Diabetes mellitus and oxidative stress-A concise review

Evaluation of some oxidative markers in diabetes and diabetic retinopathy

Aims

Diabetes mellitus and diabetic retinopathy (DR) are major public health concerns globally. Oxidative stress plays a central role in the pathogenesis of diabetes and DR. The aim of this study was to investigate the association of malondialdehyde, uric acid and bilirubin with diabetes and diabetic retinopathy development.

Methods

This study was conducted on 110 diabetics (with and without retinopathy). Beside 40 healthy individuals as a control group. The level of three markers (malondialdehyde, uric acid and bilirubin) was estimated in the studied groups. Receiver operating characteristic analysis and a logistic regression model was performed.

Results

The present study revealed significantly higher uric acid and malondialdehyde levels, while bilirubin showed significantly lower levels in diabetics compared to control and similarly in diabetic retinopathy compared to those without DR. Furthermore, combination of the three markers increased the accuracy and effect size for differentiation between diabetes with and without DR. In addition, higher levels of uric acid and malondialdehyde were associated with risk of diabetes and DR development.

Conclusion

This study concluded that higher levels of uric acid and malondialdehyde were associated with increase in the risk of diabetes and DR development, while bilirubin wasn't associated with decreasing the risk of diabetes or DR. However, the combination of malondialdehyde, uric acid and bilirubin may be a valuable addition to the current options for the prognosis of DR. In addition, malondialdehyde may be independent predictor of diabetes and DR as well as uric acid may be used as independent biomarker to predict the risk of DR.

Evaluation of the neuro-protective effect of Artemisia judaica extract in a murine diabetic model

Chronic hyperglycemia is associated with several negative outcomes including neuronal injury. Medicinal plants supplementation has been widely applied to treat or decrease diabetic complications. Here, the possible neuroprotective effect of Artemisia judaica extract (AjE. 300 mg kg^-1  day^-1 ) against neuronal deficits in diabetes model induced by high-fat diet (HFD) administration and streptozotocin (STZ, 30 mg/Kg) injection in rats was investigated. Diabetic rats showed a disturbance in the neuronal redox homeostasis as confirmed by the elevated lipoperoxidation and nitric oxide formation along with the decreased antioxidant molecules. In addition, a state of neuroinflammation and apoptosis were recorded in the brain tissue in diabetic rats. Furthermore, HFD/STZ provoked neurochemical alterations. However, AjE administration was found to abrogate significantly the neuronal impairments associated with diabetes. This neuroprotective effect comes from its strong antioxidant, anti-inflammatory, antiapoptotic, and neuromodulatory activity; suggesting that AjE may be applied to alleviate neurological impairments in diabetic patients. PRACTICAL APPLICATIONS: Diabetes mellitus (DM) is a metabolic disorder characterized by high blood glucose level comes from the dysregulation of insulin production and/or its action. The persisted hyperglycemia is correlated with the progression of several physical complications including renal, hepatic, vascular, retinal, and neuronal dysfunction. Artemisia is used in the nutritional and medicinal proposes due to the enriched bioactive molecules such as essential oil, flavonoids, phenolics, sesquiterpenoids, triterpenoids, and artemisinin. And we found that Artemisia judaica extract (AjE) administration was able to abrogate significantly the neuronal impairments associated with diabetes. This neuroprotective effect comes from its strong antioxidant, anti-inflammatory, anti-apoptotic and neuromodulatory activity; suggesting that AjE may be applied to alleviate neurological impairments in diabetic patients.

Combined effect of high-dose vitamin A, vitamin E supplementation, and zinc on adult patients with diabetes: A randomized trial

In type 2 diabetes mellitus (T2DM), hyperglycemia leads to oxidative insult. Vitamins A and E have antioxidant potentials and may help in managing diabetes. The combined effect of high-dose vitamin A plus E supplementation with and without zinc on T2DM, has never been examined. Thus, this study aimed to evaluate and compare the effect of high-dose vitamin A plus E supplementation (AE) versus high-dose vitamin A plus E with zinc (AEZ), on different diabetic parameters. Ninety-eight patients with T2DM were randomized to receive either: 50,000 IU vitamin A and 100 mg vitamin E (AE group, N = 36), an equivalent dose of vitamin A and E combined with 25 mg zinc (AEZ group, N = 35), or no supplements (control group, N = 27) for three months. Compared to control, AEZ group showed significant reductions in fasting blood glucose, 2 h postprandial blood glucose, and glycated hemoglobin (HbA1c) with significant increases in homeostasis model assessment of beta-cell function and difference value of fasting insulin. Two hair loss cases were recorded in both treated groups. Although vitamin A needs dose moderation, these results suggest that, high-dose vitamin A plus E supplementation combined with zinc may improve glycemic control, β-cell function, and insulin secretion in adults with T2DM.

Strychnos nux-vomica L. seed preparation promotes functional recovery and attenuates oxidative stress in a mouse model of sciatic nerve crush injury

Background

Peripheral nerve injury is a debilitating condition that may lead to partial or complete motor, sensory and autonomic function loss and lacks effective therapy until date. Therefore, it is quite imperative to explore impending remedies for rapid and accurate functional retrieval following such conditions. Natural product-based intervention can prove effective to facilitate the process of functions regain.

Methods

Here, we investigated the effect of processed Strychnos nux-vomica seeds at a dose of 250 mg/kg body weight in a mouse model of induced Sciatic nerve lesion in promoting the recovery of the functions. A compression injury was induced in the Sciatic nerve of the right leg in the mice. Sensory function recovery was evaluated by hot-plate and formalin tests, whereas the motor function retrieval was assessed by measuring muscle grip strength, sciatic functional index, and muscle mass restoration. Oxidative stress and blood cell count were measured by biochemistry and haematological analyses.

Results

This study indicates that Strychnos nux-vomica seeds enhance the rate of recovery of both sensory and motor functions. It helps restore the muscle mass, attenuates total oxidant status and enhances the total anti-oxidant capacity of the biological system. Moreover, the treated animals manifested an enhanced glucose tolerance aptitude and augmented granulocyte and platelet counts. Improved oxidant control, enhanced glucose sensitivity and amended granulocyte and platelet counts are likely to contribute to the advantageous effects of Strychnos nux-vomica, and warrant further in-depth studies for deciphering possible mechanisms and identification of active constituent(s) responsible for these effects.

Conclusion

Strychnos nux-vomica seed offers functional recovery promoting effects following a mechanical injury to the Sciatic nerve and the possible reasons behind this effect can be reduced oxidative stress and improved glycaemic control. Further and detailed investigations can unravel this mystery.

