Medicine (General)
Brain-derived Neurotrophic Factor Level and Gene Polymorphism as Risk Factors for Depression in Patients with type 2 Diabetes Mellitus- A Case-Controlled Study
Diabetes mellitus and depression are comorbidities that can be caused by each other. Brain-derived neurotrophic factor (BDNF) functions as a neuronal growth factor. It maintains the functional integrity of the nervous system.
To study the possible association between BDNF levels and gene polymorphism with depression in patients diagnosed with type 2 diabetes mellitus.
The Elisa technique measured BDNF and rs6265 gene polymorphism was detected using real-time PCR. Depression was assessed utilizing a clinical interview tool designed to establish the diagnosis of depression and differentiate it from other psychiatric diseases.
BDNF levels were significantly lower in patients with type 2 diabetes mellitus and symptoms of depression than in patients with type 2 diabetes mellitus and no symptoms of depression (82.6±16.1. vs. 122± 17.47 P˂ 0.001). There was a statistically significant difference in BDNF levels in patients with diabetes among the three genotypes of the BDNF gene (P-value < 0.001). Val/ Val carriers had the highest serum BDNF levels and Met/ Met carriers had the lowest serum BDNF levels. Subgroup analysis showed statistically significant genotype-related differences in serum BDNF levels among the three subgroups in the Depression group. Val/ Val carriers had the highest serum BDNF levels and Met/ Met carriers had the lowest serum BDNF levels. BDNF Val66Met polymorphism had no significant association with the presence of depression yet there was a trend towards significance (p = 0.05).
In this pilot Low levels of BDNF were associated with depression in patients with type 2 diabetes. Carriers of the Met/ Met allele have the lowest serum BDNF levels. Multi-center studies with more participants are required.
Stem Cells Reprogramming in Diabetes Mellitus and Diabetic Complications: Recent Advances
The incidence of diabetes mellitus (DM) is dramatically increasing worldwide and it is expected to affect 700 million cases by 2045. Diabetes influences health care economics human quality of life morbidity and mortality which were primarily seen extensively in developing countries. Uncontrolled DM which results in consistent hyperglycemia may lead to severe life-threatening complications such as nephropathy retinopathy neuropathy and cardiovascular complications.
In addition to traditional therapies with insulin and oral anti-diabetics researchers have developed new approaches for treatment including stem cell (SC) therapy which exhibits promising outcomes. Besides its significant role in treating type one DM (T1DM) and type two DM (T2DM) it can also attenuate diabetic complications. Furthermore the development of insulin-producing cells can be achieved by using the different types of SCs such as embryonic stem cells (ESCs) induced pluripotent stem cells (iPSCs) and multiple types of adult stem cells such as pancreatic hepatic and mesenchymal stem cells (MSC). All these types have been extensively studied and proved their ability to develop insulin-producing cells but every type has limitations.
This review aims to enlighten researchers about recent advances in stem cell research and their potential benefits in DM and diabetic complications.
“Hyperglycemic Memory”: Observational Evidence to Experimental Inference
Several epidemiological studies have appreciated the impact of “duration” and “level” of hyperglycemia on the initiation and development of chronic complications of diabetes. However glycemic profiles could not fully explain the presence/absence and severity of diabetic complications. Genetic issues and concepts of “hyperglycemic memory” have been introduced as additional influential factors involved in the pathobiology of late complications of diabetes. In the extended phase of significant diabetes randomized controlled clinical trials including DCCT/EDIC and UKPDS studies have concluded that the quality of glycemic or metabolic control at the early time around the diabetes onset could maintain its protective or detrimental impact throughout the following diabetes course.
There is no reliable indication of the mechanism by which the transient exposure to a given glucose concentration level could evoke a consistent cellular response at target tissues at the molecular levels. Some biological phenomena such as the production and the concentration of advanced glycation end products (AGEs) reactive oxygen species (ROS) and protein kinase C (PKC) pathway activations epigenetic changes and finally the miRNAs-mediated pathways may be accountable for the development of hyperglycemic memory. This work summarizes evidence from previous experiments that may substantiate the hyperglycemic memory soundness by its justification in molecular terms.
