Correlation of HbA1c levels and diabetic neuropathy complications in diabetes mellitus patients

Introduction: Type 2 Diabetes Mellitus (DM) is a metabolic disease caused by impairments in insulin secretion by pancreatic beta cells and/or impaired insulin regulation by the body (insulin resistance). Inadequate management of DM can be a trigger of several complications, such as diabetic neuropathy.

A Comprehensive Model of Glucose-Insulin Regulation Including Acute and Prolonged Effects of Physical Activity in Type 1 Diabetes

Objective: For type 1 diabetic patients, accurate adjustment of insulin treatment to physical activity (PA) is a challenging open problem. Glucose uptake by the exercising muscles increases acutely, causing increased hepatic glucose production to maintain glucose homeostasis. Meanwhile, insulin sensitivity is elevated for a prolonged period to drive glycogen repletion during recovery. These processes strongly depend on PA duration and intensity, making their combined effects difficult to predict accurately. In this work, we develop a model of glucose-insulin regulation that captures PA from low to high intensity including acute and prolonged effects on glucose metabolism. Methods: We extended an existing minimal model of glucose-insulin regulation to capture PA-driven changes in glucose metabolism. We incorporated the insulin-independent increase in glucose uptake and production, including the effects of glycogen depletion and of high-intensity PA on production. The model also captures the prolonged increase in insulin sensitivity. Results: The model accurately predicts glucose dynamics of published data during short and prolonged PA of moderate to high intensity and during subsequent recovery. In-silico full-day studies elucidate the effects of timing, duration and intensity of PA and of insulin bolus reduction on glucose levels during and after the activity. Conclusion: The proposed model captures the blood glucose dynamics during all main PA regimes. Significance: Mathematical models of glucose-insulin regulation are critical components of closed-loop insulin delivery and clinical decision support systems for achieving good glycemic control. The presented model shows potential for the development and assessment of algorithms targeting treatment adjustment to PA.

Transient Hyperinsulinemic Hypoglycemia Linked to PAX6 Mutation

Prolonged hyperinsulinemic hypoglycemia in infancy can result in developmental sequelae. A mutation in the paired box-6 gene (PAX6) has been reported to cause disorders in oculogenesis and neurogenesis. A limited number of cases of diabetes mellitus in adults with a PAX6 mutation suggest that the gene also plays a role in glucose homeostasis. The present case report describes a boy with a PAX6 mutation, born with anophthalmia, who underwent hypoglycemic seizures starting at 5 months old, and showed a prediabetic condition at 60 months. This patient provides novel evidence that connects PAX6 to glucose homeostasis and highlights that life-threatening hypoglycemia or early onset glucose intolerance may be encountered. The role of PAX6 in glucose metabolism and insulin regulation should be further investigated.

Mesodiencephalic modulation in complex therapy of diabetic polyneuropathy

The effect of mesodiencephalic modulation on the metabolism of carbohydrates and lipids, insulin and cortisol secretion, the severity of neurological disorders and pain syndrome has been studied in patients with diabetic polyneuropathy. It has been established that the addition of a standard therapeutic complex with MDM-therapy reduces the neurological symptoms of the disease and the severity of the pain syndrome by half, as well as significantly improves the insulin regulation of carbohydrate and lipid metabolism. It has been proven that MDM-therapy reduces the body’s insulin resistance, which makes it possible to recommend this physical factor for the treatment of diseases associated with metabolic syndrome. The hypothesis of the systemic nature of MDM-therapy and its effect on the formation of adaptive responses is considered.