Search

Neonatal diabetes mellitus (NDM), defined as diabetes with an onset during the first 6 months of life, is a rare form of monogenic diabetes. The initial publications on this condition began appearing in the second half of the 1990s and quite surprisingly, the search for new NDM genes is still ongoing with great vigor. Between 2018 and early 2024, six brand new NDM‐genes have been discovered (CNOT1, FICD, ONECUT1, PDIA6, YIPF5, ZNF808) and three genes known to cause different diseases were identified as NDM‐genes (EIF2B1, NARS2, KCNMA1). In addition, NDM cases carrying mutations in three other genes known to give rise to diabetes during childhood have been also identified (AGPAT2, BSCL2, PIK3R1). As a consequence, the list of NDM genes now exceeds 40. This genetic heterogeneity translates into many different mechanism(s) of disease that are being investigated with state‐of‐the‐art methodologies, such as induced pluripotent stem cells (iPSC) and human embryonic stem cells (hESC) manipulated with the CRISPR technique of genome editing. This diversity in genetic causes and the pathophysiology of diabetes dictate the need for a variety of therapeutic approaches. The aim of this paper is to provide an overview on recent achievements in all aspects of this area of research. [ABSTRACT FROM AUTHOR]

Diabetes is a widespread disease that needs to be controlled. Therapeutic monitoring of drugs is very helpful in maintaining desirable doses. To study a correlation between the blood level of metformin (to a lesser extent, glimepiride) and genotyping (mainly the SULT1A1 genotype). Determine drug levels using a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) tool. A validated LC-MS/MS method was developed to determine metformin and glimepiride levels in human plasma. DNA extraction was performed using Jena Bioscience’s Blood DNA preparation, in which a column kit was used to extract DNA for genetic polymorphism. The investigation was carried out using both medications in type 2 diabetes patients alongside the genetic polymorphism. One hundred and six patients were assessed. The prevalence of homozygosity for SULT1A1 and wild-type CYP2D6 * 4 were 72.6% and 73.6%, respectively. After adjustment for daily intake of metformin, three patients out of five with the highest levels of metformin had no homozygosity (SULT1A1 genotype). Statistically, variables that demonstrated an insignificant correlation with the level of metformin were body mass index (rs (87) = 0.32, P = 0.011) and age (rs (87) =0.26, P = 0.017). The homozygous (SULT1A1 genotype) correlation was moderate (rs (87) =0.21, P = 0.052). According to the findings, patients with the wt/wt CYP2D6 genotype had considerably greater levels of endoxifen than those with the v/v CYP2D6 genotype. The study’s results reported a probable correlation between the blood level of metformin (to a lesser extent, glimepiride) and genotyping (mainly the SULT1A1 genotype). Genotype-guided drug therapy may provide a novel contribution to maximize drug efficacy and/or minimize toxicity.

BACKGROUND: Coronavirus disease (Covid-19) causes a systemic inflammatory syndrome with pulmonary involvement. Rheumatological involvement in patients with mild clinical forms of Covid-19 is uncertain. Diabetes mellitus (DM) is known to increase susceptibility to viral infections. Also, patients with DM have a reduced Angiotensin converting enzyme 2 (ACE2) expression that might contribute to the increased predisposition to severe lung injury. The aim of the work is to study the rheumatological manifestations with assessment of ACE2 level in post COVID patients with and without diabetes mellitus (DM). METHODS: We included a total of 160 consecutive patients in Covid-19 convalescent phase (after clinical recovery), all of them diagnosed with a positive PCR test. All participants were divided into two categories: 80 patients with COVID-19 and DM and another 80 patients with COVID-19 without DM. All patients subjected to history taking, clinical assessment, laboratory investigations (including serum ALT, AST, Albumin, Urea, Creatinine, FBG, HBA1c, Procalcitonin, CRP, Hemoglobin, WBC, Platelet count, Neutrophile count, Lymphocyte count, D-Dimer and ACE2). RESULTS: Patients with DM have a higher significant mean serum level of ACE2 (43.90 ± 20.04). Regarding post COVID rheumatological manifestation, patients with DM have a higher significant severe arthralgia and arthritis with higher significant serum level of anti-nuclear antibody (ANA), rheumatoid factor (RF) and Anti-citrullinated protein (CCP) (p < 0.05). COCLUSIONS: We found that COVID-19 patients with D.M have a higher risk of rheumatological complications with higher level of ACE2 than COVID-19 patients without D.M. [ABSTRACT FROM AUTHOR]

Contexto: según datos de la Federación Internacional de Diabetes (IDF, según sus siglas en inglés) correspondientes al año 2021, tres de cada cuatro pacientes con diabetes viven en países de bajos o medianos ingresos y se espera que el número de individuos alcance los 783 millones para el año 2045. La diabetes fue la causa de muerte del 12,2 % de las personas en el mundo para el año 2021 y, actualmente, los países con mayor número de personas que padecen diabetes son China, India y Estados Unidos. En América del Sur, Brasil ocupa el primer lugar, seguido de México y Colombia. El manejo integral de la diabetes es recomendado en las guías y los programas de abordaje interdisciplinario que buscan un adecuado control, con disminución de hipoglucemias, de complicaciones y generación de autocuidado. La clasificación de la diabetes es un pilar fundamental en el abordaje terapéutico, pronóstico y posibles complicaciones. Objetivo: se realizó una revisión bibliográfica narrativa de la clasificación de la diabetes y sus características. Metodología: se realizó una búsqueda de artículos indexados entre los años 2016 y 2022, en los buscadores Pubmed, Embase, Science Direct y Scopus. Resultados: se encontraron un total de 45 artículos y se seleccionaron 19 por conveniencia. Conclusión: una adecuada clasificación de la diabetes mejora el pronóstico, previene complicaciones y disminuye los gastos. La clasificación de la Asociación Americana de Diabetes y las variables propuestas no son suficientes para subclasificar los fenotipos de la diabetes mellitus tipo 2. El uso de más variables en la subclasificación generará un proceso más complejo, pero permitirá una mejor precisión en tratamientos, prevención de complicaciones y disminución de costos.

