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Cheung JTK, Yang A, Wu H, Lau ESH, Lui J, Kong APS, Ma RCW, Luk AOY, Chow E, Chan JCN. Association of dipeptidyl peptidase-4 inhibitor initiation at glycated haemoglobin <7.5% with reduced major clinical events mediated by low glycated haemoglobin variability. Diabetes Obes Metab 2024. [PMID: 38802991 DOI: 10.1111/dom.15662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Abstract
AIM Therapeutic inertia, hypoglycaemia and poor treatment persistence can lead to glycaemic fluctuation and poor outcomes in type 2 diabetes (T2D). We compared glycated haemoglobin (HbA1c) variability, insulin initiation, severe hypoglycaemia and clinical events in patients with T2D initiated dipeptidyl peptidase-4 inhibitors (DPP4is) at low versus high HbA1c thresholds. METHODS Using territory-wide electronic medical records in Hong Kong, we curated a propensity score-matched cohort of patients initiated DPP4i at HbA1c <7.5% versus ≥7.5% in 2007-2019. We expressed the HbA1c variability score (HVS) as a proportion of HbA1c varied by ≥0.5% compared with preceding values. We used the Cox model to compare the risks of insulin initiation and clinical outcomes, adjusted for time-varying variables between the two groups. Mediation analysis estimated the effects of HbA1c variability on outcomes. RESULTS Among 6874 insulin-naïve patients who initiated DPP4i, 88.7% were treated with metformin and 79.6% with sulphonylureas at baseline (54.9% men; mean age 65.2 ± 11.4 years). After a median follow-up of 4.6 years, compared with the high-threshold plus high-HVS group (≥50%), the low-threshold plus low-HVS (<50%) group had reduced hazard ratios (95% confidence interval) of insulin initiation (0.35, 0.31-0.40), severe hypoglycaemia (0.38, 0.34-0.44), major adverse cardiovascular endpoints (0.76, 0.66-0.88), heart failure (0.42, 0.36-0.49), end-stage kidney disease (0.65, 0.36-0.49) and mortality (0.45, 0.35-0.57). Reduced HbA1c variability explained 31.1%-81.2% of the effect size of DPP4i initiation at HbA1c <7.5% versus ≥7.5% on outcomes. CONCLUSIONS In Chinese patients with T2D, avoiding therapeutic inertia with intensified glycaemic control at HbA1c <7.5% using drugs with low risk of hypoglycaemia and good tolerability, such as DPP4i, delayed insulin treatment, reduced HbA1c variability and improved clinical events.
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Affiliation(s)
- Johnny T K Cheung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Aimin Yang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Hongjiang Wu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Eric S H Lau
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Juliana Lui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Alice P S Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Ronald C W Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Andrea O Y Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
- Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Elaine Chow
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
- Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
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Chen C, Li X, Hu Y, Chen Y, Wang H, Li X, Li X. Electrical stimulation promoting the angiogenesis in diabetic rat perforator flap through attenuating oxidative stress-mediated inflammation and apoptosis. PeerJ 2024; 12:e16856. [PMID: 38313008 PMCID: PMC10838069 DOI: 10.7717/peerj.16856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/08/2024] [Indexed: 02/06/2024] Open
Abstract
Background Skin flap transplantation is one of the effective methods to treat the diabetes-related foot ulceration, but the intrinsic damage to vessels in diabetes mellitus (DM) leads to the necrosis of skin flaps. Therefore, the discovery of a non-invasive and effective approach for promoting the survival of flaps is of the utmost importance. Electrical stimulation (ES) promotes angiogenesis and increases the proliferation, migration, and elongation of endothelial cells, thus being a potential effective method to improve flap survival. Objective The purpose of this study was to elucidate the mechanism used by ES to effectively restore the impaired function of endothelial cells caused by diabetes. Methods A total of 79 adult male Sprague-Dawley rats were used in this study. Gene and protein expression was assessed by PCR and western blotting, respectively. Immunohistochemistry and hematoxylin-eosin staining were performed to evaluate the morphology and density of the microvessels in the flap. Results The optimal duration for preconditioning the flap with ES was 7 days. The flap survival area percentage and microvessels density in the DMES group were markedly increased compared to the DM group. VEGF, MMP2, and MMP9 protein expression was significantly upregulated. ROS intensity was significantly decreased and GSH concentration was increased. The expression of IL-1β, MCP‑1, cleaved caspase-3, and Bax were downregulated in the DMES group, while TGF-β expression was upregulated. Conclusions ES improves the angiogenesis in diabetic ischemic skin flaps by attenuating oxidative stress-mediated inflammation and apoptosis, eventually increasing their viability.
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Affiliation(s)
- Cong Chen
- Second Hospital of Shandong University, Jinan, Shandong, China
| | - Xiaolu Li
- Second Hospital of Shandong University, Jinan, Shandong, China
| | - Yong Hu
- Second Hospital of Shandong University, Jinan, Shandong, China
| | - Yuan Chen
- Second Hospital of Shandong University, Jinan, Shandong, China
| | - Hongrui Wang
- Second Hospital of Shandong University, Jinan, Shandong, China
| | - Xian Li
- Second Hospital of Shandong University, Jinan, Shandong, China
| | - Xiucun Li
- Second Hospital of Shandong University, Jinan, Shandong, China
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Cheung JTK, Yang A, Wu H, Lau ESH, Kong APS, Ma RCW, Luk AOY, Chan JCN, Chow E. Early treatment with dipeptidyl-peptidase 4 inhibitors reduces glycaemic variability and delays insulin initiation in type 2 diabetes: A propensity score-matched cohort study. Diabetes Metab Res Rev 2024; 40:e3711. [PMID: 37634071 DOI: 10.1002/dmrr.3711] [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: 08/20/2022] [Revised: 04/07/2023] [Accepted: 07/24/2023] [Indexed: 08/28/2023]
Abstract
AIMS To examine whether early treatment intensification using dipeptidyl-peptidase 4 inhibitors (DPP4i) delays insulin initiation in Chinese patients diagnosed with type 2 diabetes for less than 5 years. MATERIALS AND METHODS In a territory-wide prospective cohort study, patients with type 2 diabetes initiating DPP4i at diabetes duration <2 years (early intensification) and 3-5 years (late intensification) were matched using 1:1 propensity-score matching (n = 908 in each arm). We used Cox regression to compare the risk of insulin initiation between the two groups. We explored the interactive and mediation effects of glycated haemoglobin (HbA1c) variability score (HVS), defined as the percentage of HbA1c varying by ≥0.5% compared with preceding values. RESULTS Of 1816 patients (60.7% men, mean age 54.4 ± 11.9 years), 92.4% and 71.9% were treated with metformin and sulphonylureas respectively at DPP4i initiation. Early DPP4i intensification [hazard ratio (HR) 0.71, (95% CI 0.58-0.68)] and low HVS (<50%) (HR = 0.40, 0.33-0.50) were associated with delayed insulin initiation during a median 4.08 years of follow-up. Early intensification with low HVS had the lowest risk versus late intensification with high HVS (HR = 0.30, 0.22-0.40) (pinteraction = 0.013). HVS mediated 19.5% of the total effect of early DPP4i intensification on delaying insulin initiation. The late and early intensification groups had similar HbA1c at month 0 (8.4 ± 1.3% vs. 8.4 ± 1.5%) and month 3 (7.6 ± 1.2% vs. 7.6 ± 1.3%) after DPP4i initiation. By month 12, HbA1c in the late intensification group deteriorated (7.9 ± 1.4%) but remained stable in the early intensification group (7.6 ± 1.4%, p = 0.001) with persistent between-group difference over 72 months (8.2 ± 1.7% vs. 7.7 ± 1.6%, p = 0.001). CONCLUSIONS In type 2 diabetes, early DPP4i intensification delayed insulin initiation, partially explained by reduced glycaemic variability.
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Affiliation(s)
- Johnny T K Cheung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Aimin Yang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Hongjiang Wu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Eric S H Lau
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Alice P S Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Ronald C W Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Andrea O Y Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Elaine Chow
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
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Uryash A, Umlas J, Mijares A, Adams JA, Lopez JR. Enhancing Muscle Intracellular Ca 2+ Homeostasis and Glucose Uptake: Passive Pulsatile Shear Stress Treatment in Type 2 Diabetes. Biomedicines 2023; 11:2596. [PMID: 37892970 PMCID: PMC10604129 DOI: 10.3390/biomedicines11102596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/19/2023] [Accepted: 09/19/2023] [Indexed: 10/29/2023] Open
Abstract
Type 2 diabetes mellitus (T2D) is a significant global public health problem that has seen a substantial increase in the number of affected individuals in recent decades. In a murine model of T2D (db/db), we found several abnormalities, including aberrant intracellular calcium concentration ([Ca2+]i), decreased glucose transport, increased production of reactive oxygen species (ROS), elevated levels of pro-inflammatory interleukins and creatine phosphokinase (CK), and muscle weakness. Previously, we demonstrated that passive pulsatile shear stress, generated by sinusoidal (headward-forward) motion, using a motion platform that provides periodic acceleration of the whole body in the Z plane (pGz), induces the synthesis of nitric oxide (NO) mediated by constitutive nitric oxide synthase (eNOS and nNOS). We investigated the effect of pGz on db/db a rodent model of T2D. The treatment of db/db mice with pGz resulted in several beneficial effects. It reduced [Ca2+]i overload; enhanced muscle glucose transport; and decreased ROS levels, interleukins, and CK. Furthermore, pGz treatment increased the expression of endothelial nitric oxide synthase (eNOS), phosphorylated eNOS (p-eNOS), and neuronal nitric oxide synthase (nNOS); reduced inducible nitric oxide synthase (iNOS); and improved muscle strength. The cytoprotective effects of pGz appear to be mediated by NO, since pretreatment with L-NAME, a nonspecific NOS inhibitor, abolished the effects of pGz on [Ca2+]i and ROS production. Our findings suggest that a non-pharmacological strategy such as pGz has therapeutic potential as an adjunct treatment to T2D.
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Affiliation(s)
- Arkady Uryash
- Division of Neonatology, Mount Sinai Medical Center, Miami, FL 33140, USA; (A.U.); (J.A.A.)
| | - Jordan Umlas
- Division of Neonatology, Mount Sinai Medical Center, Miami, FL 33140, USA; (A.U.); (J.A.A.)
| | - Alfredo Mijares
- Centro de Biofísica y Bioquímica, Instituto Venezolano de Investigaciones Científicas, Caracas 21827, Venezuela;
| | - Jose A. Adams
- Division of Neonatology, Mount Sinai Medical Center, Miami, FL 33140, USA; (A.U.); (J.A.A.)
| | - Jose R. Lopez
- Department of Research, Mount Sinai Medical Center, Miami Beach, FL 33140, USA
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Sytsma TT, Greenlund LS, Fischer KM, McCoy RG. Impact of Intra-Articular Corticosteroid Injection on Glycemic Control: A Population-Based Cohort Study. Clin Diabetes 2023; 42:96-103. [PMID: 38230338 PMCID: PMC10788672 DOI: 10.2337/cd22-0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
This retrospective cohort study investigated the longer-term hyperglycemic effects of intra-articular corticosteroid (IACS) administration by evaluating changes in A1C after large joint IACS injection. Among 1,169 patients (mean age 66.1 ± 12.2 years, 52.8% female), 184 (15.7%) experienced a greater-than-expected rise in A1C (actual A1C ≥0.5% above predicted) after IACS. Greater-than-expected rise in A1C was associated solely with baseline A1C (odds ratio [OR] 1.84, 95% CI 1.08-3.13 for baseline A1C of 7.0-8.0% compared with <7.0% and OR 4.79, 95% CI 2.83-8.14 for baseline A1C >8.0% compared with <7.0%). Although most patients do not experience an increase in A1C after IACS, clinicians should counsel patients with suboptimally controlled diabetes about risks of further hyperglycemia after IACS administration.
