scholarly journals Metabolic Consequences of Concomitant Strongyloides stercoralis Infection in Patients With Type 2 Diabetes Mellitus

2018 ◽  
Vol 69 (4) ◽  
pp. 697-704 ◽  
Author(s):  
Anuradha Rajamanickam ◽  
Saravanan Munisankar ◽  
Yukthi Bhootra ◽  
Chandrakumar Dolla ◽  
Kannan Thiruvengadam ◽  
...  

Abstract Background Human and animal studies have demonstrated that helminth infections are associated with a decreased prevalence of type 2 diabetes mellitus (T2DM). However, very little is known about their biochemical and immunological interactions. Methods To assess the relationship between a soil-transmitted helminth, Strongyloides stercoralis (Ss), and T2DM, we examined analytes associated with glycemic control, metabolic processes, and T-cell–driven inflammation at the time of Ss diagnosis and 6 months after definitive anthelmintic treatment. We measured plasma levels of hemoglobin A1c, glucose, insulin, glucagon, adipocytokines, and T-helper (TH) 1-, 2-, and 17- associated cytokines in patients with T2DM with (INF group) or without (UN group) Ss infection. In INF individuals, we again assessed the levels of these analytes 6 months following anthelmintic treatment. Results Compared to UN individuals, INF individuals exhibited significantly diminished levels of insulin and glucagon that increased significantly following therapy. Similarly, INF individuals exhibited significantly diminished levels of adiponectin and adipsin that reversed following therapy. INF individuals also exhibited significantly decreased levels of the TH1- and TH17- associated cytokines in comparison to UN individuals; again, anthelmintic therapy augmented these levels. As expected, INF individuals had elevated levels of TH2-associated and regulatory cytokines that normalized following definitive therapy. Multivariate analysis revealed that these changes were independent of age, sex, body mass index, and liver and renal function. Conclusions Strongyloides stercoralis infection is associated with a significant modulation of glycemic, hormonal, and cytokine parameters in T2DM and its reversal following anthelmintic therapy. Hence, Ss infection has a protective effect on diabetes-related parameters.

2011 ◽  
Vol 8 (4) ◽  
pp. 16-22
Author(s):  
O A Gerasimenko ◽  
E Pigarova ◽  
L K Dzeranova

Bromocriptine is a sympatholytic agonist of dopamine receptors, which is now proposed for treatment of type 2 diabetes mellitus. In animal studies bromocriptine elevates the decreased levels of dopamine in hypothalamus and blocks excessive sympathetic innervations in central nervous system that results in decrease of postprandial glucose. Bromocriptine decreases hepatic glucose production and increases insulin secretion and muscle insulin sensitivity. This article reviews experimental and clinical data on the use of bromocriptine for treatment of type 2 diabetes mellitus


2021 ◽  
pp. 305-310
Author(s):  
N. A. Petunina ◽  
M. E. Telnova ◽  
I. A. Kuzina

Sodium-glucose cotransporter-2 inhibitors are the new drugs for the treatment of type 2 diabetes mellitus. Its mechanism of action is to increase the excretion of glucose in the urine due to inhibition of reabsorption in the proximal renal tubules, which leads to a decrease in blood glucose levels. These drugs also have pleiotropic effects including reduce body weight and blood pressure, improve the lipid profile (raising high-density lipoprotein cholesterol and lowering triglyceride levels), and reduce the risk of cardiovascular death and nephroprotection. Ipragliflozin, a new representative of the class of sodium glucose cotransporter-2 inhibitors, registered in Russia, has shown effectiveness in relation to glycemic control, reducing the levels of glycated hemoglobin and fasting plasma glucose both in monotherapy and in combination with other antihyperglycemic drugs. The PRIME-V and ILLUMINATE studies have demonstrated that ipragliflozin helps to reduce insulin resistance, body weight, BMI and waist circumference, total and LDL cholesterol. Positive effects of ipragliflozin on pancreatic β-cell mass and function have been shown in animal studies. Several studies have examined the beneficial effects of ipragliflozin on the course of non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus. Significant reductions in ALT and GGT levels and a decrease in the absolute percentage of liver fat have been shown. Animal studies have confirmed the effect of ipragliflozin on the histological characteristics of NASH. The review presents data on the efficacy of ipragliflozin in relation to the components of the metabolic syndrome in patients with type 2 diabetes mellitus, and also discusses the likely mechanisms of a positive effect of the drug on the course of NASH in type 2 diabetes mellitus. 


