scholarly journals Effect of Irbesartan on AGEs-RAGE and MMPs systems in rat type 2 diabetes myocardial-fibrosis model

2019 ◽  
Vol 244 (7) ◽  
pp. 612-620 ◽  
Author(s):  
Ye Hongwei ◽  
Cao Ruiping ◽  
Fang Yingyan ◽  
Zhang Guanjun ◽  
Hu Jie ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Myocardial Fibrosis ◽  
Fasting Blood Glucose ◽  
Left Ventricular ◽  
Heart Weight ◽  
Sensitivity Index ◽  
Protein Expressions ◽  
Diabetes Patients

To investigate the effect of Irbesartan on the changes of myocardial advanced glycation end products and their receptor (AGEs-RAGE), and matrix metalloproteinases (MMPs) systems in rat type 2 diabetes myocardial fibrosis model. All male Sprague-Dwaley rats were randomly divided into four groups: control (CON), high glucose and high-caloric diet (HC), type 2 diabetes (T2DM) and Irbesartan + T2DM (Ir+T2DM) groups. At 12th week, the fasting blood glucose (FBG) and fasting serum insulin (FINS) levels, insulin resistance index (IRI), insulin sensitivity index (ISI), body weight (BW), the ratio of heart weight/body weight (H/B), left ventricular weight index (LVWI), and cardiac col I, col III contents, plasma MMP-2, MMP-9 levels were evaluated. The protein expressions of col I, AGE, RAGE, MMP-2, MMP-14, and TIMP-2 were analyzed by Western blot. In the T2DM group, FBG, H/B, LVWI, IRI were increased ( P < 0.01), while FINS, BW, ISI were decreased in contrast to the CON and HC groups ( P < 0.05–0.01). In the Ir+ T2DM group, BW was higher, IRI, H/B, LVWI were lower than in the T2DM group. Compared with the CON and HC groups, the contents of col I and col III, the protein expressions of col I, AGE, RAGE, TIMP-2 and MMP-14 were increased, MMP-2 protein expression, the ratios of MMP-2/TIMP-2 and MMP-14/TIMP-2, MMP-2, and MMP-9 levels were decreased in the T2DM group ( P < 0.01). After Irbesartan treatment, all parameters were reversed. Irbesartan can ameliorate myocardial fibrosis in type 2 diabetes rat model, the likely mechanisms may be related to the down-regulation of AGEs-RAGE system and changes of MMPs pathway. Impact statement There are about 425 million diabetes patients (20–79 years) in the world according to the International Diabetes Federation Diabetes Atlas – 8th Edition. The cardiovascular complication is one of the major causes of death in diabetes patients. Myocardial fibrosis is one of the serious pathological changes, so investigating the pathogenesis of myocardial fibrosis has the significant value. Our study aims to investigate the effect of Irbesartan (the angiotensin II receptor antagonist) on the changes of AGE-RAGE system and MMP family components, and analyzes the potential mechanisms in type 2 diabetes-induced myocardial fibrosis. Our results provide the theoretical base for better understanding the pathogenesis in type 2 diabetes-induced myocardial complication. It is useful for clinicians to select the effective therapeutic measures for treatment of type 2 diabetes-induced organ fibrosis.

scholarly journals Body Weight Variability and the Risk of Cardiovascular Outcomes and Mortality in Patients with Type 2 Diabetes: a Nationwide Cohort Study

2020 ◽  
Author(s):  
Ga Eun Nam ◽  
Wonsock Kim ◽  
Kyungdo Han ◽  
Chung-woo Lee ◽  
Yeongkeun Kwon ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Large Scale ◽  
Cox Proportional Hazards ◽  
Cardiovascular Outcomes ◽  
National Health Insurance System ◽  
All Cause Mortality ◽  
Quartile Group ◽  
Diabetes Patients

