Progression of a 2nd type diabetes mellitus model on mice with usage of a calorie diet

Type 2 diabetes accounts for up to 90% of all diabetes cases. It is known that people with type 2 diabetes are often obese. Long-term complications also include problems with the cardiovascular, nervous and urinary systems. The model of type 2 diabetes mellitus based on a diet rich of fat and carbohydrates was used in the work. We observed a significant increase in the body weight of mice and sugar levels in their blood. Morphometric analysis of the pancreas showed an increase of its mass coefficient. Tactile sensitivity measurement showed an increase in its threshold. The developed model is quite suitable for analyzing the diabetes progression and its side effects on the body. Key words: diabetes mellitus type 2, obesity, pancreas, tactile sensitivity.

ДОСВІД ТА ПЕРСПЕКТИВИ ЗАСТОСУВАННЯ КАРБОКСІТЕРАПІЇ ПРИ ЦУКРОВОМУ ДІАБЕТІ

Цукровий діабет (ЦД) є глобальною актуальною соціальною проблемою XXI століття. Метою даного огляду літератури: є аналіз фізіологічних властивостей та фармакотерапевтичних можливостей карбоксітерапії, а також досвіду застосування даного методу для лікування ЦД. Матеріали і методи дослідження. Наукові публікації в зарубіжних та вітчизняних журналах переважно за останні 5 років, інтернет ресурси по карбоксітерапії як методу лікування ЦД. Результати досліджувати і їх обговорення. В результаті аналізу літератури були зіставленні механізми реалізації фармакологічних ефектів карбоксітерапії з окремими ланками патогенезу ЦД. Проаналізовані механізми і ефекти карбоксітерапії як ефективного альтернативного методу лікування ЦД та його ускладнень. Представлені дані свідчать про раціональність застосування карбоксітерапії як альтернативного методу лікування ЦД та його ускладнень. Висновки. З огляду на сучасні можливості фармакотерапії ЦД та більш ніж п’ятдесятирічний досвід застосування карбоксітерапії в практичній медицині дозволяє рекомендувати цей інноваційний метод як альтернативну off-label терапію ЦД. Ключові слова: цукровий діабет, лікування, карбоксітерапія. EXPERIENCE AND PROSPECTS OF CARBOXYTHERAPY IN DIABETES MELLITUS Drogovoz S. M.1, Belik G. V.1, Kalko К. О.1, Bondariev Ye. V.1, Derymedvid L. V.1, Orlenko І. V.1, Shtroblya А. L.2 National University of Pharmacy, Kharkiv, Ukraine Uzhgorod National University, Uzhgorod, Ukraine Diabetes mellitus (DM) is a global topical social problem of the XXI century. The aim of this literature review is to analyze the physiological properties and pharmacotherapeutic possibilities of carboxytherapy, as well as the experience of this method for the treatment of diabetes. Materials and methods. Scientific publications in foreign and domestic journals mainly for the last 5 years, online resources on carboxytherapy as a method of DM treating. Results and discussions. As a result of the literature analysis, the mechanisms of implementation of the pharmacological effects with separate links of the pathogenesis of diabetes were compared. The mechanisms and effects of carboxytherapy as an effective alternative method for treating diabetes mellitus and its complications have been analyzed. The presented data indicate the rational use of carboxytherapy as an alternative method for treating diabetes and its complications. Conclusions. Given the current possibilities of pharmacotherapy of diabetes and more than fifty years of experience in the use of carboxytherapy in practical medicine allows us to recommend this innovative method as an alternative to off-label therapy of diabetes. Key words: diabetes mellitus, treatment, carboxytherapy.

