[Risk-stratified screening for diabetes in adults: results of the first investigation in Hungary]

Shellac and locust bean gum coacervated curcumin, epigallocatechin gallate nanoparticle ameliorates diabetic nephropathy in a streptozotocin-induced mouse model

Curcumin and epigallocatechin gallate have the disadvantage of low aqueous solubility and first-pass metabolism, resulting in limited bioavailability. This work aimed to enhance oral bioavailability by forming gastric pH-stable shellac nanoparticles containing curcumin and epigallocatechin gallate using locust bean gum by anti-solvent precipitation (CESL-NP). The nanoparticles were characterized by their particle size, morphology, zeta potential, gastric pH stability, release profile, drug loading, and entrapment efficiency. The findings showed that a network of hydrolyzed shellac, locust bean gum, curcumin, and epigallocatechin gallate successfully entrapped individual particles inside a complex system. The morphological investigation of the CESL-NP formulation using FESEM, TEM, and AFM revealed the presence of spherical particles. FTIR, DSC, and XRD analysis revealed that curcumin and epigallocatechin gallate were amorphous due to their bond interactions with the matrix. Streptozotocin-treated mice, upon treatment with CESL-NP, showed kidney and pancreatic improvements with normalized kidney hypertrophy index and histopathology, maintained biochemical parameters, increased beta cell count, and a 38.68-fold higher blood glucose level inhibition were observed when compared to free-(CUR + EGCG). This research affirms that the shellac-locust bean gum complex shows potential for the sustained oral delivery of curcumin and epigallocatechin gallate, specifically for treating diabetic nephropathy.

Cordycepin for Health and Wellbeing: A Potent Bioactive Metabolite of an Entomopathogenic Cordyceps Medicinal Fungus and Its Nutraceutical and Therapeutic Potential

Cordyceps is a rare naturally occurring entomopathogenic fungus usually found at high altitudes on the Himalayan plateau and a well-known medicinal mushroom in traditional Chinese medicine. Cordyceps contains various bioactive components, out of which, cordycepin is considered most vital, due to its utmost therapeutic as well as nutraceutical potential. Moreover, the structure similarity of cordycepin with adenosine makes it an important bioactive component, with difference of only hydroxyl group, lacking in the 3′ position of its ribose moiety. Cordycepin is known for various nutraceutical and therapeutic potential, such as anti-diabetic, anti-hyperlipidemia, anti-fungal, anti-inflammatory, immunomodulatory, antioxidant, anti-aging, anticancer, antiviral, hepato-protective, hypo-sexuality, cardiovascular diseases, antimalarial, anti-osteoporotic, anti-arthritic, cosmeceutical etc. which makes it a most valuable medicinal mushroom for helping in maintaining good health. In this review, effort has been made to bring altogether the possible wide range of cordycepin’s nutraceutical potential along with its pharmacological actions and possible mechanism. Additionally, it also summarizes the details of cordycepin based nutraceuticals predominantly available in the market with expected global value. Moreover, this review will attract the attention of food scientists, nutritionists, pharmaceutical and food industries to improve the use of bioactive molecule cordycepin for nutraceutical purposes with commercialization to aid and promote healthy lifestyle, wellness and wellbeing.

Hpyerglycemic and anti-diabetic nephritis activities of polysaccharides separated from Auricularia auricular in diet-streptozotocin-induced diabetic rats

Due to substantial morbidity and complications including nephropathy, a search for alternative treatment of diabetes mellitus is urgently required. The present study aimed to investigate the hypoglycemic and anti-diabetic nephropathy activities of polysaccharides separated from Auricularia auricular (AAP). Diet streptozotocin (STZ)-induced diabetic Sprague-Dawley rats were orally treated with metformin (100 mg/kg; positive control) and AAP (100 and 400 mg/kg) for four weeks, and parameters in the serum and liver associated with blood glucose, free radicals and nephropathy were determined. Similar to metformin, AAP treatment strongly reduced blood glucose levels by promoting glucose metabolism. The anti-oxidative activity of AAP, which was indicated by the modulation of superoxide dismutase, glutathione peroxidase, reactive oxygen species and methane dicarboxylic aldehyde levels in serum, was observed in diabetic rats. Furthermore, the regulatory effects of AAP on blood urea nitrogen, creatinine, uric protein and inflammatory-related factors revealed its protection against diabetic nephropathy. The present data suggests that AAP-mediated anti-diabetic and anti-nephritic effects are partially associated with their modulations on the anti-oxidative system and nuclear factor kappa B-related signaling pathway. In conclusion, AAP has potential to be a novel source of treatments for diabetes.