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Affiliation(s)
- Terin T. Sytsma
- Mayo Clinic Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Rochester, MN
| | - Laura S. Greenlund
- Mayo Clinic Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Rochester, MN
| | | | - Rozalina G. McCoy
- Mayo Clinic Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Rochester, MN
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN
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Toma L, Sanda GM, Stancu CS, Niculescu LS, Raileanu M, Sima AV. Oscillating Glucose Induces the Increase in Inflammatory Stress through Ninjurin-1 Up-Regulation and Stimulation of Transport Proteins in Human Endothelial Cells. Biomolecules 2023; 13:biom13040626. [PMID: 37189375 DOI: 10.3390/biom13040626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 03/25/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Clinical data implicate fluctuations of high levels of plasma glucose in cardiovascular diseases. Endothelial cells (EC) are the first cells of the vessel wall exposed to them. Our aim was to evaluate the effects of oscillating glucose (OG) on EC function and to decipher new molecular mechanisms involved. Cultured human ECs (EA.hy926 line and primary cells) were exposed to OG (5/25 mM alternatively at 3 h), constant HG (25 mM) or physiological concentration (5 mM, NG) for 72 h. Markers of inflammation (Ninj-1, MCP-1, RAGE, TNFR1, NF-kB, and p38 MAPK), oxidative stress (ROS, VPO1, and HO-1), and transendothelial transport proteins (SR-BI, caveolin-1, and VAMP-3) were assessed. Inhibitors of ROS (NAC), NF-kB (Bay 11-7085), and Ninj-1 silencing were used to identify the mechanisms of OG-induced EC dysfunction. The results revealed that OG determined an increased expression of Ninj-1, MCP-1, RAGE, TNFR1, SR-B1, and VAMP-3 andstimulated monocyte adhesion. All of these effects were induced bymechanisms involving ROS production or NF-kB activation. NINJ-1 silencing inhibited the upregulation of caveolin-1 and VAMP-3 induced by OG in EC. In conclusion, OG induces increased inflammatory stress, ROS production, and NF-kB activation and stimulates transendothelial transport. To this end, we propose a novel mechanism linking Ninj-1 up-regulation to increased expression of transendothelial transport proteins.
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Golfakhrabadi F, Niknejad MR, Kalantari H, Dehghani MA, Shakiba Maram N, Ahangarpour A. Evaluation of the protective effects of berberine and berberine nanoparticle on insulin secretion and oxidative stress induced by carbon nanotubes in isolated mice islets of langerhans: an in vitro study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:21781-21796. [PMID: 36279052 DOI: 10.1007/s11356-022-23508-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
The increasing use of single-walled carbon nanotubes (SWCNT) in various fields highlights the need to investigate the test toxicity of these nanoparticles in humans. Previous documents showed that SWCNT induced oxidative stress. Oxidative stress and reactive oxygen species (ROS) cause cell dysfunction and reduced insulin secretion. Therefore, this study aimed to investigate the effects of SWCNT on oxidative stress and insulin secretion of islets also evaluate the protective effects of berberine (BBR) and berberine nanoparticles (NP-BBR) as antioxidants on pancreatic β-islets. Double emulsion with solvent evaporation was the technique used to prepare nanoparticles in this study. Islets were isolated and pretreated with various concentrations of BBR and NP-BBR and then treated with single dose of SWCNT (160 μg). The results of this study showed that SWCNT decreased cell viability based on MTT assay, reduced insulin secretion of islets, increased malondialdehyde (MDA) amounts, reactive oxygen species (ROS) levels, reduced glutathione (GSH) levels, catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) activities, whereas pretreatment of islets with low doses of BBR (5 and 15 μM) and NP-BBR (5 μM) significantly reversed all changes induced by SWCNT. These findings suggested that SWCNT might trigger other pathways involved in insulin secretion by activating the oxidative stress pathway in the pancreatic islets, reducing insulin secretion, consequently diabetes. BBR and NP-BBR as antioxidants were able to protect pancreatic β-islets and prevent the progression of diabetes.
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Affiliation(s)
- Fereshteh Golfakhrabadi
- Department of Pharmacognosy, Faculty of Pharmacy, Nanotechnology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Medicinal Plant Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Reza Niknejad
- Department of Toxicology, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Medical Basic Sciences Research Institute, Toxicology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Heibatullah Kalantari
- Department of Toxicology, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Medical Basic Sciences Research Institute, Toxicology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Amin Dehghani
- Department of Toxicology, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Medical Basic Sciences Research Institute, Toxicology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nader Shakiba Maram
- Nanotechnology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Pharmaceutics, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Akram Ahangarpour
- Department of Physiology, Faculty of Medicine, Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Nedogoda SV, Barykina IN, Salasyuk AS, Lutova VO, Popova EA. Individualisation of basal insulin therapy of type 2 diabetes: evidence from large randomized controlled trials. DIABETES MELLITUS 2022. [DOI: 10.14341/dm12774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Initiation of insulin therapy with basal insulin analogues has become the standard of care for type 2 diabetes mellitus (T2DM). Timely administration of insulin allows not only to slow down the progression of type 2 diabetes, but also to reduce the frequency and severity of complications associated with it. This paper reviews the efficacy and safety of the use of the latest basal insulin analogues in type 2 diabetes from the perspective of current clinical guidelines, and also reviews updated data on the efficacy and safety of therapy by various members of the class. In this paper a review of the efficacy and safety of latest basal insulin analogues use in T2DM from the standpoint of current clinical guidelines has been carried out, and updated data on the efficacy and safety of therapy by various members of the class have been reviewed, taking into account their impact on the risk of hypoglycemia and glycemic variability. The available data indicate that insulin degludec 200 U/mL may be the drug of choice for those at high risk of developing severe forms of hypoglycemia. Since severe hypoglycemia and high glycemic variability are important risk factors for cardiovascular events and mortality, it has been shown that a differentiated approach to insulin therapy in the treatment of T2DM is currently advisable, taking into account the effect on the risk of hypoglycemia and glycemic variability.
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García León D, Trujillo Gittermann LM, Soto Isla N, Villanueva Boratovic SR, von Oetinger Giacoman A. Effects of break in sedentary behaviour on blood glucose control in diabetic patients. Systematic review. ENDOCRINOLOGIA, DIABETES Y NUTRICION 2022; 69:888-896. [PMID: 36446709 DOI: 10.1016/j.endien.2022.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/15/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION One of the main goals of prescribing physical activity for people with type 2 diabetes is to reduce hyperglycaemia, as it is a risk factor for the development of chronic complications. As less time spent each day in sedentary behaviour would lead to higher glucose consumption by skeletal muscle tissue, this could have significant positive effects on blood glucose control parameters. For this reason, the aim of this study was to analyse the information from different protocols for breaking sedentary behaviour and the association with blood glucose control parameters in patients with type 2 diabetes. MATERIAL AND METHODS A systematic search was carried out for randomised controlled studies on this topic published in the scientific literature. The following databases were considered: PubMed, Cochrane, EBSCO, WoS, ScienceDirect and Medline. RESULTS 24 studies were identified and analysed using the COVIDENCE platform. Seven articles were selected for the final analysis, comprising 138 patients. The results show that breaks in sedentary behaviour with light physical activity in people with type 2 diabetes are effective in reducing insulin resistance, the area under the glucose curve, fasting and postprandial blood glucose, and blood glucose variability. CONCLUSIONS Acute interruption of sedentary behaviour, through light-intensity and short-duration exercise, can improve blood glucose indicators in patients with type 2 diabetes, including short term blood glucose variability.
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Affiliation(s)
- Daniela García León
- Escuela de Kinesiología, Facultad de Odontología y Salud, Universidad Diego Portales, Santiago, Chile
| | - Luz María Trujillo Gittermann
- Escuela de Kinesiología, Facultad de Odontología y Salud, Universidad Diego Portales, Santiago, Chile; Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad de Las Américas, Santiago, Chile
| | - Néstor Soto Isla
- Unidad de Endocrinología y Diabetes, Hospital San Borja-Arriarán, Santiago, Chile
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Lin CC, Li CI, Juan YL, Liu CS, Lin CH, Yang SY, Li TC. Joint effect of blood pressure and glycemic variation on the risk of cardiovascular morbidity and mortality in persons with type 2 diabetes. Metabolism 2022; 136:155308. [PMID: 36058287 DOI: 10.1016/j.metabol.2022.155308] [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: 06/08/2022] [Revised: 08/16/2022] [Accepted: 08/29/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Few studies have explored the association of visit-to-visit variation in blood pressure (BP) and glycemic factors with cardiovascular disease (CVD) morbidity and mortality. This study aimed to examine the independent and joint effect of visit-to-visit BP and glycemic variation on CVD morbidity and mortality in persons with T2DM. METHODS The present study consisted of two retrospective cohort studies. The Taiwan Diabetes Study was based on a database of the National Diabetes Care Management Program (DCMP) and linked with cardiovascular morbidity incidence. The Taichung Diabetes Study was based on the DCMP database of a medical center, which can be linked with the National Death Registry dataset. The outcomes were analyzed by using Cox's proportional hazard models. RESULTS A total of 13,280 and 10,894 persons with T2DM in Taiwan and Taichung Diabetes Study, respectively, were included. SBP-CV, FPG-CV, and HbA1c-CV were significant predictors of stroke, CVD event or death, all-cause mortality, and expanded CVD mortality, whereas DBP-CV was a significant predictor of all-cause mortality and expanded and non-expanded CVD mortality. The joint effect of SBP, FPG, and HbA1c predicted the incidence of stroke and CVD event or death with increased risks of 16 %-35 %. In addition, the joint effect of SBP, DBP, FPG, and HbA1c was associated with all-cause and expanded CVD mortality with increased risks of 29 %-81 %. CONCLUSIONS The joint effect of BP and glucose variation improved the prediction of cardiovascular morbidity and mortality. Moreover, simultaneous measurement of visit-to-visit BP and glycemic variation may stratify persons with cardiovascular risks and may be regarded as important therapeutic goals in the care of T2DM.
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Affiliation(s)
- Cheng-Chieh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Ing Li
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Ya-Ling Juan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Chiu-Shong Liu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsueh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Shing-Yu Yang
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Boughton CK, Allen JM, Ware J, Wilinska ME, Hartnell S, Thankamony A, Randell T, Ghatak A, Besser REJ, Elleri D, Trevelyan N, Campbell FM, Sibayan J, Calhoun P, Bailey R, Dunseath G, Hovorka R. Closed-Loop Therapy and Preservation of C-Peptide Secretion in Type 1 Diabetes. N Engl J Med 2022; 387:882-893. [PMID: 36069870 DOI: 10.1056/nejmoa2203496] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Whether improved glucose control with hybrid closed-loop therapy can preserve C-peptide secretion as compared with standard insulin therapy in persons with new-onset type 1 diabetes is unclear. METHODS In a multicenter, open-label, parallel-group, randomized trial, we assigned youths 10.0 to 16.9 years of age within 21 days after a diagnosis of type 1 diabetes to receive hybrid closed-loop therapy or standard insulin therapy (control) for 24 months. The primary end point was the area under the curve (AUC) for the plasma C-peptide level (after a mixed-meal tolerance test) at 12 months after diagnosis. The analysis was performed on an intention-to-treat basis. RESULTS A total of 97 participants (mean [±SD] age, 12±2 years) underwent randomization: 51 were assigned to receive closed-loop therapy and 46 to receive control therapy. The AUC for the C-peptide level at 12 months (primary end point) did not differ significantly between the two groups (geometric mean, 0.35 pmol per milliliter [interquartile range, 0.16 to 0.49] with closed-loop therapy and 0.46 pmol per milliliter [interquartile range, 0.22 to 0.69] with control therapy; mean adjusted difference, -0.06 pmol per milliliter [95% confidence interval {CI}, -0.14 to 0.03]). There was not a substantial between-group difference in the AUC for the C-peptide level at 24 months (geometric mean, 0.18 pmol per milliliter [interquartile range, 0.06 to 0.22] with closed-loop therapy and 0.24 pmol per milliliter [interquartile range, 0.05 to 0.30] with control therapy; mean adjusted difference, -0.04 pmol per milliliter [95% CI, -0.14 to 0.06]). The arithmetic mean glycated hemoglobin level was lower in the closed-loop group than in the control group by 4 mmol per mole (0.4 percentage points; 95% CI, 0 to 8 mmol per mole [0.0 to 0.7 percentage points]) at 12 months and by 11 mmol per mole (1.0 percentage points; 95% CI, 7 to 15 mmol per mole [0.5 to 1.5 percentage points]) at 24 months. Five cases of severe hypoglycemia occurred in the closed-loop group (in 3 participants), and one occurred in the control group; one case of diabetic ketoacidosis occurred in the closed-loop group. CONCLUSIONS In youths with new-onset type 1 diabetes, intensive glucose control for 24 months did not appear to prevent the decline in residual C-peptide secretion. (Funded by the National Institute for Health and Care Research and others; CLOuD ClinicalTrials.gov number, NCT02871089.).
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Affiliation(s)
- Charlotte K Boughton
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Janet M Allen
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Julia Ware
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Malgorzata E Wilinska
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Sara Hartnell
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Ajay Thankamony
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Tabitha Randell
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Atrayee Ghatak
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Rachel E J Besser
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Daniela Elleri
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Nicola Trevelyan
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Fiona M Campbell
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Judy Sibayan
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Peter Calhoun
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Ryan Bailey
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Gareth Dunseath
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
| | - Roman Hovorka
- From the Wellcome-Medical Research Council Institute of Metabolic Science (C.K.B., J.M.A., J.W., M.E.W., R.H.) and the Department of Paediatrics (J.M.A., J.W., M.E.W., A.T., R.H.), University of Cambridge, and Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust (C.K.B., S.H.), Cambridge, the Department of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham (T.R.), the Department of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool (A.G.), the Department of Paediatrics, University of Oxford, and the National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford (R.E.J.B.), the Department of Diabetes, Royal Hospital for Sick Children, Edinburgh (D.E.), the Department of Paediatric Diabetes, Southampton Children's Hospital, Southampton (N.T.), the Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds (F.M.C.), and the Diabetes Research Group, Swansea University, Swansea (G.D.) - all in the United Kingdom; and Jaeb Center for Health Research, Tampa, FL (J.S., P.C., R.B.)
