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Background: Metabolic syndrome (MetS) refers to a group of risk factors that cause health problems, such as obesity, diabetes, dyslipidemia, and hyperglycemia. MetS is characterized by insulin resistance, which leads to abnormal insulin sensitivity. Cirsium japonicum var. maackii (CJ) is perennial herbaceous species found in Asia that exhibits antioxidant, antidiabetic, antitumor, antifungal, and anti-inflammatory activities. In this study, we aimed to measure the effects of CJ on MetS by improving insulin resistance in a db/db type 2 diabetes mouse model. After administrating CJ extract (CJE) for db/db mouse for 6 weeks, we measured with the evaluation of Insulin resistance, lipid profiles, histological analysis of liver, damage of liver and kideny. Results: The results showed that CJE was effective in reducing body weight and fat mas and showed a positive effect on lowering blood glucose and improving insulin sensitivity. CJE improved dyslipidemia by increasing serum-HDL levels and decreasing serum-LDL levels. In addition, CJE reduced liver and kidney damage in histological analysis. Conclusions: These results demonstrate the anti-diabetic effects of CJE and suggest its potential for improving MetS. Therefore, CJE may have potential values as a functional food material for managing MetS. [ABSTRACT FROM AUTHOR]

Background and Purpose: Liver disease is one of the main causes of death in diabetic patients. Type 2 diabetes is one of the most common chronic metabolic diseases and its prevalence is increasing rapidly all over the world. Liver is one of the most important organs that control blood glucose levels. Although the favorable role of Gymnema sylvester supplement and aerobic training has been reported in diabetic patients, the effect of Gymnema sylvester supplement and aerobic training on liver tissue is not well known. Therefore, the purpose of this research is the effect of Gymnema sylvester supplement on the signaling pathway involved in the oxidative stress of liver tissue in type 2 diabetic mice following aerobic training. Materials and Methods: In this experimental research, 32 male C57BL/6 mice were randomly divided into 4 groups of eight including diabetes group and aerobic training, diabetes group and gymnema sylvester supplement, diabetes group and aerobic training with gymnema sylvester supplement and diabetes control group. Diabetic groups were made diabetic by high-fat diet for 20 weeks. Gymnema sylvester supplement groups were gavaged with 100 mg/kg daily for six weeks. Aerobic training groups performed exercise at a speed of 10 m/min on a treadmill for six weeks and five training sessions per week. Serum concentration of SOD and MDA by ELISA method and expression of Nrf2/Keap1 (nuclear factor erythroid 2 -related factor 2/ Kelch-like ECH-associated protein 1) genes was measured by RT-PCR method. The data were analyzed by using SPSS and one-way analysis of variance, and Bonferroni's post-hoc test. The significance level was considered p<0.05. Results: Statistical analyses showed that six weeks of taking gymnema sylvester supplement, aerobic training and aerobic training with gymnema sylvester supplement caused a significant decrease in MDA and the expression of the Keap1 gene and a significant increase in SOD and the expression of the Nrf2 gene in the liver tissue (p<0.05). The greatest changes occurred in the diabetes group + aerobic training and gymnema sylvester supplement compared to diabetic control group (p<0.05). However, there were no significant differences between diabetic group and aerobic training group and gymnema supplement group (p<0.05). Conclusion: Gymnema Sylvester supplement and aerobic training improved blood variables through reducing MDA and increasing SOD, as well as improving the signaling pathway involved in oxidative stress in liver tissue by increasing the expression of the Nrf2 gene and decreasing the expression of the Keap1 gene in type 2 diabetic mice. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between stromal cell-derived factor-1 (SDF-1), angiopoietin-like 4 (ANGPTL4), glucose-regulated protein 78 (GRP78) and postoperative macular edema (ME) in patients with type 2 diabetic cataract and their predictive efficacy analysis. Methods: 195 patients (195 eyes) with type 2 diabetic cataract who were admitted to our hospital from January 2020 to March 2023 were selected, all patients underwent phacoemulsification combined with foldable intraocular lens implantation, patients were divided into ME group (45 cases) and non-ME group (150 cases) according to whether ME occurred after operation. The levels of SDF-1, ANGPTL4 and GRP78 in aqueous humor were detected before operation, and clinical data were collected. The influencing factors of postoperative ME in patients with type 2 diabetic cataract were analyzed by multivariate Logistic regression analysis, the predictive value of preoperative aqueous humor SDF-1, ANGPTL4 and GRP78 levels in predicting postoperative ME in patients with type 2 diabetic cataract were analyzed by receiver operating characteristic (ROC) curve. Results: The levels of SDF-1, ANGPTL4 and GRP78 in aqueous humor before operation in ME group were higher than those in non-ME group (P<0.05). High glycated hemoglobin, high SDF-1, high ANGPTL4, and high GRP78 were risk factors for postoperative ME in patients with type 2 diabetic cataract (P<0.05). The area under the curve (AUC) of preoperative SDF-1, ANGPTL4 and GRP78 levels in aqueous humor to predict postoperative ME in patients with type 2 diabetic cataract was 0.809, 0.801 and 0.760 respectively, the area under the curve predicted by combined SDF-1, ANGPTL4 and GRP78 was 0.896, which was higher than that of single detection (P<0.05). Conclusion: The increase levels of SDF-1, ANGPTL4 and GRP78 in aqueous humor of patients with type 2 diabetic cataract before operation are relate to the occurrence of postoperative ME, the combination of SDF-1, ANGPTL4 and GRP78 has high application value in predicting the occurrence of ME. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between serum amyloid A (SAA), procalcitonin (PCT) /blood lactic acid (Lac) ratio, C-reactive protein (CRP) /albumin (Alb) ratio and prognosis in patients with type 2 diabetic ketoacidosis complicated with infection. Methods: 178 patients with type 2 diabetic ketoacidosis complicated with infection who were admitted to the General Hospital of Eastern Theater Command of Chinese People’s Liberation Army from February 2020 to May 2023 were selected, patients were divided into survival group and death group according to the clinical outcome of 28 d after admission. The serum SAA, PCT/Lac ratio and CRP/Alb ratio were compared between two groups. The factors affecting the prognosis of patients with type 2 diabetic ketoacidosis complicated with infection were analyzed by multivariate logistic regression model, the value of serum SAA, PCT/Lac ratio and CRP/Alb ratio in predicting the prognosis of patients with type 2 diabetic ketoacidosis complicated with infection were analyzed by receiver operating characteristic (ROC) curve. Results: 28 d after admission, 31 patients died, with a mortality rate of 17.42%. The serum SAA, PCT/Lac ratio and CRP/Alb ratio in death group were higher than those in survival group (P＜0.05). Multivariate Logistic regression analysis showed that, the severity of type 2 diabetic ketoacidosis, the increase of SAA level, the increase of PCT/Lac ratio and the increase of CRP/Alb ratio were the risk factors affecting the prognosis of patients with type 2 diabetic ketoacidosis complicated with infection (P＜0.05). ROC curve analysis showed that, the area under the curve (AUC) of serum SAA, PCT/Lac ratio, CRP/Alb ratio and their combination in predicting the prognosis of patients with type 2 diabetic ketoacidosis complicated with infection were 0.781, 0.704, 0.852 and 0.901, respectively. Conclusion: Serum SAA, PCT/Lac ratio and CRP/Alb ratio of patients with type 2 diabetic ketoacidosis complicated with infection increased, and they are risk factors for the prognosis of patients. The combination of serum SAA, PCT/Lac ratio and CRP/Alb ratio has a higher predictive value for the prognosis of patients with type 2 diabetic ketoacidosis complicated with infection. [ABSTRACT FROM AUTHOR]

