ALTERATIONS OF LIPID LEVELS MAY INDUCE THE INSULIN RESISTANCE IN TYPE TWO DIABETES MELLITUS: A SYSTEMIC REVIEW

Diabetes mellitus (DM) is not one disorder; it represents a series of metabolic conditions related to hyperglycemia and caused by defects in hormone secretion and hormone action. Exposure to chronic hyperglycemia may result in microvascular complications in the retina (diabetic retinopathy), kidney (diabetic nephropathy), neuron (diabetic-neuropathy), skin, foot, and cardiac complications (stroke, hypertension…etc.). International Diabetes Federation estimates that 1.1 million children and adolescents aged 14–19 years have type one DM. Without interventions to halt the increase in diabetes, there will be at least 629 million people living with diabetes by 2045. In the body, white adipose tissue is the leading site for the storage of excess energy produced from the food intake in large quantities, of the development of insulin resistance (IR) and type 2 DM by the over intake of fatty acid in the body. It results in the accumulation of fatty acyl co-A (FA-CoA) within the myocytes. It leads to improper signaling of the insulin and reduces the level in the myocytes and pancreases beta cells. It combines with genetically reduces the expression of peroxisome proliferator-activated receptor-gamma (PPAR-γ) coactivator-1, initiates the inflammation process by the activation of the tumor necrotic factor alpha and protein kinase C. These alterations lead to further increase the intramyocellular FA-CoA and triglycerides. The sequence of events may develop mitochondrial dysfunction in the sarcolemma outer layers. Finally improves IR also with increasing intramyocellular lipids. This concept might be helpful to those who are pursuing endocrinology specialization, nursing staff, pharmacists, and other medical departments.

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A Review of Microvascular Complications

International Journal of Review in Life Sciences ◽

10.26452/ijrls.v9i1.1261 ◽

2020 ◽

Vol 9 (1) ◽

pp. 9-13

Author(s):

Arulanantham Zechariah Jebakumar

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Deleterious Effect ◽

Transport Mechanism ◽

Microvascular Complications ◽

Serum Magnesium ◽

The Body ◽

Healthy Individuals ◽

Intracellular Enzymes ◽

Low Levels

Complications of Diabetes mellitus include chronic damage, dysfunction and disappointment of various organs mainly affecting the eyes, kidneys, heart and blood vessels. Various minerals and vitamins acts as cofactors in regulation of insulin secretion and action ,among which magnesium dramas a key role. Magnesium is an essential mineral and plays a major role in carbohydrate metabolism. It acts as a co-factor in glucose transport mechanism and for various intracellular enzymes involved in carbohydrate oxidation. Deficiency of magnesium results in increase in insulin resistance and decrease in glucose uptake of the cells in the body. Serum magnesium levels in healthy individuals are constant, but 25 to 39% people with Type 2DM have low levels of magnesium. Hypomagnesemia has been found to have deleterious effect on glucose homeostasis and insulin sensitivity in Type 2DM. Low levels of magnesium have also been attributed to the progression and development of micro and macrovascular difficulties in Type 2DM.

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Towards Better Drug Repositioning: Targeted Immunoinflammatory Therapy for Diabetic Nephropathy

Current Medicinal Chemistry ◽

10.2174/0929867326666191108160643 ◽

2019 ◽

Vol 26 ◽

Author(s):

Qin zhang ◽

Ming Yang ◽

Ying Xiao ◽

Yachun Han ◽

Shikun Yang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Inflammatory Process ◽

Drug Repositioning ◽

Microvascular Complications ◽

Pathogenic Factor ◽

Progressive Decline ◽

Functional Changes ◽

Sequence Of Events ◽

Novel Treatment

: Diabetic nephropathy (DN) is one of the most common and important microvascular complications of diabetes mellitus (DM). The main clinical features of DN are proteinuria and a progressive decline in renal function , which are associated with structural and functional changes in the kidney. The pathogenesis of DN is multifactorial, including genetic, metabolic and haemodynamic factors, which can trigger a sequence of events. Controlling metabolic risks such as hyperglycaemia, hypertension and dyslipidaemia is not enough to slow the progression of DN. Recent studies have emphasized immunoinflammation as a critical pathogenic factor in the progression of DN. Therefore, targeting inflammation is considered a potential and novel treatment strategy for DN. In this review, we will briefly introduce the inflammatory process of DN and discuss the anti-inflammatory effects of antidiabetic drugs when treating DN.

