451
|
Saboory E, Gholizadeh-Ghaleh Aziz S, Samadi M, Biabanghard A, Chodari L. Exercise and insulin-like growth factor 1 supplementation improve angiogenesis and angiogenic cytokines in a rat model of diabetes-induced neuropathy. Exp Physiol 2020; 105:783-792. [PMID: 32053260 DOI: 10.1113/ep088069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 02/11/2020] [Indexed: 12/15/2022]
Abstract
NEW FINDINGS What is the central question of this study? Do changes in levels of angiogenesis-related mediators [vascular endothelial growth factor-A (VEGF-A), thrombospondin-1 (TSP-1) and nuclear factor-κB (NF-κB)] in the sciatic nerve mediate diabetic neuropathy in the streptozotocin-induced type 1 diabetic male rat? Can exercise and insulin-like growth factor 1 (IGF-I) treatment improve the diabetes-related decrease in angiogenesis in sciatic nerve in these animals? What is the main finding and its importance? Levels of VEGF-A, TSP-1 and NF-κB change in the sciatic nerve of diabetic rats and might mediate diabetic neuropathy. Treatment with IGF-I and exercise could increase angiogenesis in the diabetic rats by increasing VEGF-A and decreasing TSP-1 and NF-κB expression in the sciatic nerve. ABSTRACT Diabetic neuropathy is a severe complication of diabetes that affects 40-50% of diabetic people in the world. The aim of this study was to characterize alterations in angiogenesis and related molecular mediators in the sciatic nerve in diabetic conditions alone or in diabetes in combination with exercise and/or administration of insulin-like growth factor 1 (IGF-I). Forty male Wistar rats were assigned into one of five groups, namely control, diabetes, diabetes + exercise, diabetes + IGF-I and diabetes + exercise + IGF-I. Type 1 diabetes was induced by i.p. injection of streptozotocin (60 mg kg-1 ). After 30 days of treatment with exercise or IGF-I alone or in combination, diabetic neuropathy was evaluated with a hotplate, glycated haemoglobin was measured, angiogenesis was determined by immunostaining for PECAM-1/CD31, and expressions of vascular endothelial growth factor-A (VEGF-A), thrombospondin-1 (TSP-1) and nuclear factor-κB (NF-κB) were determined by enzyme-linked immunosorbent assay.After 4 weeks, the diabetes group showed a significant decrease in capillary density and VEGF-A levels, but a significant increase in glycated haemoglobin in blood, TSP-1 and NF-κB levels in the sciatic nerve compared with the control group, and these effects were ameliorated by exercise and IGF-I. However, simultaneous treatment of diabetic rats with IGF-I and exercise did not have any synergistic effects. These findings indicate that diabetes-induced neuropathy may be associated, in part, with decreased angiogenesis mediated by overproduction of TSP-1 and NF-κB, in addition to reduced production of VEGF-A. The findings also showed that exercise and IGF-I can reduce neuropathy, followed by increased angiogenesis, by changes in TSP-1, NF-κB and VEGF-A production levels.
Collapse
Affiliation(s)
- Ehsan Saboory
- Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Urmia, Zanjan, Iran
| | | | - Mahrokh Samadi
- Department of Physiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Abdolrahman Biabanghard
- Department of Physiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Leila Chodari
- Department of Physiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.,Neurophysiology Research Center, Cellular and Molecular Medicine Institute, Urmia University of Medical Sciences, Urmia, Iran
| |
Collapse
|
452
|
Makinde EA, Radenahmad N, Adekoya AE, Olatunji OJ. Tiliacora triandra extract possesses antidiabetic effects in high fat diet/streptozotocin-induced diabetes in rats. J Food Biochem 2020; 44:e13239. [PMID: 32281660 DOI: 10.1111/jfbc.13239] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/20/2020] [Accepted: 01/30/2020] [Indexed: 02/04/2023]
Abstract
The antidiabetic properties of Tiliacora triandra ethanol extract in diabetic rats induced with high-fat diet (HFD)/streptozotocin (STZ) was investigated. Rats were fed with HFD for 4 weeks to induced insulin resistance, and thereafter administered with 35 mg/kg of STZ to induce diabetes. Diabetic rats received 100 and 400 mg/kg of T. triandra daily for 30 days. The body weight, blood glucose level, food and fluid intake were monitored. Furthermore, biochemical and histological assessment was performed to evaluate the hypoglycemic effect of the extract in the treated rats. T. triandra significantly decreased the blood glucose level, increased the body weight and insulin secretion. Furthermore, T. triandra attenuated hyperlipidemia, improved liver and kidney functions of treated diabetic rats. Thus, T. triandra could effectively attenuate diabetes and it complications. PRACTICAL APPLICATIONS: Tiliacora triandra is a common vegetable consumed in Thailand and Laos. It is traditionally employed in the treatment of fever, cancer, malaria, and diabetes. The extract from the aerial part was investigated for its antidiabetic properties. The results obtained provides important pharmacological information that supports the use of T. triandra in management of diabetes.
Collapse
Affiliation(s)
| | - Nisaudah Radenahmad
- Department of Anatomy, Faculty of Science, Prince of Songkla University, Hat Yai, Thailand
| | | | | |
Collapse
|
453
|
Tefera YG, Gebresillassie BM, Emiru YK, Yilma R, Hafiz F, Akalu H, Ayele AA. Diabetic health literacy and its association with glycemic control among adult patients with type 2 diabetes mellitus attending the outpatient clinic of a university hospital in Ethiopia. PLoS One 2020; 15:e0231291. [PMID: 32267893 PMCID: PMC7141656 DOI: 10.1371/journal.pone.0231291] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 03/19/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Despite how much effect of low health literacy is on diabetic treatment cannot be accurate, it has an impact on controlling blood glucose level. Less is known about diabetic health literacy in Ethiopian diabetic patients which can affect patient medication adherence, self-care, and glycemic control. OBJECTIVE This study was aimed to assess the diabetic health literacy level and its association with glycemic control among adult patients with type 2 diabetes mellitus attending the outpatient clinic of University of Gondar Comprehensive Specialized Hospital (UOGCSH): Northwest Ethiopia. METHODS A cross-sectional study was employed at the outpatient clinic of the University of Gondar Comprehensive Specialized Hospital from May, 1 -May 30, 2019. The comprehensive 15-items diabetic health literacy questions with a 5-point Likert scale used to measure diabetic health literacy. The mean score calculated and switched to the percentage (5 points as 100%) to determine the level of diabetic health literacy. Morisky Green Levine Scale 4 item adherence assessment tool was used to assess the diabetic patient's level of adherence. Binary and multivariable logistic regression analysis was used to assess the association between sociodemographic, clinical variables, diabetic-related literacy, and glycemic control. Independent samples t-test and One-way ANOVA test was employed to compare the mean literacy score difference in different groups. RESULT 400 respondents were included in the study. Of all the respondents, 17.3%, 26.3%, and 56.5% had low, medium and high diabetic-related health literacy, respectively. The proportions of patients with low, medium and high adherence to medication were 9.8%, 56.3%, and 34% respectively. Patients with high diabetes literacy are 1.85 times more likely to achieve target glycemic control than lower diabetic literacy patients with 95% CI Adjusted Odds Ratio (AOR). 1.85(1.09-3.40). While patients with good adherence 1.61 times more likely to achieve target glycemic control than patients with low adherence; 95% CI AOR 1.61(1.04-4.79). Diabetic patients with morbidity have 67% less likelihood to achieve the target glycemic control; 95% CI AOR 0.33(0.15-0.73). CONCLUSION Adequate diabetic health literacy and better glycemic control are highly correlated. Adjusting all variables; younger age, high diabetic health literacy and good adherence are associated with achieving the target glycemic control.
Collapse
Affiliation(s)
- Yonas Getaye Tefera
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Begashaw Melaku Gebresillassie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yohannes Kelifa Emiru
- Department of Pharmacognosy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Ruth Yilma
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Firdos Hafiz
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Henok Akalu
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Asnakew Achaw Ayele
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
454
|
Shayeghian Z, Moeineslam M, Hajati E, Karimi M, Amirshekari G, Amiri P. The relation of alexithymia and attachment with type 1 diabetes management in adolescents: a gender-specific analysis. BMC Psychol 2020; 8:30. [PMID: 32252831 PMCID: PMC7137281 DOI: 10.1186/s40359-020-00396-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 03/19/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Several studies indicate the role of psychosocial factors in the management and control of chronic diseases in adolescents. In this regard, the roles of attachment and alexithymia in the management of type 1 diabetes in adolescents and related gender-specific patterns have rarely been the focus of empirical research. In this study we investigate the gender-specific relationship of alexithymia and attachment with self-care and blood glucose level in adolescents with type1 diabetes. METHODS This is a cross-sectional study conducted on adolescents aged 12-18 years, with type 1 diabetes. Participants were recruited from diabetes clinics and the Iranian Diabetes Society. Data were collected using the Farsi versions of the Toronto Alexithymia Scale (FTAS-20), the Inventory of Parent and Peer Attachment (IPPA) and the Summary of Diabetes Self-Care Activities Scale (SDSCA). Blood glucose levels were measured by determining HbA1c which were abstracted from medical records. Data were analyzed using SPSS21 software. RESULTS Participants were 150 adolescents (57% female), mean age 14.97 ± 2.30. Alexithymia (β = 0.10, P = 0.01), difficulty identifying feelings (β = 0.15, P = 0.03) and communication with mothers (β = - 0.08, P = 0.03) predicted HbA1c in girls, whereas no significant relationships were observed for HbA1c with alexithymia and attachment in boys. Factors that predicted self-care in girls were alexithymia (β = - 0.04, P = 0.02), difficulty identifying feelings (β = - 0.06, P = 0.04); in boys however in addition to these two factors predicting self-care [alexithymia (β = - 0.07, P = 0.01) and difficulty identifying feelings (β = - 0.11, P = 0.01)], we also found difficulty describing feelings (β = - 0.16, P = 0.02), communication with mother (β = 0.04, P = 0.04), alienation to mother (β = - 0.06, P = 0.03), to father (β = - 0.06, P = 0.01) and to peers (β = - 0.09, P = 0.03). CONCLUSIONS Our results suggest that, in a gender-specific pattern, alexithymia and attachment could affect self-care and blood glucose level in adolescents with type 1 diabetes; findings that can be used to facilitate more effective treatment strategies and interventions in this age group.
Collapse
Affiliation(s)
- Zeinab Shayeghian
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran
| | - Mina Moeineslam
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran
| | - Elnaz Hajati
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran
| | - Mehrdad Karimi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Golshan Amirshekari
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran.
| |
Collapse
|
455
|
Giannopoulos G, Karageorgiou S, Vrachatis D, Kousta M, Tsoukala S, Letsas K, Siasos G, Deftereos S. Usefulness of a Structured Adult Education Program in Modifying Markers of Cardiovascular Risk After Acute Myocardial Infarction. Am J Cardiol 2020; 125:845-850. [PMID: 31924318 DOI: 10.1016/j.amjcard.2019.12.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/02/2019] [Accepted: 12/09/2019] [Indexed: 12/12/2022]
Abstract
Patient involvement in therapeutic strategies leading to lifestyle changes and increasing adherence to beneficial treatment is important for high risk coronary artery disease patients. The hypothesis of the present substudy was that a program of education specifically structured to educate postmyocardial infarction patients would lead to measurable differences in specific indices of cardiovascular risk. Post-MI patients were randomly assigned to 2 groups. Patients in the intervention arm attended an 8-week long educational program in addition to usual treatment and controls received standard treatment. Low-density lipoprotein cholesterol, systolic blood pressure, body-mass index, and glycosylated hemoglobin were assessed at baseline and at 12 months (values are reported as median [interquartile range]). One hundred ninety-eight consecutively randomized patients were included in the present substudy. The median change in Low-density lipoprotein cholesterol was -54 (-45 to [-62]) mg/dl in the intervention group as compared with -35 (-28 to [-43]) mg/dl in controls (p <0.001). Systolic blood pressure change was -7.5 (-15.3 to 0.3) mm Hg and -3.0 (-11.8 to 2.8) mm Hg, respectively (p = 0.011). The median change in body-mass index was 0.0 (-3.0 to 3.0) kg/m2 as compared with 2.0 (-1.0 to 3.9) kg/m2, respectively (p = 0.002). The reduction in glycosylated hemoglobin was significant in both groups with a median absolute change of -0.29 (-1.11 to 0.09) % in the intervention group and -0.24 (-0.69 to 0.06) % in controls (p = 0.168). If only diabetic patients were considered, the change was -0.65 (-1.3 to [-0.23]) % in the intervention group versus -0.41 (-0.74 to [-0.07]) % in controls (p = 0.021). In conclusion, a relatively short patient education program may have long-lasting effects on established modifiable markers of cardiovascular risk.