Ming Zhang,1,2 Yu Zhang2 1School of Nursing, Yangzhou University, Yangzhou, Jiangsu, 225001, People’s Republic of China; 2Department of Orthopedics and Sports Medicine, Northern Jiangsu People’s Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, 225001, People’s Republic of ChinaCorrespondence: Yu Zhang, School of Nursing, Yangzhou University, Yangzhou, Jiangsu, 225001, People’s Republic of China, Email yizhangyu@yzu.edu.cnObjective: Postoperative rehabilitation is particularly important for Rotator cuff injury. However, type 2 diabetic patients with RCI (T2DM-RCI) are at an elevated risk of rehabilitation failure. The factors influencing the postoperative rehabilitation management of these patients have yet to be elucidated. The objective of this study was to investigate the factors influencing the postoperative rehabilitation of T2DM-RCI patients.Methods: Data was collected using a descriptive qualitative research design. The sample included 22 interviewees, who were recruited in Subei People’s Hospital according to the purposive sampling method. Colaizzi’s method was employed for the purpose of evaluation in the course of the data analysis.Findings: Thematic analysis of the postoperative rehabilitation views of the interviewees identified eight sub-themes connected to three main themes in accordance with the Behaviour Change Wheel Theory. These were capability-related, opportunity-related, and motivation-related factors.Conclusion: It is imperative to enhance the glycaemic control and health perception of T2DM-RCI patients. To this end, rehabilitation programmes, comprising exercise and dietary modifications, must be tailored to the specific needs of each patient. Furthermore, it is crucial to harness the potential of family and social support to motivate patients to maintain a positive outlook.Keywords: postoperative rehabilitation, qualitative study, type 2 diabetic, rotator cuff injury, facilitating/obstructing factors

Lagerstroemia speciosa (Lythraceae), commonly known as banaba, is a plant native to the tropical regions of Southeast Asia that thrives abundantly in Vietnam and has been historically utilized in traditional medicine. Despite evidence suggesting that its leaves have anti-diabetic properties, studies investigating the effects of L. speciosa extracts on animal models of type 2 diabetes remain limited. Herein, the effect of dry extract from L. speciosa leaves (VLDE) collected in Vietnam on blood glucose in type 2 diabetic rats was evaluated. White rats were divided into five groups, each comprising 10 rats. Group 1 served as the non-diabetic control, receiving distilled water, while type 2 diabetes was induced in other groups with a high-fat diet and low-dose streptozotocin. Group 3 received gliclazide at a dose of 20 mg/kg/day as the positive control, whereas groups 4 and 5 were administered VLDE at doses of 620 mg/kg/day and 1240 mg/kg/day, respectively, for a treatment duration of 28 days. Blood glucose levels, blood insulin levels, and insulin resistance indices were evaluated pre-and post-treatment. VLDE at both doses demonstrated significant blood glucose-lowering effects, accompanied by a reduction in the HOMA-IR index and elevation in the HOMA-β, QUICKI, and DI indices, as well as an increase in the pancreatic mass-to-body weight ratio, comparable to the gliclazidetreated group. Our findings underscore the potential of L. speciosa extract as a medicinal therapeutic agent for type 2 diabetes management, warranting further pre-clinical and clinical validation for pharmaceutical development. [ABSTRACT FROM AUTHOR]

The objective of this study was to explore the effects of camel placenta powder on associated symptoms, signs and indicators in type 2 diabetic rats. For this study sixty male Wistar rats were randomly divided into a normal group, model group, metformin group, and low-, medium- and high-dose camel placenta groups. A high-fat and high-sugar feed combined with intraperitoneal injection of STZ dissolved in a citric acid-sodium citrate buffer was used to establish a rat model of hyperglycaemia. Metformin hydrochloride tablets were used as a positive control to detect fasting blood glucose. The contents of glycated haemoglobin (HbALc), insulin (INS) and glucose (GLUC3) as well as the protein expression and mRNA levels of sodium-glucose co-transporter 2 (SGLT2) and glucose transporter 2 (GLUT2) were used to study the mechanism of the hypoglycaemic effect of CPP on diabetic rats. We found that camel placenta produced no meaningful changes in the weight of hyperglycaemic rats or the weight of the liver, kidney, or pancreas. After STZ modelling, the blood glucose levels of rats noticeably increased. However, the blood glucose values of rats decreased substantially due to camel placenta treatment from the 4th to the 6th week. Camel placenta dramatically reduced the serum HbALc and GLUC3 content in hyperglycaemic rats. Dry CPP had a down-regulating effect on the levels of SGLT2 and GLUT2 protein, SGLT2 mRNA and GLUT2 mRNA in the kidneys of hyperglycaemic rats. However, there was no meaningful difference between the metformin group and the high- and medium-dose camel placenta groups. To conclude camel placenta has a notable hypoglycaemic effect on diabetic rats induced by STZ with a high-fat and high-sugar feed. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) is one of the most serious health challenges of the 21st century. Diabetes is forecast to affect 537 million people in 2021, with the figure expected to rise to 643 million by 2030 and 783 million by 2045. A healthy diet and physical activity are essential aspects of the treatment. The aim of the study is to assess the effect of an educational programme on blood sugar and HbA1c levels. This study involved a threemonth educational program intervention in a two-group, randomised controlled trial. It included two groups of subjects, one receiving an educational program and the other serving as a control group. Between November 2021 and February 2022, 100 patients with T2DM were recruited from Erbil, Iraq. The ethical approval from the College of Medicine at Hawler Medical University was obtained for this study. Patients with T2DM were randomly allocated to one of two groups: control (n = 50) or intervention (n = 50). The intervention group received an educational program with a publisher including, diet instruction, nutritional supplements, and an exercise recommendation as part of their intervention. For categorical data, a chi-square test was used to see if there was an association between the demographics of the two groups, and a t-test was used for numerical data to see if there was a difference between the two. Data are presented as mean ± SD. A two-tailed unpaired t-test was employed for comparison between groups. A two-tailed paired t-test was employed to compare groups at baseline. Means, standard deviations, and percentages were provided as crude values for descriptive statistics. For data entry and statistical analysis, the statistical package for the social sciences, version 25.0 (IBM, SPSS USA), was used, and p-values ≤ 0.05 were considered statistically significant. The intervention group had a statistically significant reduction in weight (-2.51 kg), waist circumference (-2.27 cm), random blood sugar (-29.64 mg/dL), haemoglobin A1c (-1.13 %), and serum triglycerides (-40.06 mg/dL). The result of the study suggests that lifestyle intervention and a low-carbohydrate diet for three months are beneficial in improving glycemic control in patients with type 2 diabetes when compared to the control group. [ABSTRACT FROM AUTHOR]

Anti-viral monoclonal antibody (mAb) treatments may provide immediate but short-term immunity from coronavirus disease 2019 (COVID-19) in high-risk populations, such as people with diabetes and the elderly; however, data on their efficacy in these populations are limited. We demonstrate that prophylactic mAb treatment blocks viral replication in both the upper and lower respiratory tracts in aged, type 2 diabetic rhesus macaques. mAb infusion dramatically curtails severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-mediated stimulation of interferon-induced chemokines and T cell activation, significantly reducing development of interstitial pneumonia. Furthermore, mAb infusion significantly dampens the greater than 3-fold increase in SARS-CoV-2-induced effector CD4 T cell influx into the cerebrospinal fluid. Our data show that neutralizing mAbs administered preventatively to high-risk populations may mitigate the adverse inflammatory consequences of SARS-CoV-2 exposure.