Frequency and Antimicrobial Susceptibility Patterns of Diabetic Foot Infection of Patients from Bandar Abbas District, Southern Iran

Diabetic foot infection is among the most common complications of diabetes mellitus which significantly causes hospitalization and is the most prevalent etiology of nontraumatic amputation worldwide. The current study aimed at assessing the frequency and antimicrobial susceptibility patterns of diabetic foot infection of patients from the Bandar Abbas area, in the south of Iran. In this study, a total of 83 diabetic patients with diabetic infected foot wounds referring to Shahid Mohammadi Hospital, Bandar Abbas, from 2017 to 2018 were assessed. Samples were obtained from wound sites and evaluated by aerobic culture and also an antibiogram test for antibiotic susceptibility. Factors including age, sex, type of diabetes, the medication used for diabetes, previous history of diabetic foot infection, duration of wound incidence, fever, and laboratory indices were recorded for each subject. The most prevalent detected bacteria were Escherichia coli (20.5%), Enterococcus sp. (16.9%), Klebsiella sp. (12%), Staphylococcus aureus (8.4%), Enterobacter sp. (7.2%), and Acinetobacter sp. (6%). The results of antibiogram tests revealed the most and the least antibiotic sensitivity for E. coli sp. as meropenem and ciprofloxacin, for Enterococcus sp. as gentamicin and ciprofloxacin, for Klebsiella sp. as amikacin and cotrimoxazole, and for Enterobacter sp. as cotrimoxazole and both amikacin and ciprofloxacin. Staphylococcus aureus was sensitive to vancomycin and doxycycline, and Acinetobacter sp. was 100% resistant to all antibiotics except amikacin and gentamycin. A significant statistical association was found between the C-reactive protein and the patients' diabetic foot infection organisms (P=0.019). Findings of the study revealed E. coli sp. as the most common bacteria which are infecting the foot lesions in the studied population. The highest antibiotic susceptibility was seen for vancomycin, linezolid, and carbapenem.

Sekikaic acid modulates pancreatic β-cells in streptozotocin-induced type 2 diabetic rats by inhibiting digestive enzymes

The antioxidant and antidiabetic effects of sekikaic acid (SA) were investigated using in vitro and in vivo study models. SA possessed good antioxidant activity as assessed through hydroxyl radicals (IC₅₀ value = 41.5 µg/mL) and ferric ions assay (IC₅₀ value = 42.0 µg/mL). SA exhibited stronger α-glucosidase and α-amylase inhibition than that of aldose-reductase and protein tyrosine phosphatase 1B. The hypoglycemic activity of SA caused significant reduction of plasma glucose levels in normal and glucose loaded rats. The anti-hyperglycemic activity of SA (2 mg/Kg body weight) was indicated by the reduction of blood glucose by 44.17 ± 3.78% in the third week in streptozotocin-induced diabetic rats. The hypolipidaemic action of SA was evident by the significant decrease in the levels of low-density lipoprotein, total cholesterol, and total glycerides. Histologically, the pancreas of the treated groups showed significant regeneration of the pancreatic β-cells compared to diabetic control, possibly due to the inhibition of digestive enzymes.

Anti-hyperglycaemic activity of H. rosa-sinensis leaves is partly mediated by inhibition of carbohydrate digestion and absorption, and enhancement of insulin secretion

ETHNOPHARMACOLOGICAL RELEVANCE

Hibiscus rosa-sinensis (HRS) is a tropical flowery plant, widely distributed in Asian region and an important traditional medicine used in many diseases including cough, diarrhoea and diabetes.

AIM OF THIS STUDY

Hibiscus rosa-sinensis (HRS) leaves have been reported to possess anti-hyperglycaemic activity, but little is known concerning the underlying mechanism. This study investigated effects of ethanol extract of HRS on insulin release and glucose homeostasis in a type 2 diabetic rat model.

MATERIALS & METHODS

Effects of ethanol extract of grinded H. rosa-sinensis (HRS) leaves on insulin release, membrane potential and intracellular calcium were determined using rat clonal β-cells (BRIN-BD11 cells) and isolated mouse pancreatic islets. Effects on DPP-IV enzyme activity were investigated in vitro. Acute effects of HRS on glucose tolerance, gut perfusion in situ, sucrose content, intestinal disaccharidase activity and gut motility were measured. Streptozotocin induced type 2 diabetic rats treated for 28 days with ethanol extract of HRS leaf (250 and 500 mg/kg) were used to assess glucose homeostasis.

RESULTS

HRS, significantly increased insulin release from clonal rat BRIN-BD11 cells and this action was confirmed using isolated mouse pancreas islets with stimulatory effects equivalent to GLP-1. HRS induced membrane depolarization and increased intracellular Ca²⁺ in BRIN BD11 cells and significantly inhibited DPP-IV enzyme activity in vitro. HRS administration in vivo improved glucose tolerance in type 2 diabetic rats, inhibited both glucose absorption during gut perfusion and postprandial hyperglycaemia and it reversibly increased unabsorbed sucrose passage through the gut following sucrose ingestion. HRS decreased intestinal disaccharidase activity and increased gastrointestinal motility in non-diabetic rats. In a chronic 28-day study with type 2 diabetic rats, HRS, at 250 or 500 mg/kg, significantly decreased serum glucose, cholesterol, triglycerides and increased circulating insulin, HDL cholesterol and hepatic glycogen without increasing body weight.

CONCLUSION

These data suggest the antihyperglycaemic activity of HRS is mediated by inhibiting carbohydrate digestion and absorption, while significantly enhancing insulin secretion in a dose dependent manner. This suggests that HRS has potential as a novel antidiabetic therapy or a dietary supplement for the treatment of type 2 diabetes.

Antidyslipidemic and Antioxidant Activities of Matricaria pubescens (Desf.) Shultz. in Streptozotocin-Induced Diabetic Rats

AIMS

The study aimed to evaluate the antihyperlipidemic and antioxidant activities of Matricaria pubescens.

BACKGROUND

Matricaria pubescens (Desf.) Shultz belongs to Asteraceae family and it is commonly used traditionally for handling diabetes mellitus.

OBJECTIVE

The objective of this study was to assess the antioxidant activity of Matricaria pubescens (Desf.) Shultz and its effect on lipid and lipoprotein profile in normal and streptozotocin-induced diabetic rats.

METHODS

The effect of repeated (7 days of treatment) oral administration of the aqueous extracts of aerial part of Matricaria pubescens (MPAE) at a dose of 40 mg/kg on lipid and lipoprotein profile was examined in normal and streptozotocin-induced diabetic rats. Furthermore, a preliminary phytochemical screening and the quantification of phenolic, flavonoid and tannin contents as well as the antioxidant activity using two methods (FRAP and ABTS) were carried out.