Collapse
Affiliation(s)
| | - Sofia Karageorgiou
- Second Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Vrachatis
- Cardiology Department, Athens General Hospital "G. Gennimatas", Athens, Greece
| | - Maria Kousta
- Cardiology Department, Athens General Hospital "G. Gennimatas", Athens, Greece
| | - Styliani Tsoukala
- Cardiology Department, Athens General Hospital "G. Gennimatas", Athens, Greece
| | - Konstantinos Letsas
- Second Department of Cardiology, Evangelismos General Hospital, Athens, Greece
| | - Gerasimos Siasos
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyridon Deftereos
- Second Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
456
|
Celik A, Forde R, Sturt J. The impact of online self-management interventions on midlife adults with type 2 diabetes: a systematic review. ACTA ACUST UNITED AC 2020; 29:266-272. [DOI: 10.12968/bjon.2020.29.5.266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Online self-management education programmes are now recommended for people with type 2 diabetes to improve self-management capacities. There is limited evidence to determine whether such programmes improve the health outcomes for midlife adults with diabetes. Aims: The purpose of this systematic review was to assess the impact of online self-management interventions with digital consulting on glycated haemoglobin (HbA1c), total cholesterol, blood pressure, diabetes distress, self-efficacy, and depression in midlife adults. Methods: A systematic review was undertaken searching Medline, Embase and CINAHL. Studies were appraised using the Cochrane Collaboration's tool. Results: Eight studies were included. Online interventions resulted in the improvement of HbA1c (pooled mean difference on HbA1c: -0.35%, 95% CI (-0.52, -0.18), P<0.001). A narrative synthesis was conducted for all secondary outcomes. No conclusions could be drawn on the impact of these outcomes. Conclusion: Online interventions improve HbA1c. Further research is needed for secondary outcomes.
Collapse
Affiliation(s)
- Aycan Celik
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
| | - Rita Forde
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
| |
Collapse
|
457
|
Alqahtani F, Alqhtani N, Alkhtani F, Devang Divakar D, Al-Kheraif AA, Javed F. Clinicoradiographic markers of peri-implantitis in cigarette-smokers and never-smokers with type 2 diabetes mellitus at 7-years follow-up. J Periodontol 2020; 91:1132-1138. [PMID: 32017116 DOI: 10.1002/jper.19-0501] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/04/2020] [Accepted: 01/14/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND It is hypothesized that in the long-term, (a) peri-implant inflammatory variables (plaque index [PI], bleeding on probing [BOP], probing depth (PD) and crestal bone loss [CBL]) are worse in cigarette-smokers (CS) and patients with type-2 diabetes mellitus (T2DM) than never-smokers (NS) without T2DM. The aim of the present 7-year follow-up clinical observational study was to assess the survival of dental implant in CS and NS with T2DM. METHODS Study participants were divided into four groups based on glycemic status and self-reported cigarette-smoking habit: a) CS with T2DM; b) CS without T2DM; c) NS with T2DM; and d) NS without T2DM. Demographic information was collected using a questionnaire and hemoglobin A1c (HbA1c) levels were measured. Peri-implant PI, BOP, PD, and CBL were measured. Sample-size was estimated was statistical analysis was done using analysis of variance. P <0.01 was considered significant. RESULTS In total, 101 male patients were included. There was no significant contrast in age among the groups. Every partaker in the study groups had one dental implant placed in posterior maxilla or mandible. The mean HbA1c levels were significantly higher among CS (P <0.01) and NS (P <0.01) with T2DM than individuals without T2DM. Peri-implant PI (P <0.01), PD (P <0.01), and CBL (P <0.01) were significantly higher among CS and NS with T2DM and CS without T2DM than NS without T2DM. Peri-implant BOP was significantly higher among CS and NS with T2DM than CS and NS without T2DM (P <0.01). CONCLUSIONS Peri-implant inflammatory variables were worse among CS and NS with T2DM than NS without T2DM. A state of chronic hyperglycemia seems to be a stronger mediator of inflammation than cigarette smoking in patients with T2DM.
Collapse
Affiliation(s)
- Fawaz Alqahtani
- Department of Prosthodontics, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Nasser Alqhtani
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Fahad Alkhtani
- Department of Prosthodontics, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Darshan Devang Divakar
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz A Al-Kheraif
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Fawad Javed
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.,Division of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| |
Collapse
|
458
|
|
459
|
Al-Awaida WJ, Sharab AS, Al-Ameer HJ, Ayoub NY. Effect of simulated microgravity on the antidiabetic properties of wheatgrass ( Triticum aestivum) in streptozotocin-induced diabetic rats. NPJ Microgravity 2020; 6:6. [PMID: 32133389 PMCID: PMC7039905 DOI: 10.1038/s41526-020-0096-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 01/13/2020] [Indexed: 12/11/2022] Open
Abstract
Microgravity affects plant growth and content. A three-dimensional clinostat was used at 4 rotations/min to rotate the seeds of Triticum aestivum cultivar (Ammon) in three dimensions for 7 days, following which the antioxidant activities of ethanolic extracts were evaluated using both nitric oxide- and hydrogen peroxide-scavenging activities. The antidiabetic activities of ethanolic extracts were evaluated by measuring the concentration of plasma glucose, insulin, C peptide, and glycated hemoglobin (HbA1c); determining the number of β cells in the pancreatic islets; and performing the glucose tolerance test. Furthermore, the effects of the ethanolic extracts on the lipid profile and liver function were estimated. After rats were sacrificed, their pancreases were isolated and used for histopathological processing. The results indicated that the antioxidant potential and antioxidant metabolite content were significantly increased under microgravity conditions in comparison to those under normal gravity conditions. Rats treated with an extract of wheatgrass (T. aestivum) germinated over a period of 6-10 days under microgravity (WGM) showed a significant reduction in the levels of serum glucose, HbA1C, urea, creatinine, aspartate aminotransferase and alanine aminotransferase, and insulin resistance compared to rats treated with an extract of wheatgrass germinated under gravity. Additionally, the total cholesterol and low-density lipoprotein cholesterol levels were significantly decreased. In contrast, high-density lipoprotein cholesterol, C-peptide, and insulin levels rose significantly after treatment with T. aestivum germinated under microgravity. WGM is a promising potential diabetic treatment without side effects with a low manufacturing cost.
Collapse
Affiliation(s)
- Wajdy J. Al-Awaida
- Department of Biology and Biotechnology, American University of Madaba, Madaba, Jordan
| | - Ahmad S. Sharab
- Department of Biology and Biotechnology, American University of Madaba, Madaba, Jordan
| | - Hamzeh J. Al-Ameer
- Department of Biology and Biotechnology, American University of Madaba, Madaba, Jordan
| | - Nabil Y. Ayoub
- Department of Basic Sciences and Humanities, Faculty of Science, American University of Madaba (AUM), Amman, 11821 Jordan
| |
Collapse
|
460
|
AlShayban DM, Naqvi AA, Alhumaid O, AlQahtani AS, Islam MA, Ghori SA, Haseeb A, Ali M, Iqbal MS, Elrggal ME, Ishaqui AA, Mahmoud MA, Khan I, Jamshed S. Association of Disease Knowledge and Medication Adherence Among Out-Patients With Type 2 Diabetes Mellitus in Khobar, Saudi Arabia. Front Pharmacol 2020; 11:60. [PMID: 32153397 PMCID: PMC7045035 DOI: 10.3389/fphar.2020.00060] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 01/22/2020] [Indexed: 12/13/2022] Open
Abstract
Objective The study aimed to evaluate the association between disease knowledge and medication adherence in patients with type 2 diabetes mellitus. Methods A cross-sectional study was conducted for three months, in patients with type 2 diabetes who visited three community pharmacies located in Khobar, Saudi Arabia. Patients' disease knowledge and their adherence to medications were documented using Arabic versions of the Michigan Diabetes Knowledge Test and the General Medication Adherence Scale respectively. Data were analyzed through SPSS version 23. Chi-square test was used to report association of demographics with adherence. Spearman's rank correlation was employed to report the relationship among HbA1c values, disease knowledge and adherence. Logistic regression model was utilized to report the determinants of medication adherence and their corresponding adjusted odds ratio. Study was approved by concerned ethical committee (IRB-UGS-2019-05-001). Results A total of 318 patients consented to participate in the study. Mean HbA1c value was 8.1%. A third of patients (N = 105, 33%) had high adherence and half of patients (N = 162, 50.9%) had disease knowledge between 51% - 75%. A significantly weak-to-moderate and positive correlation (ρ = 0.221, p < 0.01) between medication adherence and disease knowledge was reported. Patients with >50% correct answers in the diabetes knowledge test questionnaire were more likely to be adherent to their medications (AOR 4.46, p < 0.01). Conclusion Disease knowledge in most patients was average and half of patients had high-to-good adherence. Patients with better knowledge were 4 to 5 times more likely to have high adherence. This highlights the importance of patient education and awareness regarding medication adherence in managing diabetes.
Collapse
Affiliation(s)
- Dhfer Mahdi AlShayban
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Atta Abbas Naqvi
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Othman Alhumaid
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ali Saad AlQahtani
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Md Ashraful Islam
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Syed Azizullah Ghori
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdul Haseeb
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia
| | - Majid Ali
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia
| | - Muhammad Shahid Iqbal
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Mahmoud E Elrggal
- Pharmaceutical Research Center, Deanship of Scientific Research, Umm Al Qura University, Makkah, Saudi Arabia
| | - Azfar Athar Ishaqui
- Department of Pharmacy, King Abdulaziz Hospital, National Guard Health Authority, Alahsa, Saudi Arabia
| | - Mansour Adam Mahmoud
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Irfanullah Khan
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia
| | - Shazia Jamshed
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia.,Qualitative Research-Methodological Application in Health Sciences Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
| |
Collapse
|
461
|
Jin H. Increased levels of glycosylated hemoglobin, microalbuminuria and serum cystatin C predict adverse outcomes in high-risk pregnancies with gestational diabetes mellitus. Exp Ther Med 2020; 19:1281-1287. [PMID: 32010300 PMCID: PMC6966206 DOI: 10.3892/etm.2019.8336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 04/05/2019] [Indexed: 11/06/2022] Open
Abstract
In the present study, the predictive value of glycosylated hemoglobin (HbA1c), microalbuminuria (24 h mAlb) and serum cystatin C (Cys-C) levels on the outcome of pregnancy in patients with gestational diabetes mellitus (GDM) was investigated. Samples of 144 females with GDM and 117 normal pregnant females as controls were selected for retrospective analysis. The following parameters were compared between the two groups: Levels of HbA1c, Cys-C and 24 h mAlb, maternal pregnancy outcome and adverse pregnancy rate. The predictive value of elevated 24 h mAlb, HbA1c and Cys-C regarding an adverse pregnancy outcome was then determined. Cys-C, 24 h mAlb and HbA1c levels in the GDM group were significantly higher than those in the control group (P<0.001). The adverse pregnancy rate in the GDM group was significantly higher than that in the control group (40.97 vs. 16.24%; P<0.001). Logistic regression and receiver operating characteristics (ROC) analyses indicated that, in subjects with GDM, HbA1c, Cys-C and 24 h mAlb levels were closely associated with adverse pregnancy outcomes (P<0.050) and may be considered as predictors for an adverse pregnancy outcome (risk ratio >1). Linear correlation analyses indicated that HbA1c, Cys-C and 24 h mAlb were negatively correlated with the neonatal Apgar scores (r=-0.509, -0.954 and -0.954, respectively; P<0.001). According to ROC analysis, the combined predictive sensitivity of HbAlc, Cys-C and 24 h mAlb for adverse pregnancy outcome in patients with GDM was 96.49% and the specificity was 77.19%. The increase in HbAlc, Cys-C and 24 h mAlb levels is expected to be an effective predictor of adverse pregnancy outcomes in high-risk pregnant women.
