Diabetes mellitus: an overview of the types, symptoms, complications and management

CYP2D6 polymorphism rs1065852 significantly increases the risk of type 2 diabetes

BACKGROUND

Genetic variations within the cytochrome P450 (CYP) gene family are significant determinants of type 2 diabetes mellitus (T2DM) susceptibility. This study aimed to investigate the association between CYP2C8 and CYP2D6 gene variants and the risk of T2DM.

METHODS

We conducted a case-control study involving 512 individuals with T2DM and 515 controls. Genotyping of CYP2C8 and CYP2D6 polymorphisms was performed using the Agena MassARRAY system. Logistic regression analysis was employed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs), thereby assessing the relationship between these genetic variants and T2DM risk. Additionally, multifactor dimensionality reduction (MDR) was utilized to assess the potential interaction effects of SNPs on T2DM risk.

RESULTS

The study found a strong correlation between rs1065852 and increased risk of T2DM in overall (A vs. G: OR = 1.22, 95% CI: 1.03-1.45, p = .024; AA vs. GG: OR = 1.46, 95% CI: 1.04-2.06, p = .031; AA-AG vs. GG: OR = 1.36, 95% CI: 1.04-1.79, p = .026; additive: OR = 1.21, 95% CI: 1.02-1.44, p = .027), males and age < 59 subgroups. However, there is no significant association between the CYP2C8 polymorphisms (rs1934953, rs1934951, rs2275620 and rs17110453) and T2DM risk. MDR analysis results showed that the best model was the one locus model (rs1065852, testing accuracy = 0.534; OR = 1.39; 95% CI: 1.05-1.85; p = .023; CVC = 10/10), indicating that rs1065852 is an independent risk factor for T2DM.

CONCLUSIONS

This study suggests that rs1065852 (CYP2D6) is an independent risk factor for T2DM. Further research is warranted to validate these results and explore their clinical implications.

Zebrafish navigating the metabolic maze: insights into human disease - assets, challenges and future implications

Zebrafish (Danio rerio) have become indispensable models for advancing our understanding of multiple metabolic disorders such as obesity, diabetes mellitus, dyslipidemia, and metabolic syndrome. This review provides a comprehensive analysis of zebrafish as a powerful tool for dissecting the genetic and molecular mechanisms of these diseases, focusing on key genes, like pparγ, lepr, ins, and srebp. Zebrafish offer distinct advantages, including genetic tractability, optical transparency in early development, and the conservation of key metabolic pathways with humans. Studies have successfully used zebrafish to uncover conserved metabolic mechanisms, identify novel disease pathways, and facilitate high-throughput screening of potential therapeutic compounds. The review also highlights the novelty of using zebrafish to model multifactorial metabolic disorders, addressing challenges such as interspecies differences in metabolism and the complexity of human metabolic disease etiology. Moving forward, future research will benefit from integrating advanced omics technologies to map disease-specific molecular signatures, applying personalized medicine approaches to optimize treatments, and utilizing computational models to predict therapeutic outcomes. By embracing these innovative strategies, zebrafish research has the potential to revolutionize the diagnosis, treatment, and prevention of metabolic disorders, offering new avenues for translational applications. Continued interdisciplinary collaboration and investment in zebrafish-based studies will be crucial to fully harnessing their potential for advancing therapeutic development.

Comprehensive review of animal models in diabetes research using chemical agents

Diabetes mellitus, characterized by insufficient insulin secretion and impaired insulin efficacy, disrupts carbohydrate, protein, and lipid metabolism. The global diabetic population is expected to double by 2025, from 380 million, posing a significant health challenge. Most diabetic individuals fall into the type 1 or type 2 categories, and diabetes adversely affects various organs, such as the kidneys, liver, nervous system, reproductive system, and eyes.This review focuses on animal models of diabetes induced by chemical agents, which are essential tools for understanding disease mechanisms, investigating complications, and testing antidiabetic drugs. Models include those caused by streptozotocin (STZ), alloxan, ferric nitrilotriacetate (Fe-NTA), dithizone, and anti-insulin serum.Streptozotocin (STZ)-induced diabetes models create type 1 and 2 diabetes by destroying pancreatic beta cells. The combination of STZ with nicotinamide mimics type 2 diabetes phenotypes. Alloxan induces a hyperglycemic state by causing free radical formation that selectively destroys pancreatic beta cells. Fe-NTA and dithizone also create diabetes models by damaging pancreatic beta cells. Anti-insulin serum models induce insulin resistance and hyperglycemia by generating antibodies against insulin receptors, leading to a condition similar to type 1 diabetes.Each model has unique characteristics that make it suitable for different aspects of diabetes research. These models are used to understand the pathogenesis of diabetes, develop new treatment strategies, and evaluate the efficacy of potential drugs.

Diabetes Mellitus Impairs the Bone Regeneration Capacity of Mesenchymal Stromal Cell-Based Therapy

BACKGROUND

Diabetes mellitus (DM) negatively impacts bone tissue, leading to bone loss and increased fracture risk. Many individuals need additional treatments, and therapy based on mesenchymal stromal cells (MSCs) represents a promising treatment for bone defects in patients with diabetes.

AIMS

The present study explored the effects of interactions between MSCs from normoglycemic (NG-MSCs) and diabetic (DM-MSCs) donors on osteoblast differentiation and the effects of cell therapy using NG-MSCs on bone regeneration in defects created in diabetic rats.

METHODS

After inducing DM with streptozotocin, we evaluated the morphometric parameters of rat femurs and the osteoblast differentiation of MSCs, as well as the effects of the interaction between NG-MSCs and DM-MSCs on their osteoblast differentiation. The efficacy of cell therapy was measured by evaluating the bone repair in calvarial defects of diabetic rats treated with local injections of either NG-MSCs or a vehicle.

RESULTS

DM induced bone loss and impaired the osteoblast differentiation of MSCs, which was partially restored by NG-MSCs, while the bone formation observed in defects treated with NG-MSCs and the vehicle was similar.

CONCLUSION

These results indicate that the beneficial effect of NG-MSCs on DM-MSCs did not translate into enhanced bone repair, mainly due to a hostile environment created by hyperglycemia, which compromised the ability of MSCs to induce bone formation.

Integration of network pharmacology, molecular docking and pharmacokinetic investigations of dandelion in rats for the treatment of diabetes mellitus

BACKGROUND

The dandelion is a medicinal and edible plant with various assumed properties, including hypoglycemic, antioxidative, anti-inflammatory, and anti-tumor effects. However, the underlying mechanism and metabolic behavior of dandelion that can be used in treating diabetes mellitus (DM) remain unclear.

AIMS

This study aimed to investigate the molecular mechanism of dandelion in the treatment of DM and the in vivo metabolic behavior of its bioactive components.

METHODS

Network pharmacology and molecular docking were used to identify the underlying mechanism of dandelion in treating DM. LC-MS/MS was used to analyze the pharmacokinetic behavior of the main active components in dandelion in rats.

RESULTS

The network pharmacology analysis demonstrated that the primary active components (hesperidin, protocatechuic acid, and syringic acid) of dandelion exert therapeutic effects on DM through multi-target interactions. These components regulated lipid and atherosclerosis pathways and the AGE-RAGE signaling pathway in diabetic complications via interactions with core targets including SRC, HRAS, and AKT1. The highest and lowest docking scores were - 8.55792 kcal·mol-1 and -4.18450 kcal·mol-1, respectively, indicating good binding activity between the compounds and the targets. Pharmacokinetic analysis revealed that all the analytes were detected in the plasma but their elimination within 24 h varied. Hesperidin, syringic acid and protocatechuic acid are abundant in rat plasma, characterized by extended long half-life and high bioavailability.

CONCLUSION

This work not only predicted the potential mechanism of dandelion in treating DM, but also revealed the pharmacokinetic profiles of its active components, a finding that is critical for advancing clinical applications of dandelion and related traditional Chinese medicine (TCM) formulae.

Zebrafish as a preclinical model for diabetes mellitus and its complications: From monogenic to gestational diabetes and beyond

With diabetes currently affecting 537 million people globally, innovative research approaches are urgently required. Zebrafish (Danio rerio) has emerged as a pivotal model organism in diabetes research, particularly valuable for developmental biology studies and preclinical therapeutic validation. Its rapid life cycle, optical transparency, and genetic tractability collectively enable efficient longitudinal observation of pathological progression and pharmacological responses. Utilizing zebrafish models, researchers have elucidated fundamental mechanisms governing islet development, β-cell dysfunction, and metabolic dysregulation. These experimental systems have significantly advanced our understanding of various diabetes subtypes, including type 1, type 2, gestational, and monogenic forms, while also facilitating mechanistic studies of diabetic complications such as retinopathy and nephropathy. Recent model refinements, particularly in simulating monogenic disorders and pregnancy-associated metabolic changes, promise to deepen our comprehension of disease pathophysiology and therapeutic interventions. Nevertheless, a persistent limitation lies in their incomplete recapitulation of human-specific physiological complexity and multi-organ metabolic interactions, factors that may influence translational applicability. Despite these constraints, zebrafish-based research continues to provide an indispensable platform for diabetes investigation, holding significant promise for alleviating the escalating global burden of this metabolic disorder.

BFGF alleviates diabetic endothelial dysfunction by downregulating Endoplasmic reticulum stress

Diabetes is a chronic metabolic disorder characterized by hyperglycemia, resulting from absolute or relative insufficiency in insulin secretion and disorder in insulin utilization. Diabetes has emerged as a global public health issue, with its incidence rate escalating year on year. Its vascular complications pose a severe challenge in clinical practice and constitute one of the principal causes of death among diabetes patients. Basic fibroblast growth factor, a member of the fibroblast growth factor family, exhibits a robust protective effect on numerous diseases. Consequently, it has become a research focus in the treatment of vascular complications related to diabetes. Nevertheless, the specific mechanism underlying basic fibroblast growth factor's vascular protective effect remains unclear. This study aims to explore whether basic fibroblast growth factor can alleviate endothelial dysfunction in diabetes by inhibiting endoplasmic reticulum stress. The research outcomes demonstrated that basic fibroblast growth factor significantly decreased the production of endoplasmic reticulum stress in db/db mice and endothelial cells incubated with high glucose and palmitic acid, augmented nitric oxide production, and reduced endothelial cell apoptosis. Treatment with the endoplasmic reticulum stress inducer Tunicamycin nullified the basic fibroblast growth factor mediated reduction in endoplasmic reticulum stress generation and endothelial protective effects. In conclusion, these discoveries imply that the endothelial protective effect of basic fibroblast growth factor in diabetes can be partially ascribed to its inhibition of endoplasmic reticulum stress.

