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Li R, Wang B, Wu C, Li D, Wu Y, Ye L, Ye L, Chen X, Li P, Yuan Y, Zhang H, Xie L, Li X, Xiao J, Wang J. Acidic fibroblast growth factor attenuates type 2 diabetes-induced demyelination via suppressing oxidative stress damage. Cell Death Dis 2021; 12:107. [PMID: 33479232 PMCID: PMC7819983 DOI: 10.1038/s41419-021-03407-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 02/06/2023]
Abstract
Prolonged type 2 diabetes mellitus (T2DM) produces a common complication, peripheral neuropathy, which is accompanied by nerve fiber disorder, axon atrophy, and demyelination. Growing evidence has characterized the beneficial effects of acidic fibroblast growth factor (aFGF) and shown that it relieves hyperglycemia, increases insulin sensitivity, and ameliorates neuropathic impairment. However, there is scarce evidence on the role of aFGF on remodeling of aberrant myelin under hyperglycemia condition. Presently, we observed that the expression of aFGF was rapidly decreased in a db/db T2DM mouse model. Administration of exogenous aFGF was sufficient to block acute demyelination and nerve fiber disorganization. Furthermore, this strong anti-demyelinating effect was most likely dominated by an aFGF-mediated increase of Schwann cell (SC) proliferation and migration as well as suppression of its apoptosis. Mechanistically, the beneficial biological effects of aFGF on SC behavior and abnormal myelin morphology were likely due to the inhibition of hyperglycemia-induced oxidative stress activation, which was most likely activated by kelch-like ECH-associated protein 1 (Keap1)/nuclear factor erythroid-derived-like 2 (Nrf2) signaling. Thus, this evidence indicates that aFGF is a promising protective agent for relieving myelin pathology through countering oxidative stress signaling cascades under diabetic conditions.
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Affiliation(s)
- Rui Li
- grid.268099.c0000 0001 0348 3990Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital and School of Pharmaceutical Sciences, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China ,grid.268099.c0000 0001 0348 3990Research Center, Affiliated Xiangshang Hospital, Wenzhou Medical University, 315700 Ningbo, Zhejiang China ,grid.12981.330000 0001 2360 039XSchool of Chemistry, Sun Yat-sen University, 510275 Guangzhou, Guangdong China
| | - Beini Wang
- grid.268099.c0000 0001 0348 3990Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital and School of Pharmaceutical Sciences, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Chengbiao Wu
- grid.268099.c0000 0001 0348 3990Research Center, Affiliated Xiangshang Hospital, Wenzhou Medical University, 315700 Ningbo, Zhejiang China
| | - Duohui Li
- grid.268099.c0000 0001 0348 3990Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital and School of Pharmaceutical Sciences, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Yanqing Wu
- grid.268099.c0000 0001 0348 3990Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital and School of Pharmaceutical Sciences, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Libing Ye
- grid.268099.c0000 0001 0348 3990Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital and School of Pharmaceutical Sciences, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Luxia Ye
- grid.268099.c0000 0001 0348 3990Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital and School of Pharmaceutical Sciences, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Xiongjian Chen
- grid.268099.c0000 0001 0348 3990Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital and School of Pharmaceutical Sciences, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Peifeng Li
- grid.268099.c0000 0001 0348 3990Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital and School of Pharmaceutical Sciences, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Yuan Yuan
- grid.268099.c0000 0001 0348 3990Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital and School of Pharmaceutical Sciences, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Hongyu Zhang
- grid.268099.c0000 0001 0348 3990Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital and School of Pharmaceutical Sciences, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Ling Xie
- grid.268099.c0000 0001 0348 3990Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital and School of Pharmaceutical Sciences, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Xiaokun Li
- grid.268099.c0000 0001 0348 3990Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital and School of Pharmaceutical Sciences, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Jian Xiao
- grid.268099.c0000 0001 0348 3990Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital and School of Pharmaceutical Sciences, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