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Kong H, Yu L, Li C, Ban X, Gu Z, Liu L, Li Z. Perspectives on evaluating health effects of starch: Beyond postprandial glycemic response. Carbohydr Polym 2022; 292:119621. [DOI: 10.1016/j.carbpol.2022.119621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/22/2022] [Accepted: 05/10/2022] [Indexed: 11/02/2022]
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Investigation of the Renal Protective Effect of Combined Dietary Polyphenols in Streptozotocin-Induced Diabetic Aged Rats. Nutrients 2022; 14:nu14142867. [PMID: 35889824 PMCID: PMC9319778 DOI: 10.3390/nu14142867] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 12/10/2022] Open
Abstract
Natural polyphenols are widely reported to have a large range of pharmacological properties, especially antioxidant activities and free radical scavenging capacities. In this study, we investigate the effects of naringin, chlorogenic acid, and quercetin mixtures (NCQ) on renal fibrosis in streptozotocin (STZ)-induced diabetic aged rats and its underlying mechanisms for ten consecutive weeks. The oxidative defense system in the kidneys of treated rats was found to be improved. Several biomarkers were investigated including the blood urea nitrogen, creatinine, and uric acid. Moreover, antioxidant parameters were evaluated and we found that superoxide dismutase, catalase, glutathione peroxidase, Na+-K+-ATPase activities, the nitric oxide production, the protein carbonyl, the advanced oxidation protein products, lipid peroxidation, and reduced glutathione levels were all significantly balanced and close to control values. In addition, NCQ restored renal injuries and fibrosis as assessed by histological method and molecular biology investigation of the matrix metalloproteinase, the transforming growth factor-beta TGF-β, the tumor necrosis factor TNFα, and p53 expression. Our study proposes the NCQ combination as potential plant-derived bioactive compounds to prevent diabetic nephropathy.
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García León D, Trujillo Gittermann LM, Soto Isla N, Villanueva Boratovic SR, von Oetinger Giacoman A. Efectos del quiebre en la conducta sedentaria sobre el control glucémico en pacientes diabéticos. Revisión sistemática. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2021.10.009] [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: 11/29/2022]
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Venugopal V, Geethanjali S, Poonguzhali S, Padmavathi R, Mahadevan S, Silambanan S, Maheshkumar K. Effect of Yoga on Oxidative Stress in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis. Curr Diabetes Rev 2022; 18:e050421192663. [PMID: 33820522 DOI: 10.2174/1573399817666210405104335] [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: 11/11/2020] [Revised: 01/05/2021] [Accepted: 02/13/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes mellitus has a significant impact on public health. Oxidative stress plays a major role in the pathophysiology of Type 2 Diabetes Mellitus (T2DM), leading to various complications of T2DM. Yoga is being widely used in the management of T2DM. The primary objective of this systematic review and meta-analysis is to understand the effects of yoga on oxidative stress parameters among adult patients diagnosed with T2DM. MATERIALS AND METHODS Electronic databases such as PubMed, Scopus, Cochrane Library and Science Direct from start of the study till March 2020 were searched to obtain eligible studies. Study designs of all nature were included (except case studies and reviews). The primary outcome was Malondialdehyde (MDA) and secondary outcomes included fasting plasma glucose, HbA1C and Superoxide Dismutase (SOD) levels. RESULTS A total of four trials with a total of 440 patients met the inclusion criteria. The results of meta-analysis indicated that yoga significantly reduced MDA (SMD: -1.4; 95% CI -2.66 to -0.13; P = 0.03; I2 = 97%), fasting plasma glucose levels (SMD: -1.87: 95% CI -3.83 to -0.09; P = 0.06; I2= 99%), and HbA1c (SMD: -1.92; 95% CI - 3.03 to -0.81; P = 0.0007; I2 = 92%) in patients with T2DM. No such effect was found for SOD (SMD: -1.01; 95% CI -4.41 to 2.38; P = 0.56; I2= 99%). CONCLUSION The available evidence suggests that yoga reduces MDA, fasting plasma glucose and HbA1C, and thus would be beneficial in the management of T2DM as a complementary therapy. However, considering the limited number of studies and its heterogeneity, further robust studies are necessary to strengthen our findings and investigate the long-term benefits of yoga.
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Affiliation(s)
- V Venugopal
- Department of Yoga, Government Yoga & Naturopathy Medical College & Hospital, Chennai-600106, India
| | - S Geethanjali
- Department of Nutrition & Psychology, Government Yoga & Naturopathy Medical College & Hospital, Chennai-600106, India
| | - S Poonguzhali
- Department of Community Medicine, Government Yoga & Naturopathy Medical College & Hospital, Chennai- 600106, India
| | - R Padmavathi
- Department of Physiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
| | - S Mahadevan
- Department of Endocrinology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
| | - S Silambanan
- Department of Biochemistry, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research (SRIHER) Chennai, Tamil Nadu, India
| | - K Maheshkumar
- Department of Physiology & Biochemistry, Govt. Yoga & Naturopathy Medical College & Hospital, Chennai-600106, India
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Chai S, Zhang R, Zhang Y, Carr RD, Zheng Y, Rajpathak S, Yu M. Influence of dipeptidyl peptidase-4 inhibitors on glycemic variability in patients with type 2 diabetes: A meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne) 2022; 13:935039. [PMID: 36017316 PMCID: PMC9396280 DOI: 10.3389/fendo.2022.935039] [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] [Received: 05/03/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The influence of dipeptidyl peptidase-4 (DPP4) inhibitors on glycemic variability compared to other oral antidiabetic drugs (OADs), measured based on the mean amplitude of glycemic excursions (MAGE), has not been comprehensively analyzed. The aim of the study was to perform a meta-analysis to compare the effects of DPP4 inhibitors on MAGE with other OADs in type 2 diabetes mellitus (T2DM) patients without concurrent insulin treatments. METHODS The Medline (PubMed), Embase (Ovid), and CENTER (Cochrane Library) databases were searched for relevant randomized controlled trials (RCTs). Study characteristics and outcome data were independently extracted by two authors. A random-effect model was used to combine the results. RESULTS Fourteen studies with 855 patients were included. Compared to other OADs, DPP4 inhibitors significantly reduced MAGE (mean difference [MD]: -0.69 mmol/L, 95% confidence interval [CI]: -0.95 to -0.43, P<0.001) with mild heterogeneity (I2 = 28%). Predefined subgroup analyses suggested that DPP4 inhibitors were more effective in reducing MAGE compared to insulin secretagogues (MD: -0.92 mmol/L, P<0.001) and non-secretagogues (MD: -0.43 mmol/L, P=0.02), as well as compared to sulfonylureas (MD: -0.91 mmol/L, P<0.001) and sodium glucose cotransporter 2 inhibitors (MD: -0.67 mmol/L, P=0.03). CONCLUSIONS DPP4 inhibitors may significantly reduce glycemic variability compared to other oral anti-diabetic drugs, as evidenced by MAGE in T2DM patients with no concurrent insulin treatment. SYSTEMATIC REVIEW REGISTRATION INPLASY, registration number: INPLASY2021120113.
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Affiliation(s)
- Shangyu Chai
- Merck Research Laboratories (MRL) Global Medical Affairs, Merck Sharp & Dohme (MSD) China, Shanghai, China
| | - Ruya Zhang
- Merck Research Laboratories (MRL) Global Medical Affairs, Merck Sharp & Dohme (MSD) China, Shanghai, China
| | - Ye Zhang
- Merck Research Laboratories (MRL) Global Medical Affairs, Merck Sharp & Dohme (MSD) China, Shanghai, China
| | - Richard David Carr
- Hatter Cardiovascular Institute, University College London, UK and Ulster University, Coleraine, United Kingdom
| | - Yiman Zheng
- Merck Research Laboratories (MRL) Global Medical Affairs, Merck Sharp & Dohme (MSD) China, Shanghai, China
| | | | - Miao Yu
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Miao Yu, ;
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Brown OI, Bridge KI, Kearney MT. Nicotinamide Adenine Dinucleotide Phosphate Oxidases in Glucose Homeostasis and Diabetes-Related Endothelial Cell Dysfunction. Cells 2021; 10:cells10092315. [PMID: 34571964 PMCID: PMC8469180 DOI: 10.3390/cells10092315] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 12/15/2022] Open
Abstract
Oxidative stress within the vascular endothelium, due to excess generation of reactive oxygen species (ROS), is thought to be fundamental to the initiation and progression of the cardiovascular complications of type 2 diabetes mellitus. The term ROS encompasses a variety of chemical species including superoxide anion (O2•-), hydroxyl radical (OH-) and hydrogen peroxide (H2O2). While constitutive generation of low concentrations of ROS are indispensable for normal cellular function, excess O2•- can result in irreversible tissue damage. Excess ROS generation is catalysed by xanthine oxidase, uncoupled nitric oxide synthases, the mitochondrial electron transport chain and the nicotinamide adenine dinucleotide phosphate (NADPH) oxidases. Amongst enzymatic sources of O2•- the Nox2 isoform of NADPH oxidase is thought to be critical to the oxidative stress found in type 2 diabetes mellitus. In contrast, the transcriptionally regulated Nox4 isoform, which generates H2O2, may fulfil a protective role and contribute to normal glucose homeostasis. This review describes the key roles of Nox2 and Nox4, as well as Nox1 and Nox5, in glucose homeostasis, endothelial function and oxidative stress, with a key focus on how they are regulated in health, and dysregulated in type 2 diabetes mellitus.
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18
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Oke SL, Hardy DB. The Role of Cellular Stress in Intrauterine Growth Restriction and Postnatal Dysmetabolism. Int J Mol Sci 2021; 22:6986. [PMID: 34209700 PMCID: PMC8268884 DOI: 10.3390/ijms22136986] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 12/18/2022] Open
Abstract
Disruption of the in utero environment can have dire consequences on fetal growth and development. Intrauterine growth restriction (IUGR) is a pathological condition by which the fetus deviates from its expected growth trajectory, resulting in low birth weight and impaired organ function. The developmental origins of health and disease (DOHaD) postulates that IUGR has lifelong consequences on offspring well-being, as human studies have established an inverse relationship between birth weight and long-term metabolic health. While these trends are apparent in epidemiological data, animal studies have been essential in defining the molecular mechanisms that contribute to this relationship. One such mechanism is cellular stress, a prominent underlying cause of the metabolic syndrome. As such, this review considers the role of oxidative stress, mitochondrial dysfunction, endoplasmic reticulum (ER) stress, and inflammation in the pathogenesis of metabolic disease in IUGR offspring. In addition, we summarize how uncontrolled cellular stress can lead to programmed cell death within the metabolic organs of IUGR offspring.
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Affiliation(s)
- Shelby L. Oke
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, ON N6A 5C1, Canada;
- The Children’s Health Research Institute, The Lawson Health Research Institute, London, ON N6A 5C1, Canada
| | - Daniel B. Hardy
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, ON N6A 5C1, Canada;
- The Children’s Health Research Institute, The Lawson Health Research Institute, London, ON N6A 5C1, Canada
- Department of Obstetrics and Gynaecology, Schulich School of Medicine and Dentistry, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 5C1, Canada
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19
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von Oetinger G A, Trujillo G LM, Soto I N. [Impact of physical activity on glycemic variability in people with diabetes mellitus type 2]. Rehabilitacion (Madr) 2021; 55:282-290. [PMID: 33865613 DOI: 10.1016/j.rh.2020.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/12/2020] [Accepted: 11/15/2020] [Indexed: 11/19/2022]
Abstract
One of the main roles of the prescription of physical activity for people with type 2 diabetes is to reduce hyperglycemia. The beneficial effect of physical training on glycemic levels is considered as the sum of the effects of each exercise session. A better understanding of acute responses to exercise, through short-term glycemic variability, could explain the differences in the results of distinct training protocols. The objective of this study was to analyze the scientific information on different exercise protocols and their association with short-term glycemic variability in patients with type 2 diabetes. A systematic review of studies published in English and Spanish was carried out. The databases used were PubMed, Cochrane, ScienceDirect, and Medline. Only studies conducted in adults (older than 18 years) were included. A total of 36 studies were identified, which were analyzed and completed using the Covidence® platform. The final analysis included 10 articles with 296 patients. The 10 included articles were divided according to the type of intervention protocol used: group 1, acute exercise, and group 2, training. Significant differences were found in glycemic variability in 71.4% of the articles in group 1 and in 100% of the articles included in group 2. Positive effects of acute exercise and physical training on short-term glycemic variability were demonstrated. The findings were more pronounced in the intervention protocols than in physical training.