Antidiabetic and Antinephritic Activities of Aqueous Extract of Cordyceps militaris Fruit Body in Diet-Streptozotocin-Induced Diabetic Sprague Dawley Rats

Cordyceps militaris has long been used as a crude drug and folk tonic food in East Asia. The present study aims to evaluate the antidiabetic and antinephritic effects of the aqueous extract of the Cordyceps militaris fruit body (CM) in diet-streptozotocin- (STZ-) induced diabetic rats. During four weeks of continuous oral administration of CM at doses of 0.5, 1.0, and 2.0 g/kg and metformin at 100 mg/kg, the fasting blood glucose and bodyweight of each rat were monitored. Hypoglycemic effects of CM on diabetic rats were indicated by decreases in plasma glucose, food and water intake, and urine output. The hypolipidemic activity of CM was confirmed by the normalization of total cholesterol, triglycerides, and low- and high-density lipoprotein cholesterol in diabetic rats. Inhibitory effects on albuminuria, creatinine, urea nitrogen, and n-acetyl-β-d-glucosaminidase verified CM's renal protective activity in diabetic rats. Furthermore, CM exerted beneficial modulation of inflammatory factors and oxidative enzymes. Compared with untreated diabetic rats, CM decreased the expression of phosphor-AKT and phosphor-GSK-3β in the kidneys. Altogether, via attenuating oxidative stress, CM displayed antidiabetic and antinephritic activities in diet-STZ-induced diabetic rats.

Survey of diabetes risk assessment tools: concepts, structure and performance

The objective of this study is to review the effectiveness and limitations of existing diabetes risk screening tools to assess the need for further developing of such tools. An electronic search of the EMBASE, MEDLINE, and Cochrane library supplemented by a manual search was performed from 1995-2010. The search retrieved a total of 2168 articles reporting diabetes risk assessment tools which, after culling, produced 41 tools developed in 22 countries, with the majority (n = 26) developed in North America and Europe. All are short questionnaires of 2-16 questions incorporating common variables including age, gender, waist circumference, BMI, family history of diabetes, history of hypertension or antihypertensive medications. While scoring format and cut-offs point are diverse between questionnaires, overall accuracy value range of 40-97%, 24-86% and 62-87% were reported for sensitivity, specificity and receiver operating characteristic curve respectively. In summary, there is a trend of increasing availability of diabetes prediction tools with the existing risk assessment tools being generally a short questionnaire aiming for ease of use in clinical practice. The overall performance of existing tools showed moderate to high accuracy in their predictive performance. However, further detailed comparison of existing questionnaires is needed to evaluate whether they can serve adequately as diabetes risk assessment tool in clinical practice.

[Risk-stratified screening for diabetes in adolescents: results of the first investigation in Hungary]

The prevalence of type 2 diabetes mellitus in children and adolescents is increasing throughout the world. Early detection of blood glucose abnormalities is essential to improve long term prognosis of type 2 diabetes, as intervention strategies could be the most effective in youngsters.

AIM

To assess the prevalence of blood glucose abnormalities in asymptomatic adolescents having increased risk of diabetes, a screening program of the Hungarian Diabetes Association has been carried out in pediatric primary care setting.

METHODS

660 adolescents aged 12-18 years recruited from general pediatric practices were involved in the study. Risk assessment was performed by a questionnaire compiled according to the ADA recommendation for testing type 2 diabetes in childhood. Fasting plasma glucose and OGTT were performed in adolescents having increased risk for type 2 diabetes (overweight plus two additional clinical risk factors) and results were assessed according to WHO criteria.

RESULTS

285 adolescents of 660 were selected with increased risk for type 2 diabetes established by questionnaire (age: 15.2±1.8 years, BMI: 30.2±4.2 kg/m 2 , 141 males). Among subjects with increased risk, 16 (5.6%) had any type of blood glucose abnormalities: 4 (1.40%) IFG, 5 (1.75%) IFG+IGT, 6 (2.11%) IGT and 1 (0.35%) type 2 diabetes. Assessing the effect of clinical variables, increased BMI proved to be the strongest predictor of the diabetes risk [OR (95% CI): 1.216 (1.174-1.258), p<0.0001].

CONCLUSIONS

Screening procedure among asymptomatic adolescents with high risk of type 2 diabetes in the general pediatric practice is a simple and effective method for early detection of blood glucose abnormalities. Screening for type 2 diabetes in adolescents at risk should be encouraged in Hungary, and should be performed in pediatric primary care setting.

Screening for type 2 diabetes and prediabetes – methodological concerns and feasibility in Hungary

A 2-es típusú diabetes kórfejlődése jellemző módon időben elhúzódó és lappangó, olykor a manifeszt betegség kezdeti stádiuma is meglehetősen tünetszegény. Ez megteremti az alapját a szűrővizsgálattal történő betegségfelismerésnek. Szűrővizsgálattal nemcsak a 2-es típusú diabetes, hanem kórmegelőző állapota (összefoglaló néven praediabetes) is felismerhető. A szűrővizsgálat céljára napjainkban az úgynevezett kockázatalapú, kétlépcsős módszer a leginkább elfogadott: az első lépcsőben kérdőív segítségével azonosíthatók a fokozott kockázatú egyének, a második lépcsőben ez utóbbiak körében vércukor-meghatározásra kerül sor. A kérdőívek közül a FINDRISC (Finnish Diabetes Risk Score) használata terjedt el a legtöbb országban, az első hazai tapasztalatok is kedvezőek alkalmazásával kapcsolatban. A szűrővizsgálat megteremti a korai diabetesesetek azonosítását, illetve a primer prevenció lehetőségét. Mindez végül elvezethet a 2-es típusú diabetes előfordulási gyakoriságának csökkenéséhez. Helyes lenne, ha ez az egészségügyi-társadalmi aktivitás hazánkban is – más országokhoz hasonlóan – nemzeti diabetesprogram keretei között valósulna meg.