Investigating Ayurvedic Strategies: An In-Depth Examination of Managing Diabetes across Different Types
In light of the escalating global concern surrounding diabetes mellitus contemporary medical practices predominantly hinge on pharmaceutical interventions accompanied by inherent side effects and enduring limitations. This investigation accentuates a discernible research void regarding the amalgamation of Ayurvedic principles an age-old traditional medical system with prevalent approaches to diabetes management. Despite Ayurveda's promising potential in furnishing a comprehensive and personalized strategy for diabetes treatment the imperative for further research and collaboration between Ayurvedic practitioners and contemporary healthcare professionals becomes evident.
Existing scholarly works underscore the potential advantages of Ayurveda in delivering holistic diabetes care encompassing not only glycemic control but also fostering overall well-being. Nevertheless a closer examination reveals specific limitations challenges and gaps in current research necessitating targeted efforts to enable a more exhaustive exploration of Ayurvedic interventions within diabetes management. This comprehensive review scrutinizes Ayurvedic recommendations pertaining to dietary practices lifestyle adjustments and herbal therapeutics shedding light on their plausible efficacy. It serves as a clarion call for heightened research endeavors aiming to bridge existing gaps and carve a pathway toward an integrated patient-centric paradigm in diabetes care. In summary as diabetes prevalence continues to rise globally the study underscores the limitations of current pharmaceutical-centric approaches and highlights the need for extensive research and collaboration to unlock the full potential of Ayurvedic principles in providing a more holistic and personalized framework for diabetes management. The review navigates through Ayurvedic recommendations emphasizing the urgency for intensified research efforts to fill existing gaps and pave the way for a seamlessly integrated patient-focused approach to diabetes care.
Endothelial versus Metabolic Insulin Resistance, A Descriptive Review
Cardiovascular complications are a primary focus in the clinical management of type 2 diabetes as they are the leading causes of disability and mortality in individuals with diabetes. Insulin resistance and endothelial dysfunction commonly coexist in diabetic patients. An increasing body of research indicates a reciprocal and interconnected association between endothelial function and insulin resistance. Insulin resistance can manifest in two distinct forms: endothelial and metabolic with the former predominantly affecting vascular endothelial cells and the latter primarily impacting peripheral cells. The understanding of endothelial insulin resistance is crucial in comprehending the pathophysiology of cardiovascular complications in type 2 diabetes. Hence the objective of this study is to examine the correlations interplays and molecular pathways linking endothelial insulin resistance and metabolic insulin resistance with the aim of offering novel insights and scholarly resources for the prevention and management of diabetic vascular complications.
3-Phosphoinositide-Dependent Kinase 1 as a Therapeutic Target for Treating Diabetes
The role of 3-phosphoinositide-dependent kinase 1 (PDK1) has been well-documented in the development of diabetes. This review offers a thorough examination of its composition and associated routes specifically focusing on insulin signaling and glucose processing. By examining the precise connection between PDK1 and diabetes various strategies specifically targeting PDK1 were also investigated. Additionally recent discoveries from mouse models were compiled where PDK1 was knocked out in certain tissues which demonstrated encouraging outcomes for focused treatments despite the absence of any currently approved clinical PDK1 activators. Moreover the dual nature of PDK1 activation was discussed encompassing both anti-diabetic and pro-oncogenic effects. Hence the development of a PDK1 modifier is of utmost importance as it can activate anti-diabetic pathways while inhibiting pro-oncogenic pathways thus aiding in the treatment of diabetes. In general PDK1 presents a noteworthy opportunity for future therapeutic strategies in the treatment of diabetes.
Comparing Methods for Induction of Insulin Resistance in Mouse 3T3-L1 Cells
Cell culture plays a crucial role in addressing fundamental research questions particularly in studying insulin resistance (IR) mechanisms. Multiple in vitro models are utilized for this purpose but their technical distinctions and relevance to in vivo conditions remain unclear. This study aims to assess the effectiveness of existing in vitro models in inducing IR and their ability to replicate in vivo IR conditions.
Insulin resistance (IR) is a cellular condition linked to metabolic disorders. Despite the utility of cell culture in IR research questions persist regarding the suitability of various models. This study seeks to evaluate these models' efficiency in inducing IR and their ability to mimic in vivo conditions. Insights gained from this research could enhance our understanding of model strengths and limitations potentially advancing strategies to combat IR and related disorders.