This study evaluates the antioxidant and antidiabetic activities of selected soybean varieties, Sri Lankan P.B 1 and Indian MACS-330. The methanolic extracts of soybean were in-vitro evaluated for their antioxidant, α–amylase, and amyloglucosidase inhibitory activities. Mixed flours with different proportions of soy flour (3%, 5%, and 8%), in wheat flour were investigated for their bread quality. Sensory properties of the bread were evaluated by trained panelists and the proximate composition of bread was assessed according to AOAC procedures. The research results show that the inhibition activity of α-amylase and amyloglucosidase did not differ significantly (P<0.05) from each variety. However, the total phenolic and flavonoid content of the Sri Lankan P.B 1 variety was not significantly difference (p > 0.05) than the Indian MACS-330 variety. The methanolic extracts from soybean may inhibit keyenzymes associated with type 2 diabetes, and thus may explain part of the mechanism by which soybeans exerts this health-promoting effect. As soy flour content increased, all the macro-nutrient parameters increased except carbohydrate content. The highest overall sensory score was the bread with 5% added soybean from Sri Lankan P.B 1. In conclusion, the functional and nutritional properties of the bread can be improved by the addition of soy flour. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) is one of the most serious health challenges of the 21st century. Diabetes is forecast to affect 537 million people in 2021, with the figure expected to rise to 643 million by 2030 and 783 million by 2045. A healthy diet and physical activity are essential aspects of the treatment. The aim of the study is to assess the effect of an educational programme on blood sugar and HbA1c levels. This study involved a three-month educational program intervention in a two-group, randomised controlled trial. It included two groups of subjects, one receiving an educational program and the other serving as a control group. Between November 2021 and February 2022, 100 patients with T2DM were recruited from Erbil, Iraq. The ethical approval from the College of Medicine at Hawler Medical University was obtained for this study. Patients with T2DM were randomly allocated to one of two groups: control (n = 50) or intervention (n = 50). The intervention group received an educational program with a publisher including, diet instruction, nutritional supplements, and an exercise recommendation as part of their intervention. For categorical data, a chi-square test was used to see if there was an association between the demographics of the two groups, and a t-test was used for numerical data to see if there was a difference between the two. Data are presented as mean ± SD. A two-tailed unpaired t-test was employed for comparison between groups. A two-tailed paired t-test was employed to compare groups at baseline. Means, standard deviations, and percentages were provided as crude values for descriptive statistics. For data entry and statistical analysis, the statistical package for the social sciences, version 25.0 (IBM, SPSS USA), was used, and p-values ≤ 0.05 were considered statistically significant. The intervention group had a statistically significant reduction in weight (-2.51 kg), waist circumference (-2.27 cm), random blood sugar (-29.64 mg/dL), haemoglobin A1c (-1.13 %), and serum triglycerides (-40.06 mg/dL). The result of the study suggests that lifestyle intervention and a low-carbohydrate diet for three months are beneficial in improving glycemic control in patients with type 2 diabetes when compared to the control group. [ABSTRACT FROM AUTHOR]

The study's main goal was to evaluate the state of pre-travel counseling for type 2 diabetic patients among PHC physicians in Jeddah. According to the findings of the study, diabetic patients should pack prescriptions and carbohydrate-rich foods in easily accessible baggage, but not insulin, which should not be packed in checked luggage. Approximately 133 responders are aware of insulin injection recommendations, whereas 28 require changes for cross-country travel across five time zones. The majority of people are ignorant of the significance of pre-travel immunization for diabetic patients traveling east or west. Most respondents strongly believe that pre-travel counseling is critical for diabetic patients, and the availability of an Arabic resource would raise knowledge of health behaviors. Seeking medical advice minimizes the chance of disease when traveling. Saudi Arabia lacks travel medicine practices, and the general public is unaware of their significance. According to the survey, 98 respondents had fewer than 20 visits to their clinic, while 42 had 20-40 visits. Each month, approximately 161 patients did not seek pre-trip counseling, and 147 were aware of travel safety recommendations. The majority of patients inquired about vaccinations and medicines. The majority of responders were unaware how to adjust insulin doses for patients traveling across time zones. Our findings may inspire the development of travel medical training programs to address the highlighted gaps and provide enough information during pre-trip counseling. A leaflet with further information, as well as a website where patients can find health information related to their location, should also be provided. [ABSTRACT FROM AUTHOR]

Abstract Background The purpose of this study was to investigate the psychometric properties of the Persian version of Diabetes Health Literacy Scale in type 2 diabetic patients. Method This cross-sectional study was conducted in 2021 in 1040 patients with type 2 diabetes in eastern Iran. Participants was selected by proportional stratified sampling method. The validity of DHLS was investigated through qualitative face validity, qualitative content validity, and structural validity (exploratory factor analysis and confirmatory factor analysis). The reliability of DHLS was checked by Cronbach's alpha coefficient, McDonald omega coefficient, and test–retest. Results In exploratory factor analysis, 3 factors with eigenvalues greater than 1 were extracted, explaining 68.57% of the variance. These factors entered the confirmatory factor analysis, none of the questions were removed, and all questions had factor loading above 0.4. Cronbach's alpha coefficient and McDonald omega coefficient of DHLS were 0.919 and 0.922. Also, the Intraclass correlation coefficient of DHLS was 0.957. Finally, the DHLS was approved with 14 questions and the three subscales of Informational Health Literacy (6 items), Numerate Health Literacy (5 items), and Communicative Health Literacy (3 items). Conclusions DHLS with 14 questions and the three subscales is a valid and reliable tool for examining diabetes health literacy in people with type 2 diabetes.

Background: the most important way to control diabetes is to follow a preventive lifestyle and if a diabetic individual follows a preventive lifestyle which he or she has accepted. The main objective of the current study is to compare the factors affecting the lifestyle in patients suffering from Type II diabetes and the healthy individuals in Kermanshah City. Methods: this study is based on a case-control design where using simple random sampling, 110 patients suffering from type II diabetes are selected as the case group and 111 healthy subjects among the companions of other patients are selected as the control group from the Center for Diabetics in Kermanshah City. The average age of the participants is 48.8 ± 11.0. The questionnaires used for collecting the data included the following: the demographic information questionnaire and the lifestyle questionnaire which covers diet, physical activity, coping with stress, and smoking. Software applications including STSTA14 and SPSS23 were used for performing statistical computations and logistic regression or linear regression tests were used for analyzing the collected data. Results: in the subscales of diet, physical activity, spiritual growth, and stress management, there was a significant difference between the diabetic and healthy groups in a wat that the average score for these subscales was higher in the healthy individuals. While the average score for "health responsibility" was higher in the diabetic group compared to the healthy subjects, the difference was not significant (P < 0.232). Moreover, there was a significant statistical relationship between the two groups, i.e. the diabetic and healthy groups, and the variables of age, education level, and occupation (P > 0.05). Conclusion: healthy lifestyle including proper diet and athletic activity is effective in preventing type II diabetes. Accordingly, implementing policies in the urban transportation system such as providing a special lane for bikers in the cities, increasing the tax for harmful foods, considering subsidies for healthy food products, and self-care of individuals can be effective. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study is to investigate whether hematological indices inflammatory parameters such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) are increased in patients with heart failure (HF) in type 2 diabetes mellitus (T2DM). It is also to compare them in diabetics Methods: The study consisted of four subject's groups in our center between Octeber 2019 and September 2021. It recorded the laboratory results of 160 subjects of which diabetic patient without HF group (n=40), non-diabetic HF group (n=40), diabetes mellitus (DM)+HF group (n=40), and healthy controls (n=40). Results: NLR and PLR were significantly higher, while LMR was significantly lower in all patients than controls. DM+HF group has the highest NLR (3.34±1.26), PLR (211.34±91.49), and white blood count (WBC) (9090±4834) among the groups. There was no significant difference in NLR and LMR between DM group and DM+HF group. PLR was significantly lower in non-diabetic HF than DM without HF. Conclusion: Among these markers, NLR, PLR, and WBC could predict the presence of HF in T2DM. NLR, PLR, and WBC are independently associated with other conventional inflammatory markers as C-reactive protein levels in the early stages of HF in T2DM. Complete blood count and hematological indices can be used as additional information in terms of being non-invasive, faster, easier, and cheap in the evaluation of HF at T2DM. [ABSTRACT FROM AUTHOR]

Background: Micro vascular complications of T2DM are associated with severe morbidity, mortality and a huge economic burden. So, there is an important need to identify new biomarker able to identify disease onset and progression and can be used as a therapeutic target for management of these complications. The Aim of this study was to assessment the Serum progranulin level as a biomarker for the presence and severity of retinopathy in type 2 diabetic patients. Methods: The current case-control study was carried out conducted on (48 type 2 diabetic patients) at the Internal Medicine and ophthalmology out-patient clinic of Zagazig University Hospitals, during the period from May 2019 to October 2019. All patient referred to ophthalmic out-patient clinic for fundal examination by ophthalmologist in which diabetic retinopathy was diagnosed, a complete physical examination including the measurement of height, weight, body mass index, and blood pressure (BP) was performed for all patients. Results: The current study showed that there was a high statistically significant increase in serum PGRN level in diabetic patients with retinopathy, there was a statistically significant positive correlation between serum PGRN level with disease duration, urea, creatinine level and urinary ACR of studied retinopathy patients and also there was a high statistically significant increase in serum PGRN level in diabetic patients with proliferative retinopathy. Conclusions: According to our results serum PGRN level could be used as a biomarker for the presence of microvascular retinal complication and to anticipate the severity of diabetic retinopathy in T2DM patients. [ABSTRACT FROM AUTHOR]