Clinical Periodontal Evaluation and Assessment of Dipeptidyl-Peptidase-4 and Galectin-3 in Gingival Crevicular Fluid of Periodontitis Patients with Heart Failure and Diabetes

Background/Objectives: Periodontitis, a prevalent chronic inflammatory disease affecting tooth-supporting structures, has been increasingly linked to systemic conditions such as diabetes mellitus (DM) and cardiovascular diseases (CVDs). This study aimed to evaluate the periodontal status and levels of dipeptidyl peptidase-4 (DPP-4) and galectin-3 (Gal-3) in gingival crevicular fluid (GCF) of patients with periodontitis, heart failure (HF), and diabetes, exploring their potential as biomarkers for disease association. Methods: A cross-sectional study was conducted on 88 patients categorized into four groups: periodontally and systemically healthy (control, C); periodontitis (P); periodontitis and HF (P+HF); and periodontitis, HF, and diabetes (P+HF+D). Periodontal status was assessed using probing pocket depth (PPD) and Gingival Index (GI). GCF samples were collected and analyzed for DPP-4 and Gal-3 levels using ELISA. Statistical analyses were performed to assess differences between groups and potential correlations. Results: Results indicated significantly higher levels of DPP-4 in all test groups compared to controls (p < 0.0001), with the highest levels in the P+HF+D group. Similarly, Gal-3 levels were elevated in periodontitis patients, particularly in those with HF (p < 0.0001), and there was no significant difference between P+HF and P+HF+D groups. No significant differences were observed between smokers and non-smokers regarding these markers. Positive correlations were found between the periodontal parameters and the immunological markers in all test groups. Conclusions: The findings suggest that DPP-4 and Gal-3 may serve as potential biomarkers for periodontitis in association with heart failure and diabetes, with DPP-4 being more upregulated in the association with diabetes and Gal-3 with heart failure.

The comparison of miRNA expression levels in Type 2 diabetes and diabetic peripheral neuropathy patients

OBJECTIVES

We aimed to investigate the correlation between miRNA expression levels in patients with type 2 diabetes mellitus (T2DM) and diabetic peripheral neuropathy (DPN) and determine their potential functions in DPN.

MATERIAL AND METHODS

The study participants were between 30 and 75 years old and divided into three groups: 30 patients with Type 2 T2DM without DPN (group 1), 30 patients with DPN (group 2), and 30 healthy controls (group 3). Whole blood samples were obtained from the individuals forming the groups, and the expression of the miR-128a, miR-146a, miR-155, and miR-375 genes in these samples was determined by real-time polymerase chain reaction (PCR). RNU6 was used as the housekeeping gene.

RESULTS

No significant differences were observed in the expression levels of miR-128a, miR-146a, and miR-155 among all groups (p > 0.05). However, miR-375 expression levels differed significantly between the group 2 and the group 3 (p < 0.05). No significant differences in miR-375 expression levels were found between the group 1 and the group 3, nor between the group 1 and the group 2 (p > 0.05).

CONCLUSIONS

miR-375 may be linked to the progression of diabetic peripheral neuropathy (DPN).

A Nomogram Based on Fibrinogen-to-Neutrophil Ratio as a Novel Predictor of Lymph Node Metastasis in Patients with Cervical Cancer and Type 2 Diabetes Mellitus

Background

The rising incidence of cervical cancer among individuals with diabetes is a matter of significant concern, presenting profound implications for the health status and quality of life worldwide. In patients diagnosed with early-stage cervical cancer, the extent of lymph node involvement has emerged as a critical prognostic factor influencing recurrence risk and survival outcomes. Therefore, the precise prediction of pelvic lymph node metastasis is essential for an accurate assessment of prognosis. The preoperative identification of lymph node metastasis constitutes a pivotal element in the formulation of personalized treatment strategies. It has been demonstrated that inflammatory markers such as neutrophils, lymphocytes, and fibrinogen significantly contribute to cancer progression and prognostic evaluations. In this regard, we propose the fibrinogen-to-neutrophil ratio (FNR) as an innovative and promising biomarker for evaluating pelvic lymph node metastasis in cervical cancer patients with type 2 diabetes.

Methods

The study was conducted on 141 patients diagnosed with cervical cancer and concomitant type 2 diabetes, who were treated at the First Affiliated Hospital of Xiamen University. The patients were randomly divided into a training set (n=98) and a validation set (n=43), with a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors, and a prognostic model was established based on these findings. The model's effectiveness was evaluated.

Results

A nomogram that integrates multiple factors, including FNR, triglycerides, maximum diameter, and total protein, demonstrates superior potential in predicting pelvic lymph node metastasis in patients with type 2 diabetes and cervical cancer, compared to the use of a single biomarker.

Conclusion

As a comprehensive biomarker, FNR shows significant potential in offering a more thorough and reliable approach for identifying cervical cancer patients with diabetes who are at an elevated risk of lymph node metastasis.

Risk Factors for the Development of Early Onset Diabetes in the Population of Sindh Province, Pakistan

Background/Objective: Early-onset diabetes (EOD), diagnosed at ≤35 years, is a growing public health crisis in low- and middle-income countries, including Pakistan. Identifying modifiable and non-modifiable risk factors is critical for developing effective prevention strategies. This study aimed to investigate the risk factors associated with EOD in Sindh, Pakistan, focusing on genetic, lifestyle, and metabolic determinants. Methods: A multicenter cross-sectional study was conducted across diabetic clinics in Sindh, with primary data collection at Baqai Institute of Diabetology and Endocrinology (Karachi, Pakistan) and secondary sites in Hyderabad, Larkana, and Sukkur. Following institutional ethical approval and informed consent, we enrolled 754 individuals (type 1 and type 2 diabetes, age at diagnosis: 15-35 years). Data on anthropometric, clinical, biochemical, and lifestyle parameters were collected via structured questionnaires. Statistical analyses included Pearson's Chi Square tests and multivariate logistic regression in determining associations. Results: Logistic regression revealed key predictors of early-onset diabetes (EOD). A two-generation diabetes family history showed a strong association (aOR:1.86, 1.12-3.43). Significant lifestyle risks included physical inactivity (OR:1.40, 1.03-1.90), frequent sugary beverage intake (OR:1.93, 1.89-1.98), and abnormal sleep duration (<6 h: OR:1.58, 1.04-2.40; >8 h: OR:1.86, 1.21-2.85). Hypertension was a major metabolic predictor (elevated BP: OR:1.79, 1.28-1.54; Stage I: OR:1.81, 1.34-1.77). Cardiovascular disease and uncontrolled fasting glucose lost significance after adjustment, indicating confounding effects. Conclusions: This study highlights familial predisposition, sedentary behavior, poor diet, sleep disturbances, and hypertension as key contributors to EOD in young Pakistani adults. Early screening and targeted lifestyle interventions are urgently needed to mitigate this escalating epidemic.

Analysis of Factors Influencing Clinical Inertia in the Treatment of Type 2 Diabetes Mellitus Patients With Metformin

Aims/Background Medication therapy is a crucial measure for type 2 diabetes mellitus (T2DM). However, approximately 50% of diabetes patients in China fail to achieve their blood glucose control targets despite receiving hypoglycemic treatment. Studies have indicated that clinical inertia is often a key factor contributing to poor long-term blood glucose control in most patients. This study aims to investigate the factors influencing clinical inertia in the treatment process of patients using metformin. Methods A retrospective study method was adopted, and 86 T2DM patients treated with metformin who have clinical inertia between June 2021 and June 2023 at Zhejiang Hospital were treated as the inertia group. Additionally, 87 patients who received the same medication treatment and follow-up evaluation without clinical inertia during the same period were selected as the control group. By comparing general data, family and economic situations, lifestyle, and diabetes conditions between the two groups, a logistic multivariate analysis model was used to analyze the factors influencing clinical inertia in the treatment process of T2DM patients using metformin. Results The proportion of male patients and those with an elementary education or below was significantly higher in the inertia group compared to the control group (p < 0.05). Additionally, the proportion of patients without commercial insurance was significantly higher in the inertia group (p < 0.05). The proportion of patients practicing dietary control was lower in the inertia group compared to the control group (p < 0.05). Furthermore, the inertia group had a lower proportion of patients with initial glycated hemoglobin levels ≥8.0%, those conducting home blood glucose monitoring, patients with diabetes-related complications, and those receiving diabetes health education compared to the control group (p < 0.05). Male gender (odds ratio (OR) = 3.487, p = 0.001), elementary education or below (OR = 2.362, p = 0.027), lack of commercial insurance (OR = 3.783, p = 0.005), absence of home blood glucose monitoring (OR = 3.127, p = 0.007), absence of diabetes-related complications (OR = 2.995, p = 0.006), and lack of chronic disease health education (OR = 2.753, p = 0.017) were identified as risk factors for clinical inertia in the treatment of T2DM patients using metformin (p < 0.05). Conclusion The risk of clinical inertia during metformin treatment in T2DM patients is relatively high and is associated with various factors. Targeted intervention measures should be implemented for high-risk populations to reduce the risk of clinical inertia.

The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and its combination with obesity indicators as a predictor of all cause and cardiovascular mortality in non-diabetic individuals

BACKGROUND

The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) represents a novel composite lipid marker for atherosclerosis and cardiovascular disease (CVD). Nevertheless, the correlation between NHHR and mortality in the non-diabetic population remains indistinct.

METHODS

This study included 20,774 non-diabetic individuals from the 1999-2018 National Health and Nutrition Examination Survey (NHANES). We employed a weighted multivariate Cox proportional hazards model and restricted cubic splines to assess the associations between NHHR, its combination with obesity indicators, and all-cause and CVD mortality.

