SUITO Index for Evaluation of Efficacy of Single Donor Islet Transplantation

Evaluation of engrafted islets mass is important for clinical care of patients after islet transplantation. Recently, we developed the secretory unit of islet transplant objects (SUITO) index, which reflected engrafted islet mass. In this study, we evaluated the SUITO index for the prediction of clinical outcome after single islet transplantation. Single islet transplantations were performed into six type 1 diabetic patients. Isolated islets were quantitatively assessed at the time of transplantation. The SUITO index was calculated as follows: fasting C-peptide (ng/dl)/[fasting blood glucose (mg/dl) – 63] × 1500. Islet yield/recipient's body weight and SUITO index were evaluated, along with HbA1C, relative insulin dose (insulin dose posttransplant/pretransplant), and M-values. HbA1C improved in all cases, irrespective of the SUITO index score or islet yield/body weight. The average SUITO index from postoperative days 3 to 30 ( R2 = 0.728, p < 0.04), but not islet yield/body weight ( R2 = 0.259, p = 0.303), correlated with relative insulin dose. The daily SUITO index strongly correlated with the daily relative insulin dose ( R2 = 0.558, p < 0.0001) and weakly correlated with the daily M-values ( R2 = 0.207, p < 0.02). A SUITO index score of less than 10 was associated with increasing insulin dose even after islet transplantation. The SUITO index seems to be a better predictor of success of islet transplantations than islet yield/body weight. SUITO index is recommended to assess clinical outcome of islet transplantation.

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The Effect of Biochanin A as PPAR γ agonist on LDL Particles Diameter and Type 2 Diabetic Dyslipidemia

International Journal of Medical Laboratory ◽

10.18502/ijml.v6i2.1028 ◽

2019 ◽

Author(s):

Darya Ghadimi ◽

Mohammad Taghi Taghi Goodarzi ◽

Mahdi Bahmani ◽

Zohre Khajehahmadi

Keyword(s):

Diabetes Mellitus ◽

Body Weight ◽

Blood Glucose ◽

Fasting Blood Glucose ◽

Male Rats ◽

Biochanin A ◽

Diabetic Patients ◽

Low Density ◽

Diabetic Dyslipidemia ◽

Ldl Particles

Background and Aims: Small dense low-density lipoproteins (sd-LDL) particles are smaller and heavier than typical LDL ones. They can penetrate into the endothelium of coronary arteries more easily because of their small size. Diabetes mellitus is accompanied by dyslipidemia such as increasing concentration of plasma very low density lipoprotein and sd-LDL. Peroxisome proliferator activated receptor γ (PPARγ ) can decrease the level of sd-LDL in plasma. Biochanin A (BCA), a natural compound, is a PPARγ agonist. The present study was designed to investigate the effect of BCA on sd-LDL-Clolesterol level in diabetic animals. Materials and Methods: Adult male rats (Wistar strain) were used as the animal models in this study. Animals were made diabetic by single intraperitoneal injection of Streptozotocin- Nicotinamide and then treated by 1 and 5 mg/kg of BCA for 28 days. Body weight and fasting blood glucose were also tested before and at the end of treatment. Furthermore, the size of LDL particles were measured by nondenaturing polyacrylamide gradient gel electrophoresis assay. Results: Results of the present study indicated that BCA administration at dose of 5mg/kg decreased fasting blood glucose level and increased body weight and diameter of LDL particles in diabetic animals significantly. Conclusions: BCA seems to be an appropriate agent in diabetes mellitus, because it improves the diabetic dyslipidemia, which is the most important complication in diabetic patients.

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Effıcacy and safety of dapagliflozin on diabetic patients receiving high-doses of insulin

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.2.21 ◽

2019 ◽

Vol 35 (2) ◽

Author(s):

Meltem Sertbas ◽

Yasar Sertbas ◽

Nalan Okuroglu ◽

Ali Burkan Akyildiz ◽

Seda Sancak ◽

...