Background and aim: Urinary tract infection (UTI) is the most common infection in type 2 diabetes patients. TNF‐β is a cytokine with multiple functions in immunomodulatory and inflammatory mechanisms. The variation at position +252 A/G of TNF‐β impacts both gene expression and plasma concentration of TNF‐β proteins. The findings may shed light on the genetic factors that predispose diabetic patients in Iraq to UTIs. Methods: A total of 200 individuals were divided into 100 patients with type 2 diabetes, categorized according to UTI, and 100 control subjects. Genetic analysis of +252 A/G of the TNF‐β gene was carried out using the TaqMan probe allele discrimination method. The level of TNF‐β was estimated by the ELISA technique. Results: In the recessive model (GG vs. AA/AG) of TNF‐β + 252 A/G in T2D/UTI patients compared to controls, a significant association p = 0.029 (OR: 2.8; CI 95% = 1.14–7.09): E = 15.6% was observed. Furthermore, in T2D patients without UTI, the dominant model AA versus AG/GG was associated with a preventive role P: 31.3% (OR: 0.4; CI 95% = 0.22–0.88) and a p value = (0.02). Overall, AG proportions showed a high level of TNF‐β within the control group p = 0.03, while all proportions of the +252 A/G showed significant differences in TNF‐β level between groups p ≤ 0.05. Pearson's correlation analysis observed a link between TNF‐ levels, fasting plasma glucose (FPG), and HbA1c. Conclusion: In T2D patients, the G allele may be linked to a higher probability of UTI, as well as an increased level of TNF‐β in a genotype‐dependent manner. [ABSTRACT FROM AUTHOR]

Two doses (300 mg/kg bw and 600 mg/kg bw) of the Lactiplantibacillus plantarum JLAU103 exopolysaccharide (EPS103) were orally administered to a type 2 diabetic (T2DM) mouse model induced by streptozotocin and a high-fat diet. The hypoglycemic, hypolipidemic and neuroprotective effects of EPS103 on T2DM mice were evaluated. The results indicated that administration of EPS103 could alleviate insulin resistance, reduce the levels of fasting blood glucose, glycosylated hemoglobin A1c, leptin and fasting serum insulin, improve glucose tolerance, protect pancreas and liver, and modulate blood lipid disorders. EPS103 promoted hepatic glycogen synthesis by upregulating the phosphorylation of GSK3β. Meanwhile, it upregulated the phosphorylation of IRS-1, PI3K and Akt, as well as the expression of IRS-2 and GLUT4, and downregulated the expression of PEPCK, G6Pase and PGC-1α, indicating that EPS103 promotes the uptake and transport of glucose and inhibits gluconeogenesis, which might be related to the activation of the IRS-1/PI3K/Akt pathway. Additionally, EPS103 can protect against brain nerve damage through improving oxidative stress injury, restoring the expression of IRS-2, alleviating neuronal apoptosis and inhibiting inflammation in the hippocampus of T2DM mice. Taken together, our results demonstrated that EPS103 may be a potential therapeutic agent for the treatment of T2DM. [ABSTRACT FROM AUTHOR]

Diabetes is a type of metabolic disease associated with changes in the intestinal flora. In this study, the regulatory effect of millet bran on intestinal microbiota in a model of type 2 diabetes (T2DM) was investigated in an effort to develop new approaches to prevent and treat diabetes and its complications in patients. The effect of purified millet bran polysaccharide (MBP) with three different intragastric doses (400 mg/kg, 200 mg/kg, and 100 mg/kg) combined with a high-fat diet was determined in a streptozotocin (STZ)-induced model of T2DM. By analyzing the changes in indicators, weight, fasting blood sugar, and other bio-physiological parameters, the changes in gut microbiota were analyzed via high-throughput sequencing to establish the effect of MBP on the intestinal flora. The results showed that MBP alleviated symptoms of high-fat diet-induced T2DM. A high dosage of MBP enhanced the hypoglycemic effects compared with low and medium dosages. During gavage, the fasting blood glucose (FBG) levels of rats in the MBP group were significantly reduced (p < 0.05). The glucose tolerance of rats in the MBP group was significantly improved (p < 0.05). In diabetic mice, MBP significantly increased the activities of CAT, SOD, and GSH-Px. The inflammatory symptoms of liver cells and islet cells in the MBP group were alleviated, and the anti-inflammatory effect was partially correlated with the dose of MBP. After 4 weeks of treatment with MBP, the indices of blood lipid in the MBP group were significantly improved compared with those of the DM group (p < 0.05). Treatment with MBP (400 mg/kg) increases the levels of beneficial bacteria and decreases harmful bacteria in the intestinal tract of rats, thus altering the intestinal microbial community and antidiabetic effect on mice with T2DM by modulating gut microbiota. The findings suggest that MBP is a potential pharmaceutical supplement for preventing and treating diabetes. [ABSTRACT FROM AUTHOR]

Abstract Background and aim Urinary tract infection (UTI) is the most common infection in type 2 diabetes patients. TNF‐β is a cytokine with multiple functions in immunomodulatory and inflammatory mechanisms. The variation at position +252 A/G of TNF‐β impacts both gene expression and plasma concentration of TNF‐β proteins. The findings may shed light on the genetic factors that predispose diabetic patients in Iraq to UTIs. Methods A total of 200 individuals were divided into 100 patients with type 2 diabetes, categorized according to UTI, and 100 control subjects. Genetic analysis of +252 A/G of the TNF‐β gene was carried out using the TaqMan probe allele discrimination method. The level of TNF‐β was estimated by the ELISA technique. Results In the recessive model (GG vs. AA/AG) of TNF‐β + 252 A/G in T2D/UTI patients compared to controls, a significant association p = 0.029 (OR: 2.8; CI 95% = 1.14–7.09): E = 15.6% was observed. Furthermore, in T2D patients without UTI, the dominant model AA versus AG/GG was associated with a preventive role P: 31.3% (OR: 0.4; CI 95% = 0.22–0.88) and a p value = (0.02). Overall, AG proportions showed a high level of TNF‐β within the control group p = 0.03, while all proportions of the +252 A/G showed significant differences in TNF‐β level between groups p ≤ 0.05. Pearson's correlation analysis observed a link between TNF‐ levels, fasting plasma glucose (FPG), and HbA1c. Conclusion In T2D patients, the G allele may be linked to a higher probability of UTI, as well as an increased level of TNF‐β in a genotype‐dependent manner.

Background: Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia caused by insulin resistance (IR) or impaired insulin production. Diabetic retinopathy (DR) is a common microvascular disorder which occurs in type 2 diabetes mellitus (T2DM) patients due to chronic hyper-glycemia. Previous studies reported that serum zinc (Zn) was associated with certain diabetic microvascular complications. Objective: To evaluate relation between serum zinc level and diabetic retinopathy in patients with type 2 diabetes mellitus. Subjects and Methods: The current study included 60 subjects with their ages ranging from 18- 60, selected from diabetes and ophthalmology outpatient clinics of Ain Shams University Hospitals for 7 months in a period from July 2022 to January 2023 with matched age and sex, fasting and post prandial blood glucose, hemoglobin A1c (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP),serum creatnine, LDL, HDL, TG, TC and serum zinc levels were measured among groups. Results: The study shows statistically significant difference between DM type II subgroups regarding duration of disease (yrs) being higher in DM II with retinopathy 12.5 (10.5 - 16.5) than DM II without retinopathy 9 (6 - 12) with p < 0.001. serum Zn levels were significantly lower in the DR group than the controls and diabetic without retinopathy in whole DM type II group, there was statistically significant negative correlation found between zinc level and duration of diabetes, HbA1c, LDL, TC, FBS, 2PP and serum creatinine level, while in DM II without retinopathy there was statistically significant negative correlation found between zinc level and duration of diabetes, LDL, TC and FBS and also in DM type II retinopathy there was statistically significant negative correlation found between zinc level and duration of diabetes, HbA1c, FBS, 2PP and serum cretainine level. There is no statistically significant difference found between control group and DM type II group regarding weight, height and BMI of the studied patients with p-value = 0.108, 0.198 and 0.343; respectively. There is no statistically significant difference found between control group and DM type II group regarding systolic and diastolic blood pressure of the studied patients with p-value = 0.554 and 0.405; respectively. Conclusion: Our study suggested that lower serum zinc level in T2D patients was related to higher prevalence of diabetic micro-vascular complications. Patients with lower serum zinc level were more likely to have a longer duration of diabetes, poorer glucose control, and worse β-cell function. Older age, higher HbA1c level, and the prevalence of DN were risk factors related to the lower serum zinc level. [ABSTRACT FROM AUTHOR]