Cardiovascular ultrasound implementation for a pragmatic approach to the diabetic patient

The tailoring of the management of diabetes is the fundamental task of the diabetologist who requires very different skills to guarantee the best diagnostic path and the best treatment for patients. To enrich the range of “measures” necessary for this customization process, it is now possible to use a tool that is now accessible to everyone: the ultrasound machine. Through some simple ultrasound scans, using a minimum amount of time, it is possible to acquire useful information for correct patient stratification and for a rational therapeutic approach, as recommended by the guidelines. The path for the certification of the skills of the diabetologist expert in the management of cardiovascular complications could be the natural context for the placement of these techniques. KEY WORDS diabetes mellitus; cardiovascular complications; tailoring of therapy; echocolordoppler; echocardiography.

The effects of gallic acid and metformin on male reproductive dysfunction in diabetic mice induced by methylglyoxal: An experimental study

Background: Diabetes mellitus is a disease that has reached a dangerous point. Today, nearly 500 million men and women around the world live with diabetes. Gallic acid (Gal) affects diabetes. Objective: To evaluate the effects of Gal and metformin (met) on the levels of glucose, insulin, testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), sperm count, antioxidant status, and histological changes in the testes of diabetic mice induced by methylglyoxal (MGO). Materials and Methods: In this experimental study, 50 male adult NMRI mice, weighting 25-30 gr, aged 3-4 months were randomly divided into five equal groups (n = 10/each). (i) Control (vehicle, normal saline), (ii) MGO (600 mg/kg/d) orally for 28 days, (iii) Gal (50 mg/kg/d), (iv) MGO+Gal, and (v) MGO+met (200 mg/kg/d). Gal and met were administered orally for 21 consecutive days after the induction of diabetes. Blood samples were taken at 24 hr after the latest doses of treatment. Histological assessment of the testis was done, and the epididymis sperm count was obtained. Antioxidant indices, glucose, insulin, LH, FSH, and testosterone levels were measured. Results: In the MGO group compared to the control group, insulin, glucose (p = 0.001), LH (p = 0.04) and malondialdehyde (p = 0.001) were increased. However, the level of testosterone (p = 0.001), seminiferous tubule diameters, epithelial height, sperm count, superoxide dismutase activity (p = 0.02), and testis volume (p = 0.01) were decreased. The results indicated that Gal and met ameliorated the MGO effects. Conclusion: These findings suggested that the animals receiving MGO became diabetic. According to the results, Gal and met can effectively prevent MGO-induced diabetes. The effect of Gal was equivalent and sometimes better than metformin. Key words: Diabetes mellitus, Gallic acid, Male reproductive system, Metformin, Mice.

The method of viscodissection with contrast enhancement of posterior hyaloid membrane for proliferative diabetic retinopathy surgery

Purpose. Study is to evaluate the efficacy of the method of viscodissection with contrast enhancement of posterior hyaloid membrane in PDR surgery. Material and methods. The study involved 26 patients with type 1 diabetes mellitus and severe PDR with the presence of tractional retinal detachment (TRD). All patients received treatment in the volume of lensectomy and IOL implantation, microinvasive vitrectomy, viscodissection with contrasting of epiretinal structures was performed, followed by segmentation and removal of membranes, endolaser coagulation followed by tamponade with sterile air of the vitreous cavity. Results. In all patients included in the study, with dynamic observation, there was a positive dynamics of morphofunctional indicators - best corrected visual acuity (BCVA) from 32.5-16.1 to 62.2-15.7 and central retinal thickness (CRT) according to optical coherence tomography (OCT) from 775.9-78.4 to 492.1-73.8 µm. Conclusion. The method of viscodissection with simultaneous contrast of the posterior hyaloid membrane facilitates the assessment of the quality of the separation of pathological membranes and improves the quality of visual control over the process of their separation, which reduces the risks of iatrogenic retinal breaks. Key words: diabetes mellitus, proliferative diabetic retinopathy, vitreoretinal surgery, viscodissection.

