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Asghar S, Ali Z, Abdullah A, Naveed S, Ahmad MS, Rafi TSM. Sensorineural hearing loss among type 2 diabetic patients and its association with peripheral neuropathy: a cross-sectional study from a lower middle-income country. BMJ Open 2024; 14:e081035. [PMID: 38692716 PMCID: PMC11086572 DOI: 10.1136/bmjopen-2023-081035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/08/2024] [Indexed: 05/03/2024] Open
Abstract
INTRODUCTION Despite potential links between diabetes and sensorineural hearing loss (SNHL), routine hearing assessments for diabetic patients are not standard practice. Our study aimed to investigate the prevalence of SNHL and its association with diabetes-related factors among patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS This cross-sectional study was conducted at the Diabetes Clinic, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from May to September 2021. A total of 396 patients fulfilling the inclusion criteria participated after informed consent. Data collection involved a sociodemographic profile, Michigan Neuropathy Screening Instrument examination followed by pure-tone audiometry and laboratory tests including haemoglobin A1C (HbA1c). HL was defined using better ear four-frequency pure-tone average of ≥26 dB HL and graded as per WHO criteria. Statistical analyses were performed using SPSS. χ2, independent t-test and multinomial logistic regression analyses were applied. P<0.05 at 95% CI was considered significant. RESULTS Our study revealed a high prevalence of SNHL among patients with T2DM. Mild HL was seen in 55.8%, while 18.7% suffered from moderate HL. Common audiological symptoms included difficulty understanding speech in noisy surroundings (44.2%), balance problems (42.9%), sentence repetition (35.9%), tinnitus (32.3%) and differentiating consonants (31.1%). Hearing impairment predominantly affected low (0.25-0.5 kHz) and high (4-8 kHz) frequencies with a significant difference at 4 kHz among both sexes (t (394)=2.8, p=0.004). Peripheral neuropathy was significantly associated with SNHL on multinomial logistic regression after adjusting with age, sex, body mass index and the presence of any comorbidities. Diabetes duration, HbA1c or family history of diabetes was found unrelated to SNHL severity. CONCLUSIONS The study highlights the substantial prevalence of SNHL among patients with T2DM and emphasises the importance of targeted audiological care as part of a holistic approach to diabetes management. Addressing HL early may significantly improve communication and overall quality of life.
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Affiliation(s)
- Saba Asghar
- Jinnah Sindh Medical University, Karachi, Pakistan
| | - Zeeshan Ali
- Jinnah Sindh Medical University, Karachi, Pakistan
| | - Ali Abdullah
- Jinnah Sindh Medical University, Karachi, Pakistan
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Tariq JA, Mandokhail K, Sajjad N, Hussain A, Javaid H, Rasool A, Sadaf H, Javaid S, Durrani AR. Effects of Age and Biological Age-Determining Factors on Telomere Length in Type 2 Diabetes Mellitus Patients. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:698. [PMID: 38792881 PMCID: PMC11122877 DOI: 10.3390/medicina60050698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Telomere length (TL) undergoes attrition over time, indicating the process of aging, and is linked to a higher risk of diabetes mellitus type 2 (DM-2). This molecular epidemiological study investigated the correlation between leukocyte TL variations and determinants of molecular aging in 121 Pakistani DM-2 patients. Materials and Methods: The ratio of telomere repeats to the SCG copy number was calculated to estimate the TL in each sample through qPCR assays. Results: In this study, smaller mean TLs were observed in 48.8% of males (6.35 ± 0.82 kb), 3.3% of underweight patients (5.77 ± 1.14 kb), 61.2% of patients on regular medication (6.50 ± 0.79 kb), 9.1% with very high stress levels (5.94 ± 0.99 kb), 31.4% of smokers (5.83 ± 0.73 kb), 40.5% of patients with low physical activity (6.47 ± 0.69 kb), 47.9% of hypertensive patients (5.93 ± 0.64 kb), 10.7% of patients with DM-2 for more than 15 years, and 3.3% of patients with a delayed onset of DM-2 (6.00 ± 0.93 kb). Conclusion: This research indicated a significant negative correlation (R2 = 0.143) between TL and the age of DM-2 patients. This study demonstrated that the correlation of telomere length with age in DM-2 patients was also influenced by various age-determining factors, including hypertension and smoking habits, with significant strong (R2 = 0.526) and moderate (R2 = 0.299) correlations, respectively; sex, obesity, the stress level and age at the onset of diabetes with significant weak correlations (R2 = 0.043, 0.041, 0.037, and 0.065, respectively), and no significant correlations of medication routine, rate of physical activity, and the durations of DM-2 with age-adjusted telomere length. These results challenge TL as the sole marker of aging, thus highlighting the need for further research to understand underlying factors and mitigate the effect of aging or premature aging on diabetic patients.
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Affiliation(s)
- Jawaria Ali Tariq
- Department of Biotechnology, Sardar Bahadur Khan Women’s University, Quetta 87300, Pakistan; (J.A.T.); (N.S.); (H.J.); (H.S.); (S.J.)
| | | | - Naheed Sajjad
- Department of Biotechnology, Sardar Bahadur Khan Women’s University, Quetta 87300, Pakistan; (J.A.T.); (N.S.); (H.J.); (H.S.); (S.J.)
| | - Abrar Hussain
- Department of Biotechnology, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta 87300, Pakistan
| | - Humera Javaid
- Department of Biotechnology, Sardar Bahadur Khan Women’s University, Quetta 87300, Pakistan; (J.A.T.); (N.S.); (H.J.); (H.S.); (S.J.)
| | - Aamir Rasool
- Institute of Biochemistry, University of Balochistan, Quetta 87300, Pakistan;
| | - Hummaira Sadaf
- Department of Biotechnology, Sardar Bahadur Khan Women’s University, Quetta 87300, Pakistan; (J.A.T.); (N.S.); (H.J.); (H.S.); (S.J.)
- Maria Sklodowska-Curie National Research Institute of Oncology, Silesian University of Technology, 02-781 Warsaw, Poland
| | - Sadia Javaid
- Department of Biotechnology, Sardar Bahadur Khan Women’s University, Quetta 87300, Pakistan; (J.A.T.); (N.S.); (H.J.); (H.S.); (S.J.)
| | - Abdul Rauf Durrani
- Provincial Reference Laboratory (PRL), Fatima Jinnah General and Chest Hospital, Quetta 87300, Pakistan;
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Taj S, Ashfaq UA, Ahmad M, Noor H, Ikram A, Ahmed R, Tariq M, Masoud MS, Hasan A. The antihyperglycemic potential of pyrazolobenzothiazine 1, 1-dioxide novel derivative in mice using integrated molecular pharmacological approach. Sci Rep 2024; 14:7746. [PMID: 38565861 PMCID: PMC10987501 DOI: 10.1038/s41598-023-49932-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/13/2023] [Indexed: 04/04/2024] Open
Abstract
Diabetes Mellitus is a metabolic disease characterized by elevated blood sugar levels caused by inadequate insulin production, which subsequently leads to hyperglycemia. This study was aimed to investigate the antidiabetic potential of pyrazolobenzothiazine derivatives in silico, in vitro, and in vivo. Molecular docking of pyrazolobenzothiazine derivatives was performed against α-glucosidase and α-amylase and compounds were selected based on docking score, bonding interactions and low root mean square deviation (RMSD). Enzyme inhibition assay against α-glucosidase and α-amylase was performed in vitro using p-nitrophenyl-α-D-glucopyranoside (PNPG) and starch substrate. Synthetic compound pyrazolobenzothiazine (S1) exhibited minimal conformational changes during the 100 ns MD simulation run. S1 also revealed effective IC50 values for α-glucosidase (3.91 µM) and α-amylase (8.89 µM) and an enzyme kinetic study showed low ki (- 0.186 µM, - 1.267 µM) and ki' (- 0.691 µM, - 1.78 µM) values with the competitive type of inhibition for both enzymes α-glucosidase and α-amylase, respectively. Moreover, studies were conducted to check the effect of the synthetic compound in a mouse model. A low necrosis rate was observed in the liver, kidney, and pancreas through histology analysis performed on mice. Compound S1 also exhibited a good biochemical profile with lower sugar level (110-115 mg/dL), increased insulin level (25-30 μM/L), and low level of cholesterol (85 mg/dL) and creatinine (0.6 mg/dL) in blood. The treated mice group also exhibited a low % of glycated haemoglobin (3%). This study concludes that S1 is a new antidiabetic-agent that helps lower blood glucose levels and minimizes the complications associated with type-II diabetes.
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Affiliation(s)
- Saman Taj
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, 38000, Pakistan
| | - Usman Ali Ashfaq
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, 38000, Pakistan
| | - Matloob Ahmad
- Department of Chemistry, Government College University Faisalabad, Faisalabad, 38000, Pakistan
| | - Hasnat Noor
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, 38000, Pakistan
| | - Ayesha Ikram
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, 38000, Pakistan
| | - Rashid Ahmed
- Department of Biotechnology, Faculty of Natural and Applied Sciences, Mirpur University of Science and Technology, New Mirpur City, 10250, Pakistan
| | - Muhammad Tariq
- Department of Biotechnology, Faculty of Natural and Applied Sciences, Mirpur University of Science and Technology, New Mirpur City, 10250, Pakistan
| | - Muhammad Shareef Masoud
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, 38000, Pakistan.
| | - Anwarul Hasan
- Department of Mechanical and Industrial Engineering, Qatar University, 2713, Doha, Qatar.
- Biomedical Research Center (BRC), Qatar University, PO Box 2713, Doha, Qatar.
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Tayyib HMU, Ali A, Jabeen S, Habib-Ur-Rehman, Kamran H, Bajaber MA, Usman M, Zhang X. Restoration of gut dysbiosis through Clostridium butyricum and magnesium possibly balance blood glucose levels: an experimental study. BMC Microbiol 2024; 24:105. [PMID: 38561662 PMCID: PMC10983686 DOI: 10.1186/s12866-024-03218-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/07/2024] [Indexed: 04/04/2024] Open
Abstract
Diabetes mellitus (DM) is a chronic metabolic disorder characterized by an elevated level of blood glucose due to the absence of insulin secretion, ineffectiveness, or lack of uptake of secreted insulin in the body. The improperly diagnosed and poorly managed DM can cause severe damage to organs in the body like the nerves, eyes, heart, and kidneys. This study was aimed at investigating the effect of Clostridium butyricum (probiotic) with magnesium supplementation to evaluate the effect on gut microbial dysbiosis and blood glucose levels. In the laboratory, 6-8 weeks old 24 male albino rats weighing 200-250 g were given free access to water and food. Diabetes was induced using streptozotocin (60 mg/kg) in overnight fasted rats. Diabetic rats were randomly divided into four groups (n = 6, 6 replicates in each group). Metformin (100 mg/kg/day) with a standard basal diet was provided to control group (G0), Clostridium butyricum (1.5 × 105 CFU/day) with standard basal diet was provided to treatment group (G1), magnesium (500 mg/kg/day) was provided to group (G2). Clostridium butyricum (1.5 × 105 CFU/day) and magnesium (300 mg/kg/day) in combination with a standard basal diet was provided to group (G3). Blood Glucose, Magnesium blood test and microbial assay were done. Random blood glucose levels were monitored twice a week for 21 days and were represented as mean of each week. The results conclude that Clostridium butyricum (1.5 × 105 CFU) is very effective in balancing random blood glucose levels from 206.6 ± 67.7 to 85.1 ± 3.8 (p = 0.006) compared to other groups (p > 0.005). The results of stool analysis showed that Clostridium butyricum as probiotic restores microbial dysbiosis as evident by the 105 CFU Clostridium butyricum load in G1, which was higher than G0, G2 and G3 which were 103 and 104 CFU respectively. The findings of this study conclude that Clostridium butyricum supplementation improved blood glucose levels and intestinal bacterial load in type II diabetes mellitus.
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Affiliation(s)
- Hafiz Muhammad Ubaid Tayyib
- Department of Bioinformatics, School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, P. R. China
- University Institute of Diet and Nutritional Sciences, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Amjed Ali
- University Institute of Physical therapy, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Shaista Jabeen
- University Institute of Diet and Nutritional Sciences, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Habib-Ur-Rehman
- University Institute of Diet and Nutritional Sciences, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Hafsa Kamran
- University Institute of Diet and Nutritional Sciences, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Majed A Bajaber
- Department of Chemistry, Faculty of Science, King Khalid University, P.O. Box 9004, Abha, 61413, Saudi Arabia
| | - Muhammad Usman
- Department of Bioinformatics, School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, P. R. China.
| | - Xiao Zhang
- Department of Bioinformatics, School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, P. R. China.
- Yantai Longch Technologies. CO., LTD, Yantai, P. R. China.
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Jennings HM, Anas A, Asmat S, Naz A, Afaq S, Ahmed N, Aslam F, Gomez GZ, Siddiqi N, Ekers D. Living with depression and diabetes: A qualitative study in Bangladesh and Pakistan. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002846. [PMID: 38271347 PMCID: PMC10810509 DOI: 10.1371/journal.pgph.0002846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/29/2023] [Indexed: 01/27/2024]
Abstract
Diabetes and depression are both serious health conditions. While their relationship is bidirectional and each condition adversely affects outcomes for the other, they are treated separately. In low and middle income countries, such as Bangladesh and Pakistan, health systems are already stretched and the integration of diabetes and depression care is rarely a priority. Within this context through interviews with patients, healthcare workers and policy makers the study explored: lived experiences of people living with depression and diabetes, current practice in mental health and diabetes care and barriers and perspectives on integrating a brief psychological therapy into diabetes care. The findings of the study included: differing patient and practitioner understandings of distress/depression, high levels of stigma for mental health and a lack of awareness and training on treating depression. While it was apparent there is a need for more holistic care and the concept of a brief psychological intervention appeared acceptable to participants, many logistical barriers to integrating a mental health intervention into diabetes care were identified. The study highlights the importance of context and of recognising drivers and understandings of distress when planning for more integrated mental and physical health services, and specifically when adapting and implementing a new intervention into existing services.