1- Investigate the technical differences between existing cell culture models used to study molecular mediators of insulin resistance (IR).
2- Compare the effectiveness of present in vitro models in inducing insulin resistance (IR).
3- Assess the relevance of the existing cell culture models in simulating the in vivo conditions and environment that provoke the induction of insulin resistance (IR).
In vitro eight sets of 3T3-L1 cells were cultured until they reached 90% confluence. Subsequently adipogenic differentiation was induced using a differentiation cocktail (media). These cells were then divided into four groups with four subjected to normal conditions and the other four to hypoxic conditions. Throughout the differentiation process each cell group was exposed to specific factors known to induce insulin resistance (IR). These factors included 2.5 nM tumor necrosis factor-alpha (TNFα) 20 ng/ml interleukin-6 (IL-6) 10 micromole 4-hydroxynonenal (4HNE) and high insulin (HI) at a concentration of 100 nM. To assess cell proliferation DAPI staining was employed and the expression of genes associated with various metabolic pathways affected by insulin resistance was investigated using Real-Time PCR. Additionally insulin signaling was examined using the Bio-plex Pro cell signaling Akt panel.
We induced insulin resistance in 3T3-L1 cells using IL-6 TNFα 4HNE and high insulin in both hypoxic and normoxic conditions. Hypoxia increased HIF1a gene expression by approximately 30% (P<0.01). TNFα reduced cell proliferation by 10-20% and chronic TNFα treatment significantly decreased mature adipocytes due to its cytotoxicity. We assessed the impact of insulin resistance (IR) on metabolic pathways focusing on genes linked to branched-chain amino acid metabolism detoxification and chemotaxis. Notably ALDH6A1 and MCCC1 genes related to amino acid metabolism were significantly affected under hypoxic conditions. TNFα treatment notably influenced MCP-1 and MCP-2 genes linked to chemotaxis with remarkable increases in MCP-1 levels and MCP-2 expression primarily under hypoxia. Detoxification-related genes showed minimal impact except for a significant increase in MAO-A expression under acute hypoxic conditions with TNFα treatment. Additional genes displayed varying effects warranting further investigation. To investigate insulin signaling's influence in vitro by IR-inducing factors we assessed phospho-protein levels. Our results reveal a significant p-Akt induction with chronic high insulin (10%) and acute TNFα (12%) treatment under hypoxia (both P<0.05). Other insulin resistance-related phospho-proteins (GSK3B mTOR PTEN) increased with IL-6 4HNE TNFα and high insulin under hypoxia while p-IRS1 levels remained unaffected.
In summary different in vitro models using inflammatory oxidative stress and high insulin conditions under hypoxic conditions can capture various aspects of in vivo adipose tissue insulin resistance (IR). Among these models acute TNFα treatment may offer the most robust approach for inducing IR in 3T3-L1 cells.
Association of the Immunity Genes with Type 1 Diabetes Mellitus
Type 1 diabetes mellitus (T1D) is a complicated illness marked by the death of insulin-producing pancreatic beta cells which ultimately leads to insulin insufficiency and hyperglycemia. T lymphocytes are considered to destroy pancreatic beta cells in the etiology of T1D as a result of hereditary and environmental factors. Although the latter factors are very important causes of T1D development this disease is very genetically predisposed so there is a significant genetic component to T1D susceptibility. Among the T1D-associated gene mutations those that affect genes that encode the traditional Human Leukocyte Antigens (HLA) entail the highest risk of T1D development. Accordingly the results of decades of genetic linkage and association studies clearly demonstrate that mutations in the HLA genes are the most associated mutations with T1D. They can therefore be used as biomarkers for prediction strategies and may even prove to be of value for personalized treatments. Other immunity-associated genetic loci are also associated with higher T1D risk. Indeed T1D is considered an autoimmune disease. Its prevalence is rising globally especially among children and young people. Given the global rise of and thus interest in autoimmune diseases here we present a short overview of the link between immunity especially HLA genes and T1D.