Collapse
Affiliation(s)
- Hongmei Jin
- Department of Obstetrics, Qingpu Branch, Zhongshan Hospital Affiliated to Fudan University, Shanghai 201700, P.R. China
| |
Collapse
|
462
|
He Z, Nie T, Hu Y, Zhou Y, Zhu J, Liu Z, Liu L, Leong KW, Chen Y, Mao HQ. A polyphenol-metal nanoparticle platform for tunable release of liraglutide to improve blood glycemic control and reduce cardiovascular complications in a mouse model of type II diabetes. J Control Release 2020; 318:86-97. [DOI: 10.1016/j.jconrel.2019.12.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/19/2019] [Accepted: 12/10/2019] [Indexed: 10/25/2022]
|
463
|
Yu Y, Hu L, Xu Y, Wu S, Chen Y, Zou W, Zhang M, Wang Y, Gu Y. Impact of blood glucose control on sympathetic and vagus nerve functional status in patients with type 2 diabetes mellitus. Acta Diabetol 2020; 57:141-150. [PMID: 31367992 PMCID: PMC6997255 DOI: 10.1007/s00592-019-01393-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/23/2019] [Indexed: 02/08/2023]
Abstract
AIMS Present study observed the impact of blood glucose control on sympathetic and vagus functional status in type 2 diabetes mellitus (DM) patients through observing the association between glycosylated hemoglobin (HbA1c) level and sympathetic and vagus functional status detected by heart rate recovery (HRR) and heart rate variability (HRV) assessments. METHODS Consecutive hospitalized DM patients were divided into well glycemic control group (HbA1c < 7.0%, group WGC, n = 100) and poor glycemic control group (HbA1c ≥ 7.0%, group PGC, n = 100), 100 hospitalized patients without DM served as control group (group C). All subjects underwent blood biochemistry test, treadmill exercise testing and 24-h Holter monitoring. RESULTS HRR and HRV parameters were significantly lower in group WGC and PGC than in group C. Standard deviation of NN intervals (SDNN), standard deviation of all 5-min average NN intervals (SDANN), very low frequency (VLF) values were significantly lower in group PGC than in group WGC. HbA1c level was negatively correlated with HRR1, SDNN, SDANN, VLF, low frequency and high frequency. Logistic regression analysis showed that lower SDNN, SDANN and VLF values were risk factors for high HbA1c levels in DM patients after adjusting for gender, age and beta-blocker use in the model 1, and for gender, age, beta-blocker use, coronary artery disease and hypertension in the model 2. CONCLUSIONS Present results indicate that sympathetic and vagal functional status are impaired independent of HbA1c level, while poor glycemic control is related to more significant neurocardiac dysfunction in DM patients.
Collapse
Affiliation(s)
- Yijun Yu
- Department of Cardiology, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, HanZheng Street 473#, QiaoKou District, Wuhan, 430033, China
| | - Liqun Hu
- Department of Cardiology, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, HanZheng Street 473#, QiaoKou District, Wuhan, 430033, China
| | - Yanling Xu
- Department of Cardiology, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, HanZheng Street 473#, QiaoKou District, Wuhan, 430033, China
| | - Shiwei Wu
- Department of Cardiology, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, HanZheng Street 473#, QiaoKou District, Wuhan, 430033, China
| | - Yafei Chen
- Department of Cardiology, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, HanZheng Street 473#, QiaoKou District, Wuhan, 430033, China
| | - Wusong Zou
- Department of Cardiology, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, HanZheng Street 473#, QiaoKou District, Wuhan, 430033, China
| | - Mingjing Zhang
- Department of Cardiology, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, HanZheng Street 473#, QiaoKou District, Wuhan, 430033, China
| | - Yuting Wang
- Department of Cardiology, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, HanZheng Street 473#, QiaoKou District, Wuhan, 430033, China
| | - Ye Gu
- Department of Cardiology, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, HanZheng Street 473#, QiaoKou District, Wuhan, 430033, China.
| |
Collapse
|
464
|
Mukherjee S, Maity S, Ghosh B, Chakraborty T, Mondal A, Bishayee A. Assessment of the antidiabetic potentiality of glyburide loaded glyceryl monostearate solid lipid nanoparticles. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2019.101451] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
465
|
Durg S, Bavage S, Shivaram SB. Withania somnifera
(Indian ginseng) in diabetes mellitus: A systematic review and meta‐analysis of scientific evidence from experimental research to clinical application. Phytother Res 2020; 34:1041-1059. [DOI: 10.1002/ptr.6589] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/17/2019] [Accepted: 11/26/2019] [Indexed: 12/27/2022]
|
466
|
Monanabela KB, van Huyssteen M, Coetzee R. Describing medicine therapy management of type 2 diabetes mellitus at primary health care facilities in Cape Town. Health SA 2020; 24:1051. [PMID: 31934403 PMCID: PMC6917458 DOI: 10.4102/hsag.v24i0.1051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 06/05/2019] [Indexed: 11/01/2022] Open
Abstract
Background Rational medicine use aims to optimise chronic disease management and prevent episodes of hospitalisation that economically burden the health care system. Diabetes mellitus is one of the most prevalent chronic diseases globally, yet more than 60% of patients with diabetes are not optimally managed according to their therapeutic glycaemic targets. Aim To describe the use of glycated haemoglobin (HbA1c) and fasting plasma glucose results in guiding treatment changes in patients with type 2 diabetes mellitus. Setting Public sector primary health care facilities in the Cape Town Metropolitan Region in South Africa. Method Retrospective, descriptive study design was employed. Data for an 18-month period were collected during 2014 and 2015. Data were collected from patient medical records and included baseline demographics, laboratory monitoring tests and the patients' last three prescriptions. Results The study consisted of 575 participants (64% female) with an average age of 57 (± 11.38) years. The average baseline HbA1c for 493 participants with at least one result was 8.78% (± 1.63), and only 28% of these participants reached the glycaemic target at consequent consultations. HbA1c levels were available to guide 245 prescription changes, of which 181 of these results were outside of the target range. Of these, 15.5% had appropriate therapy adjustments, 78.4% had no change or a lateral change in their follow-up prescriptions, and 6.1% had therapy adjustments opposite to what guidelines suggest. Conclusion Glycaemic monitoring indicated consistent suboptimal glycaemic control in more than 60% of participants. Medicine prescribing patterns did not align with the prescribed local guidelines, Society for Metabolism, Endocrinology and Diabetes of South Africa (SEMDSA). The appropriate use and interpretation of HbA1c at a clinic level should be emphasised to promote rational use of medicines that minimise acute hospitalisation episodes and optimise patients' long-term health outcomes.
Collapse
Affiliation(s)
- Khathatso B Monanabela
- School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Cape Town, South Africa
| | - Mea van Huyssteen
- School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Cape Town, South Africa
| | - Renier Coetzee
- School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Cape Town, South Africa
| |
Collapse
|
467
|
Efficacy and Safety of Resveratrol in Type 1 Diabetes Patients: A Two-Month Preliminary Exploratory Trial. Nutrients 2020; 12:nu12010161. [PMID: 31935938 PMCID: PMC7019753 DOI: 10.3390/nu12010161] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/23/2019] [Accepted: 12/04/2019] [Indexed: 01/17/2023] Open
Abstract
Resveratrol has been reported to be beneficial against diabetes complications. The objective of this study was to evaluate the efficacy of resveratrol in decreasing hyperglycemia in patients with type 1 diabetes (T1D) by a preliminary investigation designed as an exploratory clinical trial. Thirteen patients with T1D from both the sexes participated in this trial. All patients received resveratrol in 500 mg capsules, twice daily for 60 days. Bodyweight, fasting blood sugar (FBS), hemoglobin A1c (HbA1c), insulin, homeostasis model of assessment for insulin resistance (HOMA-IR), homeostasis model of assessment for β-cell function (HOMA-β), and markers of liver and kidney damage, inflammation, and oxidative stress were measured before the intervention, at 30 days and at 60 days. Resveratrol supplementation for 60 days significantly decreased FBS and HbA1c in comparison with the baseline values. Resveratrol treatment also resulted in a decrease in the level of a marker for oxidative stress, malondialdehyde, and an increase in total antioxidant capacity in T1D patients. Insulin, HOMA-IR, HOMA-β, and markers of liver and kidney function and inflammation were not significantly affected by resveratrol treatment. Overall, the results showed that 60 days of resveratrol supplementation exerted strong antidiabetic and antioxidant effects in patients with T1D.
Collapse
|
468
|
Song A, Lu L, Li Y, Lin M, Yuan X, Cheng X, Xia W, Wang O, Xing X. Low HbA1c With Normal Hemoglobin in a Diabetes Patient Caused by PIEZO1 Gene Variant: A Case Report. Front Endocrinol (Lausanne) 2020; 11:356. [PMID: 32636802 PMCID: PMC7318866 DOI: 10.3389/fendo.2020.00356] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 05/06/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Diabetes is a global disease with rapidly increasing prevalence in the world. Glycated hemoglobin (HbA1c) as an important indicator of diabetes could reflect the average serum glucose level over 120 days. However, when using HbA1c to diagnose diabetes, it is important to consider other factors that may impact HbA1c level including age, race/ethnicity, detection method, and co-morbidities. Here we report a case of diabetes with normal hemoglobin but reduced HbA1c. Case report: A 57-year-old female patient was diagnosed with diabetes by oral glucose tolerance test results. However, the HbA1c level was repeatedly decreased, glycated albumin level was high, with normal levels of hemoglobin and albumin, and a slightly elevated level of bilirubin. Moreover, life span of red blood cells was significantly shortened. Further examination of whole exome sequencing of the patient and her daughter showed heterozygous variant in PIEZO1 gene (c.6017T > A) in both, which is associated with dehydration hereditary stomatocytosis (DHS). After this diagnosis, we changed nateglinide to sitagliptin to reduce the burden of the pancreas islet function. Conclusion: In case of abnormally low HbA1c, we recommend that GA and reticulocyte should be measured simultaneously. Moreover, the methodology for hemoglobin measurement and the diseases that could cause abnormal quantity and quality of red blood cells and hemoglobin be considered.
Collapse
Affiliation(s)
- An Song
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Lin Lu
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- *Correspondence: Lin Lu
| | - Yuxiu Li
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Mei Lin
- Department of Internal Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xingxing Yuan
- Department of Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinqi Cheng
- Department of Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Weibo Xia
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Ou Wang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xiaoping Xing
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| |
Collapse
|
469
|
Miolski J, Ješić M, Zdravković V. Complications of type 1 diabetes melitus in children. MEDICINSKI PODMLADAK 2020. [DOI: 10.5937/mp71-28003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The World Health Organization has defined Diabetes mellitus as a disorder of metabolism of various causes, due to lack of secretion and / or action of insulin, with long-term hyperglycemia and altered metabolism of sugars, proteins and fats. Diabetes mellitus is the most widespread chronic non-infectious disease, with an increase in the frequency in childhood that could be the epidemic of the 21st century. The incidence is rapidly increasing in the world, while in the last thirty years in Serbia there has been an increase in the number of patients - especially in the group of small and preschool children. Exposure to the genetic, immune and environmental factors plays an important role in the etiology of the disease, but the underlying mechanisms remain unknown. Weeks before the final diagnosis, weakness, irresistible hunger, weight loss, increased thirst, pronounced diuresis, drying of the mucous membranes, skin pruritus and blurred vision could be present. Inadequate glycemic control and unregulated lipid status of children with type 1 diabetes are compatible with numerous complications and a higher risk of cardiovascular, peripheral vascular and cerebrovascular diseases. The therapy consists of insulin therapy, adequate daily physical activity, a variety of diets, overcoming stressful life situations and maintaining satisfactory metabolic control. By using intensive insulin therapy, the best control of the disease is achieved, while the frequency of possible complications is reduced.