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Affiliation(s)
- Hannah Maria Jennings
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, Heslington, United Kingdom
| | - Ashraful Anas
- Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | - Sara Asmat
- Institute of Public Health and Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Anum Naz
- Institute of Psychiatry (IoP), Benazir Bhutto Hospital, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Saima Afaq
- Institute of Public Health and Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Naveed Ahmed
- Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | - Faiza Aslam
- Institute of Psychiatry (IoP), Benazir Bhutto Hospital, Rawalpindi Medical University, Rawalpindi, Pakistan
| | | | - Najma Siddiqi
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, Heslington, United Kingdom
| | - David Ekers
- Department of Health Sciences, University of York, York, United Kingdom
- Tees Esk and Wear Valleys NHS FT, Darlington, United Kingdom
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Tahir A, Asghar K, Shafiq W, Batool H, Khan D, Chughtai O, Chaudhary SU. Fingerprinting hyperglycemia using predictive modelling approach based on low-cost routine CBC and CRP diagnostics. Sci Rep 2024; 14:1090. [PMID: 38212326 PMCID: PMC10784542 DOI: 10.1038/s41598-023-44623-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 10/10/2023] [Indexed: 01/13/2024] Open
Abstract
Hyperglycemia is an outcome of dysregulated glucose homeostasis in the human body and may induce chronic elevation of blood glucose levels. Lifestyle factors such as overnutrition, physical inactivity, and psychosocials coupled with systemic low-grade inflammation have a strong negative impact on glucose homeostasis, in particular, insulin sensitivity. Together, these factors contribute to the pathophysiology of diabetes (DM) and expanding landscape of its prevalence regionally and globally. The rapid rise in the prevalence of type 2 diabetes, therefore, underscores the need for its early diagnosis and treatment. In this work, we have evaluated the discriminatory capacity of different diagnostic markers including inflammatory biomolecules and RBC (Red Blood Cell) indices in predicting the risk of hyperglycemia and borderline hyperglycemia. For that, 208,137 clinical diagnostic entries obtained over five years from Chugtai Labs, Pakistan, were retrospectively evaluated. The dataset included HbA1c (n = 142,011), complete blood count (CBC, n = 84,263), fasting blood glucose (FBG, n = 35,363), and C-reactive protein (CRP, n = 9035) tests. Our results provide four glycemic predictive models for two cohorts HbA1c and FBG) each having an overall predictive accuracy of more than 80% (p-value < 0.0001). Next, multivariate analysis (MANOVA) followed by univariate analysis (ANOVA) was employed to identify predictors with significant discriminatory capacity for different levels of glycemia. We show that the interplay between inflammation, hyperglycemic-induced derangements in RBC indices, and altered glucose homeostasis could be employed for prognosticating hyperglycemic outcomes. Our results then conclude a glycemic predictor with high sensitivity and specificity, employing inflammatory markers coupled with RBC indices, to predict glycemic outcomes (ROC p-value < 0.0001). Taken together, this study outlines a predictor of glycemic outcomes which could assist as a prophylactic intervention in predicting the early onset of hyperglycemia and borderline hyperglycemia.
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Affiliation(s)
- Amna Tahir
- Biomedical Informatics and Engineering Research Laboratory, Department of Life Sciences, Syed Babar Ali School of Science and Engineering, Lahore University of Management Sciences, Lahore, Pakistan
| | - Kashif Asghar
- Basic Science Department, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Waqas Shafiq
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Hijab Batool
- Chughtai Institute of Pathology, Lahore, Pakistan
| | - Dilawar Khan
- Chughtai Institute of Pathology, Lahore, Pakistan
| | | | - Safee Ullah Chaudhary
- Biomedical Informatics and Engineering Research Laboratory, Department of Life Sciences, Syed Babar Ali School of Science and Engineering, Lahore University of Management Sciences, Lahore, Pakistan.
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Zaidi A, Rashid A, Majeed A, Naeem A, Akram W, Baig ZA. Expression analysis of ABCA1 in type 2 diabetic Pakistani patients with and without dyslipidemia and correlation with glycemic index and lipid profile. Sci Rep 2023; 13:17249. [PMID: 37821518 PMCID: PMC10567704 DOI: 10.1038/s41598-023-43460-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/24/2023] [Indexed: 10/13/2023] Open
Abstract
Diabetes Mellitus type II, earlier considered as an endocrinological disorder is now more regarded as an inflammatory disorder along with lipid aberrations. It demands for regular monitoring, healthy dietary habits and lifestyle modification. This study was focused on gene expression of ATP binding cassette protein 1 (ABCA1) in diabetic dyslipidemia patients in comparison with control groups of only diabetics and healthy individuals. Blood samples and data were collected from recruited 390 patients who were further divided into three groups (130 each). Glycemic index and lipid profile was assessed. Delta Delta Ct method was used that revealed downregulation of the studied gene more in diabetic dyslipidemia patients as compared to only diabetics and healthy controls. The Ct values of ABCA1 were associated with glycemic index and lipid profile using Pearson's correlation. A negative correlation with fasting blood sugar and a positive correlation with HbA1cwas observed in only diabetics group. While in diabetic dyslipidemia and normal healthy controls, a negative correlation was found with both. As far as the lipid profile is concerned a positive correlation was observed among only diabetics with whole lipid profile. In diabetics with dyslipidemia, a negative correlation with all parameters except the TAGs was observed. A positive correlation with all except HDL was observed in healthy controls. The Ct values and fold change were compared among diseased and healthy individuals by applying independent t test. The cycle threshold in only diabetics was p = 0.000018 and in diabetic dyslipdemia individuals was p = 0.00251 while fold change in only diabetics (p = 0.000230) and in diabetics with dyslipidemia (p = 0.001137) was observed to be as statistically significant.
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Affiliation(s)
- Amber Zaidi
- Department of Biochemistry and Molecular Biology, Army Medical College, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
| | - Amir Rashid
- Department of Biochemistry and Molecular Biology, Army Medical College, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan.
| | - Asifa Majeed
- Department of Biochemistry and Molecular Biology, Army Medical College, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
| | - Ayesha Naeem
- Department of Biochemistry and Molecular Biology, Army Medical College, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
| | - Wajeeha Akram
- Department of Biochemistry and Molecular Biology, Army Medical College, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
| | - Zunaira Ali Baig
- Department of Biochemistry and Molecular Biology, Army Medical College, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
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Shaukat A, Zaidi A, Anwar H, Kizilbash N. Mechanism of the antidiabetic action of Nigella sativa and Thymoquinone: a review. Front Nutr 2023; 10:1126272. [PMID: 37818339 PMCID: PMC10561288 DOI: 10.3389/fnut.2023.1126272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 07/27/2023] [Indexed: 10/12/2023] Open
Abstract
Introduction Long used in traditional medicine, Nigella sativa (NS; Ranunculaceae) has shown significant efficacy as an adjuvant therapy for diabetes mellitus (DM) management by improving glucose tolerance, decreasing hepatic gluconeogenesis, normalizing blood sugar and lipid imbalance, and stimulating insulin secretion from pancreatic cells. In this review, the pharmacological and pharmacokinetic properties of NS as a herbal diabetes medication are examined in depth, demonstrating how it counteracts oxidative stress and the onset and progression of DM. Methods This literature review drew on databases such as Google Scholar and PubMed and various gray literature sources using search terms like the etiology of diabetes, conventional versus herbal therapy, subclinical pharmacology, pharmacokinetics, physiology, behavior, and clinical outcomes. Results The efficiency and safety of NS in diabetes, notably its thymoquinone (TQ) rich volatile oil, have drawn great attention from researchers in recent years; the specific therapeutic dose has eluded determination so far. TQ has anti-diabetic, anti-inflammatory, antioxidant, and immunomodulatory properties but has not proved druggable. DM's intimate link with oxidative stress, makes NS therapy relevant since it is a potent antioxidant that energizes the cell's endogenous arsenal of antioxidant enzymes. NS attenuates insulin resistance, enhances insulin signaling, suppresses cyclooxygenase-2, upregulates insulin-like growth factor-1, and prevents endothelial dysfunction in DM. Conclusion The interaction of NS with mainstream drugs, gut microbiota, and probiotics opens new possibilities for innovative therapies. Despite its strong potential to treat DM, NS and TQ must be examined in more inclusive clinical studies targeting underrepresented patient populations.
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Affiliation(s)
- Arslan Shaukat
- Department of Physiology, Government College University - GCU, Faisalabad, Punjab, Pakistan
| | - Arsalan Zaidi
- National Probiotic Laboratory, National Institute for Biotechnology and Genetic Engineering College - NIBGE-C, Faisalabad, Punjab, Pakistan
- Pakistan Institute of Engineering and Applied Sciences - PIEAS, Nilore, Islamabad, Pakistan
| | - Haseeb Anwar
- Department of Physiology, Government College University - GCU, Faisalabad, Punjab, Pakistan
| | - Nadeem Kizilbash
- Department Medical Laboratory Technology, Faculty of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia
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Shahbaz M, Kazmi F, Majeed HA, Manzar S, Qureshi FA, Rashid S. Oral Manifestations: A Reliable Indicator for Undiagnosed Diabetes Mellitus Patients. Eur J Dent 2023; 17:784-789. [PMID: 36220121 PMCID: PMC10569842 DOI: 10.1055/s-0042-1755553] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES This article identifies undiagnosed DM (UDM) cases in the Pakistani population by perceiving the signs and symptoms of DM and associating them with oral manifestations. MATERIAL AND METHODS In this cross-sectional study, patients showing at least three or more classical or warning signs like polydipsia, polyuria, polyphagia, and general weakness were considered UDM cases. Detailed oral examination for gingivitis, periodontitis, halitosis, xerostomia, and tongue manifestations was done followed by the hemoglobin A1c (HbA1c) analysis. RESULTS Out of 5,878 patients, 214 UDM cases were identified, where 31.8% and 39.7% of the patients were diagnosed as prediabetics and diabetics, respectively, based on HbA1c analysis. Prevalence of gingivitis (97.6%), fissured tongue (91.8%), generalized periodontitis (85.9%), thick saliva (87.1%), xerostomia (84.7%), burning mouth syndrome (63.5%), yellow discoloration of tongue (57.6%), and ecchymosis/ulcers (43.5%) were more in diabetics as compared to prediabetic patients and normal population. CONCLUSION The oral manifestations can be crucial for identifying UDM cases. Dentists can play a pivotal role by taking detailed history and thorough oral examination. If three or more symptoms as concluded above are present, an HbA1c analysis should be conducted to prevent preop and postop complications associated with DM.
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Affiliation(s)
- Maliha Shahbaz
- Department of Oral Biology, Lahore Medical and Dental College, Lahore, Pakistan
| | - Farhat Kazmi
- Department of Oral Pathology, Rashid Latif Dental College/Rashid Latif Medical Complex, Lahore, Pakistan
| | - Hanna Abdul Majeed
- Department of Operative Dentistry, Rashid Latif Dental College/Rashid Latif Medical Complex, Lahore, Pakistan
| | - Saadia Manzar
- Department of Oral & Maxillofacial Surgery, Rashid Latif Dental College/Rashid Latif Medical Complex, Lahore, Pakistan
| | - Faiza Awais Qureshi
- Department of Community Dentistry, Rashid Latif Dental College/Rashid Latif Medical Complex, Lahore, Pakistan
| | - Shahrayne Rashid
- Department of Oral Pathology, Rashid Latif Dental College/Rashid Latif Medical Complex, Lahore, Pakistan
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Mohsin SN, Saleem F, Humayun A, Tanweer A, Muddassir A. Prospective Nutraceutical Effects of Cinnamon Derivatives Against Insulin Resistance in Type II Diabetes Mellitus-Evidence From the Literature. Dose Response 2023; 21:15593258231200527. [PMID: 37701673 PMCID: PMC10494518 DOI: 10.1177/15593258231200527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023] Open
Abstract
Apart from advances in pharmaceutical antidiabetic agents, efforts are being made toward hypoglycemic agents derived from natural sources. Cinnamon has been reported to have significant benefits for human health, particularly as an anti-inflammatory, antidiabetic, and anti-hypertriglyceridemic agent. The phytochemicals in cinnamon can be extracted from different parts of plant by distillation and solvent extraction. These chemicals help in decreasing insulin resistance and can act against hyperglycemia and dyslipidemia, inflammation and oxidative stress, obesity, overweight, and abnormal glycation of proteins. Cinnamon has shown to improve all of these conditions in in vitro, animal, and/or human studies. However, the mechanism of action of active ingredients found in cinnamon remains unclear. The current review presents the outstanding ability of cinnamon derivatives to control diabetes by various pathways modulating insulin release and insulin receptor signaling. It was also found that the type and dosage of cinnamon as well as subject characteristics including drug interactions are likely to affect the response to cinnamon. Future research directions based on this review include the synergistic usage of various cinnamon derivatives in managing and/or preventing diabetes and possible other relevant chronic diseases.
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Affiliation(s)
- Saima Naz Mohsin
- NIH, HRI, Research Center NHRC, Shaikh Zayed Post Graduate Medical Institute, Lahore, Pakistan
| | - Faiza Saleem
- Department of Biotechnology, Lahore College for Women University, Lahore, Pakistan
| | - Ayesha Humayun
- Department of Public Health and Community Medicine, Shaikh Zayed Postgraduate Medical Institute, Lahore, Pakistan
| | - Afifa Tanweer
- Department of Nutrition & Dietetics, School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Ambreen Muddassir
- Department of Medicine, Shaikh Zayed Post Graduate Medical Institute, Lahore, Pakistan
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11
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Alanazi AS, Rasheed S, Rehman K, Mallhi TH, Akash MSH, Alotaibi NH, Alzarea AI, Tanveer N, Khan YH. Biochemical association of regulatory variant of KLF14 genotype in the pathogenesis of cardiodiabetic patients. Front Endocrinol (Lausanne) 2023; 14:1176166. [PMID: 37351102 PMCID: PMC10282989 DOI: 10.3389/fendo.2023.1176166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/18/2023] [Indexed: 06/24/2023] Open
Abstract
Background and purpose The study focuses on examining the relationship between a single nucleotide polymorphism (SNP) in KLF14 rs4731702 and risk of type 2 diabetes mellitus (T2DM) and dyslipidemia in different ethnic populations. The purpose of this study was to evaluate the association between KLF14 rs4731702 and serum lipid profile and to determine the frequency distribution of KLF14 rs4731702 among T2DM and cardiometabolic patients. Methods A total of 300 volunteers were recruited, consisting of three groups: 100 healthy individuals, 100 individuals diagnosed with T2DM, and 100 individuals diagnosed with cardiometabolic disorders. Biochemical analysis of blood samples was conducted to assess various biomarkers related to glycemic control and lipid profile. This involved measuring levels of glucose, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and ApoA1. Genotyping analysis was performed to investigate KLF14 rs4731702 polymorphism. The Tetra ARMS-PCR method was employed for genotyping analysis. Results The results of biochemical profiling revealed a significant association between altered glycemic biomarkers and lipid profile in diseased patients compared to healthy participants. The frequencies of KLF14 rs4731702 alleles and genotypes were compared between the control group and T2DM group. A statistically significant difference was observed, indicating a potential association between KLF14 rs4731702 and T2DM. In the dominant inheritance model of KLF14 rs4731702 SNP, a statistically significant difference [odds ratio (95% confidence interval)] of 0.56 (0.34 -0.96) was found between the control and T2DM subjects. This suggests that the presence of certain genotypes influences the risk of T2DM. In T2DM patients, individuals carrying the C allele exhibited compromised insulin sensitivity, decreased HDL-C and ApoA1 levels, and increased serum glucose, TG, and LDL-C concentrations. Conversely, TT genotype carriers demonstrated increased levels of HDL-C and ApoA1, lower insulin resistance, serum glucose, LDL-C, and TG levels. Conclusion The study's findings indicate that dyslipidemia in T2DM patients is associated with reduced KLF14 functionality due to CC and CT genotypes, leading to insulin resistance and an increased risk of cardiovascular diseases. Additionally, risk of KLF14 rs4731702 polymorphism was found to increase with age and was more prevalent in female than in male individuals. These insights contribute to understanding genetic factors influencing the development and progression of T2DM and dyslipidemia in different ethnic populations.
