Objective To analyze the chemical constituents of Shanxiangyuanye(Turpiniae Folium)through liquid chromatography-tandem mass spectrometry(LC-MS/MS)method,and to evaluate their anti-oxidant,hypoglycemic,and anti-glycat...Objective To analyze the chemical constituents of Shanxiangyuanye(Turpiniae Folium)through liquid chromatography-tandem mass spectrometry(LC-MS/MS)method,and to evaluate their anti-oxidant,hypoglycemic,and anti-glycation activities related to diabetic complications.Methods The supernatant of Shanxiangyuanye(Turpiniae Folium)(TFS),obtained following water extraction and alcohol precipitation,was analyzed by LC-MS/MS.Antioxidant activity of TFS in vitro was evaluated using three experimental approaches:the 1,1-diphenyl-2-picrylhydrazyl(DPPH)radical scavenging assay,the 2,2’-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)(ABTS+)radical cation decolorization assay,and the hydroxyl(·OH)radical scavenging assay.To comprehensively evaluate hypoglycemic potential,α-glucosidase inhibition was measured to analyze in vitro hypoglycemic activity.Subsequently,in vitro models were developed to examine anti-glycation activity through the bovine serum albumin(BSA)-fructose(Fru),BSA-methylglyoxal(MGO),BSA-glyoxal(GO),and D-arginine(Arg)-MGO systems,with particular attention to the inhibitory effects of TFS.Furthermore,the concentrations of fructosamine,protein carbonyls,sulfhydryl groups,andβ-amyloid in the glycation solution were quantified using the BSA-Fru model following 7-d of incubation at 37°C.Results Using LC-MS/MS analysis in both positive and negative ion modes,we identified 750 chemical components in TFS,primarily including organic acids,amino acids,and their derivatives.In vitro activity studies demonstrated that TFS exhibited remarkable free radical scavenging capacity,with half-maximal inhibitory concentrations(IC_(50))of 0.47,1.56,and 0.36 mg/mL against DPPH,ABTS+,and·OH radicals,respectively.Regarding hypoglycemic activity,TFS dose-dependently inhibitedα-glucosidase activity(IC_(50)=0.21 mg/mL),displaying comparable efficacy to the clinical drug acarbose(IC_(50)=0.23 mg/mL).Notably,TFS intervened in the glycation process:IC_(50) values were 0.22,1.91–4.96,and 4.09 mg/mL in the BSAFru,BSA-MGO/GO,and Arg-MGO models,respectively,with the most prominent inhibitory effects observed in the BSA-Fru model.Furthermore,although TFS may not effectively preserve thiol groups in BSA or reduce thiol oxidation during glycation,it significantly reduces fructosamine levels(in a dose-dependent manner),decreasesβ-amyloid formation,and inhibits protein carbonylation(P<0.0001).Conclusion The findings demonstrate that TFS exhibits a complex chemical composition with potent antioxidant,hypoglycemic,and anti-glycation activities.These results provide compelling scientific evidence supporting TFS’s potential as a natural adjuvant for diabetes prevention and complication management,while laying a solid foundation for its applications in functional food development and adjunctive antidiabetic therapeutics.展开更多
Hyperuricemia have been thought to be caused by the ingestion of large amounts of purines, and prevention or treatment of hyperuricemia has intended to prevent gout. Xanthine dehydrogenase/xanthine oxidase(XDH/XO) is ...Hyperuricemia have been thought to be caused by the ingestion of large amounts of purines, and prevention or treatment of hyperuricemia has intended to prevent gout. Xanthine dehydrogenase/xanthine oxidase(XDH/XO) is rate-limiting enzyme of uric acid generation, and allopurinol was developed as a uric acid(UA) generation inhibitor in the 1950 s and has been routinely used for gout prevention since then. Serum UA levels are an important risk factor of disease progression for various diseases, including those related to lifestyle. Recently, other UA generation inhibitors such as febuxostat and topiroxostat were launched. The emergence of these novel medications has promoted new research in the field. Lifestyle-related diseases, such as metabolic syndrome or type 2 diabetes mellitus, often have a common pathological foundation. As such, hyperuricemia is often present among these patients. Many in vitro and animal studies have implicated inflammation and oxidative stress in UA metabolism and vascular injury because XDH/XO act as one of the major source of reactive oxygen species Many studies on UA levels and associated diseases implicate involvement of UA generation in disease onset and/or progression. Interventional studies for UA generation, not UA excretion revealed XDH/XO can be the therapeutic target forvascular injury and renal dysfunction. In this review, the relationship between UA metabolism and diabetic complications is highlighted.展开更多
Diabetes and its complications reduce quality of life and are life-limiting.At present,diabetes treatment consists of hypoglycemic agents to control blood glucose and the use of insulin-sensitizing drugs to overcome i...Diabetes and its complications reduce quality of life and are life-limiting.At present,diabetes treatment consists of hypoglycemic agents to control blood glucose and the use of insulin-sensitizing drugs to overcome insulin resistance.In diabetes,autophagy is impaired and thus there is poor intracellular environment homeostasis.Pancreaticβ-cells and insulin target tissues are protected by enhancing autophagy.Autophagy decreasesβ-cell apoptosis,promotesβ-cell proliferation,and alleviates insulin resistance.Autophagy in diabetes is regulated by the mammalian target of rapamycin(mTOR)/adenosine 5′-monophosphate(AMP)-activated protein kinase(AMPK)pathway and others.Autophagy enhancers can likely be used as a treatment for diabetes and its complications.This review examines the evidence linking autophagy to diabetes.展开更多
Diabetes and associated complications represent major global public health issues which are associated with impaired quality of life and premature death.Although some diabetic complications have decreased in the devel...Diabetes and associated complications represent major global public health issues which are associated with impaired quality of life and premature death.Although some diabetic complications have decreased in the developed world,the majority are still prevalent,with an increasing trend in the developing world.Currently used therapies are mainly‘glucocentric’,focusing on the optimization of glycemic control to prevent,delay or manage diabetes-associated complications-other common comorbidities,such as dyslipidemia and hypertension are often underestimated.Although a number of novel therapeutic approaches have been reported recently,some of them have not received comparable attention in relation to either further studies or potential clinical implementation.This editorial briefly discusses some recent therapeutic approaches to the prevention and management of diabetes and its associated complications,as well as potential directions for future research and development in this area.展开更多
Background:Diabetes mellitus is a chronic metabolic disease that is a risk factor for epidemic pathologies.Under hyperglycemic conditions,the enzyme aldose reductase catalyzes the formation of sorbitol in the metaboli...Background:Diabetes mellitus is a chronic metabolic disease that is a risk factor for epidemic pathologies.Under hyperglycemic conditions,the enzyme aldose reductase catalyzes the formation of sorbitol in the metabolism of glucose via polyols,leading to the development of diabetic complications.Therefore,inhibitors of this enzyme are therapeutic targets for the prophylaxis and treatment of these conditions.Methods:In this study,a generalized linear regression model was developed to analyze flavonoids-obtained from a database-that have been tested as inhibitors of aldose reductase.In this sense,the molecular descriptors implemented in DRAGON and MATLAB software were used to determine the correlation between the chemical structure of the inhibitors and their pharmacological activity.The model was validated according to the Organisation for Economic Co-operation and Development Standards and subsequently used for the virtual screening of the flavonoids identified in Jatropha gossypiifolia L.Results:The proposed model showed a good fit for its statistical parameters(R2=0.95).In addition,it showed good predictive power(R2 ext=0.94)and robustness(Q2 LOO=0.92).The experimental chemical space wherein the predictions were reliable(domain of application)was also defined.Finally,the model was used to identify 10 flavonoids from Jatropha gossypiifolia L.as candidates for natural drugs.Compounds with a low probability of oral absorption were identified,among which the elagic acid biflavonoid showed the greatest promise(pIC50 predicted=9.75).Conclusion:The Jatropha gossypiifolia L.species harbors flavonoids with high potential as inhibitors of the aldose reductase enzyme,in which the biflavonoid ellagic acid was shown to be the most promising inhibitor of the aldose reductase enzyme,suggesting its possible use in the treatment of the late complications of diabetes mellitus.展开更多
