diabetes

Objectives: Type-2 diabetes mellitus, caused by impaired secretion of insulin, is becoming one of the health hazardous threats to human lives across the world. Its prevalence is rising with time. In this study, 2750 phytochemicals, that are considered to have great ability to eliminate diseases caused by different viruses and bacteria, are obtained from different medicinal plants and discovery of inhibitors through in silico method was performed against Dipeptidyl peptidase-4 (DPP4). Method: The pharmacological assessment and pharmacokinetics of phytochemicals, molecular docking and density functional theory (DFT) analysis helped to explore the inhibitory action of phytochemicals against DPP4. Total forty-nine phytochemicals were screened initially to reduce the number of compounds to be analyzed further based on a threshold of binding affinity ≥ -5.5 kcal/mol and were considered for further computational studies to analyze their inhibitory effects for DPP4. For comparison and validation of the results of present study, various previously reported and experimentally validated compounds were docked with the DPP4. For these dockings, binding affinity was predicted and compared with those of phytochemicals to check if these phytochemicals are competent enough to be used as an inhibitor in the treatment of diabetes mellitus in the future. Results: Only four phytochemicals showed binding affinity greater than those of experimentally validated compounds. These included two phytochemicals from Silybum marianum, i.e. Diprenyleriodictyol and Taxifolin and while other two phytochemicals from Santolina insularis and Erythrina Varigatae i.e. Papraline and Osajin respectively. The reactivity levels for these four phytochemicals with the binding site residues of DPP4 were obtained by DFT based analysis, in which ELUMO, EHOMO and band energy gap were computed. Conclusion: Based on these results, it is concluded that these four phytochemicals, after passing through in vitro and in vivo validation, can be utilized as potential DPP4 inhibitors as they have strong properties as compared to those of various experimentally validated inhibitors.

A 78-year-old man, known case of, diabetes mellitus, and hypertension presented with fever, dry cough and dyspnea of five-day duration. He tested positive for SARS-CoV-2 infection and was admitted to the intensive care unit as a case of severe COVID -19 pneumonia. Evaluation revealed raised inflammatory markers CRP: 92.2 mg/ml, LDH: 556 IU/L, Ferritin: 286 ng/ml, D-dimer: 3716 ng/ml. On day 9 of illness, he developed numbness, pain and discoloration of right hand.

Ginseng extracts are often used as adaptogen to improve mental performances and well being, helping to overcome stress. Thus, in our times a lot of ginseng extracts are continuously produced and sold into commercial channels. Both Asian and Korean red ginseng (Panax ginseng) and American ginseng (Panax quinquefolius) are the most extensively used and researched. Both Panax ginseng and Panax quinquefolium contain different types of saponins, also known as ginsenosides, which are the substances that give ginseng medicinal properties. Human and animal studies showed that ginseng extracts can also have hypoglycemic effects. The mechanisms by which ginseng reduces blood glucose levels are unclear; some mechanisms have been proposed to explain its hypoglycemic effect, especially modulating effects on insulin sensitization and/or insulin secretion and regulating actions on digestion and intestinal absorption. We describe a case of hypoglycemia by ginseng in type 2 diabetic patient treated with oral hypoglycemic agents. Although, in order to provide better assessments of a sure anti-diabetic efficacy of ginseng, larger and longer randomized controlled clinical trials will be required, in our case we think that we have enough evidence to believe that the cause of hypoglycemia was ginseng. Obviously, this report should not be taken as a proof of the hypoglycemic effect of ginseng, nor it wants to be a suggestion to use ginseng in the treatment of diabetes; instead, it wants to be an alert for patients and clinicians to avoid hypoglycemia in daily clinical practice.

In 1955, nutrient malabsorption following upper gut surgery was shown to be related to altered upper gut microbiome. In individuals with abdominal symptoms after Roux-en-Y gastric bypass, we have reported that small intestinal glucose malabsorption is associated with upper gut bacterial overgrowth. We hypothesize that individuals with abdominal symptoms after vertical sleeve gastrectomy have glucose malabsorption associated with upper gut bacterial overgrowth, and to test this hypothesis, bacterial overgrowth and potential glucose malabsorption are examined after sleeve gastrectomy. This is a retrospective study of individuals with medically-complicated obesity who underwent sleeve gastrectomy from 2013 to 2016 with subsequent glucose hydrogen breath testing to evaluate abdominal symptoms. A fasting breath hydrogen or methane of ≥10 PPM or rise of ≥8 PPM ≤45 minutes after oral glucose is bacterial overgrowth, while glucose malabsorption is a second rise of ≥8 PPM at >45 minutes. Seven females (mean age: 48.0 years; mean body mass index at surgery: 45.7 kg/m2) are described. Five subjects (71%) have an early rise in hydrogen or methane, while three (43%) have a second rise in hydrogen or methane >45 minutes after glucose. The mean percent excess weight loss at one year was 40% in three individuals with a second peak and 46% in four subjects without a second peak. After sleeve gastrectomy, subjects have glucose malabsorption associated with the presence of bacterial overgrowth. Completion of a larger prospective study is needed to confirm and expanding upon these findings. Further work should examine the potential effects of bacterial overgrowth on expression of intestinal glucose transporters.

