Relation between Exogenous Insulin and Cognitive Function in Type 2 Diabetes Mellitus

Background and objectives: Although the role of insulin in the periphery is well understood, not as much is known about its multifactorial role in the brain. The aim of this study is to determine whether exogenous insulin, evaluated by daily insulin requirement, has an impact on mild cognitive impairment (MCI), and whether this relationship is mediated by insulin doses and other risk factors. Materials and methods: A sample of 100 participants with type 2 diabetes aged 40 and over was divided into case and control groups, according to their insulin requirement. Patients with an insulin requirement >1 IU/kg/day were assessed as the case group whereas those with an insulin dose <1 IU/kg were used as the control group. All participants underwent cognitive testing using MoCA questionnaire scoring and blood analysis to determine lipid and uric acid levels in plasma. Subjects were categorized as having normal cognitive function or MCI. Results: Results showed that the prevalence of MCI in Lithuanian elderly diabetic patients was high in the groups with a normal insulin requirement or high insulin requirement at 84.8% and 72%, respectively (p = 0.14). Age (p = 0.001) and insulin dose (p < 0.0001) were related to the MCI. Using ROC curve analysis, the highest rate risk of MCI occurred when the insulin dose was lower than 144 IU/d. Conclusions: In summary, the results of this study provided evidence that increased exogenous insulin supply improves cognitive function. Higher insulin dose (>144 IU/d) demonstrated a positive effect on cognitive function, especially in individuals with poorly controlled diabetes (HbA1c ≥ 9%). Finally, the prevalence of MCI in the T2DM population was found to be very high. Future research is needed to determine whether high exogenous insulin doses have a protective effect on MCI.

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ESTIMATION OF SERUM FERRITIN LEVELS IN TYPE 2 DIABETIC PATIENTS AND ITS RELATION WITH HbA1C LEVEL.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i8.456 ◽

2019 ◽

Vol 3 (8) ◽

Author(s):

Shah Namrata Vinubhai ◽

Pardeep Agarwal ◽

Bushra Fiza ◽

Ramkishan Jat

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Blood Sugar ◽

Serum Ferritin ◽

Inflammatory Marker ◽

Control Group ◽

Diabetic Patients ◽

Positive Correlation

Background: Serum ferritin is known as an index for body iron stores also as an inflammatory marker and it is influenced by several disease. We were looking for a correlation between HbA1c and S. Ferritin in type 2 DM. Methodology: The present study a total of 150 participants were enrolled of which 100 were confirmed cases of Type 2 Diabetes Mellitus and rest 50 age and sex matched healthy subjects constituted the control group. All were screened for HbA1c, Fasting blood sugar, Post prandial blood sugar and S.Ferritin. Results: A highly significant variation and positive correlation was observed with respect to S.Ferritin and HbA1c levels. Mean S.Ferritin was high in the subgroup with poor glycemic control. Conclusion: The fasting, post prandial sugar levels, HbA1c and S.Ferritin were significantly higher in the diabetic subjects. This study shows a positive correlation between HbA1c and S. Ferritin levels. So we can conclude that in diabetic patients S. Ferritin may serve as an independent marker of poor glycemic and metabolic control. Keywords: Serum ferritin, Type 2 Diabetes Mellitus, HbA1c.

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Fermented pork fat (Sa-um) and lifestyle risk factors as potential indicators for type 2 diabetes among the Mizo population, Northeast India

Journal of Health Population and Nutrition ◽

10.1186/s41043-021-00257-8 ◽

2021 ◽

Vol 40 (1) ◽

Author(s):

Freda Lalrohlui ◽

Souvik Ghatak ◽

John Zohmingthanga ◽

Vanlal Hruaii ◽

Nachimuthu Senthil Kumar

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Cox Regression ◽

Control Group ◽

Diabetic Patients ◽

Lifestyle Habits ◽

Pork Fat

AbstractOver the last few decades, Mizoram has shown an increase in cases of type 2 diabetes mellitus; however, no in-depth scientific records are available to understand the occurrence of the disease. In this study, 500 patients and 500 healthy controls were recruited to understand the possible influence of their dietary and lifestyle habits in relation with type 2 diabetes mellitus. A multivariate analysis using Cox regression was carried out to find the influence of dietary and lifestyle factors, and an unpaired t test was performed to find the difference in the levels of biochemical tests. Out of 500 diabetic patients, 261 (52.3%) were males and 239 (47.7%) were females, and among the control group, 238 (47.7%) were males and 262 (52.3%) were females. Fermented pork fat, Sa-um (odds ratio (OR) 18.98), was observed to be a potential risk factor along with tuibur (OR 0.1243) for both males and females. Creatinine level was found to be differentially regulated between the male and female diabetic patients. This is the first report of fermented pork fat and tobacco (in a water form) to be the risk factors for diabetes. The unique traditional foods like Sa-um and local lifestyle habits like tuibur of the Mizo population may trigger the risk for the prevalence of the disease, and this may serve as a model to study other populations with similar traditional practices.

