Diabetes and the WHO Model List of Essential Medicines

A mechanistic overview on green assisted formulation of nanocomposites and their multifunctional role in biomedical applications

The importance of nanocomposites constantly attains attention because of their unique properties all across the fields especially in medical perspectives. The study of green-synthesized nanocomposites has grown to be extremely fascinating in the field of research. Nanocomposites are more promising than mono-metallic nanoparticles because they exhibit synergistic effects. This review encapsulates the current development in the formulation of plant-mediated nanocomposites by using several plant species and the impact of secondary metabolites on their biocompatible functioning. Phyto-synthesis produces diverse nanomaterials with biocompatibility, environment-friendliness, and in vivo actions, characterized by varying sizes, shapes, and biochemical nature. This process is advantageous to conventional physical and chemical procedures. New studies have been conducted to determine the biomedical efficacy of nanocomposites against various diseases. Unfortunately, there has been inadequate investigation into green-assisted nanocomposites. Incorporating phytosynthesized nanocomposites in therapeutic interventions not only enhances healing processes but also augments the host's immune defenses against infections. This review highlights the phytosynthesis of nanocomposites and their various biomedical applications, including antibacterial, antidiabetic, antiviral, antioxidant, antifungal, anti-cancer, and other applications, as well as their toxicity. This review also explores the mechanistic action of nanocomposites to achieve their designated tasks. Biogenic nanocomposites for multimodal imaging have the potential to exchange the conventional methods and materials in biomedical research. Well-designed nanocomposites have the potential to be utilized in various biomedical fields as innovative theranostic agents with the subsequent objective of efficiently diagnosing and treating a variety of human disorders.

Status of diabetes mellitus in different regions of KSA and update on its management

Background

Complications of diabetes and its associated comorbidities can cause rapid progression of type II diabetes mellitus (T2DM). It comes at high costs and affects a patient's quality of life. We aim to assess T2DM in KSA, including the demographics, medications, complications, and comorbidities, as it remains an integral part of Vision 2030.

Methods

Observational retrospective study was designed spanning five administrative regions of KSA. A total of 638 patients' records were randomly selected from general hospitals and diabetes centers from 2017 to 2020, and the collected were statistically analyzed.

Results

Most (77%) selected patients had uncontrolled diabetes, showing a statistically significant correlation between regions and diabetes control. The Northern, Central, and Southern regions had the highest uncontrolled percentage with less than 20% control, while Western and Eastern regions' control percentages were around 40% of subjects. Eighty percent of the uncontrolled BP patients had uncontrolled diabetes contrasting the 68% of the BP-controlled patients. Biguanides, DPP-4 inhibitors, GLP-1 agonists, Insulin, and SGLT-2 inhibitors are the most common diabetes medications. Metformin was the most prescribed in all regions, followed by DPP4. Results showed that patients used one to four non-diabetes drugs on average. Dispensing of vitamin B complex and statins were higher in diabetes centers than in hospitals. Retinopathy and peripheral neuropathy were the most common complications, while hypertension and ASCVD were the most common comorbidities.

Conclusion

Results showed a poor glycemic control situation in the kingdom that necessitates implementing stricter measures to hinder disease progression and reduce complications and comorbidities. Increasing awareness, training, and monitoring programs with larger sample sizes and broader distribution is highly recommended nationally.

Okra [Abelmoschus esculentus (L.) Moench] improved blood glucose and restored histopathological alterations in splenic tissues in a rat model with streptozotocin-induced type 1 diabetes through CD8+ T cells and NF-kβ expression

Diabetes mellitus is a complex metabolic syndrome that involves dysfunction of spleen and other lymphoid organs. Medicinal plants, including okra (Abelmoschus esculentus (L.) Moench), were used widely for diabetes treatment. Scarce data are available about the potential anti-diabetic effects of okra, the histopathological alterations in splenic tissues and the mechanistic pathways underlying this association. The current research investigated the effects of okra pod extract on the biochemical parameters and expression of CD8+ T cells and nuclear factor kappa (NF-k) B and releasing proinflammatory cytokines in spleen in streptozotocin (STZ)-induced diabetic rat models. A total of 50 mature male Wister albino rats were divided into five isolated groups; the first served as control (untreated) animals, the second (DM group) diabetes induced by STZ (at a dose of 45 mg/kg body weight, administered intraperitoneally), the third group (DM + Insulin): diabetic rats administered insulin subcutaneously (10 units/kg bw/day) daily for 4 weeks, the fourth group was administrated 400 mg/kg okra extract daily for 4 weeks, and diabetic induced rats in the fifth group were administrated 400 mg/kg okra extract daily for 4 weeks. The 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity in Abelmoschus esculentus (L.) Moench was studied, and the content of phenolic compounds in okra pods was estimated using high-performance liquid chromatography. Diabetes induction led to decreased body weight, increased blood glucose levels. Capsular thickness was significantly increased, white pulp was widely dispersed, and mature lymphocytes in the periphery were also drastically decreased, with thick follicular arteries, necrosis, and depletion of lymphocytes in the germinal center. Red pulp revealed severe congestion and degenerative changes, deposition of hemosiderin granules and lymphocytic depletion. In addition, collagen fiber deposition was increased also in this group. The induction of diabetes exaggerated NF-kβ expression and mediated downregulation of the expression of CD8+ T cells in spleen tissue. Interestingly, oral administration of okra extracts post diabetes induction could mitigate and reverse such adverse effects. Altogether, our study points out the potential benefits of okra in improving blood glucose levels and restoring histopathological alterations in splenic tissues through CD8+ T cells and NF-kβ expression in a diabetic rat model.