Keyword(s):

Insulin Dose ◽

Fasting Blood Glucose ◽

Insulin Requirement ◽

Diabetic Patients ◽

High Dose ◽

Efficacy And Safety ◽

Serum Electrolyte ◽

Glucose Levels ◽

Antidiabetic Treatment ◽

High Doses

Objective: In this study we aimed to investigate the efficacy and safety of dapagliflozin addition to diabetic patients using high dose insulin. Methods: The current study was carried out in the outpatient diabetic clinics of Fatih Sultan Mehmet Education and Research Hospital. Thirty diabetic patients who were receiving high dose (>0.5U/kg) insulin and oral antidiabetic treatment (other than SGLT 2 inhibitors) were included in this study. Primary end point was the change in HbA1c, insulin doses and serum electrolyte from the addition of dapagliflozin 10 mg to the week 12. Results: At the end of three month BMI were obviously decreased from 33.31±4.51 to 32.14±4.66 (p: 0.001). There was also an evident decrease of insulin requirement from 76±23.15 U/kg to 57.60±17.61 U/day (p<0.001). As well as the decrease in insulin doses, there was also a significant decline in HbA1c (Δ 1.6 %) and fasting blood glucose levels (Δ68.6 mg/dl) (p<0.001). Among serum electrolyte levels slight but meaningful increase of blood urea nitrogen (BUN) and sodium (Na) levels were seen (p: 0.044 and p: 0.026). There were no significant changes in serum cholesterol levels with electrolytes such as potassium, calcium, phosphorus magnesium and vitamin D (p>0.05). Conclusion: In diabetic patients with inadequately controlled glucose regulation despite high-dose insulin therapy, dapagliflozin may be an alternative combination choice to decrease the need of insulin dose and obtain an optimal HbA1c, fasting plasma glucose levels and weight without major side effects. How to cite this:Sertbas M, Sertbas Y, Okuroglu N, Akyildiz AB, Sancak S, Ozdemir A. Effıcacy and safety of dapagliflozin on diabetic patients receiving high-doses of insulin. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.21 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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High Peritoneal Permeability Predisposes to Hepatic Steatosis in Diabetic Continuous Ambulatory Peritoneal Dialysis Patients Receiving Intraperitoneal Insulin

Peritoneal Dialysis International ◽

10.1177/089686080002000610 ◽

2000 ◽

Vol 20 (6) ◽

pp. 637-642 ◽

Cited By ~ 12

Author(s):

Pasi I. Nevalainen ◽

Timo Kallio ◽

Jorma T. Lahtela ◽

Jukka Mustonen ◽

Amos I. Pasternack

Keyword(s):

Body Weight ◽

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Insulin Dose ◽

Tertiary Care ◽

University Hospital ◽

Diabetic Patients ◽

Fat Accumulation ◽

Hepatic Fat ◽

Intraperitoneal Insulin

Objective To evaluate hepatic fat accumulation in diabetic patients taking intraperitoneal or subcutaneous insulin treatment during continuous ambulatory peritoneal dialysis (CAPD). Design Cross-sectional study. Setting Tertiary-care university hospital. Patients We studied 16 patients with diabetic end-stage renal disease currently treated with CAPD. Median age was 42 years (range: 34 – 70 years), duration of diabetes was 27.5 years (range: 17 – 39 years), and duration of CAPD was 16.5 months (range: 2 – 59 months). Outcome Measures Ultrasound measures of liver steatotic area and thickness, peritoneal equilibration test (PET), weekly Kt/V urea, protein catabolic rate (PCR), hemoglobin A1c (HbA1c), lipoproteins, alanine aminotransferase, alkaline phosphatase, insulin dose, and dialysate glucose load. Results Focal hepatic fat accumulation was found. The location of steatosis was subcapsular; a negligible amount was periportal. Hepatic subcapsular steatosis was present in 7 of 8 patients taking insulin intraperitoneally and in 0 of 8 patients taking insulin subcutaneously. The maximal thickness of subcapsular steatosis correlated directly with peritoneal transport rate (2-hour dialysate-to-plasma creatinine ratio in PET, r = 0.80, p < 0.05) and inversely with PCR ( r = –0.82, p < 0.05). The area of the lesions correlated directly with body weight ( r = 0.80, p < 0.05) and inversely with weekly Kt/V urea ( r = –0.90, p < 0.01). Conclusions Intraperitoneal insulin, together with glucose-based peritoneal dialysate, induces hepatic subcapsular steatosis. The amount of hepatic subcapsular steatosis increases when peritoneal transfer rate and body weight are high.