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Affiliation(s)
- A von Oetinger G
- Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Santiago, Chile; Facultad de Ciencias, Universidad Mayor, Santiago, Chile.
| | - L M Trujillo G
- Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad de Las Américas, Santiago, Chile; Escuela de Kinesiología, Facultad de Odontología y Salud, Universidad Diego Portales, Santiago, Chile
| | - N Soto I
- Unidad de Endocrinología y Diabetes, Hospital San Borja Arriarán, Santiago, Chile
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20
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Ma C, Liu Y, He S, Zeng J, Li P, Ma C, Ping F, Zhang H, Xu L, Li W, Li Y. Association between glucose fluctuation during 2-hour oral glucose tolerance test, inflammation and oxidative stress markers, and β-cell function in a Chinese population with normal glucose tolerance. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:327. [PMID: 33708954 PMCID: PMC7944279 DOI: 10.21037/atm-20-6119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Backgrounds Glucose fluctuation (GF) may have detrimental effects in individuals with diabetes; however, clinical data on the association between short-term GF, inflammation/oxidative stress markers, and islet β-cell function based on a population with normal glucose tolerance (NGT) are insufficient. Therefore, we aimed to explore these associations in a Chinese population of 209 individuals with NGT in a cross-sectional analysis. Methods Individuals were categorized based on GF tertiles, calculated as the maximum-minimum glucose levels among four time points (0, 30, 60, 120 min) during 2-hour oral glucose tolerance test (OGTT). Plasma inflammation markers tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and oxidative stress markers superoxide dismutase (SOD), and 8-oxo-2'-deoxyguanosine (8-oxo-dG) were measured. Islet β-cell function was estimated according to the disposition index (DI) at the early (30 min) and total (120 min) phase of the OGTT, adjusted for insulin sensitivity. Results Individuals in the middle and highest tertile of GF had reduced β-cell function, and increased plasma SOD and TNF-α levels compared with those in the lowest tertile of GF (P<0.05). Multiple linear regression analysis indicated that GF was positively associated with TNF-α, 8-oxo-dG and SOD levels, but negatively associated with β-cell function, whereas IL-6, TNF-α, 8-oxo-dG and SOD levels were negatively associated with β-cell function (P<0.05). Conclusions GF may increase inflammation and oxidative stress markers in individuals with NGT, which could contribute to reduced β-cell function. Thus, maintaining glucose stability after a meal may have beneficial effects on delaying β-cell dysfunction, suggesting that diet and exercise strategies to decrease diet related GF are warranted.
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Affiliation(s)
- Chifa Ma
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yiwen Liu
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Shuli He
- Department of Nutrition, Peking Union Medical College Hospital, Beijing, China
| | - Jingbo Zeng
- Department of Endocrinology, Fuxing Hospital, the Eighth Clinical Medical College, Capital Medical University, Beijing, China
| | - Pingping Li
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Diabetes Research Center of Chinese Academy of Medical Sciences, Beijing, China
| | - Chunxiao Ma
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Diabetes Research Center of Chinese Academy of Medical Sciences, Beijing, China
| | - Fan Ping
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Huabing Zhang
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Lingling Xu
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Li
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuxiu Li
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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21
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Kanwal, Khan KM, Chigurupati S, Ali F, Younus M, Aldubayan M, Wadood A, Khan H, Taha M, Perveen S. Indole-3-acetamides: As Potential Antihyperglycemic and Antioxidant Agents; Synthesis, In Vitro α-Amylase Inhibitory Activity, Structure-Activity Relationship, and In Silico Studies. ACS OMEGA 2021; 6:2264-2275. [PMID: 33521466 PMCID: PMC7841949 DOI: 10.1021/acsomega.0c05581] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/31/2020] [Indexed: 10/23/2023]
Abstract
Indole-3-acetamides (1-24) were synthesized via coupling of indole-3-acetic acid with various substituted anilines in the presence of coupling reagent 1,1-carbonyldiimidazole. The structures of synthetic molecules were elucidated through different spectroscopic techniques including electron ionization-mass spectroscopy (EI-MS), 1H-, 13C NMR, and high-resolution EI-MS (HREI-MS). These compounds were screened for their antihyperglycemic and antioxidant potentials. All compounds displayed good to moderate inhibition against α-amylase enzyme with IC50 values ranging between 1.09 ± 0.11 and 2.84 ± 0.1 μM compared to the standard acarbose (IC50 = 0.92 ± 0.4 μM). Compound 15 (IC50 = 1.09 ± 0.11 μM) was the most active compound of the series and exhibited good inhibition against α-amylase; in addition, this compound also exhibited good antioxidant potential with IC50 values of 0.35 ± 0.1 and 0.81 ± 0.25 μM in 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays, respectively. The binding interactions of synthetic molecules with the enzyme's active site were confirmed via in silico studies. The current study had identified a number of lead molecules as potential antihyperglycemic and antioxidant agents.
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Affiliation(s)
- Kanwal
- H.
E. J. Research Institute of Chemistry, International Center for Chemical
and Biological Sciences, University of Karachi, Karachi-75270, Pakistan
- Institute
of Marine Biotechnology, Universiti Malaysia Terengganu, 21030 Kuala Terengganu, Terengganu, Malaysia
| | - Khalid Mohammed Khan
- H.
E. J. Research Institute of Chemistry, International Center for Chemical
and Biological Sciences, University of Karachi, Karachi-75270, Pakistan
- Department
of Clinical Pharmacy, Institute for Research and Medical Consultations
(IRMC), Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Sridevi Chigurupati
- Department
of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, Qassim University, Buraidah 52571, Saudi Arabia
| | - Farman Ali
- H.
E. J. Research Institute of Chemistry, International Center for Chemical
and Biological Sciences, University of Karachi, Karachi-75270, Pakistan
| | - Munissa Younus
- H.
E. J. Research Institute of Chemistry, International Center for Chemical
and Biological Sciences, University of Karachi, Karachi-75270, Pakistan
| | - Maha Aldubayan
- Department
of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraidah 52571, Saudi Arabia
| | - Abdul Wadood
- Department
of Biochemistry, Computational Medicinal Chemistry Laboratory, UCSS, Abdul Wali Khan University, Mardan 23200, Pakistan
| | - Huma Khan
- Department
of Biochemistry, Computational Medicinal Chemistry Laboratory, UCSS, Abdul Wali Khan University, Mardan 23200, Pakistan
| | - Muhammad Taha
- Department
of Clinical Pharmacy, Institute for Research and Medical Consultations
(IRMC), Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Shahnaz Perveen
- PCSIR
Laboratories Complex, Karachi, Shahrah-e-Dr. Salimuzzaman Siddiqui, Karachi 75280, Pakistan
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22
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Kong H, Yu L, Gu Z, Li C, Cheng L, Hong Y, Li Z. An Innovative Short-Clustered Maltodextrin as Starch Substitute for Ameliorating Postprandial Glucose Homeostasis. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:354-367. [PMID: 33350823 DOI: 10.1021/acs.jafc.0c02828] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Dietary starch is usually associated with elevated postprandial glycemic response. This is a potential risk factor of type 2 diabetes. Here, a 1,4-α-glucan branching enzyme (GBE) was employed to reassemble α-1,4 and α-1,6 glycosidic bonds in starch molecules. Structural characterization showed that GBE-catalyzed molecular reassembly created an innovative short-clustered maltodextrin (SCMD), which showed a dense internal framework along with shortened external chains. Such short-clustered molecules obstructed digestive enzymes attack and displayed dramatically reduced digestibility. Therefore, SCMD was served as a dietary starch substitute to improve postprandial glucose homeostasis. A 22.3% decrease in glycemic peak was therefore detected in ICR mice following SCMD intake (10.7 mmol/L), compared with that in the control (13.8 mmol/L). Moreover, an attenuated insulin response (40.5% lower than that in control) to SCMD intake was regarded suitable for diabetes management. These novel discoveries demonstrate that enzymatically rebuilding starch molecules may be a meaningful strategy for diabetes management.
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Affiliation(s)
- Haocun Kong
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - Luxi Yu
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - Zhengbiao Gu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- Collaborative Innovation Center for Food Safety and Quality Control, Jiangnan University, Wuxi 214122, China
| | - Caiming Li
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- Collaborative Innovation Center for Food Safety and Quality Control, Jiangnan University, Wuxi 214122, China
| | - Li Cheng
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- Collaborative Innovation Center for Food Safety and Quality Control, Jiangnan University, Wuxi 214122, China
| | - Yan Hong
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- Collaborative Innovation Center for Food Safety and Quality Control, Jiangnan University, Wuxi 214122, China
| | - Zhaofeng Li
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- Collaborative Innovation Center for Food Safety and Quality Control, Jiangnan University, Wuxi 214122, China
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23
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Wang BR, Yao JT, Zheng H, Li QM. Association of Glycated Albumin/Glycosylated Hemoglobin Ratio with Blood Glucose Fluctuation and Long-Term Blood Glucose Control in Patients with Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2021; 14:1809-1815. [PMID: 33948086 PMCID: PMC8088300 DOI: 10.2147/dmso.s297730] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/04/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the association of the glycated albumin (GA)/glycosylated hemoglobin (HbA1c) ratio with the mean amplitude of glycemic excursion (MAGE) in type 2 diabetes mellitus (T2DM). METHODS A total of 102 patients with T2DM who were first treated in Jinjiang Hospital of Fujian Province were enrolled in this study. The patients' general clinical data, including HbA1c, GA, fasting blood glucose, and fasting and peak C-peptide values upon diagnosis and after one year of follow-up, were collected, and their MAGE was calculated. RESULTS With the increase of the GA/HbA1c ratio at baseline, the patients' fasting and peak C-peptide values decreased gradually from baseline to follow-up, while their MAGE, HbA1c, and fasting blood glucose increased gradually. A regression analysis demonstrated that the baseline MAGE was independently positively correlated with the GA/HbA1c ratio. A Cox regression analysis demonstrated that a baseline GA/HbA1c ratio of >2.78 was an independent risk factor for poor fasting blood glucose and HbA1c. CONCLUSION The GA/HbA1c ratio is closely related to the MAGE and islet function in patients with T2DM.