| | - Jian Wang
- grid.268099.c0000 0001 0348 3990Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital and School of Pharmaceutical Sciences, Wenzhou Medical University, 325000 Wenzhou, Zhejiang China
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Chernikova NA, Kamynina LL, Ametov AS, Sychev DA, Grishina EA, Ryzhikova KA. [The pharmacogenetics of hypoglycemia and the glycemic variability at the patients ith type 2 diabetes mellitus]. TERAPEVT ARKH 2020; 92:54-62. [PMID: 33346480 DOI: 10.26442/00403660.2020.10.000530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 11/22/2022]
Abstract
AIM To investigate the link between the hypoglycemia (registrated accurately by the professional Continuous Glucose Monitoring CGM; severe hypoglycemia at home) and the hetero-/homozygote carriage of single nucleotide polymorphisms (SNP) of cytochrome systems geneCYP2C9(rs1799853CYP2C9*2 иrs1057910CYP2C9*3) at the patients with Type 2 Diabetes Mellitus (T2DM) used sulphonylurea (SU). MATERIALS AND METHODS In Study Case-Control 120 T2DM-SU-patients genotyped by SNPs of geneCYP2C9(using PCR-RT) had been done the professional CGM (System iPro2, Medtronic) recorded Time in Range of Hypoglycemia (TIR-HYPO), level of Minimal CGM-hypoglycemia (MinGl) and standard CGM-parameters of Glycemic Variability. Severe hypoglycemia at home was recorded from visit to visit. The odds ratio (OR) of metabolic disturbances had been assessed for carriage SNPs in comparison with wide alleles. RESULTS The Study established that carriage of SNPsrs1799853andrs1057910geneCYP2C9at T2DM-SU-patients associated with rising of Glycemic Variability and frequency of CGM-hypoglycemia (MinGl decreasing, increasing of TIR-HYPO and number of Glycemia Excursion 4 mmol/L/h), as well as increasing severe hypoglycemia at home (p0.05). Thus, OR at the carriage ofrs1799853andrs1057910respectively equaled: for CGM-hypoglycemia 7.78 (3.0220.01) and 5.80 (0.23145.87); number of Glycemia Excursion 4 mmol/L/h 5.76 (2.2914.43) and 4.44 (1.4313.76); MinGl3.9 mmol/L 4.39 (1.7910.75) and 6.26 (1.8421.30); CV40% (vs30%) 3.63 (1.0412.62) and 15.22 (0.59393.94);p0.05. CONCLUSION At the real clinical practice the assessment of carriage of SNPs of geneCYP2C9before inclusion of SU to glucose-lowering scheme of T2DM-therapy it necessary to carry out for the detecting patients with a higher risk of hypoglycemia and rising of Glycemic Variability.
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Affiliation(s)
- N A Chernikova
- Russian Medical Academy of Continuous Professional Education
| | - L L Kamynina
- Russian Medical Academy of Continuous Professional Education
| | - A S Ametov
- Russian Medical Academy of Continuous Professional Education
| | - D A Sychev
- Russian Medical Academy of Continuous Professional Education
| | - E A Grishina
- Russian Medical Academy of Continuous Professional Education
| | - K A Ryzhikova
- Russian Medical Academy of Continuous Professional Education
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Galindo RJ, Beck RW, Scioscia MF, Umpierrez GE, Tuttle KR. Glycemic Monitoring and Management in Advanced Chronic Kidney Disease. Endocr Rev 2020; 41:5846208. [PMID: 32455432 PMCID: PMC7366347 DOI: 10.1210/endrev/bnaa017] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/19/2020] [Indexed: 02/06/2023]
Abstract
Glucose and insulin metabolism in patients with diabetes are profoundly altered by advanced chronic kidney disease (CKD). Risk of hypoglycemia is increased by failure of kidney gluconeogenesis, impaired insulin clearance by the kidney, defective insulin degradation due to uremia, increased erythrocyte glucose uptake during hemodialysis, impaired counterregulatory hormone responses (cortisol, growth hormone), nutritional deprivation, and variability of exposure to oral antihyperglycemic agents and exogenous insulin. Patients with end-stage kidney disease frequently experience wide glycemic excursions, with common occurrences of both hypoglycemia and hyperglycemia. Assessment of glycemia by glycated hemoglobin (HbA1c) is hampered by a variety of CKD-associated conditions that can bias the measure either to the low or high range. Alternative glycemic biomarkers, such as glycated albumin or fructosamine, are not fully validated. Therefore, HbA1c remains the preferred glycemic biomarker despite its limitations. Based on observational data for associations with mortality and risks of hypoglycemia with intensive glycemic control regimens in advanced CKD, an HbA1c range of 7% to 8% appears to be the most favorable. Emerging data on the use of continuous glucose monitoring in this population suggest promise for more precise monitoring and treatment adjustments to permit fine-tuning of glycemic management in patients with diabetes and advanced CKD.
