1 DM, but is for type 2 DM and pre-diabetes in certain populations. Fasting glucose, two-hour glucose tolerance test, or hemoglobin A1c are appropriate screening options. Treatment can include diabetic self-management education programs and medications. In addition to glycemic control, other cardiovascular risk factors must be reduced in these patients and specific testing and consultations should be performed to detect complications such as nephropathy or retinopathy. Along with routine age-appropriate immunizations, most diabetic patients should receive the pneumococcal polysaccharide vaccine (PPSV-23), influenza, and the hepatitis B series. Progression from pre-diabetes to type 2 DM can be prevented or delayed in some patients through lifestyle interventions and/or metformin. The South Dakota Diabetes Coalition ( is an excellent resource for clinicians and patients.