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Affiliation(s)
- Bai-Rong Wang
- Department of Endocrinology, Medical College of Soochow University, Suzhou 215123, Jiangsu, People's Republic of China; PLA Rocket Force Characteristic Medical Center, Beijing, 100088, People’s Republic of China
- Department of Endocrinology, Jinjiang Municipal Hospital, Jinjiang, 362200, People’s Republic of China
| | - Jun-Teng Yao
- Department of Endocrinology, Jinjiang Municipal Hospital, Jinjiang, 362200, People’s Republic of China
| | - Hui Zheng
- Department of Endocrinology, Medical College of Soochow University, Suzhou 215123, Jiangsu, People's Republic of China; PLA Rocket Force Characteristic Medical Center, Beijing, 100088, People’s Republic of China
| | - Quan-Min Li
- Department of Endocrinology, Medical College of Soochow University, Suzhou 215123, Jiangsu, People's Republic of China; PLA Rocket Force Characteristic Medical Center, Beijing, 100088, People’s Republic of China
- Correspondence: Quan-Min Li PLA Rocket Force Characteristic Medical Center, Beijing, 100088, People’s Republic of ChinaTel +86 10 66927601 Email
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Huang Y, Wang JS, Yang L, Yue L, Zhang L, Zhang YH, Song YW, Li D, Yang Z. Paeoniflorin ameliorates glycemic variability-induced oxidative stress and platelet activation in HUVECs and DM rats. RSC Adv 2020; 10:42605-42612. [PMID: 35692727 PMCID: PMC9119283 DOI: 10.1039/d0ra02036b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/21/2020] [Indexed: 12/16/2022] Open
Abstract
Glycemic variability (GV) plays an important role in the pathogenesis of vascular complications associated with diabetes mellitus (DM). Paeoniflorin is an effective Chinese traditional medicine with anti-inflammatory and immune-regulatory effects. Previous studies implicated the beneficial effects of paeoniflorin in treatment for diabetic complications, such as type 2 diabetic nephropathy and diabetes with myocardial ischemic injury. Current evidence suggests that oxidative stress and platelet activation, as well as their interaction, are potentially associated with GV and involved in the pathogenesis of diabetes-associated vascular complications. This study aimed to explore the effects of paeoniflorin on oxidative stress and platelet activation, using human umbilical vein endothelial cells (HUVECs) cultured with different glucose concentrations, and streptozotocin-induced diabetic rats fed different glycemic index diets. Paeoniflorin treatment effectively improved the morphology and cell viability of HUVECs under glucose fluctuation. Moreover, the platelet aggregation rate, CD62p expression, and reactive oxygen species (ROS) concentration decreased, while glutathione peroxidase (GSH-px) levels increased in paeoniflorin-treated groups. In conclusion, our study found that paeoniflorin ameliorates oxidative stress and platelet activation induced by glycemic variability both in vivo and in vitro, suggesting a novel potential strategy for treatment of diabetic complications. Glycemic variability (GV) plays an important role in the pathogenesis of vascular complications associated with diabetes mellitus (DM).![]()
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Affiliation(s)
- Ye Huang
- Emergency Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091 China +86 10 62835314 +86 10 62835314
| | - Jing-Shang Wang
- Department of Traditional Chinese Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University Beijing 100026 China
| | - Lin Yang
- Department of Cardiovascular Disease, Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091 China
| | - Long Yue
- Emergency Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091 China +86 10 62835314 +86 10 62835314
| | - Lei Zhang
- Emergency Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091 China +86 10 62835314 +86 10 62835314
| | - Yan-Hong Zhang
- Emergency Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091 China +86 10 62835314 +86 10 62835314
| | - Ye-Wen Song
- Emergency Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091 China +86 10 62835314 +86 10 62835314
| | - Dandan Li
- Institute of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091 China
| | - Zhixu Yang
- Emergency Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091 China +86 10 62835314 +86 10 62835314
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25
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Kim HJ, Kim D, Yoon H, Choi CS, Oh YS, Jun HS. Prevention of Oxidative Stress-Induced Pancreatic Beta Cell Damage by Broussonetia Kazinoki Siebold Fruit Extract Via the ERK-Nox4 Pathway. Antioxidants (Basel) 2020; 9:antiox9050406. [PMID: 32397640 PMCID: PMC7278704 DOI: 10.3390/antiox9050406] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/01/2020] [Accepted: 05/04/2020] [Indexed: 02/07/2023] Open
Abstract
Pancreatic beta cells are vulnerable to oxidative stress, which causes beta cell death and dysfunction in diabetes mellitus. Broussonetia kazinoki Siebold (BK) is a widely used herbal medicine, but its potential effects against beta cell death-induced diabetes have not been studied. Therefore, we investigated the protective effect of an ethanolic extract of BK fruit (BKFE) against streptozotocin (STZ)-induced toxicity in pancreatic beta cells. Intraperitoneal injection of STZ in mice induced hyperglycemia; however, oral administration of BKFE significantly decreased the blood glucose level as well as HbA1c levels. BKFE treatment improved glucose tolerance and increased body weight in diabetic mice. Moreover, BKFE treatment resulted in increased serum insulin levels and insulin expression in the pancreas as well as decreased 4-hydroxynonenal levels induced by oxidative stress. Treatment with STZ decreased cell viability of mouse insulinoma cells (MIN6), which was blocked by BKFE pretreatment. BKFE significantly inhibited apoptotic cells and decreased the expression levels of cleaved-caspase-3 and cleaved-poly (ADP-ribose) polymerase (PARP) induced by STZ treatment. Production of reactive oxygen species in STZ-treated MIN6 cells was also significantly decreased by treatment with BKFE. Erk phosphorylation and Nox4 levels increased in STZ-treated MIN6 cells and the pancreas of mice injected with STZ and this increase was inhibited by treatment with BKFE. Inhibition of Erk phosphorylation by treatment with the PD98059 inhibitor or siRNA Erk also blocked the expression of Nox4 induced by STZ treatment. In conclusion, BKFE inhibits Erk phosphorylation, which in turn prevents STZ-induced oxidative stress and beta cell apoptosis. These results suggested that BKFE can be used to prevent or treat beta cell damage in diabetes.
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Affiliation(s)
- Hyo-Jin Kim
- College of Pharmacy, Gachon University, Incheon 21936, Korea;
| | - Donghee Kim
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Korea; (D.K.); (H.Y.); (C.S.C.)
| | - Haelim Yoon
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Korea; (D.K.); (H.Y.); (C.S.C.)
| | - Cheol Soo Choi
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Korea; (D.K.); (H.Y.); (C.S.C.)
- Department of Medicine, College of Medicine, Gachon University, Incheon 21565, Korea
- Korea Mouse Metabolic Phenotyping Center, Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Korea
| | - Yoon Sin Oh
- Department of Food and Nutrition, Eulji University, Seongnam 13135, Korea
- Correspondence: (Y.S.O.); (H.-S.J.); Tel.: +82-31-740-7287 (Y.S.O.); +82-32-899-6056 (H.-S.J.)
| | - Hee-Sook Jun
- College of Pharmacy, Gachon University, Incheon 21936, Korea;
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Korea; (D.K.); (H.Y.); (C.S.C.)
- Gachon Medical and Convergence Institute, Gachon Gil Medical Center, Incheon 21565, Korea
- Correspondence: (Y.S.O.); (H.-S.J.); Tel.: +82-31-740-7287 (Y.S.O.); +82-32-899-6056 (H.-S.J.)
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Incani A, Marras L, Serreli G, Ingianni A, Pompei R, Deiana M, Angius F. Human Herpesvirus 8 infection may contribute to oxidative stress in diabetes type 2 patients. BMC Res Notes 2020; 13:75. [PMID: 32054515 PMCID: PMC7020602 DOI: 10.1186/s13104-020-4935-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 02/03/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To investigate the link between Human Herpesvirus 8 (HHV8) infection and plasma oxidative stress in patients with diabetes mellitus type 2 (DM2). RESULTS Blood samples collected from DM2 and control subjects were screened for the presence of antibodies against HHV8 and for biomarkers of oxidative stress. We determined the products of radical damage on the plasma lipid fraction, such as malondialdehyde (MDA), fatty acid hydroperoxides (HP) and 7-ketocholesterol (7-keto), the oxidation products of unsaturated fatty acids (UFA) and cholesterol, respectively. The level of plasma antioxidant α-tocopherol (α-toc) was also assessed. Relevant differences were observed in the redox status in DM2 and either HHV8-positive or -negative control subjects. The level of α-toc significantly decreased in both DM2 and HHV8-positive subjects. Levels of MDA, HP and 7-keto were much higher in HHV8-positive and DM2 subjects, indicating that plasma oxidative stress is a common feature in both DM2 and HHV8-infection. In addition, 7-keto was further increased in HHV8-positive DM2 patients. We hypothesized that the HHV8-infection may contribute to the production of ROS, and hence to the oxidative stress closely related to the pathogenesis and development of DM2.
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Affiliation(s)
- Alessandra Incani
- Unit of Experimental Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Luisa Marras
- Section of Applied Microbiology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Gabriele Serreli
- Unit of Experimental Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Angela Ingianni
- Section of Applied Microbiology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Raffaello Pompei
- Section of Applied Microbiology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Monica Deiana
- Unit of Experimental Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.
| | - Fabrizio Angius
- Section of Applied Microbiology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.
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Nagarkoti S, Dubey M, Sadaf S, Awasthi D, Chandra T, Jagavelu K, Kumar S, Dikshit M. Catalase S-Glutathionylation by NOX2 and Mitochondrial-Derived ROS Adversely Affects Mice and Human Neutrophil Survival. Inflammation 2019; 42:2286-2296. [DOI: 10.1007/s10753-019-01093-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Picconi F, Parravano M, Sciarretta F, Fulci C, Nali M, Frontoni S, Varano M, Caccuri AM. Activation of retinal Müller cells in response to glucose variability. Endocrine 2019; 65:542-549. [PMID: 31327157 DOI: 10.1007/s12020-019-02017-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 07/11/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE In the earliest stages of diabetic retinopathy (DR), a dysfunction of Müller cells, characterized by high levels of glial fibrillary acidic protein (GFAP), and aquaporins (AQP), has been observed. Although chronic hyperglycemia causes the activation of Müller cells, the effect of glycemic fluctuations is yet unknown. The aim of the study was to analyze the impact of glucose variability on rat retinal Müller cells (rMC-1) adapted to either normal (5 mM) or high (25 mM) glucose levels. METHODS rMC-1 were cultured in a medium containing either 5 mM (N cells) or 25 mM of glucose (H cells) and then incubated for 96 h in a medium containing (a) low glucose (either 1-3 or 5 mM), (b) basal glucose (either 5 or 25 mM), (c) high glucose (either 25 or 45 mM), (d) basal and high glucose alternated every 24 h; (e) low- and high glucose alternated every 24 h; (f) basal glucose with episodes of low glucose for 30 min twice a day. Müller cells activation was evaluated by measuring the levels of GFAP, AQP4, and phospho-active extracellular signal-regulated kinase (pERK). RESULTS Under both basal and high glucose concentrations rMC-1 were viable, but their response to glucose excursions was different. In N cells kept under normal (5 mM) glucose, a significant glial activation was measured not only in response to constant high glucose but also to alternating low/high glucose. In H cells, adapted to 25 mM glucose, a significant response was observed only after exposition to a lower (5 mM) glucose concentration. CONCLUSION Our results highlight Müller cells activation in response to glucose variability and a different susceptibility depending on the basal glucose conditions.
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Affiliation(s)
- Fabiana Picconi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | | | - Francesca Sciarretta
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Chiara Fulci
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Michela Nali
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Simona Frontoni
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
- Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy.
| | | | - Anna Maria Caccuri
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
- Center Nanoscience, Nanotechnology, Innovative Instrumentation (NAST), University of Rome Tor Vergata, Rome, Italy
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Vijayakumar V, Mavathur R, Sharma MNK, Kannan S. Reduced Glycemic Variability With Yoga in Patients With Type 2 Diabetes Mellitus: Results of a Pilot Study. J Diabetes Sci Technol 2019; 13:803-804. [PMID: 31137967 PMCID: PMC6610615 DOI: 10.1177/1932296819852064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Venugopal Vijayakumar
- Division of Yoga and Life Sciences,
S-VYASA University, Bengaluru, India
- Government Yoga and Naturopathy Medical
College, Chennai, India
- Venugopal Vijayakumar, PhD, BNYS, MSc
Diabetes (Edin), Government Yoga and Naturopathy Medical College, Anna Hospital
Campus, Arumbakkam, Chennai, India.
| | - Ramesh Mavathur
- Division of Yoga and Life Sciences,
S-VYASA University, Bengaluru, India
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Li J, Zheng L, Wang X, Yao K, Shi L, Sun X, Yang G, Jiang L, Zhang C, Wang Y, Jiang L, Liu X. Taurine protects INS-1 cells from apoptosis induced by Di(2-ethylhexyl) phthalate via reducing oxidative stress and autophagy. Toxicol Mech Methods 2019; 29:445-456. [DOI: 10.1080/15376516.2019.1588931] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Jianing Li
- Department of Nutrition and Food Safety, College of Public Health, Dalian Medical University, Dalian, Liaoning, PR China
| | - Liangliang Zheng
- Department of Nutrition and Food Safety, College of Public Health, Dalian Medical University, Dalian, Liaoning, PR China
| | - Xue Wang
- Department of Nutrition and Food Safety, College of Public Health, Dalian Medical University, Dalian, Liaoning, PR China
| | - Kun Yao
- Department of Orthopedics, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, PR China
| | - Limin Shi
- Department of Nutrition and Food Safety, College of Public Health, Dalian Medical University, Dalian, Liaoning, PR China
| | - Xiance Sun
- Department of Occupational and Environmental Health, College of Public Health, Dalian Medical University, Dalian, Liaoning, PR China
- Natural Products Engineering Technology Center, Dalian Medical University, Dalian, Liaoning, PR China
| | - Guang Yang
- Department of Nutrition and Food Safety, College of Public Health, Dalian Medical University, Dalian, Liaoning, PR China
| | - Lijie Jiang
- Department of Internal Medicine, The Afliated Zhong Shan Hospital of Dalian University, Dalian, Liaoning, PR China
| | - Cong Zhang
- Department of Nutrition and Food Safety, College of Public Health, Dalian Medical University, Dalian, Liaoning, PR China
| | - Yan Wang
- Department of Endocrinology, the Second Hospital of Chaoyang, Chaoyang, China
| | - Liping Jiang
- Natural Products Engineering Technology Center, Dalian Medical University, Dalian, Liaoning, PR China
- Preventive Medicine Laboratory College of Public Health, Dalian Medical University, Dalian, Liaoning, PR China
| | - Xiaofang Liu
- Department of Nutrition and Food Safety, College of Public Health, Dalian Medical University, Dalian, Liaoning, PR China
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Tavares WR, Seca AML. Inula L. Secondary Metabolites against Oxidative Stress-Related Human Diseases. Antioxidants (Basel) 2019; 8:E122. [PMID: 31064136 PMCID: PMC6562470 DOI: 10.3390/antiox8050122] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/01/2019] [Accepted: 05/02/2019] [Indexed: 02/07/2023] Open
Abstract
An imbalance in the production of reactive oxygen species in the body can cause an increase of oxidative stress that leads to oxidative damage to cells and tissues, which culminates in the development or aggravation of some chronic diseases, such as inflammation, diabetes mellitus, cancer, cardiovascular disease, and obesity. Secondary metabolites from Inula species can play an important role in the prevention and treatment of the oxidative stress-related diseases mentioned above. The databases Scopus, PubMed, and Web of Science and the combining terms Inula, antioxidant and secondary metabolites were used in the research for this review. More than 120 articles are reviewed, highlighting the most active compounds with special emphasis on the elucidation of their antioxidative-stress mechanism of action, which increases the knowledge about their potential in the fight against inflammation, cancer, neurodegeneration, and diabetes. Alantolactone is the most polyvalent compound, reporting interesting EC50 values for several bioactivities, while 1-O-acetylbritannilactone can be pointed out as a promising lead compound for the development of analogues with interesting properties. The Inula genus is a good bet as source of structurally diverse compounds with antioxidant activity that can act via different mechanisms to fight several oxidative stress-related human diseases, being useful for development of new drugs.