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Affiliation(s)
- Rodolfo J Galindo
- Emory University School of Medicine, Division of Endocrinology, Atlanta, Georgia
| | - Roy W Beck
- Jaeb Center for Health Research, Tampa, Florida
| | - Maria F Scioscia
- Emory University School of Medicine, Division of Endocrinology, Atlanta, Georgia
| | | | - Katherine R Tuttle
- University of Washington, Division of Nephrology, Kidney Research Institute, and Institute of Translational Health Sciences, Seattle, Washington.,Providence Medical Research Center, Providence Health Care, Spokane, Washington
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Cosenso-Martin LN, Takaoka LY, Vilela-Martin JF. Randomized Study Comparing Vildagliptin vs Glibenclamide on Glucose Variability and Endothelial Function in Patients with Type 2 Diabetes Mellitus and Hypertension. Diabetes Metab Syndr Obes 2020; 13:3221-3229. [PMID: 32982353 PMCID: PMC7508021 DOI: 10.2147/dmso.s257096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/29/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Glucose variability (GV) is considered an important factor for cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM). High GV causes endothelial dysfunction and increased oxidative stress. Dipeptidyl peptidase-4 (DPP-4) inhibitors may improve endothelial function and decrease GV. The aim of this study was to investigate the effects of vildagliptin, a DPP-4 inhibitor, compared with glibenclamide in GV and endothelial function in patients with T2DM and arterial hypertension. METHODS This is a prospective, randomized, open and drug-controlled study. Fifty patients older than 35 years with T2DM and hypertension without CVD were randomized to receive vildagliptin (n=25) or glibenclamide (n=25), both in added-on metformin. Laboratory tests and analysis of endothelial function were performed before and 12 weeks after treatment. Endothelial function, defined by reactive hyperemia index (RHI), was analyzed by peripheral artery tonometry (endo-PAT2000). GV was evaluated by capillary glucose with intermittent monitoring device, six measurements per day, for three days, before and after treatment. The median of standard deviation (SD) of mean blood glucose (MBG) was used to evaluate GV. RESULTS GV decreased in the vildagliptin group (35.2 to 30.7, P=0.037) but did not change with glibenclamide (37.6 to 37.5, P=0.765). Glycated hemoglobin was similar in both groups. MBG decreased only in glibenclamide group, without difference with vildagliptin group (P=0.374). There were no changes in the RHI in both groups and there was no correlation between GV and RHI (P=0.658). CONCLUSION Vildagliptin reduces GV; however, the action on endothelial function was not demonstrated. In addition, there was no correlation between GV and endothelial function.
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Affiliation(s)
- Luciana Neves Cosenso-Martin
- Internal Medicine Division, State Medical School at Sao Jose do Rio Preto (FAMERP), Hospital de Base, Sao Jose do Rio Preto, Sao Paulo, Brazil
| | - Lais Yumi Takaoka
- Internal Medicine Division, State Medical School at Sao Jose do Rio Preto (FAMERP), Hospital de Base, Sao Jose do Rio Preto, Sao Paulo, Brazil
| | - Jose Fernando Vilela-Martin
- Internal Medicine Division, State Medical School at Sao Jose do Rio Preto (FAMERP), Hospital de Base, Sao Jose do Rio Preto, Sao Paulo, Brazil
- Correspondence: Jose Fernando Vilela-Martin State Medical School at Sao Jose do Rio Preto (FAMERP), Hospital de Base, Ave Brig. Faria Lima 5416, Sao Jose do Rio Preto, Sao Paulo15090-000, BrazilTel +55 17 32015727 Email
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Toschi E, Fisher L, Wolpert H, Love M, Dunn T, Hayter G. Evaluating a Glucose-Sensor-Based Tool to Help Clinicians and Adults With Type 1 Diabetes Improve Self-Management Skills. J Diabetes Sci Technol 2018; 12:1143-1151. [PMID: 30060682 PMCID: PMC6232736 DOI: 10.1177/1932296818791534] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The goal of this uncontrolled pilot study was to assess the feasibility of a self-care management mobile app, called Sugar Sleuth, which incorporates the FreeStyle Libre™ glucose sensor, to help clinicians and people with type 1 diabetes (PWD) identify and mitigate self-care behaviors that contribute to glucose variability. METHODS PWDs with a baseline A1c between 7.5 and 9.0% used the mobile app for 14 weeks. The app prompted the PWD to enter the suspected cause of detected glycemic excursions, and to record food and insulin information. PWDs met with clinicians to collaboratively review data, identify challenges, and devise a specific self-care plan. Outcome measures included a single glycemic outcome score (SGOS) and attitude rating scales to better understand how participant attitudes could affect glycemic outcome. RESULTS Thirty enrolled PWDs had a mean age of 55 ± 2.6 years, and a mean diabetes duration of 32 ± 2.9 years. A significant average reduction in A1c of 0.5 ± 0.07% ( P < .01) and in mean daily carbohydrate intake of 43 ± 21 grams ( P = .05) was found. No statistically significant change in glycemic metrics, body weight, or total daily insulin dose was found. A significant negative association occurred between SGOS and "hypoglycemia tolerance" ( P = .04), and a positive correlation occurred that approached significance with "motivation to change behavior" ( P = .06). CONCLUSIONS These findings suggest that this mobile app system, in conjunction with CGM, provides a useful platform for helping clinicians and adults with T1D improve self-management skills to improve glycemic control.
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Affiliation(s)
- Elena Toschi
- Joslin Diabetes Center, Harvard Medical
School, Boston, MA, USA
- Elena Toschi, MD, Joslin Diabetes Center,
Harvard Medical School, One Joslin Place, Boston, MA 02215, USA.
| | - Lawrence Fisher
- Department of Family and Community
Medicine, University of California, San Francisco, CA, USA
| | - Howard Wolpert
- Joslin Diabetes Center, Harvard Medical
School, Boston, MA, USA
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