RESULTS

During a mean follow-up period of 62 months, a total of 897 participant deaths were recorded, of which 155 were attributed to cardiovascular causes. The restricted cubic splines revealed a U-shaped association between NHHR and all-cause mortality, while an L-shaped association was observed for CVD mortality. The analysis of threshold efects revealed that the infection points for NHHR and all-cause and CVD mortality were 2.65 and 2.07, respectively. The cubic spline revealed a nonlinear correlation was observed between NHHR-BMI, NHHR-WC and NHHR-WHtR and all-cause and CVD mortality.

CONCLUSION

NHHR and its combination with obesity indicators can be a meaningful predictor of all-cause mortality and CVD mortality in non-diabetic individuals.

Therapeutic effects and mechanisms of Xinmaitong formula for type 2 diabetes mellitus via GLP-1R signaling

Introduction

Traditional Chinese Medicine (TCM) theory posits that type 2 diabetes mellitus (T2DM) characterized by Qi and Yin deficiency, is associated with elevated blood lipid levels. The Xinmaitong formula (XMT) is a folk remedy believed to lower blood lipid levels. However, the functional components and molecular mechanisms through which XMT exerts its anti-diabetic effects remain to be elucidated. This study aimed to investigate the therapeutic effects and potential mechanisms of XMT in the treatment of T2DM, focusing on the glucagon-like peptide-1 receptor (GLP-1R) signaling pathway.

Methods

A TCM formula that promotes GLP-1R expression was screened using a GLP-1R promoter-dependent luciferase reporter gene vector (PGL3-GLP-1R-luc). The T2DM mouse model was established using a high-fat diet and streptozotocin (STZ). Blood glucose levels were measured using a glucometer and oral glucose tolerance test (OGTT). Serum biochemical parameters and insulin levels were also assessed. Organ pathology in mice was evaluated using hematoxylin and eosin (H&E) staining. Immunofluorescence (IF) was employed to observe changes in insulin and GLP-1R expression in the pancreas of mice. The effects of medicated serum on Min6 cell growth were examined using a methyl thiazolyl tetrazolium (MTT) assay. A Min6 cell injury model was established to detect cAMP and Ca2+ concentrations. Ultra high-performance liquid chromatography-mass spectrometry (UHPLC-MS) was used to identify blood-absorbed components of XMT.

Results

Luciferase reporter constructs driven by GLP-1R promoter response elements analysis identified that TCM formula XMT promoted GLP-1R expression. In vivo experiments demonstrated that XMT significantly reduced fasting blood glucose levels in T2DM mice and improved OGTT results. It also exhibited protective effects on islet tissues, notably increasing GLP-1R expression and insulin secretion in the pancreas. Biochemical markers indicated no significant adverse effects on liver or kidney function following XMT administration. After treatment with palmitic acid (PA), GLP-1R expression in Min6 cells was significantly decreased. However, treatment with XMT upregulated GLP-1R expression. Additionally, cyclic adenosine monophosphate (cAMP) and Ca2+ exhibited substantial improvements, and the key pancreatic growth protein PDX1 was activated.

Conclusion

XMT exerts hypoglycemic effects by upregulating GLP-1R gene expression, enhancing GLP-1R protein synthesis, and subsequently promoting cAMP release. This process activates Ca2+ influx in pancreatic β-cells, triggering insulin exocytosis from islet cells.

Natural, safety immunomodulatory derivatives of lactobacillus biofilms promote diabetic wound healing by metabolically regulating macrophage phenotype and alleviating local inflammation

INTRODUCTION

Long-term inflammatory microenvironment further impairs the healing process of diabetic wounds. Many studies have shown that Lactobacillus can regulate immune function and promote injured tissue repair. However, the immunomodulatory function and safety of Lactobacillus biofilm (LB) on wounds need further investigation.

OBJECTIVES

In this present research, we proposed a "bacteria-free biofilm derivative therapy" and successfully extracted Lactobacillus biofilm derivatives (LBDs) by ultrasonic separation and filtration technology for the natural and safe treatment of diabetic wounds.

METHODS

The study first cultured Lactobacillus anaerobically and extracted LBDs using ultrasound separation combined with filtration technology. LBDs were characterized via scanning electron microscopy, Concanavalin A fluorescence staining, and protein gel electrophoresis. In vivo diabetic wound model, wound closure rates were dynamically monitored, and tissue sections were analyzed using hematoxylin-eosin and immunofluorescence staining to evaluate LBDs' healing effects. An in vitro macrophage inflammation model was established, employing immunofluorescence, flow cytometry, and Western blotting techniques to explore the molecular mechanisms underlying LBDs' effects on macrophage phenotypes. Furthermore, whole-genome sequencing and proteomics of LBDs-treated macrophages were performed to further elucidate the intrinsic molecular mechanisms through which LBDs regulate macrophage phenotypes.

RESULTS

LBDs were effectively extracted utilizing ultrasonic separation coupled with filtration technology. Studies revealed that LBDs modulate the systemic metabolic reprogramming in wound-site macrophages, suppress JAK-STAT1 signaling pathway, alleviate the local inflammatory microenvironment, promote neovascularization and ultimately accelerate wound healing.

CONCLUSION

The LBDs retains most bioactive components of the LB. As a natural, safe and immunomodulatory agent, LBDs promote diabetic wound healing by metabolically reprogramming macrophage phenotypes and improving the local immune microenvironment, offering promising potential for regenerative applications in diabetic wound management.

Development and validation of a Chinese insulin medication literacy scale for patients with diabetes mellitus

Objective

This study aimed to develop a simplified insulin medication literacy scale for patients with diabetes mellitus in China (Ch-InMLS), assess the level of insulin medication literacy, and evaluate its psychometric properties.

Methods

We developed an initial scale based on the framework of the knowledge-attitude-practice model (KAP), with "skills" added. The items were developed from literature review and insulin-related guidelines, semi-structured interviews, and face validity. After two rounds of expert consultation and a pilot survey, a final version of the scale was developed. A cross-sectional survey was conducted with 553 patients with diabetes mellitus in Zhengzhou for psychometric evaluation. In the construct validity analysis, the number of participants was 262 for exploratory factor analysis and 291 for confirmatory factor analysis. In the reliability analysis, internal consistency reliability and split-half reliability were evaluated using Cronbach's alpha coefficients.

Results

The final scale consists of 36 items with four domains: knowledge, attitude, practice, and skill. Exploratory factor analysis suggested four factors to explain 67.556% of the total variance (Kaiser-Meyer-Olkin test = 0.944, Bartlett's test χ2 = 7384.296, P < 0.001). The results of confirmatory factor analysis showed that the model fits the data adequately. Cronbach's coefficient was 0.945 for the overall scale, and for each domain, it was 0.952, 0.947, 0.908, and 0.923. The Spearman-Brown split-half reliability coefficient was 0.803 for the total scale, and for each domain, it was 0.925, 0.944, 0.901, and 0.917. The test-retest reliability coefficient of the total scale was 0.944, and for each domain of the scale, it was 0.865, 0.845, 0.987, and 0.936.

Conclusion

The scale has acceptable content validity, construct validity, and good reliability. It can be used to evaluate the level of insulin medication literacy of patients with diabetes mellitus in China.

Research progress of non-coding RNA regulating the role of PANoptosis in diabetes mellitus and its complications

Diabetes is a chronic metabolic disease that is endemic worldwide and is characterized by persistent hyperglycemia accompanied by multiple severe complications, including cardiovascular disease, kidney dysfunction, neuropathy, and retinopathy. The pathogenesis of diabetes mellitus and its complications is multifactorial, involving various molecular and cellular pathways. In recent years, research has indicated that mechanisms of cell death play a significant role in the advancement of diabetes and its complications. PANoptosis is a complex phenomenon caused by three cell death pathways: programmed apoptosis, necroptosis and pyroptosis. The contribution of PANoptosis to diabetes and its complications remains incompletely understood. Non-coding RNA, an important molecule in gene expression regulation, has shown significant regulatory functions in a variety of diseases. This paper reviews the underlying mechanisms of diverse types of non-coding RNAs (including lncRNA, miRNA and circRNA) in regulating PANoptosis and their specific contributions in diabetes, aiming to explore how non-coding RNAs influence PANoptosis and their effects in diabetes.

Crosstalk between microRNA and inflammation; critical regulator of diabetes

A growing body of evidence indicates that microRNAs (miRNAs may be used as biomarkers for the diagnosis, prognosis, and treatment of diabetes, given their changed expression profile as the disease progresses. There is growing interest in using individual miRNAs or whole miRNA clusters linked to diabetes as therapeutic targets because of their abnormal expression and functioning. In diabetes, miRNAs are also involved in inflammatory and immunological responses. Additionally, the inflammatory response controls the generation, processing, and stability of pre- or mature miRNAs and miRNA biogenesis. With a comprehensive grasp of molecular biological activities and the signaling axis, this review emphasizes the critical functions of miRNAs in inflammatory and immunological processes in diabetes. We further emphasized the potential role of these miRNAs in controlling inflammation associated with diabetes. This assessment will direct the shift from many studies to practical applications for tailored diabetes treatment and assist in identifying new therapeutic targets and approaches.

Design, synthesis, and investigation of novel 5-arylpyrazole-glucose hybrids as α-glucosidase inhibitors

Considering the global incidence of diabetes, developing new compounds to lower blood sugar levels has become increasingly crucial. As a result, there has been a growing focus on the synthesis of α-glucosidase inhibitors in recent years. This study investigated design, synthesis, and effects of novel 5-aryl pyrazole-glucose hybrids as α-glucosidase inhibitors. Thirteen derivatives from this class of compounds were synthesized, demonstrating superior in vitro inhibitory effects (IC50 values ranging from 0.5 to 438.6 µM, compared to acarbose at 750.0 µM). Among them, compound 8g (IC50 = 0.5 µM) was selected for further investigations and the kinetic studies revealed that it is a competitive inhibitor (Ki = 0.46 µM). Fluorescence assays indicated changes in the fluorescence intensity, while thermodynamic analyses suggested that compound 8g promoted a transition of the enzyme into an unfolded state. Furthermore, in vivo studies demonstrated that 8g effectively reduced blood sugar levels in rats at doses comparable to acarbose. Molecular docking studies revealed that this compound interacted with the enzyme's active site, and molecular dynamics simulations showed that pharmacophores engaged in various interactions with the enzyme.