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Affiliation(s)
- Wilson R Tavares
- Faculty of Sciences and Technology, University of Azores, 9501-801 Ponta Delgada, Portugal.
| | - Ana M L Seca
- cE3c-Centre for Ecology, Evolution and Environmental Changes/ Azorean Biodiversity Group & University of Azores, Rua Mãe de Deus, 9501-801 Ponta Delgada, Portugal.
- QOPNA & LAQV-REQUIMTE, University of Aveiro, 3810-193 Aveiro, Portugal.
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Could the high consumption of high glycaemic index carbohydrates and sugars, associated with the nutritional transition to the Western type of diet, be the common cause of the obesity epidemic and the worldwide increasing incidences of Type 1 and Type 2 diabetes? Med Hypotheses 2019; 125:41-50. [PMID: 30902150 DOI: 10.1016/j.mehy.2019.02.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 12/07/2018] [Accepted: 02/08/2019] [Indexed: 12/30/2022]
Abstract
The globally increasing incidences of Type 1 diabetes (T1DM) and Type 2 diabetes (T2DM) can have a common background. If challenged by the contemporary high level of nutritional glucose stimulation, the β-cells in genetically predisposed individuals are at risk for damage which can lead to the diseases. The fat to carbohydrate dietary shift can also contribute to the associated obesity epidemic.
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Zhang ZY, Miao LF, Qian LL, Wang N, Qi MM, Zhang YM, Dang SP, Wu Y, Wang RX. Molecular Mechanisms of Glucose Fluctuations on Diabetic Complications. Front Endocrinol (Lausanne) 2019; 10:640. [PMID: 31620092 PMCID: PMC6759481 DOI: 10.3389/fendo.2019.00640] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 09/03/2019] [Indexed: 12/11/2022] Open
Abstract
Accumulating evidence indicates the occurrence and development of diabetic complications relates to not only constant high plasma glucose, but also glucose fluctuations which affect various kinds of molecular mechanisms in various target cells and tissues. In this review, we detail reactive oxygen species and their potentially damaging effects upon glucose fluctuations and resultant downstream regulation of protein signaling pathways, including protein kinase C, protein kinase B, nuclear factor-κB, and the mitogen-activated protein kinase signaling pathway. A deeper understanding of glucose-fluctuation-related molecular mechanisms in the development of diabetic complications may enable more potential target therapies in future.
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Li CI, Li TC, Liu CS, Liao LN, Lin WY, Lin CH, Yang SY, Chiang JH, Lin CC. Risk score prediction model for dementia in patients with type 2 diabetes. Eur J Neurol 2018; 25:976-983. [PMID: 29603513 DOI: 10.1111/ene.13642] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 03/19/2018] [Indexed: 11/29/2022]
Affiliation(s)
- C.-I. Li
- School of Medicine; College of Medicine; China Medical University; Taichung Taiwan
- Department of Medical Research; China Medical University Hospital; Taichung Taiwan
| | - T.-C. Li
- Department of Public Health; College of Public Health; China Medical University; Taichung Taiwan
- Department of Healthcare Administration; College of Medical and Health Science; Asia University; Taichung Taiwan
| | - C.-S. Liu
- School of Medicine; College of Medicine; China Medical University; Taichung Taiwan
- Department of Medical Research; China Medical University Hospital; Taichung Taiwan
- Department of Family Medicine; China Medical University Hospital; Taichung Taiwan
| | - L.-N. Liao
- School of Medicine; College of Medicine; China Medical University; Taichung Taiwan
| | - W.-Y. Lin
- School of Medicine; College of Medicine; China Medical University; Taichung Taiwan
- Department of Family Medicine; China Medical University Hospital; Taichung Taiwan
| | - C.-H. Lin
- School of Medicine; College of Medicine; China Medical University; Taichung Taiwan
- Department of Family Medicine; China Medical University Hospital; Taichung Taiwan
| | - S.-Y. Yang
- Department of Public Health; College of Public Health; China Medical University; Taichung Taiwan
| | - J.-H. Chiang
- Management Office for Health Data; China Medical University Hospital; Taichung Taiwan
| | - C.-C. Lin
- School of Medicine; College of Medicine; China Medical University; Taichung Taiwan
- Department of Medical Research; China Medical University Hospital; Taichung Taiwan
- Department of Family Medicine; China Medical University Hospital; Taichung Taiwan
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Volpe CMO, Villar-Delfino PH, Dos Anjos PMF, Nogueira-Machado JA. Cellular death, reactive oxygen species (ROS) and diabetic complications. Cell Death Dis 2018; 9:119. [PMID: 29371661 PMCID: PMC5833737 DOI: 10.1038/s41419-017-0135-z] [Citation(s) in RCA: 662] [Impact Index Per Article: 110.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 09/29/2017] [Accepted: 11/02/2017] [Indexed: 12/13/2022]
Abstract
Chronic or intermittent hyperglycemia is associated with the development of diabetic complications. Several signaling pathways can be altered by having hyperglycemia in different tissues, producing oxidative stress, the formation of advanced glycation end products (AGEs), as well as the secretion of the pro-inflammatory cytokines and cellular death (pathological autophagy and/or apoptosis). However, the signaling pathways that are directly triggered by hyperglycemia appear to have a pivotal role in diabetic complications due to the production of reactive oxygen species (ROS), oxidative stress, and cellular death. The present review will discuss the role of cellular death in diabetic complications, and it will suggest the cause and the consequences between the hyperglycemia-induced signaling pathways and cell death. The signaling pathways discussed in this review are to be described step-by-step, together with their respective inhibitors. They involve diacylglycerol, the activation of protein kinase C (PKC) and NADPH-oxidase system, and the consequent production of ROS. This was initially entitled the “dangerous metabolic route in diabetes”. The historical usages and the recent advancement of new drugs in controlling possible therapeutical targets have been highlighted, in order to evaluate the evolution of knowledge in this sensitive area. It has recently been shown that the metabolic responses to stimuli (i.e., hyperglycemia) involve an integrated network of signaling pathways, in order to define the exact responses. Certain new drugs have been experimentally tested—or suggested and proposed—for their ability to modulate the possible biochemical therapeutical targets for the downregulation of retinopathy, nephropathy, neuropathy, heart disease, angiogenesis, oxidative stress, and cellular death. The aim of this study was to critically and didactically evaluate the exact steps of these signaling pathways and hence mark the indicated sites for the actions of such drugs and their possible consequences. This review will emphasize, besides others, the therapeutical targets for controlling the signaling pathways, when aimed at the downregulation of ROS generation, oxidative stress, and, consequently, cellular death—with all of these conditions being a problem in diabetes.
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Affiliation(s)
- Caroline Maria Oliveira Volpe
- Núcleo de Pós-Graduação e Pesquisa, Hospital Santa Casa de Belo Horizonte, Rua Domingos Vieira 590, Santa Efigênia, Belo Horizonte, MG30150-240, Brazil
| | - Pedro Henrique Villar-Delfino
- Núcleo de Pós-Graduação e Pesquisa, Hospital Santa Casa de Belo Horizonte, Rua Domingos Vieira 590, Santa Efigênia, Belo Horizonte, MG30150-240, Brazil
| | - Paula Martins Ferreira Dos Anjos
- Núcleo de Pós-Graduação e Pesquisa, Hospital Santa Casa de Belo Horizonte, Rua Domingos Vieira 590, Santa Efigênia, Belo Horizonte, MG30150-240, Brazil
| | - José Augusto Nogueira-Machado
- Núcleo de Pós-Graduação e Pesquisa, Hospital Santa Casa de Belo Horizonte, Rua Domingos Vieira 590, Santa Efigênia, Belo Horizonte, MG30150-240, Brazil.
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Piechowiak K, Dżygało K, Szypowska A. The additional dose of insulin for high-protein mixed meal provides better glycemic control in children with type 1 diabetes on insulin pumps: randomized cross-over study. Pediatr Diabetes 2017; 18:861-868. [PMID: 28117542 DOI: 10.1111/pedi.12500] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 11/26/2016] [Accepted: 12/16/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Delivery of insulin for high-protein low-fat meals with carbohydrates on the basis of carbohydrates leads to higher late postprandial glycemia. Studies with mixed meals demonstrated lower blood glucose level after dual wave bolus. The objective of our study was to assess the impact of additional dose of insulin in dual wave bolus for high-protein mixed meal on the postprandial glycemia. MATERIALS AND METHODS We performed a randomized, double-blind, two-way cross-over study, including 58 children with type 1 diabetes, aged 14.7 ± 2.2 years. Participants were randomly assigned into two treatment orders: NORMAL-DUAL or DUAL-NORMAL BOLUS. They consumed standardized high-protein, low-fat meals with carbohydrates. The primary outcome was postprandial glycemia (PPG) based on capillary blood glucose measurements (CBGM). The secondary outcomes were the frequency of hypoglycemia, area under glucose curve, mean amplitude of glycemic excursion (MAGE) and glycemic rise. RESULTS PPG assessed at 180 min was significantly lower when dual wave bolus was delivered (NORMAL 162 mg/dL [9 mmol/L] vs DUAL 130.0 mg/dL [7.22 mmol/L]; P = .004). There were no differences in CBGM between both groups at 60 and 120 min. We found differences between the groups in MAGE at 120 min (NORMAL 82.86 mg/dL [4.6 mmol/L] versus DUAL 54.76 mg/dL [3.04 mmol/L]; P = .0008). We observed no differences in the number of hypoglycemic episodes in both groups. CONCLUSION Applying an additional dose of insulin in dual wave bolus for high-protein mixed meal improved PPG. We observed no statistically significant increase in the number of hypoglycemic episodes associated with this intervention.
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Affiliation(s)
| | - Katarzyna Dżygało
- Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland
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Tao S, Ren Y, Zheng H, Zhao M, Zhang X, Zhu Y, Yang J, Zheng S. Salvianolic acid B inhibits intermittent high glucose-induced INS-1 cell apoptosis through regulation of Bcl-2 proteins and mitochondrial membrane potential. Eur J Pharmacol 2017; 814:56-62. [PMID: 28800882 DOI: 10.1016/j.ejphar.2017.08.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 07/19/2017] [Accepted: 08/07/2017] [Indexed: 12/22/2022]
Abstract
Blood glucose fluctuations, also referred to as intermittent high glucose, have been validated to be more harmful than sustained high glucose in exacerbating pancreatic dysfunction by inducing β cell apoptosis. Salvianolic acid B (Sal B), an aqueous component of Salvia miltiorrhiza, has been proved beneficial to pancreatic islet function in diabetes, but the underlying mechanisms remain to be elucidated. The present study investigated the protective effect of Sal B on INS-1 cells exposed to intermittent high glucose and the possible mechanisms implicated. The results indicated that Sal B was able to restore cell viability and suppress INS-1 cell apoptosis induced by intermittent high glucose. Preincubation with Sal B led to a significant decrease of caspase-9 and caspase-3 activity and poly ADP-ribose polymerase (PARP) cleavage. Exposure to intermittent high glucose induced significant up-regulation of proapoptotic proteins, down-regulation of antiapoptotic protein and depolarization of mitochondrial membrane potential (MMP) in INS-1 cells, while these changes were reversed effectively in Sal B treated groups. In addition, Sal B markedly attenuated intermittent high glucose-induced oxidative stress as manifested by notably decreased levels of intracellular reactive oxygen species and malondialdehyde (MDA). Taken together, these results indicate that Sal B is able to suppress intermittent high glucose-induced INS-1 cell apoptosis, which might be ascribed to regulation of Bcl-2 family protein expression and preservation of mitochondrial membrane potential.