Collapse
|
470
|
Jude EB, O'Leary C, Myland M, Nixon M, Gooch N, Shaunik A, Lew E. Evaluating glycaemic control in patients poorly controlled on oral antidiabetic drugs in real-world setting: Results from assessing the Appropriate Timing of Type 2 diAbetes INtensification (ATTAIN). Endocrinol Diabetes Metab 2020; 3:e00094. [PMID: 31922021 PMCID: PMC6947702 DOI: 10.1002/edm2.94] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 08/11/2019] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Many patients with type 2 diabetes mellitus (DM) fail to achieve glycaemic control despite recommended treatment strategies to reduce glycated haemoglobin (HbA1c). This real-world retrospective cohort study compared HbA1c change and treatment patterns between those intensifying and not intensifying therapy with oral antidiabetic drugs (OADs). MATERIALS AND METHODS Patients suboptimally controlled on OADs (>58 mmol/mol [>7.5%] or >64 mmol/mol [>8.0%] for high risk, index 1) were included from IQVIA Medical Research Data. Intensifiers within 12 months of index 1 were matched (1:1) to nonintensifiers. Primary outcomes were HbA1c change and proportion of participants achieving HbA1c targets 6 and 12 months post-index 2 (date of intensification [intensifiers] or pseudodate [nonintensifiers]). Therapy adherence was also assessed. RESULTS A total of 10 832 participants (5539 intensifiers and 5293 nonintensifiers) were included. Mean HbA1c decrease from baseline to 6 months was -1.13% (intensifiers) vs -0.75% (nonintensifiers), with no substantial further change at 12 months. Cox proportional hazards (PH) analysis suggested a nearly 20% greater chance of target achievement at 6 months for intensifiers vs nonintensifiers (hazard ratio [HR]: 0.79 [95% confidence interval [CI]: 0.73-0.86]), which was similar at 12 months (HR: 0.80 [95% CI: 0.74-0.86]). Intensifiers tended towards greater adherence to baseline therapy (90% [standard deviation (SD): 14.9] vs nonintensifiers 87% [SD: 16.0]), which decreased following intensification. CONCLUSIONS Significant reductions in HbA1c were evident at 6 months and were greater in intensifiers vs nonintensifiers. Little additional clinical benefit was seen 12 months postintensification. Despite good treatment adherence, many participants failed to achieve target HbA1c; actions beyond improved adherence are needed to improve suboptimal HbA1c.
Collapse
Affiliation(s)
- Edward B. Jude
- Diabetes CentreTameside General HospitalAshton‐under‐LyneUK
| | | | | | | | | | | | | |
Collapse
|
471
|
Acar K, Kurtulus Dereli A, Avci E, Zeybek V, Kutlu E, Demir S, Senol H. Determination of haemoglobin A1c levels using high-performance liquid chromatography of bloodstains. MEDICINE, SCIENCE, AND THE LAW 2020; 60:19-25. [PMID: 31645182 DOI: 10.1177/0025802419879272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study aimed to determine haemoglobin A1c (HbA1c) levels in bloodstains shed on glass and fabric surfaces on specified test dates. Blood samples were taken from 26 patients (13 diabetic and 13 non-diabetic). Initial HbA1c levels were detected by using high-performance liquid chromatography (HPLC), and bloodstains were created on both cotton fabric and glass surfaces. Samples were processed at different ages (0, 7, 14, 28 and 56 days) by diluting distilled water and then measuring HbA1c levels by HPLC again. In all stains, HbA1c levels could be determined by using HPLC, but there was a moderate rise in accordance with the age of the stains. A statistically significant difference was found for bloodstains on clothes compared to those on glass surfaces. Receiver operating curve analysis found a sensitivity of 1.0 and specificity of 0.923 (cut-off 6.55) for glass surfaces on the seventh day; a sensitivity of 1.0, a specificity of 0.846 (cut-off 6.45) for clothes on the seventh day; a sensitivity of 1.0 and a specificity of 0.923 (cut-off 6.85) for clothes on the 56th day; and a sensitivity of 1.0 and a specificity of 0.846 (cut-off 7.55) for glass surfaces on the 56th day. In conclusion, this study found that HbA1c levels could be measured with high reliability from forensic bloodstains by using HPLC. Thus, in cases where DNA data banks cannot identify individuals, it would make sense to turn to those who have a medical history of diabetes among the suspects with the results of high HbA1c levels.
Collapse
Affiliation(s)
- Kemalettin Acar
- Department of Forensic Medicine, Faculty of Medicine, Pamukkale University, Turkey
| | - Ayse Kurtulus Dereli
- Department of Forensic Medicine, Faculty of Medicine, Pamukkale University, Turkey
| | - Esin Avci
- Department of Medical Biochemistry, Faculty of Medicine, Pamukkale University, Turkey
| | - Volkan Zeybek
- Department of Forensic Medicine, Faculty of Medicine, Pamukkale University, Turkey
| | - Erdi Kutlu
- Department of Forensic Medicine, Faculty of Medicine, Pamukkale University, Turkey
| | - Süleyman Demir
- Department of Medical Biochemistry, Faculty of Medicine, Pamukkale University, Turkey
| | - Hande Senol
- Department of Biostatistics, Faculty of Medicine, Pamukkale University, Turkey
| |
Collapse
|
472
|
Influence of education training in patients with type 2 diabetes in the improvement of lifestyle and biochemical characteristics: a randomized controlled trial. FRONTIERS OF NURSING 2019. [DOI: 10.2478/fon-2019-0046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Abstract
Objective
The objective of this randomized controlled trial study was to evaluate the education training in relation to lifestyle improvement in patients with type 2 diabetes through its influence in the levels of glycated hemoglobin (HbA1c), blood pressure, triglyceride, cholesterol levels, and body mass index (BMI).
Methods
The study included patients with type 2 diabetes randomly selected from 20 residential areas in Tirana, Albania where family physicians provide services. The sample size in total was 200 patients in both groups (control and intervention). The education training (four sessions) was conducted by trained nursing staff for 6 months. Patients were screened for the biochemical profile before and after the intervention. To compare the groups with respect to the interest outcomes, the t-test was used. The value of P < 0.05 was considered significant.
Results
There were 104 male patients and 96 female patients. The mean age was 54.9 ± 8.7. No significant differences were found between the study groups in relation to clinical and biochemical data before the education sessions. After the intervention, in the intervention group, the mean level of HbA1c was significantly lower than the value in the control group (6.2% vs 6.8%, P = 0.001) as well as for the mean values of BMI. The mean reduction (more than 15%) in HbA1c after the intervention was 43% in the intervention group and 2% in the control group (OR = 36.9, P < 0.05). Differences in BMI, HbA1c, triglycerides, and cholesterol were more significantly visible in the intervention group. However, the difference in systolic and diastolic blood pressure values was almost the same (P > 0.05).
Conclusions
The results of this study further support that the approach for education of patients with type 2 diabetes on changing lifestyle benefit the patient in controlling diabetes. It is believed that the establishment of diabetes education classes in health centers is an important investment in improving the management of type 2 diabetes.
Collapse
|
473
|
Ivanov AN, Popyhova EB, Stepanova TV, Pronina EA, Lagutina DD. Changes in microcirculation induced by autotransplantation of skin flaps in experimental diabetes mellitus rats. ACTA ACUST UNITED AC 2019. [DOI: 10.24884/1682-6655-2019-18-4-72-80] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction. Micro- and macroangiopathies significantly reduce the duration and quality of life for diabetes mellitus (DM) patients, which determines the relevance of developing new ways to treat them, including non-drug ones. One of such methods is the autotransplantation of full-thickness skin flap providing a distant stimulating effect on microcirculation.The aim of the study was to investigate the influence of skin flap autotransplantation on microcirculation at alloxan insulin deficiency in white rats.Material and methods. The studies were carried out on 60 male scrub rats divided into the following groups: the control group, the comparison group (alloxan diabetes rats), the experimental group consisting of alloxan diabetes animals which had skin flap autotransplantations performed on them. Skin microcirculation (MC) of the dorsum of the feet was studied by laser Doppler flowmetry.Results. Alloxan insulin deficiency caused a violation of the MC in rats which manifested by a decrease in perfusion of the skin of the dorsum of the foot in association with a decrease in the amplitudes of endothelial and neurogenic oscillations. On the 42nd day of the experiment in alloxan diabetes animals which had skin flap autotransplantations performed on them the statistically significant increase (p=0.000001) in the perfusion index by 43 % was observed attesting to microcirculation improvment. This was accompanied by an increase in the normalized amplitudes value of endothelial (by 44 %, р=0.000047) and neurogenic (by 20 %, р=0.019515) perfusion fluctuations relative to rats of the comparison group.Conclusions. It can be concluded that skin flap autotransplantation has a positive effect on the state of MC in the feet in experimental diabetes rats due to the improvement of tissue perfusion and modulation of its activity.
Collapse
Affiliation(s)
- A. N. Ivanov
- Saratov State Medical University named after V. I. Razumovsky
| | - E. B. Popyhova
- Saratov State Medical University named after V. I. Razumovsky
| | - T. V. Stepanova
- Saratov State Medical University named after V. I. Razumovsky
| | - E. A. Pronina
- Saratov State Medical University named after V. I. Razumovsky
| | - D. D. Lagutina
- Saratov State Medical University named after V. I. Razumovsky
| |
Collapse
|
474
|
Sriwimol W, Choosongsang P, Choosongsang P, Treerut P, Muenniam B, Makkong P, Pocathikorn A. Strong correlation and high comparability of capillary electrophoresis and three different methods for HbA1c measurement in a population without hemoglobinopathy. Scandinavian Journal of Clinical and Laboratory Investigation 2019; 80:139-150. [PMID: 31841038 DOI: 10.1080/00365513.2019.1703213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present study aimed to investigate the comparability of capillary electrophoresis (CE) and three different methods for HbA1c measurement. The 270 whole blood samples with normal hemoglobin profiles were analyzed for HbA1c values by the Roche turbidimetric inhibition immunoassay (TINIA), the Mindray enzymatic assay (EA), the Arkray high-performance liquid chromatography (HPLC) in comparison with the Sebia CE. The within-laboratory coefficient of variation of all four methods was within the accepted goal (<2%), showing good performance of all of these methods. Pairwise comparisons of HbA1c values obtained by CE and other methods were determined in both total group and subgroups (HbA1c levels of <6.5%, 6.5-8% and >8%). Mean differences of HbA1c values in all groups were very small in which the mean HbA1c value measured by EA was lower while those by TINIA and HPLC were higher than that of CE. The majority of different values were within the limits of agreement in Bland-Altman analysis, indicating good agreement between CE and the others. Less than 5% of percentage differences were out of the total allowable error limit in all groups, showing that differences of HbA1c values between CE and other methods were not clinically significant. Pairwise comparisons of HbA1c values of CE and the others in Passing-Bablok regression and Spearman rank correlation studies displayed high concordance and strong correlation in all groups. In conclusion, the present study showed strong correlation, high comparability and consistent results for HbA1c measurement between capillary electrophoresis and the other three different methods.