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Wogonin Alleviates Hyperglycemia Through Increased Glucose Entry into Cells Via AKT/GLUT4 Pathway

Current Pharmaceutical Design ◽

10.2174/1381612825666190722115410 ◽

2019 ◽

Vol 25 (23) ◽

pp. 2602-2606 ◽

Cited By ~ 2

Author(s):

Shahzad Khan ◽

Mohammad A. Kamal

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Modern World ◽

Major Health Problem ◽

Major Health ◽

Chronic Hyperglycemia ◽

Main Factor

: Insulin resistance and type 2 Diabetes mellitus resulting in chronic hyperglycemia is a major health problem in the modern world. Many drugs have been tested to control hyperglycemia which is believed to be the main factor behind many of the diabetes-related late-term complications. Wogonin is a famous herbal medicine which has been shown to be effective in controlling diabetes and its complications. In our previous work, we showed that wogonin is beneficial in many ways in controlling diabetic cardiomyopathy. In this review, we mainly explained wogonin anti-hyperglycemic property through AKT/GLUT4 pathway. Here we briefly discussed that wogonin increases Glut4 trafficking to plasma membrane which allows increased entry of glucose and thus alleviates hyperglycemia. Conclusion: Wogonin can be used as an anti-diabetic and anti-hyperglycemic drug and works via AKT/GLUT4 pathway.

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Glycemic Variability and Vascular Complications in Patients with Type 2 Diabetes Mellitus

Folia Medica ◽

10.1515/folmed-2017-0048 ◽

2017 ◽

Vol 59 (3) ◽

pp. 270-278 ◽

Cited By ~ 11

Author(s):

Martin Caprnda ◽

Dasa Mesarosova ◽

Pablo Fabuel Ortega ◽

Boris Krahulec ◽

Emmanuel Egom ◽

...

Keyword(s):

Diabetes Mellitus ◽

Microvascular Complications ◽

Vascular Complications ◽

Glycemic Variability ◽

Cerebral Stroke ◽

Chronic Hyperglycemia ◽

Type 2 Dm ◽

Artery Disease ◽

Index Value

AbstractBackground:Presence of macro- and microvascular complications in patients with diabetes mellitus (DM) is not only related to chronic hyperglycemia represented by glycated hemoglobin (HbA1c) but also to acute glycemic fluctuations (glycemic variability, GV). The association between GV and DM complications is not completely clear. Aim of our study was to evaluate GV by MAGE index in patients with type 2 DM and to verify association of MAGE index with presence of macro- and microvascular DM complications.Methods:99 patients with type 2 DM were included in the study. Every patient had done big glycemic profile, from which MAGE index was calculated. Anthropometric measurements, evaluation of HbA1c and fasting plasma glucose (FPG) and assessment for macrovascular (coronary artery disease – CAD; peripheral artery disease – PAD; cerebral stroke – CS) and microvascular (diabetic retinopathy – DR; nephropathy – DN; peripheral neuropathy – DPPN) DM complications were done.Results:Average MAGE index value was 5.15 ± 2.88 mmol/l. We found no significant differences in MAGE index values in subgroups according to presence of neither CAD, CS, PAD nor DR, DN, DPPN. MAGE index value significantly positively correlated with FPG (p < 0.01) and HbA1c (p < 0.001) and negatively with weight (p < 0.05).Conclusion:In our study we failed to show association of MAGE index with presence of macrovascular and microvascular complications in patients with type 2 DM. However, this negative result does not necessarily disprove importance of glycemic variability in pathogenesis of diabetic complications.

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Ketogenic Diets as Highly Effective Treatments for Diabetes Mellitus and Obesity

10.1093/med/9780190497996.003.0037 ◽

2016 ◽

Author(s):

Eric C. Westman ◽

Emily Maguire ◽

William S. Yancy

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Modern Medicine ◽

Carbohydrate Restriction ◽

Abdominal Adiposity ◽

Ketogenic Diets ◽

Chronic Hyperglycemia ◽

Obesity And Diabetes ◽

Low Carbohydrate

Obesity and type 2 diabetes mellitus (T2DM) have reached epidemic proportions worldwide. While characterized by chronic hyperglycemia, the underlying cause of T2DM is insulin resistance—most often related to an increase in abdominal adiposity caused by obesity. The goal of treatment of T2DM is to put the disease into remission by targeting the underlying insulin resistance. The observation that dietary carbohydrate is the major factor to cause glycosuria and hyperglycemia, has been known since the early days of modern medicine. As a result, low-carbohydrate, ketogenic diets were employed to treat obesity and diabetes in the nineteenth and early twentieth centuries. This chapter reviews the rationale and recent clinical research supporting the use of a low-carbohydrate, ketogenic diet in individuals with obesity and diabetes. For individuals affected by obesity-related T2DM, clinical studies have shown that carbohydrate restriction and weight loss can improve hyperglycemia, obesity, and T2DM.