The main disturbing situation faced by any individual is obesity nowadays. Obesity occurs because of overweight and this has several reasons to gain weight like hereditary, diabetes, diet, aging, PCOS in women, stress, and tiredness. It is a major, sustaining, worsening condition of energy regulation with severe hereditary and early life natural causes. However, there are ways that we can treat obesity, but the complication emerges with the side effects. One way of treating obese by using lifestyle intervention involving exercise, maintaining a proper diet, and pharmacotherapy. Following this method does not affect much as mostly it includes lifestyle intervention. However, by using lifestyle intervention we could reduce weight to a certain extent only.

Type 2 diabetes is a common disease in these days and day by day it is arising. The main focus of the study was to investigate association of packed cell volume (PCV), Mean Corpuscular Volume (MPV), Mean Corpuscular Hemoglobin Concentration (MCHC), Red Cell Distribution Width (RDW) with glycemic marker HbA1c. So that PCV, MPV, MCHC, RDW could be used as a predictor of glucoregulation in type 2 diabetes instead of HbA1c value. This study included 87 DMT2 patients, which divided into two groups, A (n=41, presence in diabetics≤6.5-6.9%) and B (n=46, target in diabetes≥7.0%), according to HbA1c values. Spearsman correlation co-efficients were calculated to evaluate the relationship between RBC count, MCHC, RDW with random blood sugar (RBS) and PCV, MCV, MCHC with HbA1c value. Binominal logistic regression analysis was performed to estimate the relationship between glycemic control, as dichotomous outcome of MCHC, RDW, PCV, and MCV as the main prognosticator. MCHC and RDW were significantly higher in the group B compared to the group A. RDW and MCHC may be applied as the auxiliary indicators of deterioration of glucoregulation.

In this review After Observing biomedical literature (starting from some heart disease) results that some pathological phenomena are deeply involved in some metabolic endocrine condition: Kinetics and gradients in metabolism, catabolism, time related, toxic like effect, electrical cell membrane status, smooth vascular muscle cell hyper-reactivity, platelet iperactivations, central autonomic control after acute stroke, great electrolytes unbalances et other factors as pro-hypertrophic signaling and oxidative stress. Observing actual current therapy in some metabolic endocrine therapy often is used association of drugs (in example in type II diabetes). In Many other pathologies efficacy drug therapy exist, and often only 1 pharmacological molecule resolve the pathological condition. But in many disease even associating 2-3-4 drugs the % of cure not increase (efficacy, effectiveness). It mean that this drugs strategies are not the really best? Or it mean a low active level? Why for this pathological condition this association drugs in currently use not do the right works as really needed? There is the need for new really efficacy drugs strategy that show a profile of efficacy as requested in order to resolve the pathological condition? Or to be added to the actual therapy? The actual pharmacological strategies in some metabolic endocrine disorder is really the best? Or other strategies can be introduced?

Although exercise has been proposed to be beneficial to type 2 diabetes, its effects on β-cell function and mass remain unclear. In the present study, the effects of long-term swimming training on the function and mass of β-cells in diabetic OLETF rats were examined. At 44 weeks of age after developing diabetes, the OLETF rats were divided into two groups: a control group and an exercise group. The exercise group had a daily swimming for 12 weeks. While not found with the control rats, in the obese OLETF rats, the exercise reduced the weight gain which was associated with improved glucose tolerance and elevated circulating insulin levels as determined by the oral glucose tolerance test and insulin ELISA. The exercise improved plasma total cholesterol and triglyceride levels, and also significantly increased the islet β-cell mass and pancreatic insulin content associated with decreased β-cell apoptosis and elevated activation of the serine/threonine kinase, Akt. The present studies suggest that exercise improves diabetes symptoms via enhancement of the β-cell mass and function through decreasing glucolipotoxicity and reducing β-cell apoptosis by activating Akt in obese OLETF rats.

