Protective Effect of Inulin and the Integrity of the Microvasculature in Diabetes Mellitus

Type 2 diabetic microangiopathy affects every organ in the body and can lead to serious incapacitating complications. VLDL and apo C1 are two of the main biochemical abnormalities which start and propagate this condition. Inulin fructans prebiotic effect on the colonic flora enhance the bifidogenic strains. These predominate over the pathogenic strains which encourage lipidogenesis, thus reducing hyperlipidemia. Our aim is to find out the possible effect of inulin ingestion on the metabolism of VLDL and apo C1 and their role in the pathogenesis of diabetic angiopathy Twenty eight obese type 2 diabetic female patients were subjected to this study. Each patient ingested 4 grams of inulin daily for 3 weeks. Their fasting serum level of VLDL and apo C1 were estimated before and after the period of inulin ingestion. There was a significant decrease in fasting level of serum VLDL and apo C 1 after inulin ingestion period. In conclusion inulin can be given as a protective and as an add on therapy for type 2 diabetic patients. It reduces two of the main culprits which start and propagate the pathologic pathway of diabetic microangiopathy. This cuts short the other offenders (small HDL, small dense LDL and the small VLDL remnants).

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Evaluating the Synergistic Activity of Metformin and Apple Cider Vinegar in Type 2 Diabetics

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2019/v31i630376 ◽

2020 ◽

pp. 1-7

Author(s):

Momina Abid ◽

Farah Ahmed ◽

Shehla Shaheen ◽

Zahida Memon ◽

M. Zaman Shaikh ◽

...

Keyword(s):

Glycemic Control ◽

The Body ◽

Diabetic Patients ◽

Synergistic Activity ◽

Care Hospital ◽

Newly Diagnosed ◽

Type 2 Diabetic Patients ◽

Apple Cider ◽

Type 2 Diabetic

Aims: The aim of this study was to observe the effect of Apple Cider Vinegar (ACV) in combination with Metformin on the Body Mass Index (BMI) and glycemic control of newly diagnosed type 2 diabetic patients. Study Design: Single arm pre post quasi experimental clinical trial. Place and Duration of Study: Department of Medicine of a tertiary care hospital and a Diabetes and Endocrinology clinic, based in Karachi, Pakistan from April to July 2019. Methodology: A total of 30 newly diagnosed type 2 diabetic patients were enrolled in the study (Males: 17; females: 13; age range: 27-55 years) after obtaining written informed consent. The parameters of Body weight, BMI, Fasting Blood Sugar (FBS) and Hemoglobin A1c (HbA1c) of each patient were assessed before and after 12 weeks of treatment with Metformin 750 mg plus 2 tablespoons of ACV per day. The baseline and post treatment values of the aforementioned were compared with each other. Results: In all the 30 patients assessed after 12 weeks of treatment, the weight was significantly reduced from 85.66±18.30 kg. to 82.96±18.43 kg with a consequently significant change in the BMI from 29.38±5.08 kg/m2 to 28.43±5.16 kg/m2. Moreover, the glycemic control, assessed as FBS and HbA1c also showed significant reduction in the FBS (127.76±9.17 to 121.23±9.54) and HbA1c (7.14±0.29 to 6.92±0.29) after 12 weeks of treatment in all 30 patients (p<0.01). Conclusion: Apple Cider Vinegar seems to be effective therapy in combination with metformin for newly diagnosed type 2 diabetic patients in improving glycemic control as well as augmenting weight reduction.

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SYMPHYTUM OFFICINALE IN THE TREATMENT OF PLANTAR KERATOSIS IN DIABETIC PATIENTS: DOUBLE BLIND RANDOMIZED CLINICAL TRIAL

10.36106/ijsr/3730706 ◽

2021 ◽

pp. 62-64

Author(s):

Beatriz Bertolaccini Martínez ◽

Elisa Coutinho Moura

Keyword(s):

Clinical Trial ◽

Salicylic Acid ◽

Statistical Analysis ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Double Blind ◽

Double Blind Clinical Trial ◽

Before And After ◽

Type 2 Diabetic

PURPOSE: To compare the efcacy between SO and salicylic acid SA in the treatment of plantar keratosis of diabetic patients. METHODS: Randomized, double-blind clinical trial, with 47 type 2 diabetic patients, both sexes and with plantar keratosis. Patients were randomized into 2 groups: G1 (n = 48; treated with 15% SO extract) and G2 (n = 46; treated with 10% AS). The feet were photographed before (D0) and after the treatment (D30) and keratosis areas were measured using the Image J software. For each patient, a lesion in each foot was analyzed. The results were expressed by median. In the statistical analysis, the Wilcoxin test was used to compare the lesion areas before and after treatments and the Mann-Whitney test was used to compare the regression of the lesion areas between the two groups. P <0.05 was adopted. RESULTS: G1 (D0 = 2 8.156 vs D30 = 2.226; p <0.0001) and G2 (D0 = 4.835 vs D30 = 2.059; p <0.0001) showed a difference between the areas (cm ) of the keratosis, 2 before and after the treatment. There was a difference in the regression of the areas (cm ) of keratosis, between G1 and G2, respectively (4.540 vs 1.171, p <0.0001). CONCLUSION: Symphytum ofcinale proved to be more effective than Salicylic Acid in the treatment of plantar keratosis in diabetic patients.

