Melatonin, A Promising Therapeutic for Diabetes Mellitus and Its Complications: A Narrative Review

Diabetes mellitus (DM) is a non-communicable disease and still a health problem in the world. Melatonin is responsible to metabolize carbohydrate and regulate blood sugar levels. Several studies proved Melatonin is useful in the diabetes therapy and its complication by performing antioxidant activity through various signaling pathways. The role of the melatonin hormone in the pathogenesis of complications of diabetes mellitus is still a lot of controversy. Animal studies are still incomplete to explain the mechanism of action of melatonin. Therefore, this review aims to discuss Melatonin role administration in DM and its complications. This review was started by searching articles using electronic databases such as Google Scholar, Science Direct, SpringerLink and Pubmed between 2009-2019. Melatonin increased respiration within mitochondria; acted as antioxidant that fight free radical production; and reduced oxidative stress. It diminished proinflammatory cytokines in diabetes and prevents various DM complications on eyes, cardiac and male reproductive organs through antioxidant effects. It inhibited proinflammatory within several signaling Pathways, included PI3K/Akt-Nrf2,cGMP-PKG, Nrf-2-HO-1 and MAPK, Syk, p38MAPK pathways. There are various melatonin roles in diabetes and DM complications as a promising new breakthrough of DM treatment. It is necessary to explore Melatonin role in other DM complications. Most of this research is on experimental animals, thus clinical trial studies should be carried out in humans to make melatonin a promising therapeutic or prevention for diabetes and its complications in the future

Hyperglycemic memory in diabetic cardiomyopathy

Cardiovascular diseases account for approximately 80% of deaths among individuals with diabetes mellitus, with diabetic cardiomyopathy as the major diabetic cardiovascular complication. Hyperglycemia is a symptom that abnormally activates multiple downstream pathways and contributes to cardiac hypertrophy, fibrosis, apoptosis, and other pathophysiological changes. Although glycemic control has long been at the center of diabetes therapy, multicenter randomized clinical studies have revealed that intensive glycemic control fails to reduce heart failure-associated hospitalization and mortality in patients with diabetes. This finding indicates that hyperglycemic stress persists in the cardiovascular system of patients with diabetes even if blood glucose level is tightly controlled to the normal level. This process is now referred to as hyperglycemic memory (HGM) phenomenon. We briefly reviewed herein the current advances that have been achieved in research on the underlying mechanisms of HGM in diabetic cardiomyopathy.

Pharmacognostical Profile of Gymnema sylvestre and its Anti-Hyperglycemic Activity

In this paper explored the pharmacognostical profile of gymnema sylvestre and its anti-hyperglycemic activity has been documented well with references. The importance of the species in Ayurveda has been highlighted. The bioactive components like gymnema sylvestre has a variety of secondary metabolites, including oleanane, gymnemic acid, gymnemasides (A-F), gymnemic acid (IXVIII) homologue, gymnemic acid A1 and its derivatives, triterpenoidsaponin, al has been clearly includedin the review kaloid (Conduritol-A), polypeptide (Gurmarin), and gymnemasaponins. This study has provided the groundwork for developing a pharmacognostical profile of medicinal plant growers and collectors. The goal of this review study is to provide a regional profile of the indigenous knowledge system for medicinal plant usage and cultural behaviors related to healing. This study aids in the identification of novel ethnomedicinal plant species in the study region, which may lead to the development of new medicines. The plant toxicity test results indicated that it may be used as an alternative to diabetes therapy with no or little adverse effects. This study confirms the conventional use of indigenous plant-derived natural medicine for treating diabetes mellitus. The study also highlighted the efficacy of "Ayurveda" which is an ancient tradition, used in some parts of India. This ancient concept should be carefully evaluated in the light of modern medical science and can be utilized partially if found suitable. I hope that this kind of research will be useful to future researchers as per their needs.