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Affiliation(s)
- Abdullah Salah Alanazi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
- Health Sciences Research Unit, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Sumbal Rasheed
- Department of Pharmaceutical Chemistry, Government College University, Faisalabad, Pakistan
| | - Kanwal Rehman
- Department of Pharmacy, The Women University, Multan, Pakistan
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | | | - Nasser Hadal Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Abdulaziz Ibrahim Alzarea
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Nida Tanveer
- Institute of Molecular Cardiology, University of Louisville, Louisville, KY, United States
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
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12
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Rashid RSM, Temurlu S, Abourajab A, Karsili P, Dinleyici M, Al-Khateeb B, Icil H. Drug Repurposing of FDA Compounds against α-Glucosidase for the Treatment of Type 2 Diabetes: Insights from Molecular Docking and Molecular Dynamics Simulations. Pharmaceuticals (Basel) 2023; 16:ph16040555. [PMID: 37111312 PMCID: PMC10145898 DOI: 10.3390/ph16040555] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/29/2023] Open
Abstract
Type 2 diabetes mellitus is a chronic health problem that can be controlled by slowing one's carbohydrate metabolism by inhibiting α-glucosidase, an enzyme responsible for carbohydrate degradation. Currently, drugs for type 2 diabetes have limitations in terms of safety, efficiency, and potency, while cases are rapidly increasing. For this reason, the study planned and moved towards drug repurposing by utilizing food and drug administration (FDA)-approved drugs against α-glucosidase, and investigated the molecular mechanisms. The target protein was refined and optimized by introducing missing residues, and minimized to remove clashes to find the potential inhibitor against α-glucosidase. The most active compounds were selected after the docking study to generate a pharmacophore query for the virtual screening of FDA-approved drug molecules based on shape similarity. The analysis was performed using Autodock Vina (ADV)-based on binding affinities (-8.8 kcal/mol and -8.6 kcal/mol) and root-mean-square-deviation (RMSD) values (0.4 Å and 0.6 Å). Two of the most potent lead compounds were selected for a molecular dynamics (MD) simulation to determine the stability and specific interactions between receptor and ligand. The docking score, RMSD values, pharmacophore studies, and MD simulations revealed that two compounds, namely Trabectedin (ZINC000150338708) and Demeclocycline (ZINC000100036924), are potential inhibitors for α-glucosidase compared to standard inhibitors. These predictions showed that the FDA-approved molecules Trabectedin and Demeclocycline are potential suitable candidates for repurposing against type 2 diabetes. The in vitro studies showed that trabectedin was significantly effective with an IC50 of 1.263 ± 0.7 μM. Further investigation in the laboratory is needed to justify the safety of the drug to be used in vivo.
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Affiliation(s)
- Rebwar Saeed M Rashid
- Department of Chemistry, Faculty of Arts and Science, Eastern Mediterranean University, Famagusta 99628, Northern Cyprus, Mersin 10, Turkey
- Department of Chemistry, Faculty of Education, University of Sulaimani, Sulaymaniyah 46001, Iraq
| | - Selin Temurlu
- Department of Chemistry, Faculty of Arts and Science, Eastern Mediterranean University, Famagusta 99628, Northern Cyprus, Mersin 10, Turkey
| | - Arwa Abourajab
- Department of Chemistry, Faculty of Arts and Science, Eastern Mediterranean University, Famagusta 99628, Northern Cyprus, Mersin 10, Turkey
| | - Pelin Karsili
- Department of Chemistry, Faculty of Arts and Science, Eastern Mediterranean University, Famagusta 99628, Northern Cyprus, Mersin 10, Turkey
| | - Meltem Dinleyici
- Department of Chemistry, Faculty of Arts and Science, Eastern Mediterranean University, Famagusta 99628, Northern Cyprus, Mersin 10, Turkey
| | - Basma Al-Khateeb
- Department of Chemistry, Faculty of Arts and Science, Eastern Mediterranean University, Famagusta 99628, Northern Cyprus, Mersin 10, Turkey
| | - Huriye Icil
- Department of Chemistry, Faculty of Arts and Science, Eastern Mediterranean University, Famagusta 99628, Northern Cyprus, Mersin 10, Turkey
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13
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Arif R, Khan AZ, Hammad M, Ghani U, Vaddepalli R, Sanker V. Current Practices and Perceived Role of Community Pharmacists in Type 2 Diabetes Services in Pakistan. Cureus 2023; 15:e37311. [PMID: 37182028 PMCID: PMC10166723 DOI: 10.7759/cureus.37311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2023] [Indexed: 05/16/2023] Open
Abstract
Background Diabetes mellitus is a chronic illness which is becoming more prevalent in developing countries, and it is being managed mostly in hospitals or clinics in underdeveloped nations. Other strategies for treatment delivery in emerging nations must be considered as the number of diabetic patients grows. Community pharmacists are a valuable choice for diabetes care. However, only developed countries have data on community pharmacists' diabetes treatment practices. Methodology A non-probability consecutive sampling strategy was used to gather a self-administered questionnaire from 289 community pharmacists. Six points Likert scale was employed to score current practices and pharmacists' perceived role. A response rate of 55% was attained. Characteristics associated with present behaviors and perceived roles were analyzed using Chi-square and logistic regression. Results The majority of the respondents were males, 234 (81.0%). Out of 289, 229 (79.2%) were of 25-30 years of age and were pharmacists as well as qualified persons (QP) 189 (65.4%). A QP is one who has the legal authority to sell drugs to customers. The majority had <5 years of working experience as a community pharmacist, 268 (92.7%), and did not have diabetes training, 237 (82.0%). Most community pharmacies were stand-alone, 110 (38.1%), and had a single or a group of proprietors, 248 (85.8%). Open hours of most of the pharmacies were 16-20 hours per day, 202 (69.8%), and most had one pharmacist, 243 (84.1%), i.e., working as a pharmacist as well as a qualified person. Approximately 203 (70.2%) of the pharmacies had customers >2000 in a month and >100 customers purchased anti-diabetes medications per month. Only 44 (15.2%) community pharmacies had a designated room or space for patient counselling. The majority of pharmacists were also in favor of providing services other than dispensing such as counselling the patients about prescribed medicines, direction of use, use of devices for insulin administration, training on self-monitoring of glucose, and healthy lifestyle and diet practices. Pharmacy setting, ownership, patient counseling area, and the number of customers per month were key factors in the provision of diabetes services. The main obstacles identified were a lack of pharmacist availability and academic competency. Conclusion In Rawalpindi and Islamabad, most community pharmacies only provide a basic dispensing service for diabetes patients. Most of the community pharmacists agreed to extend their duties. The expansion of pharmacist professional responsibilities would help control the rising diabetes burden. The facilitators and hurdles identified would serve as a foundation for the introduction of diabetic care in community pharmacies.
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Affiliation(s)
- Rasikh Arif
- Clinical Research, Al-Shifa Trust Eye Hospital, Rawalpindi, PAK
| | - Ali Zeb Khan
- Clinical Research, Al-Shifa Trust Eye Hospital, Rawalpindi, PAK
| | - Muhammad Hammad
- Pharmacy, Shifa Tameer-E-Millat University Shifa College of Medicine, Islamabad, PAK
| | - Usman Ghani
- Clinical Research, Aga Khan University Hospital, Karachi, PAK
| | | | - Vivek Sanker
- General Surgery, Noorul Islam Institute of Medical Science and Research (NIMS), Trivandrum, IND
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14
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Abbas Q, Latif S, Ayaz Habib H, Shahzad S, Sarwar U, Shahzadi M, Ramzan Z, Washdev W. Cognitive behavior therapy for diabetes distress, depression, health anxiety, quality of life and treatment adherence among patients with type-II diabetes mellitus: a randomized control trial. BMC Psychiatry 2023; 23:86. [PMID: 36737757 PMCID: PMC9896442 DOI: 10.1186/s12888-023-04546-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/12/2023] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Diabetes distress typically causes depressive symptoms; common comorbidity of diabetes unpleasantly affects patients' medical and psychological functions. Psychotherapeutic interventions are effective treatments to treat depressive symptoms and to improve the quality of life in many chronic diseases including diabetes. The present study investigated the efficacy of cognitive behavior therapy (CBT) to treat depressive symptoms in patients with type 2 diabetes mellitus (T2DM) using experimental and waitlist control conditions. MATERIALS AND METHODS A total of 130 diagnosed patients with T2DM were taken from outdoor patients services of different hospitals in Faisalabad. Ninety patients met the eligibility criteria and were randomly assigned to experimental (n = 45) and waitlist control (n = 45) conditions. All the patients completed clinical interviews and assessment measures at pre-and post-assessment stages (16 weeks intervals). Medical consultants at the respective hospitals diagnosed the patients on the base of their medical reports and then referred those patients to us. Then we used different scales to assess primary and secondary outcomes: Diabetes Distress Scale (DDS) and Patient Health Questionnaire (PHQ) to assess primary outcomes, and a Short Health Anxiety Inventory (SHAI), a Revised Version of the Diabetes Quality of Life Questionnaire (DQLQ), and a General Medication Adherence Scale (GMAS) were used to investigate secondary outcomes. Repeated measure ANOVA was used to analyze the results. RESULTS The findings indicated that patients who received CBT got a significant reduction in their diabetes distress F(1,60) = 222.710, P < 0.001, η2 = .788), depressive symptoms F(1,60) = 94.436, P < 0.001, η2 = .611), health anxiety F(1,60) = 201.915, P < .0.001, η2 = 771), and a significant improvement in their quality of life F(1,60) = 83.352, P < 0.001, η2 = .581), treatment adherence F(1,60) = 67.579, P < 0.001, η2 = .566) and physical activity schedule F(1,60) = 164.245, P < .0.001, η2 = .736 as compared to the patients in waitlist control condition. CONCLUSION It is concluded that cognitive behavior therapy is an effective and promising intervention for depressive symptoms, diabetes distress, and health anxiety which also helps the person to promote quality of life, treatment adherence and physical activity.
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Affiliation(s)
- Qasir Abbas
- Department of Applied Psychology, Government College University Faisalabad, Old Campus, Faisalabad, Pakistan.
| | - Sana Latif
- grid.411786.d0000 0004 0637 891XDepartment of Applied Psychology, Government College University Faisalabad, Old Campus, Faisalabad, Pakistan
| | - Hina Ayaz Habib
- grid.266518.e0000 0001 0219 3705Institute of Clinical Psychology, University of Karachi, Karachi, Pakistan
| | - Salman Shahzad
- grid.266518.e0000 0001 0219 3705Institute of Clinical Psychology, University of Karachi, Karachi, Pakistan
| | - Uzma Sarwar
- grid.513947.d0000 0005 0262 5685Department of Psychology, Government College Women University Sialkot, Sialkot, Pakistan
| | - Mafia Shahzadi
- grid.411786.d0000 0004 0637 891XDepartment of Applied Psychology, Government College University Faisalabad, Main Campus, Faisalabad, Pakistan
| | - Zoobia Ramzan
- grid.412080.f0000 0000 9363 9292Institute of Behavioral Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Washdev Washdev
- grid.412080.f0000 0000 9363 9292Institute of Behavioral Sciences, Dow University of Health Sciences, Karachi, Pakistan
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15
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Isolation of a Novel Anti-Diabetic α-Glucosidase Oligo-Peptide Inhibitor from Fermented Rice Bran. Foods 2023; 12:foods12010183. [PMID: 36613397 PMCID: PMC9818066 DOI: 10.3390/foods12010183] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
At present, the incidence rate of diabetes is increasing gradually, and inhibiting α-glucosidase is one of the effective methods used to control blood sugar. This study identified new peptides from rice bran fermentation broth and evaluated their inhibitory activity and mechanism against α-glucosidase. Rice bran was fermented with Bacillus subtilis MK15 and the polypeptides of <3 kDa were isolated by ultrafiltration and chromatographic column, and were then subjected to LC-MS/MS mass spectrometry analysis. The results revealed that the oligopeptide GLLGY showed the greatest inhibitory activity in vitro. Docking studies with GLLGY on human α-glucosidase (PDB ID 5NN8) suggested a binding energy of −7.1 kcal/mol. GLLGY acts as a non-competitive inhibitor and forms five hydrogen bonds with Asp282, Ser523, Asp616, and His674 of α-glucosidase. Moreover, it retained its inhibitory activity even in a simulated digestion environment in vitro. The oligopeptide GLLGY could be developed into a potential anti-diabetic agent.
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16
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Asghar A, Firasat S, Afshan K, Naz S. Association of CDKAL1 gene polymorphism (rs10946398) with gestational diabetes mellitus in Pakistani population. Mol Biol Rep 2023; 50:57-64. [PMID: 36301463 DOI: 10.1007/s11033-022-08011-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/06/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND CDK5 regulatory subunit associated protein 1 like 1 (CDKAL1) encodes a tRNA modifying enzyme involved in the proper protein translation and regulation of insulin production encoded by the CDKL gene. Sequence variations in the CDKAL1 gene lead to the misreading of the Lys codon in proinsulin, resulting in decreased glucose-stimulated proinsulin production. Various polymorphic sequence variants of the CDKAL1 gene such as rs7754840, rs7756992, rs9465871, and rs10946398 are reported to be associated with type 2 diabetes mellitus and gestational diabetes mellitus (GDM) incidence. One of these single nucleotide polymorphisms i.e., rs10946398 has been reported to impact the risk of GDM and its outcomes in pregnant women of different ethnicities i.e., Egypt, Chinese, Korean, Indian, Arab, and Malaysian. Numerous findings have shown that rs10946398 overturns the regulation of CDKAL1 expression, resulting in decreased insulin production and elevated risk of GDM. However, there is no data regarding rs10946398 genotype association with GDM incidence in our population. METHODOLOGY In this study, 47 GDM patients and 40 age-matched controls were genotyped for rs10946398 CDKAL1 variant using Tetra primer Amplification Refractory Mutation System Polymerase Chain Reaction (Tetra ARMS-PCR). RESULTS Analysis of the results showed the significant association of the C allele of CDKAL1 SNP rs10946398 (χ2 = 0.02 p = 0.001) with the risk of GDM development. Conclusively, the results support the role of SNP i.e., rs10946398 of CDKAL1 gene in GDM development in Pakistani female patients. However, future large-scale studies are needed to functionally authenticate the role of variant genotypes in the disease pathogenesis and progression.