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Serum Levels of Progranulin Are Closely Associated with Microvascular Complication in Type 2 Diabetes

Disease Markers ◽

10.1155/2015/357279 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 17

Author(s):

Lin Xu ◽

Bo Zhou ◽

Huixia Li ◽

Jiali Liu ◽

Junhui Du ◽

...

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Microvascular Complications ◽

Linear Regression Analysis ◽

Serum Levels ◽

Diabetic Microangiopathy ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

Objective. Progranulin (PGRN) was recently introduced as a novel marker of chronic inflammatory response in obesity and type 2 diabetes capable of directly affecting the insulin signaling pathway. This study aimed to investigate the correlation between PGRN and type 2 diabetics with microvascular complications.Methods. PGRN serum levels and glucose metabolism related substance were measured in 84 type 2 diabetic patients with or without microangiopathies and 12 health persons. Further analyses of serum PGRN in different stages of diabetic microangiopathies were conducted.Results. Serum levels of PGRN were markedly higher in type 2 diabetic patients with microangiopathies. PGRN serum levels increased with the progress of diabetic microangiopathies with significantly highest values detectable in clinical diabetic nephropathy (CDN) and proliferative diabetic retinopathy (PDR) groups. Serum PGRN concentrations in all individuals positively and markedly correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), triglyceride (TG), urinary albumin excretion rate (UAER), blood urea nitrogen (BUN), creatinine (CRE), white blood cell (WBC), disease duration, IL-6, and TNF-α, while correlating negatively and significantly with eGFR. Multiple linear regression analysis showed that only UAER and CRE were independently associated with serum PGRN.Conclusion. PGRN might be considered as a marker for diabetic microangiopathy and its severity.

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Assessment of the Nutritional Status of Hospitalized Type 2 Diabetic Patients

Current Developments in Nutrition ◽

10.1093/cdn/nzab047_004 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 841-841

Author(s):

Nadia Ben Amor ◽

Faten Mahjoub ◽

Olfa Berriche ◽

Henda Jamoussi

Keyword(s):

Weight Loss ◽

Nutritional Status ◽

The Body ◽

Prise En Charge ◽

Elderly Subjects ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

The Mean ◽

Type 2 Diabetic

Abstract Objectives The aim of our work was to assess the nutritional status and to determine the prevalence of undernutrition in type 2 diabetic patients hospitalized in a center specializing in Nutrition, Diabetology and Metabolic Diseases. Methods This is a descriptive cross-sectional prospective study, which involved 40 type 2 diabetic patients, aged 18 and over, hospitalized in department A of the National Institute of Nutrition and Food Technology. The assessment of nutritional status was carried out using clinical means (kinetics of weight loss, a dietary survey, anthropometric measurements, impedancemetry, Nutritional Risk Score 2002 for those under 70 years old and the Mini Nutritional Assessment from 70 years old) and biological (albuminemia). The positive diagnosis of malnutrition was selected according to the criteria of the High Authority of Health of 2019 for adults under 70 years, and of 2007 for elderly subjects. Results The mean age was 59.6 ± 11.59 years old. The average duration of diabetes was 10.83 ± 8.03 years. The mean level of glycated hemoglobin was 11.03 ± 1.97% and the Body Mass Index was 28.88 kg/m² with extremes ranging from 14.6 to 40.9 kg/m². Weight loss was noted in 48% of patients. Calorie intake was low in 30% of the patients. Protein and mono-unsaturated fatty acid low intake was noted in respectively 28% and 70% of patients. More than half of patients had deficiency in vitamin C, D, B12 and B9 as well as in zinc, calcium, magnesium and cooper. Iron and vitamin B12 low intake was more prevalent in patients with malnutrition (p = 0.043 and p = 0.003 respectively). The mean serum albumin was 37.58 ± 2.93 g/l with ranges ranging from 27.2 to 43.8 g/l. Malnutrition was diagnosed in 25% of patients and in half of the cases, it was severe. Conclusions Patients with type 2 diabetes mellitus are at high risk of malnutrition with a high prevalence of dietary intakes deficiencies. Funding Sources 1. HAS. Diagnostic de la dénutrition de l'enfant et l'adulte. Service de bonnes pratiques professionnelles, 2019. 2. HAS. Stratégie de prise en charge en cas de dénutrition protéino-énergétique chez la personne âgée. Service des recommandations professionnelles. Avril 2007. 3. Anses. Actualisation des repères du PNNS: élaboration des références nutritionnelles. Saisie n° 2012-SA-0186. Avis de l'Anses. Rapport d'expertise collective. Décembre 2016.