Collapse
Affiliation(s)
- Wilaiwan Sriwimol
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| | - Pensiri Choosongsang
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| | - Phattanapong Choosongsang
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| | - Pittaya Treerut
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| | - Baralee Muenniam
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| | - Paspimon Makkong
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| | - Anothai Pocathikorn
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| |
Collapse
|
475
|
|
476
|
Kalam F, Gabel K, Cienfuegos S, Wiseman E, Ezpeleta M, Steward M, Pavlou V, Varady KA. Alternate day fasting combined with a low-carbohydrate diet for weight loss, weight maintenance, and metabolic disease risk reduction. Obes Sci Pract 2019; 5:531-539. [PMID: 31890243 PMCID: PMC6934424 DOI: 10.1002/osp4.367] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Alternate day fasting (ADF) is a popular weight loss regimen. Whether carbohydrate restriction can enhance the weight loss achieved with ADF remains unclear. Accordingly, this study examined the effect of ADF combined with a low-carbohydrate diet on body weight and metabolic disease risk factors. METHODS Adults with obesity (n = 31) participated in ADF (600 kcal "fast day" alternated with an ad libitum "feast day") with a low-carbohydrate background diet (30% carbohydrates, 35% protein, and 35% fat). The 6-month trial consisted of a 3-month weight loss period followed by a 3-month weight maintenance period. RESULTS Body weight decreased (-5.5 ± 0.5%; P < .001) during the weight loss period (month 0-3) but remained stable (P = .57) during the weight maintenance period (month 4-6). Net weight loss by month 6 was -6.3 ± 1.0%. Fat mass was reduced (P < .01) by month 6, while lean mass and visceral fat mass remained unchanged. Total cholesterol and low-density lipoprotein (LDL) cholesterol levels decreased (P < .05) by -6 ± 2% and - 8 ± 3%, respectively, by month 6. Systolic blood pressure was also reduced (P = .03) by -7 ± 3 mm Hg. Fasting insulin decreased (P = .03) by -24 ± 8% by month 6 relative to baseline. High-density lipoprotein (HDL) cholesterol, triglycerides, diastolic blood pressure, heart rate, fasting glucose, homeostatic model assessment of insulin resistance (HOMA-IR), and haemoglobin A1C (HbA1c) remained unchanged. CONCLUSIONS These findings suggest that ADF combined with a low-carbohydrate diet is effective for weight loss, weight maintenance, and improving certain metabolic disease risk factors such as LDL cholesterol, blood pressure, and fasting insulin. While these preliminary findings are promising, they still require confirmation by a randomized control trial.
Collapse
Affiliation(s)
- Faiza Kalam
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinois
| | - Kelsey Gabel
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinois
| | - Sofia Cienfuegos
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinois
| | - Eric Wiseman
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinois
| | - Mark Ezpeleta
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinois
| | - Malik Steward
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinois
| | - Vasiliki Pavlou
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinois
| | - Krista A. Varady
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinois
| |
Collapse
|
477
|
Šimić S, Svaguša T, Prkačin I, Bulum T. Relationship between hemoglobin A1c and serum troponin in patients with diabetes and cardiovascular events. J Diabetes Metab Disord 2019; 18:693-704. [PMID: 31890693 PMCID: PMC6915172 DOI: 10.1007/s40200-019-00460-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 10/24/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Diabetes mellitus is a group of metabolic disorders associated with high risk for cardiovascular disease. Although troponins are primarily clinically used for the diagnosis of acute coronary syndrome, they are also used in risk assessment in patients with acute coronary syndrome as well as in a number of other conditions. The aim of this review was to investigate the relationship between hemoglobin A1c and serum troponin in patients with diabetes and cardiovascular events. METHODS Hemoglobin A1c has been chosen as the best clinical indicator of glucose control and risk of micro and macrovascular complications. We investigated cardiac troponins as a group of markers of muscle injury which includes troponin T, troponin I and troponin C. Troponin T and I are specific for myocardial injury, compared to C which is specific for skeletal muscle. RESULTS In this review, we showed that there was a causal relation between hemoglobin A1c levels and serum troponin concentrations. Hemoglobin A1c has shown to be a positive predictive factor of incidence, mortality and morbidity of conditions such as acute coronary syndrome, arrhythmias, stroke, pulmonary embolism and other conditions that causes troponin elevation by its release in circulation. CONCLUSIONS Chronic hyperglycemia decreases glomerular filtration and consequently decreases troponin elimination and also by affecting the heart microcirculation it leads to microvascular damage and consequently to ischemia which contribute to troponin concentration elevation. Furthermore, correlation between hemoglobin A1c and troponin concentration manifests in their prognostic value for mortality.
Collapse
Affiliation(s)
- Stjepan Šimić
- School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia
| | - Tomo Svaguša
- School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia
- Department of Internal Medicine, Dubrava University Hospital, Zagreb, Croatia
| | - Ingrid Prkačin
- School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia
- Department of Internal Medicine, Merkur University Hospital, Zagreb, Croatia
| | - Tomislav Bulum
- School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia
- Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia
| |
Collapse
|
478
|
Bonfili L, Cecarini V, Gogoi O, Berardi S, Scarpona S, Angeletti M, Rossi G, Eleuteri AM. Gut microbiota manipulation through probiotics oral administration restores glucose homeostasis in a mouse model of Alzheimer's disease. Neurobiol Aging 2019; 87:35-43. [PMID: 31813629 DOI: 10.1016/j.neurobiolaging.2019.11.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 11/04/2019] [Accepted: 11/04/2019] [Indexed: 01/07/2023]
Abstract
Cerebral glucose homeostasis deregulation has a role in the pathogenesis and the progression of Alzheimer's disease (AD). Current therapies delay symptoms without definitively curing AD. We have previously shown that probiotics counteract AD progression in 3xTg-AD mice modifying gut microbiota and inducing energy metabolism and glycolysis-gluconeogenesis. Ameliorated cognition is based on higher neuroprotective gut hormones concentrations, reduced amyloid-β burden, and restored proteolytic pathways. Here, we demonstrate that probiotics oral administration improves glucose uptake in 3xTg-AD mice by restoring the brain expression levels of key glucose transporters (GLUT3, GLUT1) and insulin-like growth factor receptor β, in accordance with the diminished phosphorylation of adenosine monophosphate-activated protein kinase and protein-kinase B (Akt). In parallel, phosphorylated tau aggregates decrease in treated mice. Probiotics counteract the time-dependent increase of glycated hemoglobin and the accumulation of advanced glycation end products in AD mice, consistently with memory improvement. Collectively, our data elucidate the mechanism through which gut microbiota manipulation ameliorates impaired glucose metabolism in AD, finally delaying the disease progression.
Collapse
Affiliation(s)
- Laura Bonfili
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino (MC), Italy.
| | - Valentina Cecarini
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino (MC), Italy
| | - Olee Gogoi
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino (MC), Italy
| | - Sara Berardi
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino (MC), Italy
| | - Silvia Scarpona
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino (MC), Italy
| | - Mauro Angeletti
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino (MC), Italy
| | - Giacomo Rossi
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino (MC), Italy
| | - Anna Maria Eleuteri
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino (MC), Italy
| |
Collapse
|
479
|
AlQarni K, AlQarni EA, Naqvi AA, AlShayban DM, Ghori SA, Haseeb A, Raafat M, Jamshed S. Assessment of Medication Adherence in Saudi Patients With Type II Diabetes Mellitus in Khobar City, Saudi Arabia. Front Pharmacol 2019; 10:1306. [PMID: 31787894 PMCID: PMC6856211 DOI: 10.3389/fphar.2019.01306] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 10/15/2019] [Indexed: 01/19/2023] Open
Abstract
Objective: Medication adherence is defined as taking medications as advised and prescribed by health care professionals for stated duration. Diabetes mellitus (DM) is one of the most common chronic illnesses in Saudi Arabia. This study aimed to document medication adherence in Saudi patients with type 2 diabetes. Methods: A quantitative cross-sectional study was conducted in Saudi out-patients with type 2 DM in the city of Khobar, Saudi Arabia. The study used the General Medication Adherence Scale (GMAS) to document medication adherence in this population. Data was analyzed through SPSS version 23. Study was ethically approved. Results: Data was collected from 212 patients. Few patients (35.8%) had high adherence to anti diabetic medications. The correlation between HbA1c level and adherence score was negative and significantly strong (ρ = -0.413, p < 0.0001). Most patients (N = 126, 59.4%) modified their medication therapy during month of Ramadan and on Eid occassion. Education level was not a determinant of adherence in this population. Conclusion: This study highlighted that medication adherence is influenced by religious and social factors. Patient counseling is required to improve patient beliefs and increase awareness of adhering to prescribed anti diabetic pharmacotherapy. A pharmacist can play constructive role of a disease educator and patient counselor.
Collapse
Affiliation(s)
- Khaled AlQarni
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Elham A AlQarni
- Obstetrics and Gynecology, King Fahd Military Medical Complex, Dammam, Saudi Arabia
| | - Atta Abbas Naqvi
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Dhfer Mahdi AlShayban
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Syed Azizullah Ghori
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdul Haseeb
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia
| | - Mohamed Raafat
- Department of Pharmacology & Toxicology, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia
| | - Shazia Jamshed
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia.,Qualitative Research-Methodological Application in Health Sciences Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
| |
Collapse
|
480
|
Metabolomics profiles associated with HbA1c levels in patients with type 2 diabetes. PLoS One 2019; 14:e0224274. [PMID: 31697702 PMCID: PMC6837371 DOI: 10.1371/journal.pone.0224274] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/09/2019] [Indexed: 01/05/2023] Open
Abstract
Glycated hemoglobin (HbA1c) is an indicator of the average blood glucose concentration. Failing to control HbA1c levels can accelerate the development of complications in patients with diabetes. Although metabolite profiles associated with HbA1c level in diabetes patients have been characterized using different platforms, more studies using high-throughput technology will be helpful to identify additional metabolites related to diabetes. Type 2 diabetes (T2D) patients were divided into two groups based on the HbA1c level: normal (HbA1c ≤6%) and high (HbA1c ≥9%) in both discovery and replication sets. A targeted metabolomics approach was used to quantify serum metabolites and multivariate logistic regression was used to identify significant differences between groups. The concentrations of 22 metabolites differed significantly between the two groups in the discovery set. In the replication set, the levels of 21 metabolites, including 16 metabolites identified in the discovery set, differed between groups. Among these, concentrations of eleven amino acids and one phosphatidylcholine (PC), lysoPC a C16:1, were higher and four metabolites, including three PCs (PC ae C36:1, PC aa C26:0, PC aa C34:2) and hexose, were lower in the group with normal HbA1c group than in the group with high HbA1c. Metabolites with high concentrations in the normal HbA1c group, such as glycine, valine, and PCs, may contribute to reducing HbA1c levels in patients with T2D. The metabolite signatures identified in this study provide insight into the mechanisms underlying changes in HbA1c levels in T2D.
Collapse
|
481
|
Gabriel RA, Hylton DJ, Burton BN, H Schmidt U, Waterman RS. The association of preoperative haemoglobin A1c with 30-day postoperative surgical site infection following non-cardiac surgery. J Perioper Pract 2019; 30:320-325. [PMID: 31694470 DOI: 10.1177/1750458919886183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Diabetes has been shown to be associated with postoperative infections; however, the association of haemoglobin A1c (HbA1c) with postoperative surgical site infections (SSI) is unclear. All HbA1c data from patients receiving general, vascular, or orthopaedic surgeries between 1 January 2014 and 1 December 2016 were identified from hospital records. The primary outcome was 30-day SSI. Multivariable logistic regression was performed to determine if HbA1c was associated with infection. The cohorts assessed were: (1) HbA1c < 6.5% (reference group); (2) greater than or equal to 6.5% and less than 8.0%; (3) greater than or equal to 8.0% and less than 10.0%; and (4) greater than or equal to 10.0%. There were 3064 patients included in the final analysis. The overall rate of 30-day SSI was 2.42%. After adjusting for confounders, when compared to the reference group, HbA1c ≥ 8.0% and less than 10.0% (OR 2.4, 95% CI 1.2-4.7, p = 0.015) and HbA1c ≥ 10.0% (OR 3.0, 95% CI 1.2-7.3, p = 0.016) had increased odds ratio for 30-day SSI. A HbA1c of 8.0% or higher significantly increased the odds ratio of developing postoperative SSI (p < 0.05). This may aid in the development of guidelines for optimising diabetic patients.