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Affiliation(s)
- Aleesha Asghar
- Department of Zoology, Faculty of Biological Sciences, Quaid-I-Azam University, University Road, Islamabad, 45320, Pakistan
| | - Sabika Firasat
- Department of Zoology, Faculty of Biological Sciences, Quaid-I-Azam University, University Road, Islamabad, 45320, Pakistan.
| | - Kiran Afshan
- Department of Zoology, Faculty of Biological Sciences, Quaid-I-Azam University, University Road, Islamabad, 45320, Pakistan
| | - Shagufta Naz
- Department of Zoology, Lahore College for Women University, Lahore, Pakistan
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17
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Ali S, Ali M, Khan A, Ullah S, Waqas M, Al-Harrasi A, Latif A, Ahmad M, Saadiq M. Novel 5-(Arylideneamino)-1 H-Benzo[ d]imidazole-2-thiols as Potent Anti-Diabetic Agents: Synthesis, In Vitro α-Glucosidase Inhibition, and Molecular Docking Studies. ACS OMEGA 2022; 7:43468-43479. [PMID: 36506132 PMCID: PMC9730482 DOI: 10.1021/acsomega.2c03854] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 11/07/2022] [Indexed: 06/17/2023]
Abstract
A novel series of multifunctional benzimidazoles has been reported as potent inhibitors of α-glucosidase. The procedure relies on the synthesis of 5-amino-1H-benzo[d]imidazole-2-thiol 5 via the multistep reaction through 2-nitroaniline 1, benzene-1,2-diamine 2, 1H-benzo[d]imidazole-2-thiol 3, and 5-nitro-1H-benzo[d]imidazole-2-thiol 4. Further treatment of 5 with aromatic aldehydes 6a-m provided access to the target 5-(arylideneamino)-1H-benzo[d]imidazole-2-thiols 7a-m. The results of the bioactivity assessment revealed all the compounds as excellent inhibitors of the enzyme (IC50 range: 0.64 ± 0.05 μM to 343.10 ± 1.62 μM) than acarbose (873.34 ± 1.21). Among them, 7i was the most active inhibitor (IC50: 0.64 ± 0.05 μM) followed by 7d (IC50: 5.34 ± 0.16 μM), 7f (IC50: 6.46 ± 0.30 μM), 7g (IC50: 8.62 ± 0.19 μM), 7c (IC50: 9.84 ± 0.08 μM), 7m (IC50: 11.09 ± 0.79 μM), 7a (IC50: 11.84 ± 0.26 μM), 7e (IC50: 16.38 ± 0.53 μM), 7j (IC50: 18.65 ± 0.74 μM), 7h (IC50: 20.73 ± 0.59 μM), 7b (IC50: 27.26 ± 0.30 μM), 7k (70.28 ± 1.52 μM) and finally 7l (IC50: 343.10 ± 1.62 μM). Molecular docking revealed important interactions with the enzyme, thereby supporting the experimental findings.
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Affiliation(s)
- Sardar Ali
- Department
of Chemistry, University of Malakand, Dir Lower, Chakdara 18800 Khyber
Pakhtunkhwa, Pakistan
| | - Mumtaz Ali
- Department
of Chemistry, University of Malakand, Dir Lower, Chakdara 18800 Khyber
Pakhtunkhwa, Pakistan
| | - Ajmal Khan
- Natural
and Medical Sciences Research Center, University of Nizwa, P.O. Box 33, Birkat Al Mauz, Nizwa 616, Oman
| | - Saeed Ullah
- Natural
and Medical Sciences Research Center, University of Nizwa, P.O. Box 33, Birkat Al Mauz, Nizwa 616, Oman
- H. E.
J Research Institute of Chemistry, International
Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan
| | - Muhammad Waqas
- Natural
and Medical Sciences Research Center, University of Nizwa, P.O. Box 33, Birkat Al Mauz, Nizwa 616, Oman
- Department
of Biotechnology and Genetic Engineering, Hazara University, Mansehra 21120, Pakistan
| | - Ahmed Al-Harrasi
- Natural
and Medical Sciences Research Center, University of Nizwa, P.O. Box 33, Birkat Al Mauz, Nizwa 616, Oman
| | - Abdul Latif
- Department
of Chemistry, University of Malakand, Dir Lower, Chakdara 18800 Khyber
Pakhtunkhwa, Pakistan
| | - Manzoor Ahmad
- Department
of Chemistry, University of Malakand, Dir Lower, Chakdara 18800 Khyber
Pakhtunkhwa, Pakistan
| | - Muhammad Saadiq
- Department
of Chemistry, Bacha Khan University, Charsadda 18800 Khyber Pakhtunkhwa, Pakistan
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18
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Jawed F, Tanveer T, Anwar F. Iron deficiency anemia and HbA1c levels: a wake-up call for health policy planners in low- and middle-income countries. Minerva Endocrinol (Torino) 2022; 47:481-482. [PMID: 36594732 DOI: 10.23736/s2724-6507.22.03721-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Fatima Jawed
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Tehreem Tanveer
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan -
| | - Farah Anwar
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
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19
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Aamir AH, Raja UY, Qureshi FM, Asghar A, Mahar SA, Ahmed I, Ghaffar T, Zafar J, Hasan MI, Riaz A, Raza SA, Khosa IA, Khan J, Baqar JB. Safety and efficacy of Empagliflozin in Pakistani Muslim patients with type 2 diabetes (SAFE-PAK); a randomized clinical trial. BMC Endocr Disord 2022; 22:295. [PMID: 36443769 PMCID: PMC9703399 DOI: 10.1186/s12902-022-01213-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Sodium-Glucose-Co-Transporter 2 (SGLT2) inhibitor (Empagliflozin) is an effective drug in controlling blood glucose through predominantly glycosuria. Glycosuria increases the risk of genitourinary infections in diabetes. This study was aimed to establish the safety and efficacy of Empagliflozin (Group-A) versus standard care (Group-B) in Pakistani Muslim individuals with type 2 diabetes. METHODS A multicenter, randomized clinical trial was conducted in five cities across Pakistan from July 2019 to August 2020. Patients of both genders aged 18-75 years, body mass index (BMI) ≤ 45 kg/m2, glycosylated hemoglobin (HbA1c) 7-10% (53 mmol/mol to 86 mmol/mol) and treatment-naive to Empagliflozin were included. Treatment was given for 24 weeks, and allocation was done through randomization. RESULTS Out of 745 screened patients, 333 met the eligibility criteria, and a total of 244 (73.3%) patients were enrolled. More hypoglycemic events were reported in the standard care group, whereas positive urine culture, fungal infection, dehydration, and hypotension occurrence were comparable between the two groups. The 6 months mean HbA1c reduction was significant in both groups; (Group-A: 0.91 ± 0.15; p < 0.001 vs. Group-B2: 0.79 ± 0.14; p < 0.001). Efficacy comparison at 6 months revealed a significant reduction in weight and systolic blood pressure (SBP) in Group A only (Group-A: 1.4 ± 0.4 kg; p < 0.002 vs. Group-B: 0.01 ± 0.5 kg; p < 1.00), (Group-A: 5.1 ± 1.7 mmHg; p < 0.012 vs. Group-B: 2.3 ± 1.7 mmHg; p < 0.526). CONCLUSIONS Empagliflozin was a safe drug compared to standard care in Pakistani Muslim patients with diabetes. It was as effective as standard care in the clinical setting but achieved glycemic control by reducing weight and SBP in type 2 diabetes patients. TRIAL REGISTRATION This study was registered in the NIH US National Library of Medicine clinical trials registry at Clinicaltrials.gov with the registration number: NCT04665284 on 11/12/2020.
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Affiliation(s)
- Azizul Hasan Aamir
- Department of Diabetes, Endocrinology and Metabolic Diseases, Khyber Girls Medical College, Hayatabad Medical Complex, Peshawar, Pakistan.
- Post Graduate Medical Institute, Peshawar, Pakistan.
| | | | | | | | | | | | - Tahir Ghaffar
- Department of Diabetes, Endocrinology and Metabolic Diseases, Khyber Girls Medical College, Hayatabad Medical Complex, Peshawar, Pakistan
| | | | | | | | | | | | - Jahanzeb Khan
- Dow University of Health Sciences, Karachi, Pakistan
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Muacevic A, Adler JR, Atique H, Wassan A, Naqvi M, Ullah M. Randomized Clinical Trial on Efficacy of Empagliflozin Versus Sitagliptin, In Addition to Metformin in Type 2 Diabetic Patients. Cureus 2022; 14:e31699. [PMID: 36561596 PMCID: PMC9767666 DOI: 10.7759/cureus.31699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Diabetes mellitus is a syndrome affecting more than 28.7 million people worldwide and its prevalence in Pakistan is reported to be about 11%. Management includes lifestyle changes and varied therapeutic regimens. Metformin (MET) alone and in combinations is considered as an important agent for glycemic control. Our study is based on MET combination therapy with empagliflozin versus sitagliptin in order to achieve glycemic control. Methods This randomized clinical trial was conducted in the Department of Medicine and Allied of Federal Government Polyclinic Hospital, Islamabad, from January 2022 till June 2022. The ethical approval letter numbered FGPC. 1-1/2022/Ethical Committee was taken before the commencement of the trial. The patients were divided into group A and group B. All patients were given MET 1000mg twice a day. Group A patients were additionally given sitagliptin 50mg twice daily whereas Group B patients were additionally given empagliflozin 10mg once daily. Glycemic control was documented with HbA1c at the start of treatment and after three months of treatment in both groups. A proforma was used to collect data. Analysis of the data was performed using the Statistical Package for the Social Sciences version 17 (SPSS Inc., Chicago, USA). Results A total of 126 patients were included in the study with a mean age of 53.53 ± 6.49. 81.7% were males while 18.3% were females. The mean reduction in HbA1c from baseline in group A was -0.81 ± 0.19% and in group B was -1.13 ± 0.24% with statistically significant p-value (p-value = 0.000). Conclusion Empagliflozin in combination with metformin is more efficacious in maintaining glycemic control as compared to sitagliptin in combination with metformin.
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Association between type 2 diabetes mellitus and TCF7L2 gene variant in the Pakistani cohort. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-022-01138-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Butt MD, Ong SC, Wahab MU, Rasool MF, Saleem F, Hashmi A, Sajjad A, Chaudhry FA, Babar ZUD. Cost of Illness Analysis of Type 2 Diabetes Mellitus: The Findings from a Lower-Middle Income Country. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912611. [PMID: 36231911 PMCID: PMC9566593 DOI: 10.3390/ijerph191912611] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 06/02/2023]
Abstract
BACKGROUND Diabetes is a major chronic illness that negatively influences individuals and society. Therefore, this research aimed to analyze and evaluate the cost associated with diabetes management, specific to the Pakistani Type 2 diabetes population. Research scheme and methods: A survey randomly collected information and data from diabetes patients throughout Pakistan out-patient clinics. Direct and indirect costs were evaluated, and data were analyzed with descriptive and inferential statistics. RESULTS An overall of 1839 diabetes patients participated in the study. The results have shown that direct and indirect costs are positively associated with the participants' socio-demographic characteristics, except for household income and educational status. The annual total cost of diabetes care was USD 740.1, amongst which the share of the direct cost was USD 646.7, and the indirect cost was USD 93.65. Most direct costs comprised medicine (USD 274.5) and hospitalization (USD 319.7). In contrast, the productivity loss of the patients had the highest contribution to the indirect cost (USD 81.36). CONCLUSION This study showed that direct costs significantly contributed to diabetes's overall cost in Pakistan and overall diabetes management estimated to be 1.67% (USD 24.42 billion) of the country's total gross domestic product. The expense of medications and hospitalization mostly drove the direct cost. Additionally, patients' loss of productivity contributed significantly to the indirect cost. It is high time for healthcare policymakers to address this huge healthcare burden. It is time to develop a thorough diabetes management plan to be implemented nationwide.
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Affiliation(s)
- Muhammad Daoud Butt
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia
| | - Siew Chin Ong
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia
| | - Muhammad Umar Wahab
- Consultant Diabetologist, Umar Diabetes and Foot Care Centre, Umar Diabetes Foundation, Office 1, Executive Complex, G8 Markaz, Islamabad 46000, Pakistan
| | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Fahad Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy & Health Sciences, University of Baluchistan, Quetta 87300, Pakistan
| | - Adnan Hashmi
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Ahsan Sajjad
- Consultant Diabetologist, Umar Diabetes and Foot Care Centre, Umar Diabetes Foundation, Office 1, Executive Complex, G8 Markaz, Islamabad 46000, Pakistan
- Ibn Sina Community Clinic South Wilcrest Drive, Houston, TX 77099, USA
| | | | - Zaheer-Ud-Din Babar
- Department of Pharmacy, University of Huddersfield, Huddersfield HD1 3DH, UK
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Investigation of Klotho G395A and C1818T Polymorphisms and Their Association with Serum Glucose Level and Risk of Type 2 Diabetes Mellitus. Genes (Basel) 2022; 13:genes13091532. [PMID: 36140700 PMCID: PMC9498819 DOI: 10.3390/genes13091532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 12/01/2022] Open
Abstract
Objective: The objective was to study the association of Klotho gene G395A and C1818T single nucleotide polymorphisms with glycemia, serum, glycosylated hemoglobin (HbA1c) level and the risk of type 2 diabetes mellitus (T2DM) in the Pashtun population of Pakistan. Methods: In this study, 195 normal individuals and 217 T2DM patients were enrolled. All subjects were divided into three groups, namely overall subjects (control + T2DM patients), control individuals and T2DM patients, and their fasting glucose, HbA1c level, lipid profile and C1818T and G395A polymorphisms were determined. Results: The allele frequencies of G395A in overall subjects were 0.568 for A and 0.432 for G. Similarly, allele frequencies for G395A in overall subjects were 0.597 and 0.403 for C and T alleles, respectively. The AA genotype of G395A was observed to be a risk factor for T2DM. In normal individuals, no significant (p > 0.05) association was observed between klotho C1818T and G395A polymorphisms and hyperglycemia. In overall subjects, the C1818T polymorphism was associated (p < 0.05) with high fasting glucose and HbA1c levels in female subjects only. In T2DM patients, both C1818T and G395A polymorphisms were found to be significantly (p < 0.05) associated with high fasting glucose and HbA1c levels both in males and females. Conclusion: The G395A polymorphism was observed to increase the risk of T2DM. Both C1818T and G395 were associated with high fasting glucose and HbA1c levels in T2DM patients.