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Affiliation(s)
- Shanjun Tao
- Department of Pharmacology, Wannan Medical College, 22 West Wenchang Road, Wuhu 241002, China
| | - Younan Ren
- Department of Pharmacology, Wannan Medical College, 22 West Wenchang Road, Wuhu 241002, China
| | - Haowen Zheng
- Department of Pharmacology, Wannan Medical College, 22 West Wenchang Road, Wuhu 241002, China
| | - Mengqiu Zhao
- Department of Basic Medicine, Anhui Vocational Institute of Population, Chizhou 247009, China
| | - Xu Zhang
- Department of Pharmacology, Wannan Medical College, 22 West Wenchang Road, Wuhu 241002, China
| | - Yuanmei Zhu
- Department of Pharmacology, Wannan Medical College, 22 West Wenchang Road, Wuhu 241002, China
| | - Jieren Yang
- Department of Pharmacology, Wannan Medical College, 22 West Wenchang Road, Wuhu 241002, China
| | - Shuguo Zheng
- Department of Pharmacology, Wannan Medical College, 22 West Wenchang Road, Wuhu 241002, China.
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Christiansen SC, Fougner AL, Stavdahl Ø, Kölle K, Ellingsen R, Carlsen SM. A Review of the Current Challenges Associated with the Development of an Artificial Pancreas by a Double Subcutaneous Approach. Diabetes Ther 2017; 8:489-506. [PMID: 28503717 PMCID: PMC5446388 DOI: 10.1007/s13300-017-0263-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Patients with diabetes type 1 (DM1) struggle daily to achieve good glucose control. The last decade has seen a rush of research groups working towards an artificial pancreas (AP) through the application of a double subcutaneous approach, i.e., subcutaneous (SC) continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion. Few have focused on the fundamental limitations of this approach, especially regarding outcome measures beyond time in range. METHODS Based on insulin physiology, the limitations of CGM, SC insulin absorption, meal challenge, and physical activity in DM1 patients, we discuss the limitations of the double SC approach. Finally, we discuss safety measures and the achievements reported in some recent AP studies that have utilized the double SC approach. RESULTS Most studies show that a double SC AP increases the time in range compared to a sensor-augmented insulin pump and shortens the time in hypoglycemia. Despite these achievements, the proportion of time spent in hyperglycemia is still roughly 20-40%, and hypoglycemia is still present 1-4% of the time. The main factors limiting further progress are the latency of SC CGM (at least 5-10 min) and the slow pharmacokinetics of SC-delivered fast-acting insulin. The maximum blood insulin level is reached after 45 min and the maximum glucose-lowering effect is observed after 1.5-2 h, while the glucose-lowering effect lasts for at least 5 h. CONCLUSIONS Although using a double SC AP leads to significant improvements in glucose control, the SC approach has severe limitations that hamper further progress towards a robust AP.
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Affiliation(s)
- Sverre Christian Christiansen
- Department of Endocrinology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Anders Lyngvi Fougner
- Department of Engineering Cybernetics, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Central Norway Regional Health Authority, Stjørdal, Norway
| | - Øyvind Stavdahl
- Department of Engineering Cybernetics, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Konstanze Kölle
- Department of Engineering Cybernetics, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Central Norway Regional Health Authority, Stjørdal, Norway
| | - Reinold Ellingsen
- Department of Electronic Systems, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Sven Magnus Carlsen
- Department of Endocrinology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Löfvenborg JE, Andersson T, Carlsson PO, Dorkhan M, Groop L, Martinell M, Tuomi T, Wolk A, Carlsson S. Sweetened beverage intake and risk of latent autoimmune diabetes in adults (LADA) and type 2 diabetes. Eur J Endocrinol 2016; 175:605-614. [PMID: 27926472 DOI: 10.1530/eje-16-0376] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/17/2016] [Accepted: 09/15/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Sweetened beverage intake is associated with increased risk of type 2 diabetes, but its association with autoimmune diabetes is unclear. We aimed to investigate sweetened beverage intake and risk of latent autoimmune diabetes in adults (LADA); autoimmune diabetes with features of type 2 diabetes. DESIGN/METHODS Data from a Swedish population-based study was used, including incident cases of LADA (n = 357) and type 2 diabetes (n = 1136) and randomly selected controls (n = 1371). Diabetes classification was based on onset age (≥35), glutamic acid decarboxylase autoantibodies (GADA) and C-peptide. Sweetened beverage intake information was derived from a validated food frequency questionnaire. ORs adjusted for age, sex, family history of diabetes, education, lifestyle, diet, energy intake and BMI were estimated using logistic regression. RESULTS Daily intake of >2 servings of sweetened beverages (consumed by 6% of participants) was associated with increased risk of LADA (OR: 1.99, 95% CI: 1.11-3.56), and for each 200 mL daily serving, OR was 1.15 (95% CI: 1.02-1.29). Findings were similar for sugar-sweetened (OR: 1.18, 95% CI: 1.00-1.39) and artificially sweetened beverages (OR: 1.12, 95% CI: 0.95-1.32). Similarly, each daily serving increment in total sweetened beverage conferred 20% higher type 2 diabetes risk (95% CI: 1.07-1.34). In type 2 diabetes patients, high consumers displayed higher HOMA-IR levels (4.5 vs 3.5, P = 0.0002), but lower HOMA-B levels (55 vs 70, P = 0.0378) than non-consumers. Similar tendencies were seen in LADA. CONCLUSIONS High intake of sweetened beverages was associated with increased risk of LADA. The observed relationship resembled that with type 2 diabetes, suggesting common pathways possibly involving insulin resistance.
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Affiliation(s)
| | - Tomas Andersson
- Institute of Environmental MedicineKarolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental MedicineStockholm County Council, Stockholm, Sweden
| | - Per-Ola Carlsson
- Department of Medical SciencesUppsala University, Uppsala, Sweden
| | - Mozhgan Dorkhan
- Department of Clinical SciencesLund University, Malmö, Sweden
| | - Leif Groop
- Department of Clinical SciencesLund University, Malmö, Sweden
| | - Mats Martinell
- Department of Public Health and Caring SciencesUppsala University, Uppsala, Sweden
| | - Tiinamaija Tuomi
- EndocrinologyAbdominal Centre, Helsinki University Hospital, Research Program for Diabetes and Obesity, University of Helsinki, and Finnish Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Alicja Wolk
- Institute of Environmental MedicineKarolinska Institutet, Stockholm, Sweden
| | - Sofia Carlsson
- Institute of Environmental MedicineKarolinska Institutet, Stockholm, Sweden
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La Sala L, Cattaneo M, De Nigris V, Pujadas G, Testa R, Bonfigli AR, Genovese S, Ceriello A. Oscillating glucose induces microRNA-185 and impairs an efficient antioxidant response in human endothelial cells. Cardiovasc Diabetol 2016; 15:71. [PMID: 27137793 PMCID: PMC4852407 DOI: 10.1186/s12933-016-0390-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 04/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intracellular antioxidant response to high glucose is mediated by Cu/Mn-superoxide dismutases (SOD-1/SOD-2), catalase (CAT) and glutathione peroxidases (GPx), particularly glutathione peroxidase-1 (GPx-1). Although oscillating glucose can induce a more deleterious effect than high glucose on endothelial cells, the mechanism by which oscillating glucose exerts its dangerous effects is incompletely understood; however, the involvement of oxidative damage has been generally accepted. In this study we sought to determine whether oscillating glucose differentially modulates antioxidant response, and to elucidate the potential regulatory mechanisms exerted by the microRNA-185 (miR-185). METHODS Human endothelial cells were exposed for 1 week to constant and oscillating high glucose. SOD-1, SOD-2, CAT and GPx-1, as well as two markers of oxidative stress [8-hydroxy-2'-deoxyguanosine (8-OHdG) and the phosphorylated form of H2AX (γ-H2AX)] were measured at the end of the experiment. Intracellular miR-185 was measured and loss-of function assays were performed in HUVEC. Bioinformatic tool was used to predict the link between miR-185 on 3'UTR of GPx-1 gene. Luciferase assay was performed to confirm the binding on HUVEC. RESULTS After exposure to constant high glucose SOD-1 and GPx-1 increased, while in oscillating glucose SOD-1 increased and GPx-1 did not. SOD-2 and CAT remained unchanged under both conditions. A critical involvement of oscillating glucose-induced miR-185 in the dysregulation of endogenous GPx-1 was found. Computational analyses predict GPx-1 as miR-185's target. HUVEC cultures were used to confirm glucose's causal role on the expression of miR-185, its target mRNA and protein and finally the activation of antioxidant response. In vitro luciferase assays confirmed computational predictions targeting of miR-185 on 3'-UTR of GPx-1 mRNA. Knockdown of miR-185, using anti-miR-185 inhibitor, was accompanied by a significant upregulation of GPx-1 in oscillating glucose. 8-OHdG and γ-H2AX increased more in oscillating glucose than in constant high glucose. CONCLUSIONS Glucose oscillations may exert more deleterious effects on the endothelium than high glucose, likely due to an impaired response of GPx-1, coupled by the upregulation of miR-185.
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Affiliation(s)
- Lucia La Sala
- Department of Cardiovascular Research, IRCCS MultiMedica, Milan, MI, Italy
| | - Monica Cattaneo
- Department of Cardiovascular Research, IRCCS MultiMedica, Milan, MI, Italy
| | - Valeria De Nigris
- Insititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Centro de Investigación Biomedica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain
| | - Gemma Pujadas
- Insititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Centro de Investigación Biomedica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain
| | - Roberto Testa
- Experimental Models in Clinical Pathology, INRCA-IRCCS National Institute, Ancona, Italy
| | - Anna R Bonfigli
- Scientific Direction, INRCA, Via S. Margherita, 5, Ancona, 60124, Italy
| | - Stefano Genovese
- Department of Cardiovascular Research, IRCCS MultiMedica, Milan, MI, Italy
| | - Antonio Ceriello
- Insititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Centro de Investigación Biomedica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain.
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Anti-apoptotic effects of novel phenolic antioxidant isolated from the Pacific oyster (Crassostrea gigas) on cultured human hepatocytes under oxidative stress. Food Chem 2015; 176:226-33. [DOI: 10.1016/j.foodchem.2014.12.066] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 12/04/2014] [Accepted: 12/16/2014] [Indexed: 11/20/2022]
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Yuan G, Hu H, Wang S, Yang Q, Yu S, Sun W, Qian W, Mao C, Zhou L, Chen D, Wang Z, Gong Q, Wang D. Improvement of β-cell function ameliorated glycemic variability in patients with newly diagnosed type 2 diabetes after short-term continuous subcutaneous insulin infusion or in combination with sitagliptin treatment: a randomized control trial. Endocr J 2015; 62:817-34. [PMID: 26194272 DOI: 10.1507/endocrj.ej15-0160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Glycemic variability (GV) has been proposed as contributor to diabetes-related macrovascular complications. This randomized control trial evaluated a new combination therapy with continuous subcutaneous insulin infusion (CSII) plus sitagliptin (CSII + sitagliptin) vs. CSII only in terms of metabolic control, GV and β-cell function in patients with newly diagnosed type 2 diabetes (T2DM). 217 patients were randomized to two weeks of CSII (n = 108) or CSII + sitagliptin (n = 109) therapy. As a measure of GV, the coefficient of variation (CV) was computed from capillary blood glucose during the first and second week, respectively. β-cell function before and after treatment was determined with the Insulin Secretion-Sensitivity Index-2 (ISSI-2). Good metabolic controls were established with both therapies. CSII + sitagliptin therapy resulted in greater improvements in CV and ISSI-2 than CSII alone (all P = 0.000). For each group, change in CV was inversely correlated with change in ISSI-2 (r = -0.529, P = 0.000 and r = -0.433, P = 0.000, respectively). The multivariate regression analysis demonstrated that improved ISSI-2 was the only independent contributor to reduced CV in both groups (standardized β = -0.388, P = 0.004 and standardized β = -0.472, P = 0.000, respectively). Correction of β-cell function in newly diagnosed T2DM patients via use of either CSII or CSII + sitagliptin therapy was feasible in controlling GV to prevent secondary complications of T2DM. Moreover, CSII + sitagliptin therapy was superior to CSII monotherapy in terms of GV.