RESULTS

MPAE demonstrated a potent antidyslipidemic effect in diabetic rats by reducing serum levels of triglycerides, total cholesterol and Low-Density Lipoprotein (LDL). In addition, the results showed that the extract is rich in several phytochemical compounds and revealed an important antioxidant activity.

CONCLUSION

In summary, this study proved that Matricaria pubescens (Desf.) Shultz. has a favorable effect on diabetic dyslipidemia.

The association between urinary metabolites of polycyclic aromatic hydrocarbons and diabetes: A systematic review and meta-analysis study

To examine the association between urinary metabolites of polycyclic aromatic hydrocarbons (OH-PAHs) and diabetes, online databases, including PubMed, Scopus, and Web of Science, were searched on July 17, 2019. Of the 668 articles identified through searching, six cross-sectional studies involving 24,406 participants were included. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effect model. Heterogeneity was measured by reporting the I-square index. Moreover, subgroup analysis according to types of metabolites was performed. We found a significantly higher odds of diabetes in the highest versus the lowest category of urinary naphthalene (NAP), fluorine (FLU), phenanthrene (PHEN), and total OH-PAH metabolites. The pooled OR (95% CI) was estimated at 1.47 (1.17, 1.78), 1.50 (1.29, 1.71), 1.41 (1.21, 1.60), and 1.61 (1.01, 2.21), respectively. We also found a significant association per 1-fold increase in FLU (OR = 1.09, 95% CI [1.00, 1.19]) and PHEN (OR = 1.19, 95% CI [1.08, 1.30]) metabolites. In subgroup analysis stratified by types of OH-PAH metabolites, A significant stronger odds of diabetes was observed in the highest versus the lowest category of 2-PHEN (OR = 1.66, 95% CI [1.32, 2.00]), 2-NAP (OR = 1.66, 95% CI [1.16, 2.17]), 2-FLU (OR = 1.62, 95% CI [1.28, 1.97]), and 9-FLU (OR = 1.62, 95% CI [1.21, 2.04]) metabolites. Furthermore, there was a meaningfully greater likelihood of diabetes per 1-fold increase in 2-FLU (OR = 1.34, 95% CI [1.10, 1.57]), 2-PHEN (OR = 1.33, 95% CI [1.14, 1.51]), and 3-PHEN (OR = 1.19, 95% CI [1.04, 1.34]) metabolites. In conclusion, our study suggests the significant odds of association between urinary OH-PAH metabolites and diabetes.

The role of apoptosis and autophagy in the insulin-enhancing activity of oxovanadium(IV) bipyridine complex in streptozotocin-induced diabetic mice

Metal-based therapies (e.g. Vanadium) possess an attractive proposition in medicinal treatment of diabetes mellitus. Defective insulin secretion can result from impaired β-cell function which is mediated by many process including apoptosis and autophagy. In this study. diabetes was induced by administration of streptozotocin then treatment was performed by vanadyl sulfate and [VO(bpy)₂ Cl] Cl.H₂O complex. Blood glucose level, AST, ALT, BUN, CR, TCHO, TG and total protein were determined in serum. MDA, NO, erythrocyte GSH and SOD were estimated. LC3 and Caspase 3 levels in pancreatic cells were assessed by flow cytometer. Histopathological investigation of pancreatic tissue was performed. Results of Diabetic group showed a significant increase in transaminases activities, TCHO, TG, MDA, NO and Caspase 3 levels and significant decrease in TP, GSH, SOD and LC3 levels. Oral administration of vanadium complex resulted in normoglycemia, significant increase in blood GSH, SOD, TP and LC3 levels, significant decrease in ALT, AST, BUN, TCHO, TG, MDA and NO and Caspase 3 levels. In addition, proliferative effect of complex prevents islet atrophy. From previous results, the insulin-enhancing effect induced by this complex indicated that this new complex can be a valuable candidate as insulin-enhancing and antioxidant compound than inorganic vanadyl sulfate.

Alteration of the Mitochondrial Effects of Ceria Nanoparticles by Gold: An Approach for the Mitochondrial Modulation of Cells Based on Nanomedicine

Ceria nanoparticles are cell compatible antioxidants whose activity can be enhanced by gold deposition and by surface functionalization with positive triphenylphosphonium units to selectively target the mitochondria. The antioxidant properties of these nanoparticles can serve as the basis of a new strategy for the treatment of several disorders exhibiting oxidative stress, such as cancer, diabetes or Alzheimer’s disease. However, all of these pathologies require a specific antioxidant according with their mechanism to remove oxidant species excess in cells and diminish their effect on mitochondrial function. The mechanism through which ceria nanoparticles neutralize oxidative stress and their effect on mitochondrial function have not been characterized yet. In the present study, the mitochondria antioxidant effect of ceria and ceria-supported gold nanoparticles, with or without triphenylphosphonium functionalization, was assessed in HeLa cells. The effect caused by ceria nanoparticles on mitochondria function in terms of mitochondrial membrane potential (∆Ψm), adenosine triphosphate (ATP) production, nuclear respiratory factor 1 (NRF1) and nuclear factor erythroid–2–like 1 (NFE2L1) was reversed by the presence of gold. Furthermore, this effect was enhanced when nanoparticles were functionalized with triphenylphosphonium. Our study illustrates how the mitochondrial antioxidant effect induced by ceria nanoparticles can be modulated by the presence of gold.

The Oxidative Stress Markers of Horses-the Comparison with Other Animals and the Influence of Exercise and Disease

Diacron-reactive oxygen metabolite (d-ROM) and biological antioxidant potential (BAP) levels in the serum of horses were measured (ponies, n = 15; thoroughbred, n = 31; other full-sized horses, n = 7). The mean d-ROM levels in horses were significantly higher (p < 0.001) than those in dairy cattle (n = 25) and dogs (n = 31). However, d-ROM levels in horses were lower than the standard levels reported in humans. When d-ROM and BAP levels were plotted graphically, the points for horses with a disease (ringbone in 1 Japanese sports horse, cellulitis in 1 thoroughbred, melanoma in 1 Lipizzaner) fell outside the group of points for other (non-diseased) horses. A similar separation was seen (using data from other authors) for a horse with Rhodococcus equi, a horse following castration surgery, and a mare following delivery. These results, comparing horses, other animals, and humans, are interesting from the standpoint of comparative medicine, and they contribute to the sparse literature available on d-ROM and BAP levels in animals. Because the level of d-ROM and BAP levels were changed depending on the situation of health, those indexes are promising as indices of health in horses.

