Evaluation of the Vasoprotective Effects of Metformin versus Glibenclamide in Type 2 Diabetic Patients

Adiponectin (APN) is an adipokine with anti-inflammatory and anti-atherogenic properties decreased in type 2 diabetes mellitus (T2DM) that may influence endothelial function by regulating serum nitric oxide (NO) levels. The current study aimed to investigate the effect of two oral hypoglycemic drugs, Metformin and Glibenclamide (GLC), on circulating APN and NO levels and to find a correlation between APN and NO levels in type 2 diabetic patients. Fifty males and females previously diagnosed with T2DM were conducted in this trial and classified into groups: Group A involved 18 untreated patients with T2DM, group B involved 16 patients receiving Metformin monotherapy (1000 mg/day) for up to 1 year and group C involved 16 patients receiving GLC (5 mg/day) for up to 1 year. Circulating APN and NO were measured. Compared to GLC, Metformin therapy showed a significant increase in APN and NO levels in type 2 diabetic patients. Our findings established that Metformin has a protective effect on endothelial function, including increased APN and NO bioavailability, beyond its glucose-lowering effect.

Amelioration of related complications by the combined usage of Gymnadenia orchidis Lindl and pumpkin seed in type 2 diabetic mice

Background Inflammation, insulin resistance, hyperinsulinemia and cell damage are the major patho-physiological reasons behind type 2 diabetes (T2DM), which is one of the most prevalent non communicable metabolic disorders in the world. Oral hypoglycemic drugs and insulin shots are usually exercised to treat the diabetic patients but it produces many side effects. Thereby paving the way for natural hypoglycemic agents; a Himalayan herb and alternative nutritional therapy; low glycaemic indexed pumpkin seed, are used in combination for a better management of the disease. Objectives To explore the combined efficacy of Gymnadenia orchidis Lindl root Salep and low-glycemic indexed-pumpkin seeds in better management of T2DM and associated complications. Methods Balb/c mice were randomly allocated to six different groups (n=5). Streptozotocin along with high-fat-diet was used to induce T2DM. The experimental animals were supplemented with low-glycemic food or root Salep (200 mg/kg body weight) or combination of both according to their groups for 21 days, post which various biochemical tests were performed. Results T2DM augmented the IL-6, IFN-γ, TNF-α, BAX, Insulin levels, and HOMA-IR with concurrent reduction of IL-4, QUICKI, Bcl-2, estradiol and progesterone levels. FACS revealed augmented cellular damage in T2DM mice. Interestingly, root Salep and pumpkin seeds normalized those parameters in T2DM animals suggesting significant (p<0.001) improvement of immunity of the diseased animals and ameliorated associated complications. Conclusions Root Salep and pumpkin seed display synergism among binomial set of herbal agents which may be safely used for T2DM management.

Anti-Diabetic Potential of Plant-Based Pentacyclic Triterpene Derivatives: Progress Made to Improve Efficacy and Bioavailability

Diabetes mellitus (DM) results from the inability of the pancreas to produce sufficient insulin or weakened cellular response to the insulin produced, which leads to hyperglycemia. Current treatments of DM focus on the use of oral hypoglycemic drugs such as acarbose, alpha-glucose inhibitors, sulphonylureas, thiazolidinediones, and biguanides to control blood glucose levels. However, these medications are known to have various side effects in addition to their bioavailability, efficacy, and safety concerns. These drawbacks have increased interest in the anti-diabetic potential of plant-derived bioactive compounds such as oleanolic and maslinic acids. Although their efficacy in ameliorating blood glucose levels has been reported in several studies, their bioavailability and efficacy remain of concern. The current review examines the anti-diabetic effects of oleanolic, maslinic, asiatic, ursolic, and corosolic acids and their derivatives, as well as the progress made thus far to enhance their bioavailability and efficacy. The literature for the current review was gathered from leading academic databases—including Google Scholar and PubMed—the key words listed below were used. The literature was searched as widely and comprehensively as possible without a defined range of dates.