Improving Glycaemic Control in Patients with Type 2 Diabetes Mellitus through A Peer Support Instant Messaging Service Intervention (Diabpeers): Study Protocol for a Randomized Controlled Trial

Background: the context and purpose of the studyDiabetes mellitus is one of the four priority non-communicable diseases worldwide. It can lead to serious long-term complications and produces significant costs. Due to the chronicle character of the disease, it requires continuous medical treatment and good therapy adherence of those suffering. Therefore, diabetes self-management education (DSME) (and support DSMES) plays a significant role to increase patient’s self-management capacity and improve diabetes therapy. Research indicates that these outcomes might be difficult to maintain. Consequently, effective strategies to preserve the positive effects of DSMES are needed. Preliminary results show that peer support, which means support from a person who has experiential knowledge of a specific behaviour or stressor and similar characteristics as the target population, is associated with better outcomes in terms of HbA1c, cardiovascular disease risk factors or self-efficacy at lower cost compared to standard therapy. Peer-supported instant messaging services (IMS) approaches have significant potential for diabetes management because support can be provided easily and prompt, is inexpensive, and needs less effort to attend compared to standard therapy. The major objective of the study is to analyse the impact of a peer-supported IMS intervention in addition to a standard diabetes therapy on the glycaemic control of type 2 diabetic patients. Methods: how the study will be performedA total of 205 participants with type 2 diabetes mellitus will be included and randomly assigned to intervention or control group. Both groups will receive standard therapy, but the intervention group will participate in the peer-supported IMS intervention, additionally. The duration of the intervention will last for seven months, followed by a follow-up of seven months. Biochemical, behavioural and psychosocial parameters will be measured before, in the middle, and after the intervention as well as after the follow-up.Discussion: a brief summary and potential implicationsDiabetes mellitus type 2 and other non-communicable diseases put healthcare systems worldwide to the test. Peer-supported IMS interventions in addition to standard therapy might be part of new and cost-effective approaches to support patients independent from time and place.Trial registration: If your article reports the results of a health care intervention on human participants, it must be registered in an appropriate registry and the registration number and date of registration should be in stated in this section. If it was not registered prospectively (before enrollment of the first participant), you should include the words 'retrospectively registered'. See our editorial policies for more information on trial registration.ClinicalTrials.gov Identifier: NCT04797429Date of registration: 15 March 2021

FOLK ANTIDIABETIC PLANTS OF ASSAM: A SURVEY ON THEIR REPORTED ACTIVITY AND FUTURE POTENTIAL

Assam is a state in Indias north-eastern region, known for its lush floral and cultural diversity. We combed through the literature and discovered that about 117 Assamese plant species had been shown to have antidiabetic potential in preclinical studies. Diabetes, in its many forms, has been a long-standing problem for doctors for decades. Many aspects of diabetes must be investigated, including the physiological actions of insulin and the different clinical features of the condition, such as tissue complications. Since diabetes is a lifestyle disease, careful care with regard to diet and anti-diabetic agents is essential. Herbal diabetes therapy is not a novel concept. Plants and plant extracts have been used to treat diabetes since 1550 B.C., with as many as 400 prescribed before the development of effective diabetes drugs earlier this century.

Synaptotagmin 13 orchestrates pancreatic endocrine cell egression and islet morphogenesis

Epithelial cell egression is important for organ development, but also drives cancer metastasis. Better understandings of pancreatic epithelial morphogenetic programs generating islets of Langerhans aid to diabetes therapy. Here we identify the Ca2+-independent atypical Synaptotagmin 13 (Syt13) as a key driver of endocrine cell egression and islet formation. We detected upregulation of Syt13 in endocrine precursors that correlates with increased expression of unique cytoskeletal components. High-resolution imaging reveals a previously unidentified apical-basal to front-rear repolarization during endocrine cell egression. Strikingly, Syt13 interacts with acetylated tubulin and phosphatidylinositol phospholipids and localizes to the leading-edge of egressing cells. Knockout of Syt13 impairs endocrine cell egression and skews the α- to-β-cell ratio. Mechanistically, Syt13 regulates endocytosis to remodel the basement membrane and cell-matrix adhesion at the leading-edge of egressing endocrine cells. Altogether, these findings implicate an unexpected role of Syt13 in regulating cell polarity to orchestrate endocrine cell egression and islet morphogenesis.