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Detection of Cytomorphological Changes in Buccal Mucosal Cells of Type 2 Diabetic Patients Using Oral Exfoliative Cytology

Annals of King Edward Medical University ◽

10.21649/akemu.v23i2.1575 ◽

2017 ◽

Vol 23 (2) ◽

Author(s):

Sadia Sharif ◽

Naureen Sarwar ◽

Bushra Nisar ◽

Muhammad Khalid Masood ◽

Asim Hameed

Keyword(s):

The Body ◽

P Value ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Control Subjects ◽

Nuclear Diameter ◽

Chronic Hyperglycemia ◽

Mucosal Cells ◽

Type 2 Diabetic

AbstractBackground: Diabetes mellitus is an extremely common endocrine metabolic disorder that results in chronic hyperglycemia. It has effects on various tissues of the body. Due to this increased blood glucose levels considerable cellular changes occur in oral cavity as well. This field has attracted little research. The aim of the study was to analyze the changes in morphology and cytomorphometric measurements in the buccal mucosal cells of type 2 diabetic patients.Objectives: The Objective of this study was to detect the cytological and morphological alterations of oral epithelial cells, in type 2 diabetic patients and healthy control subjects in exfoliated cytology smears, to com-pare the cytoplasmic diameter, nuclear diameter, and nucleus: cytoplasm ratio in type 2 diabetics and heal-thy control subjects and to analyze the above mentioned cellular alterations in patients with controlled and uncontrolled diabetes.Methods: Cross-sectional analysis was performed in three groups on the bases of HbA1c levels. Group 1 was uncontrolled diabetics with HbA1C ≥ 7.0%, Gro-up 2 was well controlled diabetics with HbA1c ≤ 7.0% and Group 3 was Control healthy having HbA1C ≤ 5. 6%. Smears from normal buccal mucosa were obtai-ned from each subject and stained with Papanicolaou method. An eyepiece micrometer was used to take mean values of ND, CyD, and N: C ratio. Fifty (50) clearly defined cells were measured in each case in a step wise manner, to evade quantifying cells once more. Comparison of Nuclear Diameter (ND), Cytoplasmic Diameter (CY D) and ratio of two Diameters (N: C) among three groups was performed by using ANOVA. TUKEY’S test for post –hoc analysis was used where required.Results: The variability in diameter of nucleus among all three sample groups showed significant p-value < 0.001.Whereas the measurement for cytoplasmic diameter between three groups was not significant (p-value 0.178). The ratio of nuclear diameter to cytoplasmic diameter calculated was significant (p-value < 0.001). Hence it proved from the results that considerably exaggerated ND and N: C ratios were seen as the glycemic control (HbA1C) is poorer.Conclusion: The results suggested that nuclear size of buccal mucosal cells increased in type 2 diabetic pati-ents while no change was observed in cytoplasmic dimensions.

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Study of vitamin D level in type 2 diabetic patients before and after treatment with pioglitazone

Egyptian Journal of Obesity Diabetes and Endocrinology ◽

10.4103/2356-8062.159994 ◽

2015 ◽

Vol 1 (1) ◽

pp. 43

Author(s):

AA EL Sherbeney ◽

WW Mohamed ◽

MR Halaw ◽

MM Abu Shady ◽

YM Eid

Keyword(s):

Vitamin D ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Before And After ◽

Type 2 Diabetic

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Blood Glucose Before and After ECT Treatments in Type 2 Diabetic Patients

Journal of Ect ◽

10.1097/00124509-200606000-00009 ◽

2006 ◽

Vol 22 (2) ◽

pp. 124-126 ◽

Cited By ~ 7

Author(s):

Keith G. Rasmussen ◽

Debra A. Ryan ◽

Paul S. Mueller

Keyword(s):

Blood Glucose ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Before And After ◽

Type 2 Diabetic

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Short-term renoprotective effect of SGLT-2 inhibitor for renal function and albuminuria in type 2 diabetes

10.21203/rs.3.rs-23179/v1 ◽

2020 ◽

Author(s):

Mitsunobu Kubota ◽

Eri SHiroyama ◽

Kanako Tanaka ◽

Yoko Yoshii

Keyword(s):