Pharmacotherapy of Gestational Diabetes Mellitus: Current Recommendations

The incidence of gestational diabetes mellitus (GDM) is still rising, and this pathological condition is strongly associated with some serious adverse pregnancy outcomes. Therefore, GDM must be timely recognized and adequately managed. Treatment of GDM is aimed to maintain normal glycemia and it should involve regular glucose monitoring, dietary modification, lifestyle changes, moderate physical activity, and pharmacotherapy, when necessary. As for the pharmacotherapy, needed in approximately one-third of GDM women, insulin administration is the first choice of pharmacological treatment, although oral hypoglycemic drugs, for example, metformin (a biguanide agent) or glyburide (a second-generation sulfonylurea drug), could be indicated, too. Metformin is considered as a reasonable and safe first-line alternative to insulin. If comparing two oral agents, metformin seems to be safer than glyburide, since glyburide was found to be linked to neonatal hypoglycemia and higher birth weight, which can for example increase the hazard for shoulder dystocia and a necessity for Cesarean delivery. Finally, it should be underlined that many pregnant women turn to complementary and alternative medicine for health maintenance or symptom relief, including traditional herbal medicine and the use of supplements. Given the previous facts, this chapter will address current pharmacotherapy options and challenges related to GDM treatment.

LAJU FILTRASI GLOMERULUS PASIEN DIABETES MELITUS TIPE II DI SALAH SATU RUMAH SAKIT SWASTA DI KABUPATEN DEMAK

Diabetes Mellitus (DM) Type II is a group of metabolic diseases with hyperglycemia characteristics. The use of oral hypoglycemic drugs (OHO) lasts for a relatively long time. Most of the OHO is excreted through the kidneys. This study aims to determine the Glomerulus Filtration Rate (GFR) of type 2 DM patients who use OHO at the "X" Hospital, District of Demak. This study is an observational descriptive study using retrospective data obtained from medical record data (RM) of outpatient JKN participants with type 2 DM for the period October-December 2020. Inclusion criteria were patients who received OHO for at least one year with or without comorbidities, aged 36-65 years, and had a serum creatinine test. Patients receiving combination therapy with insulin were excluded. LFG is calculated using the Cockroft-Gault formula. From 82 patients, 52 patients (62.2%) were female, 74 patients (90.2%) were more than 45 years old. Patients who consumed OHO for more than 2 years were 47 (57.3%). Patients without comorbidities were 62 (75.7%) people. Patients who experienced a decrease in GFR in the moderate category (stage 3) as many as 24 people (29.3%), a decrease in GFR in the severe category (stage 4) as many as 5 people (6.1%) and 1 person (1.2%) experienced End Stage Renal Disease.

Emerging Treatment Strategies for Diabetes Mellitus and Associated Complications: An Update

The occurrence of diabetes mellitus (DM) is increasing rapidly at an accelerating rate worldwide. The status of diabetes has changed over the last three generations; whereas before it was deemed a minor disease of older people but currently it is now one of the leading causes of morbidity and mortality among middle-aged and young people. High blood glucose-mediated functional loss, insulin sensitivity, and insulin deficiency lead to chronic disorders such as Type 1 and Type 2 DM. Traditional treatments of DM, such as insulin sensitization and insulin secretion cause undesirable side effects, leading to patient incompliance and lack of treatment. Nanotechnology in diabetes studies has encouraged the development of new modalities for measuring glucose and supplying insulin that hold the potential to improve the quality of life of diabetics. Other therapies, such as β-cells regeneration and gene therapy, in addition to insulin and oral hypoglycemic drugs, are currently used to control diabetes. The present review highlights the nanocarrier-based drug delivery systems and emerging treatment strategies of DM.

Clinical profile of patients with diabetes: a hospital based cross sectional study

Background: Diabetes is a leading cause of morbidity and mortality. Early identification of complications and management of the same is important to prevent the morbidity and mortality. The objective of the study was to study the clinical profile of patients with diabetes.Methods: A hospital based cross sectional study was carried out among 25 diabetic individuals. Baseline demographic details, risk factors and complications were noted. Investigations like fasting blood sugar, lipid profile and blood pressure were carried out for all patients. Their treatment status was noted.Results: Majority (56%) belonged to age group of 40-59 years. Males were more (64%) than females (36%). Only 28% were normal weight. 52% admitted that they consumed alcohol. 72% were non-smokers and only 8% were tobacco chewers. Hypertension was the most common complication associated with diabetes in 64% of the cases. 4% each had coronary heart disease, stroke, and neuropathy. No one was found to have cataract. 12% had diabetic foot while 8% had kidney disease. Mean levels of total cholesterol was 164.76; mean level of triglyceride was 169.28; mean level of HDL was 45.08; mean level of LDL was 91.32; mean level of Fasting blood sugar was 186; mean Systolic blood pressure was 168.48 and mean Diastolic blood pressure was 114.4. Majority (76%) were on Oral hypoglycemic drugs only and only 4% were on insulin. 20% were on Oral hypoglycemic drugs + insulin.Conclusions: Males were affected more with diabetes. Hypertension was the most common complication. Significant number had developed serious complications and hence early screening for complications in all diabetes patients is required.