A gastro-resistant peptide from Momordica charantia improves diabetic nephropathy in db/db mice via its novel reno-protective and anti-inflammatory activities

Diabetic nephropathy (DN), a principal diabetic microvascular complication, is a chronic inflammatory immune disorder. A gastro-resistant peptide mcIRBP-9 from Momordica charantia has shown the modulation of blood glucose homeostasis in...

NEURODEGENERATION AS AN EARLY SIGN OF DIABETIC RETINOPATHY

Diabetic retinopathy is major cause of visual impairment and blindness in diabetic patients worldwide. The concept of diabetic retinopathy as vascular disease has established into not only microvascular complication but also neurodegeneration problems. Neurodegeneration plays an important role in pathogenesis of diabetic retinopathy. In fact, neuroretinal changes in diabetes can take place even before vasculopathy can be clinically detected. This condition is marked by accelerated loss of neurons due to apoptosis, particularly in the inner retinal layer. The characteristic of neurodegeneration can be detected through retinal imaging and electrodiagnostics. This review is very crucial, because identifying the pathophysiology of diabetic neurodegeneration better, we may be able to provide interventions using the appropriate therapy. We may also be able to utilize these diagnostic tools for early detections of diabetic retinopathy, thus preventing blindness due to diabetes.

Impact of type 2 diabetes and microvascular complications on mortality and cardiovascular outcomes in a multiethnic Asian population

IntroductionDiabetes mellitus is a growing public health epidemic in Asia. We examined the impact of type 2 diabetes, glycemic control and microvascular complications on mortality and cardiovascular outcomes in a multiethnic population-based cohort of Asians without prior cardiovascular disease.Research design and methodsThis was a prospective population-based cohort study in Singapore comprising participants from the three major Asian ethnic groups: Chinese, Malays and Indians, with baseline examination in 2004–2011. Participants with type 1 diabetes and those with cardiovascular disease at baseline were excluded. Type 2 diabetes, Hemoglobin A1c (HbA1c) levels and presence of microvascular complications (diabetic retinopathy and nephropathy) were defined at baseline. The primary outcome was all-cause mortality and major adverse cardiovascular events (MACEs), defined as a composite of cardiovascular mortality, myocardial infarction, stroke and revascularization, collected using a national registry.ResultsA total of 8541 subjects were included, of which 1890 had type 2 diabetes at baseline. Subjects were followed for a median of 6.4 (IQR 4.8–8.8) years. Diabetes was a significant predictor of mortality (adjusted HR 1.74, 95% CI 1.45 to 2.08, p<0.001) and MACE (adjusted HR 1.64, 95% CI 1.39 to 1.93, p<0.001). In those with diabetes, higher HbA1c levels were associated with increased MACE rates (adjusted HR (per 1% increase) 1.18, 95% CI 1.11 to 1.26, p<0.001) but not mortality (p=0.115). Subjects with two microvascular complications had significantly higher mortality and MACE compared with those with only either microvascular complication (adjusted p<0.05) and no microvascular complication (adjusted p<0.05).ConclusionDiabetes is a significant predictor of mortality and cardiovascular morbidity in Asian patients without prior cardiovascular disease. Among patients with type 2 diabetes, poorer glycemic control was associated with increased MACE but not mortality rates. Greater burden of microvascular complications identified a subset of patients with poorer outcomes.

Analysis of Glycemic Control and Low-Density Lipoprotein Cholesterol with Glaucomatous Optic Neuropathy as a Microvascular Complication in Patients with Type 2 Diabetes Mellitus: A Cross-sectional Study in North Sumatera, Indonesia

BACKGROUND: Diabetes mellitus (DM) is an important health problem that induces microvascular complication such as retinopathy, nephropathy, and neuropathy. Ocular complications associated with type 2 DM are progressive and rapidly becoming the world’s most significant cause of morbidity and preventable with early detection and timely treatment. AIM: This study to analyze of glycemic control and low-density lipoprotein cholesterol (LDL-C) with glaucomatous optic neuropathy as a microvascular complication in patients with type 2 DM. MATERIALS AND METHODS: A prospective, analytical observational with cross-sectional study was conducted in Universitas Sumatera Utara Hospital and Satellite Hospital, Medan, Indonesia, from April 2020 to August 2020. The study included 66 participants with type 2 DM. The patients were investigated for hemoglobin A1c (HbA1c) level, LDL-C level, and ophthalmology examination including visual acuity (VA), intraocular pressure (IOP) measurement by Goldmann Applanation Tonometer, retinal nerve fiber layer (RNFL) thickness with spectral domain Optovue optical coherence tomography, and visual field defect with Octopus Perimeter. RESULTS: This study showed a significant correlation between HbA1c with VA (p = 0.030), IOP (p = 0.035), RNFL thickness (p = 0.002), visual field defect (p = 0.032), and duration of DM (p = 0.003) and showed significant correlation between LDL-C with VA (p = 0.048), IOP (p = 0.006), and duration of DM (p = 0.042). CONCLUSION: Higher HbA1c and LDL-C correlated with Glaucomatous Optic Neuropathy as a microvascular complication in type 2 DM. Advantage of research is still rarely studied.