<b>Objective: </b>Obesity and type 2 diabetes are risk factors for cardiovascular diseases and mortality, and that commonly result in weight variabilities. We aimed to investigate the association between body weight variability and risk of major cardiovascular outcomes and mortality in individuals with type 2 diabetes using large-scale, nationwide cohort data on the Korean population. <div><p><b>Research Design and Methods: </b>We enrolled 624,237 individuals with type 2 diabetes who underwent health examinations provided by the Korean National Health Insurance System between 2009 and 2010, with ≥3 body weight measurements within 5 years since enrollment and followed up until the end of 2017. We assessed body weight variability using four indices, including variability independent of the mean (VIM). Multivariable-adjusted Cox proportional hazards regression analysis was performed.</p> <p><b>Results: </b>During the follow-up, 15,832, 25,038, and 44,716 cases of myocardial infarction (MI), stroke, and all-cause mortality, respectively, were recorded. Body weight variability was associated with increased risks of major cardiovascular outcomes after adjusting for confounding variables. Compared with the hazard ratios (HRs) of the lowest quartile group, the HRs (95% CIs) of the highest quartile group of VIM for body weight were 1.15 (1.10–1.20), 1.22 (1.18–1.26), and 1.58 (1.53–1.62) for MI, stroke, and all-cause mortality, respectively.</p> <p><b>Conclusions: </b>Body weight variability was associated with increased risks of MI, stroke, and all-cause mortality in type 2 diabetes patients and may be a predictor of cardiovascular outcomes in such patients. Appropriate interventions to maintain stable weight could positively influence health outcomes in type 2 diabetes patients.</p> </div> <br>

scholarly journals Triangulating evidence for the causal impact of single-dose zinc supplement on glycemic control for type-2 diabetes

2021 ◽  
Author(s):  
Zhiyang Wang ◽  
Carine Ronsmans ◽  
Benjamin Woolf
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Fasting Glucose ◽  
Causal Effect ◽  
Fasting Blood Glucose ◽  
Zinc Supplement ◽  
Diabetes Patients

Background: Although previous studies suggested the protective effect of zinc for type-2 diabetes, the unitary causal effect remains inconclusive. Objective: We investigated the causal effect of zinc as a single intervention on glycemic control in type-2 diabetes patients, using a systematic review of RCTs and two-sample Mendelian randomization (MR). Methods: Four outcomes were identified: fasting blood glucose/fasting glucose, hemoglobin A1c (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR), and serum insulin/fasting insulin level. In the systematic review, four databases were searched up to June 2021. Results were synthesized through the random-effects meta-analysis. Single nucleotide polymorphisms (SNPs) that are independent and are strongly related to zinc supplements were selected from MR-base to perform the two-sample MR with inverse-variance weighted (IVW) coefficient. Results: In the systematic review, 14 trials were included. The zinc supplement led to a significant reduction in the post-trial mean of fasting blood glucose (mean difference (MD): -26.52, 95%CI: -35.13, -17.91), HbA1C (MD: -0.52, 95%CI: -0.90, -0.13), and HOMA-IR (MD: -1.65, 95%CI: -2.62, -0.68), compared to the control group. In the two-sample MR, zinc supplement with 2 SNPs associated with lower fasting glucose (IVW coefficient: -2.04, 95%CI: -3.26, -0.83), but not specified type-2 diabetes. Conclusion: Although the study was limited by the few trials (review) and SNPs (two-sample MR), we demonstrated that the single zinc supplementary improved glycemic control among type-2 diabetes patients with causal evidence to a certain extent.

scholarly journals Factors Related to Self-care in Patients with Type 2 Diabetes

2020 ◽  
Vol 14 (1) ◽  
pp. 64-73
Author(s):  
Seung-Yeon Kong ◽  
Mi-Kyoung Cho
Keyword(s):  
Type 2 Diabetes ◽  
Self Efficacy ◽  
Smoking Status ◽  
Explanatory Power ◽  
Fasting Blood Glucose ◽  
Self Care ◽  
Self Report ◽  
University Hospital ◽  
Diabetes Patients