Background: Insulin resistance is identified as an impaired biological response to insulin stimulation of target tissues, primarily the liver, muscle, and adipose tissue. The metabolic consequences of insulin resistance can result in hyperglycaemia, hypertension, dyslipidaemia, visceral adiposity, hyperuricemia, elevated inflammatory markers, endothelial dysfunction, and a prothrombotic state. Progression of insulin resistance can lead to metabolic syndrome, non-alcoholic fatty liver disease, and type 2 diabetes mellitus. Aim of the Work: We aimed by our study to assess the relationship of platelet distribution width and red blood cell distribution width with insulin resistance in patients with type 2 diabetes with and without non-alcoholic fatty liver disease (NAFLD) and to check if platelet distribution width or red blood cell distribution width could be easy predictors of insulin resistance. Patients and Methods: The present study is a Case Control Study was conducted in Ain Shams University Hospital. This study includes 80 subjects with matched age and sex. Results: The present study results confirmed that low RDW was associated with increased risk of developing diabetes mellitus. Their study found that RDW is negatively correlated with waist and FG, insulin and TG concentrations. We also found that the group with the lowest quartile of RDW had the highest glucose, insulin and HOMA levels. Moreover, our results were found that there is a significant negative correlation of RDW with poor glycemic control. Our results also found that decreased levels of red blood cell distribution widths (RDW) were all associated with increased fasting insulin. Our study was documented a negative correlation between HbA1c and the platelet index PDW. Conclusion: In our study, we found a relation between insulin resistance and red blood cell distribution width. RDW (fl) could be used to discriminate between patients with type II diabetes and controls. [ABSTRACT FROM AUTHOR]

Background: Many disorders associated with diabetes, such as oxidative stress, hyperglycemia, and body weight, can be considered to be involved in the pathogenesis of diabetic bone disorder. Among them, oxidative stress may be a candidate, since it is increased under diabetic conditions and is known to induce cellular dysfunction in a wide variety of cell types. Reactive oxygen species (ROS) generated by high glucose concentrations are also considered to be a causal link between hyperglycemia and other metabolic abnormalities in the development of many diabetic complications. Aim of the Work: This study evaluated the relation between advanced oxidation protein product and bone mass density in type2 diabetic patient. Patients and Methods: This cross sectional study was conducted on 90 postmenopausal female patients aged from 50-60 years old, selected from endocrine outpatient clinic of Ain shams university hospitals for 12 months in a period from May 2019 to May 2020. Results: AOPP was significantly higher in group I (diabetic patients) than group II. There were significant correlations between AOPP and (BMI, HbA1c, forearm, femur, spine T-SCORE) in group I and both groups but there were no significant correlations between AOPP and (menopause duration, age, creatinine, urea, eGFR, Ca level, phosphate level and PTH). Conclusion: From the results of current study we can conclude that: AOPP is significantly higher in diabetic patient's more than non-diabetic patients. Higher AOPP levels were associated with lower BMD. BMD of spine was significantly decreased in diabetic patients than other bony parts. AOPP was significantly increased with high BMI, HbA1c level [ABSTRACT FROM AUTHOR]

Oxidative stress plays an important role in vascular complications observed in patients with obesity and Type 2 Diabetes (T2D). Xanthine oxidase (XO) breaks down purine nucleotides into uric acid and contributes to the production of reactive oxygen species (ROS). However, the relationship between XO activity and glucose homeostasis in T2D subjects with obesity is unclear. We hypothesized that disordered glucose levels are associated with serum XO activity in overweight women and men with T2D and without hyperuricemia. We studied serum XO activity in women and men with and without T2D. Our results show that serum XO activity was greater in T2D patients with body mass index (BMI) ≥ 25 kg/m2 than in those with BMI < 25 kg/m2 (p < 0.0001). Sex-based comparative analyses of overweight T2D patients showed that serum XO activity correlated with homeostasis model assessment of β-cell function (HOMA-β), fasting plasma glucose (FPG), and hemoglobin A1C in overweight T2D women but not in overweight T2D men. In addition, as compared to overweight T2D men, women had higher high-sensitivity C-reactive protein (hs-CRP) levels. However, overweight T2D men had higher XO activity and uric acid levels than women. Our results suggest that XO activity is higher in overweight T2D patients, especially in men, but is more sensitive to disordered glucose levels in overweight women with T2D. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate the psychometric properties of the Persian version of Diabetes Health Literacy Scale in type 2 diabetic patients. Method: This cross-sectional study was conducted in 2021 in 1040 patients with type 2 diabetes in eastern Iran. Participants was selected by proportional stratified sampling method. The validity of DHLS was investigated through qualitative face validity, qualitative content validity, and structural validity (exploratory factor analysis and confirmatory factor analysis). The reliability of DHLS was checked by Cronbach's alpha coefficient, McDonald omega coefficient, and test–retest. Results: In exploratory factor analysis, 3 factors with eigenvalues greater than 1 were extracted, explaining 68.57% of the variance. These factors entered the confirmatory factor analysis, none of the questions were removed, and all questions had factor loading above 0.4. Cronbach's alpha coefficient and McDonald omega coefficient of DHLS were 0.919 and 0.922. Also, the Intraclass correlation coefficient of DHLS was 0.957. Finally, the DHLS was approved with 14 questions and the three subscales of Informational Health Literacy (6 items), Numerate Health Literacy (5 items), and Communicative Health Literacy (3 items). Conclusions: DHLS with 14 questions and the three subscales is a valid and reliable tool for examining diabetes health literacy in people with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Diabetes is a complex disease that can only be controlled and prevented by a healthy lifestyle. We have selected the investigation of diabetes for this research as a substantially large fragment of our society is suffering from diabetes. It has been observed that diabetic patients are more expressive on social media as compared to real-life interactions. Furthermore, online communities are playing a significant role in providing social support and knowledge to patients through their experiences. Diabetes has only been monitored through wearable (sensor-based) and glucose meters. However, the problem arises when the patients become reluctant about giving the required information themselves. For this purpose, a taxonomic system based on business process models has been developed which uses the textual data from the patients in which they express their emotions regarding Diabetes. Social media support groups related to Diabetes are used to gather data. Diabetic patients tend to share their emotions and feelings with people who are face a similar situation. However, there is no established measure to calculate the behavioral impact of diabetes on diabetic patients. In our research, we have studied how diabetic patients collaborate with each other to help others through social media and the impact of social communities on diabetic patient's lifestyles. The results show the extent to which diabetic people follow a healthy lifestyle. [ABSTRACT FROM AUTHOR]

Obesity is a chronic disease often associated with type 2 diabetes mellitus (T2DM) and metabolic syndrome. Coexistence of diabetes and hypertension have adverse clinical outcomes with micro and macrovascular complications. This study investigates the relationship of oxidative stress markers and antioxidants with occurrence of hypertension in obese type 2 diabetic subjects in Osun State, Nigeria. Four hundred and forty-five participants made up of 138 non-obese diabetics, 107 obese diabetic subjects attending two tertiary Hospitals in Osogbo in addition to 100 obese non-diabetes (positive controls) and 100 non-obese non-diabetes (negative controls) were enrolled in this study. FBS (9.55±0.13 mmol/l) and HbA1c (9.51±0.15 %) showed highest significant increase in obese diabetic subjects compared to other groups. Mean serum MDA was highest among obese diabetics (p<0.05) while least values of superoxide dismutase (121.09±3.10 μ/ml) and catalase (24.97±0.66 pg/ml) were recorded in non-obese diabetics (p<0.05). 21.0% of non-obese diabetics (n=29), 54.2% of obese diabetics (n=58), 45.0% of obese non-diabetic (n=45) and 21% of non-obese non-diabetics (n=21) were hypertensive. Age, sex, marital status, religion and occupation (X²=9.856, 8.405, 22.701, 12.066 and 14.468) respectively were all significantly associated with occurrence of hypertension among obese diabetics. Receiver operating characteristics (ROC) and area under the curve (AUC) showed MDA having the highest cut off point among obese diabetes subject: 0.529 (0.42-0.64 95% CI) with a steep increase in LDL: 0.505(0.40-0.62 95% CI). This study revealed that increased oxidative stress and reduced antioxidant defense enzymes are strongly associated with dyslipidemia among obese diabetic subject. [ABSTRACT FROM AUTHOR]

