Diabetes Mellitus
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Evin Ilter Bahadur ◽  
Şervan Özalkak ◽  
Asena Ayça Özdemir ◽  
Semra Çetinkaya ◽  
Elif Nursel Özmert

Abstract Objectives To examine sleep and behavior problems in children with type 1 Diabetes Mellitus (T1DM) compared to nondiabetic controls in a bridging country between east and west and to evaluate the interaction of sleep on behavior problems, maternal sleep, and maternal depressive symptoms. Methods The study included children with T1DM (4–12 years old) and age/sex-matched healthy controls. Parents completed the Children Sleep Habits Questionnaire (CSHQ), Children Behavior Checklist/4–18 (CBCL/4–18), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and a study-specific sociodemographic questionnaire. Clinical parameters regarding T1DM were collated from medical records. Results Participants included 75 children with T1DM and 49 controls. Based on CSHQ results 65.3% of all participants in both groups had sleep problems. Children with T1DM slept less and had higher daytime sleepiness problems than controls (p=0.024, p=0.008, respectively). No association was found between CSHQ or sleep duration and mode of diabetes treatment (pump, multiple daily injections) or glycemic control. CSHQ correlated with maternal PSQI (r=0.336 p=0.004) and BDI (r=0.341 p=0.004) in children with T1DM, but there was no association amongst controls. Children with T1DM had higher internalizing problems compared to controls. CSHQ and BDI correlated with internalizing, externalizing, and the total scores of the CBCL/4–18 in children with T1DM (R2=0.260 p<0.001; R2=0.207 p<0.001, R2=0.381 p<0.001 respectively). In controls, only BDI was associated with internalizing, externalizing, and the total scores of the CBCL/4–18. Conclusions Children with T1DM should be evaluated for sleep pattern and quality at follow-up, to identify those at risk for behavior problems and improve maternal life quality. Large longitudinal studies are necessary to assess the effect of new diabetes treatment modalities on sleep.

Venkatesan Ramasamy ◽  
S Raja Suresh S ◽  
R Vijayakumar. ◽  
K Panneer Selvam.

Diabetes mellitus is a very serious systemic disease worldwide. Around 416 million cases were estimated in 2015 worldwide, and are expected to reach 549 million in 2030 which is 8.6% higher. Diabetes mellitus is the leading cause of mortality and morbidity and is responsible for 3.8 million deaths annually. 25% of the diabetic patients are affected with foot infections out of which, 15% people are forced for limb amputation which affects the quality of life of the patients. Diabetic foot ulcer is a poly microbial infection mostly occurs due to Staphylococcus spp and Pseudomonas spp and pose serious complications. Bacteria are the cause for much type of diseases and generate resistance to wide range of biofilm forming. Biofilms constitute reservoirs of pathogens and are associated with resistance to antimicrobial agents and chronic infection. The study included 156 patients (59% male and 41% female) suffering diabetic foot ulcer whose pus culture was isolated. The identification of isolates for both gram-negative and gram-positive organisms was done as per the procedures mentioned in Bergey’s manual of Determinative Bacteriology. Further, MALDI- TOF (Matrix-Assisted Laser Desorption/Ionization) was used to confirm the identification of the isolates using classical methods. Staphylococcus spp (65%) and Pseudomonas spp (35%) biofilm producing isolates were identified for Congo red method assay and Tissue culture plate method. Results of biofilm production in positive, intermediate, negative differentiation on the Congo red plate assay and Tissue culture plate method assays were analyzed.

2021 ◽  
Vol 21 (1) ◽  
Mater H. Mahnashi ◽  
Yahya S. Alqahtani ◽  
Ali O. Alqarni ◽  
Bandar A. Alyami ◽  
Muhammad Saeed Jan ◽  