Collapse
Affiliation(s)
- Rodney A Gabriel
- Department of Anesthesiology, University of California, San Diego, CA, USA.,Department of Biomedical Informatics, University of California, San Diego, CA, USA
| | - Diana J Hylton
- Department of Anesthesiology, University of California, San Diego, CA, USA
| | - Brittany N Burton
- Department of Anesthesiology, University of California, Los Angeles, CA, USA
| | - Ulrich H Schmidt
- Department of Anesthesiology, University of California, San Diego, CA, USA
| | - Ruth S Waterman
- Department of Anesthesiology, University of California, San Diego, CA, USA
| |
Collapse
|
482
|
Ofori-Asenso R, Liew D, Lalic S, Mazidi M, Magliano DJ, Ademi Z, Bell JS, Ilomaki J. Adherence, Persistence, and Switching Among People Prescribed Sodium Glucose Co-transporter 2 Inhibitors: A Nationwide Retrospective Cohort Study. Adv Ther 2019; 36:3265-3278. [PMID: 31482509 DOI: 10.1007/s12325-019-01077-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Non-adherence and non-persistence to diabetes medications are associated with worse clinical outcomes. In this study, we aimed to characterise the 1-year switching, adherence, and persistence patterns among people with diabetes aged 18 years and older prescribed sodium-glucose co-transporter 2 inhibitors (SGLT2is) in Australia. METHODS Using data from Australia's national Pharmaceutical Benefits Scheme (PBS), we identified 11,981 adults (mean age 60.9 years; 40.5% female) newly initiated on SGLT2is (5993 dapagliflozin; 5988 empagliflozin) from September 2015 to August 2017. Adherence was assessed via the proportion of days covered (PDC), persistence was defined as the continuous use of SGLT2i without a gap of ≥ 90 days, and switching was defined as the first change from dapagliflozin to empagliflozin or vice versa. Generalised linear models (GLMs) were used to compare the adherence (PDC = continuous), logistic regression models were used to compare the likelihoods of being adherent (PDC ≥ 0.80), and Cox proportional hazard models were used to compare the likelihoods of persistence and switching between people prescribed empagliflozin and dapagliflozin. RESULTS Overall, 65.8% (7879/11,981) of people dispensed SGLT2is were adherent (PDC ≥ 0.80) and 72.1% (8644/11,981) were persistent at 12 months. The mean PDC was 0.79 ± 0.27. The use of empagliflozin was associated with higher adherence (PDC = continuous) [odds ratio (OR) 1.04, 95% confidence interval (CI) 1.03-1.05], being adherent (OR 1.39, 95% CI 1.29-1.51), and persisting for 12 months [hazard ratio (HR) 1.14, 95% CI 1.06-1.22] compared with dapagliflozin. Only 4.3% (509/11,981) of people switched between the SGLT2i. Compared with dapagliflozin, people initiated on empagliflozin were less likely to switch [HR 0.46, 95% CI 0.38-0.55]. CONCLUSIONS A considerable proportion of Australians prescribed SGLT2is were non-adherent or non-persistent. However, empagliflozin was associated with better adherence and persistence rates and a lower likelihood of switching compared with dapagliflozin.
Collapse
Affiliation(s)
- Richard Ofori-Asenso
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Danny Liew
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Samanta Lalic
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia
| | - Mohsen Mazidi
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Dianna J Magliano
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Zanfina Ademi
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - J Simon Bell
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - Jenni Ilomaki
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
483
|
Ervin C, Joish VN, Evans E, DiBenedetti D, Reaney M, Preblick R, Castro R, Danne T, Buse JB, Lapuerta P. Insights Into Patients' Experience With Type 1 Diabetes: Exit Interviews From Phase III Studies of Sotagliflozin. Clin Ther 2019; 41:2219-2230.e6. [DOI: 10.1016/j.clinthera.2019.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 10/25/2022]
|
484
|
Dhama K, Latheef SK, Dadar M, Samad HA, Munjal A, Khandia R, Karthik K, Tiwari R, Yatoo MI, Bhatt P, Chakraborty S, Singh KP, Iqbal HMN, Chaicumpa W, Joshi SK. Biomarkers in Stress Related Diseases/Disorders: Diagnostic, Prognostic, and Therapeutic Values. Front Mol Biosci 2019; 6:91. [PMID: 31750312 PMCID: PMC6843074 DOI: 10.3389/fmolb.2019.00091] [Citation(s) in RCA: 136] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/11/2019] [Indexed: 02/05/2023] Open
Abstract
Various internal and external factors negatively affect the homeostatic equilibrium of organisms at the molecular to the whole-body level, inducing the so-called state of stress. Stress affects an organism's welfare status and induces energy-consuming mechanisms to combat the subsequent ill effects; thus, the individual may be immunocompromised, making them vulnerable to pathogens. The information presented here has been extensively reviewed, compiled, and analyzed from authenticated published resources available on Medline, PubMed, PubMed Central, Science Direct, and other scientific databases. Stress levels can be monitored by the quantitative and qualitative measurement of biomarkers. Potential markers of stress include thermal stress markers, such as heat shock proteins (HSPs), innate immune markers, such as Acute Phase Proteins (APPs), oxidative stress markers, and chemical secretions in the saliva and urine. In addition, stress biomarkers also play critical roles in the prognosis of stress-related diseases and disorders, and therapy guidance. Moreover, different components have been identified as potent mediators of cardiovascular, central nervous system, hepatic, and nephrological disorders, which can also be employed to evaluate these conditions precisely, but with stringent validation and specificity. Considerable scientific advances have been made in the detection, quantitation, and application of these biomarkers. The present review describes the current progress of identifying biomarkers, their prognostic, and therapeutic values.
Collapse
Affiliation(s)
- Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Shyma K. Latheef
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Karaj, Iran
| | - Hari Abdul Samad
- Division of Physiology and Climatology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Ashok Munjal
- Department of Genetics, Barkatullah University, Bhopal, India
| | - Rekha Khandia
- Department of Genetics, Barkatullah University, Bhopal, India
| | - Kumaragurubaran Karthik
- Central University Laboratory, Tamil Nadu Veterinary and Animal Sciences University, Chennai, India
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, UP Pandit Deen Dayal Upadhayay Pashu Chikitsa Vigyan Vishwavidyalay Evum Go-Anusandhan Sansthan, Mathura, India
| | - Mohd. Iqbal Yatoo
- Division of Veterinary Clinical Complex, Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Srinagar, India
| | - Prakash Bhatt
- Teaching Veterinary Clinical Complex, College of Veterinary and Animal Sciences, Govind Ballabh Pant University of Agriculture and Technology, Pantnagar, India
| | - Sandip Chakraborty
- Department of Veterinary Microbiology, College of Veterinary Sciences and Animal Husbandry, Agartala, India
| | - Karam Pal Singh
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Hafiz M. N. Iqbal
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey, Mexico
| | - Wanpen Chaicumpa
- Department of Parasitology, Faculty of Medicine, Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sunil Kumar Joshi
- Division of Hematology, Oncology and Bone Marrow Transplantation, Department of Microbiology & Immunology, Department of Pediatrics, University of Miami School of Medicine, Miami, FL, United States
| |
Collapse
|
485
|
Dhama K, Latheef SK, Dadar M, Samad HA, Munjal A, Khandia R, Karthik K, Tiwari R, Yatoo MI, Bhatt P, Chakraborty S, Singh KP, Iqbal HMN, Chaicumpa W, Joshi SK. Biomarkers in Stress Related Diseases/Disorders: Diagnostic, Prognostic, and Therapeutic Values. Front Mol Biosci 2019. [PMID: 31750312 DOI: 10.3389/fmolb.2019.0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Various internal and external factors negatively affect the homeostatic equilibrium of organisms at the molecular to the whole-body level, inducing the so-called state of stress. Stress affects an organism's welfare status and induces energy-consuming mechanisms to combat the subsequent ill effects; thus, the individual may be immunocompromised, making them vulnerable to pathogens. The information presented here has been extensively reviewed, compiled, and analyzed from authenticated published resources available on Medline, PubMed, PubMed Central, Science Direct, and other scientific databases. Stress levels can be monitored by the quantitative and qualitative measurement of biomarkers. Potential markers of stress include thermal stress markers, such as heat shock proteins (HSPs), innate immune markers, such as Acute Phase Proteins (APPs), oxidative stress markers, and chemical secretions in the saliva and urine. In addition, stress biomarkers also play critical roles in the prognosis of stress-related diseases and disorders, and therapy guidance. Moreover, different components have been identified as potent mediators of cardiovascular, central nervous system, hepatic, and nephrological disorders, which can also be employed to evaluate these conditions precisely, but with stringent validation and specificity. Considerable scientific advances have been made in the detection, quantitation, and application of these biomarkers. The present review describes the current progress of identifying biomarkers, their prognostic, and therapeutic values.
Collapse
Affiliation(s)
- Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Shyma K Latheef
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Karaj, Iran
| | - Hari Abdul Samad
- Division of Physiology and Climatology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Ashok Munjal
- Department of Genetics, Barkatullah University, Bhopal, India
| | - Rekha Khandia
- Department of Genetics, Barkatullah University, Bhopal, India
| | - Kumaragurubaran Karthik
- Central University Laboratory, Tamil Nadu Veterinary and Animal Sciences University, Chennai, India
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, UP Pandit Deen Dayal Upadhayay Pashu Chikitsa Vigyan Vishwavidyalay Evum Go-Anusandhan Sansthan, Mathura, India
| | - Mohd Iqbal Yatoo
- Division of Veterinary Clinical Complex, Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Srinagar, India
| | - Prakash Bhatt
- Teaching Veterinary Clinical Complex, College of Veterinary and Animal Sciences, Govind Ballabh Pant University of Agriculture and Technology, Pantnagar, India
| | - Sandip Chakraborty
- Department of Veterinary Microbiology, College of Veterinary Sciences and Animal Husbandry, Agartala, India
| | - Karam Pal Singh
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Hafiz M N Iqbal
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey, Mexico
| | - Wanpen Chaicumpa
- Department of Parasitology, Faculty of Medicine, Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sunil Kumar Joshi
- Division of Hematology, Oncology and Bone Marrow Transplantation, Department of Microbiology & Immunology, Department of Pediatrics, University of Miami School of Medicine, Miami, FL, United States
| |
Collapse
|
486
|
Low-Energy Extracorporeal Shock Wave Ameliorates Streptozotocin Induced Diabetes and Promotes Pancreatic Beta Cells Regeneration in a Rat Model. Int J Mol Sci 2019; 20:ijms20194934. [PMID: 31590394 PMCID: PMC6801760 DOI: 10.3390/ijms20194934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 01/03/2023] Open
Abstract
Traditional therapy for diabetes mellitus has focused on supportive treatment, and is not significant in the promotion of pancreatic beta cells regeneration. We investigated the effect of low- energy extracorporeal shock wave (SW) on a streptozotocin induced diabetes (DM) rat model. Methods: The DM rats were treated with ten sessions of low-energy SW therapy (weekly for ten consecutive weeks) or left untreated. We assessed blood glucose, hemoglobin A1c (HbA1c), urine volume, pancreatic islets area, c-peptide, glucagon-like peptide 1 (GLP-1) and insulin production, beta cells number, pancreatic tissue inflammation, oxidative stress, apoptosis, angiogenesis, and stromal cell derived factor 1 (SDF-1) ten weeks after the completion of treatment. Results: The ten- week low-energy SW therapy regimen significantly reduced blood glucose, HbA1c, and urine volume as well as significantly enhancing pancreatic islets area, c-peptide, GLP-1, and insulin production in the rat model of DM. Moreover, low-energy SW therapy increased the beta cells number in DM rats. This was likely primarily attributed to the fact that low-energy SW therapy reduced pancreatic tissue inflammation, apoptosis, and oxidative stress as well as increasing angiogenesis, cell proliferation, and tissue repair potency. Conclusions: Low-energy SW therapy preserved pancreatic islets function in streptozotocin-induced DM. Low-energy SW therapy may serve as a novel noninvasive and effective treatment of DM.