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Serum Selenium Status in Patients with Type 2 Diabetes and Control Group

Global Journal of Health Science ◽

10.5539/gjhs.v9n5p234 ◽

2016 ◽

Vol 9 (5) ◽

pp. 234

Author(s):

Zahra Heidari ◽

Zahra Sepehri ◽

Aleme Doostdar

Keyword(s):

Type 2 Diabetes ◽

Serum Level ◽

Control Group ◽

Diabetic Patients ◽

Diabetes Incidence ◽

Serum Selenium ◽

Type 2 Diabetic Patients ◽

Significant Difference ◽

The Mean

<p>In addition to known risk factors, the role of different micronutrients such as selenium in diabetes incidence has been proposed. Some previous studies have shown an association of selenium deficiency and type 2 diabetes mellitus, while other studies have not confirmed such a relationship. The aim of this study was to evaluate serum level of selenium in patients with Type 2 diabetes compared with the control group. This cross-sectional study was carried out on patients with type 2 diabetes in Zahedan, southeastern Iran. One hundred newly diagnosed type 2 diabetic patients were evaluated for serum selenium level. One hundred subjects from the general population who had normal fasting blood sugar levels were selected as the control group. The control group subjects were matched in pairs with each of patients on the basis of sex, age (± one year), and body mass index (±1). Serum level of selenium was determined by spectrometry method. Results were compared using t-test. The mean serum level of selenium in patients was 94.47±18.07 µg/L whereas in control group was 142.79±23.67 µg/L. The mean serum level of selenium was significantly different between the two groups (P<0.001). Serum levels of selenium in diabetic patients with significant difference statistically were lower than the control group. In order to evaluate serum level of selenium in patients with diabetes, studies with larger sample size are required. Likewise, prospective studies along with selenium supplementation and investigating its effect on incidence of diabetes are accordingly needed.</p>

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Elabela levels in patients with type 2 diabetes: can it be a marker for diabetic nephropathy?

African Health Sciences ◽

10.4314/ahs.v20i2.37 ◽

2020 ◽

Vol 20 (2) ◽

pp. 833-840

Author(s):

Erhan Onalan ◽

Yusuf Doğan ◽

Ebru Onalan ◽

Nevzat Gozel ◽

Ilay Buran ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Nephropathy ◽

High Serum ◽

Control Group ◽

Diabetic Patients ◽

Healthy Individuals ◽

Urine Albumin ◽

Healthy Control ◽

Group 2

Backround: Elabela (ELA) is a hormone that is secreted at high levels in the kidneys of a healthy adult. This study aims to investigate whether serum ELA levels of patients with Type 2 Diabetes vary with the severity of renal damage. Methods: Our study included 50 healthy control subjects and 100 diabetic patients, who were categorized into groups based on urine albumin/creatinine ratios (ACR). Patients included in the study were assigned to four groups: Group 1 (healthy control), Group 2 (ACR<29mg/g), Group 3 (ACR=30-299 mg/g), and Group 4 (ACR>300 mg/g normal or high serum creatinine). Physical examination findings, demographic characteristics of the study group were recorded, and serum ELA levels and other laboratory parameters were assessed using appropriate methods. Results: The results of the study indicated that ELA levels determined in healthy individuals gradually decreased through stages of normal albuminuria, microalbuminuria, and macroalbuminuria. Moreover, ELA had a significant negative corre- lation with LDL-C (r=-0.201, p=0.014), glucose (r=-0.437, P<0.001), retinopathy (r=-0.222, P=0.006), serum BUN (r=- 0.161, P=0.049), and a positive correlation with eGFR (r=0.250, P=0.002). Conclusions: The fact that ELA levels are higher in healthy individuals compared to diabetic patients without microalbu- minuria, and higher in diabetic patients without microalbuminuria compared to patients with advanced albuminuria and kidney damage, suggests that the ELA level can be an important clinical prognostic variable and even a promising agent for the treatment of diabetic nephropathy patients. Keywords: Elabela, diabetes, diabetic kidney disease, albuminuria.

