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Not much is currently known about disturbances in insulin signaling and glucose transport in leukocytes of women with gestational diabetes mellitus (GDM) during and after pregnancy. In this study, the expression of insulin signaling (INSR, IRS1, IRS2 and PIK3R1)- and glucose transporter (SLC2A1, SLC2A3 and SLC2A4)-related genes in the leukocytes of 92 pregnant women was assayed using quantitative RT-PCR. The cohort consisted of 44 women without GDM (NGT group) and 48 with GDM (GDM group) at 24–28 weeks of gestation. GDM women were then tested again one year after childbirth (pGDM group: 14 women (29.2%) with abnormal glucose tolerance (AGT) and 34 women (70.8%) with normoglycemia). The GDM and NGT groups were closely matched for gestational age and parameters of obesity, such as pre-pregnancy body mass index (BMI), pregnancy weight, and gestational weight gain (GWG) (p > 0.05). Compared to the NGT group, the GDM and pGDM groups were hyperglycemic, but the GDM group featured a more highly insulin-resistant condition than the pGDM group, as reflected by higher fasting insulin (FI) levels and the values of the homeostasis model assessment for insulin resistance (HOMA-IR) (p < 0.05). In leukocytes from the GDM and pGDM groups, PIK3R1, SLC2A1, and SLC2A3 were upregulated and IRS1 was downregulated, with a larger magnitude in fold change (FC) values for PIK3R1 and IRS1 in the GDM group and for SLC2A1 and SLC2A3 in the pGDM group. The expression of SLC2A4 was unchanged in the GDM group but upregulated in the pGDM group, where it was inversely correlated with HOMA-IR (rho = −0.48; p = 0.007). Although the INSR and IRS2 levels did not significantly differ between the groups, the IRS2 transcript positively correlated with pregnancy weight, fasting plasma glucose, FI, and HOMA-IR in the GDM group. Our findings indicate that pronounced quantitative changes exist between the GDM and pGDM groups with respect to the expression of certain genes engaged in insulin signaling and glucose transport in leukocytes, with insulin resistance of a variable degree. These data also highlight the relationship of leukocyte SLC2A4 expression with insulin resistance in the postpartum period. [ABSTRACT FROM AUTHOR]

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Success in treating diabetes is highly dependent on the patient's satisfaction with the therapy. The aim of the study was to assess the effectiveness and satisfaction of the use of Automatic Injection System GensuPen2 device which is a pen with a spring-assisted insulin release mechanism and a laterally located trigger. 4707 adult insulin treated diabetic patients (50.44% women) from all over Poland took part in the study. For 42% of subjects, the previously used pen was changed to the GensuPen2. During the first visit demographic and medical data were gathered. HbA1c was measured and the questionnaires concerning the satisfaction with the currently used pen and evaluation of pain severity, satisfaction with the treatment (all three are 5-point scales), and the health-related quality of life (HRQoL) were filled out twice - at the beginning and after 12 weeks of the study. The mean age was 64.8±10.1 years and duration of diabetes was 9.9±6.5 years. Impaired visual function was found in 13.7% and 12.3% of the subjects had an impaired manual efficiency. After 12 weeks, HbA1c level dropped from 8.26±1.17% to 7.72±0.89% (P <0.001). Satisfaction with the use of pen increased from on average 3.33 to 4.31 points (P <0.001) after switching to GensuPen2. Evaluation of pain severity revealed that discomfort and pain related to insulin injection decreased from on average 3.82 to 2.41 points (P <0.001). Insulin therapy with the use of GensuPen2 was comfortable for 94.48% of patients. More than half of the patients were more satisfied with GensuPen2 than with the previously used pen, and 98.63% of subjects declared that they did not want to return to previous pen. Satisfaction with diabetes treatment raised from 81.2% to 94.5% (P <0.001). The HRQoL increased from on average 5.81 to 7.39 points (P <0.001). The use of the GensuPen2 by diabetes patients improved metabolic control, increased satisfaction with diabetes treatment and the use of insulin pen, reduced the pain during injection, and improved their quality of life. Disclosure: K. Cypryk: Advisory Panel; Self; Eli Lilly and Company, Novo Nordisk A/S. Speaker's Bureau; Self; Abbott, Servier. M. Zurawska-Klis: Speaker's Bureau; Self; Polfa Tarchomin S.A. Other Relationship; Self; Berlin-Chemie AG, Lilly Diabetes, Novo Nordisk Inc. Funding: Bioton [ABSTRACT FROM AUTHOR]