Vaccination in special populations: pregnancy and patients with cancer

The current COVID-19 pandemic and the strategies implemented for tackling its spread have highlighted the importance of vaccination strategies for immunization from communicable diseases. Vaccinations are one of the most effective preventive tools in Public Health, being able to effectively and safely prevent the development of some infectious diseases, their complications, and their spread. Compared to the general population, there are groups of individuals who present a specific risk of contracting particular infections or developing more serious consequences. The purpose of this brief review is to describe the vaccination strategies currently recommended for pregnant women and cancer patients, paying particular attention to subjects simultaneously suffering from diabetes and providing some specific information on COVID-19 vaccination. The knowledge of this constantly evolving issue, also in relation to special populations such as pregnant or lactating women and cancer patients, allows Diabetologists to safeguard the undisputed health and social value of this fundamental preventive strategy. KEY-WORDS diabetes mellitus; pregnancy; cancer; vaccination; COVID-19.

Diabetes management in telemedicine: patients’ opinion (preliminary data)

With the outbreak of the COVID-19 pandemic and the resulting restrictions, telemedicine has enabled healthcare to be provided to patients with chronic diseases, although with some restrictions. During the lockdown The Campania region was the first to order (03/27/2020), to protect the health of citizens suffering from diabetes mellitus, the use of telemedicine and a tele-health service was activated in our clinics. At the end of the consultation, a survey was submitted to our diabetic patients in order to evaluate their opinion about the telemedicine experience in comparison with the traditional clinic visit. 100% of both type 1 and type 2 patients consider the telemedicine visit adequate, 89.2% of types 1 and 75.9% of types 2 consider the two forms of visit absolutely overlapping from a professional point of view, and even 6.9% of type 2, but none of type 1, considers the tele-visit more effective than the traditional visit. However, only 44.8% (type 2 diabetic patients) and 13,5%% (type 1 diabetic patients) expressed a preference for telemedicine visits over traditional visits. Telemedicine has allowed continuity of care for diabetic patients despite the difficulties of this emergency time. We believe that the opinion of patients and health care professionals on the telemedicine experience can be useful to assess the limitations and advantages in order to improve and enhance the use of this method. KEY WORDS diabetes mellitus; telemedicine system; survey.

Evaluation of complications of the late postoperative period in patients with diabetes mellitus after drainage surgery of neovascular glaucoma

Today diabetes mellitus (DM) is one of the leading medical and social problems. Its complications lead to terrible concomitant pathologies that qualitatively affect the lives of patients. At the end of 2019, there were more than 463 million people with diabetes in the world and this number is increasing every year. Diabetic retinopathy (DR) is one of the most severe complications of DM on the organ of vision. Secondary neovascular glaucoma (NG) is a manifestation of the end-stage proliferative DR. This is a relatively rare but difficult-to-treat pathology that often leads working-age patients to disability and impaired social adaptation. The main objective of treatment for NG is to compensate for intraocular pressure (IOP), but conservative (drug) therapy is often ineffective. Therefore, doctors are forced to use surgical methods of treatment. At the same time, do not forget about the multiple complications during the operation, as well as in the early and late postoperative periods. A special feature of the course of NG in patients with DM is its combination with the failure of the ligamentous-capsular apparatus of the lens, iris bombage, anterior and posterior synechiae, traction retinal detachment and various hemorrhagic complications. All this allows us to talk about the so-called diabetic glaucoma (DG). Currently, drainage devices have become the standard in the treatment of refractory NG. The effectiveness of such operations according to various sources is about 70-80% of success. Purpose. To assess the condition of patients with DM in the late (10-15 years) postoperative period after performing NG drainage surgery, to analyze the effectiveness of the intervention by studying the dynamics of IOP, the presence or absence of pain syndrome and various intraocular complications. Material and methods. During the period 2006-2020, 150 patients with NG and DM were operated on in the Department of Diabetic Retinopathy of the Federal State Budgetary Institution «Endocrinology Research Centre» of the Ministry of Health of the Russian Federation. Results. In 100% of the postoperative period, the pain syndrome was stopped. And also, in 59.7% of cases, the presence of late complications: vascular thorn, EED, subatrophy and anophthalmos. Conclusion. Despite the presence of complications, drainage surgery in patients with DM continues to be an effective method of choosing surgical treatment for patients with uncompensated NG. Key words: diabetes mellitus; diabetic retinopathy; neovascular glaucoma; drainage surgery.