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Fenofibrate decreased microalbuminuria in the type 2 diabetes patients with hypertriglyceridemia

10.21203/rs.2.20116/v2 ◽

2020 ◽

Author(s):

Xiaomeng Sun ◽

Jia Liu ◽

Guang Wang

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Treatment Group ◽

Glycosylated Hemoglobin ◽

Fasting Blood Glucose ◽

Control Group ◽

Diabetic Patients ◽

Fenofibrate Treatment

Abstract Background: This study was to research the efficacy of fenofibrate in the treatment of microalbuminuria in the patients with type 2 diabetes mellitus (T2DM) and hypertriglyceridemia. Methods: Type 2 diabetic patients (56) with microalbuminuria and hypertriglyceridemia aged 30 to 75 were randomly divided into the fenofibrate treatment group(n=28) and the control group (n=28) for 180 days. Urinary microalbumin /creatinine ratio (UACR) and other metabolic parameters were compared at baseline, during treatment and after treatment. Results: After 180 days, the reduction of levels of fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) in two groups were no differences. In treatment group, uric acid (UA) (296.42 ± 56.41 vs 372.46 ± 72.78), triglyceride (TG) [1.51(1.17, 2.06) vs 3.04(2.21, 3.29)], and UACR [36.45 (15.78,102.41) vs 129.00 (53.00, 226.25)] were significantly decreased compared with the baseline. The high-density lipoprotein cholesterol (HDL-C) levels were significantly increased (1.22 ± 0.26 vs 1.09 ± 0.24) compared with the baseline. The decrease in UACR [-44.05(-179.47, -12.16) vs -8.15(-59.69, 41.94)]in treatment group was significantly higher compared with the control group. The decrease in UACR was positively associated with the decreases in TG ( r = 0.447, P = 0.042) and UA ( r = 0.478, P = 0.024) after fenofibrate treatment. Conclusion: In the patients with hypertriglyceridemia and type 2 diabetes mellitus, fenofibrate can improve microalbuminuria and do not increase the deterioration of glomerular filtration rate

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Intermuscular Fat Content in Young Chinese Men With Newly Diagnosed Type 2 Diabetes: Based on MR mDIXON-Quant Quantitative Technique

Frontiers in Endocrinology ◽

10.3389/fendo.2021.536018 ◽

2021 ◽

Vol 12 ◽

Author(s):

Fuyao Yu ◽

Bing He ◽

Li Chen ◽

Fengzhe Wang ◽

Haidong Zhu ◽

...

Keyword(s):

Type 2 Diabetes ◽

Skeletal Muscle ◽

Fat Content ◽

Control Group ◽

Diabetic Patients ◽

Diabetes Group ◽

Control Subjects ◽

Intermuscular Fat ◽

And Control

ObjectiveSkeletal muscle fat content is one of the important contributors to insulin resistance (IR), but its diagnostic value remains unknown, especially in the Chinese population. Therefore, we aimed to analyze differences in skeletal muscle fat content and various functional MRI parameters between diabetic patients and control subjects to evaluate the early indicators of diabetes. In addition, we aimed to investigate the associations among skeletal muscle fat content, magnetic resonance parameters of skeletal muscle function and IR in type 2 diabetic patients and control subjects.MethodsWe enrolled 12 patients (age:29-38 years, BMI: 25-28 kg/m2) who were newly diagnosed with type 2 diabetes (intravenous plasma glucose concentration≥11.1mmol/l or fasting blood glucose concentration≥7.0mmol/l) together with 12 control subjects as the control group (age: 26-33 years, BMI: 21-28 kg/m2). Fasting blood samples were collected for the measurement of glucose, insulin, 2-hour postprandial blood glucose (PBG2h), and glycated hemoglobin (HbAlc). The magnetic resonance scan of the lower extremity and abdomen was performed, which can evaluate visceral fat content as well as skeletal muscle metabolism and function through transverse relaxation times (T2), fraction anisotropy (FA) and apparent diffusion coefficient (ADC) values.ResultsWe found a significant difference in intermuscular fat (IMAT) between the diabetes group and the control group (p<0.05), the ratio of IMAT in thigh muscles of diabetes group was higher than that of control group. In the entire cohort, IMAT was positively correlated with HOMA-IR, HbAlc, T2, and FA, and the T2 value was correlated with HOMA-IR, PBG2h and HbAlc (p<0.05). There were also significant differences in T2 and FA values between the diabetes group and the control group (p<0.05). According to the ROC, assuming 8.85% of IMAT as the cutoff value, the sensitivity and specificity of IMAT were 100% and 83.3%, respectively. Assuming 39.25ms as the cutoff value, the sensitivity and specificity of T2 value were 66.7% and 91.7%, respectively. All the statistical analyses were adjusted for age, BMI and visceral fat content.ConclusionDeposition of IMAT in skeletal muscles seems to be an important determinant for IR in type 2 diabetes. The skeletal muscle IMAT value greater than 8.85% and the T2 value greater than 39.25ms are suggestive of IR.