Effects of Bilberry Supplementation on Metabolic and Cardiovascular Disease Risk

Metabolic syndrome is a cluster of interrelated conditions that is associated with an increased risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Oxidative stress may impair normal physiological functions, leading to various illnesses. T2DM is considered to be associated with increased oxidative stress, inflammation, and dyslipidemia, which may play a significant role in the development of cardiovascular complications, cancer and vision loss through cataracts and retinopathy. While conventional therapies are a cornerstone for the management of the major risk factors of metabolic syndrome, increasing antioxidant defense by increasing intake of antioxidant-rich foods may improve long term prospects in CVD, obesity and T2DM. Bilberry (Vaccinium myrtillus L.) is one of the richest natural sources of anthocyanins which give berries their red/purple/blue coloration. Anthocyanins are powerful antioxidants and are reported to play an important role in the prevention of metabolic disease and CVD as well as cancer and other conditions. This review focuses on the potential effects of bilberry supplementation on metabolic and cardiovascular risk factors. Although there is evidence to support the use of bilberry supplementation as part of a healthy diet, the potential benefits from the use of bilberry supplementation in patients with T2DM or CVD needs to be clarified in large clinical trials.

Possible therapeutic effects of vindoline on testicular and epididymal function in diabetes-induced oxidative stress male Wistar rats

OBJECTIVE

The study evaluated the effects of vindoline on testicular and epididymal oxidative stress in diabetes-induced male Wistar rats.

METHODS

Forty-eight (48), 6-week old male Wistar rats weighing between 190-230g were divided into 6 groups (n = 8) and used for this study. Group 1 was the normal control, group 2 comprised non-diabetic rats treated with vindoline, and group 3 was the non-diabetic group of rats treated with glibenclamide-the standard drug for the treatment of diabetes. Group 4 was the diabetic control, group 5 comprised diabetic rats treated with vindoline and group 6 was the diabetic rats treated with glibenclamide. Diabetes was induced in group 4, group 5 and group 6 rats by subjecting them to 10% fructose water over a period of 2 weeks, followed by administration of a single intraperitoneal injection of 40 mg/kg b.w streptozotocin (STZ). Testicular and epididymal lipid peroxidation levels, antioxidant enzymes, scavenging activity and total antioxidant capacity were measured.

RESULTS

Diabetes-induced male Wistar rats demonstrated chronic hyperglycaemia, oxidative stress and reduced oxygen radical absorption capacity in both testicular and epididymal tissues. Short-term treatment of diabetic rats with vindoline for 5 weeks significantly reduced fasting blood glucose levels, minimise testicular oxidative stress, increased testicular and epididymal catalase and epididymal SOD and increase total antioxidant activity capacity.

CONCLUSION

Treatment with vindoline showed protective effects against diabetes-induced oxidative stress in both testicular and epididymal tissues of male Wistar rats, hence can be considered potential agent in the management of diabetes-induced oxidative stress male sexual dysfunction.

Assessment of Oxidative Stress in Patients with Chronic Myeloid Leukemia Depending on Associated Comorbidities

Oxidative stress (OS) implies an imbalance between the amount of tissue level of prooxidant and antioxidant compounds. It is involved in the pathophysiology of multiple pathological entities (neoplasms, disorders of carbohydrate and lipid metabolism, cardiovascular and renal pathology etc.), as well as in the pharmacokinetics of specific treatments for these pathologies. Chronic myeloid leukemia (CML) is a chronic myeloproliferative disease for which current standard treatment is BCR-ABL tyrosine kinase inhibitors (TKIs). It is known that OS is involved in CML pathogenesis and response to TKIs therapy, but in reality, there are a number of additional factors (associated comorbidities, specific therapies) that modulate oxidative status, possibly affecting the evolution and prognosis of CML. In the present paper we proposed the evaluation of OS in a group of patients with CML following treatment with TKIs, depending on the presence of comorbidities and associated treatments. There were considered associated comorbidities: diabetes mellitus, dyslipidemia, arterial hypertension, heart failure, chronic kidney disease. The variability of the oxidative status was found depending on the type of associated comorbidity, but also according to the associated treatment, with the possibility of producing drug interactions between the standard treatment of CML and the associated specific therapies. Their impact on the prognosis of CML patients in treatment with TKIs is not negligible and may represent a future research topic.

Detection of Early Disease Risk Factors Associated with Metabolic Syndrome: A New Era with the NMR Metabolomics Assessment

The metabolic syndrome is a multifactorial disease developed due to accumulation and chronification of several risk factors associated with disrupted metabolism. The early detection of the biomarkers by NMR spectroscopy could be helpful to prevent multifactorial diseases. The exposure of each risk factor can be detected by traditional molecular markers but the current biomarkers have not been enough precise to detect the primary stages of disease. Thus, there is a need to obtain novel molecular markers of pre-disease stages. A promising source of new molecular markers are metabolomics standing out the research of biomarkers in NMR approaches. An increasing number of nutritionists integrate metabolomics into their study design, making nutrimetabolomics one of the most promising avenues for improving personalized nutrition. This review highlight the major five risk factors associated with metabolic syndrome and related diseases including carbohydrate dysfunction, dyslipidemia, oxidative stress, inflammation, and gut microbiota dysbiosis. Together, it is proposed a profile of metabolites of each risk factor obtained from NMR approaches to target them using personalized nutrition, which will improve the quality of life for these patients.

Effects of selenium, zinc, insulin and metallothionein on cadmium-induced oxidative stress and metallothionein gene expression levels in diabetic rats

Background The aim of this study was to investigate the effects of selenium, zinc, insulin, and metallothionein on oxidative damage and metallothionein (MT) gene expression levels in streptozotocin (STZ)-induced type 1 diabetic rats exposed to Cd. Methods Rats were categorized under eight groups (control, STZ, Cd, STZ + Cd, Group 5, Group 6, Group 7, and STZ + Cd + MT [n:8/group]) were used. After diabetes was induced by STZ (55 mg/kg, i.p.), Cd was administered (1 mg/kg CdCl, orally) for 4 weeks. In cadmium-treated groups selenium (Na2SeO3 1.5 mg/kg, i.p.), zinc (ZnSO4 10 mg/kg via oral gavage), insulin (insulin glargine, 2U/day, s.c.), and MT (1mg/kg, every other 10 days, s.c.) were administered. MT gene expression levels, MDA levels, GPx, SOD, and CAT activity levels were determined in liver and kidney tissues. Results MT gene expression and MDA levels increased (p < 0.05) while GPx and SOD activity levels decreased (p < 0.05) in STZ, Cd, and STZ + Cd groups. In Group 5, Group 6, Group 7, and Group 8 groups MT gene expression and MDA levels were decreased while GPx and SOD activity levels were increased (p < 0.05). CAT activity significantly increased (p < 0.05) in STZ + Cd group while there were no significance in other groups (p > 0.05). Compared to the control, Group 5, Group 6, Group 7, and Group 8 groups provided no difference for alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen and creatinine levels (p > 0.05). Conclusions Our results suggest that Se, insulin, Zn and MT may have protective effects against hepatotoxicity and nephrotoxicity caused by Cd exposure in diabetic rats by reducing oxidative stress and MT gene expression levels.