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Tariq O, Rosten C, Huber J. Experiences of living with type 2 diabetes in Pakistan: the role of culture and family in physical activity. Int J Equity Health 2022; 21:103. [PMID: 35906689 PMCID: PMC9336021 DOI: 10.1186/s12939-022-01706-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 07/19/2022] [Indexed: 12/03/2022] Open
Abstract
Background Diabetes-related guidelines recommend lifestyle changes for people living with type 2 diabetes (PLwD). In South Asian (SA) families, cultural and contextual expectations often influence people’s decisions. However, broad explanations provided in the existing literature and theories concerning family involvement can increase the chance of health professionals overlooking the complexities of family roles within SA communities. Previous literature has identified the need to examine the perspectives of PLwD and their family members in Pakistan to shed light on factors perceived to support and hinder recommended physical activity (PA) to manage type 2 diabetes. This study explored (1) the enablers of and barriers to PA in the context of PLwD in Pakistan and (2) family involvement regarding PLwD’s engagement with PA. Methods Semi-structured interviews were conducted with 30 PLwD and 17 family members of PLwD who were recruited in metropolitan Lahore (Pakistan) and primarily used state health services available to relatively disadvantaged populations. Interviews were transcribed and analysed using thematic analysis. Results Three themes were identified: (1) Going for a walk as a feasible PA; (2) the role of family members in influencing PA; and (3) gender differences and cultural acceptability of an activity. PA enablers for PLwD consist of gender-specific opportunities for activity facilitated by peers and family members. Culturally acceptable opportunities for PA in Pakistan for specific genders and age groups within the socio-cultural context constituted an essential factor. In this study, all women with diabetes described walking as the only acceptable form of PA, whereas some men mentioned other activities such as running, playing cricket, and cycling. Conclusions Medical guidelines must consider patients’ daily routines, account for cultural and familial expectations of different genders and age groups, and address social and physical barriers encountered by these different groups to encourage PA among PLwD in SA cultures.
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Affiliation(s)
- Omama Tariq
- Institute of Applied Psychology, University of the Punjab, Lahore, Pakistan.
| | - Claire Rosten
- School of Sport and Health Sciences, University of Brighton, Brighton, UK
| | - Jörg Huber
- School of Sport and Health Sciences, University of Brighton, Brighton, UK
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Andayeshgar B, Janatolmakan M, Soroush A, Azizi SM, Khatony A. The prevalence of obstructive sleep apnea in patients with type 2 diabetes: a systematic review and meta-analysis. SLEEP SCIENCE AND PRACTICE 2022. [DOI: 10.1186/s41606-022-00074-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Obstructive Sleep Apnea (OSA) is one of the diseases related to diabetes. Considering the varying prevalence of OSA in patients with type 2 diabetes in different parts of the world, in order to aggregate the results and come to a general review about the topic mentioned, the current study performed a systematic review and meta-analysis of OSA in patients with type 2 diabetes.
Methods
In this study, the international databases (PubMed, Scopus, Web of science, and Cochran library) were searched without time limit using keywords diabetes, obstructive sleep apnea, and prevalence or epidemiology. Homogeneity was investigated among studies using Cochran Q test and I2 index. Given the heterogeneity of studies, random effect model was used to estimate the prevalence of OSA. Meta-regression was used to investigate the effect of quantitative variables on the prevalence of OSA. Comprehensive Meta-analysis (CMA) software was used for data analysis.
Results
Twenty studies were included in the meta-analysis. In these 19 studies, the total number of patients with type 2 diabetes was 10,754, with a mean age of 58.6 ± 4.1 years. Final estimation of OSA prevalence was calculated to be 56.0%. The results of meta-regression showed the prevalence of OSA increased with a rise in the mean age, the percentage of male sex, body mass index, and sample size.
Conclusion
Given the high prevalence of OSA in patients with type 2 diabetes, weight control can partly mitigate their problems and possibly reduce OSA prevalence.
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Rosén A, Otten J, Stomby A, Vallin S, Wennberg P, Brunström M. Oral glucose tolerance testing as a complement to fasting plasma glucose in screening for type 2 diabetes: population-based cross-sectional analyses of 146 000 health examinations in Västerbotten, Sweden. BMJ Open 2022; 12:e062172. [PMID: 35676014 PMCID: PMC9185658 DOI: 10.1136/bmjopen-2022-062172] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To assess the effect of adding an oral glucose tolerance test (OGTT) to fasting plasma glucose (FPG) in terms of detection of type 2 diabetes (T2D) and impaired glucose tolerance (IGT). DESIGN Retrospective analysis of serial cross-sectional screening study. SETTING Population-based health examinations within primary care in Västerbotten County, Sweden. PARTICIPANTS Individuals aged 40- 50 and 60 years with participation from 1985 to 2017. Those with previously diagnosed diabetes and FPG≥7 mmol/L were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES Prevalence of hyperglycaemia on the OGTT (IGT and T2D defined as 2-hour postload capillary plasma glucose of 8.9-12.1 mmol/L and ≥12.2 mmol/L, respectively). Analyses were further stratified by age, sex and risk factor burden to identify groups at high or low risk of IGT and T2D on testing. The numbers needed to screen (NNS) to prevent one case of T2D through detection and treatment of IGT was estimated, combining prevalence numbers with average progression rates and intervention effects from previous meta-analyses. RESULTS The prevalence of IGT ranged from 0.9% (95% CI 0.7% to 1.1%) to 29.6% (95% CI 27.4% to 31.7%), and the prevalence of T2D ranged from 0.06% (95% CI 0.02% to 0.11%) to 7.0% (95% CI 5.9% to 8.3%), depending strongly on age, sex and risk factor burden. The estimated NNS to prevent one case of T2D through detection and lifestyle treatment of IGT ranged from 1332 among 40-year-old men without risk factors, to 39 among 60-year-old women with all risk factors combined. CONCLUSIONS The prevalence of hyperglycaemia on OGTT is highly dependent on age, sex and risk factor burden; OGTT should be applied selectively to high-risk groups to avoid unnecessary testing in the general population.
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Affiliation(s)
- Anna Rosén
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Julia Otten
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | - Andreas Stomby
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
- Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Futurum, Region Jönköping County, Jönköping, Sweden
| | - Simon Vallin
- Northern Register Centre, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Patrik Wennberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Mattias Brunström
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
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Azeem S, Khan U, Liaquat A. The increasing rate of diabetes in Pakistan: A silent killer. Ann Med Surg (Lond) 2022; 79:103901. [PMID: 35860160 PMCID: PMC9289249 DOI: 10.1016/j.amsu.2022.103901] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 05/29/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Saleha Azeem
- King Edward Medical University, Lahore, Pakistan
- Corresponding author.
| | - Ubaid Khan
- King Edward Medical University, Lahore, Pakistan
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Habas E, Errayes M, Habas E, Farfar KL, Alfitori G, Habas AE, Rayani A, Elzouki ANY. Fasting Ramadan in Chronic Kidney Disease (CKD), Kidney Transplant and Dialysis Patients: Review and Update. Cureus 2022; 14:e25269. [PMID: 35755525 PMCID: PMC9218841 DOI: 10.7759/cureus.25269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 11/12/2022] Open
Abstract
Chronic kidney disease (CKD) is a common disease in the Islamic regions. Dehydration occurs after prolonged fasting, particularly in hot and humid climates. In the Arabic months’ calendar, Ramadan is a month of maximum given deeds, where Muslims are required to fast from dawn till sunset. Depending on where you live and when the Ramadan month falls, fasting might last anywhere from 10 to 20 hours or more. In certain circumstances, such as poorly controlled diabetes and advanced CKD patients who are allowed to break their fast, the Ramadan fasting amendment is viable. Some Muslims, however, continue fasting despite these circumstances, placing themselves at risk, which is not allowed in the Islamic religion. There are no medical recommendations that specify who should and should not fast. Nonetheless, the recommendations have been extracted from several published studies. The authors searched EMBASE, PubMed, Google Scholar, and Google for publications, research, and reviews. All authors debate and analyze the related articles. Each author was assigned a part or two of the topics to read, study, and summarize before creating the final draft of their given section. Then this comprehensive review was completed after discussion sessions. In conclusion, by the Islamic religion view, fasting Ramadan is mandatory for every wise adult person. People who have chronic diseases or that may deteriorate by fasting are exempted from fasting. It seems that fasting and the associated disease hours are determinant factors to fasting or not fasting. Up to our knowledge, there are no established guidelines for CKD patients and physicians to follow; however, the International Diabetes Federation and Diabetes and Ramadan (IDF-DAR) Practical Guidelines 2021 have been issued for CKD diabetic patients and fasting.
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Ali A, Alfajjam S, Gasana J. Diabetes Mellitus and Its Risk Factors among Migrant Workers in Kuwait. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073943. [PMID: 35409622 PMCID: PMC8997920 DOI: 10.3390/ijerph19073943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/01/2022] [Accepted: 03/16/2022] [Indexed: 12/14/2022]
Abstract
The prevalence of diabetes mellitus (DM) is growing enormously worldwide, and actions need to be taken in order to minimize the burden of diabetes mellitus and reduce its complications. Since two-thirds of Kuwait's population are expatriates, the prevalence of and factors associated with diabetes among migrant workers was assessed as it has a significant impact on migrant workers' quality of life, health, and productivity. The data used in this study was for all migrant workers who attended Shuaiba Industrial Medical Center (SIMC) for physical examination in the year 2018. Univariate and multivariate regression were used to assess the relationship between diabetes mellitus and the other independent factors where odds ratios with confidence intervals were delineated. Information for a total of 3477 participants was recorded in the dataset for 2018. Of the total participants, 10.1% had diabetes mellitus. About 49% of the participants were overweight. The largest age group of participants was between 31 and 40 years of age. A small percentage of the participants were diagnosed with hypertension at 11.8%. Additionally, 76.1% of the participants reported themselves as non-smokers. Diabetes was positively associated with age, hypertension, and nationalities. However, no association was found between BMI and smoking tobacco. This is the first study in SIMC to assess DM and its associated risk factor among migrants, since migrant workers are neglected subpopulations that need our focus and attention to achieve justice and fairness. The findings revealed that the prevalence of DM among our study population was considerably lower. However, a healthy lifestyle, including a healthy diet and being physically active, need to be introduced to prevent any further damage.
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Affiliation(s)
- Anwar Ali
- Public Health Department, Ministry of Health, P.O. Box 5, Kuwait City 12009, Kuwait;
| | - Shaikhah Alfajjam
- Occupational Health Department, Ministry of Health, P.O. Box 5, Kuwait City 12009, Kuwait;
| | - Janvier Gasana
- Department of Environmental and Occupational Health, Faculty of Public Health, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
- Correspondence:
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Al-Jawaldeh A, Abbass MMS. Unhealthy Dietary Habits and Obesity: The Major Risk Factors Beyond Non-Communicable Diseases in the Eastern Mediterranean Region. Front Nutr 2022; 9:817808. [PMID: 35369054 PMCID: PMC8970016 DOI: 10.3389/fnut.2022.817808] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/11/2022] [Indexed: 12/14/2022] Open
Abstract
There are 22 countries in the Eastern Mediterranean Region (EMR) expanding from Morocco in the west to Pakistan and Afghanistan in the east, containing a population of 725,721 million in 2020. In the previous 30 years, the illness burden in the EMR has transmitted from communicable diseases to non-communicable diseases such as diabetes, cardiovascular diseases, and cancer. In 2019, cardiovascular mortality in the EMR was mostly attributed to ischemic heart disease, the first reason for mortality in 19 countries in the region. Stroke was the second reason for death in nine countries followed by diabetes, which was ranked as the second reason for death in two countries. The prominent nutrition-related NCDs risk factors in EMR include obesity, hypertension, high fasting plasma glucose, and upregulated unhealthy diet consumption. Most of the EMR population are unaware of their NCDs risk factor status. These risk factors, even if treated, are often poorly controlled, therefore, inhibiting their existence by changing the lifestyle to proper dietary habits and sufficient physical activity is mandatory. In this review, the epidemiology and nutrition-related risk factors of NCDs in the EMR will be discussed and illustrated, aiming to scale up action and support decision-makers in implementing cost effective strategies to address obesity and NCDs prevention and management in the region.
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Affiliation(s)
- Ayoub Al-Jawaldeh
- World Health Organization (WHO), Regional Office for the Eastern Mediterranean (EMRO), Cairo, Egypt
| | - Marwa M. S. Abbass
- World Health Organization (WHO), Regional Office for the Eastern Mediterranean (EMRO), Cairo, Egypt
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
- *Correspondence: Marwa M. S. Abbass
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Baig FA, Khan S, Rizwan A. Frequency of Vitamin B12 Deficiency in Type 2 Diabetic Patients Taking Metformin. Cureus 2022; 14:e22924. [PMID: 35399475 PMCID: PMC8986136 DOI: 10.7759/cureus.22924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Type 2 diabetes mellitus (DM) is a prevalent global health problem and is on a constant rise, especially in middle- and low-income countries. Vitamin B12 malabsorption is one of the reported side effects of metformin. Our study aims to assess the correlation of B12 deficiency in type 2 diabetics using metformin for their treatment. Methods This case-control study was conducted in a tertiary care hospital in Pakistan from February 2021 to December 2021. Patients (n=100) with a documented diagnosis of type 2 DM on metformin monotherapy for a minimum of six months were enrolled via consecutive convenient non-probability sampling. Another 100 patients without a history of diabetes were included in the study as a control group for comparison. Results Serum vitamin B-12 levels were higher in the non-diabetic participants as compared to the diabetic group (301.71 ± 72.12 vs. 189.25 ± 31.22; p-value: <0.0001). Hypovitaminosis was more significant in the diabetic group (p-value: 0.0000). Serum vitamin B12 levels were found to be declining with the increasing duration of metformin use (p-value: <0.0001). Conclusion Our study found a significant effect of vitamin B12 deficiency in metformin-treated patients. Therefore, it is prudent to recognize B12 deficiency as a potential side effect of long-term use of metformin. A periodic screening of B12 in such patients and subsequent supplementation of vitamin B12 is an effective and safe means of prevention of development or worsening of peripheral nerve damage and other clinical manifestations.