Aim: The aim of the present study is to assess the efficacy and safety of Hydroxychloroquine in comparison with Teneligliptin in type 2 diabetes patients whose blood glucose levels were inadequately controlled with metformin, Glimepiride and insulin therapy. Methods: This was a randomized, prospective, parallel-group, experimental trial done in 300 Type 2 Diabetes patients who were uncontrolled (HbA1c=7.5–10%) with metformin, Glimepiride and insulin therapy. Patients were randomly divided into two groups one received Teneligliptin 20 mg (n=152) and other received Hydroxychloroquine 400 mg (n=148) while continuing insulin therapy with other 2 OHA. Insulin doses were adjusted to maintain normal blood glucose levels. Result: The adjusted mean change from baseline to endpoint in HbA1c was −1.2±0.5% in patient group receiving Hydroxychloroquine and −0.9±0.5% in patients group receiving Teneligliptin, respectively, with a significant between-treatment difference (p<0.001). The incidence of adverse events was similar in the Hydroxychloroquine (72%) and Teneligliptin (77%) groups. However, hypoglycaemic events were less common (p<0.001) and less severe (p<0.05) in patients receiving Hydroxychloroquine than in those receiving Teneligliptin. Conclusion: Hydroxychloroquine decreases HbA1c in patients whose type 2 diabetes is poorly controlled with high doses of insulin as compare to Teneligliptin. Addition of hydroxychloroquine to insulin therapy is also associated with reduced incidence of confirmed and severe hypoglycaemia.

Diabetes mellitus increases the possibility of different cancers. Scientists have substantiated the link of diabetes with increased prevalence, augmented progression and improved cancer aggression. Research has strengthened link of diabetes with the colorectal cancer risk among various cancers. Diagnosis and treatment have made some progress in recent years, but Colorectal is major issue for the health of people even today. In order to reduce cancer mortality, there is importance of prophylaxis, evaluation and proper treatment. Factors distressing cancer prognosis is required by policy-making system for beneficial approaches of cancer patients and improvement of disease. Eventually diabetes- specific strategies for different cancers are explored.

Our research aimed to check the impact of some significant risk variables on diabetes growth and the specific goal of this study was to evaluate the connection of industrial fields with diabetes risk variables. The current research also informs us about the most important risk factor for male and female people with diabetes. A cross-section and convenient sample of 100 people, male and female, without discernment of risk factors and diabetes mellitus (Meta-Analysis on the effect of major risk factors on the diabetic patients form Jinnah Hospital Lahore). The risk factors in the general assessment i.e. lack of exercise, kidney problems, high ranges of tests and residence in industrial areas are found to be significant. Assessment of these factors is helpful in early diagnosis and in prognosis of diabetes.

The measures put in place by many governments around the world to fight the spread of COVID-19 have drastically reduced visits to diabetes centres. To keep providing people with diabetes the professional support they need and reduce the inconvenience caused by the interruption of traditional assistance, the typical control visit can be carried out by virtual visit, telemedicine (TM) that should have the necessary characteristics to provide a correct execution. Especially this is important for pregnant women first diagnosed with gestational diabetes mellitus (GDM), they have the necessity to frequent checks in a short time due to the pregnancy.

Metabolic syndrome composed of abdominal obesity, atherogenic dyslipidemia, raised blood pressure, insulin resistance and/or glucose intolerance, proinflammatory state and prothrombotic state is a complex multisystem disorder. It is well known that patients with metabolic syndrome have increased cardiovascular risk and risk of developing diabetes type II. But besides these well known risk states, there are other conditions such as polycystic ovary syndrome, fatty liver, cholesterol gallstones, asthma, sleep disturbances and some forms of cancer associated with a metabolic syndrome. In this case report we will present a patient who developed many of these conditions related to the metabolic syndrome and will highlight the novel efforts regarding to the lifestyle changes, primarily weight loss.

Central Diabetes Insipidus (CDI) results from the inability to secrete ADH secreted by the neurohypophysis system to control water-electrolyte metabolism. In the etiology of CDI in childhood, many congenital and acquired central nervous system (CNS) tumors (germinoma, pinealoma, craniopharyngioma, optic glioma, acute myeloid leukemia), infiltrative diseases (Langerhans cell histiocytosis, sarcoidosis), infections (meningitis, tuberculosis, encephalitis), autoimmune events, head trauma, idiopathic) can be responsible [1]. Hibernomas, which are very rare in childhood, may also rarely involve the central nervous system.

