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Ofori E, Dziedzorm W, Buabeng A, Dogodzi F, Adusu‐Donkor L, Bernard S, Amponsah S, Asare‐Anane H. Comparative Determination of Mitochondrial Biomarkers and Their Relationship With Insulin Resistance in Type 2 Diabetic Patients: An Observational Cross-Sectional Study. Endocrinol Diabetes Metab 2024; 7:e507. [PMID: 38943337 PMCID: PMC11213964 DOI: 10.1002/edm2.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/14/2024] [Accepted: 06/15/2024] [Indexed: 07/01/2024] Open
Abstract
INTRODUCTION Data suggest malfunctioning mitochondria reduce oxidation and adenosine triphosphate (ATP) production, disrupting insulin signalling. Cytochrome c (CC), acylcarnitine (AC) and citrate synthase (CS) are essential components of the mitochondria machinery and can be used as reliable biomarkers of mitochondrial dysfunction. This study aimed to determine whether mitochondrial biomarkers (AC, CS and CC) are altered in individuals with type 2 diabetes mellitus (T2DM) and to examine the association between these biomarkers and insulin resistance. METHODOLOGY A cross-sectional observational study that recruited 170 participants (88 with T2DM and 82 without DM) was conducted. Blood samples were collected from the recruits and analysed for levels of fasting glucose (FBG), AC, CS, CC, insulin, total cholesterol, triglycerides (TG), glycated haemoglobin (HbA1c) and magnesium. Blood pressure (BP) and anthropometric characteristics of participants were also taken. Appropriate formulas were used to determine %body fat, body mass index (BMI), waist-to-hip ratio (WHR), the homeostatic model assessment for insulin resistance (HOMA-IR) and insulin sensitivity (HOMA-β). RESULTS Patients with T2DM had higher levels of CC, %body fat, FBG, TG, HbA1c, BMI and HOMA-IR than controls (p < 0.05, respectively). Results showed a significant relationship between circulating CC levels versus HOMA-β (r = -0.40, p = 0.001), CS (r = -0.70, p = 0.001) and AC (r = -0.72, p = 0.001) levels in patients with T2DM. The adjusted odds increased in the T2DM patients for VLDL (OR = 6.66, p = 0.002), HbA1c (OR = 6.50, p = 0.001), FPG (OR = 3.17, p = 0.001), TG (OR = 2.36, p = 0.010), being female (OR = 2.09, p = 0.020) and CC (OR = 1.14, p = 0.016). CONCLUSION Overall, alterations in mitochondrial biomarkers, measured by AC, CC and CS, were observed in people with T2DM and showed a direct relationship with insulin resistance. These findings are potentially significant in Africa, although additional confirmation from a larger cohort is necessary.
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Affiliation(s)
| | | | | | - Francis K. Dogodzi
- School of Veterinary Medicine, College of Basic and Applied SciencesUniversity of GhanaAccraGhana
| | | | - Segla K. Bernard
- West African Centre for Cell Biology of Infectious PathogensAccraGhana
| | - Seth K. Amponsah
- Department of Medical PharmacologyUniversity of Ghana Medical SchoolAccraGhana
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Chen R, Li J, Chen D, Wen W, Zhang S, Li J, Ruan Y, Zhang Z, Sun J, Chen H. Efficacy and Safety of DPP-4 Inhibitors and Metformin Combinations in Type 2 Diabetes: A Systematic Literature Review and Network Meta-Analysis. Diabetes Metab Syndr Obes 2024; 17:2471-2493. [PMID: 38910912 PMCID: PMC11193992 DOI: 10.2147/dmso.s450994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/15/2024] [Indexed: 06/25/2024] Open
Abstract
Objective Several oral antidiabetic regimens are available for treating type 2 diabetes mellitus (T2DM), dipeptidyl peptidase-4 inhibitors (DPP4i) being one of them. We conducted a network meta-analysis (NMA) comparing DPP4i plus metformin (Met) combination with other Met-based oral antidiabetic drug (OAD) combinations used in treating patients with T2DM. Methods We searched PubMed and Embase from inception until 19th April, 2022 for phase II and phase III trials in patients with T2DM on Met-based traditional OADs. The primary outcome was assessed by change in glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and 2-hour post-prandial blood glucose (2h-PPG). The secondary safety outcomes assessed were hypoglycemic events, serious adverse events (SAEs), cardiovascular (CV) events, and gastrointestinal (GI) events. Results Sixty-two trials were included in the analysis. The combination of DPP4i + Met revealed a comparable mean reduction in HbA1c levels to the glinides (Gli) + Met combination (mean difference [MD]: -0.03%, 95% CI: 0.69, -0.65), although the difference was not statistically significant. The mean HbA1c reduction with DPP4i + Met was greater than with sulfonylureas (SU) + Met (MD: -0.05, 95% CI: -0.29, 0.39), thiazolidinedione (TZD) + Met (MD: -0.69, 95% CI: -1.39, -0.02), and SU + TZD (MD: 0.21; 95% CI: -1.30, 1.71), with no statistical significance. DPP4i + Met demonstrated a non-significant lower incidence of CV events in comparison to TZD + Met (RR: 1.01, 95% CI: 0.46, 2.45) and SU + Met (RR: 1.06, 95% CI: 0.61, 2.06). Conclusion DPP4i in combination with Met was efficacious and had a well-tolerated safety profile compared with other traditional OADs. This combination can be considered as a suitable treatment option for patients with T2DM.
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Affiliation(s)
- Rongping Chen
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Jing Li
- Department of Endocrinology, HuaZhong University of Science and Technology Union ShenZhen Hospital, Guangdong, People’s Republic of China
| | - Danqi Chen
- Institute for Prevention and Control of Chronic Noncommunicable Diseases, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People’s Republic of China
| | - Weiheng Wen
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Susu Zhang
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Jitong Li
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Yuting Ruan
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Zhen Zhang
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Jia Sun
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Hong Chen
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
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Ciccacci F, Ismael F, Parruque F, Maquete DJ, Loureiro S, Balamala M, Morviducci L, Manto A, Lanti F, Orlando S, Guidotti G. Implementing HbA1c monitoring in sub-Saharan Africa: Lessons learnt from a pilot project in Mozambique. PUBLIC HEALTH IN PRACTICE 2024; 7:100504. [PMID: 38840715 PMCID: PMC11152726 DOI: 10.1016/j.puhip.2024.100504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 04/03/2024] [Accepted: 05/09/2024] [Indexed: 06/07/2024] Open
Abstract
Aims We aimed to evaluate lesson learnt from a pilot project in Mozambique focused on point-of-care (POC) HbA1c testing for diabetes management in primary health care facilities. Methods Over a three-year period, several health centers were equipped with POC HbA1c testing machines. The evaluation involved 12 months of data collection, interviews with patients and staff, and regular supervision visits. Results The project screened over 22,000 individuals and provided HbA1c testing to 2362 diabetes patients. Among the analyzed results, 65.7 % had HbA1c levels below 7 %, 10.9 % between 7 % and 8.5 %, and 23.4 % above 8.5 %. POC testing showed advantages such as reduced costs and improved workload management. Conclusions Limited access to HbA1c testing remains a challenge in African countries. The pilot project demonstrated the feasibility of POC HbA1c testing and highlighted the need for increased efforts to make it more widely available, leading to improved diabetes management and patient outcomes.
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Affiliation(s)
- Fausto Ciccacci
- UniCamillus, Saint Camillus International University of Health Sciences, Rome, Italy
| | - Flavio Ismael
- DREAM Program, Community of Sant'Egidio, Maputo, Mozambique
| | | | | | - Sandra Loureiro
- Mozambican Diabetes Association (AMODIA), Maputo, Mozambique
| | | | - Leilo Morviducci
- Azienda Sanitaria Locale Roma 1, Santo Spirito Hospital-Diabetology and Dietology Unit, Rome, Italy
| | | | | | - Stefano Orlando
- University of Rome Tor Vergata, Department of Biomedicine and Prevention, Rome, Italy
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Munir H, Yaqoob S, Awan KA, Imtiaz A, Naveed H, Ahmad N, Naeem M, Sultan W, Ma Y. Unveiling the Chemistry of Citrus Peel: Insights into Nutraceutical Potential and Therapeutic Applications. Foods 2024; 13:1681. [PMID: 38890908 PMCID: PMC11172398 DOI: 10.3390/foods13111681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/18/2024] [Accepted: 05/22/2024] [Indexed: 06/20/2024] Open
Abstract
The recent millennium has witnessed a notable shift in consumer focus towards natural products for addressing lifestyle-related disorders, driven by their safety and cost-effectiveness. Nutraceuticals and functional foods play an imperative role by meeting nutritional needs and offering medicinal benefits. With increased scientific knowledge and awareness, the significance of a healthy lifestyle, including diet, in reducing disease risk is widely acknowledged, facilitating access to a diverse and safer diet for longevity. Plant-based foods rich in phytochemicals are increasingly popular and effectively utilized in disease management. Agricultural waste from plant-based foods is being recognized as a valuable source of nutraceuticals for dietary interventions. Citrus peels, known for their diverse flavonoids, are emerging as a promising health-promoting ingredient. Globally, citrus production yields approximately 15 million tons of by-products annually, highlighting the substantial potential for utilizing citrus waste in phyto-therapeutic and nutraceutical applications. Citrus peels are a rich source of flavonoids, with concentrations ranging from 2.5 to 5.5 g/100 g dry weight, depending on the citrus variety. The most abundant flavonoids in citrus peel include hesperidin and naringin, as well as essential oils rich in monoterpenes like limonene. The peel extracts exhibit high antioxidant capacity, with DPPH radical scavenging activities ranging from 70 to 90%, comparable to synthetic antioxidants like BHA and BHT. Additionally, the flavonoids present in citrus peel have been found to have antioxidant properties, which can help reduce oxidative stress by 30% and cardiovascular disease by 25%. Potent anti-inflammatory effects have also been demonstrated, reducing inflammatory markers such as IL-6 and TNF-α by up to 40% in cell culture studies. These findings highlight the potential of citrus peel as a valuable source of nutraceuticals in diet-based therapies.
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Affiliation(s)
- Hussan Munir
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China; (H.M.); (S.Y.)
- University Institute of Food Science and Technology, University of Lahore, Lahore 54590, Pakistan
| | - Sanabil Yaqoob
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China; (H.M.); (S.Y.)
- Department of Food Science and Technology, Faculty of Science and Technology, University of Central Punjab, Lahore 54000, Pakistan; (K.A.A.); (H.N.); (W.S.)
| | - Kanza Aziz Awan
- Department of Food Science and Technology, Faculty of Science and Technology, University of Central Punjab, Lahore 54000, Pakistan; (K.A.A.); (H.N.); (W.S.)
| | - Aysha Imtiaz
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad 03802, Pakistan;
| | - Hiba Naveed
- Department of Food Science and Technology, Faculty of Science and Technology, University of Central Punjab, Lahore 54000, Pakistan; (K.A.A.); (H.N.); (W.S.)
| | - Naveed Ahmad
- Joint Center for Single Cell Biology, Shanghai Collaborative Innovation Center of Agri-Seeds, School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai 200240, China;
| | - Muhammad Naeem
- Department of Plant Science, School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai 200240, China;
| | - Waleed Sultan
- Department of Food Science and Technology, Faculty of Science and Technology, University of Central Punjab, Lahore 54000, Pakistan; (K.A.A.); (H.N.); (W.S.)
| | - Yongkun Ma
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China; (H.M.); (S.Y.)
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Kiçaj E, Saliaj A, Çerçizaj R, Prifti V, Qirko S, Rogozea L. Navigating Diabetes: Enhancing Self-Management through Education among Diabetic People at the Early Stages of the Disease-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:522. [PMID: 38791737 PMCID: PMC11120700 DOI: 10.3390/ijerph21050522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 05/26/2024]
Abstract
Diabetes self-management education helps to improve health outcomes and qualities of life for diabetic patients. This systematic review examines the effectiveness of several types of diabetes self-management education for patients at the early stages of type 2 diabetes mellitus (T2DM). A review of studies that have researched the use and impacts of health education on diabetic patients with T2DM was conducted using the electronic databases PubMed, Elsevier, JSTORE, Walters Kluwer, and the Cochrane Library between January 2017 and November 2022. We found 789 studies, and after selecting the PRISMA flowchart, we selected 19 studies, including those of 2512 adult patients diagnosed with T2DM. Biomedical results presented the pooled effect of a glycated hemoglobin (HbA1c) of -0.64% and a fasting blood glucose (FBG) of -0.32. Emotional and social results and behavioral effects were evaluated in 10 and nine studies, respectively. The education and support of diabetic patients at the early stages of the disease impact various aspects, including the biomedical profile, lifestyle, emotional and social well-being, and anthropometric parameters. Among the factors that have been identified to enhance the effectiveness of educational interventions are the following: conducting individualized sessions (or at least in small groups of patients), extending the duration of interventions by at least 12 months, adopting a combined approach that includes both face-to-face and online components, and ensuring the involvement of a multidisciplinary healthcare team.
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Affiliation(s)
- Emirjona Kiçaj
- Faculty of Medicine, Transylvania University, 500019 Brasov, Romania; (R.Ç.); (V.P.); (S.Q.); (L.R.)
- Faculty of Health, University “Ismail Qemali” Vlore, 9401 Vlore, Albania;
| | - Aurela Saliaj
- Faculty of Health, University “Ismail Qemali” Vlore, 9401 Vlore, Albania;
| | - Rudina Çerçizaj
- Faculty of Medicine, Transylvania University, 500019 Brasov, Romania; (R.Ç.); (V.P.); (S.Q.); (L.R.)
- Faculty of Health, University “Ismail Qemali” Vlore, 9401 Vlore, Albania;
| | - Vasilika Prifti
- Faculty of Medicine, Transylvania University, 500019 Brasov, Romania; (R.Ç.); (V.P.); (S.Q.); (L.R.)
- Faculty of Health, University “Ismail Qemali” Vlore, 9401 Vlore, Albania;
| | - Sonila Qirko
- Faculty of Medicine, Transylvania University, 500019 Brasov, Romania; (R.Ç.); (V.P.); (S.Q.); (L.R.)