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Roystonn K, Lau JH, AshaRani PV, Siva Kumar FD, Wang P, Sum CF, Lee ES, Chong SA, Subramaniam M. Recognition of diabetes and sociodemographic predictors: results of a cross-sectional nationwide population-based survey in Singapore. BMJ Open 2022; 12:e050425. [PMID: 35232779 PMCID: PMC8889315 DOI: 10.1136/bmjopen-2021-050425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE To assess recognition of diabetes among a nationally representative multiethnic sample of Singapore's general public. Also, to explore the sociodemographic predictors associated with the ability to correctly recognise diabetes. DESIGN AND SETTING This was a cross-sectional vignette-based survey. Respondents were instructed to read the vignette, then answer the open-ended question, 'What do you think the person in the vignette is suffering from?' PARTICIPANTS A sample of 2895 household residents aged 18 years and above, of which 436 were persons with diabetes. RESULTS 82.7% could correctly recognise diabetes in the vignette. Overall, recognition was significantly higher among respondents aged 35-49 years (OR 1.85, 95% CI 1.15 to 2.98), 50-64 years (OR 2.06, 95% CI 1.19 to 3.56), ethnic Malays (OR 1.39, 95% CI 1.02 to 1.89) and persons with diabetes (OR 2.64, 95% CI 1.38 to 5.08). By contrast, male (OR 0.64, 95% CI 0.46 to 0.90), ethnic Others (OR 0.59, 95% CI 0.37 to 0.93) and the unemployed (OR 0.48, 95% CI 0.25 to 0.92) were significantly associated with poor recognition of diabetes. CONCLUSION Overall public recognition of diabetes was high, but the significant gaps in knowledge in certain demographic groups were of concern. Public health interventions aimed at preventing and controlling diabetes should continue to target all members of the population with accurate and appropriate information. Ongoing efforts of diabetes awareness and screening programmes need to be improved, particularly for young adults, males and the unemployed.
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Affiliation(s)
| | - Jue Hua Lau
- Research Division, Institute of Mental Health, Singapore
| | - P V AshaRani
- Research Division, Institute of Mental Health, Singapore
| | | | - Peizhi Wang
- Research Division, Institute of Mental Health, Singapore
| | - Chee Fang Sum
- Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore
| | - Eng Sing Lee
- Clinical Research Unit, National Healthcare Group, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Yield, NNS and prevalence of screening for DM and hypertension among pulmonary tuberculosis index cases and contacts through single time screening: A contact tracing-based study. PLoS One 2022; 17:e0263308. [PMID: 35089989 PMCID: PMC8797235 DOI: 10.1371/journal.pone.0263308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 01/18/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Diabetes mellitus (DM), hypertension and pulmonary tuberculosis (PTB) are catastrophic illnesses that collectively lead to increased mortality and premature death. However, the size of the problem and the appropriate approach to deal with the burden is still unclear. We aimed to evaluate the yield, number needed to screen (NNS) to prevent one death or adverse event for screening DM and hypertension and assess the prevalence and contributors to DM and/or hypertension. METHODS Based on PTB contact tracing, a cross-sectional study was conducted among 801 PTB index cases and 972 household contacts from April 2019 to October 2020 in Guizhou, China. All the participants were screened for DM and hypertension. The yield was calculated as the proportion of newly detected cases among the study subjects, excluding known cases. The NNS was computed by dividing the number needed to treat for risk factors by the prevalence of the unrecognized diseases. The univariate and multivariate logistic regression analyses were applied to determine the independent predictors of DM and/or hypertension. RESULTS Of the 1,773 participants, the prevalence of DM and hypertension was 8.7% (70/801) and 15.2% (122/801) in the PTB patients, 3.2% (31/972) and 14.0% (136/972) in the contacts, respectively. The prevalence of DM and/or hypertension was 21.2% (170/801) among the PTB patients and 15.4% (150/972) among their contacts. The screening yields to detect new cases of DM and hypertension among PTB patients were 1.9% and 5.2%, and that in the contacts were 0.8% and 4.8%, respectively. The NNS for DM was 359 for the PTB cases and 977 for the contacts, 299 for PTB cases and 325 for hypertension, respectively. Older age, under or overweight and obesity, family history hypertension and earlier diagnosis of other chronic conditions were the independent predictors for DM and/or hypertension among both PTB cases and their contacts. CONCLUSION Screening for DM and hypertension should be mandated in PTB patients and their household contacts to disclose undetected cases of these two conditions during TB contact tracing, which might reduce the potential cardiovascular disease deaths.
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Masood KI, Irfan M, Masood Q, Yameen M, Jamil B, Ram N, Rao S, Rottenberg M, Hasan Z. Latent
M. tuberculosis
infection is associated with increased inflammatory cytokine and decreased suppressor of cytokine signalling (SOCS)‐3 in the diabetic host. Scand J Immunol 2021; 95:e13134. [DOI: 10.1111/sji.13134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 01/06/2023]
Affiliation(s)
- Kiran Iqbal Masood
- Department of Pathology and Laboratory Medicine The Aga Khan University Karachi Pakistan
- Department of Medicine The Aga Khan University Karachi Pakistan
- Department of Microbiology, Tumor and Cell Biology Karolinska Institutet Stockholm Sweden
| | - Muhammad Irfan
- Department of Pathology and Laboratory Medicine The Aga Khan University Karachi Pakistan
- Department of Medicine The Aga Khan University Karachi Pakistan
- Department of Microbiology, Tumor and Cell Biology Karolinska Institutet Stockholm Sweden
| | - Qamar Masood
- Department of Pathology and Laboratory Medicine The Aga Khan University Karachi Pakistan
- Department of Medicine The Aga Khan University Karachi Pakistan
- Department of Microbiology, Tumor and Cell Biology Karolinska Institutet Stockholm Sweden
| | - Maliha Yameen
- Department of Pathology and Laboratory Medicine The Aga Khan University Karachi Pakistan
- Department of Medicine The Aga Khan University Karachi Pakistan
- Department of Microbiology, Tumor and Cell Biology Karolinska Institutet Stockholm Sweden
| | - Bushra Jamil
- Department of Pathology and Laboratory Medicine The Aga Khan University Karachi Pakistan
- Department of Medicine The Aga Khan University Karachi Pakistan
- Department of Microbiology, Tumor and Cell Biology Karolinska Institutet Stockholm Sweden
| | - Nanik Ram
- Department of Pathology and Laboratory Medicine The Aga Khan University Karachi Pakistan
- Department of Medicine The Aga Khan University Karachi Pakistan
- Department of Microbiology, Tumor and Cell Biology Karolinska Institutet Stockholm Sweden
| | - Shoaib Rao
- Department of Pathology and Laboratory Medicine The Aga Khan University Karachi Pakistan
- Department of Medicine The Aga Khan University Karachi Pakistan
- Department of Microbiology, Tumor and Cell Biology Karolinska Institutet Stockholm Sweden
| | - Martin Rottenberg
- Department of Pathology and Laboratory Medicine The Aga Khan University Karachi Pakistan
- Department of Medicine The Aga Khan University Karachi Pakistan
- Department of Microbiology, Tumor and Cell Biology Karolinska Institutet Stockholm Sweden
| | - Zahra Hasan
- Department of Pathology and Laboratory Medicine The Aga Khan University Karachi Pakistan
- Department of Medicine The Aga Khan University Karachi Pakistan
- Department of Microbiology, Tumor and Cell Biology Karolinska Institutet Stockholm Sweden
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Rafique I, Mir A, Siddiqui S, Saqib MAN, Fawwad A, Marchand L, Adnan M, Naeem M, Basit A, Polychronakos C. Comprehensive genetic screening reveals wide spectrum of genetic variants in monogenic forms of diabetes among Pakistani population. World J Diabetes 2021; 12:1957-1966. [PMID: 34888019 PMCID: PMC8613659 DOI: 10.4239/wjd.v12.i11.1957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/14/2021] [Accepted: 10/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Monogenic forms of diabetes (MFD) are single gene disorders. Their diagnosis is challenging, and symptoms overlap with type 1 and type 2 diabetes.
AIM To identify the genetic variants responsible for MFD in the Pakistani population and their frequencies.
METHODS A total of 184 patients suspected of having MFD were enrolled. The inclusion criterion was diabetes with onset below 25 years of age. Brief demographic and clinical information were taken from the participants. The maturity-onset diabetes of the young (MODY) probability score was calculated, and glutamate decarboxylase ELISA was performed. Antibody negative patients and features resembling MODY were selected (n = 28) for exome sequencing to identify the pathogenic variants.
RESULTS A total of eight missense novel or very low-frequency variants were identified in 7 patients. Three variants were found in genes for MODY, i.e. HNF1A (c.169C>A, p.Leu57Met), KLF11 (c.401G>C, p.Gly134Ala), and HNF1B (c.1058C>T, p.Ser353Leu). Five variants were found in genes other than the 14 known MODY genes, i.e. RFX6 (c.919G>A, p.Glu307Lys), WFS1 (c.478G>A, p.Glu160Lys) and WFS1 (c.517G>A, p.Glu173Lys), RFX6 (c.1212T>A, p.His404Gln) and ZBTB20 (c.1049G>A, p.Arg350His).
CONCLUSION The study showed wide spectrum of genetic variants potentially causing MFD in the Pakistani population. The MODY genes prevalent in European population (GCK, HNF1A, and HNF4a) were not found to be common in our population. Identification of novel variants will further help to understand the role of different genes causing the pathogenicity in MODY patient and their proper management and diagnosis.
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Affiliation(s)
- Ibrar Rafique
- Department of Biological Sciences, International Islamic University, Islamabad 44000, Pakistan
- Departments of Pediatrics and Human Genetics, McGill University Health Centre Research Institute, Montreal H4A 3J1, Canada
- Research Development and Coordination, Pakistan Health Research Council, Islamabad 44000, Pakistan
| | - Asif Mir
- Department of Biological Sciences, International Islamic University, Islamabad 44000, Pakistan
| | - Shajee Siddiqui
- Department of Medicine, Pakistan Institute of Medical Sciences, Islamabad 44000, Pakistan, Pakistan
| | | | - Asher Fawwad
- Department of Biochemistry, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi 74600, Sindh, Pakistan
| | - Luc Marchand
- Departments of Pediatrics and Human Genetics, McGill University Health Centre Research Institute, Montreal H4A 3J1, Canada
| | - Muhammad Adnan
- PHRC Research Centre, FJMU, Pakistan Health Research Council, Lahore 54000, Pakistan
| | - Muhammad Naeem
- Department of Biotechnology, Quaid-I-Azam University, Islamabad 44000, Pakistan
| | - Abdul Basit
- Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi 74600, Sindh, Pakistan
| | - Constantin Polychronakos
- Departments of Pediatrics and Human Genetics, McGill University Health Centre Research Institute, Montreal H4A 3J1, Canada
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Yasin S, Iqbal N, Ali T, Draz U, Alqahtani A, Irfan M, Rehman A, Glowacz A, Alqhtani S, Proniewska K, Brumercik F, Wzorek L. Severity Grading and Early Retinopathy Lesion Detection through Hybrid Inception-ResNet Architecture. SENSORS 2021; 21:s21206933. [PMID: 34696146 PMCID: PMC8537739 DOI: 10.3390/s21206933] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/06/2021] [Accepted: 10/10/2021] [Indexed: 12/14/2022]
Abstract
Diabetic retinopathy (DR) is a diabetes disorder that disturbs human vision. It starts due to the damage in the light-sensitive tissues of blood vessels at the retina. In the beginning, DR may show no symptoms or only slight vision issues, but in the long run, it could be a permanent source of impaired vision, simply known as blindness in the advanced as well as in developing nations. This could be prevented if DR is identified early enough, but it can be challenging as we know the disease frequently shows rare signs until it is too late to deliver an effective cure. In our work, we recommend a framework for severity grading and early DR detection through hybrid deep learning Inception-ResNet architecture with smart data preprocessing. Our proposed method is composed of three steps. Firstly, the retinal images are preprocessed with the help of augmentation and intensity normalization. Secondly, the preprocessed images are given to the hybrid Inception-ResNet architecture to extract the vector image features for the categorization of different stages. Lastly, to identify DR and decide its stage (e.g., mild DR, moderate DR, severe DR, or proliferative DR), a classification step is used. The studies and trials have to reveal suitable outcomes when equated with some other previously deployed approaches. However, there are specific constraints in our study that are also discussed and we suggest methods to enhance further research in this field.
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Affiliation(s)
- Sana Yasin
- Faculty of Computing, University of Okara, Okara 56141, Pakistan; (S.Y.); (N.I.)
| | - Nasrullah Iqbal
- Faculty of Computing, University of Okara, Okara 56141, Pakistan; (S.Y.); (N.I.)
| | - Tariq Ali
- Department of Computer Science, COMSATS University Islamabad (CUI), Sahiwal Campus, Sahiwal 57000, Pakistan;
| | - Umar Draz
- Department of Computer Science, University of Sahiwal, Sahiwal 57000, Pakistan
- Computer Science Department, CUI, Lahore Campus, Lahore 54000, Pakistan
- Correspondence:
| | - Ali Alqahtani
- College of Computer Science and Information Systems, Najran University, Najran 11001, Saudi Arabia; (A.A.); (S.A.)
| | - Muhammad Irfan
- Electrical Engineering Department, College of Engineering, Najran University Saudi Arabia, Najran 61441, Saudi Arabia;
| | - Abdul Rehman
- IT Department, Superior University, Lahore 120000, Pakistan;
| | - Adam Glowacz
- Department of Automatic Control and Robotics, Faculty of Electrical Engineering, Automatics, Computer Science and Biomedical Engineering, AGH University of Science and Technology, al. A. Mickiewicza 30, 30-059 Krakow, Poland;
| | - Samar Alqhtani
- Electrical Engineering Department, College of Engineering, Najran University Saudi Arabia, Najran 61441, Saudi Arabia;
| | - Klaudia Proniewska
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Anny 12, 31-008 Krakow, Poland;
| | - Frantisek Brumercik
- Department of Design and Machine Elements, Faculty of Mechanical Engineering, University of Zilina, Univerzitna 1, 010 26 Zilina, Slovakia;
| | - Lukasz Wzorek
- Wzorek. Systems, ul. Kapelanka 10/18, 30-347 Krakow, Poland;
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Majid Khan A, Lohana P, Anvekar P, Hassan Mustafa S, Kumar R, Lnu A, Bhimani P, Ali SR, Lnu A, Hamad Ali Shah S. Risk Factors of Peripheral Vascular Disease in Diabetes Mellitus in Abbottabad, Pakistan: A Cross-Sectional Study. Cureus 2021; 13:e17556. [PMID: 34646613 PMCID: PMC8480069 DOI: 10.7759/cureus.17556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Diabetes mellitus (DM) is a significant and common risk factor for the development of peripheral vascular disease (PVD). Peripheral vascular disease is the atherosclerotic narrowing of peripheral arteries and has a high prevalence among patients with diabetes. Material and methods A cross-sectional study was conducted in the Department of Medicine of Ayub Teaching Hospital, Abbottabad. A total of 271 diagnosed diabetic patients aged 40 years or above were included in the study. Ankle-brachial pressure index (ABPI) was measured using a hand-held Doppler device and sphygmomanometer. An ABPI < 0.9 was taken to be abnormal. The risk factors were noted through history taking, physical examination, and appropriate investigations. Results Our study sample included 271 patients. A hundred and forty-five (53.5%) of them were males, and 126 (46.5%) were females. Fifty-three (19.9%) out of 271 patients had peripheral vascular disease. The prevalence of peripheral vascular disease was stratified among smoking (p=0.00), hypertension (p=0.00), obesity (p=0.004), and hypercholesterolemia (p=0.005) to determine if there was any association between these and peripheral vascular disease. A p-value less than 0.05 was taken to be significant. Conclusion This study showed a significant association between PVD and smoking, hypertension, hypercholesterolemia, and obesity.