<em>Diabetes </em>is a chronic illness that occurs when the pancreas stops producing insulin or when the body cannot use the produced insulin. <em>Insulin</em> is a hormone produced by the panc...<em>Diabetes </em>is a chronic illness that occurs when the pancreas stops producing insulin or when the body cannot use the produced insulin. <em>Insulin</em> is a hormone produced by the pancreas that helps glucose from meals enters the body’s cells for energy. The overall goal is to assess diabetes patients’ knowledge, attitudes, and behaviors about prevalent diabetic complications. This research used a descriptive qualitative methodology to assess diabetes complication knowledge, attitude, and practice. Ninety-eight diabetic patients were visiting the Egyptian Hospital in Mogadishu for four weeks. The data was collected using questionnaires. Finally, SPSS 20 was utilized for analysis. The research was performed from May to July 2020 with a non-probability sample size of 98 diabetics. The bulk of responders were aged 40 - 60 (36.7%). Type 2 was the most common (47.96%). 44.9% of respondents had diabetes for more than ten years. 60.2% had regular checkups, and 54.1 percent had therapy. 52% of participants were on a diet. 63.3% of respondents do not exercise often. However, most responders know the common issues (75%). Less than half of those polled had problems (41.8%). 22% incidence of Diabetic ketoacidosis. 78.6% of respondents know variables that decrease diabetes complications, whereas 22.4% do not. 37.8% of respondents saw a doctor for diabetes problems, whereas 62.2% did not. Diabetic patients’ knowledge, attitude, and practice were satisfactory for fundamental illness entanglements and self-testing. These findings may also be due to patient notification and, therefore, long-term illness that leads them to get acquainted with things alone. However, the tendency for regular exercise was low, which may produce more specific consequences of illness. <strong>Conclusion:</strong> We find that DM patients’ KAP was adequate in terms of knowledge of diabetic complications. These results may explain the patients’ long-standing illness, which forces them to discover things independently. At the same time, just a handful of them were familiar with vasculopathy and cardiovascular disorders. However, the researchers discovered low level of attitudes and practice toward regular exercise and insufficient levels of attitudes and practice toward diet management and treatment adherence. In general, this degree of KAP is suboptimal and requires further assessment of KAP obstacles in Somalia.展开更多
Background:Patients with type 2 diabetes are at high risk for developing multiple chronic complications.However,there is a lack of studies of the cumulative number of diabetic complications in China.Methods:A retrospe...Background:Patients with type 2 diabetes are at high risk for developing multiple chronic complications.However,there is a lack of studies of the cumulative number of diabetic complications in China.Methods:A retrospective cohort study was performed from 2009 to 2021.Type 2 diabetes patients who were first diagnosed after the age of 35 years between January 1,2009,and December 31,2017,were included.Five states were defined according to the number of chronic complications:no(S0),one(S1),two(S2),three(S3),and four or more complications(S4).A multi-state Markov model was constructed to estimate transition probability,transition intensity,mean sojourn time,and the possible factors for each state.Results:The study included 32653 type 2 diabetes patients(mean age,59.59 years;15929(48.8%)male),and mean follow-up time of 7.75 years.In all,4375 transitions were observed.The 12-year transition probability of from state S0 to S1 was the lowest at 16.4%,while that from S2 to S3 was the highest,at 45.6%.Higher fasting blood glucose,lower high-density lipoprotein cholesterol,higher total cholesterol,and an unhealthy diet were associated with higher risk of progression from S0 to S1.Being female,less than 60 years old,weekly physical activity,and vegetarian diet decreased this risk.Being female and less than 60 years old reduced the likelihood of transition from S1 to S2,whereas lower high-density lipoprotein cholesterol increased this likelihood.Conclusions:Following the occurrence of two complications in type 2 diabetes patients,the risk for accumulating a third complication within a short time is significantly increased.It is important to take advantage of the stable window period when patients have fewer than two complications,strengthen the monitoring of blood glucose and blood lipids,and encourage patients to maintain good living habits to prevent further deterioration.展开更多
BACKGROUND Type 2 diabetes mellitus(T2DM),driven by insulin resistance and β cell dysfunction,necessitates reliable assessment of β cell function.C-peptide(CP)measurement,a stable marker of endogenous insulin secret...BACKGROUND Type 2 diabetes mellitus(T2DM),driven by insulin resistance and β cell dysfunction,necessitates reliable assessment of β cell function.C-peptide(CP)measurement,a stable marker of endogenous insulin secretion,is useful for this clinically as it avoids interference from exogenous insulin.While fasting CP(FCP)and postprandial CP(PCP),along with glucose-adjusted indices and ratios,such as FCP/fasting plasma glucose(FPG),2 hours postprandial CP(2hCP)/postprandial blood glucose(PBG)and CP ratio,are used,their comparative efficacy in reflectingβcell function remains unclear.Hemoglobin A1c(HbA1c),a key glycemic control indicator,theoretically linksβcell function to complications,but limited studies have explored the associations between diverse CP indices,HbA1c,and diabetic microvascular complications.AIM To investigate the relationships between different CP indices and HbA1c as well as diabetic microvascular complications in T2DM.METHODS T2DM patients admitted to Department of Endocrinology at Beijing Hospital between July 1,2021 and December 31,2021 were included in the study.Clinical and laboratory data were collected,including CP levels,glucose levels,HbA1c levels and diabetic microvascular complications.Statistical analysis was performed using Statistical Package for the Social Sciences 24.0.RESULTS A total of 453 patients were included in the final analysis.Adjusted by confounding factors,CP ratio and CP/blood glucose(BG)ratio were not relevant to HbA1c,but FCP,2hCP,delta CP,FCP/FPG,2hCP/PBG and delta CP/BG were still negatively correlated to HbA1c,of which 2hCP/PBG showed the strongest negative correlation(r=-0.485,P<0.001).Independent of HbA1c and other confounding factors,2hCP,2hCP/PBG,delta CP and delta CP/BG were protective factors of diabetic retinopathy while 2hCP,delta CP and FCP/FPG were protective factors of diabetic peripheral neuropathy.CONCLUSION This study indicates that higher levels of CP indices suggest better glucose control and a lower prevalence of diabetic microvascular complications,and PCP indices,particularly 2hCP/PBG,were more relevant to HbA1c and diabetic microvascular complications than FCP indices.These results suggest CP-related indices could be useful biomarkers for diabetes management,warranting further research.展开更多
One of the most prevalent long-term effects of diabetes is diabetic kidney disease(DKD),which is linked to problems with the metabolism of amino acids,fats,and carbohydrates.The fundamental pathogenic mechanisms of DK...One of the most prevalent long-term effects of diabetes is diabetic kidney disease(DKD),which is linked to problems with the metabolism of amino acids,fats,and carbohydrates.The fundamental pathogenic mechanisms of DKD cannot be adequately treated by current clinical medicines;they can only slow the illness’s progression to end-stage renal disease.We will concentrate on integrating human umbilical cord mesenchymal stem cell(hUC-MSC)-related mechanisms and potential applications into the therapy of DKD,as this work shows that hUCMSCs can be used to treat metabolic liver obesity associated with diabetes.Future studies on the connection between hUC-MSCs and related illnesses ought to be promoted.展开更多