2021 ◽  
Vol 10 (3) ◽  
pp. 565
Author(s):  
Ronald Pratama Adiwinoto ◽  
Robert Dwitama Adiwinoto ◽  
Jongky Hendro Prajitno

Diabetic retinopathy (DR) is the major cause of visual impairment in the working-age population with type 2 diabetes mellitus (T2DM). Magnesium (Mg) is involved in various metabolic processes and in experimental animal studies; Mg has shown essential roles in physiological eye function. Magnesium deficiency is common in T2DM; therefore we analyzed the association between serum Mg status and the presence of DR in T2DM patients. Systematic literature searching in several databases, from 1988 to September 2020, was performed using search terms: “serum magnesium” or “hypomagnesemia” and “diabetic retinopathy” or “retinopathy”. A total of 3,227 patients from 17 studies were included in this meta-analysis. Hypomagnesemia was associated with increased risk of developing DR (OR 4.52 [2.08, 9.81], p=0.0001) in T2DM patients. Serum Mg levels also lower in patients with DR than those without DR (MD –0.30 mg/dL [–0.44, –0.15], p<0.0001). Additionally, serum Mg levels were lower in patients with proliferative DR (PDR) than those with non-proliferative DR (NPDR) (MD-0.21 mg/dL [–0.34, –0.09], p=0.0009). Leave-one-out sensitivity analysis did not change the overall effect. Hypomagnesemia or low serum Mg levels in T2DM patients increased the risk of developing DR.


2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Russell Hays ◽  
Fintan Thompson ◽  
Adrian Esterman ◽  
Robyn McDermott

Abstract Background.  This study examines the predictive value of eosinophilia for Strongyloides stercoralis infection, as measured by enzyme-linked immunosorbent assay (ELISA) testing, in an endemic community. In remote communities, eosinophilia is frequently used as a proxy test for the presence of helminth infections. Past studies of eosinophilia and Strongyloides infection have been conducted in specific groups such as immigrants and refugees, or in subpopulations of nonendemic communities, rather than in endemic communities. Methods.  We conducted a cross-sectional study of the relationship between eosinophilia and Strongyloides ELISA serology, as part of a study into the relationship between S stercoralis infection and type 2 diabetes mellitus (T2DM) in an Indigenous community in northern Australia. Results.  Two hundred thirty-nine adults had their eosinophil count and S stercoralis ELISA serology measured in 2012 and 2013, along with other biometric and metabolic data. Eosinophilia was found to have a relatively poor sensitivity (60.9%), specificity (71.1%), positive predictive value (54.6%), and negative predictive value (76.1%) for S stercoralis ELISA positivity in this group. However, there was a more constant relationship between eosinophilia and S Stercoralis ELISA positivity in patients with T2DM (negative predictive value 87.5%). Conclusion.  This study suggests that the presence or absence of eosinophilia is not an adequate proxy test for S stercoralis infection in a community where the infection is prevalent, and that the association between eosinophilia and S stercoralis ELISA positivity is more constant in patients with T2DM.


Biology ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 155
Author(s):  
Nuno Henrique Franco ◽  
Sonia Batista Miranda ◽  
Nóra Kovács ◽  
Attila Nagy ◽  
Bùi Quốc Thiện ◽  
...  

Although there is a wide range of animal models of type 2 diabetes mellitus (T2DM) used in research; we have limited evidence on their translation value. This paper provides a) a comparison of preclinical animal and clinical results on the effect of five dipeptidyl peptidase-4 (DPP4) inhibitors by comparing the pharmaceutical caused glucose changes, and b) an evaluation of methodological and reporting standards in T2DM preclinical animal studies. DPP4 inhibitors play an important role in the clinical management of T2DM: if metformin alone is not sufficient enough to control the blood sugar levels, DPP4 inhibitors are often used as second-line therapy; additionally, DPP-4 inhibitors are also used in triple therapies with metformin and sodium-glucose co-transporter-2 (SGLT-2) inhibitors or with metformin and insulin. In our analysis of 124 preclinical studies and 47 clinical trials, (1) we found no evidence of species differences in glucose change response to DPP4 inhibitors, which may suggest that, for this drug class, studies in mice and rats may be equally predictive of how well a drug will work in humans; and (2) there is good reporting of group size, sex, age, euthanasia method and self-reported compliance with animal welfare regulations in animal studies but poor reporting of justification of group size, along with a strong bias towards the use of male animals and young animals. Instead of the common non-transparent model selection, we call for a reflective and evidenced-based assessment of predictive validity of the animal models currently available.


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