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Affiliation(s)
- Abdul Majid Khan
- Assistant Professor, Department of Medicine, Ayub Medical College, Abbottabad, PAK
| | - Petras Lohana
- Internal Medicine, Liaquat University of Medical and Health Sciences Hospital, Karachi, PAK
| | - Priyanka Anvekar
- Medicine and Surgery, Mahatma Gandhi Mission Medical College and Hospital, Mumbai, IND
| | | | - Ramesh Kumar
- Internal Medicine, Civil Hospital Karachi, Karachi, PAK
| | - Adnan Lnu
- Assistant Professor, Department of Internal Medicine, Ayub Medical College, Abbottabad, PAK
| | - Pushpa Bhimani
- Obstetrics and Gynecology, Civil Hospital Karachi, Karachi, PAK
| | - Syed R Ali
- Internal Medicine, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
| | - Arti Lnu
- Bachelor of Medicine and Bachelor of Surgery (MBBS), Liaquat University of Medical and Health Sciences, Kunri, PAK
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Jaffery SMF, Khan MA, Ullah S, Atia‐tul‐Wahab, Choudhary MI, Basha FZ. Synthesis of New Valinol‐Derived Sultam Triazoles as
α
‐Glucosidase Inhibitors. ChemistrySelect 2021. [DOI: 10.1002/slct.202102119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Syeda Mehak Fatima Jaffery
- H.E.J. Research Institute of Chemistry International Center for Chemical and Biological Sciences University of Karachi Karachi 75270 Pakistan
| | - Maria Aqeel Khan
- Third World Center for Science and Technology (TWC) H.E.J. Research Institute of Chemistry International Center for Chemical and Biological Sciences University of Karachi Karachi 75270 Pakistan
| | - Saeed Ullah
- H.E.J. Research Institute of Chemistry International Center for Chemical and Biological Sciences University of Karachi Karachi 75270 Pakistan
| | - Atia‐tul‐Wahab
- Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD) International Center for Chemical and Biological Sciences University of Karachi-75270 Karachi Pakistan
| | - Muhammad Iqbal Choudhary
- H.E.J. Research Institute of Chemistry International Center for Chemical and Biological Sciences University of Karachi Karachi 75270 Pakistan
- Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD) International Center for Chemical and Biological Sciences University of Karachi-75270 Karachi Pakistan
| | - Fatima Zehra Basha
- H.E.J. Research Institute of Chemistry International Center for Chemical and Biological Sciences University of Karachi Karachi 75270 Pakistan
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El-Kebbi IM, Bidikian NH, Hneiny L, Nasrallah MP. Epidemiology of type 2 diabetes in the Middle East and North Africa: Challenges and call for action. World J Diabetes 2021; 12:1401-1425. [PMID: 34630897 PMCID: PMC8472500 DOI: 10.4239/wjd.v12.i9.1401] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/21/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023] Open
Abstract
Type 2 diabetes continues to be a serious and highly prevalent public health problem worldwide. In 2019, the highest prevalence of diabetes in the world at 12.2%, with its associated morbidity and mortality, was found in the Middle East and North Africa region. In addition to a genetic predisposition in its population, evidence suggests that obesity, physical inactivity, urbanization, and poor nutritional habits have contributed to the high prevalence of diabetes and prediabetes in the region. These risk factors have also led to an earlier onset of type 2 diabetes among children and adolescents, negatively affecting the productive years of the youth and their quality of life. Furthermore, efforts to control the rising prevalence of diabetes and its complications have been challenged and complicated by the political instability and armed conflict in some countries of the region and the recent coronavirus disease 2019. Broad strategies, coupled with targeted interventions at the regional, national, and community levels are needed to address and curb the spread of this public health crisis.
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Affiliation(s)
- Imad M El-Kebbi
- Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Faculty of Medicine, Beirut 11072020, Lebanon
- Department of Internal Medicine, Sheikh Shakhbout Medical City, Abou Dhabi 11001, United Arab Emirates
| | - Nayda H Bidikian
- School of Medicine, American University of Beirut, Faculty of Medicine, Beirut 11072020, Lebanon
| | - Layal Hneiny
- University Libraries, Saab Medical Library, American University of Beirut, Beirut 11072020, Lebanon
| | - Mona Philippe Nasrallah
- Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Faculty of Medicine, Beirut 11072020, Lebanon
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40
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Kamin M, Khan SA, Raja UY, Ishtiaq O, Malik A, Rehman T, Wahab MU. Efficacy and Safety of Dulaglutide in Type 2 Diabetes Patients in Endocrinology Clinics of Islamabad, Pakistan. Indian J Endocrinol Metab 2021; 25:456-461. [PMID: 35300442 PMCID: PMC8923314 DOI: 10.4103/ijem.ijem_402_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/18/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Our objective was to ascertain the efficacy and safety of once weekly Dulaglutide among patients with Type 2 diabetes of Pakistani origin. METHODS This prospective cohort study was conducted at the Endocrinology Clinics of Shifa International Hospital, Islamabad and Umar Diabetes and Foot Care Centre, Islamabad, Pakistan during the period from July 2020 to December 2020. Dulaglutide at the dose of 1.5 mg once weekly was initiated in patients with BMI >28 and suboptimal glucose control in the background of Type 2 Diabetes who were also taking one or more of oral anti-diabetic and/or insulin therapy. RESULTS Mean age of patient cohort (n = 148) was 49.51 years (SD +/- 12.15) with 53.5% (n = 85) having type 2 diabetes for a duration of over 10 years. Mean weight was 93.2 kg at baseline with end of study mean weight being 90.7 kg. Mean HbA1c at baseline was 9.2%, which improved to 8.05% at the end of study. The main side-effects were nausea in 32%, vomiting in 8%, and diarrhea in 7% with 19% discontinuation rate due to cost and side-effects. CONCLUSION Dulaglutide as a therapy demonstrated favorable HbA1c and weight reduction in obese type 2 diabetes patients of Pakistani origin.
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Affiliation(s)
- Matiullah Kamin
- Department of Endocrine, Bolan University of Medical and Health Sciences, Quetta, Pakistan
| | - Sajjad Ali Khan
- Department of Endocrine, Aga Khan University Hospital, Karachi, Pakistan
| | - Umar Yousaf Raja
- Department of Endocrine, Shifa International Hospital, Islamabad, Pakistan
| | - Osama Ishtiaq
- Department of Endocrine, Shifa International Hospital, Islamabad, Pakistan
| | - Asmara Malik
- Department of Community Medicine, National University of Medical Sciences, Karachi, Pakistan
| | - Tejhmal Rehman
- Department of Endocrine, Shifa International Hospital, Islamabad, Pakistan
| | - Muhammad Umar Wahab
- Department of Diabetes, Umar Diabetes and Foot Care Clinic and Umar Diabetes Foundation, Islamabad, Pakistan
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Abbas U, Imdad B, Mughal SA, Baloch IA, Khan AM, Kamran DES. Differential expression of micro RNA-29 family in non-diabetic adults of diabetic and non-diabetic parents. BMC Res Notes 2021; 14:294. [PMID: 34321097 PMCID: PMC8317273 DOI: 10.1186/s13104-021-05703-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/18/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE MicroRNAs are known to regulate 60% of genes at post translational level. MicroRNAs including Micro RNA-29 family play a vital role in cellular activities and have validate role in numerous metabolic disorders inclusive of diabetes mellitus and its complications. While micro RNA profile changes years before the occurrence of disease. This cross-sectional study was conducted in non-diabetic adults of diabetic and non-diabetic parents to explore the early changes in expression of micro RNA-29 family as it can be served as early biomarker of type 2 diabetes in non-diabetic adults. This study was conducted from January 2019 to January 2021. Micro RNA was extracted from plasma of 50 participants and expression was compared through qPCR. While data was analyzed through SPSS version 21.0. RESULTS 29a and 29b had lower expression in participants with family history of DM compared to those having no family history of DM (P < 0.0001). While micro RNA 29c was found to be significantly higher in participants with positive family history of type 2 diabetes as compared to those without family history of diabetes (P = 0.001).
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Affiliation(s)
- Uzair Abbas
- Department of Physiology, Dow University of Health Sciences, Karachi, Pakistan.
| | - Bushra Imdad
- Department of Physiology, Dow University of Health Sciences, Karachi, Pakistan
| | | | | | - Afshan Mehboob Khan
- Department of Physiology, Dow University of Health Sciences, Karachi, Pakistan
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Clinical factors and comorbidities affecting health-related quality of life in postrenal transplant patients. Porto Biomed J 2021; 6:e131. [PMID: 34136716 PMCID: PMC8202575 DOI: 10.1097/j.pbj.0000000000000131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/25/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Health-related quality of life is different among different transplant cohorts with respect to different variables which predict mortality and graft survival. The aim of this study was to identify the effects of clinical factors on the health-related quality of life in postrenal transplant patients. Methods: This census study was conducted at the Institute of Kidney Diseases Peshawar, Pakistan. Data were collected on a questionnaire “ Kidney Diseases Quality of Life-Short Form-1.3 Urdu version” and were analyzed in the 3 main domains, for example, physical component summary (PCS), mental component summary, and kidney disease component summary using SPSS version 21. Mean scores for patients with diabetes mellitus (DM), hypertension, levels of hemoglobin, and serum creatinine were compared by unpaired t-test. Results: A total of 277 men (87.9%) and 38 (12.1%) women participated in the study. Mean age was 37.26 (±10.14) years (range 18–65 years). Hypertension was reported in 72.2% and DM in 10.8%. Hemoglobin was <12.5g% in 26.0% patients. Patients with DM had significant lower PCS (P = .001) and mental component summary (MCS; P = .001) scores. Patients with hypertension had significant lower MCS score (P = .01). Patients with hemoglobin <12.5g% had significantly lower PCS (P = .001) score than those with hemoglobin >12.5 g%. The PCS score in patients with serum creatinine level >2 mg% was significantly lower (P = .02) than those with serum creatinine <2 mg%. Conclusion: Lower graft function and DM were associated with lower PCS and MCS scores. Hypertension was associated with lower MCS score and anemia with lower PCS score.
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Talpur AS, Amar Z, Zafar S, Memon A, Eimal Latif AH, Hafizyar F, Hashim S, Nazary K. Association Between Diabetic Retinopathy and Carotid Intima-Media Thickness. Cureus 2021; 13:e15575. [PMID: 34277197 PMCID: PMC8270072 DOI: 10.7759/cureus.15575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction Patients with diabetes having advanced stage of diabetic retinopathy (DR) may predict future risk of coronary artery disease. To predict cardiovascular outcomes carotid intima-media thickness (CIMT) is utilized in diabetic patients. The aim of our study was the evaluation of the relationship between retinopathy and CIMT as two valuable non-invasive methods for early detection of micro- and macrovascular complication of diabetes. Methods This comparative cross-sectional study was conducted in the internal medicine ward of tertiary care hospital in Pakistan from November 2020 to January 2021. Three hundred patients with type 2 diabetes mellitus and 300 control subjects were enrolled in the study after taking informed consent. Ophthalmological examination was done to screen patients for DR. CIMT was evaluated by a Doppler ultrasound for both carotid arteries. Results Carotid artery intimal thickness was more in patients with retinopathy compared to patients without retinopathy in both right (0.77 ± 0.16 vs. 0.66 ± 0.12; p-value: <0.0001) and left carotid artery (0.77 ± 0.15 vs. 0.65 ± 0.11; p-value: <0.0001). Conclusion In our study, there was a correlation between DR and CIMT. Screening for DR, which may be a potential early marker for complications, may help detect patients at risk of various macro and microvascular complications.
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Affiliation(s)
- Abdul Subhan Talpur
- Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Zain Amar
- Internal Medicine, Isra University, Hyderabad, PAK
| | | | | | | | | | - Sara Hashim
- Pathology, Bolan Medical College, Quetta, PAK
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Tauseef A, Zafar M, Syyed E, Thirumalareddy J, Sood A, Mirza M. Asymptomatic Bacteriuria (ASB) in diabetic patients: Treat or not to treat: A prospective, observational study conducted at a tertiary care hospital. J Family Med Prim Care 2021; 10:1963-1969. [PMID: 34195132 PMCID: PMC8208176 DOI: 10.4103/jfmpc.jfmpc_1894_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/24/2020] [Accepted: 12/16/2020] [Indexed: 12/02/2022] Open
Abstract
Background: The term asymptomatic bacteriuria (ASB) refers to the isolation of bacteria in a urine specimen of individuals who denied symptoms of urinary tract infection. Diabetes mellitus (DM) is a disease involving multiple organ systems, hallmarked for its chronicity and thus-forth endless complications including asymptomatic bacteriuria. Objectives: This study aimed to determine the characteristics of asymptomatic bacteriuria and antibiotic susceptibility pattern amongst patients with diabetes. Settings and Design: A prospective observational study was conducted at a tertiary care hospital in Karachi, Pakistan. Methods and Material: The study included all those patients with a diagnosis of diabetes with no signs and symptoms of urinary tract infection but showing the growth of an organism in urine culture. Pregnant females and subjects who used antibiotics in last two weeks were excluded. A total of 222 urine cultures were observed prospectively who met the inclusion criteria through non-probability consecutive sampling. Results: Out of 222 urine cultures observed, mean age of subjects were 62.89 ± 13.77 out of which 76% were females, and 61% had a family history of diabetes. The most frequent organisms isolated were Escherichia. Coli (E. Coli), Enterococcus, Klebsiella, Pseudomonas, and Enterobacter species. A total of 20 subjects got dual bacterial growth in their cultures among which 17 subjects had a growth of Enterococcus with any other pathogen causing UTI. Gender, family history of diabetes, levels of HBA1c, and older age groups all were found significantly associated with ASB. Conclusions: Our study is the first to analyze and study the associated risk factors amongst ASB in DM patients, and to identify the pathogens involved along with assessing their antibiotic resistance profiles. Also, due to the increase resistance to antibiotics we would recommend to use antibiotics in ASB patients only if they have any two or more comorbidities.