The aim of this study was to investigate the effects of high-advanced glycation end products （AGEs） diet on diabetic vascular complications. The Streptozocin （STZ）-induced diabetic mice were fed with high-AGEs die...The aim of this study was to investigate the effects of high-advanced glycation end products （AGEs） diet on diabetic vascular complications. The Streptozocin （STZ）-induced diabetic mice were fed with high-AGEs diet. Diabetic characteristics, indicators 3f renal and cardiovascular functions, and pathohistology of pancreas, heart and renal were evaluated. AGEs/RAGE/ROS pathway parameters were determined. During the experiments, the diabetic mice exhibited typical characteristics including weight loss, polydipsia, polyphagia, polyuria, high-blood glucose, and low-serum insulin levels. However, high-AGEs diet effectively aggravated these diabetic sharacteristics. It also increased the 24-h urine protein levels, serum levels of urea nitrogen, creatinine, c-reactive protein （CRP）, low density lipoprotein （LDL）, tumor necrosis factor-a （TNF-a）, and interleukin-6 （IL-6） in the diabetic mice. High-AGEs diet deteriorated the histology of pancreas, heart, and kidneys, and caused structural alterations of endothelial ceils, mesangial cells and podocytes in renal ：ortex. Eventually, high-AGEs diet contributed to the high-AGE levels in serum and kidneys, high-levels of reactive oxygen species ＇,ROS） and low-levels of superoxide dismutase （SOD） in serum, heart, and kidneys. It also upregulated RAGE mRNA and protein expression in heart and kidneys. Our results showed that high-AGEs diet deteriorated vascular complications in the diabetic mice. The activation of AGEs/RAGE/ROS pathway may be involved in the pathogenesis of vascular complications in diabetes.展开更多
BACKGROUND Type 2 diabetes is one of the most prevalent chronic diseases worldwide,significantly impacting patients'quality of life.Current treatment options like metformin(MET)effectively counteract hyperglycemia...BACKGROUND Type 2 diabetes is one of the most prevalent chronic diseases worldwide,significantly impacting patients'quality of life.Current treatment options like metformin(MET)effectively counteract hyperglycemia but fail to alleviate diabetes-associated complications such as retinopathy,neuropathy,nephropathy,hepatopathy,and cardiovascular diseases.AIM To propose the supplementation of cholecalciferol(CHO)and taurine(TAU)to enhance MET efficacy in controlling diabetes while minimizing the risk of associated complications.METHODS The study involved sixty rats,including ten non-diabetic control rats and fifty experimental rats with type 2 diabetes induced by streptozotocin.The experimental rats were further subdivided into positive control and treatment subgroups.The four treatment groups were randomly allocated to a single MET treatment or MET combined with supplements either CHO,TAU,or both.RESULTS Diabetic rats exhibited elevated levels of glucose,insulin,Homeostasis Model Assessment of Insulin Resistance(HOMA-IR),glycated hemoglobin percentage,lipid markers,aspartate aminotransferase,and malondialdehyde,along with reduced levels of antioxidant enzymes(catalase and superoxide dismutase).The administration of CHO and TAU supplements alongside MET in diabetic rats led to a noticeable recovery of islet mass.The antioxidative,anti-inflammatory,and anti-apoptotic properties of the proposed combination therapy significantly ameliorated the aforementioned abnormalities.CONCLUSION The supplementation of CHO and TAU with MET showed the potential to significantly improve metabolic parameters and protect against diabetic complications through its antioxidative,anti-inflammatory,and antiapoptotic effects.展开更多
BACKGROUND Social determinants of health are social and economic factors that influence health intervention outcomes.Type 2 diabetes is a highly prevalent disease,primarily affecting individuals in low-to-middle-incom...BACKGROUND Social determinants of health are social and economic factors that influence health intervention outcomes.Type 2 diabetes is a highly prevalent disease,primarily affecting individuals in low-to-middle-income countries.However,the association between social determinants and cardiovascular complications in type 2 diabetes has not been widely studied.AIM To examine the relationship between social determinants of health and cardiovascular complications in individuals with type 2 diabetes.METHODS We conducted a retrospective cohort study with an analytical component at a national-level referral hospital for military personnel in Bogota,Colombia.Patients treated at the diabetes clinic between September 2021 and December 2022 who met the inclusion criteria were included.A total of 583 patients participated in the study.We performed descriptive,bivariate,and binary logistic regression analyses,adjusting for confounding variables.RESULTS Among the 583 patients included,urban residency[odds ratio(OR)=3.05,95%confidence interval(CI):1.01-9.20]and a middle or high educational level(OR=2.33,95%CI:1.14-4.72)were associated with an increased risk of coronary artery disease.Additionally,receiving diabetes education beyond that provided by the clinic(OR=2.15,95%CI:1.14-4.05)and lack of access to spaces for physical activity(OR=4.05,95%CI:1.31-12.5)were associated with a higher risk of diabetic nephropathy and cerebrovascular disease,respectively.CONCLUSION Programs for diabetes management should account for social determinants of health that contribute to cardiovascular complications and increased healthcare costs.Population-based studies are needed to guide targeted interventions and clarify causal relationships.展开更多
OBJECTIVE： To evaluate the efficacy of α-lipoic acid（ALA） plus epalrestat combination therapy in the treatment of diabetic peripheral neuropathy（DPN）. DATA SOURCES： The electronic databases of Pub Med, Medline,...OBJECTIVE： To evaluate the efficacy of α-lipoic acid（ALA） plus epalrestat combination therapy in the treatment of diabetic peripheral neuropathy（DPN）. DATA SOURCES： The electronic databases of Pub Med, Medline, Embase, the Cochrane Library, the Chinese National Knowledge Infrastructure, the Wanfang Database and the Chinese Biomedical Database were used to retrieve relevant studies without language restrictions. The search was conducted from the inception of each database to 7 October 2016. The key terms were（diabetic peripheral neuropathy or diabetic neuropathy or DPN） AND（α-lipoic acid or lipoic acid or thioctic acid） AND epalrestat. DATA SELECTION： All of the eligible studies met the following inclusion criteria：（1） Randomized controlled trials that compared efficacy and safety of epalrestat plus ALA combination therapy versus epalrestat or ALA monotherapy in patients with DPN.（2） The minimum duration of treatment was 2 weeks.（3） The DPN patients were diagnosed using the World Health Organization standardized type 2 diabetes mellitus and DPN criteria.（4） Studies contained at least one measure that could reflect the efficacy of the drug and nerve conduction velocities. Studies in which the control group used epalrestat or ALA combined with other drugs were excluded. Statistical analyses were performed using STATA software for meta-analysis. OUTCOME MEASURES： The primary outcomes were the therapeutic efficacy, median motor nerve conduction velocity（MNCV）, median sensory nerve conduction velocity（SNCV）, peroneal MNCV and peroneal SNCV.RESULTS： Twenty studies with 1894 DPN patients were included, including 864 patients in the ALA plus epalrestat group, 473 in the ALA group and 557 in the epalrestat group. The efficacy of ALA plus epalrestat combination therapy was superior to ALA and epalrestat monotherapies（RR = 1.29, 95% CI： 1.21–1.38; RR = 1.43, 95% CI： 1.34–1.54, respectively）. ALA plus epalrestat combination therapy also significantly improved median MNCV（WMD = 5.41, 95% CI： 2.07–8.75）, median SNCV（WMD = 5.87, 95% CI： 1.52–10.22）, peroneal MNCV（WMD = 5.59, 95% CI： 2.70–8.47） and peroneal SNCV（WMD = 4.57, 95% CI： 2.46–6.68）.CONCLUSION： ALA plus epalrestat combination therapy was superior to ALA and epalrestat monotherapies for clinical efficacy and nerve conduction velocities in patients with DPN.展开更多
Increased reactive oxygen species by the activation of NADPH oxidase（NOX） contributes to the development of diabetic complications.Apocynin,a NOX inhibitor,increases sciatic nerve conductance and blood flow in diabe...Increased reactive oxygen species by the activation of NADPH oxidase（NOX） contributes to the development of diabetic complications.Apocynin,a NOX inhibitor,increases sciatic nerve conductance and blood flow in diabetic rats.We investigated potential protective effect of apocynin in rat diabetic neuropathy and its precise mechanism of action at molecular level.Rat models of streptozotocin-induced diabetes were treated with apocynin（30 and 100 mg/kg per day,intragastrically） for 4 weeks.Mechanical hyperalgesia and allodynia were determined weekly using analgesimeter and dynamic plantar aesthesiometer.Western blot analysis and histochemistry/immunohistochemistry were performed in the lumbar spinal cord and sciatic nerve respectively.Streptozotocin injection reduced pain threshold in analgesimeter,but not in aesthesiometer.Apocynin treatment increased pain threshold dose-dependently.Western blot analysis showed an increase in catalase and NOX-p47 phox protein expression in the spinal cord.However,protein expressions of neuronal and inducible nitric oxide synthase（n NOS,i NOS）,superoxide dismutase,glutathion peroxidase,nitrotyrosine,tumor necrosis factor-α,interleukin-6,interleukin-1β,aldose reductase,cyclooxygenase-2 or MAC-1（marker for increased microgliosis） in the spinal cord remained unchanged.Western blot analysis results also demonstrated that apocynin decreased NOX-p47 phox expression at both doses and catalase expression at 100 mg/kg per day.Histochemistry of diabetic sciatic nerve revealed marked degeneration.n NOS and i NOS immunoreactivities were increased,while S-100 immunoreactivity（Schwann cell marker） was decreased in sciatic nerve.Apocynin treatment reversed these changes dose-dependently.In conclusion,decreased pain threshold of diabetic rats was accompanied by increased NOX and catalase expression in the spinal cord and increased degeneration in the sciatic nerve characterized by increased NOS expression and Schwann cell loss.Apocynin treatment attenuates neuropathic pain by decelerating the increased oxidative stress-mediated pathogenesis in diabetic rats.展开更多