Aqueous extract of Digitaria exilis grains ameliorate diabetes in streptozotocin-induced diabetic male Wistar rats

ETHNOPHARMACOLOGICAL RELEVANCE

The absence of scientific data on the age long folkloric use of Digitaria exilis grains by sufferers of diabetes prompted the present investigation. This study was aimed at evaluating the antidiabetic activity of aqueous extract of Digitaria exilis grains in streptozotocin (STZ)-induced diabetic rats.

MATERIAL AND METHODS

Forty two male rats (166.43 ± 3.32 g) were completely randomized into six groups (A-F) of 7 animals each. Animals in group A (control) were administered 0.5 ml of distilled water while those in groups B, C, D, E and F which were induced with diabetes mellitus (by intraperitoneal administration of 60 mg/kg body weight of STZ) were also administered distilled water, 50 mg/kg body weight of metformin (a reference antidiabetic drug), 50, 100 and 200 mg/kg body weight of aqueous extract of D. exilis grains respectively, twice daily for 14 days. Blood glucose levels and some relevant biomolecules were determined 14 days post-administration.

RESULTS

Alkaloids, flavonoids, saponins, tannins, anthraquinones, terpenoids, cardiac glycosides, phlobatannins, phenolics and cardenolides were detected in the extract with alkaloids (30.20 mg/ml) occurring the most and phlobatannins (0.22 mg/ml) the least. Streptozotocin significantly (p < 0.05) increased the levels of blood glucose, serum albumin, urea, creatinine and cholesterol, activities of glucose-6-phosphatase and fructose-1,6-bisphosphatase in the liver and intake of feed and water. Body weight, weight of pancreas, pancreatic insulin, liver glycogen content, red blood cell and white blood cell and their related indices, liver hexokinase and phosphofructokinase activities were significantly reduced by STZ. In contrast, the extract significantly reversed all those STZ-treatment induced changes with the 200 mg/kg body weight of the extract producing profound values that compared favourably with the distilled water treated non-diabetic animals and metformin treated diabetic animals.

CONCLUSION

Overall, this study revealed that Digitaria exilis grains possess antidiabetic activity via increased insulin secretion, as plasma concentrations of insulin were not determined, enhanced activities of hexokinase and phosphofuctokinase and repletion of hepatic glycogen content.

Evaluation of antidiabetic activity of Pleurotus pulmonarius against streptozotocin-nicotinamide induced diabetic wistar albino rats

The current research aims to evaluate the antidiabetic properties of Pleurotus pulmonarius, an edible basidiomycetes mushroom fungi in diabetic induced wistar albino rats. Mycelial Hot Water Extracts (HWE) and Acetone Extracts (AE) of Pleurotus pulmonarius was orally administrated to STZ-NA induced (55 mg/kilogram body weight) diabetic wistar albino rats at a concentration of 200 and 400 mg/kg for 4 weeks. The outcomes revealed that the HWE of Pleurotus pulmonarius resulted in a significant (p < 0.001) reduction in blood glucose level. A noteworthy (p < 0.001) reduction in serum lipid profile and elevation in High-Density Lipoprotein Cholesterol (HDL-C) after administration with HWE, also demonstrating the protective effects of HWE in diabetes-related complications. Besides all antidiabetic parameters, pathological morphology of the pancreas, liver and kidney are regularised. This observation indicated that HWE of Pleurotus pulmonarius possessed higher antidiabetic activity than AE. Besides, HWE also promoted a significant control of alpha amylase enzyme in a concentration-dependent manner with a maximum activity of 99.23% inhibition at 1000 µg/ml. The outcomes of the present study indicated that the HWE possesses a potential antidiabetic activity both in vitro and in vivo. Thus, it can be used as a nontoxic complementary drug in the controlling of diabetes and related complications, thus providing scientific authentication of its use as an antidiabetic agent.

Correlation between Antioxidant Activity and the Garcinol Content Released from Fruit Rinds of Endemic Garcinia quaesita Pierre on Different Cooking Conditions

The antioxidant activity of garcinol has been identified as the basis for various bioactivities in it, and the genus Garcinia is the main source for the garcinol. G. quaesita, which is endemic to Sri Lanka, is a representative member of genus Garcinia, and the dried fruit rind of G. quaesita is used practically in all curry preparations to impart a sour flavor. In our study, garcinol was isolated (yield: 3.67%) from the dried fruit rind of G. quaesita, for the first time. Further, how cooking conditions enable the ingestion of garcinol during the consumption of curries was also examined. The garcinol content released in different cooking conditions was positively correlated with the antioxidant activity in vitro. The results revealed that boiling virgin coconut oil extract of G. quaesita, simulating the common practice of oil frying during cooking, is the best method for obtaining the highest amount of garcinol into the curry medium.

Effect of simulated microgravity on the antidiabetic properties of wheatgrass (Triticum aestivum) in streptozotocin-induced diabetic rats

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.

Possible Involvement of Vitamin C in Periodontal Disease-Diabetes Mellitus Association

Ascorbic acid (vitamin C) is an important water-soluble vitamin found in many fruits and vegetables. It has well-documented beneficial effects on the human body and is used as a supplement, alone or in combination with other vitamins and minerals. Over recent years, research has focused on possible new therapeutic actions in chronic conditions including periodontal disease (PD). We conducted a systematic review on clinical trials from four databases (PubMed, Clinical Trials, Cochrane, Web of Science) which measured plasmatic/salivary levels of ascorbic acid in PD–diabetes mellitus (DM) association. Six studies were included in our review, three of them analyzing patients with different grades of PD and DM who received vitamin C as a treatment (500 mg vitamin C/day for 2 months and 450 mg/day for 2 weeks) or as part of their alimentation (guava fruits), in combination with standard therapies and procedures. Decreased levels of vitamin C were observed in PD patients with DM but data about efficacy of vitamin C administration are inconclusive. Given the important bidirectional relationship between PD and DM, there is a strong need for more research to assess the positive effects of ascorbic acid supplementation in individuals suffering from both diseases and also its proper regimen for these patients.