- Faculty of Health, University “Ismail Qemali” Vlore, 9401 Vlore, Albania;
| | - Liliana Rogozea
- Faculty of Medicine, Transylvania University, 500019 Brasov, Romania; (R.Ç.); (V.P.); (S.Q.); (L.R.)
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Feng X, Yang X, Zhong Y, Cheng X. The role of ncRNAs-mediated pyroptosis in diabetes and its vascular complications. Cell Biochem Funct 2024; 42:e3968. [PMID: 38439590 DOI: 10.1002/cbf.3968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/06/2024]
Abstract
Over the past decade, the prevalence of diabetes has increased significantly worldwide, leading to an increase in vascular complications of diabetes (VCD), such as diabetic cardiomyopathy (DCM), diabetic nephropathy (DN), and diabetic retinopathy (DR). Noncoding RNAs (ncRNAs), such as microRNAs (miRNAs), long Noncoding RNAs (lncRNAs), and circular RNAs (circRNAs), play a key role in cellular processes, including the pathophysiology of diabetes and VCD via pyroptosis. ncRNAs (e.g., miR-17, lnc-MEG3, and lnc-KCNQ1OT1) can regulate pyroptosis in pancreatic β cells. Some ncRNAs are involved in VCD progression. For example, miR-21, lnc-KCNQ1OT1, lnc-GAS5, and lnc-MALAT1 were reported in DN and DCM, and lnc-MIAT was identified in DCM and DR. Herein, this review aimed to summarize recent research findings related to ncRNAs-mediated pyroptosis at the onset and progression of diabetes and VCD.
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Affiliation(s)
- Xinyao Feng
- Hunan Key laboratory of Vascular Biology and Translational Medicine, Medical School, Hunan University of Chinese Medicine, Changsha, China
| | - Xiaoxu Yang
- Hunan Key laboratory of Vascular Biology and Translational Medicine, Medical School, Hunan University of Chinese Medicine, Changsha, China
| | - Yancheng Zhong
- Hunan Key laboratory of Vascular Biology and Translational Medicine, Medical School, Hunan University of Chinese Medicine, Changsha, China
| | - Xihua Cheng
- Hunan Key laboratory of Vascular Biology and Translational Medicine, Medical School, Hunan University of Chinese Medicine, Changsha, China
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Kumar P, Nesakumar N, Gopal J, Sivasubramanian S, Vedantham S, Rayappan JBB. Clinical validation of electrochemical biosensor for the detection of methylglyoxal in subjects with type-2 diabetes mellitus. Bioelectrochemistry 2024; 155:108601. [PMID: 37951008 DOI: 10.1016/j.bioelechem.2023.108601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/08/2023] [Accepted: 11/04/2023] [Indexed: 11/13/2023]
Abstract
Methylglyoxal (MG), a highly reactive by-product of glycolysis, is involved in the formation of advanced glycation end-products (AGEs). Elevated levels of MG have been correlated with micro-and macro-angiopathic complications in diabetes, including neuropathy, kidney disease, retinopathy, and cardiovascular disease. Therefore, point-of-care devices for detecting MG may be of great use in the screening of diabetes complications. This study was designed to determine the utility of the developed electrochemical biosensor to measure the level of MG in human plasma from type-2 diabetes mellitus patients. Electrochemical studies were carried out with optimized experimental parameters using the modified Platinum-electrode. Subsequently, clinical studies using 350 blood plasma samples were conducted and the results were validated against the ELISA kit, Normal Glucose Tolerance (NGT), and glycosylated haemoglobin (HbA1c). The MG sensor exhibited a linear range of 1.0-7.5 μM concentration with a sensitivity of 1.02 mA µM-1, a limit of detection of 0.21 µM, a limit of quantification of 0.70 µM and a response time less than 10 s. The sensor showed 90% correlation with ELISA data. The developed biosensor showed a significant correlation with HbA1c and fasting plasma glucose suggesting that it can be used as a point-of-care device to screen for diabetes.
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Affiliation(s)
- Priyanga Kumar
- Centre for Nanotechnology & Advanced Biomaterials (CeNTAB), SASTRA Deemed University, Thanjavur 613 401, India; School of Electrical & Electronics Engineering (SEEE), SASTRA Deemed University, Thanjavur 613 401, India
| | - Noel Nesakumar
- School of Chemical & Biotechnology (SCBT), SASTRA Deemed University, Thanjavur 613 401, India
| | | | | | - Srinivasan Vedantham
- School of Chemical & Biotechnology (SCBT), SASTRA Deemed University, Thanjavur 613 401, India; DifGen Pharmaceuticals Private Ltd., Hyderabad, India
| | - John Bosco Balaguru Rayappan
- Centre for Nanotechnology & Advanced Biomaterials (CeNTAB), SASTRA Deemed University, Thanjavur 613 401, India; School of Electrical & Electronics Engineering (SEEE), SASTRA Deemed University, Thanjavur 613 401, India.
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Wang S, Wang R, Li R, Li Y. Research Progress on Application of Inonotus obliquus in Diabetic Kidney Disease. J Inflamm Res 2023; 16:6349-6359. [PMID: 38161352 PMCID: PMC10756068 DOI: 10.2147/jir.s431913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 12/03/2023] [Indexed: 01/03/2024] Open
Abstract
Diabetic kidney disease (DKD) is one of the prime causes of end-stage renal disease. At present, the treatment of DKD is mainly confined to inhibiting the renin-angiotensin-aldosterone system, but the therapeutic effects is not satisfactory. As a kind of very rare and precious medicinal fungi, Inonotus obliquus has a very high medicinal value. Due to its special hypoglycemic and pharmacological effect, researchers currently have attached great importance to it. In this paper, the biological activities, pharmacological effects and application status in the treatment of DKD-related diseases of Inonotus obliquus and the latest progress of metabolites isolated from it in DKD were summarized, thus providing detailed insights and basic understanding of the potential application prospects in DKD.
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Affiliation(s)
- Shuyue Wang
- Department of Nephrology, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, 030012, People’s Republic of China
| | - Ruihua Wang
- The Third Clinical College, Shanxi University of Chinese Medicine, Taiyuan, Shanxi, 030002, People’s Republic of China
| | - Rongshan Li
- Department of Nephrology, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, 030012, People’s Republic of China
| | - Yafeng Li
- Department of Nephrology, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, 030012, People’s Republic of China
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Hossain Z, Khanam M, Razzaque Sarker A. Out-of-pocket expenditure among patients with diabetes in Bangladesh: A nation-wide population-based study. HEALTH POLICY OPEN 2023; 5:100102. [PMID: 37744423 PMCID: PMC10514070 DOI: 10.1016/j.hpopen.2023.100102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 09/05/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023] Open
Abstract
Background and objectives Diabetes has become one of the fastest growing public health emergencies worldwide. The objective of this study was to estimate the average annual out-of-pocket cost of diabetes treatment as well as to find out the catastrophic health expenditure (CHE) and their determinants in Bangladeshi context. Data and methods The study utilised data from the most recent nationally representative Household Income and Expenditure Survey 2016-2017. The incidence of CHE was estimated by applying 10% and 25% of the annual total household expenditure threshold levels. The factors associated with CHE was presented as adjusted odds ratio with 95% confidence intervals. Results The annual average out-of-pocket cost per diabetes patient was US$ 323 (BDT 25,473). The cost of medication was the main cost driver contributed for 75.43% of the total out-of-pocket cost. The incidence of CHE was 14.34%, and 5.86% of the study households for 10% and 25% of the threshold levels, respectively. The patient aged more than 60 (AOR: 4.89; CI 0.82 to 28.95), uneducated (AOR: 1.83; CI 0.25 to 2.12), comorbid condition (AOR: 1.62; CI 0.94 to 2.79), small household size (AOR: 3.20; CI 0.58 to 17.51), rural resident (AOR: 1.85; CI 0.46 to 1.57), poorest asset quintile (AOR: 4.06; CI 1.43 to 13.87) and private facility type (AOR: 8.16; CI 3.46 to 19.;25) were significantly associated with the incidence of CHE due to diabetes treatment. Conclusions There are considerable out-of-pocket costs needed for diabetes care in Bangladesh. The evidence of catastrophic expenditure suggests the urgent need to improve financial risk protection to ensure access to care.
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Affiliation(s)
- Zakir Hossain
- Population Studies Division, Bangladesh Institute of Development Studies (BIDS), Dhaka, Bangladesh
| | - Moriam Khanam
- Institute of Health Economics, University of Dhaka, Dhaka, Bangladesh
| | - Abdur Razzaque Sarker
- Population Studies Division, Bangladesh Institute of Development Studies (BIDS), Dhaka, Bangladesh
- Institute of Applied Health Research, University of Birmingham, United Kingdom
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Ștefănescu R, Ősz BE, Pintea A, Laczkó-Zöld E, Tero-Vescan A, Vari CE, Fulop E, Blaș I, Vancea S. Fennel Essential Oil as a Complementary Therapy in the Management of Diabetes. Pharmaceutics 2023; 15:2657. [PMID: 38139998 PMCID: PMC10747567 DOI: 10.3390/pharmaceutics15122657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/05/2023] [Accepted: 11/18/2023] [Indexed: 12/24/2023] Open
Abstract
Diabetes is a serious pathology that affects a significant number of people worldwide. Its progression is rapid and leads to serious complications if glycemic control is missing. The micro and macrovascular complications of diabetes produce disabilities over time that affect the daily lives of patients. The major challenge of diabetes therapy is to reach a stable glycemic state and to delay the onset of specific complications. Aromatherapy is considered an alternative or complementary therapy, but in recent years, there has been a tendency to overuse essential oils. The present study was designed to evaluate and compare the effects produced by the topical and oral administration of fennel essential oil to diabetic rats. Eighteen compounds in fennel essential oil were identified by gas chromatography-mass spectrometry (GC-MS) analysis. The major compounds were trans-anethole (64.6%) and fenchone (24.5%). The in vivo study revealed that after a four-week treatment with fennel essential oil, the rats' glycemic levels were significantly reduced (p ≤ 0.05). Furthermore, there were no differences between the two routes of administration. In addition, an ex vivo study underlined the potential effect of this essential oil in the prevention of cataract formation.
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Affiliation(s)
- Ruxandra Ștefănescu
- Department of Pharmacognosy and Phytotherapy, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mures, 38 Gheorghe Marinescu Street, 540139 Târgu Mures, Romania; (R.Ș.); (E.L.-Z.)
| | - Bianca-Eugenia Ősz
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 38 Gheorghe Marinescu Street, 540139 Târgu Mures, Romania;
| | - Andrada Pintea
- Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 38 Gheorghe Marinescu Street, 540139 Târgu Mures, Romania; (A.P.); (I.B.)
| | - Eszter Laczkó-Zöld
- Department of Pharmacognosy and Phytotherapy, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mures, 38 Gheorghe Marinescu Street, 540139 Târgu Mures, Romania; (R.Ș.); (E.L.-Z.)
| | - Amelia Tero-Vescan
- Department of Biochemistry, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 38 Gheorghe Marinescu Street, 540139 Târgu Mures, Romania;
| | - Camil-Eugen Vari
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 38 Gheorghe Marinescu Street, 540139 Târgu Mures, Romania;
| | - Emoke Fulop
- Emergency County Hospital Târgu Mureș, Department of Pathology, 50 Gh. Marinescu Street, 540136 Târgu Mureș, Romania;
| | - Iuliana Blaș
- Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 38 Gheorghe Marinescu Street, 540139 Târgu Mures, Romania; (A.P.); (I.B.)
| | - Szende Vancea
- Legal Medicine Service, Emergency County Hospital Miercurea Ciuc, 530173 Miercurea Ciuc, Romania;
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Yunus NA, Russell G, Muhamad R, Sturgiss EA. Patients' experience of accessing healthcare for obesity in Peninsular Malaysia: a qualitative descriptive study. BMJ Open 2023; 13:e071087. [PMID: 37989390 PMCID: PMC10668280 DOI: 10.1136/bmjopen-2022-071087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 10/30/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE To explore patients' experiences accessing healthcare for obesity and their perceived behaviour changes following the care. DESIGN Using a descriptive qualitative research approach informed by Levesque's framework of access to healthcare, we conducted phone interviews in the Malaysian language, which were audio-recorded and transcribed verbatim. Data were analysed inductively using a reflexive thematic analysis approach. SETTING Primary care clinics in five states in Peninsular Malaysia. PARTICIPANTS Adult patients with obesity receiving face-to-face care for obesity from healthcare providers in Peninsular Malaysia. RESULTS We interviewed 22 participants aged 24-62, with the majority being female (77%), Malay (95%), married (73%) and with tertiary education (82%). Most participants attended obesity management services at public primary care clinics. We identified five themes: (1) moving from perceiving the need to seeking obesity care is a non-linear process for patients, (2) providers' words can inspire patients to change, (3) patients' needs and preferences are not adequately addressed in current obesity care, (4) over-focusing on weight by patients and healthcare providers can lead to self-blame and loss of hope for patients and (5) obesity healthcare can have consequences beyond weight loss. CONCLUSION Patients lack the self-regulatory skills to continue their lifestyle changes and struggle with self-blame and hopelessness. Over-focusing on weight by patients and obesity healthcare increase patients' self-stigmatisation. While provider-initiated weight discussions and engaging and personalised consultation provide the initial step towards weight management, obesity healthcare could be enhanced by behavioural support and patient education on the complexity of obesity. Further considerations could be given to shifting from a weight-centric to a more holistic health-centred approach in obesity healthcare.