Obesity is a chronic disease often associated with type 2 diabetes mellitus (T2DM) and metabolic syndrome. Coexistence of diabetes and hypertension have adverse clinical outcomes with micro and macrovascular complications. This study investigates the relationship of oxidative stress markers and antioxidants with occurrence of hypertension in obese type 2 diabetic subjects in Osun State, Nigeria. Four hundred and forty-five participants made up of 138 non-obese diabetics, 107 obese diabetic subjects attending two tertiary Hospitals in Osogbo in addition to 100 obese non-diabetes (positive controls) and 100 non-obese non-diabetes (negative controls) were enrolled in this study. FBS (9.55±0.13 mmol/l) and HbA1c (9.51±0.15 %) showed highest significant increase in obese diabetic subjects compared to other groups. Mean serum MDA was highest among obese diabetics (p

influence of Ramadan fasting (RF) on patients with "Metabolic Syndrome" (MetS) remains debatable. Meanwhile, the majority of evidences demonstrated a beneficial effect on nearly most of the metabolic criteria that are reducing the risk of MetS. Hypoglycemia is a significant consequence of diabetes that has already been associated to an increased cardiovascular risk, and hypertension. However, there have also been reports of mixed results. Therefore, the objective of this observational study was to detect the impact of “Ramadan Fasting” on Metabolic criteria among treated hypertensive and diabetic patients. A total of 73 female MetS patients aged 20 to 45 years old took part in this prospective study, were evaluated a week before Ramadan fasting and, after Ramadan month having hypertension and diabetics of more than 2 years. All attended Halabja Hospital and were treated with one daily medication based on the doctor’s prescription. To estimate the sample size, the sample random technique was employed, and the computed sample size was used. The eligibility criteria for female patients having diabetes and hypertension were based on the International Diabetic Federation (IDF) definition criteria. Fasting blood samples were taken, blood pressure was assessed, and BMI was computed, as well as fasting blood sugar and lipid profiles of all collected blood samples. There was a substantial weight loss, and WC decreased. This result has been reflected on BMI as well ( p ˂ 0.0001). During the month of fasting, both the systolic and diastolic blood pressures changed significantly. Overall, Ramadan fasting was found to decrease fasting glucose levels. Fasting Ramadan was found to have a significant drop in TC and TG levels in terms of lipid profile modifications. The levels of LDL-C in the blood did not differ significantly, after Ramadan compared to baseline. However, we did notice a decrease in serum HDL-C levels, which was not accompanied by any significant alterations. Ramadan has a synergistic effect. In people with a history of hypertension and hyperglycemia, fasting combined with conventional medical treatment results in significant improvements in weight, BMI, waist circumference, lipid profile, systolic and diastolic blood pressure, are all heart disease risk indicators. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between T950C polymorphism in the promoter region of osteoprotegerin (OPG) gene and type 2 diabetes mellitus (T2DM) complicated with osteoporosis, and to understand the genetically related susceptibility genes of T2DM complicated with osteoporosis. Methods (1) Using polymerase chain reaction technology, the T2DM without osteoporosis group(group A), the T2DM with osteopenia group (B group), the T2DM with osteoporosis group (C group), the OPG gene T950C group were detected. Genotype, the OPG gene T950C polymorphism in the three groups was analyzed respectively; (2) Gender, body mass index, age, blood pressure, weight, glycated hemoglobin, height, blood lipids, fasting blood glucose, testosterone, estrogen, vitamin D were compared among the three groups.(3) The differences in bone mineral density was compared between different parts of the OPG gene T950C genotype; (4) The independent risk factors of T2DM patients with osteoporosis was learned through logistic regression analysis. Results (1) TC type was the main genotype of OPG gene T950C in T2DM and T2DM patients with osteoporosis;(2) There was no significant difference in the genotype frequency and allele frequency of OPG gene T950C among the three groups (P > 0.05); (3) The weight, age, height, BMI, and BMI of the three groups of patients were compared, the difference was statistically significant (P < 0.05), and the differences among the groups were statistically significant (P < 0.05); (4) Comparison of the three genotypes of the OPG gene T950C, there was no difference in the bone mineral density of each part (P > 0.05); (5) Regression analysis showed that age and smoking entered the regression equation, but the genotype of the OPGOPG gene T950C did not enter regression equation. Conclusions (1) TC type is the main genotype of OPG gene T950C in T2DM and T2DM patients with osteoporosis; (2) The genotype of OPG gene T950C may not be a susceptibility gene for T2DM and T2DM combined with osteoporosis; (3) Smoking and age are independent risk factors of T2DM combined with osteoporosis. [ABSTRACT FROM AUTHOR]

Mulberry possesses many biological characteristics, such as reduce blood sugar and antioxidant properties, but whether mulberry galacto-oligosaccharide (MGO) can impact the characteristics of the gut microbiota is not yet clear. The objective of this work was to investigate the protective effects of MGO in type 2 diabetic (T2D) mice. The analysis of typical diabetic symptoms and serum status showed that oral MGO alleviated hyperglycemia, insulin resistance and oxidative stress in diabetic mice. These changes were caused by up-regulating the expression of key proteins in the PI3K/Akt pathway, involved in the control of liver glycolysis and gluconeogenesis, and liver glucose metabolism having a positive hypoglycemic effect. Additionally, the gut microbiota indicated that MGO treatment could positively modulate the microbiome composition to decrease the blood glucose in diabetic mice by promoting the growth of Prevotellaceae and Lactobacillus, whereas decreasing the abundance of Lachnospiraceae.

Two doses (300 mg/kg bw and 600 mg/kg bw) of the Lactiplantibacillus plantarum JLAU103 exopolysaccharide (EPS103) were orally administered to a type 2 diabetic (T2DM) mouse model induced by streptozotocin and a high-fat diet. The hypoglycemic, hypolipidemic and neuroprotective effects of EPS103 on T2DM mice were evaluated. The results indicated that administration of EPS103 could alleviate insulin resistance, reduce the levels of fasting blood glucose, glycosylated hemoglobin A1c, leptin and fasting serum insulin, improve glucose tolerance, protect pancreas and liver, and modulate blood lipid disorders. EPS103 promoted hepatic glycogen synthesis by upregulating the phosphorylation of GSK3β. Meanwhile, it upregulated the phosphorylation of IRS-1, PI3K and Akt, as well as the expression of IRS-2 and GLUT4, and downregulated the expression of PEPCK, G6Pase and PGC-1α, indicating that EPS103 promotes the uptake and transport of glucose and inhibits gluconeogenesis, which might be related to the activation of the IRS-1/PI3K/Akt pathway. Additionally, EPS103 can protect against brain nerve damage through improving oxidative stress injury, restoring the expression of IRS-2, alleviating neuronal apoptosis and inhibiting inflammation in the hippocampus of T2DM mice. Taken together, our results demonstrated that EPS103 may be a potential therapeutic agent for the treatment of T2DM.

Introduction: Changes in plasma adipicin and inflammatory parameters in type 2 diabetes are due to obesity and directly related to the condition of diabetes. The aim of this study was to investigate the effect of High intensity interval training (HIIT) on the ratio of adiponectin to leptin and C-reactive protein (CRP) in type 2 diabetic rats. Materials & Methods: In this experimental study, 42 Wistar rats with mean weight of 205±54 were randomly assigned to healthy control, diabetic control and diabetic training groups. The diabetic training group received ten weeks of HIIT training following the induction of diabetes. At the end of the experimental period, blood samples were taken to assess leptin, adiponectin and insulin resistance. Data were analyzed by one-way ANOVA and Tukey's post hoc test at a significant level of 0.05%. Findings: The induction of diabetes by streptozotocin-nicotinamide resulted in a significant decrease in adiponectin (P =0.000) and leptin (P=0.000) and a significant increase in C-reactive protein (P=0.000) in diabetic control group compared to healthy control group Became 10 weeks of HIIT training resulted in a significant decrease in fasting blood glucose (P=0.109), C-reactive protein (P=0.024), and a significant increase in serum leptin levels (P=0.001), adiponectin (P=0.42) In the HIIT training group compared to the diabetic control group. Discussion & Conclusions: It seems that HIIT training improves inflammation (C-reactive protein) in type 2 diabetic rats by altering serum levels of adiponectin and leptin. In the present study, 10 weeks of HIIT training led to an increase in the ratio of adiponectin to leptin and consequent reduction of C-reactive protein.