Approach toward diabetic nephropathy and its management in patients with type 2 diabetes: results of a web-based italian survey

AIM The purpose of this survey was to investigate the attitudes and clinical approach of Italian diabetologists toward diabetic nephropathy (DN). METHODS A 28-item web survey was distributed to Italian diabetologists by the Associazione Medici Diabetologi. The first part of the questionnaire was aimed at describing the sample of clinicians involved (age, gender, practice setting, etc.). The second part analyzed more deeply the clinical approach to DN. RESULTS Two hundred and thirty-five clinicians, expert in the field (over 44% have been working as diabetologists for more than 20 years) and well distributed across the country, participated in the survey. The lack of medical care provided from a team remains a main concern, since only in a minority of diabetes centers diabetologists can collaborate with health professionals with expertise and a special interest in diabetes. Screening of DN is performed at first visit by 95% of participants. Urinary albumin creatinine ratio and estimated glomerular filtration rate by CKD-EPI are two approaches used. The relevance of intensive glycemic treatment respect to the onset and progression of DN is mostly considered in patients with microalbuminuria, less frequently in patients with more advanced kidney disease. Almost the totality of participants prescribes renin angiotensin system blocking drugs for the treatment of hypertension, mainly in presence of albuminuria. This class of drugs is less frequently recommended in normotensive patients with microalbuminuria. Regarding the new anti-hyperglycemic drugs, more attention is paid for SGLT2 inhibitors or GLP-1 receptor agonist. CONCLUSIONS The present survey highlights the clinical relevance of DN and the high attention for this diabetic complication by Italian diabetologists. Although the lack of medical care provided from a team remains a main concern, the diabetologists are engaged in promoting educational and screening programs. They are also in keeping with guidelines in choosing antihypertensive treatment or new antihyperglycemic drugs showing to protect kidney function. Finally, participants to the survey declare that they are willing to collaborate with nephrologists, mainly in the more advanced stage of DN. KEY WORDS diabetes mellitus; chronic kidney disease; SGLT2 inhibitors; GLP-1 receptor agonist; diabetic nephropathy.

ANALISIS DRUG RELATED PROBLEMS (DRPs) PADA PASIEN RAWAT JALAN DIABETES MELITUS TIPE 2 DI UPT PUSKESMAS RAWAT INAP GEDONG AIR BANDAR LAMPUNG

Abtract Diabetes mellitus (DM) is a serious chronic disease that occurs because the pancreas does not produce enough insulin or when insulin is not use effectively in the body. This study aims to analyze the incidence of Drug Related Problems (DRPs) and find out the category of DRPs in outpatients with a diagnosis of type 2 diabetes mellitus at UPT Puskesmas Gedong Air Inpatient for the Bandar Lampung. This research is a nonexperimental research with a descriptive design taken retrospectively. The sampling technique used in this study is total sampling based on the patient's medical record data. Data were analyzed using the classification of DRPs according to Cipolle 2004, then using Medscape Tools as a tool to check potential drug interactions. The results of this study were 61 patients including 29 patients (46%) with DRPs and 33 patients (54%) without DRPs. The number of male patients is 25 patients and the number of female patients is 36 patients with age range 25-45 and 46-65. A total 52 patien Type 2 Diabetes Mellitus have cormobid and 9 patients without comorbid. DRP categories that occur include drugs without indication as much (8%), indications without drugs as much as (15%), and potential drug interactions (48%). The conclusion in this study is that Drug Related Problems (DRPs) have occurred in outpatients diagnosed with type 2 diabetes mellitus in UPT Puskesmas Gedong Air Inpatient with the highest DRPs category is the potential for drug interactions (48%). Key words: Diabetes Mellitus Type 2, Drug Related Problems