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Affiliation(s)
- Nor Akma Yunus
- School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Grant Russell
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rosediani Muhamad
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Elizabeth Ann Sturgiss
- School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
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12
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Durma AD, Saracyn M, Kołodziej M, Jóźwik-Plebanek K, Dmochowska B, Kapusta W, Żmudzki W, Mróz A, Kos-Kudła B, Kamiński G. Epidemiology of Neuroendocrine Neoplasms and Results of Their Treatment with [ 177Lu]Lu-DOTA-TATE or [ 177Lu]Lu-DOTA-TATE and [ 90Y]Y-DOTA-TATE-A Six-Year Experience in High-Reference Polish Neuroendocrine Neoplasm Center. Cancers (Basel) 2023; 15:5466. [PMID: 38001726 PMCID: PMC10670106 DOI: 10.3390/cancers15225466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/10/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
Neuroendocrine neoplasms (NENs) are a group of neoplasms arising from neuroendocrine cells. The worldwide incidence and prevalence of the NENs are estimated to be 6/100,000 and 35/100,000, respectively. Those numbers are increasing every decade, requiring higher and higher diagnosis and treatment costs. Radioligand therapy (RLT) using beta-emitting radioisotopes is an efficient and relatively safe method of treatment, typically used as a second-line treatment. RLT tolerability is higher than other available pharmacotherapies (chemotherapy or tyrosine kinase inhibitors). Recent studies show an increase in overall survival among patients treated with RLT. The present study aimed to learn the epidemiology of NENs in Poland and assess the effectiveness of RLT in a high-reference center. A prospective analysis of 167 patients treated with RLT in one of Poland's highest-reference NEN centers was performed. The analysis covered 66 months of observation (1 December 2017-30 May 2023), during which 479 RLT single administrations of radioisotope were given. The standard procedure was to give four courses of [177Lu]Lu-DOTA-TATE alone, or tandem therapy-[177Lu]Lu-DOTA-TATE and [90Y]Y-DOTA-TATE. Grading analysis showed that most patients had non-functioning G2 NEN with a mean Ki-67 of 6.05% (SD ± 6.41). The most common primary tumor location was the pancreas. Over two-thirds of patients did undergo surgery due to primary tumors or distant metastases. The majority of patients were using lanreotide as a chronically injected somatostatin analog. Median progression-free survival (PFS) on somatostatin analogs was 21.0 (IQR = 29.0) months. Directly after the last course of RLT, disease stabilization was noted in 69.46% of patients, partial regression was noted in 20.36% of patients, complete regression was noted in 0.60% of patients, and progression was noted in 9.58% of patients. In long-term follow-up, the median observation time among patients who underwent four treatment cycles (n = 108) was 29.8 (IQR = 23.9) months. Stabilization of the disease was observed in 55.56% of the patients and progression was observed in 26.85% of the patients, while 17.59% of patients died. Median PFS was 29.3 (IQR 23.9), and the median OS was 34.0 months (IQR 16.0). The mean age of NEN diagnosis is the sixth decade of life. It takes almost three years from NEN diagnosis to the start of RLT. In long-term observation, RLT leads to disease stabilization in over half of the patients with progressive disease. No differences in PFS or OS depend on the radioisotope used for RLT. In Poland, organized coordination of NEN treatment in high-reference centers ensures the continuity of patient care.
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Affiliation(s)
- Adam Daniel Durma
- Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland
| | - Marek Saracyn
- Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland
| | - Maciej Kołodziej
- Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland
| | - Katarzyna Jóźwik-Plebanek
- Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland
| | - Beata Dmochowska
- Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland
| | - Waldemar Kapusta
- Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland
| | - Wawrzyniec Żmudzki
- Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland
| | - Adrianna Mróz
- Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland
| | - Beata Kos-Kudła
- Department of Endocrinology and Neuroendocrine Tumors, Department of Pathophysiology and Endocrinology in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Grzegorz Kamiński
- Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland
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13
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Shrivastava S, Sharma A, Saxena N, Bhamra R, Kumar S. Addressing the preventive and therapeutic perspective of berberine against diabetes. Heliyon 2023; 9:e21233. [PMID: 38027723 PMCID: PMC10663750 DOI: 10.1016/j.heliyon.2023.e21233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/20/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Diabetes has emerged as one the leading detrimental factors for human life expectancy worldwide. The disease is mainly considered as outcome of dysregulation in glucose metabolism, resulting in consistent high glucose concentration in blood. At initial stages, the diabetes particularly type 2 diabetes, is manageable by lifestyle interventions such as regular physical activity and diet with less carbohydrates. However, in advance stage, regular intake of external insulin dose and medicines like metformin are recommended. The long-term consumption of metformin is associated with several side effects such as nausea, vomiting, diarrhoea, lectic acidosis etc., In this scenario, several plant-based medicines have shown promising potential for the prevention and treatment of diabetes. Berberine is the bioactive compound present in the different plant parts of berberis family. Biochemical studies have shown that berberine improve insulin sensitivity and insulin secretion. Additionally, berberine induces glucose metabolism by activating AMPK signaling and inhibition of inflammation. A series of studies have demonstrated the antidiabetic potential of berberine at in vitro, pre-clinical and clinical trials. This review provides comprehensive details of preventive and therapeutic potential of berberine against diabetes.
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Affiliation(s)
- Suyesh Shrivastava
- ICMR-National Institute of Research in Tribal Health, Nagpur Road, Jabalpur-482003, India
| | - Anamika Sharma
- National Institute of Pharmaceutical and Education and Research 500037, Hyderabad, India
| | - Nishant Saxena
- ICMR-National Institute of Research in Tribal Health, Nagpur Road, Jabalpur-482003, India
| | - Rashmi Bhamra
- Global Research Institute of Pharmacy, Radour-135133, Haryana, India
| | - Sandeep Kumar
- ICMR-National Institute of Research in Tribal Health, Nagpur Road, Jabalpur-482003, India
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14
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Rijal P, Kumar B, Barnwal S, Khapre M, Rijal D, Kant R. Subclinical right ventricular dysfunction in patients with asymptomatic type 2 diabetes mellitus: A cross-sectional study. Indian Heart J 2023; 75:451-456. [PMID: 37863394 PMCID: PMC10774569 DOI: 10.1016/j.ihj.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/30/2023] [Accepted: 10/16/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Diabetic cardiomyopathy, which involves both the right and left ventricles, progresses from a preclinical stage to overt heart failure. Detection of this entity at a preclinical stage could be crucial in intervening to halt its progression to overt heart failure. There is a paucity of literature on subclinical RV dysfunction in diabetic patients, and it is even rarer in the Indian literature. Our study intended to study this clinical entity through an echocardiographic assessment of asymptomatic patients. OBJECTIVES This was a cross-sectional observational analytic study, comparing subclinical RV dysfunction in diabetic and non-diabetic subjects by using echocardiography as a primary objective, while the secondary objective of the study was to find out the correlation between RV dysfunction and the duration of diabetes mellitus and HbA1C levels. METHODS Conventional echocardiography with tissue Doppler imaging (TDI) was used to measure nine different echocardiographic parameters in the diabetic and non-diabetic groups. All probable causes of RV dysfunction were excluded before enrolling the patients in the study. Unpaired t-test was used to compare the parameters between the two groups, and multivariate regression analysis was done taking into consideration age, duration of diabetes, and HbA1C levels as the independent variables, and echocardiographic parameters as the dependent variables. RESULTS Out of the nine different echocardiographic parameters, Tricuspid annular plane systolic excursion (TAPSE), RV end diastolic diameter (RVEDD), Tricuspid peak late diastolic velocity (A), E/A ratio, RV basal segment peak myocardial systolic velocity (Sm), RV basal segment peak early diastolic velocity (Em), RV basal segment peak late diastolic velocity (Am), and E/Em ratio showed statistically significant differences between the two groups. These results show the presence of subclinical RV dysfunction in diabetic patients. TAPSE and E/A ratio showed a significant correlation with the duration of diabetes, while Em showed a significant correlation with HbA1C. CONCLUSION Diabetes mellitus is associated with subclinical systolic as well as diastolic RV dysfunction. In addition to helping identify people at high risk, the early recognition of RV dysfunction gives us a window of opportunity to take action and slow down the disease's course. This study emphasizes that the early identification of RV diastolic as well as systolic dysfunction in asymptomatic Type 2 diabetic patients can be a helpful tool in halting the progression of disease from subclinical to frank clinical cases, thereby preventing the morbidity and mortality associated with heart failure. Hence, it adds value to the pre-existing literature.
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Affiliation(s)
- Prabhat Rijal
- Department of Internal Medicine, All India Institute of Medical Sciences, Rishikesh, 249203, Uttarakhand, India.
| | - Barun Kumar
- Department of Cardiology, All India Institute of Medical Sciences, Rishikesh, 249203, Uttarakhand, India.
| | - Shruti Barnwal
- Department of Dermatology, Soban Singh Jeena Government Institute of Medical Sciences and Research, Uttarakhand, India.
| | - Meenakshi Khapre
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, 249203, Uttarakhand, India.
| | - Divas Rijal
- Department of Internal Medicine, Tribhuvan University Institute of Medicine, Kathmandu, 44600, Nepal.
| | - Ravi Kant
- Department of Internal Medicine, All India Institute of Medical Sciences, Rishikesh, 249203, Uttarakhand, India.
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15
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Alhadreti O. An examination of the content of diabetes websites targeting Arabic speakers. Int J Med Inform 2023; 179:105242. [PMID: 37806177 DOI: 10.1016/j.ijmedinf.2023.105242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 09/27/2023] [Accepted: 09/30/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND There has been an increase in the numbers of people in the Middle East and North Africa (MENA) region seeking online information about diabetes, as the Internet is considered a helpful tool for finding information about disease prevention and treatment. It is important that the sources available are reliable, trustworthy and easily accessible. However, the quality and readability of such information is questionable. This study examines the content of Arabic diabetes websites and offers recommendations to improve engagement and access to health information. METHODS This study employed a cross-sectional analysis approach to assess diabetes websites targeting Arabic speakers in the MENA countries. Google trends was utilized to reveal the top searched topics across the MENA region, which were used as search terms to identify the websites in search engines, resulting in the examination of 26 websites. The analysis combined automated tools with expert evaluation methods and involved five dimensions: quality, readability, engagement, popularity, and availability. RESULTS Overall, the majority of the websites performed poorly in the five dimensions and thus require careful reassessment of their content, design, and readability; no website performed well in all dimensions. Only two websites (7.6%) were HONcode certified, and none of the websites achieved a high score in the DISCERN analysis. The readability scores indicated that most websites were above the recommended level of reading. The results also revealed that all websites had poor engagement. Half of the websites had good ranking, and 58% of the websites covered all of the target topics. Of the websites examined, the non-commercial and non-professional sites (classified as "others") seem to have greater readability, higher bounce rates and longer visit duration than the commercial sites. CONCLUSIONS The results from this study show a need for improving the content of diabetes information websites available to Arabic speakers. In order to develop websites that contain easy-to-read and understand high-quality information, collaboration between multiple stakeholders is necessary.
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Affiliation(s)
- Obead Alhadreti
- Al-Qunfudhah Computing College, Umm Al-Qura University, Saudi Arabia.
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Roohi TF, Faizan S, Parray ZA, Baig MDAI, Mehdi S, Kinattingal N, Krishna KL. Beyond Glucose: The Dual Assault of Oxidative and ER Stress in Diabetic Disorders. High Blood Press Cardiovasc Prev 2023; 30:513-531. [PMID: 38041772 DOI: 10.1007/s40292-023-00611-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 11/15/2023] [Indexed: 12/03/2023] Open
Abstract
Diabetes mellitus, a prevalent global health concern, is characterized by hyperglycemia. However, recent research reveals a more intricate landscape where oxidative stress and endoplasmic reticulum (ER) stress orchestrate a dual assault, profoundly impacting diabetic disorders. This review elucidates the interplay between these two stress pathways and their collective consequences on diabetes. Oxidative stress emanates from mitochondria, where reactive oxygen species (ROS) production spirals out of control, leading to cellular damage. We explore ROS-mediated signaling pathways, which trigger β-cell dysfunction, insulin resistance, and endothelial dysfunction the quintessential features of diabetes. Simultaneously, ER stress unravels, unveiling how protein folding disturbances activate the unfolded protein response (UPR). We dissect the UPR's dual role, oscillating between cellular adaptation and apoptosis, significantly influencing pancreatic β-cells and peripheral insulin-sensitive tissues. Crucially, this review exposes the synergy between oxidative and ER stress pathways. ROS-induced UPR activation and ER stress-induced oxidative stress create a detrimental feedback loop, exacerbating diabetic complications. Moreover, we spotlight promising therapeutic strategies that target both stress pathways. Antioxidants, molecular chaperones, and novel pharmacological agents offer potential avenues for diabetes management. As the global diabetes burden escalates, comprehending the dual assault of oxidative and ER stress is paramount. This review not only unveils the intricate molecular mechanisms governing diabetic pathophysiology but also advocates a holistic therapeutic approach. By addressing both stress pathways concurrently, we may forge innovative solutions for diabetic disorders, ultimately alleviating the burden of this pervasive health issue.
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Affiliation(s)
- Tamsheel Fatima Roohi
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysore, Karnataka, 570015, India
| | - Syed Faizan
- Department of Pharmaceutical Chemistry, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysore, Karnataka, 570015, India
| | - Zahoor Ahmad Parray
- Department of Chemistry, Indian Institute of Technology (IIT) Delhi, Hauz Khas Campus, New Delhi, 110016, India
| | - M D Awaise Iqbal Baig
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysore, Karnataka, 570015, India
| | - Seema Mehdi
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysore, Karnataka, 570015, India
| | - Nabeel Kinattingal
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysore, Karnataka, 570015, India
| | - K L Krishna
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysore, Karnataka, 570015, India.