Purpose: The prevalence of diabetes and the personal and national burden from diabetes, a serious health issue around the globe, continues to increase. The purpose of this study was to identify factors influencing self-care among patients with type 2 diabetes. Methods: We conducted a cross-sectional descriptive survey of 118 outpatients with type 2 diabetes in national university hospital C in Korea. Data were collected from self-report questionnaires covering information on demographics, self-care, and self-efficacy. Additional data were collected from medical records including information on HbA1c, fasting blood glucose levels, and cholesterol levels. Collected data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and multiple regression using SPSS/WIN version 22.0 software. Results: Factors affecting self-care were the following four: self-efficacy, HbA1c, occupation status, and smoking status. Higher engagement in self-care was associated with higher self-efficacy (β = .53, p < .001), lower HbA1c (β = -0.33, p < .001), unemployment (β = -0.20, p < .001), and non-smoking status (β = -0.15, p = .011). The regression model of self-care among the type 2 diabetes patients was statistically significant (F = 67.15, p < .001), and the explanatory power of the adjusted R2 was 69%. Conclusion: Type 2 diabetes patients with high self-efficacy and self-care scores showed good glycemic control. Therefore, this finding suggests that nursing interventions should be developed to enhance self-efficacy, which is the greatest influencing factor for self-care.

Effect of Low-Carbohydrate Diet on Metabolism in Type 2 Diabetes Patients with the Aid of Intelligent Administration of Insulin-Loaded Nanoparticle

2020 ◽  
Vol 12 (12) ◽  
pp. 1445-1451
Author(s):  
Xiaofan Zhang ◽  
Youyou Zhang ◽  
Lingjia Gu ◽  
Haiying Tao ◽  
Shuang Zhu
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Solution ◽  
Fasting Blood Glucose ◽  
High Concentration ◽  
Carbohydrate Diet ◽  
Low Carbohydrate Diet ◽  
Low Carbohydrate ◽  
Hba1c Levels ◽  
Diabetes Patients

Nanoparticles play a major role in drug delivery. We investigated the effects of the intelligent administration of insulin-loaded nanoparticles (ILNP) when combined with a low-carbohydrate diet (LCD) on the metabolism of patients with type 2 diabetes. ILNP and smart vesicle polymers were developed, and their properties were studied in vitro. Further clinical trials were performed, during which body mass index (BMI), fasting blood glucose (FBG) levels, and glycated hemoglobin (HbA1c) levels were compared between type 2 diabetes patients on LCDs those on normal diets. The results demonstrated that ILNP resisted protease degradation due to steric hindrance, and remained relatively stable at a pH range of 5.0 to 7.4. The nanoparticle enteric-coated capsules resisted the gastric juice acidity (pH = 2.5) and ensured the stable embedding of the insulin. The insulin was then released at a slightly higher pH (pH = 6.6), which mimicked the small intestine. Smart vesicle polymers further embedded the insulin and glucose oxidase simultaneously in nano polymer compounds, which allowed for a dose-dependent response to the concentration of glucose. Thus, the insulin was not released in a low-concentration glucose solution, but rather in a high-concentration glucose solution. Based on these results, we concluded that the clinical trial results showed that the intelligent administration of ILNP combined with a LCD reduced BMI, FBG, and HbA1c levels in patients with type 2 diabetes.

scholarly journals Exaggerated Aortic Pulse Pressure and Wave Amplitude During Muscle Metaboreflex Activation in Type 2 Diabetes Patients

2019 ◽  
Vol 33 (1) ◽  
pp. 70-76
Author(s):  
Arturo Figueroa ◽  
Arun Maharaj ◽  
Sarah A Johnson ◽  
Stephen M Fischer ◽  
Bahram H Arjmandi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Pulse Pressure ◽  
Pressure Wave ◽  
Aortic Stiffness ◽  
Wave Amplitude ◽  
Fasting Blood Glucose ◽  
Isometric Handgrip ◽  
Muscle Metaboreflex ◽  
Diabetes Patients