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The effects of Anethum graveolens (dill) powder supplementation on clinical and metabolic status in patients with type 2 diabetes

10.21203/rs.2.12262/v2 ◽

2020 ◽

Author(s):

Fatemeh Haidari ◽

Mehrnoosh Zakerkish ◽

Fatemeh Borazjani ◽

Kambiz Ahmadi Angali ◽

Golnaz Amoochi

Keyword(s):

Type 2 Diabetes ◽

Lipid Profile ◽

Intervention Group ◽

Gastrointestinal Symptoms ◽

Control Group ◽

Diabetic Patients ◽

Anethum Graveolens ◽

Type 2 Diabetic Patients ◽

The Mean

Abstract Background: The objective of this study was to investigate the effects of anethum graveolens (dill) powder supplementation on glycemic control, lipid profile, some antioxidants and inflammatory markers, and gastrointestinal symptoms in type 2 diabetic patients. Material and methods: In this study, 42 patients with type 2 diabetes were randomly allocated to intervention and control groups and received either 3g/day dill powder or placebo (3 capsules/day, 1 g each). Fasting blood sugar (FBS), insulin, homeostatic model assessment of insulin resistance (HOMA- IR), lipid profile, hs-C-reactive protein (hs-CRP), total antioxidant capacity (TAC), malondialdehyde (MDA), and gastrointestinal symptoms were measured in all of the subjects at baseline and post-intervention. Results: The dill powder supplementation significantly decreased the mean serum levels of insulin, HOMA-IR, LDL-C, TC, and MDA in the intervention group in comparison with the baseline measurements (p < 0.05). Also, the mean serum levels of HDL and TAC were significantly increased in the intervention group in comparison with the baseline measurement (p < 0.05). Colonic motility disorder was the only gastrointestinal symptom whose frequency was significantly reduced by supplementation (P = 0.01). The mean changes of insulin, LDL-C , TC, and MDA were significantly lower in the intervention group than in the control group (p < 0.05). In addition, the mean changes in HDL were significantly higher in the intervention group than in the control group (p < 0.05). Conclusion: Dill powder supplementation can be effective in controlling the glycemic, lipid, stress oxidative, and gastrointestinal symptoms in type 2 diabetic patients. Keywords: Type 2 diabetes; Dill powder; Glycemic control; Lipid profile; Stress oxidative status

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Relationship between homocysteine and non-dipper pattern in patients with type 2 diabetes mellitus

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302012000500002 ◽

2012 ◽

Vol 56 (5) ◽

pp. 285-290 ◽

Cited By ~ 2

Author(s):

Serdal Korkmaz ◽

Abdulkerim Yilmaz ◽

Gürsel Yildiz ◽

Fatih Kiliçli ◽

Serhat Içağasioğlu

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Control Group ◽

Diabetic Patients ◽

Nocturnal Blood Pressure ◽

Type 2 Dm ◽

Significant Difference

OBJECTIVE: The rate of reduction of nocturnal blood pressure (NBP) is lesser than normal in patients with type 2 diabetes mellitus (type 2 DM). Hyperhomocysteinemia (HHC) disrupts vascular structure and function, no matter the underlying causes. The risk of development of vascular disease is greater in diabetic patients with hyperhomocysteinemia than in patients with normal homocystein levels. The aim of the study was to investigate whether there are differences of homocystein levels in dipper and non-dippers patients with type 2 DM. SUBJECTS AND METHODS: We compared 50 patients (33 females, 17 males) with type 2 DM and 35 healthy individuals (18 females, 17 males ) in a control group. Ambulatory blood pressure monitoring (ABPM) was performed and homocysteine levels were measured in all patients. RESULTS: We found that the percentage of non-dipper pattern was 72% in patients with type 2 DM and 57% in control group. In diabetic and control individuals, homocystein levels were higher in non-dipper (respectively 13.4 ± 8.1 µmol/L and 11.8 ± 5 µmol/L) than in dipper subjects (respectively, 11.8 ± 5.8 µmol/L and 10.1 ± 4.2 µmol/L), but there was no significant difference between the two groups (respectively, p = 0.545, p = 0.294). CONCLUSION: In both groups, homocystein levels were higher in non-dipper than in dipper participants, but there was no significant difference between the groups. High homocystein levels and the non-dipper pattern increases cardiovascular risk. Therefore, the relationship between nocturnal blood pressure changes and homocystein levels should be investigated in a larger study.