Diabetes is a type of metabolic disease associated with changes in the intestinal flora. In this study, the regulatory effect of millet bran on intestinal microbiota in a model of type 2 diabetes (T2DM) was investigated in an effort to develop new approaches to prevent and treat diabetes and its complications in patients. The effect of purified millet bran polysaccharide (MBP) with three different intragastric doses (400 mg/kg, 200 mg/kg, and 100 mg/kg) combined with a high-fat diet was determined in a streptozotocin (STZ)-induced model of T2DM. By analyzing the changes in indicators, weight, fasting blood sugar, and other bio-physiological parameters, the changes in gut microbiota were analyzed via high-throughput sequencing to establish the effect of MBP on the intestinal flora. The results showed that MBP alleviated symptoms of high-fat diet-induced T2DM. A high dosage of MBP enhanced the hypoglycemic effects compared with low and medium dosages. During gavage, the fasting blood glucose (FBG) levels of rats in the MBP group were significantly reduced (p < 0.05). The glucose tolerance of rats in the MBP group was significantly improved (p < 0.05). In diabetic mice, MBP significantly increased the activities of CAT, SOD, and GSH-Px. The inflammatory symptoms of liver cells and islet cells in the MBP group were alleviated, and the anti-inflammatory effect was partially correlated with the dose of MBP. After 4 weeks of treatment with MBP, the indices of blood lipid in the MBP group were significantly improved compared with those of the DM group (p < 0.05). Treatment with MBP (400 mg/kg) increases the levels of beneficial bacteria and decreases harmful bacteria in the intestinal tract of rats, thus altering the intestinal microbial community and antidiabetic effect on mice with T2DM by modulating gut microbiota. The findings suggest that MBP is a potential pharmaceutical supplement for preventing and treating diabetes.

Gynura procumbens (GP) is a perennial herbal medicine and food homologous plant, which has been reported to have a good hypoglycemic effect. However, its active components and underlying mechanism of action are not clear. Here, we aimed to confirm the effects of GP on type 2 diabetes (T2DM) from several different aspects. We used UPLC/Q-TOF MS to analyze the metabolic patterns, which included blood samples of clinical subjects and db/db mice to screen for serum metabolic markers and metabolic pathways. We also used network pharmacology to study GP targets in the treatment of T2DM. Data from endogenous metabolites in plasma showed that two common pathways, including glycerol phosphate metabolism and retinol metabolism, were identified in plasma samples of the groups. Finally, Western blot analysis was used to verify the expression of proteins in the PI3K/AKT and AGE–RAGE signaling pathways. The protein expression of AKT, eNOS, iNS, and MAPK was significantly upregulated, and the expression of caspase-8 and caspase-3 was significantly downregulated. Thus, our findings indicated that GP could alleviate insulin resistance by regulating biometabolic markers and key proteins in the PI3K/AKT and AGE–RAGE signaling pathways to treat T2DM.

Gynura procumbens (GP) is a perennial herbal medicine and food homologous plant, which has been reported to have a good hypoglycemic effect. However, its active components and underlying mechanism of action are not clear. Here, we aimed to confirm the effects of GP on type 2 diabetes (T2DM) from several different aspects. We used UPLC/Q-TOF MS to analyze the metabolic patterns, which included blood samples of clinical subjects and db / db mice to screen for serum metabolic markers and metabolic pathways. We also used network pharmacology to study GP targets in the treatment of T2DM. Data from endogenous metabolites in plasma showed that two common pathways, including glycerol phosphate metabolism and retinol metabolism, were identified in plasma samples of the groups. Finally, Western blot analysis was used to verify the expression of proteins in the PI3K/AKT and AGE–RAGE signaling pathways. The protein expression of AKT, eNOS, iNS, and MAPK was significantly upregulated, and the expression of caspase-8 and caspase-3 was significantly downregulated. Thus, our findings indicated that GP could alleviate insulin resistance by regulating biometabolic markers and key proteins in the PI3K/AKT and AGE–RAGE signaling pathways to treat T2DM. [ABSTRACT FROM AUTHOR]

Background: Peripheral neuropathy (PN) is a risk factor for foot disease in type 2 diabetes mellitus (T2DM). There are scanty data on prevalence of PN and its clinical correlates in Nigerian T2DM subjects without neuropathic symptoms. Objectives: To evaluate the prevalence and clinical correlates of PN diagnosed using objective methods in T2DM subjects without symptoms of PN. Materials and Methods: This is a cross-sectional study involving T2DM subjects at the Diabetes Clinic of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. History was obtained and physical examination done on subjects. Fasting plasma glucose (FPG) done on the day of assessment and values of glycated haemoglobin (HbA1c), and fasting lipid profile done within the preceding three months- were obtained from subjects' clinic folders. Diabetic Neuropathy Symptom Score (DNSS) was used to identify subjects without neuropathic symptoms. PN was diagnosed using tuning fork, and two biothesiometers. Data collection was done using researcher-administered study proforma. Data were analyzed using SPSS version 20. Results: 524 subjects [244 (46.6%) males and 280 (53.4%) females] were recruited for the study. 223 (42.6%) of these subjects did not have neuropathic symptoms and PN tested further with 3 objective methods. PN prevalence with tuning fork, analog and digital biothesiometers were 71.5%, 14.8% and 14.8% respectively. All clinical variables evaluated were poor predictors of PN (P > 0.05). Conclusion: PN diagnosed by objective methods is present in South-Eastern Nigerian T2DM subjects who do not have symptoms of PN. Tuning fork diagnosed PN much more than the other methods reflecting its subjectivity.

Objective: This study examined the effect of high intensity interval training (HIIT) on HNF-4α gene expression, glucose and insulin in liver tissue of type 2 diabetic male Wistar rats. Materials and Methods: In this study, 20 male Wistar rats weighing 220 (±20) grams were selected. After type 2 diabetes (T2D) induction, the samples were divided into two groups of HIIT and control. The training program was 12 weeks and 5 times a week. Fasting glucose, serum insulin and HNF-4α gene expression in the liver tissue were measured in both groups after the last exercise session by using independent T-test. Results: The results showed that HIIT decreased significantly the fasting glucose (P-value: 0.001) and increased serum insulin (P-value: 0.001). Also, the expression of HNF-4α after HIIT significantly decreased in comparison to the control group (P-value: 0.003). Conclusion: Based on the findings, HIIT resulted in a significant decrease in fasting glucose and a significant increase in insulin that is likely to reduce the liver HNF-4α gene expression of T2D male Wistar rats by increasing serum insulin.

