Study of magnesium, glycosylated hemoglobin and lipid profile in diabetic retinopathy

Chronopharmacology of the alpha-lipoic acid/nifedipine/glimepiride combination in the amelioration of retinopathy in rats

Time of drug administration affects both the kinetics and dynamics of medications. This study investigated diurnal efficacy of alpha-lipoic acid (ALA), nifedipine, and glimepiride combination in the treatment of diabetic retinopathy. The study design comprised seven groups of rats, with groups 1 and 2 serving as non-diabetic and diabetic controls, respectively, receiving 1 ml/kg distilled water. All other groups were diabetic, and received 10 mg/kg glimepiride at 20:00 h. Groups 4-7 also received 20 mg/kg nifedipine at 08:00 h. In addition, groups 5-7 received 100 mg/kg ALA at 08:00 h, 14:00 h, and 20:00 h, respectively. Oral drug administration was for 28 days during which fasting and random blood glucose sampling were done weekly at 07:30 h and 13:30 h, respectively. On the 29^th day, rats were euthanized; blood was collected via the jugular veins for determination of serum ocular markers like magnesium, cholesterol, and triglyceride. Furthermore, the eyes were excised and their relative organ/body weight ratios determined. The right eyes were persevered in phosphate buffer for homogenization and determination of retina antioxidant profile (MDA, SOD, CAT, GSH), while the left eyes were preserved in formalin for histological examination. Results showed that treatment with ALA and glimepiride at 20:00 h along with nifedipine at 08:00 h resulted in better prognosis than other treatment groups and with improved glycemic control. Also, all their serum markers for retinopathy, organ weight, and histology did not differ significantly from that of the non-diabetic rats. Findings imply that diurnal efficacy in alpha-lipoic acid, nifedipine and glimepiride combination ameliorates diabetic retinopathy in rats and may be beneficial in the treatment of diabetic retinopathy.

Association of trace metal elements with lipid profiles in type 2 diabetes mellitus patients: a cross sectional study

BACKGROUND

It is well known that dyslipidemia and chronic hyperglycemia increase the onset of diabetes and diabetic complication. The aim of this study is to see the association of trace metals elements and lipid profile among type 2 diabetes mellitus patients.

METHODS

The study was conducted on 214 type 2 diabetic patients at Jimma University Specialized Hospital, Jimma, Ethiopia. All the eligible study participants responded to the structured interviewer administered questionnaire and fasting venous blood was drawn for biochemical analysis. Trace metal elements (zinc(Zn⁺²), magnesium(Mg⁺²), chromium(Cr⁺³), calcium(Ca⁺²), phosphorus(Po₄^-3), manganese(Mn⁺²), copper(Cu⁺²), and iron(Fe⁺³)) and lipid profiles (total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein (HDL-C), and triglycerides (TG)) were measured by atomic absorption spectrophotometry and enzymatic determination method respectively. Data were analyzed by SPSS version 24 software for windows. Bonferroni correction for multiple statistical comparisons was used and a p-value less than 0.01 were accepted as a level of significance.

RESULT

The mean age of study participants was 42.95(±12.6) with an average of 5.83(±3.1) years being diagnosed with diabetes mellitus. The BMI of female (27.1(±4.9)) was significantly higher than male (25.21(±4.2)). BMI shows positive and significant (p < 0.01) association with lipid profiles (TC, LDL-C, and TG) among type 2 diabetic patients in the liner regression model. In addition, WH-R was positively associated with TG. In Pearson partial correlation adjusted for sex and age, Za⁺² shown to have statistically significant and negative correlations with TC, LDL-C and with TG. Mg⁺² and Cr⁺² negatively and significantly correlated with the lipid profile TC and LDL-C. Ca⁺² negatively correlated with TC and TG. Po^-3₄ positively correlated with HDL-C; iron negatively correlated with TC. However, in the liner regression model, only calcium positively and significantly (Beta = -0.21, p < 0.01) associated with TG.

CONCLUSION

In the current study, a negative correlation was observed between trace metal elements (Zn⁺², Mg⁺², Cr⁺³, Ca⁺² and Fe⁺³) and lipid profile (TC, LDL-C and TG) among type 2 diabetes mellitus patients. In addition, Ca⁺² observed to be associated with TG. Future studies are highly advised to uncover the bidirectional association between trace metal element and dyslipidemia in diabetic patients.

Association of Insulin Resistance, β-Cell Function Impairment and Calcium, Magnesium, and Fetuin-A Concentrations in Women with Type 2 Diabetes Mellitus

Insulin resistance and β-cell function impairment play a role in the pathogenesis of type 2 diabetes (T2DM). Insulin signaling is inhibited by fetuin-A, an abundant plasma protein. Fetuin-A is also a candidate marker of the T2DM risk. This case-control study aimed to determine whether fetuin-A serum level is related to insulin resistance, β-cell function impairment, and total and ionized Ca and Mg serum levels in Erbil patients with T2DM.