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Systematic Inspection of Insulin Injection Sites for Local Complications Related to Incorrect Injection Technique

Tropical Doctor ◽

10.1177/004947559602600406 ◽

1996 ◽

Vol 26 (4) ◽

pp. 159-161 ◽

Cited By ~ 27

Author(s):

Berhane Seyoum ◽

Jemal Abdulkadir

Keyword(s):

Blood Glucose ◽

Insulin Dose ◽

Fasting Blood Glucose ◽

Insulin Injection ◽

Diabetic Control ◽

Common Finding ◽

Injection Technique ◽

Diabetic Patients ◽

Local Complications ◽

Significant Difference

We systematically inspected insulin injection sites in 100 insulin-requiring patients attending the Diabetic Clinic of the Tikur Anbassa Hospital (TAH) in order to identify local complications related to incorrect injection technique: local complications were found in 53 cases: skin hyperpigmentation and/or indurations in 30 patients; and fat atrophy or hypertrophy in 31 patients. Illiteracy was significantly more common among those with local complications (18/53 versus 6/47, χ2 5.03, P < 0.05). Mean fasting blood glucose on the day of the inspection was significantly higher (14.9 +6.3 mmol/l versus 10.5 + 6.1 mmol/l, P < 0.001) and a fasting blood glucose > 10 mmol/l more common (41/53 versus 20/47, χ2 14.1, P < 0.0005) in those with than in those without local complications. There was no significant difference between the two groups in mean duration of diabetes (6.9 + 5.6 years versus 6.6 + 5.8 years), frequency of hypoglycaemic episodes (12/53 versus 5/47, χ2 1.76, P > 0.05) or mean daily insulin dose (44 + 18 units versus 44 + 22 units per day). Therefore, we concluded that local complications resulting from incorrect injection technique, a common finding in the group of patients studied, may be common among insulin requiring diabetic patients in general. Incorrect insulin injection causes local complications and disfigurement which may compromise compliance. Furthermore, insulin absorption tends to be erratic from intradermal and fat hypertrophy sites thus interfering with effective diabetic control. Insulin injection sites should be inspected routinely to detect and correct faulty technique promptly.

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Effect of Ramadan Fasting on Anthropometric Measures and Metabolic Profiles among Type 2 Diabetic Subjects

Journal of Enam Medical College ◽

10.3329/jemc.v5i2.23382 ◽

2015 ◽

Vol 5 (2) ◽

pp. 93-98 ◽

Cited By ~ 2

Author(s):

Ajit Kumar Paul ◽

Murshed Ahamed Khan ◽

Md Fariduddin

Keyword(s):

Blood Pressure ◽

Body Weight ◽

Serum Creatinine ◽

Fasting Glucose ◽

Fasting Blood Glucose ◽

Diabetic Patients ◽

Ramadan Fasting ◽

The Impact ◽

Type 2 Diabetic

Background: Fasting from dawn to dusk during the month of Holy Ramadan is obligatory for all healthy adult Muslims. Individuals are exempted from fasting if they are suffering from an illness that could be adversely affected by fasting. Although The Quran exempts sick people from fasting, many Muslim diabetic patients may not perceive themselves as sick and are keenly interested to fast. But they fast without proper medical guidance exposing themselves to certain risks as a direct consequence of fasting. So we designed this study to assess the impact of fasting during Ramadan and to evaluate the effects of fasting on their biochemical profiles in patients with diabetes.Objective: The objective of this study was to investigate whether Ramadan fasting has any effect on body weight, blood pressure, fasting glucose, HbA1C, serum lipids, serum creatinine among type 2 diabetic patients.Materials and Methods: Fifty two stable outpatients with type 2 diabetes with intention to fast were studied in the month of Ramadan 1434 Hijri calendar year (11th July to 9th August, 2013) at two points of time: one week before Ramadan (visit 1) and within last 3 days before the end of Ramadan (visit 2). During each visit the height, body weight and blood pressure were recorded. Blood samples were collected for fasting glucose, HbA1C, total cholesterol, triglyceride, high density and low density lipoprotein cholesterol and creatinine. Data were analyzed by Students paired t-test using SPSS system and results were expressed as mean ± SD. Probability values were considered to be significant if it was less than 0.05.Results: There were 30 (62.8%) males and 22 (37.2%) females with a mean age of 54.7 ± 11.55 (range 3580) years and mean duration of diabetes was 5.5 ± 5.2 years (range 9 months18 years). In this study mean weight of the patients decreased significantly from 60.5 ± 12.6 kg to 58.5 ± 11.3 kg (p<0.001). Blood pressure reduced but not significantly. Fasting blood glucose showed significant reduction from 10.7 ± 4.2 to 8.9 ± 3.7 mmol/L (p=0.002) at the end of the study though HbA1C showed no significant change. Lipid profile and serum creatinine values did not show any significant change.Conclusion: The effects of fasting during Ramadan on stable diabetic patients are minimal. So, stable diabetic patients can fast during Ramadan without significant detrimental effects.J Enam Med Col 2015; 5(2): 93-98