Collapse
|
487
|
Kamal YA. Optimal HbA1c Threshold to Predict Post-Operative Mortality. Turk J Anaesthesiol Reanim 2019; 47:429-430. [PMID: 31572999 DOI: 10.5152/tjar.2019.58897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 11/23/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
- Yasser Ali Kamal
- Department of Cardiothoracic Surgery, Minia University, El-Minya, Egypt
| |
Collapse
|
488
|
A multi-source data integration approach reveals novel associations between metabolites and renal outcomes in the German Chronic Kidney Disease study. Sci Rep 2019; 9:13954. [PMID: 31562371 PMCID: PMC6764972 DOI: 10.1038/s41598-019-50346-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 09/09/2019] [Indexed: 01/25/2023] Open
Abstract
Omics data facilitate the gain of novel insights into the pathophysiology of diseases and, consequently, their diagnosis, treatment, and prevention. To this end, omics data are integrated with other data types, e.g., clinical, phenotypic, and demographic parameters of categorical or continuous nature. We exemplify this data integration issue for a chronic kidney disease (CKD) study, comprising complex clinical, demographic, and one-dimensional 1H nuclear magnetic resonance metabolic variables. Routine analysis screens for associations of single metabolic features with clinical parameters while accounting for confounders typically chosen by expert knowledge. This knowledge can be incomplete or unavailable. We introduce a framework for data integration that intrinsically adjusts for confounding variables. We give its mathematical and algorithmic foundation, provide a state-of-the-art implementation, and evaluate its performance by sanity checks and predictive performance assessment on independent test data. Particularly, we show that discovered associations remain significant after variable adjustment based on expert knowledge. In contrast, we illustrate that associations discovered in routine univariate screening approaches can be biased by incorrect or incomplete expert knowledge. Our data integration approach reveals important associations between CKD comorbidities and metabolites, including novel associations of the plasma metabolite trimethylamine-N-oxide with cardiac arrhythmia and infarction in CKD stage 3 patients.
Collapse
|
489
|
Mobile Health for Diagnosis-PixoTest HbA1c POCT System. J Med Biol Eng 2019. [DOI: 10.1007/s40846-019-00488-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
490
|
Akram Z, Alqahtani F, Alqahtani M, Al‐Kheraif AA, Javed F. Levels of advanced glycation end products in gingival crevicular fluid of chronic periodontitis patients with and without type‐2 diabetes mellitus. J Periodontol 2019; 91:396-402. [DOI: 10.1002/jper.19-0209] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/05/2019] [Accepted: 07/07/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Zohaib Akram
- Department of Oral Restorative and Rehabilitative Sciences UWA Dental School The University of Western Australia Crawley WA Australia
| | - Fawaz Alqahtani
- Department of Prosthodontics School of Dentistry Prince Sattam Bin Abdul‐Aziz University Al‐Kharj Kingdom of Saudi Arabia
| | - Mana Alqahtani
- Faculty of Medicine University of Tabuk Tabouk Kingdom of Saudi Arabia
| | - Abdulaziz A. Al‐Kheraif
- Dental Biomaterials Research Chair Dental Health Department College of Applied Medical Sciences King Saud University Riyadh Kingdom of Saudi Arabia
| | - Fawad Javed
- Department of Orthodontics Eastman Institute for Oral Health University of Rochester New York NY USA
| |
Collapse
|
491
|
Mulder D, Phiri MM, Vorster BC. Tailor-made gold nanostar colorimetric detection determined by morphology change and used as an indirect approach by using hydrogen peroxide to determine glucose concentration. SENSING AND BIO-SENSING RESEARCH 2019. [DOI: 10.1016/j.sbsr.2019.100296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
|
492
|
Fugger G, Dold M, Bartova L, Kautzky A, Souery D, Mendlewicz J, Serretti A, Zohar J, Montgomery S, Frey R, Kasper S. Major Depression and Comorbid Diabetes - Findings from the European Group for the Study of Resistant Depression. Prog Neuropsychopharmacol Biol Psychiatry 2019; 94:109638. [PMID: 31054944 DOI: 10.1016/j.pnpbp.2019.109638] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/01/2019] [Accepted: 04/30/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The major aim of this multicenter study of the European Group for the Study of Resistant Depression (GSRD) was to elucidate associations between major depressive disorder (MDD) and comorbid diabetes. METHODS Demographic and clinical information of 1410 patients with a primary MDD diagnosis according to DSM-IV were retrieved cross-sectionally between 2012 and 2016. By applying descriptive statistics, analyses of covariance (ANCOVA) and binary logistic regression analyses, a comparison between patient characteristics with and without comorbid diabetes was performed. RESULTS The point prevalence rate for comorbid diabetes across MDD patients was 6%. Individuals with MDD + comorbid diabetes were significantly older, heavier, more likely to be inpatient and diagnosed with additional comorbid chronic somatic diseases. In addition, current suicide risk was significantly increased and melancholic features were more likely pronounced. In general, patients in the MDD + diabetes group received a combination therapy with at least one additional antidepressant rather than various other augmentation strategies. CONCLUSION Our analyses depict a lower prevalence rate of diabetes in MDD patients than previous studies. However, in light of the prevalence of diabetes in the geographical area of the study, we found an increased risk for individuals with depression compared to the general population. Current suicide risk is markedly elevated and has to be thoroughly assessed in every patient with comorbid diabetes. Depression severity and treatment response remained unaffected by concurrent diabetes in MDD.
Collapse
Affiliation(s)
- Gernot Fugger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Markus Dold
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Lucie Bartova
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Alexander Kautzky
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Daniel Souery
- Université Libre de Bruxelles, Bruxelles, Belgium; Psy Pluriel Centre Européen de Psychologie Médicale, Bruxelles, Belgium
| | | | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Joseph Zohar
- Psychiatric Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | | | - Richard Frey
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
| |
Collapse
|
493
|
Alomar MJ, Al-Ansari KR, Hassan NA. Comparison of awareness of diabetes mellitus type II with treatment's outcome in term of direct cost in a hospital in Saudi Arabia. World J Diabetes 2019; 10:463-472. [PMID: 31523382 PMCID: PMC6715573 DOI: 10.4239/wjd.v10.i8.463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/08/2015] [Accepted: 07/20/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Saudi Arabia is among the top 10 countries with the highest prevalence of diabetes. Cost of prevention and the indirect cost must be calculated to increase the awareness of society and to emphasize disease prevention and limit further complications. AIM To understand the importance of awareness and the impact on the expenditure of diabetes mellitus and treatments outcomes. METHODS A prospective descriptive and comparative survey was carried out among patients with diabetes mellitus in Saudi Arabia. RESULTS One hundred and one participants were included in the study of which 40% were female and one third were above the age of 50. The mean of the first HbA1c reading was 6.95, and the median was 7. The mean of the second reading of HbA1c was 7.26, and the median was 7. The mean body mass index was 32.1, and the median was 30.9. The average yearly cost of the medication was 995.14 SR. Comparing participants who think that a healthy low-sugar diet can affect blood sugar with those who do not, showed a statistically significant difference when cost was considered (P value = 0.03). Also, when comparing the group of participants who know when to take their oral hyperglycemic medicine and their yearly direct cost and those who do not know when to take it, by using independent sample T test, showed significant statistical difference (P value = 0.046). CONCLUSION It is essential for the governments to invest in ways to prevent and help in the early detection of such an expensive disease by performing national screening and education programs. Many pharmaco-economic studies can be done to help the decision-maker in our hospitals think about strategies to help the patient to be physically fit by offering gymnasium or places to walk or contract.
Collapse
Affiliation(s)
- Muaed Jamal Alomar
- Clinical Pharmacy Department, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Khadeja Rashed Al-Ansari
- Clinical Pharmacy Department, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Najeeb A Hassan
- Clinical Pharmacy Department, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| |
Collapse
|
494
|
Wu T, Seaver P, Lemus H, Hollenbach K, Wang E, Pierce JP. Associations between Dietary Acid Load and Biomarkers of Inflammation and Hyperglycemia in Breast Cancer Survivors. Nutrients 2019; 11:nu11081913. [PMID: 31443226 PMCID: PMC6723571 DOI: 10.3390/nu11081913] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/31/2019] [Accepted: 08/09/2019] [Indexed: 12/12/2022] Open
Abstract
Metabolic acidosis can lead to inflammation, tissue damage, and cancer metastasis. Dietary acid load contributes to metabolic acidosis if endogenous acid-base balance is not properly regulated. Breast cancer survivors have reduced capacities to adjust their acid-base balance; yet, the associations between dietary acid load and inflammation and hyperglycemia have not been examined among them. We analyzed data collected from 3042 breast cancer survivors enrolled in the Women's Healthy Eating and Living (WHEL) Study who had provided detailed dietary intakes and measurements of plasma C-reactive protein (CRP) and hemoglobin A1c (HbA1c). Using a cross-sectional design, we found positive associations between dietary acid load and plasma CRP and HbA1c. In the multivariable-adjusted models, compared to women with the lowest quartile, the intakes of dietary acid load among women with the highest quartile showed 30-33% increases of CRP and 6-9% increases of HbA1c. Our study is the first to demonstrate positive associations between dietary acid load and CRP and HbA1c in breast cancer survivors. Our study identifies a novel dietary factor that may lead to inflammation and hyperglycemia, both of which are strong risk factors for breast cancer recurrence and comorbidities.
Collapse
Affiliation(s)
- Tianying Wu
- School of Public Health, Division of Epidemiology and Biostatistics, San Diego State University, San Diego, CA 92182-4162 USA.
- Moores Cancer Center, University of California at San Diego, San Diego, CA 92093, USA.
| | - Phoebe Seaver
- School of Public Health, Division of Epidemiology and Biostatistics, San Diego State University, San Diego, CA 92182-4162 USA
| | - Hector Lemus
- School of Public Health, Division of Epidemiology and Biostatistics, San Diego State University, San Diego, CA 92182-4162 USA
| | - Kathryn Hollenbach
- Department of Pediatrics and Rady Children's Hospital, University of California at San Diego, San Diego, CA 92093, USA
| | - Emily Wang
- School of Medicine, Department of Pathology, University of California at San Diego, San Diego, CA 92093, USA
| | - John P Pierce
- Moores Cancer Center, University of California at San Diego, San Diego, CA 92093, USA
| |
Collapse
|
495
|
Gold Nanostar Colorimetric Detection of Fructosyl Valine as a Potential Future Point of Care Biosensor Candidate for Glycated Haemoglobin Detection. BIOSENSORS-BASEL 2019; 9:bios9030100. [PMID: 31416267 PMCID: PMC6784361 DOI: 10.3390/bios9030100] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/02/2019] [Accepted: 08/07/2019] [Indexed: 12/13/2022]
Abstract
Diabetes Mellitus is a growing global concern. The current methods used to detect glycated haemoglobin are precise, however, utilise expensive equipment, reagents and consumables. These are luxuries which rural communities cannot access. The nanotechnology methods which have been developed for glycated haemoglobin detection are predominantly electrochemically based, have complicated lengthy fabrication processes and utilise toxic chemicals. Here a fructosyl amino acid oxidase gold nanostar biosensor has been developed as a potential future point of care biosensor candidate for glycated haemoglobin detection. The workup done on this biosensor showed that it was able to give a spectrophotometric readout and colorimetric result with naked eye detection in blank serum spiked with fructosyl valine.