A total of 60 patients with T2DM were recruited, and 30 healthy persons were included in the control group. Fetuin-A and insulin concentrations were measured through ELISA. Other biochemical parameters were determined spectrophotometrically. Insulin resistance (HOMA2IR), insulin sensitivity (HOMA2%S), and β-cell function were examined by using a homeostatic model assessment 2 (HOMA2).

Fasting serum insulin, fetuin-A serum levels, and HOMA2IR were significantly increased. HOMA2%S of the patients with diabetes was significantly lower than that of the control group. The total serum and ionized Ca and Mg contents and the Ca/Mg ratio were reduced in the patients.

Therefore, fetuin-A is related to T2DM pathogenesis and is strongly associated with insulin resistance and glycemic control in T2DM patients. Future large-scale studies are necessary to validate fetuin-A as an indicator of IR in T2DM patients.

SERUM magnesium levels as an indicator of status of Diabetes Mellitus type 2

CONTEXT

Magnesium deficiency is commonly associated with endocrine and metabolic disorders, especially with Diabetes Mellitus type 2 though the mechanism of hypomagnesemia in Diabetes Mellitus is not completely known. There is a close association between metabolic control of Diabetes Mellitus and impaired magnesium balance.

AIMS

To estimate the serum levels of magnesium in patients of with Diabetes Mellitus type 2 and to find a correlation if any, with the duration and control (by estimating HbA1c) of Diabetes Mellitus type 2.

MATERIALS AND METHODS

Fifty patients of Diabetes Mellitus type 2 were included in the study. Blood samples were analyzed for fasting and post prandial glucose, HbA1c and magnesium. The patients were grouped into three categories based upon their HbA1c levels into those with good control, need intervention and poor control. The three groups were compared with reference to their mean levels of blood glucose and magnesium. Association of serum magnesium levels with HbA1c, Fasting and postprandial blood glucose and duration of Diabetes Mellitus was also done.

RESULTS

Serum magnesium levels were found to decline with rise in HbA1c levels and with duration of Diabetes Mellitus type 2.

CONCLUSION

Hypomagnesemia is linked to poor control of Diabetes Mellitus type 2 and depletion of serum magnesium occurs exponentially with duration of disease.

Effect of some high consumption spices on hemoglobin glycation

Formation of glycation products is major factor responsible in complications of diabetes. Worldwide trend is toward the use of natural additives in reducing the complications of diseases. Therefore, there is a growing interest in natural antiglycation found in plants. Herbs and spices are one of the most important targets to search for natural antiglycation from the point of view of safety. This study investigated the ability of some of the spices to inhibit glycation process in a hemoglobin/glucose model system and compared their potency with each other. For this subject the best concentration and time to incubate glucose with hemoglobin was investigated. Then the glycosylation degree of hemoglobin in the presence of extracts by the three concentrations 0.25, 0.5 and 1 μg/ml was measured colorimetrically at 520 nm. Results represent that some of extracts such as wild caraway, turmeric, cardamom and black pepper have inhibitory effects on hemoglobin glycation. But some of the extracts such as anise and saffron have not only inhibitory effects but also aggravated this event and have proglycation properties. In accordance with the results obtained we can conclude that wild caraway, turmeric, cardamom and black pepper especially wild caraway extracts are potent antiglycation agents, which can be of great value in the preventive glycation-associated complications in diabetes.

Effect of livingstonepotato (Plectranthus esculenthus N.E.Br) on hyperglycemia, antioxidant activity and lipid metabolism of streptozotocin induced diabetic rats

The effect of livingstone potato (Plectranthus esculenthus N.E.Br) on serum glucose, glycated hemoglobin (HbA1C), serum triglyceride, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), hepatic malic enzyme (ME), isocitrate dehydrogenase (IDH) and catalase activities of Streptozotocin induced diabetic rats were investigated using standard techniques. The atherogenic index (AI) and coronary risk index (CRI) of the rats were calculated as the ratios of LDL to HDL and total cholesterol to HDL, respectively. The serum glucose of the non-diabetic, diabetic control and diabetic rats given livingstone potato incorporated feeds (test feed) were 92.58 ± 3.97, 352.30 ± 4.88 and 165.50 ± 7.88 mg/dl, respectively. Intake of the test feed by the diabetic rats of group 3, resulted in significant (P < 0.05) decrease of their serum glucose, HbA1c, triglyceride, cholesterol, LDL, VLDL, AI and CRI but significant increase (P < 0.05) of hepatic levels of ME, IDH, catalase and serum HDL compared with the diabetic control rats that had significant alteration of these parameters (P < 0.05) compared with the non-diabetic rats. The feed intakes of the non-diabetic, diabetic control and diabetic rats given the test feed were 133.34 ± 1.32, 137.84 ± 5.77 and 146.38 ± 4.33 g/rat/week by the last week of experimentation. The diabetic control rats recorded significant loss of weight (P < 0.05) compared with the non diabetic rats despite increased feed intake. Chemical analysis of the standard and test feeds showed that the standard rat feed contained 15.00 ± 0.78% protein, 7.24 ± 1.20% fat, 31.55 ± 2.62% carbohydrates, energy value of 290.65 ± 4.77 kcal/100 g, 10% crude fiber and 0.12 ± 0.04 mg Gallic Acid Equivalent while the test feed contained 40.10 ± 0.16% carbohydrates, 17.22 ± 0.40% protein, 22.16 ± 0.34% fat, energy value of 428.70 ± 2.12 kcal/100 g, 8.51 ± 0.16% crude fiber, 1.3 ± 0.2 mg Gallic Acid Equivalent/g of sample and strong antioxidant activity comparable to standard quercetin. The study shows the potentials of livingstone potato in the management of diabetes and hyperlipidemia.