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The Effects of Different Quantities and Qualities of Protein Intake in People with Diabetes Mellitus

Nutrients ◽

10.3390/nu12020365 ◽

2020 ◽

Vol 12 (2) ◽

pp. 365 ◽

Cited By ~ 3

Author(s):

Andreas F.H. Pfeiffer ◽

Eva Pedersen ◽

Ursula Schwab ◽

Ulf Risérus ◽

Anne-Marie Aas ◽

...

Keyword(s):

Body Weight ◽

Protein Intake ◽

Fasting Blood Glucose ◽

Plant Protein ◽

Metabolic Effects ◽

Diabetic Patients ◽

Stable Conditions ◽

Lower Protein ◽

Protein Diets

The recommended amount and quality of protein in diets of diabetic patients are highly controversial. In order to provide evidence-based information, the Diabetes Nutrition Study Group (DNSG) used a grading procedure used for quality of evidence and strength of recommendations (GRADE). A protein intake of 10% to 20% of energy intake (E%) or about 0.8 to 1.3 g/kg body weight in people below 65 years of age, and 15% to 20% of E% in people above 65 years of age appeared safe in weight-stable conditions. There were no intervention studies addressing metabolic effects, mortality, or cardiovascular events over prolonged periods. Body weight is closely linked to metabolic control and high protein diets are often recommended. Weight-loss diets that include 23% to 32% of E% as protein for up to one year reduced blood pressure and body weight slightly but significantly more than lower protein diets, whereas blood lipids, fasting blood glucose, and HbA1c improved similarly with higher or lower protein intakes in participants with a glomerular filtration rate (GFR) >60 mL/min/1.73 m2. Patients with a GFR <60 mL/min/1.73 m2 did not show a faster decline of GFR or kidney function with protein intakes around 0.8 g/kg body weight as compared with lower intakes, thereby arguing against a restriction. The effects of protein intake on diabetic eye or nerve disease have not been reported. There are a number of studies that have compared different types of animal proteins (milk, chicken, beef, pork, and fish) or compared animal with plant protein in diabetic patients and have reported a greater reduction of serum cholesterol with plant protein. In summary, the suggested range of protein intake appears to be safe and can be adapted according to personal dietary preferences.

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The blood glucose lowering effect of Malaysian Tinospora crispa in rats

Jurnal Natural ◽

10.24815/jn.v20i1.15907 ◽

2020 ◽

Vol 20 (1) ◽

pp. 20-23

Author(s):

SARAH FIRDAUSA ◽

MAUNG MAUNG CHO ◽

KHIN MAUNG MAUNG ◽

NILAR AUNG ◽

NORSIDAH KUZAIFAH ◽

...

Keyword(s):

Body Weight ◽

Blood Glucose ◽

Fasting Blood Glucose ◽

Diabetic Rats ◽

The Body ◽

Hypoglycemic Agents ◽

Diabetic Patients ◽

Chronic Hyperglycemia ◽

Reduce Blood Glucose ◽

Maintain Body Weight

Diabetes is defined as a chronic hyperglycemia which should be countered by the effective, safe and readily available hypoglycemic agents. Herbal is among alternatives that has been used by society for years but lacks of documented evidences. Tinospora crispa (TC) is enriched by phytochemicals which potentially reduce blood glucose thus is useful for diabetic patients. This study aimed to investigate the potency of TC inreducing blood sugar and body weight. It involved 30 healthy rats divided into 5 groups namely: normal control, normal fed with TC extract, diabetic, TC-treated diabetic (dose 500 mg/kg w/w), and vitamin E-traeted diabetic rats (60 IU). The body weight and fasting blood glucose were measured each week for 1 month. The administration of TC extract 500 mg/kg (w/w) helps to maintain body weight in diabetic rats and reduce the fasting blood glucose. TC is highly potent as hypoglycemic agents therefore needed to be explored further.