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17
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Shi B, Dhaliwal SS, Soo M, Chan C, Wong J, Lam NWC, Zhou E, Paitimusa V, Loke KY, Chin J, Chua MT, Liaw KCS, Lim AWH, Insyirah FF, Yen SC, Tay A, Ang SB. Assessing Elevated Blood Glucose Levels Through Blood Glucose Evaluation and Monitoring Using Machine Learning and Wearable Photoplethysmography Sensors: Algorithm Development and Validation. JMIR AI 2023; 2:e48340. [PMID: 38875549 PMCID: PMC11041426 DOI: 10.2196/48340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 08/31/2023] [Accepted: 09/28/2023] [Indexed: 06/16/2024]
Abstract
BACKGROUND Diabetes mellitus is the most challenging and fastest-growing global public health concern. Approximately 10.5% of the global adult population is affected by diabetes, and almost half of them are undiagnosed. The growing at-risk population exacerbates the shortage of health resources, with an estimated 10.6% and 6.2% of adults worldwide having impaired glucose tolerance and impaired fasting glycemia, respectively. All current diabetes screening methods are invasive and opportunistic and must be conducted in a hospital or laboratory by trained professionals. At-risk participants might remain undetected for years and miss the precious time window for early intervention to prevent or delay the onset of diabetes and its complications. OBJECTIVE We aimed to develop an artificial intelligence solution to recognize elevated blood glucose levels (≥7.8 mmol/L) noninvasively and evaluate diabetic risk based on repeated measurements. METHODS This study was conducted at KK Women's and Children's Hospital in Singapore, and 500 participants were recruited (mean age 38.73, SD 10.61 years; mean BMI 24.4, SD 5.1 kg/m2). The blood glucose levels for most participants were measured before and after consuming 75 g of sugary drinks using both a conventional glucometer (Accu-Chek Performa) and a wrist-worn wearable. The results obtained from the glucometer were used as ground-truth measurements. We performed extensive feature engineering on photoplethysmography (PPG) sensor data and identified features that were sensitive to glucose changes. These selected features were further analyzed using an explainable artificial intelligence approach to understand their contribution to our predictions. RESULTS Multiple machine learning models were trained and assessed with 10-fold cross-validation, using participant demographic data and critical features extracted from PPG measurements as predictors. A support vector machine with a radial basis function kernel had the best detection performance, with an average accuracy of 84.7%, a sensitivity of 81.05%, a specificity of 88.3%, a precision of 87.51%, a geometric mean of 84.54%, and F score of 84.03%. CONCLUSIONS Our findings suggest that PPG measurements can be used to identify participants with elevated blood glucose measurements and assist in the screening of participants for diabetes risk.
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Affiliation(s)
- Bohan Shi
- Actxa Pte Ltd, Singapore, Singapore
- Activate Interactive Pte Ltd, Singapore, Singapore
| | - Satvinder Singh Dhaliwal
- Curtin Health Innovation Research Institute, Curtin University, Perth, Australia
- Faculty of Health Sciences, Curtin University, Perth, Australia
- Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore
| | | | - Cheri Chan
- KK Women's and Children's Hospital, Singapore, Singapore
| | | | | | - Entong Zhou
- Activate Interactive Pte Ltd, Singapore, Singapore
| | | | - Kum Yin Loke
- Activate Interactive Pte Ltd, Singapore, Singapore
| | - Joel Chin
- Activate Interactive Pte Ltd, Singapore, Singapore
| | - Mei Tuan Chua
- KK Women's and Children's Hospital, Singapore, Singapore
| | | | | | | | - Shih-Cheng Yen
- Innovation and Design Programme, Faculty of Engineering, National University of Singapore, Singapore, Singapore
| | - Arthur Tay
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
| | - Seng Bin Ang
- Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Menopause Unit, KK Women's and Children's Hospital, Singapore, Singapore
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Özkan İ, İlaslan E. Investigation of the relationship between the attitudes of patients with type 2 diabetes toward insulin therapy and complementary alternative medicine. Prim Care Diabetes 2023; 17:479-485. [PMID: 37407297 DOI: 10.1016/j.pcd.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/12/2023] [Accepted: 06/23/2023] [Indexed: 07/07/2023]
Abstract
AIM This study aimed to determine the attitudes of patients with type 2 diabetes toward insulin treatment and complementary alternative medicine and to examine the relationship between them. METHOD A cross-sectional design was used in the study. A total of 293 patients with type 2 diabetes were included in the study. The study data were collected by using a Descriptive Information Form, Complementary, Alternative and Conventional Medicine Attitude Scale (CACMAS), and the Insulin Treatment Appraisal Scale (ITAS). The factors related to the attitudes of patients with type 2 diabetes toward insulin were examined by using multiple linear regression analysis. RESULTS It was determined that 36.5% of the patients used CAM, 49.8% received insulin therapy, and that 38.6% received oral antidiabetic treatment. Patients' mean score on the total CACMAS was 106.8 ± 19.7, indicating a moderately positive attitude. Their mean score on the total ITAS was 57.1 ± 11.6, suggesting that they had a negative attitude toward insulin therapy. In regular drug use, negative attitudes toward insulin decreased (β = -0.151, p < 0.001), and when dissatisfaction with conventional medicine increased, negative attitudes toward insulin increased, as well (β = -0.432p<0.05). CONCLUSION While almost all of the patients (93.9%) had a negative attitude toward insulin, they had a moderately positive attitude toward the use of CAM. A significant portion of them (36.5%) stated that they used CAM. There was a weak positive correlation between attitude toward CAM and negative attitude toward insulin.
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Affiliation(s)
- İlknur Özkan
- Akdeniz University, Kumluca Faculty of Health Sciences, Internal Medicine Nursing Department, Kumluca, Antalya, Turkey.
| | - Emine İlaslan
- University, Kumluca Faculty of Health Sciences, Internal Medicine Nursing Department, Kumluca, Antalya, Turkey
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19
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Sekitoleko I, Nakanga WP, Webb E, Mugamba V, Balungi P, Mpairwe B, Terry O, Makanga R, Nabanoba E, Mugisha JO, Kimbugwe G, Nyirenda MJ, Niwaha AJ. Identification and characterisation of diabetes in Uganda: protocol for the nested, population-based 'Diabetes in low-resource Populations' (DOP) Study. BMJ Open 2023; 13:e071747. [PMID: 37709304 PMCID: PMC10921991 DOI: 10.1136/bmjopen-2023-071747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 07/16/2023] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION Sub-Saharan Africa is experiencing an increasing burden of diabetes, but there are little reliable data, particularly at the community level, on the true prevalence or why this condition affects young and relatively lean individuals. Moreover, the detection of diabetes in Africa remains poor, not only due to a lack of resources but because the performance of available diagnostic tests is unclear. METHODS This research aims to (1) determine the prevalence and risk factors of diabetes in a rural Ugandan population, (2) use clinical and biochemical markers to define different diabetes phenotypes and (3) study the progression of diabetes in this population. We will also assess the utility of the widely used tests (glycated haemoglobin (HbA1c), oral glucose tolerance test (OGTT) and fasting glucose) in diagnosing diabetes. DESIGN This is a population-based study nested within the longstanding general population cohort in southwestern Uganda. We will undertake a population survey to identify individuals with diabetes based on fasting glucose, HbA1c, OGTT results or history of pre-existing diabetes. PARTICIPANTS The study intends to enrol up to 11 700 individuals aged 18 years and above, residing within the study area and not pregnant or within 6 months post-delivery date. All participants will have detailed biophysical and biochemical/metabolic measurements. Individuals identified to have diabetes and a random selection of controls will have repeat tests to test reproducibility before referral and enrolment into a diabetic clinic. Participants will then be followed up for 1 year to assess the course of the disease, including response to therapy and diabetes-related complications. CONCLUSIONS These data will improve our understanding of the burden of diabetes in Uganda, the risk factors that drive it and underlying pathophysiological mechanisms, as well as better ways to detect this condition. This will inform new approaches to improve the prevention and management of diabetes. ETHICS AND DISSEMINATION This study protocol was approved by the Uganda Virus Research Institute Research Ethics Committee (REC) (number: G.C./127/21/09/858), the London School of Hygiene and Tropical Medicine REC (number: 26638) and the Uganda National Council for Science and Technology (protocol number: HS1791ES). Written informed consent will be obtained from all participants before being enrolled on to the study and conducting study-related procedures. Research findings will be disseminated in policy briefs, seminars, local and international conferences and publications in peer-reviewed open-access journals. As part of the dissemination plans, findings will also be disseminated to patient care groups and to clinicians. TRIAL REGISTRATION NUMBER NCT05487079.
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Affiliation(s)
- Isaac Sekitoleko
- Statistics and Data Science, Medical Research Council/Uganda Virus Research Institute and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Wisdom P Nakanga
- Non-communicable diseases, Malawi Epidemiology and Intervention Research Unit (MEIRU), Chilumba, Malawi
| | - Emily Webb
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Viola Mugamba
- Non-communicable diseases Theme, Medical Research Council/Uganda Virus Research Institute and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Priscilla Balungi
- Non-communicable diseases Theme, Medical Research Council/Uganda Virus Research Institute and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Bernard Mpairwe
- Non-communicable diseases Theme, Medical Research Council/Uganda Virus Research Institute and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Ongaria Terry
- Non-communicable diseases Theme, Medical Research Council/Uganda Virus Research Institute and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Ronald Makanga
- Non-communicable diseases Theme, Medical Research Council/Uganda Virus Research Institute and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Esther Nabanoba
- Non-communicable diseases Theme, Medical Research Council/Uganda Virus Research Institute and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Joseph O Mugisha
- Non-communicable diseases Theme, Medical Research Council/Uganda Virus Research Institute and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Geofrey Kimbugwe
- Non-communicable diseases Theme, Medical Research Council/Uganda Virus Research Institute and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Moffat J Nyirenda
- Non-communicable diseases Theme, Medical Research Council/Uganda Virus Research Institute and LSHTM Uganda Research Unit, Entebbe, Uganda
- NCD Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Anxious J Niwaha
- Non-communicable diseases Theme, Medical Research Council/Uganda Virus Research Institute and LSHTM Uganda Research Unit, Entebbe, Uganda
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Sharma P, Dilip TR, Mishra US, Kulkarni A. The lifetime risk of developing type II diabetes in an urban community in Mumbai: findings from a ten-year retrospective cohort study. BMC Public Health 2023; 23:1673. [PMID: 37653484 PMCID: PMC10469861 DOI: 10.1186/s12889-023-16596-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/23/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Incidence and prevalence do not capture the risk of developing diabetes during a defined period and only limited evidence exists on the lifetime risk of diabetes based on longer and continuous follow-up studies in India. Lacunae in evidence on lifetime risk can be attributed primarily to the absence of comprehensive and reliable information on diabetes incidence, mortality rates and lack of longitudinal studies in India. In light of the scarcity of evidence in India, the objective of this study was to estimate the incidence of diabetes and its lifetime risk in an urban community of Mumbai. METHODS The research study utilized data which is extracted from the electronic medical records of beneficiaries covered under the Contributory Health Service Scheme in Mumbai. The dataset included information on 1652 beneficiaries aged 40 years and above who were non-diabetic in 2011-2012, capturing their visit dates to medical center and corresponding laboratory test results over a span ten years from January, 2012- December, 2021. Survival analysis techniques are applied to estimate the incidence of diabetes. Subsequently, the remaining life years from the life table were utilized to estimate the lifetime risk of diabetes for each gender, stratified by age group. RESULTS A total of 546 beneficiaries developed diabetes in ten years, yielding an unadjusted incidence rate of 5.3 cases per 1000 person-years (95% CI: 4.9- 5.8 cases/ 1000 person years). The age-adjusted lifetime risk of developing type II diabetes in this urban community is estimated to be 40.3%. Notably, males aged 40 years and above had 41.5% chances of developing diabetes in their lifetime as compared to females with a risk of 39.4%. Moreover, the remaining lifetime risk of diabetes decreased with advancing age, ranging from 26.4% among 40-44 years old to 4.2% among those age 70 years and above. CONCLUSION The findings stress the significance of recognizing age specific lifetime risk and implementing early interventions to prevent or delay diabetes onset and to focus on diabetes management programs in India.
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Affiliation(s)
- Palak Sharma
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, 400088, India.
| | - T R Dilip
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, 400088, India
| | - Udaya Shankar Mishra
- Department of Bio-Statistics and Epidemiology, International Institute for Population Sciences, Mumbai, 400088, India
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21
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Darenskaya M, Kolesnikov S, Semenova N, Kolesnikova L. Diabetic Nephropathy: Significance of Determining Oxidative Stress and Opportunities for Antioxidant Therapies. Int J Mol Sci 2023; 24:12378. [PMID: 37569752 PMCID: PMC10419189 DOI: 10.3390/ijms241512378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
Diabetes mellitus (DM) belongs to the category of socially significant diseases with epidemic rates of increases in prevalence. Diabetic nephropathy (DN) is a specific kind of kidney damage that occurs in 40% of patients with DM and is considered a serious complication of DM. Most modern methods for treatments aimed at slowing down the progression of DN have side effects and do not produce unambiguous positive results in the long term. This fact has encouraged researchers to search for additional or alternative treatment methods. Hyperglycemia has a negative effect on renal structures due to a number of factors, including the activation of the polyol and hexosamine glucose metabolism pathways, the activation of the renin-angiotensin-aldosterone and sympathetic nervous systems, the accumulation of advanced glycation end products and increases in the insulin resistance and endothelial dysfunction of tissues. The above mechanisms cause the development of oxidative stress (OS) reactions and mitochondrial dysfunction, which in turn contribute to the development and progression of DN. Modern antioxidant therapies for DN involve various phytochemicals (food antioxidants, resveratrol, curcumin, alpha-lipoic acid preparations, etc.), which are widely used not only for the treatment of diabetes but also other systemic diseases. It has also been suggested that therapeutic approaches that target the source of reactive oxygen species in DN may have certain advantages in terms of nephroprotection from OS. This review describes the significance of studies on OS biomarkers in the pathogenesis of DN and analyzes various approaches to reducing the intensity of OS in the prevention and treatment of DN.
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Affiliation(s)
- Marina Darenskaya
- Department of Personalized and Preventive Medicine, Scientific Centre for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia; (S.K.); (N.S.); (L.K.)
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22
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Naidoo P, Naidoo K, Karamchand S, Leisegang RF. Access to novel anti-diabetic agents in resource limited settings: A brief commentary. World J Diabetes 2023; 14:939-941. [PMID: 37547585 PMCID: PMC10401454 DOI: 10.4239/wjd.v14.i7.939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/31/2022] [Accepted: 06/13/2023] [Indexed: 07/12/2023] Open
Abstract
The prevalence of diabetes mellitus is increasing in resource limited settings. Simultaneously, there has been an increase in the number of novel therapies for the management of diabetes mellitus. However, use of novel antidiabetic therapies is limited because of major market access challenges in resource limited settings. Niching products to those patients with the highest absolute risk for major adverse cardiovascular outcomes, and thus most likely to benefit from the therapy, are less likely to have negative budget impact for funders. To improve access, and reduce morbidity and mortality, requires alignment amongst key stakeholders including patient advocacy groups, health care professional councils, national departments of health, the pharmaceutical industry, treasury and finance departments.
