Fetal adrenal cortex function in pregnancy, complicated by maternal insulin-dependent diabetes mellitus

Fetal adrenal cortex glucocorticoid andfetal hypophysial adrenocorticotropic function in normal pregnancy and pregnancy, complicated with maternal insulin dependent diabetes mellitus were examined in the present study. Statistically significant feta l hypercortisolemia was observed in pregnancies, complicated by insulin-dependent diabetes mellitus. Correlations between vascular complications o f maternal insulin-dependent diabetes mellitus and fetal cortisol andACTG levels were revealed during the investigation. Severe vascular lesions o f maternal diabetes have been associated with delayed feta l lung maturity. Fetal pulmonary maturity was significantly associated with fe ta l cortisol levels.

CANDIED: A Pan-Canadian Cohort of Immune Checkpoint Inhibitor-Induced Insulin-Dependent Diabetes Mellitus

Immune checkpoint inhibitor (ICI)-induced insulin-dependent diabetes mellitus (IDDM) is a rare but potentially fatal immune-related adverse event (irAE). In this multicentre retrospective cohort study, we describe the characteristics of ICI-induced IDDM in patients treated across five Canadian cancer centres, as well as their tumor response rates and survival. In 34 patients identified, 25 (74%) were male and 19 (56%) had melanoma. All patients received anti-programed death 1 (anti-PD1) or anti-programmed death ligand-1 (anti-PD-L1)-based therapy. From ICI initiation, median time to onset of IDDM was 2.4 months (95% CI 1.1–3.6). Patients treated with anti-PD1/PD-L1 in combination with an anti-cytotoxic T lymphocyte antigen 4 antibody developed IDDM earlier compared with patients on monotherapy (1.4 vs. 3.9 months, p = 0.05). Diabetic ketoacidosis occurred in 21 (62%) patients. Amongst 30 patients evaluable for response, 10 (33%) had a complete response and another 10 (33%) had a partial response. Median overall survival was not reached (95% CI NE; median follow-up 31.7 months). All patients remained insulin-dependent at the end of follow-up. We observed that ICI-induced IDDM is an irreversible irAE and may be associated with a high response rate and prolonged survival.

Diabetic ketoacidosis as a hallmark of autoimmune diabetes occurring after two cycles of cemiplimab

Introduction Clinical indications of immune checkpoint inhibitors have expanded to a variety of malignancies. Nearly 50% of patients with advanced cutaneous squamous cell carcinoma, respond to the programmed-death 1 inhibitor cemiplimab. To date, insulin-dependent diabetes mellitus has been documented with the use of several immune checkpoint inhibitors but not cemiplimab. Case report We report herein the first case of a patient with cutaneous squamous cell carcinoma who developed diabetic ketoacidosis and insulin-dependent diabetes mellitus following only two cycles of cemiplimab. A score of 6 on the Naranjo nomogram makes the causality relationship between cemiplimab use and the insulin-dependent diabetes mellitus probable. Management and outcome The patient's developed diabetic ketoacidosis was managed with intravenous fluids and intravenous insulin, with a prompt resolution. Cemiplimab was discontinued, and the patient was discharged on long-acting and short-acting insulin therapy, with a follow-up with endocrinology. Discussion/conclusions The mechanism by which cemiplimab caused insulin-dependent diabetes mellitus is most likely due to lack of endogenous insulin production in the setting of immune-mediated loss of pancreatic beta-cells. Patients may benefit from fasting blood glucose monitoring and early immune checkpoint inhibitor discontinuation where elevated serum glucose is detected.

Herbal Drugs with Anti-Diabetic Potential

Diabetes mellitus (DM), also known as insulin-dependent diabetes mellitus (IDDM) and non-insulin dependent diabetes mellitus (NIDDM), is a common and serious metabolic condition that affects people all over the world. Traditional herbal plants have been utilized to treat diabetes mellitus all throughout the world. Several herbs have been found to treat and control diabetes among numerous medicines and poly herbal plants; they also have no adverse effects. Diabetes mellitus is a horrible disease that affects people all over the world and is becoming a serious danger to humanity's health. Thus, herbal plants may be a possible source of anti-diabetic medicines, with ethno botanical data indicating that around 800 plants may have anti-diabetic potential. Although synthetic oral hypoglycemic agents/insulin are a popular diabetes therapy and are effective in controlling hyperglycemia, they have significant side effects and do not significantly modify the course of diabetic complications. This is the primary reason why an increasing number of individuals are looking for alternative medicines with fewer or no adverse effects. The botanical name, common name, component, and mechanism of action for anti-diabetic activity were provided in this review study, as well as plant-based commercial poly herbal formulations. Keywords: Diabetes mellitus, Medicinal plants, glucose, poly herbal plants

Automated Glucose Control

Automated blood glucose control for diabetes mellitus is a highly desired pursuit of researchers around the globe. Advancement in sensing and control capabilities has paced the development of closed-loop control systems for insulin dependent diabetes. Traditional treatment methods and recent approaches using automated control systems are reviewed in this article. Invasive and non-invasive glucose sensing methods along with insulin therapy are presented in detail. Control algorithms are studied and evaluated based on their ability to keep blood glucose levels in euglycemic range by regulating the amounts of insulin bolus. The article highlight the advantages of using automated control system over the traditional control strategies for insulin dependent diabetes.

Automated glucose control

Automated blood glucose control for diabetes mellitus is a highly desired pursuit of researchers around the globe. Advancement in sensing and control capabilities has paced the development of closed-loop control systems for insulin dependent diabetes. Traditional treatment methods and recent approaches using automated control systems are reviewed in this article. Invasive and non-invasive glucose sensing methods along with insulin therapy are presented in detail. Control algorithms are studied and evaluated based on their ability to keep blood glucose levels in euglycemic range by regulating the amounts of insulin bolus. The article highlight the advantages of using automated control system over the traditional control strategies for insulin dependent diabetes.