Abstract Background Peripheral mean arterial pressure (MAP) responses to muscle metaboreflex activation using postexercise muscle ischemia (PEMI) in type 2 diabetes patients (T2D) are contradictory. Given that aortic pulse pressure (PP) and wave reflections are better indicators of cardiac load than peripheral MAP, we evaluated aortic blood pressure (BP) and wave amplitude during PEMI. METHODS Aortic BP and pressure wave amplitudes were measured at rest and during PEMI following isometric handgrip at 30% maximum voluntary contraction (MVC) in 16 T2D and 15 controls. Resting aortic stiffness (carotid-femoral pulse wave velocity, cfPWV) and fasting blood glucose (FBG) were measured. RESULTS Increases in aortic MAP (Δ26 ± 2 mmHg vs. Δ17 ± 2 mmHg), PP (Δ15 ± 2 mmHg vs. Δ10 ± 1 mmHg), augmentation index (AIx) (Δ8.2 ± 1.0% vs. Δ4.5 ± 1.3%), augmented pressure (AP) (Δ11 ± 1 mmHg vs. Δ5 ± 1 mmHg), forward (Pf) (Δ9 ± 1 mmHg vs. Δ5 ± 1 mmHg), and backward pressure waves (Pb) (Δ10 ± 1 mmHg vs. Δ5 ± 1 mmHg) responses to PEMI were greater in T2D than controls (P &lt; 0.05). Aortic PP, but not MAP, response to PEMI was correlated to Pf (r = 0.63, P &lt; 0.001) and Pb (r = 0.82, P &lt; 0.001) responses and cfPWV (r = 0.37, P &lt; 0.05). CONCLUSIONS Aortic BP and pressure wave responses to muscle metaboreflex activation are exaggerated in T2D. Aortic PP during PEMI was related to increased wave reflection, forward wave amplitude, and aortic stiffness in T2D patients.

scholarly journals Alterations in Serum Electrolyte Homeostasis in Type-2 Diabetes Mellitus Patients - A Cross-Sectional Study in VIMSAR, Burla

2020 ◽  
Vol 7 (52) ◽  
pp. 3148-3152
Author(s):  
Labanyabati Pattanaik ◽  
Madhusmita Acharya ◽  
Manoj Kumar Yadav ◽  
Prafulla Kumar Mishra ◽  
Madhab Nayak
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Electrolyte Disturbances ◽  
Uncontrolled Diabetes ◽  
Diabetes Patients

BACKGROUND Type 2 diabetes mellitus is a widely prevalent lifestyle disease associated with high morbidity and mortality due to dead end complications like acute coronary syndrome, chronic kidney failure and acute stroke. Diabetes mellitus patients frequently develop problems of dyselectrolytemia which is common among hospitalised patients with decompensated diabetes. But there is little information on the prevalence of electrolyte disturbances among diabetes patients. Our aim is to find out the pattern of dyselectrolytemia among type 2 diabetes patients and to know if there is any association of blood glucose level with dyselectrolytemia. METHODS An analytical cross-sectional study was done among type 2 diabetes patients admitted in the department of medicine. Fasting blood glucose (FBG), glycosylated haemoglobin level (HbA1c), blood sodium (Na+), potassium (K+) and calcium (Ca2+) were analysed. Occurrence of dyselectrolytemia was compared between patients of very much controlled versus uncontrolled blood glucose levels. RESULTS Out of 199 patients included in the study, 112 (56 %) had uncontrolled diabetes mellitus (DM) with HbA1c level > / = 7.0 %. Occurrence of hyponatremia, hypokalaemia, hyperkalaemia, hypocalcaemia and hypercalcemia were 35 %, 13 %, 7 %, 16 % and 2 % respectively. In diabetes patients, hyponatremia was seen more commonly in patients with uncontrolled DM than those with very much controlled blood glucose (52.67 % versus 12.64 %, p < 0.001). The extent of patients with hypokalaemia or hyperkalaemia didn't vary between the two groups. Patients on insulin treatment were more likely to have hyponatremia than noninsulin patients (p < 0.001). CONCLUSIONS Type 2 DM patients specifically those who have uncontrolled diabetes mellitus have an increased chance to develop dyselectrolytemia. The most well-known electrolyte disturbances seen were hyponatremia followed by hypocalcaemia in our study and they were generally predominant among patients with uncontrolled DM. KEYWORDS Type 2 Diabetes, Dyselectrolytemia, Hyperglycaemia, Fasting Blood Glucose, Hyponatremia

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