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Affiliation(s)
- Poobalan Naidoo
- Department of Internal Medicine, Nelson R Mandela, School of Medicine, University of Kwa-Zulu Natal, Durban 4001, Kwa-Zulu Natal, South Africa
| | - Kiolan Naidoo
- Department of Law, University of South Africa, Pretoria 3, Gauteng, South Africa
| | - Sumanth Karamchand
- Department of Cardiology, University of Stellenbosch and Tygerberg Hospital, Stellenbosch 7600, Western Cape, South Africa
| | - Rory F Leisegang
- Department of Pharmacometrics, Upsala University, Uppsala 751 04, Sweden
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23
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Vaishya R, Misra A, Nassar M, Vaish A. Global trend of research and publications in endocrinology, diabetes, and metabolism: 1996–2021. Int J Diabetes Dev Ctries 2023. [DOI: 10.1007/s13410-023-01221-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/29/2023] [Indexed: 10/20/2023] Open
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McClorry S, Ji P, Parenti MG, Slupsky CM. Antibiotics augment the impact of iron deficiency on metabolism in a piglet model. J Nutr Biochem 2023:109405. [PMID: 37311489 DOI: 10.1016/j.jnutbio.2023.109405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 06/15/2023]
Abstract
Infancy and childhood represent a high-risk period for developing iron deficiency (ID) and is a period of increased susceptibility to infectious disease. Antibiotic use is high in children from low-, middle-, and high-income countries, and thus we sought to determine the impact of antibiotics in the context of ID. In this study, a piglet model was used to assess the impact of ID and antibiotics on systemic metabolism. ID was induced by withholding a ferrous sulfate injection after birth to piglets in the ID group and providing an iron deficient diet upon weaning on postnatal day (PD) 25. Antibiotics (gentamicin and spectinomycin) were administered on PD34-36 to a set of control (Con*+Abx) and ID piglets (ID+Abx) after weaning. Blood was analyzed on PD30 (before antibiotic administration) and PD43 (7 days after antibiotic administration). All ID piglets exhibited growth faltering and had lower hemoglobin and hematocrit compared to control (Con) and Con*+Abx throughout. The metabolome of ID piglets at weaning and sacrifice exhibited elevated markers of oxidative stress, ketosis, and ureagenesis compared to Con. The impact of antibiotics on Con*+Abx piglets did not result in significant changes to the serum metabolome 7-days after treatment; however, the impact of antibiotics on ID+Abx piglets resulted in the same metabolic changes observed in ID piglets, but with a greater magnitude when compared to Con. These results suggest that antibiotic administration in the context of ID exacerbates the negative metabolic impacts of ID and may have long lasting impacts on development.
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Affiliation(s)
- Shannon McClorry
- Department of Nutrition, UC Davis, One Shields Ave, Davis, CA, 95616, USA
| | - Peng Ji
- Department of Nutrition, UC Davis, One Shields Ave, Davis, CA, 95616, USA
| | - Mariana G Parenti
- Department of Nutrition, UC Davis, One Shields Ave, Davis, CA, 95616, USA
| | - Carolyn M Slupsky
- Department of Nutrition, UC Davis, One Shields Ave, Davis, CA, 95616, USA; Department of Food Science and Technology, UC Davis, One Shields Ave, Davis, CA, 95616, USA.
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25
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Aloke C, Iwuchukwu EA, Achilonu I. Exploiting Copaifera salikounda compounds as treatment against diabetes: An insight into their potential targets from a computational perspective. Comput Biol Chem 2023; 104:107851. [DOI: 10.1016/j.compbiolchem.2023.107851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/25/2023] [Accepted: 03/19/2023] [Indexed: 03/29/2023]
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26
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Visagie E, Deacon E, Kok R. Exploring the role of CBT in the self-management of type 2 diabetes: A rapid review. Health SA 2023; 28:2254. [PMID: 37292235 PMCID: PMC10244871 DOI: 10.4102/hsag.v28i0.2254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/08/2023] [Indexed: 06/10/2023] Open
Abstract
Background Type 2 diabetes has been recognised as a global health concern: one that requires intervention to lessen the incumbrance caused by the chronic illness. This rapid review was conducted to determine the scientific evidence available on how Cognitive Behaviour Therapy (CBT) interventions improved the self-management of individuals with type 2 diabetes. Aim The aim of the review was to synthesise current scientific evidence regarding CBT-based interventions and self-management practices. Method The rapid review served as a framework to appraise current national and international literature. The researchers used Google Scholar, Journal Storage (JSTOR), PsycINFO, APA PsycArticles, SAGE journals and EBSCO Discovery Services to search for relevant studies. This was performed by employing keywords. Nine relevant studies were identified. The studies were heterogenous in methodology. Seven of the nine studies were conducted in developing countries. Results The study found that the context of developmental countries plays a significant role in the development of type 2 diabetes and requires tailored intervention because of socio-economic variabilities. The main themes identified in relation to improving self-management included: the characteristics of the CBT-based interventions, namely the format, duration, and outcomes, and identifying the techniques and components used in the CBT-based interventions. Conclusion The review emphasised the need to further investigate the role of CBT in improving self-management of type 2 diabetes, especially in a South African context. Contribution The review summarised the techniques that have proven to be effective for the self-management of type 2 diabetes.
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Affiliation(s)
- Elne Visagie
- Compress Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Elmari Deacon
- Optentia Research Unit, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Rümando Kok
- Centre for Health and Human Performance (CHHP), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Chockalingam A, Natarajan P, Dorairajan S, Khan U. Early Recognition of Overweight Hyperglycaemia May Improve Clinical Outcomes in Type 2 Diabetes. TOUCHREVIEWS IN ENDOCRINOLOGY 2023; 19:33-37. [PMID: 37313244 PMCID: PMC10258620 DOI: 10.17925/ee.2023.19.1.33] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/20/2023] [Indexed: 06/15/2023]
Abstract
Diabetes is the ninth leading cause of death, directly accounting for 1.5 million deaths annually worldwide. Despite several breakthrough discoveries, little progress has been made in type 2 diabetes outcomes over the past 100 years. Younger age (below 60 years), a diet high in calories and processed food, and severe obesity (body mass index >35 kg/m2) may identify reversible beta cell dysfunction. Much of the clinical presentation pertains to flooding the body's adaptive limits with overnutrition. Recognizing this as a global societal trend brought about by lifestyle changes, sedentary work, mental stress and unlimited access to calorie-dense foods is crucial. Insulin resistance and genetic abnormalities cannot account for the dramatic increase in diabetes, from only 1% five decades ago to nearly 10% today. Obesity - and not insulin resistance - is at the core of the problem. As well as hyperglycaemia, end-organ damage can also be reversed with diet and weight loss in many affected individuals. We present the evolution of our understanding and compelling reasons to reframe diabetes in the severely obese to what it really is - overweight hyperglycaemia. This may shift societal perception, governmental funding, workplace reformations and individual engagement with healthy lifestyles. The objective of this review is to better understand global trends and the potential to improve outcomes by reframing the diabetes narrative towards remission. This may shift societal perception, governmental funding, workplace reformations and individual engagement with healthy lifestyles.
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Affiliation(s)
- Anand Chockalingam
- Division of Cardiovascular Medicine, University of Missouri, Columbia, MO, USA
- Cardiology Section, Harry S Truman VA Medical Center, Columbia, MO, USA
| | - Pandiyan Natarajan
- Nova IVF Fertility, Chettinad Super Speciality Hospital (Retired), Chennai, India
| | - Smrita Dorairajan
- Nephrology Section, Harry S Truman VA Medical Center, Columbia, MO, USA
| | - Uzma Khan
- Division of Endocrinology, University of Missouri, Columbia, MO, USA
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Huang H, Luo Y, Wang Q, Zhang Y, Li Z, He R, Chen X, Dong Z. Vaccinium as Potential Therapy for Diabetes and Microvascular Complications. Nutrients 2023; 15:2031. [PMID: 37432140 DOI: 10.3390/nu15092031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/15/2023] [Accepted: 04/20/2023] [Indexed: 07/12/2023] Open
Abstract
Diabetes mellitus is one of the most critical global health concerns, with a fast-growing prevalence. The incidence of diabetic vascular complications is also rapidly increasing, exacerbating the burden on individuals with diabetes and the consumption of public medical resources. Despite the overall improvements in the prevention, diagnosis, and treatment of diabetic microvascular complications in recent years, safe and effective alternative or adjunctive therapies are urgently needed. The mechanisms underlying diabetic vascular complications are complex, with hyperglycemia-induced oxidative stress and inflammation being the leading causes. Therefore, glycemic control, antioxidation, and anti-inflammation are considered the main targets for the treatment of diabetes and its vascular comorbidities. Vaccinium L. (Ericaceae) is a genus of plants enriched with polyphenolic compounds in their leaves and fruits. Vaccinium and its extracts have demonstrated good bioactivity in reducing blood glucose, oxidative stress, and inflammation, making them excellent candidates for the management of diabetes and diabetic vascular complications. Here, we review recent preclinical and clinical studies on the potential effect of Vaccinium on ameliorating diabetes and diabetic complications, particularly diabetic kidney disease and diabetic retinopathy.
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Affiliation(s)
- Hui Huang
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, Beijing 100853, China
- School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Yayong Luo
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, Beijing 100853, China
- School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Qian Wang
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, Beijing 100853, China
| | - Yihan Zhang
- BYHEALTH Institute of Nutrition & Health, No. 3 Kehui 3rd Street, No. 99 Kexue Avenue Central, Huangpu District, Guangzhou 510663, China
| | - Zhongxia Li
- BYHEALTH Institute of Nutrition & Health, No. 3 Kehui 3rd Street, No. 99 Kexue Avenue Central, Huangpu District, Guangzhou 510663, China
| | - Ruikun He
- BYHEALTH Institute of Nutrition & Health, No. 3 Kehui 3rd Street, No. 99 Kexue Avenue Central, Huangpu District, Guangzhou 510663, China
| | - Xiangmei Chen
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, Beijing 100853, China
- School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Zheyi Dong
- National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, Beijing 100853, China
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Maiti S, Akhtar S, Upadhyay AK, Mohanty SK. Socioeconomic inequality in awareness, treatment and control of diabetes among adults in India: Evidence from National Family Health Survey of India (NFHS), 2019-2021. Sci Rep 2023; 13:2971. [PMID: 36805018 PMCID: PMC9941485 DOI: 10.1038/s41598-023-29978-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
Diabetes is a growing epidemic and a major threat to most of the households in India. Yet, there is little evidence on the extent of awareness, treatment, and control (ATC) among adults in the country. In this study, we estimate the prevalence and ATC of diabetes among adults across various sociodemographic groups and states of India. We used data on 2,078,315 individuals aged 15 years and over from the recent fifth round, the most recent one, of the National Family Health Survey (NFHS-5), 2019-2021, that was carried out across all the states of India. Diabetic individuals were identified as those who had random blood glucose above 140 mg/dL or were taking diabetes medication or has doctor-diagnosed diabetes. Diabetic individuals who reported diagnosis were labelled as aware, those who reported taking medication for controlling blood glucose levels were labelled as treated and those whose blood glucose levels were < 140 mg/dL were labelled as controlled. The estimates of prevalence of diabetes, and ATC were age-sex adjusted and disaggregated by household wealth quintile, education, age, sex, urban-rural residence, caste, religion, marital status, household size, and state. Concentration index was used to quantify socioeconomic inequalities and multivariable logistic regression was used to estimate the adjusted differences in those outcomes. We estimated diabetes prevalence to be 16.1% (15.9-16.1%). Among those with diabetes, 27.5% (27.1-27.9%) were aware, 21.5% (21.1-21.7%) were taking treatment and 7% (6.8-7.1%) had their diabetes under control. Across the states of India, the adjusted rates of awareness varied from 14.4% (12.1-16.8%) to 54.4% (40.3-68.4%), of treatment from 9.3% (7.5-11.1%) to 41.2% (39.9-42.6%), and of control from 2.7% (1.6-3.7%) to 11.9% (9.7-14.0%). The age-sex adjusted rates were lower (p < 0.001) among the poorer and less educated individuals as well as among males, residents of rural areas, and those from the socially backward groups Among individuals with diabetes, the richest fifth were respectively 12.4 percentage points (pp) (11.3-13.4; p < 0.001), 10.5 pp (9.7-11.4; p < 0.001), and 2.3 pp (1.6-3.0; p < 0.001) more likely to be aware, getting treated, and having diabetes under control, than the poorest fifth. The concentration indices of ATC were 0.089 (0.085-0.092), 0.083 (0.079-0.085) and 0.017 (0.015-0.018) respectively. Overall, the ATC of diabetes is low in India. It is especially low the poorer and the less educated individuals. Targeted interventions and management can reduce the diabetes burden in India.
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Affiliation(s)
- Suraj Maiti
- International Institute for Population Sciences, Mumbai, India.
| | - Shamrin Akhtar
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, India
| | - Ashish Kumar Upadhyay
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, India
| | - Sanjay K. Mohanty
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, India
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Meenakshi S, Misra A. Effect of dates on blood glucose and other metabolic variables: A narrative review. Diabetes Metab Syndr 2023; 17:102705. [PMID: 36702045 DOI: 10.1016/j.dsx.2023.102705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/30/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023]
Abstract
BACKGROUND There is a common belief that individuals with type 2 diabetes mellitus (T2DM) must avoid consumption of dates. This article aims to review and discuss the available studies on dates on different variables, specifically blood glucose. METHODS A survey of studies related to the influence of consumption of dates on blood glucose, glycosylated hemoglobin, lipid profile, and body weight was conducted between January 2009 and Nov 2022, using various data bases (PubMed, Medline, Google Scholar and Scopus). RESULTS The glycemic index (GI) of date varieties ranges from 42.8 to 74.6, and glycemic load (GL) 8.5-24. The glycemic indices of various stages of dates are; Rutab (semi-ripe), 47.2; Tamer (fully ripe, traditionally sun-dried), 45.3, and Tamer (commercial), 35.5. Glucose tolerance-based studies and cross-sectional studies show no significant changes in glycemic indices or association with glycemic worsening with intake of dates. Few randomized controlled trials (RCT) also showed no change in glycemia and weight in the intervention groups consuming dates. Some data (including one RCT) show that the consumption of dates improve total cholesterol and LDL-C. CONCLUSIONS Available studies show that consumption of dates may not lead to impairment of glycemia in patients with T2DM, however, studies have several limitations like small sample size and short duration. More RCTs pertaining to the GI of different date varieties in different amounts are needed.