Diabetes mellitus and oral cancer/oral potentially malignant disorders: A systematic review and meta-analysis

The objective was to evaluate current evidence on the prevalence and risk of oral cancer and potentially malignant oral disorders among patients with diabetes mellitus. We searched PubMed, Embase, Web of Science, and Scopus for observational studies published before November 2019. We evaluated the study quality using GRADE, QUIPS, and a specific method for systematic reviews addressing prevalence questions. Meta-analyses were conducted, and heterogeneity and publication bias were examined. A total of 1,489 studies were found, 116 analyzed in full text, 52 included in qualitative synthesis and 49 meta-analyzed. Pooled prevalence (PP) of oral cancer in patients with diabetic was 0.25% (95% CI = 0.15-0.39)-250 per 100,000 patients with diabetes mellitus -with a greater chance of oral cancer among patients with diabetes mellitus (OR = 1.41 [95% CI = 1.10-1.81], p = .007). Patients with oral cancer and diabetes mellitus had a higher mortality than controls (HR = 2.09 [95%CI = 1.36-3.22], p = .001). Leukoplakia had a PP = 2.49% (95% CI = 1.14-4.29)-2,490 per 100,000 patients with diabetes mellitus -(OR = 4.34 [95% CI = 1.14-16.55], p = .03). A PP of 2.72 (95% CI = 1.64-4.02) was obtained for oral lichen planus among patients with diabetic -2,720 per 100,000 patients with diabetes mellitus (OR = 1.87 [95% CI = 1.37-2.57], p < .001). A low PP was estimated for erythroplakia (0.02%[95%CI = 0.00-0.12]-20 per 100,000 patients with diabetes mellitus. In conclusion, patients with diabetes mellitus have a higher prevalence and greater chance of oral cancer and OPMD development in comparison with non-diabetic patients. In addition, patients with oral cancer suffering from diabetes mellitus have a higher mortality compared to non-diabetic patients with oral cancer.

[In vitro antioxidant and anti-inflammatory activity of chaya extracts (Cnidoscolus aconitifolius (Mill.) I.M. Johnst)]

Introduction

Introduction: noncommunicable diseases (NCDs) are the main cause of death worldwide. Secondary metabolites from plant sources such as Cnidoscolus aconitifolius may be used as adjuvants in the prevention of diseases related to oxidative stress and inflammation such as NCDs. Objective: the in vitro antioxidant and anti-inflammatory activities associated with biologically active compounds in C. aconitifolius extracts were evaluated. Method: the contents of phenols, flavonoids, flavonones and hydroflavonoles were determined. The potential antioxidant activity was determined with 1,1-Diphenyl-2-picrylhydrazyl (DPPH) and 2,2'-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays, and angiotensin-converting enzyme (ACE) activity. For anti-inflammatory activity quantitative PCR and enzyme-linked immunosorbent assay (ELISA) tests were used in macrophages derived from THP-1 monocytes and stimulated with LPS. Results: the aqueous extract recorded the highest phenolic content (70.61  0.07 g/100 g of extract), and the ethanolic extract registered the highest content in flavonoids (47.76  4.84 g/100 g of extract), flavonones and dihydroflavonoles (70.10  7.29 g/100 g of extract). The acetone extract obtained the highest DPPH inhibition (49.85 ± 5.30%), while the ethanolic extract showed the highest ABTS inhibition (41.01 ± 3.81%). The etanolic and aqueous extracts had the highest ACE inhibition. The ethanolic extract had the highest anti-inflammatory activity, decreasing gene expression for TNF- by 39.78% and for IL-6 by 97.81%, and their production by 46% and 48.38%, respectively, in macrophages stimulated with LPS. Conclusion: these extracts demonstrated in vitro their antioxidant and anti-inflammatory potential due to their content of bioactive compounds.

Chrysin Reduces Oxidative Stress but Does Not Affect Polyol Pathway in the Lenses of Type 1 Diabetic Rats

Prolonged hyperglycemia is one of the main causes of reactive oxygen species and free radicals generation in diabetes which may affect various organs, including the eye. Oxidative damage to proteins and lipids in the eye lens could lead to cataract formation. To cope with oxidative stress, the endogenous antioxidative system may be supported by the supplementation of exogenous antioxidants. The aim of this study was to evaluate the effect of chrysin, a natural flavonoid, on oxidative stress and polyol pathway-related markers in the lenses of streptozotocin-induced type 1 male diabetic rats. Chrysin at doses of 50 and 100 mg/kg was administered by gavage for 28 days. This treatment resulted in a decrease in antioxidative enzymes activity and oxidative stress index. Moreover, chrysin administration elevated the reduced glutathione level in the lenses. A decrease in the markers linked to oxidative damage to proteins and lipids in the lenses was noted, especially after treatment with 50 mg/kg of chrysin. Neither of the chrysin doses affected glycemia-related markers in the serum or altered parameters related to the polyol pathway and advanced glycation end-products level in the lenses of diabetic rats. Upon obtaining results, it can be concluded that chrysin reveals antioxidative activity in the lenses but shows no antihyperglycemic or antiglycation properties.

Protein-Bound Anthocyanin Compounds of Purple Sweet Potato Ameliorate Hyperglycemia by Regulating Hepatic Glucose Metabolism in High-Fat Diet/Streptozotocin-Induced Diabetic Mice

Purple sweet potato is known as a rich source of protein and anthocyanins. Anthocyanins can form complexes with protein present in food products through non-covalent forces or covalent bonds during processing, transportation, and storage as their protein affinity. We evaluated the hypoglycemic effects of protein-bound anthocyanin compounds of purple sweet potato (p-BAC-PSP) and free anthocyanin compounds of purple sweet potato (FAC-PSP) in high-fat diet/streptozotocin-induced diabetic mice. The results showed that administration of both p-BAC-PSP and FAC-PSP improved diabetic condition, as evidenced by the improvement of glucose tolerance and lipid metabolism, and the decrease of oxidative stress and liver damage. For the mechanism study, we have found that p-BAC-PSP and FAC-PSP induced the expression of AMP-activated protein kinase in liver. With p-BAC-PSP or FAC-PSP treatment, glucose transporter type 2, the protein levels of glucokinase, and insulin receptor α were found to be improved significantly (p < 0.05). Glycolysis key genes, phosphofructokinase and pyruvate kinase, were upregulated in two treatment groups, while gluconeogenic genes, glucose-6-phosphatase and phosphoenolpyruvate carboxykinase, were downregulated. Our findings suggested that p-BAC-PSP has great potential as a dietary supplement with hypoglycemic activity for general, pre-diabetic, and diabetic population.