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Mushrooms of the Genus Ganoderma Used to Treat Diabetes and Insulin Resistance

Molecules ◽

10.3390/molecules24224075 ◽

2019 ◽

Vol 24 (22) ◽

pp. 4075 ◽

Cited By ~ 4

Author(s):

Katarzyna Wińska ◽

Wanda Mączka ◽

Klaudia Gabryelska ◽

Małgorzata Grabarczyk

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Chronic Disease ◽

Conventional Therapy ◽

Theoretical Basis ◽

The Body ◽

Antidiabetic Activity ◽

Mechanism Study ◽

Medicinal Mushrooms ◽

Natural Substances

Pharmacotherapy using natural substances can be currently regarded as a very promising future alternative to conventional therapy of diabetes mellitus, especially in the case of chronic disease when the body is no longer able to produce adequate insulin or when it cannot use the produced insulin effectively. This minireview summarizes the perspectives, recent advances, and major challenges of medicinal mushrooms from Ganoderma genus with reference to their antidiabetic activity. The most active ingredients of those mushrooms are polysaccharides and triterpenoids. We hope this review can offer some theoretical basis and inspiration for the mechanism study of the bioactivity of those compounds.

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Insulin Resistance in Osteoarthritis: Similar Mechanisms to Type 2 Diabetes Mellitus

Journal of Nutrition and Metabolism ◽

10.1155/2020/4143802 ◽

2020 ◽

Vol 2020 ◽

pp. 1-16 ◽

Cited By ~ 1

Author(s):

Elena V Tchetina ◽

Galina A Markova ◽

Eugeniya P Sharapova

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

The Body ◽

Whole Body ◽

Insulin Resistant ◽

Resistant State ◽

Insulin Resistant State

Osteoarthritis (OA) and type 2 diabetes mellitus (T2D) are two of the most widespread chronic diseases. OA and T2D have common epidemiologic traits, are considered heterogenic multifactorial pathologies that develop through the interaction of genetic and environmental factors, and have common risk factors. In addition, both of these diseases often manifest in a single patient. Despite differences in clinical manifestations, both diseases are characterized by disturbances in cellular metabolism and by an insulin-resistant state primarily associated with the production and utilization of energy. However, currently, the primary cause of OA development and progression is not clear. In addition, although OA is manifested as a joint disease, evidence has accumulated that it affects the whole body. As pathological insulin resistance is viewed as a driving force of T2D development, now, we present evidence that the molecular and cellular metabolic disturbances associated with OA are linked to an insulin-resistant state similar to T2D. Moreover, the alterations in cellular energy requirements associated with insulin resistance could affect many metabolic changes in the body that eventually result in pathology and could serve as a unified mechanism that also functions in many metabolic diseases. However, these issues have not been comprehensively described. Therefore, here, we discuss the basic molecular mechanisms underlying the pathological processes associated with the development of insulin resistance; the major inducers, regulators, and metabolic consequences of insulin resistance; and instruments for controlling insulin resistance as a new approach to therapy.

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Angiogenic microenvironment augments impaired endothelial responses under diabetic conditions

AJP Cell Physiology ◽

10.1152/ajpcell.00201.2013 ◽

2014 ◽

Vol 306 (8) ◽

pp. C768-C778 ◽

Cited By ~ 5

Author(s):

Abdul Q. Sheikh ◽

Courtney Kuesel ◽

Toloo Taghian ◽

Jennifer R. Hurley ◽

Wei Huang ◽

...

Keyword(s):

Endothelial Cells ◽

Endothelial Cell ◽

High Glucose ◽

Microvascular Complications ◽

The Body ◽

Type I ◽

Chronic Hyperglycemia ◽

Biomechanical Responses ◽

Acute And Chronic Exposure

Diabetes-induced cardiomyopathy is characterized by cardiac remodeling, fibrosis, and endothelial dysfunction, with no treatment options currently available. Hyperglycemic memory by endothelial cells may play the key role in microvascular complications in diabetes, providing a potential target for therapeutic approaches. This study tested the hypothesis that a proangiogenic environment can augment diabetes-induced deficiencies in endothelial cell angiogenic and biomechanical responses. Endothelial responses were quantified for two models of diabetic conditions: 1) an in vitro acute and chronic hyperglycemia where normal cardiac endothelial cells were exposed to high-glucose media, and 2) an in vivo chronic diabetes model where the cells were isolated from rats with type I streptozotocin-induced diabetes. Capillary morphogenesis, VEGF and nitric oxide expression, cell morphology, orientation, proliferation, and apoptosis were determined for cells cultured on Matrigel or proangiogenic nanofiber hydrogel. The effects of biomechanical stimulation were assessed following cell exposure to uniaxial strain. The results demonstrate that diabetes alters cardiac endothelium angiogenic response, with differential effects of acute and chronic exposure to high-glucose conditions, consistent with the concept that endothelial cells may have a long-term “hyperglycemic memory” of the physiological environment in the body. Furthermore, endothelial cell exposure to strain significantly diminishes their angiogenic potential following strain application. Both diabetes and strain-associated deficiencies can be augmented in the proangiogenic nanofiber microenvironment. These findings may contribute to the development of novel approaches to reverse hyperglycemic memory of endothelium and enhance vascularization of the diabetic heart, where improved angiogenic and biomechanical responses can be the key factor to successful therapy.