Abstract Background Diabetes mellitus is a common disease effecting the lifestyles of majority world population. In this research work, we have embarked the potential role of crude extracts and isolated compounds of Notholirion thomsonianum for the management diabetes mellitus. Methods The crude extracts of N. thomsonianum were initially evaluated for α-glucosidase, α-amylase and antioxidant activities. The compounds were isolated from the activity based potent solvent fraction. The structures of isolated compounds were confirmed with NMR and MS analyses. The isolated compounds were tested for α-glucosidase, α-amylase, protein tyrosine phosphatase 1B (PTP1B) and DPPH activities. The molecular docking studies were carried out to find the binding interactions of isolated compounds for α-glucosidase, α-amylase and PTP1B. Results Initially, we screened out crude extracts and subfractions of N. thomsonianum against different in-vitro targets. Among all, Nt.EtAc was observed a potent fraction among all giving IC50 values of 67, 70, < 0.1, 89 and 16 μg/mL against α-glucosidase, α-amylase, DPPH, ABTS and H2O2 respectively. Three compounds (Nt01, Nt02 and Nt03) were isolated from Nt.EtAc of N. thomsonianum. The isolated compounds Nt01, Nt02 and Nt03 exhibited IC50 values of 58.93, 114.93 and 19.54 μM against α-glucosidase, while 56.25, 96.54 and 24.39 μM against α-amylase respectively. Comparatively, the standard acarbose observed IC50 values were 10.60 and 12.71 μM against α-glucosidase, α-amylase respectively. In PTP1B assay, the compounds Nt01, Nt02 and Nt03 demonstrated IC50 values of 12.96, 36.22 and 3.57 μM in comparison to the standard ursolic acid (IC50 of 3.63 μM). The isolated compounds also gave overwhelming results in DPPH assay. Molecular docking based binding interactions for α-glucosidase, α-amylase and PTP1B were also encouraging. Conclusions In the light of current results, it is obvious that N. thomsonianum is potential medicinal plant for the treatment of hyperglycemia. Overall, Nt.EtAc was dominant fraction in all in-vitro activities. Three compounds Nt01, Nt02 and Nt03 were isolated from ethyl acetate fraction. The Nt03 specifically was most potent in all in-vitro assays. The molecular docking studies supported our in-vitro results. It is concluded that N. thomsonianum is a rich source of bioactive antidiabetic compounds which can be further extended to in-vivo based experiments.

2021 ◽  
pp. 103985622110423
Vladimir Sazhin ◽  
Pushkal Pushkal

Objectives: Constipation, a clinical manifestation of gastrointestinal hypomotility, is a common and potentially serious complication of clozapine therapy, requiring laxatives for its prevention and treatment. We explored the predictive factors of the increased laxative use in inpatients receiving a long-term clozapine therapy. Methods: In the cross-sectional study of 93 patients in a psychiatric rehabilitation hospital, we examined a four-week prevalence of laxative use and a range of demographic and clinical factors associated with the number of prescribed laxatives. Results: Seventy-four percent of inpatients with schizophrenia were prescribed laxatives, and they were statistically significant older and taking higher daily doses of clozapine. In generalized Poisson regression analysis, the clozapine dose, age, and comorbid diabetes mellitus and hypothyroidism were independently associated with the number of concurrently used laxatives. No association was found between the laxatives and gender, duration of clozapine treatment, and the number of other medications with a potential to cause constipation. Conclusion: The clozapine dose, age, diabetes mellitus, and hypothyroidism were shown to be the independent predictors of the increased laxative use among inpatients on clozapine and might be associated with the increased risk of clozapine-induced constipation and gastrointestinal hypomotility.

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Nayab Ishrat ◽  
Hamda Khan ◽  
Om P. S. Patel ◽  
Abbas Ali Mahdi ◽  
Farina Mujeeb ◽  

The dysregulation of glucose metabolism that includes the modification of biomolecules with the help of glycation reaction results in the formation of advanced glycation end products (AGEs). The formation of AGEs may activate receptors for advanced glycation end products which induce intracellular signaling, ultimately enhancing oxidative stress, a well-known contributor to type 2 diabetes mellitus. In addition, AGEs are possible therapeutic targets for the treatment of type 2 diabetes mellitus and its complications. This review article highlights the antioxidant, anti-inflammatory, and antidiabetic properties of the Nymphaea species, and the screening of such aquatic plants for antiglycation activity may provide a safer alternative to the adverse effects related to glucotoxicity. Since oxidation and glycation are relatively similar to each other, therefore, there is a possibility that the Nymphaea species may also have antiglycating properties because of its powerful antioxidant properties. Herbal products and their derivatives are the preeminent resources showing prominent medicinal properties for most of the chronic diseases including type 2 diabetes mellitus. Among these, the Nymphaea species has also shown elevated activity in scavenging free radicals. This species has a load of phytochemical constituents which shows various therapeutic and nutritional value including anti-inflammatory and antioxidant profiles. To the best of our knowledge, this is the first article highlighting the possibility of an antiglycation value of the Nymphaea species by inhibiting AGEs in mediation of type 2 diabetes mellitus. We hope that in the next few years, the clinical and therapeutic potential may be explored and highlight a better perspective on the Nymphaea species in the inhibition of AGEs and its associated diseases such as type 2 diabetes mellitus.

