A Review on the Structure and Anti-Diabetic (Type 2) Functions of β-Glucans

Type 2 diabetes, a long-term chronic metabolic disease, causes severe and increasing economic and health problems globally. There is growing evidence that β-glucans can function as bioactive macromolecules that help control type 2 diabetes with minimal side effects. However, conflicting conclusions about the antidiabetic activities of β-glucans have been published, potentially resulting from incomplete understanding of their precise structural characteristics. This review aims to increase clarity on the structure–function relationships of β-glucans in treating type 2 diabetes by examining detailed structural and conformational features of naturally derived β-glucans, as well as both chemical and instrumental methods used in their characterization, and their underlying anti-diabetic mechanisms. This may help to uncover additional structure and function relationships and to expand applications of β-glucans.

The effect of Borago officinalis on the signaling pathway of the NLRP3 inflammasome complex, TLR4 and some inflammatory cytokines in type II diabetic patients with acute respiratory distress syndrome

Acute respiratory distress syndrome (ARDS) is a life-threatening condition in which the lungs become severely inflamed, causing the alveoli to constrict or fill with fluid, which prevents the lungs from functioning properly. This disease becomes more dangerous when it occurs in patients with diabetes. Because of the clinical condition of these patients, it is not possible to treat them with usual medicines. One of the best options for treating these people is to use herbs. Borage (Borago officinalis) is a medicinal herb that, in addition to its anti-inflammatory properties, is also able to control blood sugar. Therefore, in the current study, the effect of borage oil was considered on the signaling pathway of the NLRP3 inflammasome complex, TLR4, and serum levels of inflammatory cytokines (IL-1? and IL-18) in type II diabetic patients with ARDS. For this purpose, 25 diabetic type II patients with ARDS were divided into three groups by ARDS Berlin Definition. Then, after providing the demographic and clinical characteristics of the patients, they were treated with 30 mg/day borage oil for seven days. The expression of NLRP3 and TLR4 genes (by Real-time PCR technique) and serum levels of IL-1? and IL-18 (by ELISA test) were evaluated before and after treatment with borage oil through blood samples taken from patients. The results showed that serum levels of inflammatory cytokines (IL-1? and IL-18), NLRP3 gene, and TLR4 gene were significantly decreased in diabetic type II patients with mild ARDS by treating with borage oil. IL-1? serum level and TLR4 were significantly decreased in diabetic type II patients with moderate ARDS. But there was not any significant decrease or increase in IL-1?, IL-18, NLRP3 gene, and TLR4 gene in diabetic type II patients with severe ARDS after 7 days of treatment with borage oil. According to the obtained results, borage oil can act as a double-edged blade. Thus, in the early and middle stages of ARDS, borage oil can be effective in reducing the inflammasome pathway of inflammation and also reduce blood sugar levels in these diabetic patients. But in the severe stage of ARDS, it not only does not help to treat the ARDS; it also increases systolic and diastolic blood pressure in diabetic patients.

Changes of Corneal Thickness and Intraocular Pressure in Type II Diabetic Patients

Aims. The purpose of the present paper is to present the results of central corneal thickness & intraocular pressure measurements in diabetic patients with or without retinopathy, and compare the results with non-diabetic control patients. Methods. Total number was 152 patients were 152 eyes The study group was divided into 3 groups as following: 50 non diabetic (control). 50 diabetic type II with no diabetic retinopathy. 52 diabetic type II patient with diabetic retinopathy. Correlation analysis was performed to assess the association between glycosylated hemoglobin levels& Intraocular pressures and retinal changes among subgroups. Results. Demographic characteristics of study and control groups were similar (P>0.05). Mean CCT 553.62 with Std deviation (14.47) in control cases and 622.27 with Std deviation (507.09) in diabetic cases which is more than control however the distinction failed to reach applied math significance were (p value= > 0.05). additionally, CCT and diabetic retinopathy association was significant were CCT in diabetic patients with no retinal changes was 563.96 Std deviation (18.85) and in diabetic patients with retinopathy was 670.45 Std deviation (717.2) and P value = 0.004 (significant). There was significant correlation between increased corneal thickness and intraocular pressure were p-value = 0.002. Conclusions. We found that the central cornea of diabetic patients is thicker when compared with non-diabetic patients. Thicker central cornea associated with diabetes mellitus should be taken into consideration while obtaining accurate intraocular pressure measurements in diabetics.