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To study the effect of taurine on the effects of vital bones and regulate the level of glucose in type II diabetes

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v10i3.1508 ◽

2019 ◽

Vol 10 (3) ◽

pp. 2545-2551 ◽

Cited By ~ 2

Author(s):

Falah Hassan Shari ◽

Hiba Dawood ◽

Jubran K. Hassan ◽

Qais A. ALJazeari ◽

Mazin A.A. Najm ◽

...

Keyword(s):

Vitamin D ◽

Body Weight ◽

Blood Glucose ◽

Glycemic Control ◽

Serum Calcium ◽

Bone Mineralization ◽

Fasting Blood Glucose ◽

Controlled Study ◽

Diabetic Patients ◽

Type Ii

Taurine is sulfur containing semi-essential amino acid that has important roles in many biological processes, but its effect on glucose homeostasis, weight, growth and bone mineralization weren’t well defined. Objectives: the evaluation of oral Taurine effects has used for 3 months on bone mineralization biomarker, glycemic control and body weight in type ll diabetic patients. Methods: the interventional double-blind placebo-controlled study in which 80 patients with type 2 diabetes mellitus (age range 45-55) assigned in either control (n=40), or study group the (n=40) group. The last group has received a 1000mg capsule of Taurine once a day for three months. Parameters measured were serum calcium, 25(OH) vitamin D and osteocalcin, NTX-1 HbA1C% with fasting blood glucose before and after 3 months. Results: taurine led to significant (p<0.05) rise in osteocalcin, significant lowering in body weight, BMI and there were no significant changes in serum calcium, NTX-1, Vitamin D, HbA1C and fasting blood glucose, all as compared with the control value. Conclusions: the 3 months of oral Taurine are used in type II diabetic patients may modulate bone mineralization represented by elevation of osteocalcin and reduction of body weight, but has no significant effect on glycemic control and did not reduce HbA1C%.

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The Potential Anti-Obesity, Anti-Diabetic and Anti-Oxidant Effects of Vitamin a in Streptozotocin-Induced Diabetic Mice

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i631189 ◽

2021 ◽

pp. 50-64

Author(s):

Yosra Alhindi ◽

Anwar Bafaraj ◽

Abeer Barasain ◽

Massarah Hadidi ◽

Norah Bajandooh ◽

...

Keyword(s):

Body Weight ◽

Blood Glucose ◽

Vitamin A ◽

Lipid Profile ◽

Fat Mass ◽

Serum Insulin ◽

Fasting Blood Glucose ◽

Diabetic Patients ◽

Diabetic Mice ◽

Water Control

Background: Evidence suggests that there is a link between diabetes mellitus and Vitamin A. Moreover, it has been reported that diabetes induces oxidative stress. Lately, a wide attention has been developed to the protective biochemical function of natural antioxidants contained vitamins, which can reduce the oxidative damage caused by free radical species. Objective: To investigate the anti-obesity, anti-diabetic and anti-oxidative effects of vitamin A in streptozotocin (STZ)-induced diabetic mice. Methods: Male mice were randomly divided into three groups: Control- nondiabetic, received a normal diet and water; Control-diabetic, received STZ 45mg/kg once intraperitoneally; and Treated-diabetic, received both STZ as before plus Vitamin A (4-IU/day) orally daily for 16 weeks. Food intake, body weight, fat mass, fasting blood glucose, serum insulin, and lipid profile were estimated. Also, superoxide dismutase (SOD), glutathione peroxidase (GPO), catalase (CAT), and malonaldehyde (MDA) were measured. Results: Treated diabetic mice with Vitamin A showed a significant improvement in their body weight, fat mass, lipid profile as well as SOD, GPO and CAT compared to Control-diabetic mice. However, Vitamin A caused no significant change on fasting blood glucose and insulin levels. Furthermore, plasma level of MDA was significantly elevated in diabetic mice compared to normal mice. Diabetic mice treated with vitamin A had a significantly reduced level of MDA, suggesting that vitamin A might have a vital role in the protection of tissues from damage by free radicals. Conclusion: Supplementation with vitamin A may be a useful treatment strategy for diabetic patients to reduce/prevent the pathological complications of diabetes.

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