Fucoidan Ameliorates Oxidative Stress, Inflammation, DNA Damage, and Hepatorenal Injuries in Diabetic Rats Intoxicated with Aflatoxin B1

The current study was carried out to evaluate the ameliorative effect of fucoidan against aflatoxicosis-induced hepatorenal toxicity in streptozotocin-induced diabetic rats. Sixty-four Wister albino male rats were randomly assigned into eight groups (8 rats each) that received normal saline, fucoidan (FUC) at 100 mg/kg/day orally for 4 weeks, streptozotocin (STZ) at 50 mg/kg/i.p. single dose, STZ plus FUC, aflatoxin B₁ (AFB₁) at 50 μg/kg/i.p. after one month of the beginning of the experiment for 2 weeks, AFB₁ plus FUC, STZ plus AFB₁, or STZ plus AFB₁ and FUC. Injection of rats with STZ induced hyperglycemia. Rats with STZ-induced diabetes, with or without AFB₁ intoxication, had significantly elevated activities of serum aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase, and levels of serum urea, creatinine, cholesterol, 8-oxo-2′-deoxyguanosine, interleukin-1β, interleukin-6, and tumor necrosis factor-α. In addition, these rats exhibited increased lipid peroxidation and reduced glutathione concentration and activities of superoxide dismutase, catalase, and glutathione peroxidase enzymes in the hepatic and renal tissues. In contrast, administration of FUC to diabetic rats, with or without AFB₁ intoxication, ameliorated the altered serum parameters, reduced oxidative stress, DNA damage, and inflammatory biomarkers, and enhanced the antioxidant defense system in the hepatic and renal tissues. These results indicated that FUC ameliorated diabetes and AFB₁-induced hepatorenal injuries through alleviating oxidative stress, DNA damage, and inflammation.

Antidiabetic activity of aqueous stem bark extract of Annickia polycarpa in alloxan-induced diabetic mice

Background and aim

There is a growing need to develop new drugs for type II diabetes mellitus (DM) from plant sources due to the high cost and adverse side effects of current drug therapies. To this end, the antidiabetic activity of aqueous stem-bark extract of A. polycarpa (APE) in alloxan-induced diabetic ICR mice was investigated.

Experimental procedure

The effect of APE (20, 100 and 500 mg/kg), glibenclamide and metformin as positive controls, were determined over 4 weeks on fasting blood glucose (FBG). An oral glucose tolerance test (OGTT) was also conducted. The effects of these treatments on the morphology of the pancreas were assessed. In addition, phytochemical constituents and antioxidant properties of APE were determined.

Results and conclusion

APE, like glibenclamide and metformin, showed significant hypoglycaemic effect. The OGTT supported the hypoglycaemic effect. The destroyed pancreatic beta-cells in diabetic control mice were restored to normal by APE or drug treatment. APE showed antioxidant activity by scavenging DPPH free radicals; this may be due to the presence of phenolic compounds, particularly flavonoids. Thus, APE may act by restoring pancreatic beta-cell integrity through mopping of reactive oxygen species (ROS) associated with the diabetic state, and thereby improving pancreatic function and consequently, the lowering of FBG levels. These findings provide ample evidence to validate the traditional use of A. polycarpa in the management of DM.

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Aqueous stem bark extract of A. polycarpa (APE) possesses significant antidiabetic activity.

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APE has the ability to cause the regeneration of beta cells of the pancreas.

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APE’s possess antioxidant activity and may scavenge ROS, thus help in overcoming advanced complications of DM.

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Alkaloids and phenolics (flavonoids) detected may be responsible for the hypoglycaemic and antioxidant activity of APE.

Imaging of hydrogen peroxide (H2O2) during the ferroptosis process in living cancer cells with a practical fluorescence probe

Hydrogen peroxide (H₂O₂) plays an important role in intracellular signal transduction pathway. It has been closely associated with the occurrence and development of tumors as well as the recent studied ferroptosis. In this work, monitoring the H₂O₂ level during the ferroptosis process in living cancer cells was achieved by using a new practical fluorescence probe, HP, accompanying with a series of property evaluation and model construction. As a practical tool, HP indicated high sensitivity (LOD 0.77 μM), high selectivity and low toxicity. Most satisfactorily, it could realize the applications of mapping the variation of intracellular H₂O₂ level regulated by the inducer or activator and visualizing the H₂O₂ release event as a significant feature during the ferroptosis process. This work was a challenging trial to monitor dynamic parameters of ferroptosis, and offered crucial information about the role of H₂O₂ for investigating further physiological or pathological processes.

Factors associated with high oxidative stress in patients with type 2 diabetes: a meta-analysis of two cohort studies

OBJECTIVE

Our objective is to identify the potential factors associated with serum Diacron's reactive oxygen metabolites test (D-ROM) levels of patients with type 2 diabetes mellitus (T2DM) by conducting cross-sectional and longitudinal analyses in two large cohorts and further strengthening these results by performing a meta-analysis.

METHODS

Serum D-ROM concentrations were measured in 1045 and 1101 patients with T2DM from two independent cohort studies from Germany at baseline and repeatedly 3-4 years later. The cross-sectional and longitudinal associations of various potential determinants with D-ROM levels were assessed with a backwards selection algorithm in multivariable adjusted models.

RESULTS

In the meta-analysis of the cross-sectional analysis, female sex, low education, obesity, smoking, high total cholesterol, hemoglobin A_1c ≥7%, no diabetes medication, a history of myocardial infarction, heart failure, a history of cancer and C reactive protein levels (CRP) >3 mg/L were statistically significantly associated with increased D-ROM levels in patients with T2DM. The meta-analysis of the longitudinal analysis revealed that old age, female sex, obesity, smoking, physical inactivity, high alcohol consumption, ≥5 years since diabetes diagnosis and CRP levels between 3 mg/L and 10 mg/L were statistically significantly associated with D-ROM levels measured 3-4 years later.

CONCLUSIONS VALIDITY, LIMITATIONS AND CLINICAL APPLICABILITY

This comprehensive analysis confirmed that several modifiable risk factors are being associated with oxidative stress in patients with T2DM within an observational study design. We discuss potential prevention measures against these risk factors that might help to reduce oxidative stress and to prevent some cases of premature mortality in patients with T2DM.