Role of Leptin with hypothyroidism in Iraqi diabetic type 2 patients

In thyroid subjects, leptin hormone and thyroid-stimulating hormone levels connect; both are emphatically corresponding with adiposity. “Leptin hormone was essentially raised in the hypothyroid topic,” to levels like those seen in corpulent thyroid topic. This study aimed to determine leptin hormone levels, T3, T4, TSH, HbA1c %, FBG, lipid profile in diabetic and diabetic with hypothyroidism patients and compare the outcome with the healthy group. 90 samples were registered in this study with their ages ranging between (40 - 65) years that dole out into 3 groups as follows: thirty healthy groups (G1), thirty patients with diabetes (G2), and category three (G3) include diabetic patients and hypothyroidism as an associated disease. This study revealed a slightly significant elevated leptin in G3, contrasting to G2 and G1. Meantime no significant elevated spotted between G2 and G1. The conclusion could be from this investigation that leptin levels were changed in patients’ gatherings that might be utilized in checking and early analysis of thyroid dysfunction in these patients relying upon the significant connection for leptin chemical with T3, T4, and TSH.

Evaluation of the Association of CGM Metrics with Antihyperglycemic Drugs in Insulin-Treated Diabetics

<b><i>Introduction:</i></b> Intermittent flash glucose monitoring (FGM) and real-time continuous glucose monitoring (CGM) are used to monitor glycemic excursions for 14 days and can demonstrate time in range (TIR), time above range (TAR), and time below range (TBR). The utility of CGM metrics, such as TIR, TBR, and TAR, in diabetics treated with insulin combined with antihyperglycemic drugs is uncertain. <b><i>Methods:</i></b> In a cross-sectional and retrospective study, we investigated the relationship between target metrics from CGM/FGM and HbA1c or glucose variabilities in 80 type 1 and 2 diabetic patients receiving insulin treatment with ≥1 injections per day. The proportions of TIR, TAR, and TBR from FGM in relation to HbA1c and coefficient of variation (CV)% in types 1 and 2 diabetics were analyzed. Multivariable analyses were performed regarding the associations of TIR with biochemical factors and glycemic variabilities. TBR was also examined in relation to antidiabetic agents and diabetic type in multiple regression analyses. Finally, the association of retinopathy with FGM-CGM metrics was examined using a logistic analysis. <b><i>Results:</i></b> When patients were grouped by sex and diabetic type, significant differences in age, TIR, TBR, high-density lipoprotein cholesterol (HDLC), and insulin dose were detected using Kruskal-Wallis analyses. HbA1c significantly correlated with TIR (<i>p</i> &#x3c; 0.001) and TAR (<i>p</i> &#x3c; 0.001) using Pearson’s correlation analysis. TBR significantly correlated with CV% (<i>p</i> &#x3c; 0.001). Multivariable analysis of TIR showed a significant negative association with HbA1c (<i>p</i> = 0.02). Incretin combined with insulin therapy reduced the TBR proportion significantly according to the multivariate analysis. Retinopathy tended to be related to HbA1c (<i>p</i> = 0.059) and duration (<i>p</i> = 0.078) but not TIR (<i>p</i> = 0.891), according to the logistic analysis. <b><i>Conclusions:</i></b> These results demonstrate that CGM metrics reflect glucose control for 2 weeks using TIR. In addition, combined therapy with incretin and insulin therapy is superior for reducing hypoglycemia, based on TBR. Thus, TBR is also useful for monitoring hypoglycemia. However, FGM/CGM metrics do not predict retinopathy accurately.

The non-benzodiazepine anxiolytic etifoxine limits mechanical allodynia and anxiety-like symptoms in a mouse model of streptozotocin-induced diabetic neuropathy

More than 450 million people worldwide suffer from diabetes, or 1 in 11 people. Chronic hyperglycemia degrades patients’ quality of life and the development of neuropathic pain contributes to the burden of this disease. In this study, we used the mouse model of streptozocin-induced diabetic type 1 neuropathy to assess the analgesic potential of etifoxine. Etifoxine is a prescribed anxiolytic that increases GABAAA receptor function through a direct positive allosteric modulation effect and, indirectly, by stimulating the production of endogenous GABAA receptor positive modulators such as allopregnanolone-type neurosteroids. We show that a post-symptomatic or preventive treatment strongly and durably reduces mechanical hyperalgesia and anxiety in diabetic neuropathic mice. This analgesic and neuroprotective effect on painful symptoms and emotional comorbidities is promising and should now be clinically evaluated.