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Affiliation(s)
- Sachdev Meenakshi
- Tamil Nadu Government Multi Super Specialty Hospital, Chennai, India
| | - Anoop Misra
- Diabetes Foundation (India), Safdarjung Development Area, New Delhi, 110016, India; National Diabetes Obesity and Cholesterol Foundation (N-DOC), Safdarjung Development Area, New Delhi, 110016, India; Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, B-16, Chirag Enclave, New Delhi, India.
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Shabil M, Bushi G, Bodige PK, Maradi PS, Patra BP, Padhi BK, Khubchandani J. Effect of Fenugreek on Hyperglycemia: A Systematic Review and Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020248. [PMID: 36837450 PMCID: PMC9962665 DOI: 10.3390/medicina59020248] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/17/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
Fenugreek is used for medicinal purposes in various traditions. Some studies have demonstrated that the seeds of this plant may have an anti-diabetic effect by lowering fasting blood sugar levels and improving glucose tolerance. We conducted a systematic review of the hypoglycemic effects of fenugreek. An electronic literature search was carried out in the PubMed, Google Scholar, Scopus, and Cochrane Library databases through 18 November 2022 to find trials that assessed fasting blood glucose, postprandial blood glucose, and HbA1c changes in participants treated with fenugreek and in the control group. The mean difference with 95% confidence intervals (CI) was calculated to represent the analysis. Fourteen trials, consisting of 894 participants, were included in the meta-analysis. The results showed a reduction in fasting blood glucose levels (MD: 3.70, 95% CI of -27.02, 19.62; p = 0.76), postprandial blood glucose (MD: -10.61, 95% CI of -68.48, 47.26; p = 0.72), and HbA1c (MD: -0.88, 95% CI -1.49, -0.27; p = 0.00) with fenugreek consumption. While this review and included trials that found beneficial effects of fenugreek consumption on glycemic control, the quality and heterogeneity of studies remain a concern. Given the wider availability and lower cost of fenugreek, rigorous double-blinded randomized controlled trials should be conducted with fenugreek to understand its true potential as a diabetes control herbal agent.
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Affiliation(s)
- Muhammed Shabil
- National Institute of Pharmaceutical Education and Research-Hajipur, Hajipur 844102, India
| | - Ganesh Bushi
- National Institute of Pharmaceutical Education and Research-Hajipur, Hajipur 844102, India
| | - Pavan Kalyan Bodige
- National Institute of Pharmaceutical Education and Research-Hajipur, Hajipur 844102, India
| | - Pavan Sagar Maradi
- National Institute of Pharmaceutical Education and Research-Hajipur, Hajipur 844102, India
| | - Bibhu Prasad Patra
- National Institute of Pharmaceutical Education and Research-Hajipur, Hajipur 844102, India
| | - Bijaya K. Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
- Correspondence: (B.K.P.); (J.K.)
| | - Jagdish Khubchandani
- Department of Public Health, New Mexico State University, Las Cruces, NM 88003, USA
- Correspondence: (B.K.P.); (J.K.)
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Alimoradi Z, Jafari E, Lin CY, Rajabi R, Marznaki ZH, Soodmand M, Potenza MN, Pakpour AH. Estimation of moral distress among nurses: A systematic review and meta-analysis. Nurs Ethics 2023; 30:334-357. [PMID: 36704986 PMCID: PMC9902807 DOI: 10.1177/09697330221135212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Moral distress is a common challenge among professional nurses when caring for their patients, especially when they need to make rapid decisions. Therefore, leaving moral distress unconsidered may jeopardize patient quality of care, safety, and satisfaction. AIM To estimate moral distress among nurses. METHODS This systematic review and meta-analysis conducted systematic search in Scopus, PubMed, ProQuest, ISI Web of Knowledge, and PsycInfo up to end of February 2022. Methodological quality of included studies was assessed using the Newcastle Ottawa checklist. Data from included studies were pooled by meta-analysis with random effect model in STATA software version 14. The selected key measure was mean score of moral distress total score with its' 95% Confidence Interval was reported. Subgroup analyses and meta-regressions were conducted to identify possible sources of heterogeneity and potentially influencing variables on moral distress. Funnel plots and Begg's Tests were used to assess publication bias. The Jackknife method was used for sensitivity analysis. ETHICAL CONSIDERATION The protocol of this project was registered in the PROSPERO database under decree code of CRD42021267773. RESULTS Eighty-six manuscripts with 19,537 participants from 21 countries were included. The pooled estimated mean score of moral distress was 2.55 on a 0-10 scale [95% Confidence Interval: 2.27-2.84, I2: 98.4%, Tau2:0.94]. Publication bias and small study effect was ruled out. Moral distress significantly decreased in the COVID-19 pandemic versus before. Nurses working in developing countries experienced higher level of moral distress compared to their counterparts in developed countries. Nurses' workplace (e.g., hospital ward) was not linked to severity of moral disturbance. CONCLUSION The results of the study showed a low level of pooled estimated score for moral distress. Although the score of moral distress was not high, nurses working in developing countries reported higher levels of moral distress than those working in developed countries. Therefore, it is necessary that future studies focus on creating a supportive environment in hospitals and medical centers for nurses to reduce moral distress and improve healthcare.
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Affiliation(s)
| | - Elahe Jafari
- 113106Qazvin University of Medical Sciences, Qazvin, Iran
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Taiwan
| | | | | | | | - Marc N Potenza
- Yale University, USA; Connecticut Council on Problem Gambling, USA; Connecticut Mental Health Center, USA; Wu Tsai Institute, Yale University, USA
| | - Amir H Pakpour
- Jönköping University, Sweden; Qazvin University of Medical Sciences, Iran
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Antioxidant Phytochemicals as Potential Therapy for Diabetic Complications. Antioxidants (Basel) 2023; 12:antiox12010123. [PMID: 36670985 PMCID: PMC9855127 DOI: 10.3390/antiox12010123] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/10/2022] [Accepted: 12/21/2022] [Indexed: 01/06/2023] Open
Abstract
The global prevalence of diabetes continues to increase partly due to rapid urbanization and an increase in the aging population. Consequently, this is associated with a parallel increase in the prevalence of diabetic vascular complications which significantly worsen the burden of diabetes. For these diabetic vascular complications, there is still an unmet need for safe and effective alternative/adjuvant therapeutic interventions. There is also an increasing urge for therapeutic options to come from natural products such as plants. Hyperglycemia-induced oxidative stress is central to the development of diabetes and diabetic complications. Furthermore, oxidative stress-induced inflammation and insulin resistance are central to endothelial damage and the progression of diabetic complications. Human and animal studies have shown that polyphenols could reduce oxidative stress, hyperglycemia, and prevent diabetic complications including diabetic retinopathy, diabetic nephropathy, and diabetic peripheral neuropathy. Part of the therapeutic effects of polyphenols is attributed to their modulatory effect on endogenous antioxidant systems. This review attempts to summarize the established effects of polyphenols on endogenous antioxidant systems from the literature. Moreover, potential therapeutic strategies for harnessing the potential benefits of polyphenols for diabetic vascular complications are also discussed.
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Lee CH, Chen DY, Hsieh MJ, Hung KC, Huang SC, Cho CJ, Liu SJ. Nanofibrous insulin/vildagliptin core-shell PLGA scaffold promotes diabetic wound healing. Front Bioeng Biotechnol 2023; 11:1075720. [PMID: 37168611 PMCID: PMC10164987 DOI: 10.3389/fbioe.2023.1075720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 04/11/2023] [Indexed: 05/13/2023] Open
Abstract
Introduction: Slow wound repair in diabetes is a serious adverse event that often results in loss of a limb or disability. An advanced and encouraging vehicle is wanted to enhance clinically applicable diabetic wound care. Nanofibrous insulin/vildagliptin core-shell biodegradable poly (lactic-co-glycolic acid) (PLGA) scaffolds to prolong the effective drug delivery of vildagliptin and insulin for the repair of diabetic wounds were prepared. Methods: To fabricate core-shell nanofibrous membranes, vildagliptin mixture with PLGA, and insulin solution were pumped via separate pumps into two differently sized capillary tubes that were coaxially electrospun. Results and Discussion: Nanofibrous core-shell scaffolds slowly released effective vildagliptin and insulin over 2 weeks in vitro migration assay and in vivo wound-healing models. Water contact angle (68.3 ± 8.5° vs. 121.4 ± 2.0°, p = 0.006) and peaked water absorbent capacity (376% ± 9% vs. 283% ± 24%, p = 0.003) of the insulin/vildagliptin core-shell nanofibrous membranes remarkably exceeded those of a control group. The insulin/vildagliptin-loaded core-shell nanofibers improved endothelial progenitor cells migration in vitro (762 ± 77 cells/mm2 vs. 424.4 ± 23 cells/mm2, p < 0.001), reduced the α-smooth muscle actin content in vivo (0.72 ± 0.23 vs. 2.07 ± 0.37, p < 0.001), and increased diabetic would recovery (1.9 ± 0.3 mm2 vs. 8.0 ± 1.4 mm2, p = 0.002). Core-shell insulin/vildagliptin-loaded nanofibers extend the drug delivery of insulin and vildagliptin and accelerate the repair of wounds associated with diabetes.
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Affiliation(s)
- Chen-Hung Lee
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
- *Correspondence: Chen-Hung Lee, ; Chia-Jung Cho, ; Shih-Jung Liu,
| | - Dong-Yi Chen
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ming-Jer Hsieh
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Kuo-Chun Hung
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Shu-Chun Huang
- Department of Physical Medicine and Rehabilitation, New Taipei Municipal Tucheng Hospital, Chang Gung Memorial Hospital, New Taipei City, Taiwan
- Department of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Jung Cho
- Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan
- *Correspondence: Chen-Hung Lee, ; Chia-Jung Cho, ; Shih-Jung Liu,
| | - Shih-Jung Liu
- Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan
- Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan
- *Correspondence: Chen-Hung Lee, ; Chia-Jung Cho, ; Shih-Jung Liu,
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Injectable self-healing chitosan-based POSS-PEG hybrid hydrogel as wound dressing to promote diabetic wound healing. Carbohydr Polym 2023; 299:120198. [PMID: 36876768 DOI: 10.1016/j.carbpol.2022.120198] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/09/2022]
Abstract
Promoting the healing of diabetic wounds remains a major challenge in scientific research today. A star-like eight-arm cross-linker octafunctionalized POSS of benzaldehyde-terminated polyethylene glycol (POSS-PEG-CHO) was synthesized, and crosslinked with hydroxypropyltrimethyl ammonium chloride chitosan (HACC) via Schiff base reaction to obtain Chitosan-based POSS-PEG hybrid hydrogels. The designed composite hydrogels exhibited strong mechanical strength, injectability, excellent self-healing efficiency, good cytocompatibility and antibacterial properties. Furthermore, the composite hydrogels could accelerate cells migration and proliferation, as expected by remarkably promoting wound healing in diabetic mice. The wounds treated with the composite hydrogels displayed faster regeneration of epithelial tissue, fewer inflammatory cells, more collagen deposition and higher expression level of VEGF. Therefore, Chitosan-based POSS-PEG hybrid hydrogel has great application potential as a dressing for promoting the healing of diabetic wounds.
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Wang Q, Luo Z, Wu YL, Li Z. Recent Advances in Enzyme‐Based Biomaterials Toward Diabetic Wound Healing. ADVANCED NANOBIOMED RESEARCH 2022. [DOI: 10.1002/anbr.202200110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Qi Wang
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology School of Pharmaceutical Sciences Xiamen University Xiamen 361102 China
| | - Zheng Luo
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology School of Pharmaceutical Sciences Xiamen University Xiamen 361102 China
- Institute of Materials Research and Engineering A*STAR (Agency for Science, Technology and Research) 2 Fusionopolis Way Innovis, #08-03 Singapore 138634 Singapore
| | - Yun-Long Wu
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology School of Pharmaceutical Sciences Xiamen University Xiamen 361102 China
| | - Zibiao Li
- Institute of Materials Research and Engineering A*STAR (Agency for Science, Technology and Research) 2 Fusionopolis Way Innovis, #08-03 Singapore 138634 Singapore
- Institute of Sustainability for Chemicals, Energy and Environment (ISCE2) Agency for Science, Technology and Research (A*STAR) 2 Fusionopolis Way Singapore 138634 Singapore
- Department of Materials Science and Engineering National University of Singapore 9 Engineering Drive 1 Singapore 117576 Singapore
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Zhang S, Jiang H, Wang L, Jia X, Zhang J, Wang H, Zhang B, Wang Z, Ding G. Longitudinal relationship between body fat percentage and risk of type 2 diabetes in Chinese adults: Evidence from the China Health and Nutrition Survey. Front Public Health 2022; 10:1032130. [PMID: 36523583 PMCID: PMC9744757 DOI: 10.3389/fpubh.2022.1032130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
Objective Body fat percentage (BF%) might be an alternative index of obesity which is the major risk factor for developing type 2 diabetes (T2D). We aim to longitudinally evaluated the relationship between BF% and risk of T2D. Methods A sample of 5,595 adults aged 18-65 who participated in two waves of China Health and Nutrition Survey (CHNS 2015 and 2018) was analyzed. Two level mixed-effects modified Poisson regression with robust estimation of variance stratified by sex was used to evaluate the risk ratios (RRs) for T2D according to quintiles of BF%, and the curves of receiver operating characteristic (ROC) were plotted to identify the optimal total and trunk BF% cut-off points for predicting an increased T2D risk. Results In males, compared with subjects in the first quintile of total BF%, those in the third (RR = 2.03, 95% CI 1.09-3.79), fourth (RR = 2.56, 95%CI 1.46-4.48), and fifth (RR = 2.16, 95%CI 1.22-3.82) quintile had higher risk of T2D after adjusting for all potential confounders (p-trend < 0.001). For females, the RR (95% CI) was 1.92 (1.14, 3.24) in the fifth quintile (p-trend = 0.014). Males and females with a trunk BF% >25.5 and 34.4% (≥ quintile 4), respectively, were at significantly increased risk of T2D (p-trend = 0.001). Besides, the optimal cut-off values of total and trunk BF% were 21.9 and 25.2% for males, and 36.7 and 30.3% for females, respectively. Conclusions The incident risk of T2D significantly increased over specific level of total and trunk BF% in both Chinese males and females, and the optimal BF% cut-off values were valuable for clinical application of BF% based on sex difference, which may be a cost-effective implementation for prevention and treatment of T2D in China.