Combined use of anti-platelet aggregation drugs and shujin huoluo decoction for diabetic peripheral vascular disease: enhanced therapeutic efficacy

OBJECTIVE

To investigate the clinical effect of anti-platelet aggregation drugs combined with Shujin Huoluo Decoction (SJHLD, a decoction for relaxing muscles and activating collaterals) in the treatment of diabetic peripheral vascular disease.

METHODS

A total of 130 patients with diabetic peripheral vascular disease were retrospectively included in this study and divided into two groups. In the monotherapy group, 65 patients were treated with cilostazol (CTZ) monotherapy; in the combined group, 65 patients were treated with CTZ combined with SJHLD. The treatment efficacy, inflammatory indexes, blood glucose and lipid levels, ultrasound parameters, and hemorheology of the two groups were compared before and after treatment.

RESULTS

Both groups showed significant improvements in walking distance and skin temperature of the toes, with more pronounced changes observed in the combined group (P < 0.05). After treatment, inflammatory markers decreased notably in both groups (P < 0.05). Blood glucose and lipid levels decreased markedly, with a more substantial reduction in lipid levels observed in the combined group (P < 0.05). Lower limb arterial conditions improved markedly in both groups, with greater improvements seen in the combined group (P < 0.05). Additionally, the pulsatile index and blood flow velocity in the ankle-brachial and dorsalis pedis arteries increased markedly in both groups, with the combined group showing a greater improvement (P < 0.05). Hemorheology parameters also decreased significantly in both groups, with the combined group showing a more significant reduction (P < 0.05). The effective treatment rate was significantly higher in the combined group (P < 0.05).

CONCLUSIONS

The combination of CTZ and SJHLD significantly improves lower limb function, ultrasound parameters, and blood flow, enhancing treatment efficiency in patients with diabetic peripheral vascular disease. This therapeutic approach offers valuable clinical guidance and warrants consideration for use in diabetic patients.

Electrospun Nanofiber Membrane with Sustained Release of Mogroside V Enhances Alveolar Bone Defect Repair in Diabetic Rats

The impaired healing of alveolar bone defects in diabetic patients has attracted considerable attention, with Mogroside V (MV) emerging as a promising candidate due to its demonstrated antioxidation, hypoglycemic, and anti-inflammatory properties in patients with diabetes mellitus. To address the limitations of oral MV administration, such as low bioavailability, rapid metabolism, and a short half-life, we developed a nanofiber membrane utilizing electrospinning technology for topical application by preparing membranes using MV, chitosan (CS), nanohydroxyapatite (HA), and poly(vinyl alcohol) (PVA) as raw materials to prolong the effect of MV and enhance bone regeneration in diabetic patients. The MV/HA/PVA/CS exhibited a good fiber diameter, prolonged drug release, and suitable degradation time, along with other favorable properties. In vitro experiments revealed its excellent biocompatibility, effectiveness in promoting osteogenesis, upregulation of osteogenic and anti-inflammatory genes, and concurrent downregulation of pro-inflammatory genes. In vivo evaluations further confirmed its ability to effectively modulate the diabetic microenvironment, reduce bone damage, and facilitate anti-inflammatory effects and alveolar bone regeneration in diabetics. These findings suggest that a nanofiber membrane with sustained release of MV may serve as a promising biomaterial, providing new insights into improving the healing of diabetic alveolar bone defects.

Bioactivities and Structure-Activity Relationships of Harmine and Its Derivatives: A Review

Natural products and their derivatives play a crucial role in treating various diseases. Harmine, a tricyclic β-carboline alkaloid isolated from the seeds of Peganum harmala L., has emerged as a promising therapeutic candidate owing to its multifaceted biological activities. Recent studies have further highlighted the enhanced therapeutic potential of harmine derivatives. To assess the current research landscape on harmine and its derivatives, we conducted a comprehensive analysis of studies published between 2019 and 2024 in scientific databases, such as PubMed, Web of Science, and Google Scholar. In this review, the possible applications of harmine and its derivatives were systematically illustrated, including biological activities, structure-activity relationships, and nanotechnology applications. Notably, the biological activities of harmine and its derivatives mainly contained antitumor, neuroprotective, antiparasitic, anti-inflammatory, and antidiabetic properties. In addition, structural modifications and the application of nanocarriers make harmine and its derivatives more druggable. The aim of this review is to summarize the recent advancements in harmine and its derivatives research, analyze emerging trends, and explore their clinical value.

Study on the mechanism of activating SIRT1/Nrf2/p62 pathway to mediate autophagy-dependent ferroptosis to promote healing of diabetic foot ulcers

Diabetic foot (DF), a prevalent and grave diabetes sequela, is considered as a notable clinical concern, with SIRT1 downregulation observed in DF patients' blood specimens. Nonetheless, the regulatory mechanisms of SIRT1 in diabetic foot ulcer (DFU) remain unclear. Thus, in the current study, we investigated the role and mechanisms of SIRT1 in alleviating DFU. Western blotting was used to detect the expression of autophagy and ferroptosis-related proteins, CCK8 assay was used to measure cell proliferation. Plate colony method was used to measure bacterial growth, and the inhibitory effect on intracellular and extracellular Staphylococcus aureus was observed after drug intervention. ELISA was used to detect inflammatory cytokines and oxidative stress markers levels. ROS, total iron, and Fe2+ levels were detected using corresponding assays. Additionally, HE staining detected the thickness of the epidermis and dermis of the rat wound tissue while the collagen deposition in the wound tissue was detected using Masson staining. In addition, Prussian blue staining was used to detect iron deposition, and C11 BODIPY 581/591 lipid peroxidation probe was used to detect lipid ROS. Our results suggested that the activation of SIRT1/Nrf2/p62 signaling affects cell proliferation, colony formation, ferroptosis, and the production of lipid ROS in DFU-infected cell model through autophagy. In vivo experiments indicated that activating SIRT1/Nrf2/p62 signaling affects oxidative stress, inflammation, and autophagy in wound tissue and promotes wound healing in DFU rats through mediating autophagy-dependent ferroptosis. Taken together, the activation of SIRT1/Nrf2/p62 pathway can promote DFU healing, which might be mediated by autophagy-dependent ferroptosis.

Abnormal expression of miR-454-3p in type 2 diabetes mellitus induces dysfunction of pancreatic β cells by regulating Yy1

ObjectiveImpairment of pancreatic β cells is a pathophysiological feature of type 2 diabetes mellitus (T2DM). However, whether abnormally dysregulated miR-454-3p in T2DM is related to the dysfunction of pancreatic β cell remains to be further investigated.MethodsFirst, T2DM patients and healthy subjects were recruited to measure miR-454-3p. Subsequently, pancreatic β cells were cultured with high glucose. The role of miR-454-3p in insulin synthesis, secretion, cell proliferation, and apoptosis were investigated by RT-qPCR, Glucose-stimulated insulin secretion determination, cell counting kit-8, and flow cytometry assays. The target mRNA of miR-454-3p was predicted using bioinformatics software. Then, the targeted binding relationships between the above two factors were verified through RNA Immunoprecipitation and Dual-Luciferase Reporter assays.ResultsThe expression of miR-454-3p was increased in T2DM patients and pancreatic β cells cultured with high glucose. Moreover, miR-454-3p was positively correlated with FPG and HbA1c levels in patients. In cell experiments, miR-454-3p inhibitors significantly improved the function of pancreatic β cells, including increased insulin synthesis and secretion, and promoted proliferation. Moreover, silencing Yy1 reversed the protective effect of miR-454-3p inhibitors on pancreatic β cells.ConclusionmiR-454-3p, which is dysregulated in T2DM, promotes the damage of pancreatic β cells by regulating Yy1, thus aggravating T2DM.

Cuproptosis gene characterizes the immune microenvironment of diabetic nephropathy

BACKGROUND

The cuproptosis is an intracellular copper (Cu) accumulation triggering the aggregation of mitochondrial lipoylated proteins and destabilization of iron‑sulfur (FeS) cluster proteins, leading to cell death. This copper-triggered modality of mitochondrial cell death has been associated with cuproptosis-related signature key genes (CRGs). Our study focused on the relationship between the cuproptosis CRGs and diabetic nephropathy (DN) to understand how such immune microenvironment may influence DN.

METHODS

We downloaded and compared RNA sequencing data sets of DN glomerular tissue samples vs. normal renal tissue samples (GSE142025, GSE30528, and GSE96804) from Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) between DN and control samples were screened. Immune cell subtypes infiltration and immune score were figured out via different algorithms. Consensus clustering was performed by the Ward's method to determine different phenotypes of DN. CRG key genes between two phenotypes were identified via machine learning algorithm. Logistic regression analysis was applied to establish a nomogram for assessing the risk of DN.

RESULTS

In DN samples, two genes NLRP3 and CDKN2A were positively correlated to the immune score. In contrast, six genes NFE2L2, LIAS, LIPT1, DLD, DBT and DLST were negatively correlated to the immune score. Via Consensus clustering based on cuproptosis CRG key genes, the DN samples were divided into cluster C1 and cluster C2. The cluster C1 was characterized by low cuproptosis CRG genes expression, high immune cell subtypes infiltration, and high enrichment of immune-related pathways. Cluster C2 was on the contrary, the Dicarbonyl/l-xylulose reductase (DCXR) and heat-responsive protein 12 (HRSP12) genes were related to clinical traits and the immune microenvironment, negatively correlated with most immune cell subtypes. The nomogram was constructed based on DCXR and HRSP12 showing good efficiency for the DN diagnosis.

CONCLUSION

We conclude that the immune microenvironment imbalance and metabolic disorders lead to the occurrence of DN. The signature cuproptosis genes, regulating the immune microenvironment and metabolism, represented the DN disease clustering to describe the heterogeneity and characterize immune microenvironment. Both HRSP12 and DCXR key genes are related to DN disease phenotypes and immune microenvironment characteristic and may help in DN diagnosis.