Type 2 diabetes mellitus(T2 DM)is one of metabolic diseases with the major inducer of obesity.Due to the change in lifestyle and dietary structure,more and more people are being suffered from T2 DM.Therefore,the preve...Type 2 diabetes mellitus(T2 DM)is one of metabolic diseases with the major inducer of obesity.Due to the change in lifestyle and dietary structure,more and more people are being suffered from T2 DM.Therefore,the prevention and treatment of T2 DM and its complications has become an urgent problem to be solved.As a secreted peptide,adropin is identifi ed as a useful regulator associated with insulin sensitivity and energy homeostasis.It has the potential for regulating metabolic diseases including obesity and T2 DM.It should be noted that the secretion of adropin can be induced by diets,aerobic exercise and other interventions.In this article,the underlying mechanisms of adropin for regulating obesity,T2 DM and its complications including diabetic nephropathy,diabetic retinopathy,diabetic encephalopathy,diabetic vascular disease and diabetic cardiovascular disease were summarized.Meanwhile,the strategies for promoting the secretion of adropin were also discussed,which will provide a target for the prevention and targeted treatment,or a candidate of novel and effective functional food or drug for metabolic diseases in the future.展开更多
Licorice is one of the oldest herbal medicines for its various ethno pharmacological uses.In both Asian and European countries,it has been recorded for treatment of inflammatory diseases.A large number of ingredients ...Licorice is one of the oldest herbal medicines for its various ethno pharmacological uses.In both Asian and European countries,it has been recorded for treatment of inflammatory diseases.A large number of ingredients have been isolated from licorice,including triterpene saponins and flavonoids,which are normally being considered to be the main biologically active components.In the last decade,licorice has been proved exert anti-diabetic effect in various in vivo and in vitro models of diabetes mellitus.Furthermore,licorice can also antagonize all sorts of diabetes complications,including diabetic nephropathy,atherosclerosis,diabetic retinopathy and neuropathy.Except anti-inflammation,licorice and its active components show anti-diabetic effects by improving insulin resistance and increasing insulin secretion,regulating lipid metabolism,and anti-oxidation.The useful effects of licorice and its active components are due to regulating different pathways and proteins,including NF-κB,AMPK,insulin signaling pathway,MAPK,etc.In this review,we provide an overview of the beneficial effects and related molecular mechanism of licorice and its effective components on improving diabetes and its complications.展开更多
Diabetes is a metabolic disease characterized by abnormally elevated blood glucose levels.Persistent hyperglycemia leads to diabetic nephropathy,diabetic retinopathy,diabetes with periodontal disease and other diabeti...Diabetes is a metabolic disease characterized by abnormally elevated blood glucose levels.Persistent hyperglycemia leads to diabetic nephropathy,diabetic retinopathy,diabetes with periodontal disease and other diabetic complications.These diseases have become the main causes of disability and death in diabetic patients.Artesunate is well known as an antimalarial drug for controlling malaria symptoms.Current studies have shown that artesunate improves diabetes and its complications by protecting islet cells,improving glucose and lipid metabolism,anti-inflammatory and immune regulation.Based on the research status in recent years,this paper focuses on the mechanism of artesunate in diabetes and its complications,to provide a theoretical basis for future diabetes research.展开更多
BACKGROUND Type 2 diabetes mellitus(T2DM)causes both macrovascular and microvascular complications.However,currently,selection of glycemic measures and their thresholds to diagnose T2DM,and efficacy outcomes in evalua...BACKGROUND Type 2 diabetes mellitus(T2DM)causes both macrovascular and microvascular complications.However,currently,selection of glycemic measures and their thresholds to diagnose T2DM,and efficacy outcomes in evaluation of anti-diabetic drugs is predominantly informed by the relation of T2DM to microvascular complications.We can be severely mistaken on T2DM by neglecting macrovascular complications which are generally more severe,if they also occur more commonly than microvascular complications.AIM To compare the incidence of major cardiovascular events(MACEs)and severe microvascular complications(SMICs)in T2DM patients.METHODS MEDLINE,EMBASE,and Cochrane Central Register of Controlled Trials were searched from inception to September 2017.Cohort studies or trials of T2DM patients aged 18 years or older that reported incidence of both MACEs and SMICs were included.MACEs were defined as nonfatal myocardial infarction and stroke,and cardiovascular death,while SMICs included serious retinopathy,nephropathy and diabetic disorder.The relative risk(RR)was estimated as the incidence of MACEs divided by that of SMICs in same patients and combined with meta-analysis in a random-effect model.RESULTS Twelve studies with a total of 16 cohorts and 387376 patients were included,and the combined RR was 2.02(95%CI:1.46–2.79).The higher incidence of MACEs remained in various subgroup and sensitivity analyses.CONCLUSION Patients with T2DM are much more likely to develop MACEs than SMICs.By taking more serious consequences and relatively higher incidence into consideration,macrovascular complications deserve more emphasis in developing the diagnostic criteria of T2DM and in evaluating the efficacy of antidiabetic drugs.展开更多
Diabetes mellitus(DM)is a progressive metabolic disease characterized by chronic hyperglycemia and caused by different degree of pancreatic islet dysfunction and/or insulin resistance(IR).Long course DM can lead to a ...Diabetes mellitus(DM)is a progressive metabolic disease characterized by chronic hyperglycemia and caused by different degree of pancreatic islet dysfunction and/or insulin resistance(IR).Long course DM can lead to a variety of macrovascular and microvascular complications which involve artery vessels,heart,kidney,retina,nervous system,etc.In recent years,DM has attracted more and more attention due to its high morbidity and mortality.In addition to achieve effective glycemic control,prevention of complications has also been considered a priority for type 2 diabetes mellitus(T2DM)management.Herein,we provide a comprehensive overview on the pharmacotherapeutics for T2DM and perspectives on the future directions of basic and translational research on anti-diabetic therapy and pharmatheutical development of new drugs.展开更多
Background: Diabetes is a risk factor for depression, but little is known about anxiety and other psychiatric disorders and quality of life. The aim of this study was to assess the prevalence of depression, anxiety in...Background: Diabetes is a risk factor for depression, but little is known about anxiety and other psychiatric disorders and quality of life. The aim of this study was to assess the prevalence of depression, anxiety in diabetic patients in our locality and to assess the quality of life in type 2 DM. Subjects & Methods: This study was a cross-sectional study and was carried out in outpatient clinics of specialized medical hospital, Mansoura university for a period of one year. From 217 diabetes mellitus subjects, only 202 patients were matched with 247 healthy people as a control group. All subjects were examined by using socioeconomic data, clinical data, and anthropometric examinations to assess body mass index and waist circumference. All patients were interviewed by using the Mini-International Neuropsychiatric Interview (MINI) version 5, MINI, Hospital Anxiety and Depression scale (HAD) and health-related quality of life (HRQOL) scales. Laboratory investigation in the form of fasting and two-hour postprandial blood sugar (FBS & 2hpp) and HbA1C levels were done. Results: 18.3% were found to be major depressive disorder;and 2.5% panic disorder, 1% other phobia. Generalized anxiety disorder and obsessive-compulsive disorder were found in one patient, no patients were found to be diagnosed as Bipolar disorder, schizophrenia, or substance abuse. Although there was no statistically significant difference between subjects and control groups regarding height, there was statistically significant difference between weights, BMI, with more scores among DM group. Moreover our study showed that HbA1c, fasting blood sugar, two hours post prandial blood sugar were more among DM patients and control groups. Anxiety, depression, and poorer quality of life were found to be more prevalent among DM patients than control groups. Conclusion: DM is associated with depression anxiety disorder with poorer quality of life.展开更多