Background and Objective: Type 1 diabetes mellitus and its associated comorbidities are regarded as significant health issues. The present research aims to assess the impact of glycemic control on lipid profile of hospitalized patients with type 1 diabetes mellitus and for early diagnosis of dyslipidemia in cases with type 1 diabetes mellitus. Methods: This cross-sectional was conducted at the Pediatric Department of Al-Imamain Al-Kadhmain Medical City from March 2018 to July 2019. Information about the gender and age of the patient, the age of diagnosis and duration of diabetes, insulin therapy: 2-3 times a day, regular blood sugar checking (daily) were collected using a questionnaire. Using American Diabetes Association criteria, cases were separated into excellent and poor glycemic control groups, and lipid profile anomalies were compared. Findings: Out of the total of 128 people present in this study, 86 people (67%) had poor control. Increasing age of patients was associated with poor blood sugar control, so that between the ages of 13 and 18, 47 cases (54.7%) had poor control. It also increased the duration of poorly controlled diabetes. An increase in triglyceride level was evident in 76 people (88.4%), cholesterol in 52 people (60.5%) and low-density lipoprotein in 12 people (14%) among patients with poor control. Conclusion: The results of the present study showed that increasing age and duration of the disease and high levels of triglycerides, cholesterol and low-density lipoprotein are predictors of poor glycemic control in children with type 1 diabetes.

Diabetes is a widespread disease that needs to be controlled. Therapeutic monitoring of drugs is very helpful in maintaining desirable doses. To study a correlation between the blood level of metformin (to a lesser extent, glimepiride) and genotyping (mainly the SULT1A1 genotype). Determine drug levels using a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) tool. A validated LC-MS/MS method was developed to determine metformin and glimepiride levels in human plasma. DNA extraction was performed using Jena Bioscience's Blood DNA preparation, in which a column kit was used to extract DNA for genetic polymorphism. The investigation was carried out using both medications in type 2 diabetes patients alongside the genetic polymorphism. One hundred and six patients were assessed. The prevalence of homozygosity for SULT1A1 and wild-type CYP2D6 * 4 were 72.6% and 73.6%, respectively. After adjustment for daily intake of metformin, three patients out of five with the highest levels of metformin had no homozygosity (SULT1A1 genotype). Statistically, variables that demonstrated an insignificant correlation with the level of metformin were body mass index (rs (87) = 0.32, P = 0.011) and age (rs (87) =0.26, P = 0.017). The homozygous (SULT1A1 genotype) correlation was moderate (rs (87) =0.21, P = 0.052). According to the findings, patients with the wt/wt CYP2D6 genotype had considerably greater levels of endoxifen than those with the v/v CYP2D6 genotype. The study's results reported a probable correlation between the blood level of metformin (to a lesser extent, glimepiride) and genotyping (mainly the SULT1A1 genotype). Genotype-guided drug therapy may provide a novel contribution to maximize drug efficacy and/or minimize toxicity., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Advanced Pharmaceutical Technology & Research.)

Atorvastatin, a widely prescribed 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitor (HMG-CoA reductase inhibitor), is associated with various adverse effects, including many dermatologic manifestations. We present the case of a 73-year-old man who developed eosinophilic spongiosis shortly after initiating atorvastatin therapy, an adverse effect which to our knowledge has not yet been reported in association with atorvastatin. Our investigation explores the clinical and histopathologic characteristics of eosinophilic spongiosis induced by atorvastatin, delving into potential mechanisms behind statin-induced eosinophilia. A literature review, focusing on atorvastatin's dermatological side effects, revealed a limited number of relevant studies, emphasizing the scarcity of documented cases. Our aim is to raise awareness of eosinophilic spongiosis as a potential side effect of atorvastatin, emphasizing its impact on patients' quality of life. This case prompts further research into the mechanisms underlying such dermatologic reactions, contributing to a better understanding of atorvastatin's diverse adverse effects., Competing Interests: This work was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare-affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities. This material is the result of work supported with resources and the use of facilities at the Orlando VA Healthcare System (Orlando, Florida). The contents of this publication do not represent the views of the Department of Veterans Affairs or the United States Government., (Copyright © 2024, Al-Moussally et al.)

In patients with diabetes, diabetic ketoacidosis (DKA) is a well-documented potential complication, usually presenting with hyperglycemia, anion gap acidosis, and positive ketones. Metformin toxicity in the setting of acute renal failure is also a well-known cause of lactic acidosis. However, metformin-induced euglycemic ketoacidosis is less well-known or studied. We report a case of metformin toxicity in the setting of acute renal failure with both lactic acidosis and ketosis and an initial confounded clinical presentation of sulphonylurea-induced hypoglycemia. A high index of suspicion for metformin-associated lactic acidosis (MALA) and metformin-associated lactic acidosis with euglycemic ketoacidosis (MALKA) should be in place in patients who are taking metformin and presenting with acute renal failure and euglycemia., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Al-Moussally et al.)