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Affiliation(s)
- Abubakar Tauseef
- Resident Physician, Department of Internal Medicine, Creighton University Hospital Program, Omaha, NE, USA
| | - Maryam Zafar
- Resident Physician in Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Erum Syyed
- Medical Student at Dow University of Health Sciences, Karachi, Pakistan
| | - Joseph Thirumalareddy
- Hospitalist, Department of Internal Medicine, Creighton University Hospital Program, Omaha, NE, USA
| | - Akshat Sood
- Hospitalist, Department of Internal Medicine, Creighton University Hospital Program, Omaha, NE, USA
| | - Mohsin Mirza
- Associate Program Director, Department of Internal Medicine, Creighton University Hospital Program, Omaha, NE, USA
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Umm-E-Farwa, Ullah S, Khan MA, Zafar H, Atia-Tul-Wahab, Younus M, Choudhary MI, Basha FZ. Dibenzazepine-linked isoxazoles: New and potent class of α-glucosidase inhibitors. Bioorg Med Chem Lett 2021; 40:127979. [PMID: 33766763 DOI: 10.1016/j.bmcl.2021.127979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/05/2021] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
α-Glucosidase inhibition is a valid approach for controlling hyperglycemia in diabetes. In the current study, new molecules as a hybrid of isoxazole and dibenzazepine scaffolds were designed, based on their literature as antidiabetic agents. For this, a series of dibenzazepine-linked isoxazoles (33-54) was prepared using Nitrile oxide-Alkyne cycloaddition (NOAC) reaction, and evaluated for their α-glucosidase inhibitory activities to explore new hits for treatment of diabetes. Most of the compounds showed potent inhibitory potency against α-glucosidase (EC 3.2.1.20) enzyme (IC50 = 35.62 ± 1.48 to 333.30 ± 1.67 µM) using acarbose as a reference drug (IC50 = 875.75 ± 2.08 µM). Structure-activity relationship, kinetics and molecular docking studies of active isoxazoles were also determined to study enzyme-inhibitor interactions. Compounds 33, 40, 41, 46, 48-50, and 54 showed binding interactions with critical amino acid residues of α-glucosidase enzyme, such as Lys156, Ser157, Asp242, and Gln353.
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Affiliation(s)
- Umm-E-Farwa
- Third World Center for Science and Technology (TWC), H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan
| | - Saeed Ullah
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan
| | - Maria Aqeel Khan
- Third World Center for Science and Technology (TWC), H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan.
| | - Humaira Zafar
- Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD), International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan.
| | - Atia-Tul-Wahab
- Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD), International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan
| | - Munisaa Younus
- Third World Center for Science and Technology (TWC), H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan
| | - M Iqbal Choudhary
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan; Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD), International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan; Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21412, Saudi Arabia; Department of Chemistry, Faculty of Science and Technology, Universitas Airlangga, Komplek, Campus C, Surabaya 60115, Indonesia
| | - Fatima Z Basha
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan.
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Aamir AH, Raja UY, Asghar A, Mahar SA, Ghaffar T, Ahmed I, Qureshi FM, Zafar J, Hasan MI, Riaz A, Raza SA, Khosa IA, Khan J, Raza M, Baqar JB. Asymptomatic urinary tract infections and associated risk factors in Pakistani Muslim type 2 diabetic patients. BMC Infect Dis 2021; 21:388. [PMID: 33902477 PMCID: PMC8077900 DOI: 10.1186/s12879-021-06106-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/21/2021] [Indexed: 01/11/2023] Open
Abstract
Background One of the leading long-term complications of type 2 diabetes mellitus (T2DM) includes renal dysfunction and urinary tract infections (UTI) which are considered to be prevalent in uncontrolled diabetes. Moreover, physiological factors like age, gender, duration of diabetes, other diabetic complications like neuropathy, autonomic neuropathy and glycosuria are also considered as predisposing factors for increased prevalence of UTI in diabetes which can be symptomatic or asymptomatic. Methods This was a cross-sectional, multi-centre study including diabetic patients from 12 clinical sites spread across major cities of Pakistan. The inclusion criteria were adult Pakistani population of age between 18 to 75 years both genders and suffering from T2DM irrespective of duration. A detailed clinical history of the past 3 months was recorded and, biochemical investigations of blood samples were conducted. Urine culture analysis performed identified the type of pathogen present and was done only for asymptomatic patients. Results A total of 745 type 2 diabetic patients were initially screened, out of 545 patients considered for final analysis 501 (91.92%) were negative and the rest 44 (8.08%) had positive urine culture. Female gender had a significantly higher proportion of positive urine culture (77.27%, p-value< 0.001). Body mass index and mean age had insignificant distribution among the two groups of positive and negative urine culture, with age 40–59 years having higher proportion (70.45%) in the positive group. Escherichia coli was detected in most of the positive samples (52.3%). All bacterial samples were found resistant to Ciprofloxacin. Conclusion Diabetic Pakistani muslim female patients are identified to be at high risk of suffering from asymptomatic UTI and age more than 40 years is an important risk factor. Escherichia coli was the most common causative organism among people living in this geographical area.
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Affiliation(s)
- Azizul Hasan Aamir
- Khyber Girls Medical College, Hayatabad Medical complex, Peshawar, Pakistan. .,Post Graduate Medical Institute, Peshawar, Pakistan.
| | | | | | | | - Tahir Ghaffar
- Khyber Girls Medical College, Hayatabad Medical complex, Peshawar, Pakistan
| | | | | | | | | | | | | | | | - Jahanzeb Khan
- Dow University of Health Sciences, Karachi, Pakistan
| | - Mahwish Raza
- Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan
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Hameed T, Khan Z, Imran M, Ali S, Albegali AA, Ullah MI, Ejaz H. Associations of transcription factor 7-Like 2 ( TCF7L2) gene polymorphism in patients of type 2 diabetes mellitus from Khyber Pakhtunkhwa population of Pakistan. Afr Health Sci 2021; 21:15-22. [PMID: 34394276 PMCID: PMC8356593 DOI: 10.4314/ahs.v21i1.4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) is the most prevalent component of metabolic syndrome. Environmental factors and various complex genes like transcription factor 7-like 2 (TCF7L2) gene have involved in the disease development. Objective To determine TCF7L2 genetic association (rs7903146C/T and rs12255372G/T) in T2DM patients of Khyber Pakhtunkhwa population of Pakistan. Subjects and methods This study comprised of 176 subjects including 118 T2DM patients and 58 healthy controls. Genomic DNA was extracted and genotype of common variants (rs7903146 C/T and rs12255372 G/T) was carried out by amplification-refractory mutation system (ARMS)-PCR of sequence specific oligonucleotides. Results The distribution of genotype of TCF7L2 SNPs (rs7903146 C/T and rs12255372 G/T) was significantly associated with T2DM as compared to the controls (p <0.0001). The genetic models of the rs7903146 (C/T) and rs12255372 (G/T) SNPs were significantly associated between cases and controls (p <0.0001). On the other hand, the significant association was observed between the two SNPs and different biochemical parameters like serum fasting glucose, lipid profile, creatinine and blood HbA1c levels (p <0.05). Conclusion It is concluded that the SNPs of the TCF7L2 gene are significantly associated with T2DM disease susceptibility in the population of Khyber Pakhtunkhwa of Pakistan.
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Affiliation(s)
- Taha Hameed
- Department of Biochemistry, University of Peshawar, Pakistan
| | - Zahid Khan
- Department of Biochemistry, University of Peshawar, Pakistan
| | - Muhammad Imran
- Department of Biochemistry, University of Peshawar, Pakistan
| | - Saif Ali
- Department of Biochemistry, University of Peshawar, Pakistan
| | | | - Muhammad Ikram Ullah
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University Sakaka, Saudi Arabia
| | - Hasan Ejaz
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University Sakaka, Saudi Arabia
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Basit A, Mustafa N, Waris N, Askari S, Fawwad A. Predicting the risk of type 2 diabetes through anthropometric indices in Pakistani adults- A sub-analysis of second National diabetes survey of Pakistan 2016-2017 (NDSP-07). Diabetes Metab Syndr 2021; 15:543-547. [PMID: 33684806 DOI: 10.1016/j.dsx.2021.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/18/2021] [Accepted: 02/20/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIM Excess adiposity is associated with an increased risk of diabetes. Amongst the various measures of adiposity, the most appropriate one to predict the risk of diabetes remains debatable. Therefore, the aim of this study was to compare the ability of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) in predicting type 2 diabetes mellitus (DM) among Pakistani adults. SUBJECTS AND METHODS This was the sub-analysis of a large population based Second National Diabetes Survey of Pakistan (NDSP) 2016-2017. With this survey, 10834 individuals were recruited and 4788 individuals fulfilled the inclusion criteria for this sub-analysis (subjects with missing anthropometric details were excluded). Participants were categorized into two groups; subjects with type 2 DM and subjects without DM. Data of participants was collected via pre-designed detailed questionnaire. Clinical and anthropometric measurements were measured using standardized techniques. RESULTS Out of 4788 individuals, 3085(64.4%) were non-DM subjects and 1703(35.6%) were type 2 DM subjects with mean age of 39.78 ± 13.79 and 50.38 ± 11.33 years, respectively. Logistic regression analysis revealed a significant association of WC with type 2 diabetes after adjustment for possible confounders. Area under the curve (AUC) of WC was found higher than AUC of BMI and WHR. CONCLUSION The findings from second NDSP (2016-2017) demonstrated that WC is a better marker than WHR and BMI in predicting type 2 DM for Pakistani population.
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Affiliation(s)
- Abdul Basit
- Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Nida Mustafa
- Department of Research, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Nazish Waris
- Department of Research, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Saima Askari
- Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan; Department of Research, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Asher Fawwad
- Department of Research, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan; Department of Biochemistry, Baqai Medical University, Karachi, Sindh, Pakistan.
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Asghar MS, Akram M, Singh M, Yasmin F, Yaseen R, Ahmed N, Siddiqui M, Hassan M, Rasheed U, Ali A. Characteristics of Asymptomatic Bacteriuria in Diabetes Mellitus Patients: A Retrospective Observational Study. Cureus 2021; 13:e13562. [PMID: 33791179 PMCID: PMC8004580 DOI: 10.7759/cureus.13562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background and objective The term asymptomatic bacteriuria (ASB) refers to the isolation of bacteria in a urine specimen of individuals without any symptoms of urinary tract infection (UTI). Diabetes mellitus (DM) is a disease involving multiple organ systems, characterized by its chronicity and hence endless complications including ASB. This study aimed to determine the characteristics of ASB and antibiotic susceptibility patterns among patients with diabetes. Materials and methods This was a retrospective observational study conducted in a tertiary care hospital. The study included patients with a diagnosis of diabetes with no signs and symptoms of UTI but who still showed the growth of an organism in urine culture. A total of 222 urine cultures were analyzed retrospectively, ensuring that they met the inclusion criteria through non-probability consecutive sampling. Results The mean age of the study participants was 62.89 ± 13.77 years; 76% of them were females, and 61% had a family history of diabetes. The most frequent organisms isolated were Escherichia coli (E. coli), Enterococcus, Klebsiella pneumonia, Pseudomonas aeruginosa, and Enterobacter species. A total of 20 subjects had dual bacterial growth in their cultures, with Enterococcus species (n=17) being the most common organism. Gender, family history of diabetes, levels of hemoglobin A1c (HbA1c), and advanced age were all found significantly associated with ASB. Conclusion Our study is the first of its kind to analyze and examine the risk factors associated with ASB in DM patients, and to identify the pathogens involved, along with assessing their antibiotic resistance profiles.
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Affiliation(s)
| | - Mohammed Akram
- Internal Medicine, Liaquat National Hospital, Karachi, PAK
| | - Manjeet Singh
- Internal Medicine, Liaquat National Hospital, Karachi, PAK
| | - Farah Yasmin
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Rabail Yaseen
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Nisar Ahmed
- Internal Medicine, Liaquat National Hospital, Karachi, PAK
| | - Mariam Siddiqui
- Internal Medicine, Dow International Medical College, Karachi, PAK
| | - Maira Hassan
- Internal Medicine, Liaquat National Hospital, Karachi, PAK
| | - Uzma Rasheed
- Internal Medicine, Liaquat National Hospital, Karachi, PAK
| | - Abraish Ali
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
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Sohail E, Ahsan T, Ghaus S, Aijaz W. SGLT 2 Inhibitors; glycemic control, weight loss and safety profile in patients with type 2 Diabetes, at Medicell Institute (MIDEM). Pak J Med Sci 2020; 37:87-92. [PMID: 33437256 PMCID: PMC7794133 DOI: 10.12669/pjms.37.1.2701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background & Objective: Sodium glucose co-transporter-2 inhibitors (SGLT 2 inhibitors) are newer anti-hyperglycemic agents, which improve glycemic control independent of insulin secretion with a low risk of hypoglycemia. This study aimed to assess the efficacy of SGLT 2 inhibitors in terms of glycemic control, weight reduction and safety profile in our patients with type 2 Diabetes (T2D). Methods: This is a prospective analysis, conducted at Medicell Institute of Diabetes, Endocrinology and Metabolism (MIDEM), Karachi Pakistan from January 2018 till July 2019. This study included patients with T2D, who were treated with SGLT 2 inhibitors add on to other anti-diabetic drugs. Baseline and follow up weight, BMI, HbA1c, blood pressure (BP), renal function and side effect profile was assessed. Results: Study included 140 patients; 53% females and 47% males. Mean Age was 55.6 ± 10.3 years. Mean weight at baseline was 81.5 ±16.5 kg. Mean duration of T2D was 10.3 ± 6.75 years, with a mean HbA1C at baseline of 9.1± 1.6%. Follow up data was available for 90 patients at the time of analysis. HbA1C improved considerably to 7.6± 0.9 (P< 0.001) and mean weight reduced to 78.5 ± 16.1 kg (P≤0.003), at first follow-up. Conclusion: Dapagliflozin and Empagliflozin offer a significant additional drug in improving glycemic control with the additional advantage of weight loss and hypoglycemia safety.
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Affiliation(s)
- Erum Sohail
- Dr. Erum Sohail, FCPS, MBBS. Medicell Institute of Diabetes Endocrinology & Metabolism (MIDEM), 9E, 8Zamzama Commercial Lane, Phase-V, DHA, Karachi, Pakistan
| | - Tasnim Ahsan
- Prof. Tasnim Ahsan, MRCP(UK), FRCP(Glasg), FRCP(Edin), FRCP(Lon). Medicell Institute of Diabetes Endocrinology & Metabolism (MIDEM), 9E, 8Zamzama Commercial Lane, Phase-V, DHA, Karachi, Pakistan
| | - Saima Ghaus
- Dr. Saima Ghaus, FCPS, MBBS. Medicell Institute of Diabetes Endocrinology & Metabolism (MIDEM), 9E, 8Zamzama Commercial Lane, Phase-V, DHA, Karachi, Pakistan
| | - Wasfa Aijaz
- Dr. Wasfa Aijaz, FCPS, MBBS. Medicell Institute of Diabetes Endocrinology & Metabolism (MIDEM), 9E, 8Zamzama Commercial Lane, Phase-V, DHA, Karachi, Pakistan
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