基金Key Project of Hunan Provincial Education Bureau(23A0307)Natural Science Foundation of Hunan Province (2025JJ80089)。
文摘Objective To analyze the chemical constituents of Shanxiangyuanye(Turpiniae Folium)through liquid chromatography-tandem mass spectrometry(LC-MS/MS)method,and to evaluate their anti-oxidant,hypoglycemic,and anti-glycation activities related to diabetic complications.Methods The supernatant of Shanxiangyuanye(Turpiniae Folium)(TFS),obtained following water extraction and alcohol precipitation,was analyzed by LC-MS/MS.Antioxidant activity of TFS in vitro was evaluated using three experimental approaches:the 1,1-diphenyl-2-picrylhydrazyl(DPPH)radical scavenging assay,the 2,2’-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)(ABTS+)radical cation decolorization assay,and the hydroxyl(·OH)radical scavenging assay.To comprehensively evaluate hypoglycemic potential,α-glucosidase inhibition was measured to analyze in vitro hypoglycemic activity.Subsequently,in vitro models were developed to examine anti-glycation activity through the bovine serum albumin(BSA)-fructose(Fru),BSA-methylglyoxal(MGO),BSA-glyoxal(GO),and D-arginine(Arg)-MGO systems,with particular attention to the inhibitory effects of TFS.Furthermore,the concentrations of fructosamine,protein carbonyls,sulfhydryl groups,andβ-amyloid in the glycation solution were quantified using the BSA-Fru model following 7-d of incubation at 37°C.Results Using LC-MS/MS analysis in both positive and negative ion modes,we identified 750 chemical components in TFS,primarily including organic acids,amino acids,and their derivatives.In vitro activity studies demonstrated that TFS exhibited remarkable free radical scavenging capacity,with half-maximal inhibitory concentrations(IC_(50))of 0.47,1.56,and 0.36 mg/mL against DPPH,ABTS+,and·OH radicals,respectively.Regarding hypoglycemic activity,TFS dose-dependently inhibitedα-glucosidase activity(IC_(50)=0.21 mg/mL),displaying comparable efficacy to the clinical drug acarbose(IC_(50)=0.23 mg/mL).Notably,TFS intervened in the glycation process:IC_(50) values were 0.22,1.91–4.96,and 4.09 mg/mL in the BSAFru,BSA-MGO/GO,and Arg-MGO models,respectively,with the most prominent inhibitory effects observed in the BSA-Fru model.Furthermore,although TFS may not effectively preserve thiol groups in BSA or reduce thiol oxidation during glycation,it significantly reduces fructosamine levels(in a dose-dependent manner),decreasesβ-amyloid formation,and inhibits protein carbonylation(P<0.0001).Conclusion The findings demonstrate that TFS exhibits a complex chemical composition with potent antioxidant,hypoglycemic,and anti-glycation activities.These results provide compelling scientific evidence supporting TFS’s potential as a natural adjuvant for diabetes prevention and complication management,while laying a solid foundation for its applications in functional food development and adjunctive antidiabetic therapeutics.
文摘Hyperuricemia have been thought to be caused by the ingestion of large amounts of purines, and prevention or treatment of hyperuricemia has intended to prevent gout. Xanthine dehydrogenase/xanthine oxidase(XDH/XO) is rate-limiting enzyme of uric acid generation, and allopurinol was developed as a uric acid(UA) generation inhibitor in the 1950 s and has been routinely used for gout prevention since then. Serum UA levels are an important risk factor of disease progression for various diseases, including those related to lifestyle. Recently, other UA generation inhibitors such as febuxostat and topiroxostat were launched. The emergence of these novel medications has promoted new research in the field. Lifestyle-related diseases, such as metabolic syndrome or type 2 diabetes mellitus, often have a common pathological foundation. As such, hyperuricemia is often present among these patients. Many in vitro and animal studies have implicated inflammation and oxidative stress in UA metabolism and vascular injury because XDH/XO act as one of the major source of reactive oxygen species Many studies on UA levels and associated diseases implicate involvement of UA generation in disease onset and/or progression. Interventional studies for UA generation, not UA excretion revealed XDH/XO can be the therapeutic target forvascular injury and renal dysfunction. In this review, the relationship between UA metabolism and diabetic complications is highlighted.
基金This work was supported by grants from the Hubei Province Scientific Research Project of Health Commission(No.WJ2021Q015)the Yangtze Fund for Youth Teams of Science and Technology Innovation(No.2016cqt04)+1 种基金Central Funds Guiding the Local Science and Technology Development of Hubei Province(No.2019ZYYD066)Joint Foundation of the Health Commission of Hubei Province(No.WJ2018H173).
文摘Diabetes and its complications reduce quality of life and are life-limiting.At present,diabetes treatment consists of hypoglycemic agents to control blood glucose and the use of insulin-sensitizing drugs to overcome insulin resistance.In diabetes,autophagy is impaired and thus there is poor intracellular environment homeostasis.Pancreaticβ-cells and insulin target tissues are protected by enhancing autophagy.Autophagy decreasesβ-cell apoptosis,promotesβ-cell proliferation,and alleviates insulin resistance.Autophagy in diabetes is regulated by the mammalian target of rapamycin(mTOR)/adenosine 5′-monophosphate(AMP)-activated protein kinase(AMPK)pathway and others.Autophagy enhancers can likely be used as a treatment for diabetes and its complications.This review examines the evidence linking autophagy to diabetes.
文摘Diabetes and associated complications represent major global public health issues which are associated with impaired quality of life and premature death.Although some diabetic complications have decreased in the developed world,the majority are still prevalent,with an increasing trend in the developing world.Currently used therapies are mainly‘glucocentric’,focusing on the optimization of glycemic control to prevent,delay or manage diabetes-associated complications-other common comorbidities,such as dyslipidemia and hypertension are often underestimated.Although a number of novel therapeutic approaches have been reported recently,some of them have not received comparable attention in relation to either further studies or potential clinical implementation.This editorial briefly discusses some recent therapeutic approaches to the prevention and management of diabetes and its associated complications,as well as potential directions for future research and development in this area.
文摘Background:Diabetes mellitus is a chronic metabolic disease that is a risk factor for epidemic pathologies.Under hyperglycemic conditions,the enzyme aldose reductase catalyzes the formation of sorbitol in the metabolism of glucose via polyols,leading to the development of diabetic complications.Therefore,inhibitors of this enzyme are therapeutic targets for the prophylaxis and treatment of these conditions.Methods:In this study,a generalized linear regression model was developed to analyze flavonoids-obtained from a database-that have been tested as inhibitors of aldose reductase.In this sense,the molecular descriptors implemented in DRAGON and MATLAB software were used to determine the correlation between the chemical structure of the inhibitors and their pharmacological activity.The model was validated according to the Organisation for Economic Co-operation and Development Standards and subsequently used for the virtual screening of the flavonoids identified in Jatropha gossypiifolia L.Results:The proposed model showed a good fit for its statistical parameters(R2=0.95).In addition,it showed good predictive power(R2 ext=0.94)and robustness(Q2 LOO=0.92).The experimental chemical space wherein the predictions were reliable(domain of application)was also defined.Finally,the model was used to identify 10 flavonoids from Jatropha gossypiifolia L.as candidates for natural drugs.Compounds with a low probability of oral absorption were identified,among which the elagic acid biflavonoid showed the greatest promise(pIC50 predicted=9.75).Conclusion:The Jatropha gossypiifolia L.species harbors flavonoids with high potential as inhibitors of the aldose reductase enzyme,in which the biflavonoid ellagic acid was shown to be the most promising inhibitor of the aldose reductase enzyme,suggesting its possible use in the treatment of the late complications of diabetes mellitus.