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Інсулінорезистентність за гестаційного цукрового діабету у суки (клінічний випадок)

Вісник Полтавської державної аграрної академії ◽

10.31210/visnyk2018.03.28 ◽

2018 ◽

pp. 180-182

Author(s):

В. В. Боброва

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Gestational Diabetes ◽

Late Pregnancy ◽

The Body ◽

Insulin Dependent Diabetes ◽

Common Disease ◽

Β Cells ◽

Insulin Synthesis ◽

Insulin Dependent

Цукровий діабет є досить поширеним захворюванням серед людей та тварин. На сьогодні ветеринарні клініцисти відмічають певне збільшення кількості собак та котів, яким встановлено діагноз «цукровий діабет». Окрему проблему на лікувальному етапі становить контроль над рівнем глюкози за наявності резистентності тканин організму до інсуліну. У роботі наведено аналіз клінічного випадку інсулінорезистентності за гестаційного діабету у не стерилізованої суки. Diabetes mellitus is a fairly common disease among humans and animals. Today veterinarians mark a certain increase in the number of dogs and cats diagnosed with diabetes mellitus. It is a hormonal disease characterized by the presence of hyperglycemia and permanent glucosuria. The causes of diabetes are absolute or relative insufficiency of insulin synthesis by the pancreas (first type or insulin dependent diabetes, more common in dogs) and insulin resistance of the body with β-cell dysfunction (second type or non-insulin dependent diabetes, more commonly sick of cats). Permanent degeneration of β-cells occurs due to enhanced insulin synthesis. Treatment in the first and second cases is carried out by insulin. In animals with diabetes, polydipsia/polyuria syndrome is manifest, may be complications in the form of ketoacidosis, which is characterized by significant violations of acid-alkaline and electrolyte balances, which directly endangers life. Separate secretion of secondary or transient diabetes, which occurs due to the development of another disease – pancreatitis, hyperadrenocorticism or long-term use of progestogens and glucocorticoids. Timely detection and treatment of the primary disease with the neutralization of the causes of hyperglycemia to the desolation of β-cells can lead to recovery. It also applies to gestational diabetes mellitus, which may occur during the late pregnancy or diestrus in a female dog, when high levels of progesterone, somatotropin and structurally similar hormones cause the appearance of insulin resistance of the tissues of the body. Timely control of hyperglycemia and subsequent ovariogestarterectomy contributes to the recovery of the animal. Unfortunately, the issue of controlling hyperglycemia in the occurrence of insulin resistance in the treatment of diabetes is very complicated and does not provide immediate results. The paper presents an analysis of the clinical case of insulin resistance in gestational diabetes in a non-sterilized female dog.

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Analysis of the Effects of Curcuma Longa Supplementation and Physical Exercise in Patients With Diabetes: Systematic Review

10.20944/preprints202006.0061.v1 ◽

2020 ◽

Author(s):

Ailton Santos Sena Júnior ◽

Felipe José Aidar ◽

Ana Mara de Oliveira e Silva ◽

Fábio Bessa Lima ◽

Jymmys Lopes dos Santos ◽

...

Keyword(s):

Diabetes Mellitus ◽

Physical Exercise ◽

Curcuma Longa ◽

Relevant Information ◽

The Body ◽

Diabetic Patients ◽

Electronic Library ◽

Scientific Publications ◽

Chronic Hyperglycemia ◽

Patients With Diabetes

Diabetes Mellitus is one of the most prevalent chronic diseases in the world and one of its main features is chronic hyperglycemia. Among the therapeutic forms used to control the pathology are pharmacotherapy and the use of other alternatives such as regular exercise, which participates in glycemic control and the ingestion of plant extracts with antioxidant effects in the body. Among the different plants used, curcumin is a possible plant to be used to attenuate the hyperglycemic picture triggered by Diabetes Mellitus. Some studies suggest that this plant is antioxidant and hypoglycemic. The review aimed to know the antioxidant and hypoglycemic potential of curcumin supplementation in DM. The search was performed considering articles published between 2010 to 2019, in English and Portuguese, and a theoretical survey of relevant information was conducted in the main databases of scientific publications: Virtual Health Library and its indexed databases as Pubmed, LILACS, Scielo and Scientific Electronic Library Online. The associated use Turmeric and Physical Exercise demonstrated antioxidant, anti-inflammatory and hypoglycemic activity caused by Diabetes Mellitus. We may suggest that these are potential therapeutic ways to improve the quality and survival of diabetic patients.

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