The relationship between dietary index for gut microbiota and diabetes

This study aims to explore the relationship between the Dietary Index for Gut Microbiota (DI-GM) and diabetes. In recent years, there has been increasing attention to the role of the gut microbiome in regulating host metabolism. However, the relationship between DI-GM and the risk of diabetes has not been sufficiently studied. This study utilized relevant data from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. Multiple logistic regression analysis was conducted to explore the relationship between DI-GM and the risk of diabetes. The dose-response relationship between DI-GM and the risk of diabetes was observed using restricted cubic splines (RCS). Threshold effect analysis was performed based on RCS results. Subgroup analyses were used to conduct a sensitivity analysis of the relationship between DI-GM and the risk of diabetes. The results from multiple logistic regression analysis indicated a significant negative correlation between DI-GM and the risk of diabetes (OR, 0.954, 95%CI, 0.918-0.991). RCS results also showed a significant nonlinear negative relationship between DI-GM and the risk of diabetes (P < 0.001, P for nonlinear = 0.010). The threshold effect analysis revealed that when DI-GM was below 6.191, there was a significant negative correlation between DI-GM and the risk of diabetes (OR, 0.921, 95% CI, 0.876-0.969). However, when DI-GM exceeded 6.191, the relationship between DI-GM and the risk of diabetes was no longer significant. Subgroup analysis revealed that the negative correlation between DI-GM and the risk of diabetes remained significant in Whites, participants with a poverty-income ratio > 3.5, body mass index > 24, current drinkers, never or current smokers, and those without chronic kidney disease (P < 0.05). This study demonstrates a nonlinear negative correlation between DI-GM and the risk of diabetes. Maintaining DI-GM above 6.191 may help prevent diabetes.

Overexpression of Circ-Astn1 Suppresses Hyperglycemia-Induced Endothelial Cell Damage via the miR-138-5p/SIRT1 Axis

OBJECTIVE

To elucidate the regulatory mechanism of circRNAs in diabetic retinopathy.

METHODS

Next-generation sequencing (NGS) was employed to identify circRNAs that are abnormally expressed in endothelial progenitor cells (EPCs) under hyperglycemia (HG) conditions. The regulatory mechanism and predicted targets of this circRNA were also studied via bioinformatics analysis, luciferase reporter assays, angiogenic differentiation experiments, flow cytometry, and RT-qPCR.

RESULTS

Circ-astrotactin 1 (circ-Astn1) expression was decreased in EPCs under HG conditions, and circ-Astn1 overexpression inhibited HG-induced endothelial damage. The miR-138-5p and silencing information regulator 2 related enzyme 1 (SIRT1) were identified as circ-Astn1 downstream targets, which were further verified through luciferase reporter assays. SIRT1 silencing or miR-138-5p overexpression reversed the protective effect of circ-Astn1 on HG-induced endothelial cell dysfunction, as evidenced by increased apoptosis, abnormal vascular differentiation, and inflammatory factor secretion. SIRT1 overexpression reversed miR-138-5p-induced endothelial cell dysfunction under HG conditions. In vivo experiments confirmed that circ-Astn1 overexpression promoted skin wound healing through the regulation of SIRT1.

CONCLUSIONS

These findings suggest that circ-Astn1 promotes SIRT1 expression by sponging miR-138-5p. Circ-Astn1 overexpression suppresses HG-induced endothelial cell damage via miR-138-5p/SIRT1 axis.

Acute superior mesenteric artery embolism: A case report

The incidence rate of superior mesenteric artery embolism (SMAE) is low and its mortality rate is high due to its rapid onset and progression. Due to its clinical manifestations being similar to other acute abdominal diseases, such as gastrointestinal perforation, acute appendicitis and acute pancreatitis, its misdiagnosis rate can reach 75-90%. Reducing the mortality rate of this disease is dependent upon an early diagnosis and timely surgical intervention. In the present case report, the diagnosis and treatment process of a female patient aged 83 years with SMAE were reported. The patient recovered well following timely and effective intervention. The patient was admitted due to acute abdominal pain, and computed tomography angiography (CTA) examination showed filling defect in the superior mesenteric artery (SMA). The patient was diagnosed with SMAE and underwent emergency surgical treatment for a thrombectomy and thrombolysis of the SMA under general anesthesia. After surgery, recanalization of the SMA was achieved. The patient was followed up six months later, and SMA CTA revealed that the main trunk and branches of the SMA were well visualized. In addition, relevant literature was reviewed to improve the understanding and treatment of SMAE among clinicians. If patients experience severe abdominal pain that cannot be relieved by antispasmodic drugs, SMAE should be suspected. Patients with history of atrial fibrillation, valvular heart disease and atherosclerosis need further examination. At present, there is a lack of highly sensitive and specific serological indicators. CTA can provide a diagnosis with high sensitivity and specificity.

Dapagliflozin Suppresses High Glucose-Induced Proliferation, Oxidative Stress, and Fibrosis by Reducing Mettl3-Induced m6A Modification in Marcks mRNA

Diabetic cardiomyopathy (DCM) is a common and severe complication of Diabetes mellitus (DM). Dapagliflozin (DAPA) is an oral anti-diabetic drug worldwide for the treatment of type 2 DM. However, the action and mechanism of DAPA in cardiac fibrosis during DCM remain vague. Primary cardiac fibroblasts (CFs) were incubated with high glucose (HG) in vitro. Cell proliferation was detected by MTT and EdU assays. Oxidative stress was evaluated by determining the production of reactive oxygen species and malondialdehyde. Cell fibrosis was assessed by detecting fibrosis-related proteins by western blotting. Levels of Mettl3 (Methyltransferase 3) and Marcks (myristoylated alanine-rich C kinase substrate) were measured using qRT-PCR and western blotting. The m6A modification profile was determined by methylated RNA immunoprecipitation assay and the interaction between Mettl3 and Marcks was verified using dual-luciferase reporter and RIP assays. DAPA treatment alleviated HG-induced proliferation, oxidative stress, and fibrosis in CFs. HG promoted the expression of Mettl3 in CFs. Knockdown of Mettl3 reversed HG-induced proliferation, oxidative stress, and fibrosis in CFs; moreover, forced expression of Mettl3 abolished the protective effects of DAPA on CFs under HG condition. Mechanistically, Mettl3 interacted with Marcks in CFs and induced Marcks mRNA m6A modification. HG induced high expression of Marcks in CFs. The overexpression of Marcks could counteract DAPA or Mettl3 knockdown-evoked inhibitory effects on CF proliferation, oxidative stress, and fibrosis under HG condition. Dapagliflozin suppressed HG-induced proliferation, oxidative stress, and fibrosis by reducing Mettl3-induced m6A modification in Marcks mRNA.

Favorable Trends in Mortality among Patients with Concomitant Peripheral Arterial Disease and Diabetes Mellitus over Past Two Decades

BACKGROUND

This study examines the temporal trends in diabetes and peripheral artery disease (PAD)-related mortality in the United States, considering sociodemographic and regional factors, using data from death certificates in a national public database.

METHODS

Data were extracted from the Centers for Disease Control and Prevention Wide Ranging Online Data for Epidemiologic Research database from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 individuals and annual percent changes (APCs) with 95% confidence intervals (CI) were calculated.

RESULTS

Between 1999 and 2020, there were 2,252,252 PAD-related and 5,413,811 diabetes-related deaths, with 469,699 deaths involving both conditions. The overall AAMR for PAD and diabetes-related mortality (aged ≥25 years) decreased from 7.97 in 1999 to 6.37 in 2020, with a notable decline from 2001 to 2010 (APC: -6.16, 95% CI: -7.07, -5.23). The AAMR for PAD-related mortality fell from 40.25 to 30.56, while the AAMR for diabetes-related deaths rose from 76.71 to 93.63. Males and non-Hispanic (NH) Black individuals had higher AAMRs than females and other racial groups. The highest crude mortality rate was in the 80-84 age group. Nonmetropolitan areas consistently reported higher AAMRs than metropolitan areas, and states like Ohio, Vermont, District of Columbia, and West Virginia had significantly higher rates.

CONCLUSIONS

Over 2 decades, PAD- and diabetes-related mortality trends show a positive overall reduction in AAMR. However, disparities persist, with higher rates among males, NH Black individuals, and residents of nonmetropolitan areas. Significant state-level variations highlight the need for targeted interventions and tailored health-care strategies.

Antidiabetic potency of glimepiride and naringin: an in silico and in vitro investigation

Glimepiride (GLM) is one of the potential antidiabetic drugs used in clinics for a long time. It is currently used in combination with metformin along with other drugs, but has shown various complications in patients from long-term use. Thus, the hypothesis is to use a lower dose of GLM with a non-toxic class of flavonoid, naringin (NARN), for better therapy with minimal side-effects. Initially, we assessed the binding efficacy of GLM and NARN against nine putative target enzymes using AutoDock 4.2 software. We also analysed the drug chemistry, drug-ability, and cytotoxicity, as well as performed molecular dynamic (MD) simulation at 100 ns with individual and combination states using GROMACS-2022 software. Both candidates showed higher binding efficacy, especially against the AKT-serine/threonine kinase-1 (AKT1) target enzyme (-11.85 kcal/mol), and demonstrated higher stability and compatibility with AKT1 from MD-simulation (based on RMSD, Rg, RMSF, and H-bond plots) in combination than individual form. The in vitro cytotoxicity with human embryonic kidney (HEK-293) cells suggested 100 µg/mL (observed 80% of the cell viability) as a non-toxic dose for further study. Alpha-amylase, alpha-glucosidase, and DPP-IV inhibition assays revealed that both GLM and NARN inhibited up to 60% at 100 µg/mL in a concentration-dependent manner. At the end, selecting a lower dose of GLM and a higher dose of NARN (2:8 v/v ratio) showed up to 87% inhibition at 100 µg/mL. Both in silico and in vitro studies suggest that the investigated formulation could be a potential and non-toxic dose for diabetics.