Blood Pressure ◽

Body Weight ◽

Diabetic Patients ◽

Protective Effects ◽

Renal Protection ◽

Short Term ◽

Type 2 Diabetic Patients ◽

Before And After ◽

Type 2 Diabetic

Abstract Background Progression of diabetic nephropathy in type 2 diabetic patients is a factor that determines the prognosis of life. Empagliflozin and canagliflozin, two oral diabetic SGLT-2 inhibitors, have shown improved renal outcomes in type 2 diabetic patients with chronic kidney disease in a large clinical study. These results suggest that SGLT-2 inhibitors could be used not only for hypoglycemic effects, but also for renal protective effects in patients with type 2 diabetes. It is not fully understood in which contexts the use of SGLT-2 inhibitors is likely to exert its renal protective effects. The purpose of this study was to clarify the profiles of patients in whom SGLT-2 inhibitors are more likely to exert a renal protective effect in clinical practice. We examined renal function and urinary albumin changes in short-term use of SGLT-2 inhibitors by patient background. Methods We retrospectively analyzed the chart information of sixty-three type 2 diabetic patients (33 males, 30 females, average age 53.0 ± 13.0 years) who were given usual doses of a SGLT-2 inhibitor. We investigated changes in body weight, blood pressure, glucose metabolism index, lipid metabolism index, estimated glomerular filtration rate (eGFR) and albuminuria (urinary albumin-to-creatinine ratio, UACR) three months before and after administration of a SGLT-2 inhibitor. Results Three months after administration of an SGLT-2 inhibitor, there were improvements in glucose tolerance, weight loss, blood pressure, and lipid indices. In all cases, there was no significant change in eGFR, but UACR decreased significantly. UACR decreased regardless of Angiotensin II Receptor Blocker medication and significantly decreased in the nephropathy stage 2 and 3 groups. UACR decreased only in the group in which blood pressure, body weight, and HbA1c decreased before and after administration of the SGLT-2 inhibitor. Conclusions Our study shows that SGLT-2 inhibitors are independent of renin-angiotensin system (RAS) inhibitors, and in addition to direct renal protection, the comprehensive effects of SGLT-2 inhibitors, which lower body weight, blood pressure, and blood glucose, are also important for their renal protection effects.

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Short-term renoprotective effect of SGLT-2 inhibitor for renal function and albuminuria in type 2 diabetes: a retrospective study

10.21203/rs.3.rs-35892/v1 ◽

2020 ◽

Author(s):

Mitsunobu Kubota ◽

Eri Shiroyama ◽

Kanako Tanaka ◽

Yoko Yoshii

Keyword(s):

Blood Pressure ◽

Body Weight ◽

Diabetic Patients ◽

Protective Effects ◽

Renal Protection ◽

Short Term ◽

Type 2 Diabetic Patients ◽

Before And After ◽

Type 2 Diabetic

Abstract Background Progression of diabetic nephropathy in type 2 diabetic patients is a factor that determines the prognosis of life. Empagliflozin and canagliflozin, two oral diabetic SGLT-2 inhibitors, have shown improved renal outcomes in type 2 diabetic patients with chronic kidney disease in a large clinical study. These results suggest that SGLT-2 inhibitors could be used not only for hypoglycemic effects, but also for renal protective effects in patients with type 2 diabetes. It is not fully understood in which contexts the use of SGLT-2 inhibitors is likely to exert its renal protective effects. The purpose of this study was to clarify the profiles of patients in whom SGLT-2 inhibitors are more likely to exert a renal protective effect in clinical practice. We examined renal function and urinary albumin changes in short-term use of SGLT-2 inhibitors by patient background. Methods We retrospectively analyzed the medical record information of sixty-three type 2 diabetic patients (33 males, 30 females, average age 53.0 ± 13.0 years) who were given usual doses of a SGLT-2 inhibitor. We investigated changes in body weight, blood pressure, glucose metabolism index, lipid metabolism index, estimated glomerular filtration rate (eGFR) and albuminuria (urinary albumin-to-creatinine ratio, UACR) three months before and after administration of a SGLT-2 inhibitor. Results Three months after administration of an SGLT-2 inhibitor, there were improvements in glucose tolerance, weight loss, blood pressure, and lipid indices. In all cases, there was no significant change in eGFR, but UACR decreased significantly. UACR decreased regardless of Angiotensin II Receptor Blocker medication and significantly decreased in nephropathy patients with microalbuminuria or overt albuminuria. UACR decreased only in the group in which blood pressure, body weight, and hemoglobin A1c decreased before and after administration of the SGLT-2 inhibitor. Conclusions Our study shows that the renoprotective effects of SGLT-2 inhibitors are more likely to be exerted in diabetic nephropathy patients who have advanced to at least microalbuminuria stage, and in addition to direct renal protection, the comprehensive effects of SGLT-2 inhibitors, which lower body weight, blood pressure, and blood glucose, are also important for their renal protection effects.

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