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Utility of Tissue Inhibitor Metalloproteinase-1 and Osteopontin as Prospective Biomarkers of Early Cardiovascular Complications in Type 2 Diabetes

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2018.081 ◽

2018 ◽

Vol 6 (2) ◽

pp. 314-319 ◽

Cited By ~ 1

Author(s):

Doaa Samir Salah El-Din ◽

Ahmed Ibrahim Amin ◽

Ahmed Osman Egiza

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Complications ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Diabetic Patients ◽

Tissue Inhibitor ◽

Type 2 Diabetic Patients ◽

Healthy Control ◽

Clinical Measurements

AIM: This work investigated associations between tissue inhibitor metalloproteinase-1 and diabetic cardiovascular diseases in type 2 diabetic patients; also it investigated the role of osteopontin in the diagnosis of type 2 cardiovascular diabetes complications.SUBJECTS AND METHODS: These were examined on eighty subjects, divided into three groups as follows: twenty volunteer healthy control subjects, thirty type 2 diabetes mellitus (DM) patients, and thirty cardiovascular, diabetic patients. Full clinical measurements were carried out, and the expression level of tissue inhibitor metalloproteinase-1 in blood samples was analysed by real-time PCR, using gene-specific primer pairs. Also osteopontin concentrations had been measured by the enzyme-linked immunosorbent assay. Data were tested statistically by parametric tests.RESULTS: The concentrations of osteopontin and the expression levels of tissue inhibitor metalloproteinase-1 were significantly increased in diabetic and cardiovascular diabetic groups compared to control group also they were significantly increased in the cardiovascular diabetic group compared to the diabetic group.CONCLUSION: Tissue inhibitor metalloproteinase-1 and osteopontin concentrations were significantly increased in diabetic patients with cardiovascular complications than other groups.

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Extremely high-dose insulin requirement in a diabetic patient with COVID-19: a case report

BMC Endocrine Disorders ◽

10.1186/s12902-020-00632-2 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

François R. Jornayvaz ◽

Benjamin Assouline ◽

Jérôme Pugin ◽

Karim Gariani

Keyword(s):

Type 2 Diabetes ◽

Diabetic Patient ◽

Insulin Requirement ◽

Diabetic Patients ◽

High Dose ◽

Intravenous Insulin ◽

Patients With Diabetes ◽

Mechanical Ventilation Support ◽

High Insulin

Abstract Background Detailed description of hyperglycemia management in diabetic patients infected with SARS-CoV-2 remain limited, although patients with diabetes show higher complication and mortality rate than patients without diabetes. Transient non-severe increased insulin requirement in patients hospitalized for medical conditions such as sepsis or myocardial infarction is a well-known phenomenon. However, extremely high-dose insulin requirement remains a very rarely reported entity. Here, we report the case of an extreme and transitory insulin requirement episode in a type 2 diabetic patient presenting an acute respiratory distress syndrome caused by SARS-CoV-2. Case presentation A 57-year-old man resident in Geneva, Switzerland, previously known for type 2 diabetes for 3 years was admitted for an aggravation of his dyspnea. His type 2 diabetes was treated only with metformin and his latest Hb1Ac was 6.1%. Chest CT SCAN showed a bilateral multilobar ground-glass opacification. Twenty-four hours after his admission he presented a worsening of dyspnea and severe hypoxemia requiring a transfer to the intensive care unit rapidly followed by oro-tracheal intubation for mechanical ventilation support. A bronchoalveolar lavage was performed and test of SARS-CoV-2 by RT-qPCR assay was positive. At day 3, he presented a rapidly progressive insulin requirement at a rate of up to 50 units/hour intravenous insulin aspart. Despite the high insulin doses, he maintained an elevated plasma glucose level at 270 mg/dL on average. His extremely high-dose insulin requirement “resolved” at day 9, and the insulin infusion rate was rapidly reduced. Conclusions This case may reflect a specific and profound impact of SARS-CoV-2 on metabolic homeostasis, in particular in diabetic patients that appear more prone to complications of COVID-19 infection. Yet, the mechanisms behind this remain to be elucidated. The optimal management of hyperglycemia of diabetic patients infected with SARS-CoV-2 has yet not be defined, however insulin remain the mainstay of treatment approach. Report of extreme dysregulation of chronic conditions such as diabetes in patients with COVID-19 may help clinicians to better take care of patients during the pandemic of SARS-CoV-2. To the best of our knowledge this is the first description of extremely high-dose insulin requirement in patient with COVID-19.

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