Background and Aim: Diabetes mellitus is a major risk factor for coronary heart disease (CHD). Matrix metalloproteinases (MMPs) can play a pivotal role in the remodelling of extracellular matrix associated with the development of atherosclerosis. Therefore, the aim of the study was to compare the distribution of genotypes and frequency of alleles of two polymorphisms of the MMP-1 gene promoter, an A/G substitution and a 1G/2G insertion, in correlation with antigen levels of matrix metalloproteinase-1 (MMP-1) in type 2 diabetic patients with or without CHD as well as individuals with normal glucose level without CHD., Methods: Genotypes of 115 patients with type 2 diabetes mellitus (T2DM) and a subpopulation of 66 patients with coexisting CHD as well as 120 non-diabetic control subjects were determined by PCR-based restriction fragment length polymorphism (PCR-RFLP)., Results: We demonstrated that antigen levels of MMP-1 in the serum of diabetic patients were significantly higher than those of individuals with normal glucose metabolism (p <0.05). Elevated levels of MMP-1 positively correlated with CHD occurrence in T2DM patients (p <0.01). The distribution of genotypes revealed higher frequency of the 2G/2G polymorphism variant in diabetic patients with CHD [OR 5.76, 95% CI (1.24; 26.87)], thus suggesting its strong association with high level of MMP-1. In T2DM patients with coexisting CHD, a higher frequency of the 2G allele of 1G/2G [OR 1.74, CI 95% (1.01; 2.99)] and the G allele of A/G polymorphism [OR 2.15, 95% CI (1.22; 3.80)] was also found., Conclusion: Our results suggest that type 2 diabetes mellitus is linked with elevated blood level of MMP-1, and polymorphisms of the promoter region of its gene might be associated with CHD.

Objective: The aim of the study was to evaluate the effect of gliclazide modified release (MR) treatment on adiponectin, interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) plasma concentrations in type 2 diabetic patients., Research Design and Methods: 24 randomly selected type 2 diabetic patients, aged 61.2 +/- 15.4 years, with poorly controlled glucose level (mean glycated hemoglobin [HbA1c] 7.6 +/- 1.1%) despite treatment with diet and/or oral hypoglycemic agents, were included in the study. All of the patients, after a 2-week run-in period, were given gliclazide MR for 12 weeks. At baseline, and after gliclazide MR treatment, HbA(1c) and plasma concentrations of IL-6, TNF-alpha, and adiponectin were measured., Results: Gliclazide MR treatment produced significant reductions in fasting plasma glucose (from 7.6 +/- 1.4 to 6.6 +/- 1.2 mmol/L, p < 0.01), HbA(1c) (from 7.6 +/- 1.1 to 6.9 +/- 0.8%, p < 0.01), and plasma IL-6 concentrations (from 2.5 +/- 1.8 to 1.8 +/- 1.2 pg/mL, p < 0.05). A significant increase in plasma adiponectin level was noted (from 6.4 +/- 3.3 to 7.6 +/- 4.4 mug/mL, p < 0.05). Plasma TNF-alpha concentrations and homeostasis model assessment of insulin resistance (HOMA-IR) decreased after treatment, but these changes did not reach statistical significance., Conclusions: Gliclazide MR improves glycemic control and, in addition, has a positive influence on the plasma level of some inflammatory markers and adiponectin. Increased plasma adiponectin and decreased plasma IL-6, and TNF-alpha levels may explain, at least in part, the anti-atherogenic action of this drug reported elsewhere.