2021 ◽  
Vol 11 (1) ◽  
Jiyu Sun ◽  
Gyu Ri Kim ◽  
Su Jin Lee ◽  
Hyeon Chang Kim

AbstractRecent studies have shown that gestational diabetes mellitus (GDM) is associated with an increased risk for cardiovascular disease. GDM has also been shown to be a risk factor for type 2 diabetes (T2DM) after pregnancy. However, there is limited evidence regarding the role of intercurrent T2DM on the relationship between GDM and future CVD. Thus, we investigated the risks of incident cardiovascular events among women with GDM during pregnancy compared to women without GDM and whether the increased CVD risk is dependent on intercurrent development of T2DM. We conducted a population-based retrospective cohort study using the Korean National Health Insurance Service claims database. Outcomes were the first occurrence of any CVD (myocardial infarction, treatment with coronary revascularization, heart failure, and cerebrovascular disease). Cox proportional hazard models were used to assess the association between GDM and incident CVD events, using landmark analysis at 4 years. A total of 1,500,168 parous women were included in the analysis, of which 159,066 (10.60%) had GDM. At a median follow-up of 12.8 years, 13,222 incident cases of total CVD were observed. Multivariable-adjusted hazard ratio for total CVD among women with prior GDM, compared with those without GDM, was 1.08 (95% CI 1.02–1.14). Further classifying GDM by progression to T2DM in relation to total CVD risk indicated a positive association for GDM with progression to T2DM vs no GDM or T2DM (HR 1.74; 95% CI 1.40–2.15), and no statistically significant association for GDM only (HR 1.06; 95% CI 1.00–1.12). GDM with subsequent progression to T2DM were linked with an increased risk of cardiovascular diseases. These findings highlight the need for more vigilant postpartum screening for diabetes and the implementation of diabetes interventions in women with a history of GDM to reduce future CVD risk.

2021 ◽  
Vol 1 (2) ◽  
pp. 112-117
Fahruddin Kurdi ◽  
Zainal Abidin ◽  
Ratna Puji Priyanti ◽  
Anja Hesnia Kholis

Elderly are high risk for the development of type 2 diabetes due to the combined effects of increasing insulin resistance and impaired pancreatic function with aging. Diabetes mellitus is a chronic disease that causes insulin in the pancreas is not effective one of the treatments that can be done by diabetics to reduce blood sugar levels One of them with physical activity, the activity is taichi exercises.The purpose of this study was to investigate the effect of taichi exercises on reducing blood sugar levels in patients with type II diabetes mellitus.The design of this study was pre-experiment one group pre-test and post-test design with a population of 88 patients and a sample of 44 respondents. Research sampling technique used purposive sampling. Data collection with observation sheets. The intervention was carried out four times during 4 weeks. Before the intervention, sugar levels of type II diabetics were classified as moderate as 24 people (54.5%) and high as many as 20 people (45.5%). After the management of taichi exercises sugar levels experienced changes in the categories of good as many as 16 people (36.4%), moderate as many as 20 people (45.5%) and high as many as 8 people (18.2%). Data analized with Wilcoxon Signed Rank test with a significant level α = 0.05, the result ρ-value = 0.001 means ρ-value <α so that there is a significant effect of taichi exercises on decreasing blood sugar levels in patients with type II diabetes mellitus. Blood sugar levels in patients with diabetes mellitus before doing taichi exercises with the number of respondents 44 people mostly experienced changes, evidenced by the level of blood sugar levels from moderate levels to good. Keywords: Elderly, Taichi, Diabetes Mellitus, Blood sugar level

2021 ◽  
Vol 12 ◽  
Shan Gao ◽  
Hongliang Zhang ◽  
Chen Long ◽  
Zhenhua Xing

This study aimed to evaluate the association between obesity, evaluated by fat mass index (FMI) with the risk of microvascular diseases in patients with type 2 diabetes mellitus (T2DM) and compare the magnitude of associations of FMI, body mass index (BMI), and waist circumference (WC) with the risk of microvascular diseases. We performed a post-hoc analysis of the Action to Control Cardiovascular Risk in Diabetes study. The primary microvascular outcomes of the present study included chronic kidney disease (CKD) progression, retinopathy, and neuropathy. Cox proportional-hazards models were performed to evaluate the association of FMI with microvascular diseases. A discordant analysis was performed to compare the magnitude of associations of FMI, BMI, and WC with the risk of microvascular diseases. Our study included 10,251 T2DM participants with a median of 5 years (interquartile range, 4.2–5.7) of follow-up. A total of 6,184 participants developed CKD progression, 896 participants had retinopathy, and 3,213 participants developed neuropathy (Michigan Neuropathy Screening Instrument, &gt;2.0). After the confounding factors were adjusted for, patients in the highest FMI quartile had a higher risk of CKD progression (HR: 1.26, 95%CI: 1.16–1.36) and neuropathy (HR: 1.93, 95% CI: 1.74–2.15), except for retinopathy (HR: 1.17, 95% CI: 0.96–1.43), than those in the lowest quartile. Discordant analyses found that FMI and WC are better in identifying individuals with obesity-related risk of neuropathy, compared with BMI; neither is better in identifying individuals with obesity-related risk of CKD progression and retinopathy. Obesity is associated with CKD progression and neuropathy in T2DM participants. Further randomized trials are needed to test whether obesity control can improve the outcomes of T2DM participants with CKD or neuropathy. FMI and WC are more useful in identifying obesity-related risk of neuropathy compared with BMI in T2DM patients.Clinical Trial Registrationhttp://www.clinicaltrials.gov, NCT00000620.

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