Elevated β-cell stress levels promote severe diabetes development in mice with MODY4

Maturity-onset diabetes of the young (MODY) is a group of monogenetic forms of diabetes mellitus caused by mutations in genes regulating β-cell development and function. MODY represents a heterogeneous group of non-insulin-dependent diabetes arising in childhood or adult life. Interestingly, clinical heterogeneity in MODY patients like variable disease onset and severity is observed even among individual family members sharing the same mutation, an issue that is not well understood. As high blood glucose levels are a well-known factor promoting β-cell stress and ultimately leading to cell death, we asked whether additional β-cell stress might account for the occurrence of disease heterogeneity in mice carrying a MODY4 mutation. In order to challenge β-cells, we established a MODY4 animal model based on Pdx1 (pancreatic and duodenal homeobox 1) haploinsufficiency, which allows conditional modulation of cell stress by genetic inhibition of the stress-responsive IKK/NF-κB signalling pathway. While Pdx1+/- mice were found glucose intolerant without progressing to diabetes, additional challenge of β-cell function by IKK/NF-κB inhibition promoted rapid diabetes development showing hyperglycaemia, hypoinsulinemia and loss of β-cell mass. Disease pathogenesis was characterized by deregulation of genes controlling β-cell homeostasis and function. Importantly, restoration of normal IKK/NF-κB signalling reverted the diabetic phenotype including normalization of glycaemia and β-cell mass. Our findings implicate that the avoidance of additional β-cell stress can delay a detrimental disease progression in MODY4 diabetes. Remarkably, an already present diabetic phenotype can be reversed when β-cell stress is normalized.

PHYSICAL TRAINING ON GLYCEMIA AND OXIDATIVE STRESS IN TYPE 2 DIABETES: A SYSTEMATIC REVIEW

ABSTRACT Introduction: Diabetes mellitus is accompanied by increased formation of reactive oxygen species (ROS) and decreased antioxidant capacity, leading to oxidative damage to cellular components. There is evidence to suggest that regular physical training positively changes oxidative homeostasis in the cells and tissues by lowering basal levels of oxidative damage, increasing resistance to oxidative stress. Objective: To verify the possible effects of aerobic physical training and resistance on glycemia and oxidative metabolism, and to determine whether there is any difference in outcomes resulting from different types of training in sedentary people with Type 2 Diabetes Mellitus (T2DM). Methods: A systematic review of controlled and randomized trials based on PRISMA. The databases LILACS, IBECS, Pubmed/MEDLINE, Cochrane Library, SciELO, PEDro, ScienceDirect and BIREME were searched, combining the descriptors type 2 diabetes mellitus, resistance training, aerobic exercise and oxidative stress in Portuguese, English and Spanish. The methodological quality of the papers was assessed by the PEDro scale. The data were read, analyzed, extracted and summarized. Results: Of the 1386 papers retrieved, only five met the inclusion criteria. The five selected papers, consisting of controlled and randomized clinical trials, were summarized. Conclusion: There have been many published studies reporting on exercises and diabetes. However, there is limitation when it comes to comparing their results. The variability of research methods and measurement instruments used makes it difficult to draw conclusions as to which physical training modality is most effective in reducing glycemic levels and oxidative stress in sedentary individuals with T2DM, considering that in each study analyzed in this review, the response to these variables is different. In future research, it would be important to standardize exercise modality, intensity, training time and evaluation parameters. Level of evidence I; Systematic review of RCTs (Randomized controlled trials).

Vitamin D Supplementation Is Associated with Increased Glutathione Peroxidase-1 Levels in Arab Adults with Prediabetes

Vitamin D supplementation may be used to lower oxidative stress. This interventional study aimed to investigate the effects of vitamin D supplementation on glutathione peroxidase 1 (GPx1) levels and other parameters in Arab adults with prediabetes. A total of 203 Saudi adults with prediabetes and vitamin D deficiency [intervention group, N = 146 (53 males and 93 females); control group, N = 57 (25 males and 32 females)] were included in this non-randomized, six-month intervention study. The intervention group received 50,000 international units (IU) cholecalciferol tablets once a week for two months, then twice a month for the next two months, followed by 1000 IU daily for the last two months. The control group received no supplementation. Serum 25(OH)D, lipid profile, glucose, C-reactive protein (CRP) and GPx1 were measured at baseline and after six months. Post-intervention, GPx1 concentrations increased significantly in the intervention group [17.3 (11.5–59.0) vs 26.7 (11.4–59.9) p < 0.01] while no changes were observed in the control group (p = 0.15). This significant increase in 25(OH)D and GPx1 levels persisted after adjusting for age and BMI. Stratification according to sex revealed that this favourable increase in GPx1 was true only for males (p = 0.002). In all groups, baseline GPx1 was inversely correlated with low density lipoprotein (LDL)-cholesterol (r = −0.26, p < 0.01) and body mass index (BMI) (r = −0.20, p < 0.05), while positively correlated with age (r = 0.18, p < 0.05) and systolic blood pressure (r = 0.19, p < 0.05). In conclusion, vitamin D supplementation favourably enhanced GPx1 levels in adult Arabs with prediabetes, particularly in males.

Chamomile (Matricaria recutita L.) and diabetes mellitus, current knowledge and the way forward: A systematic review

Chamomile, as a rich source of phenolic compounds and terpenoids, seems to be an effective approach in the management of chronic conditions such as diabetes mellitus. The aim of this systematic review was to evaluate evidence from animal and human studies of the effects of chamomile on metabolic risk markers and complications of diabetes mellitus. The literature search was conducted in PubMed, SCOPUS, Embase, ProQuest and Google Scholar electronic and were considered the articles published on April 2019. Original studies that investigated the effect of chamomile in diabetes mellitus which met the inclusion criteria were eligible. After screening 208 citations, 15 studies were included. The results of these studies demonstrated a significant effect of chamomile administration on metabolic profiles. All 12 studies that examined the impact of chamomile supplementation on glycemic control indicated this feature. Four of the five studies appraising the impact of chamomile on lipid profiles showed that it improved dyslipidemia. Six studies showed that chamomile markedly decreased oxidative stress particularly malondialdehyde. Altogether, four chamomile studies evaluating diabetes complications, including renal and hepatic profiles, found significant decreases compared to controls. These findings extend the novel functions of chamomile in the improvement of glycemic and lipid profiles and oxidative stress indicators in diabetes mellitus and related complications. In-depth studies focusing on underlying mechanisms are warranted to make useful conclusions.

The Gut Microbiome and Type 2 Diabetes Mellitus: Discussing a Complex Relationship

Type 2 diabetes mellitus (T2DM) is a disease that affects over 9% of the United States population and is closely linked to obesity. While obesity was once thought to stem from a sedentary lifestyle and diets high in fat, recent evidence supports the idea that there is more complexity pertinent to the issue. The human gut microbiome has recently been the focus in terms of influencing disease onset. Evidence has shown that the microbiome may be more closely related to T2DM than what was originally thought. High fat diets typically result in poor microbiome heath, which then shifts the gut into a state of dysbiosis. Dysbiosis can then lead to metabolic deregulation, including increased insulin resistance and inflammation, two key factors in the development of T2DM. The purpose of this review is to discuss how microbiome relates to T2DM onset, especially considering obesity, insulin resistance, and inflammation.