Incretin Therapy and Insulin Signaling: Therapeutic Targets for Diabetes And Associated Dementia
Dementia is the primary cause of disability and dependence among the elderly population worldwide. The population living with dementia is anticipated to double in the next 17 years. Recent studies show the fact that compared to people without diabetes people with Type 2 Diabetes (T2D) have about a 60% increased chance of developing dementia. In addition to cholinergic function being downregulated improper insulin signalling also has a negative impact on synaptic plasticity and neuronal survival. Type 2 diabetes and dementia share various similar pathophysiological components. The ageing of the population and the ensuing rise in dementia prevalence are both results of ongoing medical advancements. It is possible that restoring insulin signaling could be a helpful therapy against dementia as it is linked to both diminished cognitive function and the development of dementia including AD. This review article comprehensively focused on scientific literature to analyze the relationship of Dementia with diabetes recent experimental studies and insight into incretin-based drug therapy for diabetes-related dementia.
Effects of Diabetes and Hyperlipidemia in Physiological Conditions - A Review
Diabetes mellitus (DM) is an autoimmune manifestation defined by persistent hyperglycemia and alterations in protein fatty substances and carbohydrate metabolism as an effect of problems with the secretion of insulin action or both. Manifestations include thirst blurred eyesight weight loss and ketoacidosis which can majorly lead to coma. There are different types of diabetes according to class or by cellular level. They are interrelated with hyperlipidemia as they are involved in the metabolism and regulation of physiological factors. Most parameters are seen at cellular or humoral levels yet the underlying concern remains the same.
To create a systematic correlation between the disease and locate the exact mechanism and receptors responsible for it. So this article covers a proper way to resolve the conditions and their manifestation through literacy and diagrammatic.
Hence this will be an insight for many scholars to understand the exact mechanism involved in the process.
Prevalence and Predictors of Diabetic Peripheral Neuropathy in Newly Diagnosed Type 2 Diabetes Mellitus Patients
The present study aimed to determine the prevalence and predictors of DPN in newly diagnosed T2DM patients.
Diabetic Peripheral Neuropathy (DPN) is the most common and debilitating complication of Type 2 Diabetes Mellitus (T2DM).
Newly diagnosed T2DM patients visiting the outpatient department were recruited. Detailed demographic parameters histories physical examinations and biochemical investigations were carried out. Patients were screened for DPN using the Diabetic Neuropathy Symptom (DNS) score the revised Disability Neuropathy Score (NDS) Vibration Perception Threshold (VPT) using a biosthesiometer and the 10 g SW Monofilament Test (MFT).
A total of 350 newly diagnosed T2DM patients (mean age 46.4±13.6 years) were included. The prevalence of DPN was found to be 34% using the combined DNS and NDS scores. VPT was moderately impaired in 18.3% and severely impaired in 12% patients while MFT revealed a loss of protective sensation in 35.4% patients. After logistic regression analysis DPN was significantly associated with increasing age (OR 1.08 95%CI 1.06-1.11) increasing HbA1C levels (OR 1.23 95%CI 1.05-1.42) increasing TSH levels (OR 1.23 95%CI 1.05-1.44) presence of hypertension (OR 2.78 95%CI 1.51-5.11) and reduced BMI (OR 0.9 95%CI 0.84-0.99). The sensitivity and specificity of detecting DPN by combining VPT and MFT were 91.6% and 84.2% respectively.
The prevalence of DPN was high even in newly diagnosed T2DM and associated significantly with increasing age HbA1C levels TSH levels hypertension and reduced BMI. Earlier screening for DPN along with aggressive control of glycemia blood pressure and hypothyroidism may be beneficial.
Unraveling the Therapeutic Potential of Muscle Strengthening Exercises for Reversing Diabetes Mellitus
Millions of people worldwide are affected by the serious consequences of diabetes mellitus which is a major global health concern. We analyze the possibility of muscle-strengthening activities as an appropriate therapeutic strategy for controlling the progression of diabetes mellitus in this comprehensive review. In this review we explore the molecular processes underlying the glucose uptake in skeletal muscle revealing how exercise can improve insulin sensitivity and glucose homeostasis.
Articles published between 2010 and 2023 were analyzed in detail by using bibliographic databases like PubMed Medline and Scopus. The most commonly searched terms were “muscle strengthening exercises” “diabetes mellitus” “insulin resistance” “glucose uptake” “skeletal muscle” and even “exercise therapy.” The inclusion criteria were randomized controlled trials observational studies and systematic reviews. This allowed for the selection of sources that were related to the topic at hand and were reliable.