Pharmacological Mechanisms of Bile Acids Targeting the Farnesoid X Receptor

Bile acids (BAs), a category of amphiphilic metabolites synthesized by liver cells and released into the intestine via the bile duct, serve a vital role in the emulsification of ingested fats during the digestive process. Beyond their conventional emulsifying function, BAs, with their diverse structures, also act as significant hormones within the body. They are pivotal in facilitating nutrient absorption by interacting with the farnesoid X receptor (FXR), and they serve as key regulators of lipid and glucose metabolism, as well as immune system balance. Consequently, BAs contribute to the metabolism of glucose and lipids, enhance the digestion and absorption of lipids, and maintain the equilibrium of the bile pool. Their actions are instrumental in addressing obesity, managing cholestasis, and treating diabetes, and are involved in the onset and progression of cancer. This paper presents an updated systematic review of the pharmacological mechanisms by which BAs target the FXR, incorporating recent findings and discussing their signaling pathways in the context of novel research, including their distinct roles in various disease states and populations. The aim is to provide a theoretical foundation for the continued research and clinical application of BAs.

Application value of high-pressure-resistant peripherally inserted central catheters in enhanced computer tomography of diabetic patients with malignant tumors

BACKGROUND

Individuals with diabetes mellitus have a higher risk of developing malignant tumors, and diagnosing these tumors can be challenging.

AIM

To confirm the benefits of using peripherally inserted central catheters (PICCs) in contrast-enhanced computerized tomography (CECT) for diagnostic imaging in diabetic patients with malignant tumors and to provide a research basis for follow-up research.

METHODS

This retrospective study analyzed 204 diabetic patients with malignancies treated at The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, from January 2024 to June 2024. The patients were divided into two groups: A control group (n = 102) with indwelling peripheral intravenous catheters and a research group (n = 102) with high-pressure-resistant PICC. The study compared baseline data, the incidence of iodine contrast extravasation during CECT, the incidence of adverse events (discomfort, redness and swelling at the puncture site, and blood oozing), imaging quality, nursing time, intubation success rate, number of venipuncture attempts, and catheter maintenance cost.

RESULTS

Male patients accounted for 51.96% in the control group and 55.88% in the research group; the average age was (59.68 ± 11.82) years in the control group and (61.41 ± 12.92) years in the research group; the proportions of lung cancer, colorectal cancer, and gastric cancer patients in the control group were 42.16%, 38.24%, and 19.61%, respectively, while those in the research group were 34.31%, 37.25%, and 28.43%, respectively. Except for the gender distribution, age, and cancer type mentioned above, other general information such as underlying diseases, puncture location, and long-term chemotherapy shows no significant differences as tested (P > 0.05). The results showed that the research group had significantly reduced incidence of iodine contrast extravasation (7 vs 1, P = 0.031), similar incidence of adverse events (11 vs 7, P = 0.324), reduced nursing time [(18.50 ± 2.68) minutes vs (13.26 ± 3.00) minutes, P = 0.000], fewer venipuncture attempts [(2.21 ± 0.78) times vs (1.49 ± 0.58) times, P = 0.000], lower catheter maintenance cost [(1251.79 ± 205.47) China yuan (CNY) vs (1019.25 ± 117.28) CNY, P = 0.000], increased intubation success rate (16.67% vs 58.82%, P = 0.000), and better imaging quality (85.29% vs 94.12%, P = 0.038).

CONCLUSION

High-pressure-resistant PICCs can lessen the physical burden of diabetic patients during nursing, reduce treatment costs, and improve the efficiency and quality of imaging for diagnosis malignant tumors.

Bile acids as a key target: traditional Chinese medicine for precision management of insulin resistance in type 2 diabetes mellitus through the gut microbiota-bile acids axis

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease caused by insulin resistance (IR) and insufficient insulin secretion. Its characteristic pathophysiological processes involve the interaction of multiple mechanisms. In recent years, globally, the prevalence of T2DM has shown a sharp rise due to profound changes in socio-economic structure, the persistent influence of environmental factors, and the complex role of genetic background. It is worth noting that most T2DM patients show significant IR, which further exacerbates the difficulty of disease progression and prevention. In the process of extensively exploring the pathogenesis of T2DM, the dynamic equilibrium of gut microbes and its diverse metabolic activities have increasingly emphasized its central role in the pathophysiological process of T2DM. Bile acids (BAs) metabolism, as a crucial link between gut microbes and the development of T2DM, not only precisely regulates lipid absorption and metabolism but also profoundly influences glucose homeostasis and energy balance through intricate signaling pathways, thus playing a pivotal role in IR progression in T2DM. This review aims to delve into the specific mechanism through which BAs contribute to the development of IR in T2DM, especially emphasizing how gut microbes mediate the metabolic transformation of BAs based on current traditional Chinese medicine research. Ultimately, it seeks to offer new insights into the prevention and treatment of T2DM. Diet, genetics, and the environment intricately sculpt the gut microbiota and BAs metabolism, influencing T2DM-IR. The research has illuminated the significant impact of single herbal medicine, TCM formulae, and external therapeutic methods such as electroacupuncture on the BAs pool through perturbations in gut microbiota structure. This interaction affects glucose and lipid metabolism as well as insulin sensitivity. Additionally, multiple pathways including BA-FXR-SHP, BA-FXR-FGFR15/19, BA-FXR-NLRP3, BA-TGR5-GLP-1, BAs-TGR5/FXR signaling pathways have been identified through which the BAs pool significantly alter blood glucose levels and improve IR. These findings offer novel approaches for enhancing IR and managing metabolic disorders among patients with T2DM.

New natural protein tyrosine phosphatase 1B inhibitors from Gynostemma pentaphyllum

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease mainly caused by insulin resistance, which can lead to a series of complications such as cardiovascular disease, retinopathy, and its typical clinical symptom is hyperglycaemia. Glucosidase inhibitors, including Acarbose, Miglitol, are commonly used in the clinical treatment of hypoglycaemia. In addition, Protein tyrosine phosphatase 1B (PTP1B) is also an important promising target for the treatment of T2DM. Gynostemma pentaphyllum is a well-known oriental traditional medicinal herbal plant, and has many beneficial effects on glucose and lipid metabolism. In the present study, three new and nine known dammarane triterpenoids isolated from G. pentaphyllum, and their structures were elucidated by spectroscopic methods including HR-ESI-MS,1H and 13C NMR and X-ray crystallography. All these compounds were evaluated for inhibitory activity against α-glucosidase, α-amylase and PTP1B. The results suggested that compounds 7∼10 were potential antidiabetic agents with significantly inhibition activity against PTP1B in a dose-dependent manner.

Lignan-rich extract from Cinnamomum camphora leaf attenuates metabolic syndrome by modulating glycolipid metabolism and gut microbiota in T2DM mice

BACKGROUND

Type 2 diabetes mellitus (T2DM) is a serious metabolic syndrome with high mortality and disability rates globally, which usually caused by unhealthy dietary patterns. Cinnamomum camphora leaf is a traditional Chinese medicinal herb used for attenuating hyperglycemia and digestive disorder, and high level of lignans has been found in C. camphora leaf.

PURPOSE

This study aimed to examine the chemical composition of lignans extracted from C. camphora leaf (LCCL), and illustrate its therapeutic effect and mechanism on T2DM and its concomitant glycolipid metabolic disorder.

METHODS

The components of LCCL were separated and purified by silica gel and macroporous adsorption resin, and were distinguished through LC/MS and NMR. The antioxidant activity of LCCL was determined by free radical scavenging assay in vitro; the hypoglycemic and hypolipidemic abilities were evaluated by α-glucosidase, α-amylase and pancreatic lipase inhibition trials, respectively. T2DM model mice were established by high-sugar and high-fat (HSHF) feed together with streptozotocin (STZ) infection, and then grouped to assess the effect of LCCL treatment. Hematoxylin-eosin (H&E), Periodic Acid-Schiff (PAS) and oil red O staining were employed to analyze the histopathology. qRT-PCR assay, 16S rRNA analysis, and western blot were conducted to illuminate the anti-diabetic mechanism of LCCL.

RESULTS

6 sesamin lignans were identifed from LCCL. The in vitro assays showed strong inhibitive abilities of LCCL with low IC50 on DPPH (33.68 ± 0.54 μg/ml),O2- (39.25 ± 0.61 μg/ml), OH• (45.72 ± 0.72 μg/ml), α-glucosidase (0.82 ± 0.14 mg/ml), α-amylase (0.86 ± 0.11 mg/ml) and pancreatic lipase (0.91 ± 0.12 mg/ml). LCCL treatment (100, 200 and 400 g kg-1mg kg-1) gradually decreased the fasting blood glucose (FBG) and fasting insulin (FINS), improved the glucose and insulin tolerance, down-regulated the homeostasis model assessment insulin resistance (HOMA-IR) indexes, alleviated the hepatic inflammatory response and oxidative stress, promoted the glycogen storage and depleted the fat accumulation in the liver. Besides, LCCL administration alleviated the glycolipid metabolism disorder in T2DM mice with a gut microbiota dependent manner, that significantly increased biodiversity, altered the composition of gut microbiota and increased the proportion of Lactobacillus.

CONCLUSION

The lignan-rich extract of C. camphor leaf (LCCL), containing at least 6 lignans compounds, displayed promising antioxidant, hypoglycemic and hypolipidemic activities. The treatment of LCCL alleviated the glycolipid metabolism disorder in T2DM mice with a gut microbiota dependent manner. These finding suggested that LCCL should be further investigated to develop its complementary therapeutic effect on T2DM.

Alpha-glucosidase and α-amylase inhibitory activity of Pistacia atlantica Desf. gall extracts and identification of putative bioactives using a combined UPLC fingerprinting and molecular docking approach

Aims

Pistacia atlantica Desf. (Anacardiaceae) is traditionally used in Mediterranean medicine, with previous studies showing antidiabetic potential in its fruits and leaves. This study evaluates the antidiabetic activity of P. atlantica galls (PAG) extracts using in vitro, chemometric, and in silico approaches.

Method

The antidiabetic activity of the samples were studied by measuring their half-maximal inhibitory concentrations (IC50s) concentrations according to the in vitro enzyme inhibition assays and modelled as a function of the LC fingerprints using the partial least squares technique. Crystal structures of the human pancreatic α-amylase (HPA) and the α-glucosidase homologue isomaltase were obtained from the Protein Data Bank website (http://www.rcsb.org/pdb). Docking simulations and calculations were carried out using AutoDock Vina.