文摘<em>Diabetes </em>is a chronic illness that occurs when the pancreas stops producing insulin or when the body cannot use the produced insulin. <em>Insulin</em> is a hormone produced by the pancreas that helps glucose from meals enters the body’s cells for energy. The overall goal is to assess diabetes patients’ knowledge, attitudes, and behaviors about prevalent diabetic complications. This research used a descriptive qualitative methodology to assess diabetes complication knowledge, attitude, and practice. Ninety-eight diabetic patients were visiting the Egyptian Hospital in Mogadishu for four weeks. The data was collected using questionnaires. Finally, SPSS 20 was utilized for analysis. The research was performed from May to July 2020 with a non-probability sample size of 98 diabetics. The bulk of responders were aged 40 - 60 (36.7%). Type 2 was the most common (47.96%). 44.9% of respondents had diabetes for more than ten years. 60.2% had regular checkups, and 54.1 percent had therapy. 52% of participants were on a diet. 63.3% of respondents do not exercise often. However, most responders know the common issues (75%). Less than half of those polled had problems (41.8%). 22% incidence of Diabetic ketoacidosis. 78.6% of respondents know variables that decrease diabetes complications, whereas 22.4% do not. 37.8% of respondents saw a doctor for diabetes problems, whereas 62.2% did not. Diabetic patients’ knowledge, attitude, and practice were satisfactory for fundamental illness entanglements and self-testing. These findings may also be due to patient notification and, therefore, long-term illness that leads them to get acquainted with things alone. However, the tendency for regular exercise was low, which may produce more specific consequences of illness. <strong>Conclusion:</strong> We find that DM patients’ KAP was adequate in terms of knowledge of diabetic complications. These results may explain the patients’ long-standing illness, which forces them to discover things independently. At the same time, just a handful of them were familiar with vasculopathy and cardiovascular disorders. However, the researchers discovered low level of attitudes and practice toward regular exercise and insufficient levels of attitudes and practice toward diet management and treatment adherence. In general, this degree of KAP is suboptimal and requires further assessment of KAP obstacles in Somalia.
基金supported by the National Natural Science Foundation of China(grant No.72074011)the Real World Study Project of Hainan Boao Lecheng Pilot Zone(Real World Study Base of NMPA)(HNLC2022RWS012)+1 种基金the fundamental research funds for central public welfare research institutes(2023CZ-11)National Natural Science Foundation of China(No.82003536).
文摘Background:Patients with type 2 diabetes are at high risk for developing multiple chronic complications.However,there is a lack of studies of the cumulative number of diabetic complications in China.Methods:A retrospective cohort study was performed from 2009 to 2021.Type 2 diabetes patients who were first diagnosed after the age of 35 years between January 1,2009,and December 31,2017,were included.Five states were defined according to the number of chronic complications:no(S0),one(S1),two(S2),three(S3),and four or more complications(S4).A multi-state Markov model was constructed to estimate transition probability,transition intensity,mean sojourn time,and the possible factors for each state.Results:The study included 32653 type 2 diabetes patients(mean age,59.59 years;15929(48.8%)male),and mean follow-up time of 7.75 years.In all,4375 transitions were observed.The 12-year transition probability of from state S0 to S1 was the lowest at 16.4%,while that from S2 to S3 was the highest,at 45.6%.Higher fasting blood glucose,lower high-density lipoprotein cholesterol,higher total cholesterol,and an unhealthy diet were associated with higher risk of progression from S0 to S1.Being female,less than 60 years old,weekly physical activity,and vegetarian diet decreased this risk.Being female and less than 60 years old reduced the likelihood of transition from S1 to S2,whereas lower high-density lipoprotein cholesterol increased this likelihood.Conclusions:Following the occurrence of two complications in type 2 diabetes patients,the risk for accumulating a third complication within a short time is significantly increased.It is important to take advantage of the stable window period when patients have fewer than two complications,strengthen the monitoring of blood glucose and blood lipids,and encourage patients to maintain good living habits to prevent further deterioration.
基金Supported by National High Level Hospital Clinical Research Funding,No.BJ-2022-145China Endocrinology and Metabolism Young Scientific Talent Research Project,No.2021-N-03.
文摘BACKGROUND Type 2 diabetes mellitus(T2DM),driven by insulin resistance and β cell dysfunction,necessitates reliable assessment of β cell function.C-peptide(CP)measurement,a stable marker of endogenous insulin secretion,is useful for this clinically as it avoids interference from exogenous insulin.While fasting CP(FCP)and postprandial CP(PCP),along with glucose-adjusted indices and ratios,such as FCP/fasting plasma glucose(FPG),2 hours postprandial CP(2hCP)/postprandial blood glucose(PBG)and CP ratio,are used,their comparative efficacy in reflectingβcell function remains unclear.Hemoglobin A1c(HbA1c),a key glycemic control indicator,theoretically linksβcell function to complications,but limited studies have explored the associations between diverse CP indices,HbA1c,and diabetic microvascular complications.AIM To investigate the relationships between different CP indices and HbA1c as well as diabetic microvascular complications in T2DM.METHODS T2DM patients admitted to Department of Endocrinology at Beijing Hospital between July 1,2021 and December 31,2021 were included in the study.Clinical and laboratory data were collected,including CP levels,glucose levels,HbA1c levels and diabetic microvascular complications.Statistical analysis was performed using Statistical Package for the Social Sciences 24.0.RESULTS A total of 453 patients were included in the final analysis.Adjusted by confounding factors,CP ratio and CP/blood glucose(BG)ratio were not relevant to HbA1c,but FCP,2hCP,delta CP,FCP/FPG,2hCP/PBG and delta CP/BG were still negatively correlated to HbA1c,of which 2hCP/PBG showed the strongest negative correlation(r=-0.485,P<0.001).Independent of HbA1c and other confounding factors,2hCP,2hCP/PBG,delta CP and delta CP/BG were protective factors of diabetic retinopathy while 2hCP,delta CP and FCP/FPG were protective factors of diabetic peripheral neuropathy.CONCLUSION This study indicates that higher levels of CP indices suggest better glucose control and a lower prevalence of diabetic microvascular complications,and PCP indices,particularly 2hCP/PBG,were more relevant to HbA1c and diabetic microvascular complications than FCP indices.These results suggest CP-related indices could be useful biomarkers for diabetes management,warranting further research.
文摘One of the most prevalent long-term effects of diabetes is diabetic kidney disease(DKD),which is linked to problems with the metabolism of amino acids,fats,and carbohydrates.The fundamental pathogenic mechanisms of DKD cannot be adequately treated by current clinical medicines;they can only slow the illness’s progression to end-stage renal disease.We will concentrate on integrating human umbilical cord mesenchymal stem cell(hUC-MSC)-related mechanisms and potential applications into the therapy of DKD,as this work shows that hUCMSCs can be used to treat metabolic liver obesity associated with diabetes.Future studies on the connection between hUC-MSCs and related illnesses ought to be promoted.