Pathogenetic role of magnesium deficiency in ophthalmic diseases

Magnesium is one of the most important regulatory cation involved in several biological processes. It is important for maintaining the structural and functional integrity of several vital ocular tissues such as cornea, lens and retina. The magnesium content of lens, especially in its peripheral part, is higher than that in aqueous and vitreous humor. Magnesium has also been shown to play critically important role in retinal functions. Magnesium plays significant role as a cofactor for more than 350 enzymes in the body and regulates neuroexcitability and several ion channels. Membrane associated ATPase functions that are crucial in regulating the intracellular ionic environment, are magnesium-dependent. Moreover, the enzymes involved in ATP production and hydrolysis are also magnesium-dependent. Magnesium deficiency by interfering with ATPase functions causes increased intracellular calcium and sodium and decreases intracellular potassium concentration. Such ionic imbalances in turn alter the other cellular enzymatic reactions and form the basis of the association of magnesium deficiency with ophthalmic diseases such as cataract. In presence of magnesium deficiency, an imbalance between mediators of vasoconstriction and vasorelaxation may underlie the vasospasm, which is one of the pathogenic factors in primary open angle glaucoma. Furthermore, magnesium deficiency is also a contributing factor in increased oxidative stress and inducible NOS stimulation that can further contribute in the initiation and progression of ocular pathologies such as cataract, glaucoma and diabetic retinopathy. In this paper we review the association of disturbances of magnesium homeostasis with several ophthalmic diseases.

Trace elements in diabetes mellitus

INTRODUCTION

Diabetes Mellitus is the commonest major metabolic disease and most prevalent diseases worldwide.Its related morbidity is due to its micro and macro angiopathic complications.

AIM

The aim of this study was to measure and compare the serum levels of zinc and magnesium in normal individuals and in diabetic patients.

METHOD

Analysis of minerals was done in plasma by using a Varian Spectra AA 220 model atomic absorption spectrophotometer.

RESULT

Our observations showed a definite lowering of serum magnesium (p<0.001) and serum zinc levels (p<0.001) were significant in diabetic group.

CONCLUSION

The cause of diabetic hypomagnesaemia is multifactorial. An altered metabolism, a poor glycaemic control and osmotic diuresis may be contributory factors. Decreased serum zinc levels in diabetes may be caused by an increase in urinary loss. These decreased levels of trace elements cause disturbances in glucose transport across cell membrane lead to insufficient formation and secretion of insulin by pancreas which compromise in the antioxidant defense mechanisms.

Association of macrovascular complications of type 2 diabetes mellitus with serum magnesium levels

BACKGROUND

Diabetes mellitus and its complications are a significant cause of morbidity and mortality worldwide. Micronutrients have been evaluated as potential preventive and therapeutic measures in diabetes. The present study evaluated serum magnesium levels in diabetic patients-uncomplicated and those with macrovascular complications.

METHOD

This study was done on 150 subjects (60 normal, healthy controls and 90 diabetics). The 90 diabetic patients were selected in the following categories-30 patients without complications (Study Group I), 30 diabetic patients with coronary artery disease (Study Group II) and 30 diabetic patients with peripheral vascular disease (Study Group III). Plasma glucose, glycated hemoglobin and serum magnesium levels were estimated in all the patients.

RESULTS

Fasting plasma glucose and glycated hemoglobin levels were significantly higher in all the 3 study groups as compared to the controls, however, serum magnesium levels were significantly lower (p<0.05). In diabetic patients with coronary atherosclerosis or peripheral vascular disease, a significant negative correlation was observed between serum magnesium and fasting plasma glucose and glycated hemoglobin indicating the role of hypomagnesemia in diabetic complications.

CONCLUSION

Dietary supplementation with magnesium in addition to classical therapies for diabetes may help in prevention of diabetic complications.