This review highlights the benefits of exercise for diabetes mellitus elucidating the positive effects of acute and regular exercise on glucose uptake in skeletal muscle. It also analyzes the impact of various exercise modalities including aerobic and resistance exercises on glucose metabolism in individuals with and without type 2 diabetes. Furthermore this review examines the effectiveness of combining aerobic and resistance training for optimal diabetes management.
Our analysis reveals promising evidence supporting the role of resistance training in diabetes mellitus reversal. Regular resistance exercise has been shown to improve glycemic control insulin sensitivity and muscle function in individuals with type 2 diabetes. Combining aerobic and resistance exercises appears to be more effective than single-mode training in managing blood glucose levels and enhancing overall metabolic health. However potential contraindications for exercise in diabetes patients along with barriers to implementing resistance training warrant careful consideration.
Interferon Upregulation Associates with Insulin Resistance in Humans
In humans insulin resistance is a physiological response to infections developed to supply sufficient energy to the activated immune system. This metabolic adaptation facilitates the immune response but usually persists after the recovery period of the infection and predisposes the hosts to type 2 diabetes and vascular injury. In patients with diabetes superimposed insulin resistance worsens metabolic control and promotes diabetic ketoacidosis. Pathogenic mechanisms underlying insulin resistance during microbial invasions remain to be fully defined. However interferons cause insulin resistance in healthy subjects and other population groups and their production is increased during infections suggesting that this group of molecules may contribute to reduced insulin sensitivity. In agreement with this notion gene expression profiles (transcriptomes) from patients with insulin resistance show a robust overexpression of interferon-stimulated genes (interferon signature). In addition serum levels of interferon and surrogates for interferon activity are elevated in patients with insulin resistance. Circulating levels of interferon-γ-inducible protein-10 neopterin and apolipoprotein L1 correlate with insulin resistance manifestations such as hypertriglyceridemia reduced HDL-c visceral fat and homeostasis model assessment-insulin resistance. Furthermore interferon downregulation improves insulin resistance. Antimalarials such as hydroxychloroquine reduce interferon production and improve insulin resistance reducing the risk for type 2 diabetes and cardiovascular disease. In addition diverse clinical conditions that feature interferon upregulation are associated with insulin resistance suggesting that interferon may be a common factor promoting this adaptive response. Among these conditions are systemic lupus erythematosus sarcoidosis and infections with severe acute respiratory syndrome-coronavirus-2 human immunodeficiency virus hepatitis C virus and Mycobacterium tuberculosis.
Herbal Nanoformulations for Diabetes: Mechanisms, Formulations, and Clinical Impact
Diabetes mellitus remains a global health challenge demanding innovative therapeutic strategies. Herbal remedies have garnered attention for their potential in diabetes management and recent advancements in nanotechnology have enabled the development of herbal nanoformulations with enhanced efficacy and bioavailability.
This review aimed to comprehensively analyze the mechanisms formulations and clinical impact of herbal nanoformulations in managing diabetes mellitus.
A systematic literature search was conducted to identify relevant studies exploring the mechanisms of action various formulations and clinical outcomes of herbal nanoformulations in diabetes management.
Herbal nanoformulations exert their anti-diabetic effects through multiple mechanisms including enhanced bioavailability improved tissue targeting and potentiation of insulin signaling pathways. Various herbal ingredients such as bitter melon fenugreek and Gymnema sylvestre have been encapsulated into nanocarriers like liposomes polymeric nanoparticles and solid lipid nanoparticles to enhance their therapeutic potential. Clinical studies have demonstrated promising results showing improvements in glycemic control lipid profile and antioxidant status with minimal adverse effects.
Herbal nanoformulations represent a promising avenue for the management of diabetes mellitus offering improved therapeutic outcomes compared to conventional herbal preparations. Further research is warranted to optimize formulation strategies elucidate long-term safety profiles and explore the potential synergistic effects of herbal nanoformulations in combination therapies for diabetes management.
Diabetic Retinopathy - Pathophysiology to Treatment: A Review
Diabetic retinopathy (DR) is a microvascular disease affecting the eyes of diabetic patients and is the most prevalent complication of diabetes mellitus. Vision improvement is not possible in the majority of DR patients. Several studies have indicated that microvascular changes inflammation oxidative stress and retinal neurodegeneration are involved in the pathogenesis of DR. Therefore there is an urgent need for the development of new and effective treatment for DR. Understanding the molecular mechanisms involved in the pathogenesis of disease will pave a way for better treatment and management of DR. This article has emphasized the molecular pathogenesis and treatment of DR.