Diseases - diabetes mellitus (especially type 1) and autoimmune diseases are incurable diseases. In type 1 diabetes, the beta cells of the tail of the pancreas die. It is in the beta cells of the tail of the pancreas that insulin is located, a hormone that maintains normal blood sugar levels in patients with type 1 diabetes. Until now, no methods have been known to restore dead pancreatic beta cells. Methods for restoring the lymphoid system in patients with autoimmune diseases were not known. With these diseases, the normal properties of the lymphoid system are lost. This review aims to present materials on the effective treatment (cure) of these diseases. For the treatment, the resonance therapy method was used, which has been known for at least 25 years and which has been modified in our work since 2016. The essence of our modification was that the author began to use 1. Not only low (previously known) but also high potencies of resonant drugs. 2. We have created a direction in resonance therapy, which is called “resonance of creation.” So far, only the direction is known as “resonance of destruction” is known, with the help of which oncological tissues, infectious processes, cysts, stones, etc. are treated - destroyed. With the help of the resonance of creation, various biological structures that have undergone degeneration and death are restored - the myelin sheath of the nerves in multiple sclerosis, nerve cells in Parkinson’s disease and Alzheimer’s disease, etc. With the help of the resonance of creation, the beta cells of the tail of the pancreas are restored in type 1 diabetes and restoration of the lymphoid system in autoimmune diseases. So, in patients with autoimmune diseases, organ preparations were tested: “lymph nodes”, “lymphocytes”. It turned out that in all patients with various autoimmune diseases, lymph nodes, and lymphocytes were tested as being in a degenerative state. There was not a single patient whose lymph nodes and lymphocytes were tested as normal. The task was to normalize the functional state of the lymph nodes and lymphocytes in our patients and thereby take an important step towards curing their autoimmune disease. To this end, it was necessary to increase the potency of the lymph nodes and lymphocytes in the same way as we did it in relation to the beta cells of the pancreas in patients with diabetes mellitus, in relation to the substantia nigra of the midbrain in patients with Parkinson’s disease and in relation to the myelin sheath. Nerves in multiple sclerosis. After testing organ preparations: “lymph nodes”, and “lymphocytes” in patients with autoimmune diseases, the potency was selected, which led to the fact that lymph nodes and lymphocytes were no longer tested as degenerated formations. It was this potency of lymph nodes and lymphocytes that was the basis for the treatment of patients. Thus, as a result of the treatment of diabetes mellitus (especially type 1) and autoimmune diseases by resonance therapy, these diseases become curable.

Cancer metastasis to the pituitary gland is rare, but in most cases, it originates from a late-stage breast tumor or lung cancer. The most common symptoms of metastasis to the pituitary gland are diabetes insipidus and visual disturbance. The common site of metastasis is the posterior portion of the pituitary gland because it is highly vascularized. Metastases to this site represent 1% of all tumors [1]. Metastasis to the pituitary gland is difficult to diagnose by hormonal analysis and magnetic resonance imaging of the brain and requires biopsy for confirmation [2].

Objectives: To examine the effect of dietary supplements on diabetic risk progression, blood glucose level, and lipid profiles.Methods: A randomized, double-blind, placebo-controlled study was conducted at Rajavithi hospital, Thailand. Participants with prediabetes were randomly allocated to three arms of dietary supplements: placebo (PL) or curcumin plus fish oil and vitamin D (CFD), or curcumin plus fish oil (CF) for 24 weeks. Primary outcomes were the progression of glycemic status and the progression to overt diabetes at 24-week and 36-week follow-ups. Secondary outcomes were changes in glycemic profiles (fasting plasma glucose, 75 g OGTT 2-h plasma glucose or HbA1C), body weight, BMI and lipid profiles.Results: A total of forty-seven participants (PL, n = 16; CFD, n = 15; CF, n = 16) were included in the study. At the 24-week follow-up, the participants with worsening glycemic status in the intervention groups were lower, CFD, CF and Placebo, 14.29%, 13.33% and 31.25%, respectively. However, the primary outcome, progression of glycemic status, was statistically different, with p - value = 0.046 (p < 0.05) when excluding previous diabetes in the study. As well as the incidence of type 2 diabetes at 24-week follow-up was not statistically different between the three groups, 14.29%, 13.33%, and 12.5%, p - value = 0.699 (p < 0.05) in CFD, CF, PL group, respectively. The secondary outcomes also failed to demonstrate the effect of dietary supplements on blood glucose, lipid profiles, weight, BMI and blood chemistry.Conclusion: The combined dietary supplements which contained curcumin-fish oil-vitamin D,could lower the glycemic status progression in prediabetes at six months follow-up and were well-tolerated among the participants.