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Affiliation(s)
- Siting Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hongru Jiang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Liusen Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Xiaofang Jia
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Jiguo Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Zhihong Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China,*Correspondence: Zhihong Wang
| | - Gangqiang Ding
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China,Gangqiang Ding
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Development of the Brazilian Version of a Pan-Canadian Behavior Change Program and Its Health and Fitness Outcomes. J Clin Med 2022; 11:jcm11195926. [PMID: 36233793 PMCID: PMC9573575 DOI: 10.3390/jcm11195926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/29/2022] [Accepted: 10/01/2022] [Indexed: 11/17/2022] Open
Abstract
Chronic diseases are a major health problem worldwide, especially in lower-income jurisdictions. Considering this scenario, the World Health Organization has recently established, as a research priority, preventive interventions for populations from lower-income countries, such as the middle-income country of Brazil. The purpose of this article is to describe the components of a pan-Canadian lifestyle program adapted to Brazilians and to report its health and fitness outcomes. A 12-week program called ACCELERATION was translated and culturally adapted to Brazilians. A quasi-randomized controlled trial was designed, consisting of weekly emails and educational videos addressing risk factors for chronic disease. Health and fitness measures included body composition, cardiovascular variables, aerobic fitness, and muscular strength. The Brazilian experimental group showed maintenance in heart rate, blood pressure, and VO2max values while presenting an improvement of 3.3% in body fat percentage (p = 0.040, d = −0.325) and 5.1% in muscular strength (p = 0.039, d = 0.328). Overall, these results were similar to the Canadian intervention. Based on these findings, the Brazilian version of the program has the potential to contribute to the fight against chronic diseases in Brazil.
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Is nutrition labeling associated with decreased obesity? A quantitative approach to nutritional health policy in Ecuador. J Public Health Policy 2022; 43:593-612. [PMID: 36195650 DOI: 10.1057/s41271-022-00368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 11/21/2022]
Abstract
Few studies assess consumer response to nutrition labeling, especially in less-developed countries. We analyzed the link between nutrition labeling and obesity in Ecuador using a representative cross-sectional sample of 29,770 individuals from the National Health and Nutrition Survey (ENSANUT) in 2018. Nutrition labeling reduced the probability of obesity in adolescent (12-18 years old) and adult (18-59 years old) people by 4% (CI: - 5.7, - 2.2) and 8.4% (CI: - 12.7, - 4.0), respectively. The magnitude of average treatment effect of using nutrition label on obesity ranged from 0.90 (CI: - 1.299, - 0.500) to 1 (CI: - 1.355, - 0.645) BMI points for adolescent, and from 1.16 (CI: - 1.554, - 0.766) to 1.80 (CI: - 2.791, - 0.811) BMI points for adult. The effect of nutrition labeling is greater among the less obese. We recommend that health policy makers and clinicians continue to promote nutrition labeling especially where obesity is not chronic, where nutrition labeling is most successful.
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Butt MD, Ong SC, Wahab MU, Rasool MF, Saleem F, Hashmi A, Sajjad A, Chaudhry FA, Babar ZUD. Cost of Illness Analysis of Type 2 Diabetes Mellitus: The Findings from a Lower-Middle Income Country. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912611. [PMID: 36231911 PMCID: PMC9566593 DOI: 10.3390/ijerph191912611] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 06/02/2023]
Abstract
BACKGROUND Diabetes is a major chronic illness that negatively influences individuals and society. Therefore, this research aimed to analyze and evaluate the cost associated with diabetes management, specific to the Pakistani Type 2 diabetes population. Research scheme and methods: A survey randomly collected information and data from diabetes patients throughout Pakistan out-patient clinics. Direct and indirect costs were evaluated, and data were analyzed with descriptive and inferential statistics. RESULTS An overall of 1839 diabetes patients participated in the study. The results have shown that direct and indirect costs are positively associated with the participants' socio-demographic characteristics, except for household income and educational status. The annual total cost of diabetes care was USD 740.1, amongst which the share of the direct cost was USD 646.7, and the indirect cost was USD 93.65. Most direct costs comprised medicine (USD 274.5) and hospitalization (USD 319.7). In contrast, the productivity loss of the patients had the highest contribution to the indirect cost (USD 81.36). CONCLUSION This study showed that direct costs significantly contributed to diabetes's overall cost in Pakistan and overall diabetes management estimated to be 1.67% (USD 24.42 billion) of the country's total gross domestic product. The expense of medications and hospitalization mostly drove the direct cost. Additionally, patients' loss of productivity contributed significantly to the indirect cost. It is high time for healthcare policymakers to address this huge healthcare burden. It is time to develop a thorough diabetes management plan to be implemented nationwide.
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Affiliation(s)
- Muhammad Daoud Butt
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia
| | - Siew Chin Ong
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia
| | - Muhammad Umar Wahab
- Consultant Diabetologist, Umar Diabetes and Foot Care Centre, Umar Diabetes Foundation, Office 1, Executive Complex, G8 Markaz, Islamabad 46000, Pakistan
| | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Fahad Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy & Health Sciences, University of Baluchistan, Quetta 87300, Pakistan
| | - Adnan Hashmi
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Ahsan Sajjad
- Consultant Diabetologist, Umar Diabetes and Foot Care Centre, Umar Diabetes Foundation, Office 1, Executive Complex, G8 Markaz, Islamabad 46000, Pakistan
- Ibn Sina Community Clinic South Wilcrest Drive, Houston, TX 77099, USA
| | | | - Zaheer-Ud-Din Babar
- Department of Pharmacy, University of Huddersfield, Huddersfield HD1 3DH, UK
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Dutta A, Hasan MK, Ahmad M, Awal MA, Islam MA, Masud M, Meshref H. Early Prediction of Diabetes Using an Ensemble of Machine Learning Models. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912378. [PMID: 36231678 PMCID: PMC9566114 DOI: 10.3390/ijerph191912378] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/20/2022] [Accepted: 09/24/2022] [Indexed: 05/15/2023]
Abstract
Diabetes is one of the most rapidly spreading diseases in the world, resulting in an array of significant complications, including cardiovascular disease, kidney failure, diabetic retinopathy, and neuropathy, among others, which contribute to an increase in morbidity and mortality rate. If diabetes is diagnosed at an early stage, its severity and underlying risk factors can be significantly reduced. However, there is a shortage of labeled data and the occurrence of outliers or data missingness in clinical datasets that are reliable and effective for diabetes prediction, making it a challenging endeavor. Therefore, we introduce a newly labeled diabetes dataset from a South Asian nation (Bangladesh). In addition, we suggest an automated classification pipeline that includes a weighted ensemble of machine learning (ML) classifiers: Naive Bayes (NB), Random Forest (RF), Decision Tree (DT), XGBoost (XGB), and LightGBM (LGB). Grid search hyperparameter optimization is employed to tune the critical hyperparameters of these ML models. Furthermore, missing value imputation, feature selection, and K-fold cross-validation are included in the framework design. A statistical analysis of variance (ANOVA) test reveals that the performance of diabetes prediction significantly improves when the proposed weighted ensemble (DT + RF + XGB + LGB) is executed with the introduced preprocessing, with the highest accuracy of 0.735 and an area under the ROC curve (AUC) of 0.832. In conjunction with the suggested ensemble model, our statistical imputation and RF-based feature selection techniques produced the best results for early diabetes prediction. Moreover, the presented new dataset will contribute to developing and implementing robust ML models for diabetes prediction utilizing population-level data.
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Affiliation(s)
- Aishwariya Dutta
- Department of Biomedical Engineering (BME), Khulna University of Engineering & Technology (KUET), Khulna 9203, Bangladesh
- Department of Biomedical Engineering (BME), Military Institute of Science and Technology (MIST), Mirpur Cantonment, Dhaka 1216, Bangladesh
| | - Md. Kamrul Hasan
- Department of Electrical and Electronic Engineering (EEE), Khulna University of Engineering & Technology (KUET), Khulna 9203, Bangladesh
| | - Mohiuddin Ahmad
- Department of Electrical and Electronic Engineering (EEE), Khulna University of Engineering & Technology (KUET), Khulna 9203, Bangladesh
| | - Md. Abdul Awal
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD 4072, Australia
- Electronics and Communication Engineering (ECE) Discipline, Khulna University (KU), Khulna 9208, Bangladesh
- Correspondence:
| | | | - Mehedi Masud
- Department of Computer Science, College of Computers and Information Technology, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Hossam Meshref
- Department of Computer Science, College of Computers and Information Technology, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
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In Vitro and In Vivo Validation of GATA-3 Suppression for Induction of Adipogenesis and Improving Insulin Sensitivity. Int J Mol Sci 2022; 23:ijms231911142. [PMID: 36232443 PMCID: PMC9569927 DOI: 10.3390/ijms231911142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/08/2022] [Accepted: 09/16/2022] [Indexed: 12/02/2022] Open
Abstract
Impaired adipogenesis is associated with the development of insulin resistance and an increased risk of type 2 diabetes (T2D). GATA Binding Protein 3 (GATA3) is implicated in impaired adipogenesis and the onset of insulin resistance. Therefore, we hypothesize that inhibition of GATA3 could promote adipogenesis, restore healthy fat distribution, and enhance insulin signaling. Primary human preadipocytes were treated with GATA3 inhibitor (DNAzyme hgd40). Cell proliferation, adipogenic capacity, gene expression, and insulin signaling were measured following well-established protocols. BALB/c mice were treated with DNAzyme hgd40 over a period of 2 weeks. Liposomes loaded with DNAzyme hgd40, pioglitazone (positive), or vehicle (negative) controls were administered subcutaneously every 2 days at the right thigh. At the end of the study, adipose tissues were collected and weighed from the site of injection, the opposite side, and the omental depot. Antioxidant enzyme (superoxide dismutase and catalase) activities were assessed in animals’ sera, and gene expression was measured using well-established protocols. In vitro GATA3 inhibition induced the adipogenesis of primary human preadipocytes and enhanced insulin signaling through the reduced expression of p70S6K. In vivo GATA3 inhibition promoted adipogenesis at the site of injection and reduced MCP-1 expression. GATA3 inhibition also reduced omental tissue size and PPARγ expression. These findings suggest that modulating GATA3 expression offers a potential therapeutic benefit by correcting impaired adipogenesis, promoting healthy fat distribution, improving insulin sensitivity, and potentially lowering the risk of T2D.
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Examining Barriers and Opportunities of Conducting Genome-Wide Association Studies in Developing Countries. CURR EPIDEMIOL REP 2022. [DOI: 10.1007/s40471-022-00303-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Identification of missense SNP-mediated mutations in the regulatory sites of aldose reductase (ALR2) responsible for treatment failure in diabetic complications. J Mol Model 2022; 28:260. [PMID: 35984530 DOI: 10.1007/s00894-022-05256-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 07/31/2022] [Indexed: 10/15/2022]
Abstract
Scientific pieces of evidence indicate that the polymorphism in the ALR2 regulatory gene favors the susceptibility to diabetic complications (DCs). Previous studies have uncovered several single nucleotide polymorphisms (SNPs) in the ALR2 regulatory sites that negatively modulate the activity of this enzyme and eventually increase the risks of DCs. In view of this, the current study aimed at investigating whether the mutation as a resultant of missense SNPs in the regulatory site of ALR2 enzyme can also hamper the interactions of ALR2 inhibitors with the key amino acid residues in the ALR2 binding site. Around 202 SNPs in the ALR2 gene were reported in the dbSNP database. Out of these, eighteen SNPs that are responsible for point mutations in the regulatory sites of ALR2 enzyme were identified and considered for the study. Identified SNPs were then categorized as stabilizing or destabilizing using various in silico tools and webservers. The resulting mutational constructs of ALR2 were further probed for their influence on the binding affinities and binding modes with well-known ALR2 inhibitors using structure-based analyses. This study identified three destabilizing SNPs, i.e., rs779176563 (C298S), rs1392886142 (G16A), and rs1407261115 (A245T), that lead to the compromised response to most of the ALR2 inhibitors which are in clinical trials. On the other hand, treatment with these ALR2 inhibitors may benefit the population which carries missense SNPs rs748119899, rs1402962430, and rs1467939858 that code for W219S, Q183V, and S214A, respectively. Overall findings of the study suggest that one SNP in the inhibitor site and two SNPs in the co-factor site of ALR2 may be responsible for the low efficacy and unsuccessful journey of ALR2 inhibitors in the clinical trials.
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Zhang Y, Zhang L, Xu P, Qin X, Wang P, Cheng Y, Yao B, Wang X. Cytochrome P450 2E1 gene knockout or inhibition prevents obesity induced by high-fat diet via regulating energy expenditure. Biochem Pharmacol 2022; 202:115160. [PMID: 35780828 DOI: 10.1016/j.bcp.2022.115160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/02/2022]
Abstract
Cytochrome P450 2E1 (CYP2E1), an important member of the CYP metabolic enzyme family in the liver, regulates the disposal of drugs and the biotransformation of endogenous substances. Although previous studies have found that CYP2E1 is related to energy metabolism, the role of CYP2E1 in energy homeostasis remains unclear. Herein this study shows that the deletion of Cyp2e1 gene in rats can prevent obesity, fatty liver and insulin resistance induced by high-fat diet. Mechanism studies uncover that Cyp2e1 deficiency not only increases the expression of thermogenic genes in brown adipose tissue (BAT) and subcutaneous adipose tissue (SAT), but also promotes fatty acid metabolism in the liver and BAT. In particular, Cyp2e1 deficiency elevates energy expenditure through an increase of liver-generated acylcarnitines, which promote BAT thermogenesis and increase β-oxidation. Interestingly, disulfiram as a CYP2E1 inhibitor can also prevent obesity induced by high-fat diet in normal rats. In general, this study explains the relationship between CYP2E1 and energy metabolism, and provides a new perspective for the prevention and treatment of obesity.