Collapse
|
496
|
Saadane I, Ashraf T, Ali T, Lessan N. Diabetes and Ramadan: Utility of flash-glucose monitoring derived markers of glycaemic control and comparison with glycosylated haemoglobin. Diabetes Res Clin Pract 2019; 153:150-156. [PMID: 31150718 DOI: 10.1016/j.diabres.2019.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 05/20/2019] [Indexed: 01/20/2023]
Abstract
AIMS Flash glucose monitoring (FGM)-derived markers of glucose control and variability and laboratory measured HbA1c among patients with diabetes on insulin in context of Ramadan fasting (RF) were examined and compared. METHODS FGM data on insulin-treated patients (n = 20, age 42.3 ± 11.4 years; 18 male, 2 female; 13 with type 1 and 7 with type 2 diabetes) who fasted during Ramadan were used to calculate Q-score as an indicator of glycaemia before, during and after RF. Post-hoc analysis in a group of patients (n = 12) who had HbA1c available and appropriate for these periods was performed. Other relevant data were extracted from patient records. RESULTS Mean glucose (9.6 ± 1.32 v 10.78 ± 1.64 mmol/l; P < 0.0001) and Q-score increased significantly with Ramadan fasting and reduced after Ramadan. Post-hoc subgroup analysis showed a significant rise in eA1c (7.2 ± 0.4%; 55.0 ± 4.4 mmol/mol v 7.7 ± 0.5%; 61.0 ± 5.5 mmol/mol) but not in laboratory HbA1c with Ramadan fasting; eA1c reduced after Ramadan (P = 0.018). CONCLUSIONS Ramadan fasting was associated with a deterioration in overall glucose control and time in hyperglycaemia in insulin-treated patients. FGM-derived markers are useful and a preferable alternative to HbA1c in Ramadan studies.
Collapse
Affiliation(s)
- Ilham Saadane
- Imperial College London Diabetes Centre, Research Department, Abu Dhabi, United Arab Emirates.
| | - Tanveer Ashraf
- Imperial College London Diabetes Centre, Research Department, Abu Dhabi, United Arab Emirates.
| | - Tomader Ali
- Imperial College London Diabetes Centre, Research Department, Abu Dhabi, United Arab Emirates.
| | - Nader Lessan
- Imperial College London Diabetes Centre, Research Department, Abu Dhabi, United Arab Emirates.
| |
Collapse
|
497
|
Anderson P, Grills N, Singh R, Singh R, Evans RG, Sengupta P, Thrift AG. Prevalence of diabetes and pre-diabetes in rural Tehri Garhwal, India: influence of diagnostic method. BMC Public Health 2019; 19:817. [PMID: 31234815 PMCID: PMC6591826 DOI: 10.1186/s12889-019-7184-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 06/17/2019] [Indexed: 01/14/2023] Open
Abstract
Background There are few available data regarding the prevalence of diabetes in the sub-Himalayan region of India. The aim of this study was to determine the prevalence of pre-diabetes and diabetes in rural Garhwal based on glycosylated hemoglobin. Methods In a cross-sectional survey of 500 adults from five randomly selected villages in Chamba, a mountainous Tehri Garhwal district in Uttarakhand in north-west India, we determined the prevalence of diabetes (hemoglobin (Hb) A1c ≥ 6.5%) and pre-diabetes (5.7% ≤ HbA1c ≤ 6.4%). In a sub-sample of those diagnosed with diabetes or pre-diabetes (n = 140), fasting blood glucose (FBG, n = 117) or postprandial blood glucose (PBG, n = 23), and blood hemoglobin concentration, was measured at follow-up. Results Based on HbA1c, 10.0% had diabetes and 56.4% pre-diabetes. Of those diagnosed as diabetic by HbA1c, 10 of 16 (62.5%) were diagnosed as diabetic by FBG (> 125 mg/dL) or PBG (≥200 mg/dL). In those diagnosed as pre-diabetic by HbA1c, only 55 of 124 (44.4%) were diagnosed as pre-diabetic by FBG (100–125 mg/dL) or PBG (140–199 mg/dL). A large proportion of these 140 individuals (67.1%) were moderately to severely anemic (Hb < 11.4 mg/dL). The diagnostic gap for pre-diabetes between HbA1c and FBG/PBG was similar for the groups with and without moderate to severe anemia. Conclusions HbA1c and FBG/PBG have similar diagnostic performance for diabetes in this population. However, many individuals were diagnosed with pre-diabetes by HbA1c but not FBG/PBG. The relative excess diagnosis of pre-diabetes with HbA1c does not appear to be explained by anemia, an endemic condition in India. The prognostic significance of diagnosis of pre-diabetes by HbA1c but not FBG/PBG remains unknown, but merits investigation. Electronic supplementary material The online version of this article (10.1186/s12889-019-7184-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Pam Anderson
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - Nathan Grills
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - Rajesh Singh
- Garhwal Community Development and Welfare Society, Mussoorie Road, Chamba, India
| | - Rajkumari Singh
- Garhwal Community Development and Welfare Society, Mussoorie Road, Chamba, India
| | - Roger G Evans
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Victoria, Australia
| | | | - Amanda G Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, 3800, Australia.
| |
Collapse
|
498
|
Hicks PM, Melendez SAC, Vitale A, Self W, Hartnett ME, Bernstein P, Morgan DJ, Feehan M, Shakoor A, Kim I, Owen LA, DeAngelis MM. Genetic Epidemiologic Analysis of Hypertensive Retinopathy in an Underrepresented and Rare Federally Recognized Native American Population of the Intermountain West. JOURNAL OF COMMUNITY MEDICINE & PUBLIC HEALTH 2019; 3:152. [PMID: 31475247 PMCID: PMC6716530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Understanding disease risk is challenging in multifactorial conditions as it can differ by environment, ethnicity and race. The Confederated Tribes of the Goshute Reservation are one of the most isolated populations in the United States. Retinal changes are a reliable indicator for systemic disease. We conducted a cross-sectional study to identify correlations between genetic data and epidemiological risk factors for blinding retinal disease in this tribe. As part of the "Supporting Prediction and Prevention Blindness Project (SPBPP)" in the Native American Population of the Intermountain West, we found that hypertensive retinopathy was the most prevalent retinal disease. We found that forty-two percent of the Goshute population was affected. Blood samples, fundus photos and intraocular pressure were obtained for all participants. In addition, a standardized questionnaire was administered. DNA and total cholesterol, HDL, LDL, VLDL, triglycerides and HbA1c were also evaluated. Our study interrogated genetic variants from the PAGE study (ARMS2 rs10490924, CFH rs800292, rs1061170) and additional studies that looked at previously associated genetic variants with retinal disease associated with cardiovascular disease. We conducted univariate and multivariate logistic regression in Stata v15.0. We found an association between hypertriglyceridemia and HTR (adjp = .05) within the Goshute population. To the best of our knowledge, this is the first study to demonstrate the prevalence of hypertensive retinopathy in a Native American population. Moreover, our study is the first to demonstrate an independently predictive relationship between hypertriglyceridemia and hypertensive retinopathy in an American Indian population. This study furthers our knowledge about prevalent blinding eye disease within the most geographically isolated federally recognized native United States American tribe, for which nothing has been published with respect to any disease. Although, this study furthers our understanding about the prevalence of genetic epidemiological risk factors within this population, it has greater implications for the screening of blinding diseases in underserved populations in general. This study can inform public health on planning and delivering of quality, accessible and relevant care to this population.
Collapse
Affiliation(s)
- Patrice M Hicks
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | | | - Albert Vitale
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
| | - William Self
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
| | - Mary Elizabeth Hartnett
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
| | - Paul Bernstein
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
| | - Denise J Morgan
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
| | - Michael Feehan
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Akbar Shakoor
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
| | - Ivana Kim
- Retina Service, Harvard Medical School, Massachusetts Eye and Ear, Boston, MA, USA
| | - Leah A Owen
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
| | - Margaret M DeAngelis
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
499
|
Chehregosha H, Khamseh ME, Malek M, Hosseinpanah F, Ismail-Beigi F. A View Beyond HbA1c: Role of Continuous Glucose Monitoring. Diabetes Ther 2019; 10:853-863. [PMID: 31037553 PMCID: PMC6531520 DOI: 10.1007/s13300-019-0619-1] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Indexed: 01/17/2023] Open
Abstract
Hemoglobin A1C (HbA1c) is used as an index of average blood glucose measurement over a period of months and is a mainstay of blood glucose monitoring. This metric is easy to measure and relatively inexpensive to obtain, and it predicts diabetes-related microvascular complications. However, HbA1c provides only an approximate measure of glucose control; it does not address short-term glycemic variability (GV) or hypoglycemic events. Continuous glucose monitoring (CGM) is a tool which helps clinicians and people with diabetes to overcome the limitations of HbA1c in diabetes management. Time spent in the glycemic target range and time spent in hypoglycemia are the main CGM metrics that provide a more personalized approach to diabetes management. Moreover, the glucose management indicator (GMI), which calculates an approximate HbA1c level based on the average CGM-driven glucose level, facilitates individual decision-making when the laboratory-measured HbA1c and estimated HbA1c are discordant. GV, on the other hand, is a measure of swings in blood glucose levels over hours or days and may contribute to diabetes-related complications. In addition, addressing GV is a major challenge during the optimization of glycemia. The degree of GV is associated with the frequency, duration, and severity of the hypoglycemic events. Many factors affect GV in a patient, including lifestyle, diet, the presence of comorbidities, and diabetes therapy. Recent evidence supports the use of some glucose-lowering agents to improve GV, such as the new ultra-long acting insulin analogs, as these agents have a smoother pharmacodynamic profile and improve glycemic control with fewer fluctuations and fewer nocturnal hypoglycemic events. These newer glucose-lowering agents (such as incretin hormones or sodium-glucose cotransporter 2 inhibitors) can also reduce the degree of GV. However, randomized trials are needed to evaluate the effect of GV on important diabetes outcomes. In this review, we discuss the role of HbA1c as a measure of glycemic control and its limitations. We also explore additional glycemic metrics, with a focus on time (duration) in glucose target range, time (duration) in hypoglycemia, GV, GMI, and their correlation with clinical outcomes.
Collapse
Affiliation(s)
- Haleh Chehregosha
- Endocrine Research Center (Firouzgar), Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mohammad E Khamseh
- Endocrine Research Center (Firouzgar), Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Mojtaba Malek
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
500
|
Antihyperglycemic Potential of Back Tea Extract Attenuates Tricarboxylic Acid Cycle Enzymes by Modulating Carbohydrate Metabolic Enzymes in Streptozotocin-Induced Diabetic Rats. Indian J Clin Biochem 2019; 35:322-330. [PMID: 32647410 DOI: 10.1007/s12291-019-00831-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/04/2019] [Indexed: 02/06/2023]
Abstract
The present study was aimed to investigate the effect of black tea extract on blood glucose, plasma insulin, Hemoglobin, carbohydrate metabolic enzymes and tricarboxylic enzymes in streptozotocin (STZ) induced diabetic rats. Diabetes was induced in male albino Wistar rats by intraperitoneal administration of STZ (40 mg/kg b wt). Black tea extract was administered to diabetic rats at a dose of 25, 50 and 100 mg/kg body weight for 30 days. The effects of black tea extract on glucose, insulin and HbA1c levels were analyzed to confirm the effective dose. Administration of black tea extract to diabetic rats was significantly decreased the level of glucose, glycated hemoglobin and increased the levels of insulin in a dose dependent manner. The black tea extracts at a dose of 100 mg/kg b wt showed a highly significant effect compared to other two doses (25 and 50 mg/kg b wt). The effect produced by black tea extract (100 mg/kg b wt) was comparable to that of glibenclamide (5 mg/kg b wt) a reference anti diabetic drug. Therefore, 100 mg/kg b wt was fixed as an effective dose and used for further analyses. Black tea extract was administered to diabetic rats at a dose of 100 mg/kg b wt for 30 days reinstated the altered levels of the plasma glucose, insulin, hemoglobin, glycosylated hemoglobin, carbohydrate metabolizing enzymes and tricarboxylic cycle enzymes in diabetic rats. Black tea extract administered to diabetic rats at a dose of 100 mg/kg b wt for 30 days reinstated the altered levels of the plasma glucose, insulin, hemoglobin, glycosylated hemoglobin, carbohydrate metabolizing enzymes and tricarboxylic cycle enzymes in diabetic rats. The effect produced by black tea extract of all the biochemical parameters were comparable with glibenclamide-used as a reference drug.
Collapse
|