Results

PAG extracts inhibited HPA (IC50s ranging from 1.85 to 2.92 mg/mL) and α-glucosidase (IC50s ranging from 34 to 49 µg/mL) activities, with galls collected from male plants showing higher activity than those from female plants. UPLC fingerprinting, linked to chemometric analysis using a partial least squares regression model, putatively identified five compounds (quinic acid, methyl gallate, digalloyl quinic acid, methyl digallate, and valoneic acid dilactone) responsible for this antidiabetic effect. Molecular docking using AutoDock Vina revealed that the identified compounds interacted with key amino acid residues of HPA and α-glucosidase.

Conclusions

By employing UPLC fingerprinting combined with chemometric analysis and molecular docking simulations, quinic acid and digalloyl quinic acid were identified from P. atlantica gall extract as the most promising ligands for further investigation into their antidiabetic potential.

Graphical Abstract

SRSF2 is essential for maintaining pancreatic beta-cell identity and regulating glucose homeostasis in mice

Diabetes is characterized by decreased beta-cell mass and islet dysfunction. The splicing factor SRSF2 plays a crucial role in cell survival, yet its impact on pancreatic beta cell survival and glucose homeostasis remains unclear. We observed that the deletion of Srsf2 specifically in beta cells led to time-dependent deterioration in glucose tolerance, impaired insulin secretion, decreased islet mass, an increased number of alpha cells, and the onset of diabetes by the age of 10 months in mice. Single-cell RNA sequencing (scRNA-seq) analyses revealed that, despite an increase in populations of unfolded protein response (UPR)-activated and undifferentiated beta cells within the SRSF2_KO group, there was a notable decrease in the expression of UPR-related and endoplasmic reticulum (ER)-related genes, accompanied by a loss of beta-cell identity. This suggests that beta cells have transitioned from an adaptive phase to a maladaptive phase in islets of 10-month-old SRSF2_KO mice. Further results demonstrated that deletion of SRSF2 caused decreased proliferation in beta cells within 3-month-old islets and Min6 cells. These findings underscore the essential role of SRSF2 in controlling beta-cell proliferation and preserving beta-cell function in mice.

Machine learning-driven discovery of novel therapeutic targets in diabetic foot ulcers

BACKGROUND

To utilize machine learning for identifying treatment response genes in diabetic foot ulcers (DFU).

METHODS

Transcriptome data from patients with DFU were collected and subjected to comprehensive analysis. Initially, differential expression analysis was conducted to identify genes with significant changes in expression levels between DFU patients and healthy controls. Following this, enrichment analyses were performed to uncover biological pathways and processes associated with these differentially expressed genes. Machine learning algorithms, including feature selection and classification techniques, were then applied to the data to pinpoint key genes that play crucial roles in the pathogenesis of DFU. An independent transcriptome dataset was used to validate the key genes identified in our study. Further analysis of single-cell datasets was conducted to investigate changes in key genes at the single-cell level.

RESULTS

Through this integrated approach, SCUBE1 and RNF103-CHMP3 were identified as key genes significantly associated with DFU. SCUBE1 was found to be involved in immune regulation, playing a role in the body's response to inflammation and infection, which are common in DFU. RNF103-CHMP3 was linked to extracellular interactions, suggesting its involvement in cellular communication and tissue repair mechanisms essential for wound healing. The reliability of our analysis results was confirmed in the independent transcriptome dataset. Additionally, the expression of SCUBE1 and RNF103-CHMP3 was examined in single-cell transcriptome data, showing that these genes were significantly downregulated in the cured DFU patient group, particularly in NK cells and macrophages.

CONCLUSION

The identification of SCUBE1 and RNF103-CHMP3 as potential biomarkers for DFU marks a significant step forward in understanding the molecular basis of the disease. These genes offer new directions for both diagnosis and treatment, with the potential for developing targeted therapies that could enhance patient outcomes. This study underscores the value of integrating computational methods with biological data to uncover novel insights into complex diseases like DFU. Future research should focus on validating these findings in larger cohorts and exploring the therapeutic potential of targeting SCUBE1 and RNF103-CHMP3 in clinical settings.

Flavokawain B is an effective natural peroxisome proliferator-activated receptor γ-selective agonist with a strong glucose-lowering effect

Rosiglitazone, a full PPARγ agonist and a classical insulin sensitizer, was once used as a powerful weapon in the treatment of T2DM. However, its applications have been restricted recently because of its multiple side effects. Here, a natural compound, flavokawain B (FKB), which was screened in our previous experiments, was investigated for its potential as a preferable insulin sensitizer because it has no or few side effects. Using the surface plasmon resonance (SPR) technique, we confirmed that FKB is a natural ligand for PPARγ with high binding affinity. In in vitro experiments, FKB significantly increased 2-NBDG uptake in HepG2 and 3T3-L1 cells, which partially stimulated PPARγ transcriptional activity. Compared with rosiglitazone, FKB had little effect on the adipose differentiation of 3T3-L1 cells, and all of these features suggest that FKB is a selective modulator of PPARγ (SPPARγM). Moreover, FKB increased the mRNA expression levels of most genes related to insulin sensitivity and glucose metabolism but had no obvious effect on those related to adipose differentiation. In vivo experiments confirmed that FKB effectively decreased abnormal fasting blood glucose and postprandial blood glucose levels and reduced glycated hemoglobin levels, similar to rosiglitazone, in HFD-fed/STZ-treated and db/db mice, two T2DM animal models, but did not cause side effects, such as weight gain or liver or kidney damage. Further investigation revealed that FKB could inhibit PPARγ-Ser273 phosphorylation, which is the key mechanism involved in improving insulin resistance. Together, FKB is a well-performing SPPARγM that exerts a powerful glucose-lowering effect without causing the same side effects as rosiglitazone, and it may have great potential for development.

Correlations between the long noncoding RNA MEG3 and clinical characteristics for diabetic kidney disease in type 2 diabetes mellitus

BACKGROUND AND AIMS

Diabetic kidney disease (DKD) is a common complication of type 2 diabetes mellitus (T2DM) that leads to systemic inflammation. Maternally expressed gene 3 (MEG3) is a tumor suppressor that is involved in inflammation regulation. The current study investigated the association between DKD and the prevalence of the single-nucleotide polymorphisms (SNPs) of MEG3.

METHODS

A total of 706 and 735 patients were included in the DKD and non-DKD groups, respectively. The five SNPs of MEG3, namely rs4081134 (G/A), rs10144253 (T/C), rs7158663 (G/A), rs3087918 (T/G), and rs11160608 (A/C), were genotyped using TaqMan allelic discrimination.

RESULTS

Our results revealed that, in the DKD group, the distribution of the GG genotype of the MEG3 SNP rs3087918 was significantly lower than that of the wild-type genotype (AOR: 0.703, 95% CI: 0.506-0.975, P = 0.035). In addition, in the pre-ESRD DKD subgroup, the distribution of the TG + GG genotype of the MEG3 SNP rs3087918 was significantly lower than that of the wild-type genotype (AOR: 0.637, 95% CI: 0.421-0.962, P = 0.032). In addition, among men in the DKD subgroup, the distribution of the GG genotype of the MEG3 SNP rs3087918 was significantly lower than that of the wild-type genotype (AOR: 0.630, 95% CI: 0.401-0.990, P = 0.045). Glycated hemoglobin (HbA1c) level was significantly higher in all T2DM patients with the wild-type genotype of the MEG3 SNP rs3087918 (P = 0.020). In addition, HbA1c levels were significantly higher in male patients and male DKD patients with the wild-type genotype of the MEG3 SNP rs3087918 (P = 0.032 and 0.031, respectively).

CONCLUSION

MEG3 SNP rs3087918 is significantly less prevalent in patients with DKD, and the SNP rs3087918 of MEG3 is associated with lower HbA1c levels.

Research Progress on Peptide Drugs for Type 2 Diabetes and the Possibility of Oral Administration

Diabetes is a global disease that can lead to a range of complications. Currently, the treatment of type 2 diabetes focuses on oral hypoglycemic drugs and insulin analogues. Studies have shown that drugs such as oral metformin are useful in the treatment of diabetes but can limit the liver's ability to release sugar. The development of glucose-lowering peptides has provided new options for the treatment of type 2 diabetes. Peptide drugs have low oral utilization due to their easy degradation, short half-life, and difficulty passing through the intestinal mucosa. Therefore, improving the oral utilization of peptide drugs remains an urgent problem. This paper reviews the research progress of peptide drugs in the treatment of diabetes mellitus and proposes that different types of nano-formulation carriers, such as liposomes, self-emulsifying drug delivery systems, and polymer particles, should be combined with peptide drugs for oral administration to improve their absorption in the gastrointestinal tract.

Bidirectional relationship between diabetes mellitus and depression: Mechanisms and epidemiology

Diabetes mellitus and depression exhibit a complex bidirectional relationship that profoundly impacts patient health and quality of life. This review explores the physiological mechanisms, including inflammation, oxidative stress, and neuroendocrine dysregulation, that link these conditions. Psychosocial factors such as social support and lifestyle choices also contribute significantly. Epidemiological insights reveal a higher prevalence of depression among diabetics and an increased risk of diabetes in depressed individuals, influenced by demographic variables. Integrated management strategies combining mental health assessments and personalized treatments are essential. Future research should focus on longitudinal and multi-omics studies to deepen understanding and improve therapeutic outcomes.