Qatar's Silent Epidemic: A Comprehensive Meta-analysis on the Prevalence of Metabolic Syndrome
Metabolic syndrome comprises various conditions like abdominal obesity insulin resistance elevated triglyceride levels reduced HDL and high blood pressure which pose significant health challenges globally. It's imperative to determine its prevalence in specific populations to formulate effective preventive measures.
This systematic review and meta-analysis aimed to determine the prevalence of metabolic syndrome in the Qatari population.
Using the PRISMA guidelines a systematic search was executed on PubMed until July 2023 with keywords “Metabolic syndrome” and “Qatar.” Eligibility criteria included human subjects studies assessing metabolic syndrome components and research conducted in Qatar or on Qatari subjects. The quality of the studies was evaluated using the Newcastle-Ottawa Scale (NOS). Pooled prevalence rates were calculated using the inverse variance weighting meta-analysis.
Out of 237 studies 14 met our inclusion criteria with a combined sample size of 14772 from the Qatari population. The overall pooled prevalence of metabolic syndrome was 26%. The ATP III and IDF criteria exhibited significant differences in prevalence rates with the IDF criteria showing a higher prevalence. Patients in the age of 40 or older demonstrated a higher prevalence compared to the younger group. Studies post-2018 reported a decreasing trend in metabolic syndrome prevalence.
The prevalence of metabolic syndrome in the Qatari population is comparable to rates in the Middle East. The study underscores the need for tailored interventions and strategies especially targeting the older age group. Continuous research and monitoring are essential to track and understand the disease's progression in Qatar.
Using Machine Learning and Artificial Intelligence to Predict Diabetes Mellitus among Women Population
Diabetes Mellitus is a chronic health condition (long-lasting) due to inadequate control of blood levels of glucose. This study presents a prediction of Type 2 Diabetes Mellitus among women using various Machine Learning Algorithms deployed to predict the diabetic condition. A University of California Irvine Diabetes Mellitus Dataset posted in Kaggle was used for analysis.
The dataset included eight risk factors for Type 2 Diabetes Mellitus prediction including Age Systolic Blood Pressure Glucose Body Mass Index Insulin Skin Thickness Diabetic Pedigree Function and Pregnancy. R language was used for the data visualization while the algorithms considered for the study are Logistic Regression Support Vector Machines Decision Trees and Extreme Gradient Boost. The performance analysis of these algorithms on various classification metrics is also presented here considering the Area Under the Curve and Receiver Operating Characteristics score is the best for Extreme Gradient Boost with 85% followed by Support Vector Machines and Decision Trees.
The Logistic Regression is showing low performance. But the Decision Trees and Extreme Gradient Boost show promising performance against all the classification metrics. But the Support Vector Machines offers a lower support value; hence it cannot be claimed to be a good classifier. The model showed that the most significant predictors of Type 2 Diabetes Mellitus were strongly correlated with Glucose Levels and mediumly correlated with Body Mass Index whereas Age Skin Thickness Systolic Blood Pressure Insulin Pregnancy and Pedigree Function were less significant. This type of real-time analysis has proved that the symptoms of Type 2 Diabetes Mellitus in women fall entirely different compared to men which highlights the importance of Glucose Levels and Body Mass Index in women.
The prediction of Type 2 Diabetes Mellitus helps public health professionals to help people by suggesting proper food intake and adjusting lifestyle activities with good fitness management in women to make glucose levels and body mass index controlled. Therefore the healthcare systems should give special attention to diabetic conditions in women to reduce exacerbations of the disease and other associated symptoms. This work attempts to predict the occurrence of Type 2 Diabetes Mellitus among women on their behavioral and biological conditions.
The Teachers’ Knowledge of Type 1 Diabetes in Schools: An Interventional Study
Managing type 1 diabetes in school is a real challenge for teachers parents and students themselves. Involving school educators in providing care and support is becoming more of a necessity than a luxury to facilitate access to healthcare services in schools for children with type 1 diabetes.
Our work aimed to assess the background knowledge of teachers on type 1 diabetes and evaluate the impact of an educational intervention in improving this knowledge.