Objectives: This study aimed to compare the quality and quantity of bone at intraoral autogenous graft donor sites in type II diabetes mellitus (DM) patients versus healthy controls using cone-beam computed tomography (CBCT). Materials and methods: This case-control study was conducted on CBCT scans of 50 DM patients and 50 healthy controls between 20-70 years. Maximum height, width, length, and volume of harvestable bone at the symphysis, ramus, palate, and tuberosity were measured bilaterally. The Hounsfield unit (HU) was also calculated to assess bone quality. The two groups were compared regarding the quality and quantity of harvestable bone using an independent t-test. The effect of confounders was analyzed by the regression model (alpha = 0.05). Results: DM patients had significantly lower harvestable bone volume at the symphysis, ramus, and tuberosity than healthy controls (p < 0.001) but this difference was not significant at the palate (p = 0.957). Also, bone quality was significantly lower at the symphysis, ramus, palate, and tuberosity in DM patients (p < 0.001). Conclusion: Diabetic patients had significantly lower bone quality and quantity at intraoral graft donor sites than healthy controls. Mandibular symphysis had higher bone volume and density than ramus, palate, and tuberosity for graft harvesting in diabetic patients.

The primary objective of this study was to detect the success and short-term survival rate of dental implant prosthetic therapy. The valuation of a possible relationship between the general and local clinical conditions of the patients (presence of risk factors and type of dental implant-supported prosthesis) and the satisfaction perceived by the patient, with success and survival of implant devices was investigated.The sample trial consisted of 23 patients, for a total of 50 dental implants supporting a prosthetic therapy. Preliminarily, an analysis of averages and frequencies of the anamnestic data was presented, as numbers and percentages. The implant success rate was calculated by assessing whether the implants fulfilled the success criteria defined by the Pisa Consensus Conference. The ANOVA test was used to check whether there was an association between the success of the implant device, the anamnestic data collected, and the type of prosthesis supported by the implants. Finally, the survival rate was calculated using the Kaplan - Meier method.The 2-year success rate of 50 implants was assessed at 98%. The 2-year survival rate was 97%. Finally, sex, age, compensated diabetes, a smaller and equal number of cigarettes per day (10 per day), the BOP, and the type of titanium dental implants supported by prosthesis, do not determine a change in success and are therefore not adequate parameters to predict the outcome of implant success. Following the results obtained, it is appropriate to continue the research by expanding the clinical observation times in order to obtain more solid scientific and clinical evidence.

Background: Prophylactic dental procedures following implant placement are critical to the long-term success of implants and are also dependent on the patient maintaining effective home care.Purpose: Evaluation of the effectiveness of preventive measures in patients with diabetes during long periods after prosthetic treatment with implants.Materials and methods: The study included 62 patients with diabetes with edentulism using 146 dental implants. Patients underwent constant monitoring, including regular occupational hygiene during follow-up examinations. Their frequency was set individually from 2 to 4 times A clinical index including Bleeding on Probing (BOP), Probing Depth (PD), and Marginal Bone Loss (MBL). Results: In patients included in the preventive protocol after 12 months, the mean BOP was 1.4 ± 0.15, and PPD was 2.46 ± 0.42. After 12 months in patients mean MBL was 0.72 ± 0.6 mm, after 3 years MBL was 1.24 ± 0.25 mm. For patients who were excluded from preventive services after 12 months, the mean BOP 1.9 ± 0.25, and the mean PPD was 3.56 ± 0.28). After 12 months in patients mean MBL was 0.87 ± 0.7 mm, after 3 years MBL was 1.52 ± 0.32 mm (p > 05). Compared to persons enrolled in the preventive protocol, those in the group without services were more likely to develop peri-implantitis (42.4% vs. 12,6%). The survival rate of implants after 3 years was 98.4%. The survival rate of implants in those patients who were excluded from preventive services after 3 years was 95.4%.Conclusion: For patients with diabetes, regular medical examinations, accompanied by professional oral hygiene procedures, prevent the development of negative reactions of the soft tissues surrounding the implant.