基金supported by National Nature Science Foundation of China(No.81073111)the Priority Academic Program Development of Jiangsu Higher Education Institutions(No.nzyzyxjp1006)Jiangsu Province graduate student scientific research innovation plan project(No.CXZZ13_0622)
文摘The aim of this study was to investigate the effects of high-advanced glycation end products （AGEs） diet on diabetic vascular complications. The Streptozocin （STZ）-induced diabetic mice were fed with high-AGEs diet. Diabetic characteristics, indicators 3f renal and cardiovascular functions, and pathohistology of pancreas, heart and renal were evaluated. AGEs/RAGE/ROS pathway parameters were determined. During the experiments, the diabetic mice exhibited typical characteristics including weight loss, polydipsia, polyphagia, polyuria, high-blood glucose, and low-serum insulin levels. However, high-AGEs diet effectively aggravated these diabetic sharacteristics. It also increased the 24-h urine protein levels, serum levels of urea nitrogen, creatinine, c-reactive protein （CRP）, low density lipoprotein （LDL）, tumor necrosis factor-a （TNF-a）, and interleukin-6 （IL-6） in the diabetic mice. High-AGEs diet deteriorated the histology of pancreas, heart, and kidneys, and caused structural alterations of endothelial ceils, mesangial cells and podocytes in renal ：ortex. Eventually, high-AGEs diet contributed to the high-AGE levels in serum and kidneys, high-levels of reactive oxygen species ＇,ROS） and low-levels of superoxide dismutase （SOD） in serum, heart, and kidneys. It also upregulated RAGE mRNA and protein expression in heart and kidneys. Our results showed that high-AGEs diet deteriorated vascular complications in the diabetic mice. The activation of AGEs/RAGE/ROS pathway may be involved in the pathogenesis of vascular complications in diabetes.
文摘BACKGROUND Type 2 diabetes is one of the most prevalent chronic diseases worldwide,significantly impacting patients'quality of life.Current treatment options like metformin(MET)effectively counteract hyperglycemia but fail to alleviate diabetes-associated complications such as retinopathy,neuropathy,nephropathy,hepatopathy,and cardiovascular diseases.AIM To propose the supplementation of cholecalciferol(CHO)and taurine(TAU)to enhance MET efficacy in controlling diabetes while minimizing the risk of associated complications.METHODS The study involved sixty rats,including ten non-diabetic control rats and fifty experimental rats with type 2 diabetes induced by streptozotocin.The experimental rats were further subdivided into positive control and treatment subgroups.The four treatment groups were randomly allocated to a single MET treatment or MET combined with supplements either CHO,TAU,or both.RESULTS Diabetic rats exhibited elevated levels of glucose,insulin,Homeostasis Model Assessment of Insulin Resistance(HOMA-IR),glycated hemoglobin percentage,lipid markers,aspartate aminotransferase,and malondialdehyde,along with reduced levels of antioxidant enzymes(catalase and superoxide dismutase).The administration of CHO and TAU supplements alongside MET in diabetic rats led to a noticeable recovery of islet mass.The antioxidative,anti-inflammatory,and anti-apoptotic properties of the proposed combination therapy significantly ameliorated the aforementioned abnormalities.CONCLUSION The supplementation of CHO and TAU with MET showed the potential to significantly improve metabolic parameters and protect against diabetic complications through its antioxidative,anti-inflammatory,and antiapoptotic effects.
文摘BACKGROUND Social determinants of health are social and economic factors that influence health intervention outcomes.Type 2 diabetes is a highly prevalent disease,primarily affecting individuals in low-to-middle-income countries.However,the association between social determinants and cardiovascular complications in type 2 diabetes has not been widely studied.AIM To examine the relationship between social determinants of health and cardiovascular complications in individuals with type 2 diabetes.METHODS We conducted a retrospective cohort study with an analytical component at a national-level referral hospital for military personnel in Bogota,Colombia.Patients treated at the diabetes clinic between September 2021 and December 2022 who met the inclusion criteria were included.A total of 583 patients participated in the study.We performed descriptive,bivariate,and binary logistic regression analyses,adjusting for confounding variables.RESULTS Among the 583 patients included,urban residency[odds ratio(OR)=3.05,95%confidence interval(CI):1.01-9.20]and a middle or high educational level(OR=2.33,95%CI:1.14-4.72)were associated with an increased risk of coronary artery disease.Additionally,receiving diabetes education beyond that provided by the clinic(OR=2.15,95%CI:1.14-4.05)and lack of access to spaces for physical activity(OR=4.05,95%CI:1.31-12.5)were associated with a higher risk of diabetic nephropathy and cerebrovascular disease,respectively.CONCLUSION Programs for diabetes management should account for social determinants of health that contribute to cardiovascular complications and increased healthcare costs.Population-based studies are needed to guide targeted interventions and clarify causal relationships.
基金supported by the National Natural Science Foundation of China,No.81370165a grant from the Public Benefit Technology and Society Development Program of Zhejiang Province of China,No.2015C33309+2 种基金a grant from the Ningbo Science and Technology Innovation Team Program in China,No.2014B82002,2015B11050a grant from the Ningbo Science and Technology Project in China,No.2015A610217the Fang Runhua Fund of Hong Kong,K.C.Wong Magna Fund in Ningbo University
文摘OBJECTIVE： To evaluate the efficacy of α-lipoic acid（ALA） plus epalrestat combination therapy in the treatment of diabetic peripheral neuropathy（DPN）. DATA SOURCES： The electronic databases of Pub Med, Medline, Embase, the Cochrane Library, the Chinese National Knowledge Infrastructure, the Wanfang Database and the Chinese Biomedical Database were used to retrieve relevant studies without language restrictions. The search was conducted from the inception of each database to 7 October 2016. The key terms were（diabetic peripheral neuropathy or diabetic neuropathy or DPN） AND（α-lipoic acid or lipoic acid or thioctic acid） AND epalrestat. DATA SELECTION： All of the eligible studies met the following inclusion criteria：（1） Randomized controlled trials that compared efficacy and safety of epalrestat plus ALA combination therapy versus epalrestat or ALA monotherapy in patients with DPN.（2） The minimum duration of treatment was 2 weeks.（3） The DPN patients were diagnosed using the World Health Organization standardized type 2 diabetes mellitus and DPN criteria.（4） Studies contained at least one measure that could reflect the efficacy of the drug and nerve conduction velocities. Studies in which the control group used epalrestat or ALA combined with other drugs were excluded. Statistical analyses were performed using STATA software for meta-analysis. OUTCOME MEASURES： The primary outcomes were the therapeutic efficacy, median motor nerve conduction velocity（MNCV）, median sensory nerve conduction velocity（SNCV）, peroneal MNCV and peroneal SNCV.RESULTS： Twenty studies with 1894 DPN patients were included, including 864 patients in the ALA plus epalrestat group, 473 in the ALA group and 557 in the epalrestat group. The efficacy of ALA plus epalrestat combination therapy was superior to ALA and epalrestat monotherapies（RR = 1.29, 95% CI： 1.21–1.38; RR = 1.43, 95% CI： 1.34–1.54, respectively）. ALA plus epalrestat combination therapy also significantly improved median MNCV（WMD = 5.41, 95% CI： 2.07–8.75）, median SNCV（WMD = 5.87, 95% CI： 1.52–10.22）, peroneal MNCV（WMD = 5.59, 95% CI： 2.70–8.47） and peroneal SNCV（WMD = 4.57, 95% CI： 2.46–6.68）.CONCLUSION： ALA plus epalrestat combination therapy was superior to ALA and epalrestat monotherapies for clinical efficacy and nerve conduction velocities in patients with DPN.
基金supported by the Research Fund of Ege University(Project No.2010-TIP-076)
文摘Increased reactive oxygen species by the activation of NADPH oxidase（NOX） contributes to the development of diabetic complications.Apocynin,a NOX inhibitor,increases sciatic nerve conductance and blood flow in diabetic rats.We investigated potential protective effect of apocynin in rat diabetic neuropathy and its precise mechanism of action at molecular level.Rat models of streptozotocin-induced diabetes were treated with apocynin（30 and 100 mg/kg per day,intragastrically） for 4 weeks.Mechanical hyperalgesia and allodynia were determined weekly using analgesimeter and dynamic plantar aesthesiometer.Western blot analysis and histochemistry/immunohistochemistry were performed in the lumbar spinal cord and sciatic nerve respectively.Streptozotocin injection reduced pain threshold in analgesimeter,but not in aesthesiometer.Apocynin treatment increased pain threshold dose-dependently.Western blot analysis showed an increase in catalase and NOX-p47 phox protein expression in the spinal cord.However,protein expressions of neuronal and inducible nitric oxide synthase（n NOS,i NOS）,superoxide dismutase,glutathion peroxidase,nitrotyrosine,tumor necrosis factor-α,interleukin-6,interleukin-1β,aldose reductase,cyclooxygenase-2 or MAC-1（marker for increased microgliosis） in the spinal cord remained unchanged.Western blot analysis results also demonstrated that apocynin decreased NOX-p47 phox expression at both doses and catalase expression at 100 mg/kg per day.Histochemistry of diabetic sciatic nerve revealed marked degeneration.n NOS and i NOS immunoreactivities were increased,while S-100 immunoreactivity（Schwann cell marker） was decreased in sciatic nerve.Apocynin treatment reversed these changes dose-dependently.In conclusion,decreased pain threshold of diabetic rats was accompanied by increased NOX and catalase expression in the spinal cord and increased degeneration in the sciatic nerve characterized by increased NOS expression and Schwann cell loss.Apocynin treatment attenuates neuropathic pain by decelerating the increased oxidative stress-mediated pathogenesis in diabetic rats.