We included 346 participants working in elementary schools in Oujda City Morocco. We collected data on anonymous data sheets. Then a first pre-coded questionnaire was distributed to the participants to assess their background knowledge of type 1 diabetes. Afterward a simplified educational session was delivered to them. Subsequently the same pre-coded questionnaire was distributed for evaluation after education.
Around 84% of the participants recognized polyuria and polydipsia as major signs of diabetes. Only 35.3% of them knew the definition of hypoglycemia. Hyperglycemia was identified by 65% of the participants. About 40% believed children cannot exercise while 55.5% thought taking free sugar before exercise was mandatory. We found a significant correlation between a good level of knowledge and knowing a person with diabetes (aOR=2.66 CI95%: 1.51-4.70 p=0.001). There was a significant improvement in knowledge after the educational intervention (p=0.0001).
Our study showed a lack of information about type 1 diabetes among teachers. We also proved the effectiveness of targeted education in correcting misconceptions and encouraging awareness of type 1 diabetes.
Effect of Novel Laser Shoe Photobiomodulation on Neuropathic Pain and Plantar Pressure Profile in Type 2 Diabetes Mellitus with Peripheral Neuropathy
Photobiomodulation (PBM) or Low-level laser is used to treat diabetic foot complications. The existing method of laser application to the foot did not cover the foot's entire area to improve the foot's microcirculation. Therefore we have developed a cost-effective Special LASER Shoe device focusing exclusively on the entire foot region to manage neuropathic pain and other symptoms in individuals with type 2 diabetes mellitus.
The main objective of the present study was to evaluate the effect of this newly developed special laser shoe PBM on neuropathic pain and plantar pressure profile in individuals with type 2 diabetes mellitus with neuropathy.
We included 60 participants with diabetic peripheral neuropathy of both genders and age more than 20 years. Participants were treated with PBM by a specially designed novel Laser Shoe. Outcomes were clinical variables like Vibration Perception Threshold (VPT) Visual Analogue Scale (VAS) Michigan neuropathy screening instrument A&B Ankle-Brachial Index (ABI) and Static dynamic gait parameters.
Participants were with an average age of 62 and the average duration of diabetes was 11 years. Analysis showed a significant difference in VPT VAS Michigan neuropathic screening inventory and ankle-brachial index (P < 0.05).
We conclude that Novel laser shoe photobiomodulation using 'Laser Shoe' effectively reduces peripheral neuropathic pain. It is also effective in reducing average and maximum plantar pressure. Reduction in neuropathic pain and improvement in plantar pressure distribution can reduce further complications.
An In-Silico Approach to Identify Therapeutic Target and Markers Associated with Diabetic Nephropathy
Renal disease in T2DM could arise independently of hyperglycemia aka non diabetic kidney disease. Its prevalence ranges from 33% to 72.5% among T2DM patients. Specific molecular signatures that distinguish Diabetic Nephropathy from NDKD (FSGS) in T2DM might provide new targets for CKD management.
Five original GEO microarray DN and FSGS datasets were evaluated (GSE111154 GSE96804 GSE125779 GSE129973 and GSE121233). Each of the three groups (DN FSGS and Controls) had equal renal transcriptome data (n=32) included in the analysis to eliminate bias. The DEGs were identified using TAC4.0. Pathway analysis was performed on the discovered genes aligned to official gene symbols using Reactome followed by functional gene enrichment analysis using Funrich Enrichr. STRING and Network analyst investigated PPI followed by Webgestalt's pathway erichment. Finally using the Targetscan 7.0 and DIANA tools filtered differential microRNAs downregulated in DN were evaluated for target identification.
Between the three groups DN FSGS and Control a total of 194 DEGs with foldchange >2 & <-2 and P-value 0.01 were found in the renal transcriptome. In comparison to control 45 genes were elevated particularly in DN whereas 43 were upregulated specifically in FSGS. DN datasets were compared to FSGS in a separate analysis. FABP4 EBF1 ADIRF and ART4 were shown to be among the substantially up-regulated genes unique to DN in both analyses. The transcriptional regulation of white adipocytes was discovered by pathway analysis.
The molecular markers revealed might be employed as specific targets in the aetiology of DN as well as in T2DM patients' therapeutic care.