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Affiliation(s)
- Yuanjin Zhang
- Changning Maternity and Infant Health Hospital and School of Life Sciences, Shanghai Key Laboratory of Regulatory Biology, East China Normal University, Shanghai, China
| | - Lei Zhang
- Changning Maternity and Infant Health Hospital and School of Life Sciences, Shanghai Key Laboratory of Regulatory Biology, East China Normal University, Shanghai, China
| | - Peipei Xu
- Changning Maternity and Infant Health Hospital and School of Life Sciences, Shanghai Key Laboratory of Regulatory Biology, East China Normal University, Shanghai, China
| | - Xuan Qin
- Center of Drug Discovery, Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, United States
| | - Peili Wang
- Changning Maternity and Infant Health Hospital and School of Life Sciences, Shanghai Key Laboratory of Regulatory Biology, East China Normal University, Shanghai, China
| | - Yi Cheng
- Changning Maternity and Infant Health Hospital and School of Life Sciences, Shanghai Key Laboratory of Regulatory Biology, East China Normal University, Shanghai, China
| | - Bingyi Yao
- Changning Maternity and Infant Health Hospital and School of Life Sciences, Shanghai Key Laboratory of Regulatory Biology, East China Normal University, Shanghai, China
| | - Xin Wang
- Changning Maternity and Infant Health Hospital and School of Life Sciences, Shanghai Key Laboratory of Regulatory Biology, East China Normal University, Shanghai, China.
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Saiyed NS, Yagoub U, Al Qahtani B, Al Zahrani AM, Al Hariri I, Syed MJ, Elmardi ME, Tufail MA, Manajreh M. Risk Factors of Microvascular Complications Among Type 2 Diabetic Patients Using Cox Proportional Hazards Models: A Cohort Study in Tabuk Saudi Arabia. J Multidiscip Healthc 2022; 15:1619-1632. [PMID: 35923155 PMCID: PMC9342245 DOI: 10.2147/jmdh.s367241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The burden of type 2 diabetes (T2D) is high in Saudi Arabia, but data related to its complications are limited. This study aimed to determine the incidence of microvascular complications caused by T2D and evaluate the impact of the associated risk factors. Patients and Methods This retrospective cohort study was conducted at two military hospitals in Tabuk, Saudi Arabia. Data on the socio-demographics, glycaemic profile, blood lipid indices, duration of T2D, and associated microvascular complications were collected from electronic health records and medical files. Descriptive statistics and Cox proportional hazards models were used for data analysis. Results This study included 1563 T2D patients. The incidence of microvascular complications was 34.3% (95% confidence interval [CI], 32.0-36.6). Retinopathy was the most common complication (incidence=20.0%; 95% CI, 18.0-22.0%), while nephropathy was the least common complication (incidence=12.2%; 95% CI, 10.6-13.8%). Advanced age (≥65 years) showed the highest risk of retinopathy (Hazard ratios [HR], 2.86; 95% CI, 2.56-3.21), neuropathy (HR, 2.70; 95% CI, 2.40-3.05), and nephropathy (HR, 2.37; 95% CI, 2.12-2.64) compared with their counterparts. After adjusting for potential confounders, the study found that the significant risk factors for microvascular complications were longer duration (≥10 years) of T2D (HR, 5.3; 95% CI, 5.1-5.6), uncontrolled hypertension (HR, 3.9; 95% CI, 3.3-4.2), poor glycaemic control (HR, 4.6; 95% CI, 4.3-5.1), obesity (HR, 2.3; 95% CI, 2.2-2.6), and dyslipidaemia (HR, 1.6; 95% CI, 1.2-2.0). Conclusion Given the high burden of microvascular complications in military healthcare facilities in Tabuk, Saudi Arabia, a context-specific accessible public health program focusing on the promotion of a healthy lifestyle, physical activity, and consumption of a healthy diet, as well as the early diagnosis and management of diabetes, needs to be developed and implemented.
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Affiliation(s)
- Nasrin S Saiyed
- Research Department, King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
| | - Umar Yagoub
- Research Department, King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
| | - Bandar Al Qahtani
- Academic Affairs Department, King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
| | | | - Ibrahim Al Hariri
- Family Medicine Department, King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
| | - Meerab Javed Syed
- Internal Medicine Department, King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
| | | | | | - Marwan Manajreh
- Research Department, King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
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Bhatt SP, Misra A, Pandey RM, Upadhyay AD. Shortening of leucocyte telomere length is independently correlated with high body mass index and subcutaneous obesity (predominantly truncal), in Asian Indian women with abnormal fasting glycemia. BMJ Open Diabetes Res Care 2022; 10:10/4/e002706. [PMID: 35835478 PMCID: PMC9289012 DOI: 10.1136/bmjdrc-2021-002706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 06/21/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Leucocyte telomere length (LTL) is linked to accelerate aging and premature mortality. In this research, we aimed to explore the relations between biochemical and anthropometry markers and LTL in Asian Indian women with abnormal fasting glycemia (impaired fasting glucose). RESEARCH DESIGN AND METHODS In this study, 797 pre-diabetic women (obese, 492; non-obese, 305) were recruited. Demographic and clinical profiles, anthropometry, and fasting blood glucose were evaluated. LTL was quantified by a quantitative PCR. LTL was expressed as the relative telomere length or telomere repeat:single copy gene (T:S) ratio. The subjects were separated into quartiles according to the LTL. RESULTS The average LTL was significantly decreased with increasing age. The average LTL was significantly shorter in obese women with abnormal fasting glycemia (p<0.05). R-squared (R2) statistic for multivariable linear model after adjusted for age, family income, education and hypertension showed that LTL was inversely correlated with body mass index (BMI), waist and hip circumference, waist-hip and waist-to-height ratio, truncal skinfolds (subscapular, and subscapular/triceps ratio, central and total skinfolds), fat mass (kg) and % body fat. The relationship between obesity measures and LTL (using the LTL quartile 1 as reference) identified central skinfolds (R2=0.92, p<0.0001), Σ4SF (R2=0.90, p<0.0001), BMI (R2=0.93, p<0.0001) and % body fat (R2=0.91, p<0.0001) as independent predictors of LTL. CONCLUSIONS Besides age, obesity and subcutaneous adiposity (predominantly truncal) are major contributors to telomere shortening in Asian Indian women with abnormal fasting glycemia (impaired fasting glucose).
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Affiliation(s)
- Surya Prakash Bhatt
- Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, Delhi, India
- Metabolic Research Unit, Diabetes Foundation (India), Safdarjung Development Area (SDA), New Delhi, Delhi, India
- Metabolic Research Unit, National Diabetes Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, Delhi, India
| | - Anoop Misra
- Metabolic Research Unit, Diabetes Foundation (India), Safdarjung Development Area (SDA), New Delhi, Delhi, India
- Metabolic Research Unit, National Diabetes Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, Delhi, India
- Diabetes and Metabolic Unit, Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, New Delhi, Delhi, India
| | - Ravindra Mohan Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Ashish Datt Upadhyay
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, Delhi, India
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Mannan A, Akter F, Hasan A. Chy NU, Alam N, Rana MM, Chowdhury NA, Hasan MM. The relationship between medical comorbidities and health-related quality of life among adults with type 2 diabetes: The experience of different hospitals in southern Bangladesh. PLoS One 2022; 17:e0267713. [PMID: 35613132 PMCID: PMC9132298 DOI: 10.1371/journal.pone.0267713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/13/2022] [Indexed: 12/21/2022] Open
Abstract
Objective Health-related quality of life (HRQoL) is a critical determinant to assess the severity of chronic diseases like diabetes mellitus. It has a close association with complications, comorbidities, and medical aid. This study aimed to estimate the prevalence of medical comorbidities and determine the relationship between comorbidities and HRQoL among type 2 diabetic patients of southern Bangladesh. Method This study was a cross-sectional study conducted through face to face interviews using a pre-tested structured questionnaire and by reviewing patient’s health records with prior written consent. The study was conducted on 2,136 patients with type 2 diabetes attending five hospitals of Chattogram, Bangladesh, during the tenure of November 2018 to July 2019. Quality of life was measured using the widely-used index of EQ-5D that considers 243 different health states and uses a scale in which 0 indicates a health state equivalent to death and 1 indicates perfect health status. The five dimensions of the quality index included mobility, self-care, usual activities, pain or discomfort, and anxiety or depression. Results Patients with three comorbidities and with four or more comorbidities had a higher probability of reporting “extreme problem” or “some problem” in all five dimensions of the EQ-5D index compared with those without comorbidity (Odds ratio: mobility, 3.99 [2.72–5.87], 6.22 [3.80–10.19]; usual activity, 2.67 [1.76–4.06], 5.43 [3.28–8.98]; self-care, 2.60 [1.65–4.10], 3.95 [2.33–6.69]; pain or discomfort, 2.22 [1.48–3.33], 3.44 [1.83–6.45]; anxiety or depression, 1.75 [1.07–2.88], 2.45 [1.19–5.04]). The number of comorbidities had a negative impact on quality of life. Conclusion Prevalent comorbidities were found to be the significant underlying cause of declined HRQoL. To raise diabetes awareness and for better disease management, the exposition of comorbidities in regards to HRQoL of people with diabetes should be considered for type 2 diabetes management schemas.
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Affiliation(s)
- Adnan Mannan
- Department of Genetic Engineering & Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chattogram, Bangladesh
- * E-mail:
| | - Farhana Akter
- Department of Endocrinology, Chittagong Medical College, Chattogram, Bangladesh
| | - Naim Uddin Hasan A. Chy
- Health Economics Research Group, Department of Economics, University of Chittagong, Chattogram, Bangladesh
| | - Nazmul Alam
- Department of Public Health, Asian University for Women, Chittagong, Bangladesh
| | - Md. Mashud Rana
- Department of Pharmacology and Therapeutics, Chittagong Medical College, Chattogram, Bangladesh
| | | | - Md. Mahbub Hasan
- Department of Genetic Engineering & Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chattogram, Bangladesh
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Mathur P, Leburu S, Kulothungan V. Prevalence, Awareness, Treatment and Control of Diabetes in India From the Countrywide National NCD Monitoring Survey. Front Public Health 2022; 10:748157. [PMID: 35359772 PMCID: PMC8964146 DOI: 10.3389/fpubh.2022.748157] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 01/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTo determine the prevalence, awareness, treatment and control of diabetes mellitus (DM) and associated factors amongst adults (18–69 years) in India from the National Noncommunicable Disease Monitoring Survey (NNMS).MethodsNNMS was a comprehensive, cross-sectional survey conducted in 2017–18 on a national sample of 12,000 households in 600 primary sampling units. In every household, one eligible adult aged 18–69 years were selected. Information on NCD risk factors and their health-seeking behaviors were collected. Anthropometric measurements, blood pressure and fasting capillary blood glucose were measured. DM was defined as fasting blood glucose (FBG) ≥126 mg/dl including those on medication. Awareness, treatment, and control of DM were defined as adults previously diagnosed with DM by a doctor, on prescribed medication for DM, and FBG <126 mg/dl, respectively. The weighted data are presented as mean and proportions with 95% CI. We applied the Student t-test for continuous variables, Pearson's chi-square test for categorical variables and multivariate regression to determine the odds ratio. For statistical significance, a p-value < 0.05 was considered.ResultsPrevalence of DM and impaired fasting blood glucose (IFG) in India was 9.3% and 24.5% respectively. Among those with DM, 45.8% were aware, 36.1% were on treatment and 15.7% had it under control. More than three-fourths of adults approached the allopathic practitioners for consultation (84.0%) and treatment (78.8%) for diabetes. Older adults were associated with an increased risk for DM [OR 8.89 (95% CI 6.66–11.87) and were 16 times more aware of DM. Better awareness, treatment and control levels were seen among adults with raised blood pressure and raised cholesterol.ConclusionsThe prevalence of DM and IFG is high among adults, while the levels of awareness, treatment and control are still low in India, and this varied notably between the age groups. Multifaceted approaches that include improved awareness, adherence to treatment, better preventive and counseling services are crucial to halt diabetes in India. Also, expanding traditional systems of medicine (Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy [AYUSH]) into diabetes prevention and control practices open solutions to manage this crisis.
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Affiliation(s)
- Prashant Mathur
- *Correspondence: Prashant Mathur ; orcid.org/0000-0002-9271-1373
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Liang Y, Li M, Yang Y, Qiao L, Xu H, Guo B. pH/Glucose Dual Responsive Metformin Release Hydrogel Dressings with Adhesion and Self-Healing via Dual-Dynamic Bonding for Athletic Diabetic Foot Wound Healing. ACS NANO 2022; 16:3194-3207. [PMID: 35099927 DOI: 10.1021/acsnano.1c11040] [Citation(s) in RCA: 270] [Impact Index Per Article: 135.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
In view of the lack of a specific drug-sustained release system that is responsive to chronic wounds of the type II diabetic foot, and the demands for frequent movement at the foot wound, pH/glucose dual-responsive metformin-released adhesion-enhanced self-healing easy-removable antibacterial antioxidant conductive hemostasis multifunctional phenylboronic acid and benzaldehyde bifunctional polyethylene glycol-co-poly(glycerol sebacic acid)/dihydrocaffeic acid and l-arginine cografted chitosan (PEGS-PBA-BA/CS-DA-LAG, denoted as PC) hydrogel dressings were constructed based on the double dynamic bond of the Schiff-base and phenylboronate ester. It was further demonstrated that the PC hydrogel promotes wound healing by reducing inflammation and enhancing angiogenesis in a rat type II diabetic foot model. In addition, the addition of metformin (Met) and graphene oxide (GO), as well as their synergy, were confirmed to better promote wound repair in vivo. In summary, adhesion-enhanced self-healing multifunctional PC/GO/Met hydrogels with stimuli-responsive metformin release ability and easy removability have shown a promoting effect on the healing of chronic athletic diabetic wounds and provide a local-specific drug dual-response release strategy for the treatment of type II diabetic feet.
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Affiliation(s)
- Yongping Liang
- State Key Laboratory for Mechanical Behavior of Materials, and Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Meng Li
- State Key Laboratory for Mechanical Behavior of Materials, and Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Yutong Yang
- State Key Laboratory for Mechanical Behavior of Materials, and Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Lipeng Qiao
- State Key Laboratory for Mechanical Behavior of Materials, and Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Huiru Xu
- State Key Laboratory for Mechanical Behavior of Materials, and Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Baolin Guo
- State Key Laboratory for Mechanical Behavior of Materials, and Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
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