基金financially supported by the National Natural Science Foundation of China(No.31771318)Hubei Superior Discipline Groups of Physical Education and Health Promotion+1 种基金the 14thFive-Year-Plan Advantageous and Characteristic Disciplines(Groups)of Colleges and Universities in Hubei Province for Exercise and Brain ScienceChutian Scholar Program and Innovative Start-Up Foundation from Wuhan Sports University to Ning Chen。
文摘Type 2 diabetes mellitus(T2 DM)is one of metabolic diseases with the major inducer of obesity.Due to the change in lifestyle and dietary structure,more and more people are being suffered from T2 DM.Therefore,the prevention and treatment of T2 DM and its complications has become an urgent problem to be solved.As a secreted peptide,adropin is identifi ed as a useful regulator associated with insulin sensitivity and energy homeostasis.It has the potential for regulating metabolic diseases including obesity and T2 DM.It should be noted that the secretion of adropin can be induced by diets,aerobic exercise and other interventions.In this article,the underlying mechanisms of adropin for regulating obesity,T2 DM and its complications including diabetic nephropathy,diabetic retinopathy,diabetic encephalopathy,diabetic vascular disease and diabetic cardiovascular disease were summarized.Meanwhile,the strategies for promoting the secretion of adropin were also discussed,which will provide a target for the prevention and targeted treatment,or a candidate of novel and effective functional food or drug for metabolic diseases in the future.
基金This work was supported by State Key Program of National Natural Science Foundation of China(Grant number:81430095).
文摘Licorice is one of the oldest herbal medicines for its various ethno pharmacological uses.In both Asian and European countries,it has been recorded for treatment of inflammatory diseases.A large number of ingredients have been isolated from licorice,including triterpene saponins and flavonoids,which are normally being considered to be the main biologically active components.In the last decade,licorice has been proved exert anti-diabetic effect in various in vivo and in vitro models of diabetes mellitus.Furthermore,licorice can also antagonize all sorts of diabetes complications,including diabetic nephropathy,atherosclerosis,diabetic retinopathy and neuropathy.Except anti-inflammation,licorice and its active components show anti-diabetic effects by improving insulin resistance and increasing insulin secretion,regulating lipid metabolism,and anti-oxidation.The useful effects of licorice and its active components are due to regulating different pathways and proteins,including NF-κB,AMPK,insulin signaling pathway,MAPK,etc.In this review,we provide an overview of the beneficial effects and related molecular mechanism of licorice and its effective components on improving diabetes and its complications.
文摘Diabetes is a metabolic disease characterized by abnormally elevated blood glucose levels.Persistent hyperglycemia leads to diabetic nephropathy,diabetic retinopathy,diabetes with periodontal disease and other diabetic complications.These diseases have become the main causes of disability and death in diabetic patients.Artesunate is well known as an antimalarial drug for controlling malaria symptoms.Current studies have shown that artesunate improves diabetes and its complications by protecting islet cells,improving glucose and lipid metabolism,anti-inflammatory and immune regulation.Based on the research status in recent years,this paper focuses on the mechanism of artesunate in diabetes and its complications,to provide a theoretical basis for future diabetes research.
文摘BACKGROUND Type 2 diabetes mellitus(T2DM)causes both macrovascular and microvascular complications.However,currently,selection of glycemic measures and their thresholds to diagnose T2DM,and efficacy outcomes in evaluation of anti-diabetic drugs is predominantly informed by the relation of T2DM to microvascular complications.We can be severely mistaken on T2DM by neglecting macrovascular complications which are generally more severe,if they also occur more commonly than microvascular complications.AIM To compare the incidence of major cardiovascular events(MACEs)and severe microvascular complications(SMICs)in T2DM patients.METHODS MEDLINE,EMBASE,and Cochrane Central Register of Controlled Trials were searched from inception to September 2017.Cohort studies or trials of T2DM patients aged 18 years or older that reported incidence of both MACEs and SMICs were included.MACEs were defined as nonfatal myocardial infarction and stroke,and cardiovascular death,while SMICs included serious retinopathy,nephropathy and diabetic disorder.The relative risk(RR)was estimated as the incidence of MACEs divided by that of SMICs in same patients and combined with meta-analysis in a random-effect model.RESULTS Twelve studies with a total of 16 cohorts and 387376 patients were included,and the combined RR was 2.02(95%CI:1.46–2.79).The higher incidence of MACEs remained in various subgroup and sensitivity analyses.CONCLUSION Patients with T2DM are much more likely to develop MACEs than SMICs.By taking more serious consequences and relatively higher incidence into consideration,macrovascular complications deserve more emphasis in developing the diagnostic criteria of T2DM and in evaluating the efficacy of antidiabetic drugs.
基金supported by the National Natural Science Foundation of China(NSFC)(No.81770809).
文摘Diabetes mellitus(DM)is a progressive metabolic disease characterized by chronic hyperglycemia and caused by different degree of pancreatic islet dysfunction and/or insulin resistance(IR).Long course DM can lead to a variety of macrovascular and microvascular complications which involve artery vessels,heart,kidney,retina,nervous system,etc.In recent years,DM has attracted more and more attention due to its high morbidity and mortality.In addition to achieve effective glycemic control,prevention of complications has also been considered a priority for type 2 diabetes mellitus(T2DM)management.Herein,we provide a comprehensive overview on the pharmacotherapeutics for T2DM and perspectives on the future directions of basic and translational research on anti-diabetic therapy and pharmatheutical development of new drugs.
文摘Background: Diabetes is a risk factor for depression, but little is known about anxiety and other psychiatric disorders and quality of life. The aim of this study was to assess the prevalence of depression, anxiety in diabetic patients in our locality and to assess the quality of life in type 2 DM. Subjects & Methods: This study was a cross-sectional study and was carried out in outpatient clinics of specialized medical hospital, Mansoura university for a period of one year. From 217 diabetes mellitus subjects, only 202 patients were matched with 247 healthy people as a control group. All subjects were examined by using socioeconomic data, clinical data, and anthropometric examinations to assess body mass index and waist circumference. All patients were interviewed by using the Mini-International Neuropsychiatric Interview (MINI) version 5, MINI, Hospital Anxiety and Depression scale (HAD) and health-related quality of life (HRQOL) scales. Laboratory investigation in the form of fasting and two-hour postprandial blood sugar (FBS & 2hpp) and HbA1C levels were done. Results: 18.3% were found to be major depressive disorder;and 2.5% panic disorder, 1% other phobia. Generalized anxiety disorder and obsessive-compulsive disorder were found in one patient, no patients were found to be diagnosed as Bipolar disorder, schizophrenia, or substance abuse. Although there was no statistically significant difference between subjects and control groups regarding height, there was statistically significant difference between weights, BMI, with more scores among DM group. Moreover our study showed that HbA1c, fasting blood sugar, two hours post prandial blood sugar were more among DM patients and control groups. Anxiety, depression, and poorer quality of life were found to be more prevalent among DM patients than control groups. Conclusion: DM is associated with depression anxiety disorder with poorer quality of life.