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Affiliation(s)
- Guoyue Yuan
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
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Declining ß-cell function is associated with the lack of long-range negative correlation in glucose dynamics and increased glycemic variability: A retrospective analysis in patients with type 2 diabetes. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2014; 1:192-199. [PMID: 29159101 PMCID: PMC5685022 DOI: 10.1016/j.jcte.2014.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 09/01/2014] [Accepted: 09/12/2014] [Indexed: 11/24/2022]
Abstract
Objective To determine whether characteristics of glucose dynamics are reflections of β-cell function or rather of inadequate diabetes control. Materials/methods We analyzed historical liquid meal tolerance test (LMTT) and continuous glucose monitoring (CGM) data, which had been obtained from 56 non-insulin treated type 2 diabetic outpatients during withdrawal of antidiabetic drugs. Computed CGM parameters included detrended fluctuation analysis (DFA)-based indices, autocorrelation function exponent, mean amplitude of glycemic excursions (MAGE), glucose SD, and measures of glycemic exposure. The LMTT-based disposition index (LMTT-DI) calculated from the ratio of the area-under-the-insulin-curve to the area-under-the-glucose-curve and Matsuda index was used to assess relationships among β-cell function, glucose profile complexity, autocorrelation function, and glycemic variability. Results The LMTT-DI was inverse linearly correlated with the short-range α1 and long-range scaling exponent α2 (r = −0.275 and −0.441, respectively, p < 0.01) such that lower glucose complexity was associated with better preserved insulin reserve, but it did not correlate with the autocorrelation decay exponent γ. By contrast, the LMTT-DI was strongly correlated with MAGE and SD (r = 0.625 and 0.646, both p < 0.001), demonstrating a curvilinear relationship between β-cell function and glycemic variability. On stepwise regression analyses, the LMTT-DI emerged as an independent contributor, explaining 20, 38, and 47% (all p < 0.001) of the variance in the long-range DFA scaling exponent, MAGE, and hemoglobin A1C, respectively, whereas insulin sensitivity failed to contribute independently. Conclusions Loss of complexity and increased variability in glucose profiles are associated with declining β-cell reserve and worsening glycemic control.
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Key Words
- ACF, autocorrelation function
- AUC, area under the curve
- CGM, continuous glucose monitoring
- Cp, C-peptide
- DFA, detrended fluctuation analysis
- Disposition index
- Glucose profile dynamics
- LMTT, liquid meal tolerance test
- LMTT-DI, LMTT-based disposition index
- MAGE, mean amplitude of glycemic excursions
- OHA, oral hypoglycemic agent
- SD, standard deviation
- TZDs, thiazolidinediones
- Type 2 diabetes
- β-Cell reserve
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Lin CC, Yang CP, Li CI, Liu CS, Chen CC, Lin WY, Hwang KL, Yang SY, Li TC. Visit-to-visit variability of fasting plasma glucose as predictor of ischemic stroke: competing risk analysis in a national cohort of Taiwan Diabetes Study. BMC Med 2014; 12:165. [PMID: 25255837 PMCID: PMC4182812 DOI: 10.1186/s12916-014-0165-7] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 08/29/2014] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Glycemic variation as an independent predictor of ischemic stroke in type 2 diabetic patients remains unclear. This study examined visit-to-visit variations in fasting plasma glucose (FPG), as represented by the coefficient of variation (CV), for predicting ischemic stroke independently, regardless of glycated hemoglobin (HbA1c) and other conventional risk factors in such patients. METHODS Type 2 diabetic patients enrolled in the National Diabetes Care Management Program, ≥30 years old and free of ischemic stroke (n = 28,354) in 2002 to 2004 were included, and related factors were analyzed with extended Cox proportional hazards regression models of competing risk data on stroke incidence. RESULTS After an average 7.5 years of follow-up, there were 2,250 incident cases of ischemic stroke, giving a crude incidence rate of 10.56/1,000 person-years (11.64 for men, 9.63 for women). After multivariate adjustment, hazard ratios for the second, third and fourth versus first FPG-CV quartile were 1.11 (0.98, 1.25), 1.22 (1.08, 1.38) and 1.27 (1.12, 1.43), respectively, without considering HbA1c, and 1.09 (0.96, 1.23), 1.16 (1.03, 1.31) and 1.17 (1.03, 1.32), respectively, after considering HbA1c. CONCLUSIONS Besides HbA1c, FPG-CV was a potent predictor of ischemic stroke in type 2 diabetic patients, suggesting that different therapeutic strategies now in use be rated for their potential to (1) minimize glucose fluctuations and (2) reduce HbA1c level in type 2 diabetic patients to prevent ischemic stroke.
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Fang FS, Cheng XL, Gong YP, Wang LC, Li L, Li J, Tian H, Li CL. Association between glycemic indices and beta cell function in patients with newly diagnosed type 2 diabetes. Curr Med Res Opin 2014; 30:1437-40. [PMID: 24762059 DOI: 10.1185/03007995.2014.918030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To identify the relationship between glycemic indices and β cell function in patients with newly diagnosed type 2 diabetes. METHODS The cross-sectional analysis included 61 patients with newly diagnosed type 2 diabetes who received continuous glucose monitoring (CGM) for 72 hours. The association between β cell function and glycemic indices including A1C and glycemic variability was investigated. RESULTS A1C (r = -0.405, p = 0.001) and standard deviation of blood glucose (SDBG, r = -0.274, p = 0.032) were significantly correlated to HOMA-β cell function (HBCI), whereas mean amplitude of glycemic excursions (MAGE, r = -0.210, p = 0.104) was not informative. After multiple confounders adjustments, A1C (β = -7.35, p < 0.001), MAGE (β = -4.64, p = 0.040), and SDBG (β = -12.3, p = 0.012) were associated with HBCI. CONCLUSION A1C and glycemic variability were both associated with β cell function in patients with newly diagnosed type 2 diabetes. The main limitations of the present study are the cross-sectional design in nature and the limited sample size.
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Affiliation(s)
- Fu Sheng Fang
- Department of Geriatric Endocrinology, Chinese PLA General Hospital , Beijing , China
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Akash MSH, Rehman K, Chen S. Effects of coffee on type 2 diabetes mellitus. Nutrition 2014; 30:755-63. [DOI: 10.1016/j.nut.2013.11.020] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 11/05/2013] [Accepted: 11/08/2013] [Indexed: 12/13/2022]
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Babenko A, Krasilnikova EI, Likhonosov NP, Likhonosova AP, Grineva EN. Different antihyperglycaemic drug effects on glycaemic variability in Type 2 diabetic patients. DIABETES MELLITUS 2014. [DOI: 10.14341/dm2014472-80] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Optimizing treatments for type 2 diabetes mellitus (T2DM) remains an urgent issue. In addition to T2DM treatment strategies, such as glycaemic goals (glucose and glycated haemoglobin ? HbА1c) among different patient populations, the influence of glycaemic variability (GV) on the prognosis of patients with T2DM is also important. According to recent data, GV is associated with cardiovascular complications arising from T2DM. However, although the influence of GV on the development of vascular complications arising from diabetes and underlying mechanisms has been extensively investigated, few studies have investigated the effects of different glucose-lowering medications on GV, and there are even fewer reviews of this topic. This type of analysis is highly relevant, particularly because new classes of antidiabetic medications with potent glucose-dependent insulinotropic effects have been developed. These include groups of drugs that mimic or enhance incretin activity, such as glucagon-like peptide (GLP)-1 analogues/mimetics and dipeptidyl peptidase (DPP)-4 inhibitors. A glucose-dependent mechanism suggests that these groups of antidiabetic medications have beneficial effects on GV. Thus, the current study focusses on the comparative analysis of drugs based on their incretin effects (GLP-1 analogues/mimetics and DPP-4 inhibitors) and оther antidiabetic medications with regard to GV in the patients with T2DM.
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Zhang Z, Li J, Jiang X, Yang L, Lei L, Cai D, Zhang H, Chen H. GLP-1 ameliorates the proliferation activity of INS-1 cells inhibited by intermittent high glucose concentrations through the regulation of cyclins. Mol Med Rep 2014; 10:683-8. [PMID: 24859892 DOI: 10.3892/mmr.2014.2265] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Accepted: 03/10/2014] [Indexed: 11/06/2022] Open
Abstract
Glucagon-like peptide-1 (GLP-1) and its analog exendin (EX)-4 have been considered to promote β-cell growth and expansion. In the present, study we investigated the effect of GLP-1 on proliferative activity and cell cycle regulation in the pancreatic insulin-secreting β-cell line, INS-1, treated with intermittent high glucose. INS-1 cells were treated with normal glucose (5.5 mmol/l), constant high glucose (30 mmol/l) and intermittent high glucose (rotation/24 h in 5.5 or 30 mmol/l) in the presence or absence of GLP-1 (100 nmol/l) for seven days. Proliferative activity, cell cycle and the expression of cyclin D1, p21, p27 and Skp2 were examined. INS-1 treated with intermittent high glucose and GLP-1 demonstrated a significant increase in proliferation activity (1.45±0.12; P<0.01) and decreased cell proportion in G0/G1 phase (49.73±4.04%, P<0.01) compared with those without GLP-1. Furthermore, the expression levels of cyclin D1 and Skp2 were increased, while the expression of p27 and p21 were significantly reduced. Similar results were identified in those treated with constant high glucose and GLP-1. These results suggest that GLP-1 may ease the G0/G1 cell cycle arrest of INS-1 cells induced by intermittent high glucose by upregulating the expression of cyclin D1 and Skp2, downregulating the expression of p21 and p27, and finally promoting the cell cycle progression and proliferation activity.
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Affiliation(s)
- Zhen Zhang
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Jing Li
- Department of Endocrinology, Nanshan Affiliated Hospital of Guangdong Medical College, Shenzhen, Guangdong, P.R. China
| | - Xinkui Jiang
- Function Department of Nanshan Maternal and Child's Hospital, Shenzhen, Guangdong, P.R. China
| | - Lei Yang
- Department of Nephrology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Lei Lei
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Dehong Cai
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Hua Zhang
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Hong Chen
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
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Glucagon-like peptide-1 secreting cell function as well as production of inflammatory reactive oxygen species is differently regulated by glycated serum and high levels of glucose. Mediators Inflamm 2014; 2014:923120. [PMID: 24648662 PMCID: PMC3932225 DOI: 10.1155/2014/923120] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 12/18/2013] [Accepted: 12/19/2013] [Indexed: 12/02/2022] Open
Abstract
Glucagon-like peptide-1 (GLP-1), an intestinal hormone contributing to glucose homeostasis, is synthesized by proglucagon and secreted from intestinal neuroendocrine cells in response to nutrients. GLP-1 secretion is impaired in type 2 diabetes patients. Here, we aimed at investigating whether diabetic toxic products (glycated serum (GS) or high levels of glucose (HG)) may affect viability, function, and insulin sensitivity of the GLP-1 secreting cell line GLUTag. Cells were cultured for 5 days in presence or absence of different dilutions of GS or HG. GS and HG (alone or in combination) increased reactive oxygen species (ROS) production and upregulated proglucagon mRNA expression as compared to control medium. Only HG increased total production and release of active GLP-1, while GS alone abrogated secretion of active GLP-1. HG-mediated effects were associated with the increased cell content of the prohormone convertase 1/3 (PC 1/3), while GS alone downregulated this enzyme. HG upregulated Glucokinase (GK) and downregulated SYNTHAXIN-1. GS abrogated SYNTHAXIN-1 and SNAP-25. Finally, high doses of GS alone or in combination with HG reduced insulin-mediated IRS-1 phosphorylation. In conclusion, we showed that GS and HG might regulate different pathways of GLP-1 production in diabetes, directly altering the function of neuroendocrine cells secreting this hormone.
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Xue M, Jackson CJ. Activated protein C and its potential applications in prevention of islet β-cell damage and diabetes. VITAMINS AND HORMONES 2014; 95:323-63. [PMID: 24559924 DOI: 10.1016/b978-0-12-800174-5.00013-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Activated protein C (APC) is derived from its precursor, protein C (PC). Originally thought to be synthesized exclusively by the liver, recent reports have shown that PC is also produced by many other cells including pancreatic islet β cells. APC functions as a physiological anticoagulant with anti-inflammatory, anti-apoptotic, and barrier-stabilizing properties. APC exerts its protective effects via an intriguing mechanism requiring combinations of endothelial PC receptor, protease-activated receptors, epidermal growth factor receptor, Tie2 or CD11b, depending on cell types. Diabetes is a chronic condition resulted from the body's inability to produce and/or properly use insulin. The prevalence of diabetes has risen dramatically and has become one of the major causes of premature mortality and morbidity worldwide. Diabetes prevention is an ideal approach to reduce this burden. Type 1 and type 2 diabetes are the major forms of diabetes mellitus, and both are characterized by an autoimmune response, intraislet inflammation, β-cell apoptosis, and progressive β-cell loss. Protecting β-cell from damage is critical in both prevention and treatment of diabetes. Recent in vitro and animal studies show that APC's strong anti-inflammatory and anti-apoptotic properties are beneficial in preventing β-cell destruction and diabetes in the NOD mouse model of type 1 diabetes. Future preventive and therapeutic uses of APC in diabetes look very promising.
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Affiliation(s)
- Meilang Xue
- Sutton Arthritis Research Laboratories, Kolling Institute of Medical Research, The University of Sydney at Royal North Shore Hospital, St Leonards, New South Wales, Australia.
| | - Christopher J Jackson
- Sutton Arthritis Research Laboratories, Kolling Institute of Medical Research, The University of Sydney at Royal North Shore Hospital, St Leonards, New South Wales, Australia
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