Diabetes is a disease that is expressed in life style diseases such as high blood pressure. Many of these diseases are the result of the behavior of the wrong. Objectives: The study aims at identify the degree of disease acceptance patients and their health seeking behaviors; and determine the relationship between degree of acceptance and health seeking among patients. Methodology: A descriptive study has been conducted by "purposive sample" accounts of 150 patients who review the diabetic center in Hilla City. Through the use of the questionnaire and interview techniques the data were collected and analyzed disruptively and inferentially. Results: Findings depicts that most of the study sample aged (30-39) years old, (56.7%) male, (45.3%) married, (40%) unemployed, and (52%) notable read and write. The majority of (48% and 44.7%) were never have accepted their disease and seek towards health respectively. There were a significant relationship between the degree of disease acceptance and seeking of health behavior at p-value <0.05. Conclusion: Patients who diagnosed with type 2 diabetes and who review the diabetic center were never accepted their disease and never seek health. The accepted of disease were affected the seek towards health. Study that can be supported by a qualitative work using the clinical methodology with its tools and methods such as case study, clinical interview and psychological tests to achieve satisfactory acceptance and high self-control. [ABSTRACT FROM AUTHOR]

Introduction: The mTOR and SREBP1 proteins are key proteins in the metabolism and adipose tissue regulation. Obesity and type 2 diabetes can disorder with the function of these two proteins. The purpose of the present study was to investigate the effect of high-intensity interval training on the content of mTOR and SREBP1 proteins in subcutaneous fat tissue in obese type 2 diabetic male Sprague-Dawley rats with diabetes. Methods: In this experimental study, 16 two-month-old Sprague-Dawley rats with a mean weight of 300±20 g were selected. After diabetic induction with STZ and Nicotinamide, rats were randomly assigned to two groups, diabetic training (8 heads) and diabetic control (8 heads). The training group trained HIIT for 4 days a week in accordance with the training program for 8 weeks, while the control group did not have any training program. The independent t-test was used to analyze the data. Results: There was a significant increase in the content of mTOR (P=0.001) and SREBP1 (P=0.001) proteins in the training group compared to control; The control group weight (P=0.001) and training group (P=0.009) significantly increased at the end of the eighth week compared to the first week; Also, blood glucose levels in the control group showed a significant increase in the 8th week compared to the first week (P=0.001). But in the training group at the end of the eighth week, it was lower than the first week (P=0.001). Conclusion: Endurance training can adjust the weight, blood glucose and proteins content of mTOR and SREBP1; therefore, the HIIT exercise can be a good way to regulate metabolism and adipose tissue. [ABSTRACT FROM AUTHOR]

Background: Mulberry marc (MM) which as a wasted residue contains many available resources and one of the valuable nutrients is anthocyanin. In this study, the extraction, purification, content analysis, and hypoglycemic effect of anthocyanin from MM were studied. Materials and Methods: The total anthocyanin and cyanidin-3-O-glucoside of the purified anthocyanin of mulberry marc (MMA) were determined using pH differential method and high-performance liquid chromatography. The hypoglycemic effects were studied by streptozotocin and high-fat diet-induced type 2 diabetic rats. The rats were given MMA for 4 weeks and at the end of experiment; the blood was collected for determination serum indexes; the tissue of liver, kidney, pancreas, and spleen was removed for weighting and observing pathological changes. Results: The content of total anthocyanin and cyanidin-3-O-glucoside of MMA was 39.72% and 18.63%, respectively. The fasting blood glucose of rats in the MMA treatment groups was decreased. The lipid metabolites (triglycerides and total cholesterol) and malondialdehyde were decreased and superoxide dismutase was increased of type 2 diabetes rats after MMA treated; the pathological changes were alleviated in various degrees. Conclusion: The content of anthocyanin in mulberry marc is higher than mulberry juice, and the MMA has a good hypoglycemic effect. [ABSTRACT FROM AUTHOR]

Introduction: Several treatments have been proposed for treating diabetes; however it is still unclear which one of these methods is more effective with regard to patient conditions. Therefore, the purpose of this study was to investigate the effect of 8 weeks of aerobic exercise and concurrent (aerobic resistance) exercise on serum glucose, insulin and insulin resistance levels in Type 2 diabetic patients. Materials and Methods: In this quasi-experimental study, which was performed as a pre-test, post-test with a control group, 56 type 2 diabetic men randomly assigned into Cinnamon supplement (14 person) , aerobic exercise (14 person), supplement + exercise (14 person) and control groups (14 person). The Cinnamon supplement group received 6 capsule containing 500 mg powder of cinnamon for 8 weeks. Training program for the aerobic group included 3 sessions with 35 – 45 minutes of running per week with 60 to70% maximal heart rate for 8 weeks and the concurrent group performed aerobic exercise and received cinnamon simultaneously. The variables were measured at baseline and after 8 weeks of intervention. Data were analyzed by t-test and ANOVA at significance level of p<0.05. Results: Fasting blood glucose, insulin and HOMA-IR were significantly decreases in three groups compared to control group (p<0.05), but no significant decreased were observed for these indexes between groups. Conclusion: Cinnamon supplementation, aerobic exercise and concurrent methods, can have positive effects on fasting blood glucose, insulin and insulin resistance. [ABSTRACT FROM AUTHOR]

Background and Objectives: Fenofibrate, a PPAR-α agonist, has been demonstrated to reduce the progression of diabetic retinopathy (DR) and the need for laser treatment in a FIELD (Fenofibrate Intervention and Event Lowering in Diabetes) study. However, in the subgroup of patients without pre-existing DR, there was no significant difference in the progression of DR between the fenofibrate group and the placebo group. In this study, we aim to investigate whether fenofibrate can decrease the risk of incident DR in a population-based cohort study of type 2 diabetic patients in Taiwan. Materials and Methods: A total of 32,253 type 2 diabetic patients without previous retinopathy were retrieved from 892,419 patients in 2001–2002. They were then divided into two groups based on whether they were exposed to fenofibrate or not. The patients were followed until a diagnosis of diabetic retinopathy was made or until the year 2008. Results: With a follow-up period of 6.8 ± 1.5 years and 5.4 ± 2.6 years for 2500 fenofibrate users and 29,753 non-users, respectively, the Cox proportional hazard regression analysis revealed that the hazard ratio (HR) of new onset retinopathy was 0.57 (95% CI 0.57–0.62, p < 0.001). After adjusting for hypertension; the Charlson comorbidity index (CCI); and medications such as angiotensin-converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARB), anticoagulants, gemfibrozil, statins, and hypoglycemic agents, the adjusted HR was 0.75 (95% CI 0.68–0.82, p < 0.001). The need for laser treatment has an HR and adjusted HR of 0.59 (95% CI 0.49–0.71, p < 0.001) and 0.67 (95% CI 0.56–0.81, p < 0.001), respectively. Conclusion: Our study showed that the long-term and regular use of fenofibrate may decrease the risk of incident retinopathy and the need for laser treatment in type 2 diabetic patients. Since there are limitations associated with our study, further investigations are necessary to confirm such an association.

Background and Objective: Alpha lipoic acid (ALA) is a powerful biological antioxidant which is involved in metabolism and energy production as a co-factor in mitochondrial dehydrogenase enzyme complex. This study was done to evaluate the effect of aerobic exercise and alpha lipoic acid supplement on insulin resistance in females with type 2 diabetes. Methods: In this quasi-experimental study, 44 females with type 2 diabetes divided into four groups including: control, supplementation, training and supplementation + training groups. Patients of supplementation and complex (supplementation + training) groups took three 100mg ALA capsules per day for eight weeks. The training program consisted of 8 weeks and three sessions per week. In each session, the subjects warmed up for 10-15 minutes, ran on a treadmill with the intensity of 40-50% of maximum heart rate for 30 minutes and then cooled down for 5-10 minutes. Blood samples were taken after 12-14 hours fasting in two stages - the beginning and the end of the eighth week. Results: Eight weeks of taking ALA supplements significantly reduced patients' insulin resistance (P

Objective: This study examined the effect of high intensity interval training (HIIT) on HNF-4a gene expression, glucose and insulin in liver tissue of type 2 diabetic male Wistar rats. Materials and Methods: In this study, 20 male Wistar rats weighing 220 (±20) grams were selected. After type 2 diabetes (T2D) induction, the samples were divided into two groups of HIIT and control. The training program was 12 weeks and 5 times a week. Fasting glucose, serum insulin and HNF-4a gene expression in the liver tissue were measured in both groups after the last exercise session by using independent T-test. Results: The results showed that HIIT decreased significantly the fasting glucose (P-value: 0.001) and increased serum insulin (Pvalue: 0.001). Also, the expression of HNF-4a after HIIT significantly decreased in comparison to the control group (P-value: 0.003). Conclusion: Based on the findings, HIIT resulted in a significant decrease in fasting glucose and a significant increase in insulin that is likely to reduce the liver HNF-4a gene expression of T2D male Wistar rats by increasing serum insulin. [ABSTRACT FROM AUTHOR]

In this study, the effects of Lactobacillus rhamnosus CCFM0528, a new probiotic strain isolated by our laboratory, on glucose tolerance, hyperglycemia and cytokine secretion in high-fat-fed, streptozotocin-induced type 2 diabetic mice were studied. The results indicate that L. rhamnosus CCFM0528 significantly decreased fasting and postprandial 2-h blood glucose, glycosylated hemoglobin (HbA1c), endotoxin, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8) levels compared with the control group (P