Examining the impact of polyfluoroalkyl substance exposure on erythrocyte profiles and its related nutrients: Insights from a prospective study on young Taiwanese

Per- and polyfluoroalkyl substances (PFAS) constitute a group of synthetic chemicals extensively utilized across various commonplace products. PFAS are known to have various toxic effects on human health. The relationship between PFAS exposure and erythrocytes has been a subject of interest in epidemiological research, but so far, only limited cross-sectional studies have investigated. Additionally, the role of erythrocyte related nutrition indicators on PFAS-induced changes in erythrograms has not been explored. To fill these knowledge gaps, we launched a longitudinal study over a decade, tracking 502 adolescents and young adults aged 12 to 30 from the YOung TAiwanese Cohort (YOTA). Our analysis encompassed 11 types of plasma PFAS, as well as erythrograms and serum levels of ferritin, transferrin saturation, vitamin B12, and folate. Our examination unveiled positive associations between specific average levels of PFAS compounds, including linear perfluorooctanoic acid (PFOA), branched perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS), and transferrin saturation. Furthermore, linear PFOA and both linear and branched PFOS were negatively correlated with vitamin B12 levels. Specifically, we observed that the average linear PFOA demonstrated positive correlations with mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH), while average PFNA also exhibited positive associations with hemoglobin (Hb) and hematocrit (Hct) in a multiple linear regression model. Subsequent analysis revealed noteworthy interactions between vitamin B12 and PFNA, as well as folate and PFNA, in the context of their impact on Hb, Hct, and PFNA relationships. Additionally, an interaction with transferrin saturation was identified in the correlation between Hct and PFNA. These findings suggest a plausible link between PFAS exposure and erythrograms among young populations, underscoring the potential involvement of iron status, vitamin B12, and folate in this association. Further studies are imperative to elucidate the precise effects of PFAS on erythrocyte in human subjects.

Clinical practice guidelines of foot care practice for patients with type 2 diabetes: A scoping review using self-care model

BACKGROUND

Type 2 diabetes can lead to severe foot complications, making self-care education, guided by clinical guidelines, crucial. However, fragmented and dispersed recommendations challenge effective implementation of these guidelines. Bringing together recommendations and presenting them according to a self-care model can provide a solid framework and facilitate the interpretation of results.

AIMS

to map the international guidelines that provide recommendations to nurses to enable people with type 2 diabetes for foot self-care and synthesize the recommendations according to the key concepts of the middle-range theory of self-care for chronic diseases.

DESIGN

A scoping review was undertaken, using the methodological guidance of the Joanna Briggs Institute.

DATA SOURCES

Databases were searched between September 2022 and June 2023, including PubMed, CINAHL, PsycINFO, Scopus, Web of Science Core Collection, ProQuest Dissertations and Theses Global, guideline websites and related professional association websites. The databases were chosen for their comprehensive coverage of the area.

METHODS

Eligible articles included guidance documents providing foot care recommendations for diabetes, published or updated between 2013 and 2023. Two reviewers summarized the recommendations presented in at least two guidelines according to the key concepts of the self-care model. The PRISMA-ScR checklist was used.

RESULTS

Seventeen guidelines were included. In total, we synthesized 175 recommendations. The recommendations were framed in three dimensions and their respective categories: Self-care maintenance (education for prevention, control of risk factors, daily foot care, footwear, and socks), Self-care monitoring (foot inspection, detection of signs of infection, and detection of other diabetes-related foot disease complications), and Self-care management (responses to signs and symptoms, foot wound care, follow-up with health professionals, and health services).

CONCLUSIONS

The main aspect of foot care revolves around daily care, including cleaning, moisturizing, nail care, selecting appropriate footwear, and regular inspection of both feet and footwear.

Exploration of alpha-glucosidase inhibitors: A comprehensive in silico approach targeting a large set of triazole derivatives

BACKGROUND

The increasing prevalence of diabetes and the side effects associated with current medications necessitate the development of novel candidate drugs targeting alpha-glucosidase as a potential treatment option.

METHODS

This study employed computer-aided drug design techniques to identify potential alpha-glucosidase inhibitors from the PubChem database. Molecular docking was used to evaluate 81,197 compounds, narrowing the set for further analysis and providing insights into ligand-target interactions. An ADMET study assessed the pharmacokinetic properties of these compounds, including absorption, distribution, metabolism, excretion, and toxicity. Molecular dynamics simulations validated the docking results.

RESULTS

9 compounds were identified as potential candidate drugs based on their ability to form stable complexes with alpha-glucosidase and their favorable pharmacokinetic profiles, three of these compounds were subjected to the molecular dynamics, which showed stability throughout the entire 100 ns simulation.

CONCLUSION

These findings suggest promising new alpha-glucosidase inhibitors for diabetes treatment. Further validation through in vitro and in vivo studies is recommended to confirm their efficacy and safety.

In vivo and computational investigation of butin against alloxan-induced diabetes via biochemical, histopathological, and molecular interactions

Herbs have been used as medicines since antiquity, and it has been discovered that the human body responds well to herbal remedies. Research on the effect of butin was conducted in the current study in the alloxan-induced diabetic rat paradigm. A total of 30 Wistar rats were randomly assigned into the following groups (n = 6): I-Normal; II-Alloxan-induced (50 mg/kg); III-Alloxan + butin 25 mg/kg; IV-Alloxan + butin 50 mg/kg; V-Butin per se 50 mg/kg. Various diabetic parameters (blood glucose, insulin, HbA1c), lipid profile, inflammatory (TNF-α, IL-1β, IL-6 and NF-κB), antioxidant enzymes (CAT, SOD and GSH), oxidative stress indicators (MDA), apoptosis marker (caspase-3), hepatic markers (ALT and AST), and histopathological changes were assessed. Additionally, molecular docking and dynamics were performed to evaluate the interaction of butin with target proteins. Butin treatment, at both doses, significantly restored biochemical parameters and preserved pancreatic histopathology in diabetic rats. It effectively modulated blood parameters, lipid profiles, inflammatory markers, apoptosis, antioxidant enzyme activity, oxidative stress, and hepatic markers. Molecular docking revealed that butin binds to proteins such as caspase-3 (1NME), NF-κB (1SVC), and serum insulin (4IBM) with binding affinities of - 7.4, - 6.5, and - 8.2 kcal/mol, respectively. Molecular dynamics simulations further suggested that butin induces significant conformational changes in these proteins. Butin exhibits potential effects against alloxan-induced diabetic rats by restoring biochemical balance, reducing inflammation, and protecting pancreatic tissue. Its binding to key proteins involved in apoptosis and inflammation highlights its therapeutic potential in diabetes management.

Predictive value of interleukin-6 combined with serum neuron-specific enolase on the prognosis of acute ischemic stroke

OBJECTIVE

To explore the prognostic value of interleukin-6 (IL-6) combined with serum neuron specific enolase (NSE) in arterial atherosclerotic ischemic stroke.

METHODS

116 patients with arterial atherosclerotic ischemic stroke admitted to the emergency ward of our Hospital were retrospectively analyzed. According to the score of modified Rankin scale (mRS) at 90 days after discharge, the patients were divided into the poor prognosis group (mRS > 2, n = 32) and the good prognosis group (mRS ≤ 2, n = 84). Activities of Daily Living (ADL) was used to evaluate the level of independence in activities of daily living after treatment.

RESULTS

The NIHSS score (14.91 ± 5.20 vs. 9.43 ± 4.30, P < 0.001), IL-6 (11.30 ± 3.11 vs. 6.75±1.28, P < 0.001) and NSE levels (12.47 ± 4.69 vs. 6.42 ± 1.32, P<0.001) in poor prognosis group were higher than those in the good prognosis group. At 90 days post-discharge, 100 % of the good prognosis group had ADL scores over 60, while in the poor prognosis group, 46.88 % scored 40-60, 40.63 % scored 20-40, 9.38 % scored under 20, and 3.13 % died. The AUC of NSE was 0.906 (95 % CI: 0.847-0.965, P < 0.001), the best cut-off value was 7.445 ng/mL, and the sensitivity and specificity were 75.0 % and 82.1 %, respectively. The AUC for IL-6 combined with NSE increased to 0.965 (95 %CI: 0.934-0.997, P < 0.001), and the sensitivity and specificity increased to 80.2 % and 92.9 %, respectively.

CONCLUSION

IL-6 ≥ 6.805 pg/mL and NSE ≥ 7.445 ng/mL were independently associated with poor prognosis in patients with AIS, and the combined testing of the two indicators had a higher predictive value. These results suggested that the combined assay of IL-6 and NSE could be a novel marker for predicting poor prognosis in AIS.

Knowledge and Awareness of Type 2 Diabetes Complications in Conflict-Affected Regions: A Cross-Sectional Study in Homs, Syria

Background Diabetes mellitus is a significant global health problem characterized by high blood sugar levels due to either a lack of insulin or insensitivity to it. Concerns about diabetes complications are growing both globally and locally, making effective preventive measures crucial to tackle these complications. This research aimed to determine the level of knowledge and awareness regarding type 2 diabetes complications among patients in Homs, Syria, during the ongoing conflict. Methods A cross-sectional study was conducted among 1016 diabetic patients aged 16 years and above attending internal medicine and diabetes clinics in Homs City through a structured questionnaire administered via social media, telephone interviews, and paper forms. The data collected were analyzed using SPSS version 23.0 (IBM Corp., Armonk, USA). Descriptive statistics were used to summarize the demographic characteristics. In contrast, inferential statistics such as the chi-square test were used to test for associations between different variables with p-value < 0.05 as the significance level. Results The study found that 478 (47.1%) of participants were male, and 538 (53%) were female. The majority 652 (64.2%) were between 46 and 70 years old, and 422 (41.5%) had primary-level education. Most were married 750 (73.8%) and lived in urban areas 856 (84.2%). Diabetes knowledge varied significantly by age, education, occupation, and residence. Housewives and those with lower education levels had the least knowledge, while urban residents and those with 1-5 years since diagnosis had better awareness. Individuals with relatives in the medical field had higher knowledge levels. Results indicate that gender did not significantly influence diabetes knowledge (p = 0.19), while younger adults showed poorer awareness compared to older age groups (p < 0.05). Higher education levels were associated with better knowledge (p < 0.05), and a family history of diabetes correlated with greater awareness of complications. Occupation significantly impacted knowledge, with employed individuals and urban residents demonstrating higher awareness levels (p < 0.05). Diabetes knowledge peaked during the 6-10 year disease duration (p < 0.05). Conclusion This study assesses diabetes knowledge and management practices among 1016 participants in Homs, Syria, focusing on demographic and socioeconomic factors. Our findings underscore the need for targeted educational initiatives to improve diabetes management, particularly among younger, less educated, and rural populations in Homs. The analysis reveals significant knowledge gaps about diabetes across different demographics in Homs, highlighting the need for targeted educational programs, especially for younger individuals, the less educated, and rural residents. The study emphasizes the importance of education and medical practice in understanding diabetes, particularly in conflict-affected areas.