Impact of Licochalcone A on the Progression of Diabetic Nephropathy in Type 2 Diabetes Mellitus of C57BL/6 Mice

Diabetic nephropathy (DN) is the most common chronic microvascular complication of diabetes. Therefore, it is of great significance to effectively prevent and treat DN. Licochalcone A (LicA) is a flavonoid...

EARLY PREDICTION OF DIABETIC RETINOPATHY BY MPV AND P-LCR

BACKGROUND: Mean platelet volume (MPV), platelet-large cell ratio (P-LCR) are the indicators of enhanced platelet activity and can be considered as potential biomarkers for diabetic microvascular complications like diabetic retinopathy. PURPOSE: To study MPV and P-LCR in Type 2 diabetics with and without complications of diabetic retinopathy. MATERIAL AND METHODS: A cross sectional study was conducted on 75 Type 2 diabetes patients. Detailed clinical history regarding duration, and complications was taken. MPV and P-LCR were obtained using automated cell counter. Fasting blood glucose, HbA1c were also obtained. Diabetics were further categorized into patients with complications and without complications of diabetic retinopathy. Statistical analysis was performed by Statistical Package for the Social Sciences Version 16 (Chicago, IL), the Chi-square test and the unpaired t-test. The receiving operating curve (ROC) analysis was carried out. The area under the curve (AUC) was calculated. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results: MPV and P-LCR were significantly (p=0.001) higher among patients with retinopathy than without retinopathy. Conclusion: MPV and P-LCR are predictive markers of diabetic microvascular complication diabetic retinopathy. They are more significant in microvascular complication diabetic retinopathy.

A study on nephropathy in type2 diabetes individuals in coastal Andhra Pradesh, India

Introduction: Diabetes nephropathy (DN) is an important, life-threatening microvascular complication of diabetes mellitus (DM). With this, a study was conducted to find the association between type 2 DM and DN.

Estimation and correlation of sirtuin1 with Carboxy Methyl Lysine in type 2 diabetic and its microvascular complication

Background: Increase in Diabetes Mellitus increases incidence of its Microvascular complications such as diabetic retinopathy, diabetic kidney disease (DKD), neuropathy, stroke and cardio vascular diseases (CVD). Advanced glycation end products promotes Type 2 Diabetes to its major Microvascular complication; diabetic kidney disease or diabetic nephropathy leading to increase in expression of sirtuin1; a regulatory protein mediating deacetylation of histone proteins. In addition to diet and nutrition, environmental changes may increase incidence of disorders, one such factor considered in this study is Fluoride. Objective: Estimation of Sirtuin1 in type 2 diabetes mellitus and diabetic kidney disease and interpreting the outcome by diabetic profiling of patients with controls. Participants: 150 study subjects were recruited for this cross- sectional study divided into 3groups with 50 subjects in each group. Methods: Diabetic and renal profiling was carried by fully automated analyzer available in our hospital facility, eGFR was calculated, sirtuin1 and CML were measured by ELISA, serum and urine fluoride were estimated by Ion Selective Electrode. Results: Significant differences observed in FBS, PPBS and CML of deceased with controls. Least median of sirt1 was observed in diabetic nephropathy (36.9). Also, urine and serum fluoride levels were proportionally balanced in group 1& 2 in contrast with group 3 [0.28 (0.2- 0.54) & 0.2 (0.15- 0.26)]. Conclusion: Decrease in Sirtuin1 in group 3 may be due to chronic hyperglycemia and oxidative stress in diabetes hence, further research on large cohort may aid considering sirtuin1 as a biomarker or therapeutic target in aging disorders.