1
|
Sugandh F, Chandio M, Raveena F, Kumar L, Karishma F, Khuwaja S, Memon UA, Bai K, Kashif M, Varrassi G, Khatri M, Kumar S. Advances in the Management of Diabetes Mellitus: A Focus on Personalized Medicine. Cureus 2023; 15:e43697. [PMID: 37724233 PMCID: PMC10505357 DOI: 10.7759/cureus.43697] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/17/2023] [Indexed: 09/20/2023] Open
Abstract
Diabetes mellitus poses a substantial global health challenge, necessitating innovative approaches to improve patient outcomes. Conventional one-size-fits-all treatment strategies have shown limitations in addressing the diverse nature of the disease. In recent years, personalized medicine has emerged as a transformative solution, tailoring treatment plans based on individual genetic makeup, lifestyle factors, and health characteristics. This review highlights the role of genetic screening in predicting diabetes susceptibility and response to treatment, as well as the potential of pharmacogenomics in optimizing medication choices. Moreover, it discusses the incorporation of lifestyle modifications and behavioral interventions to empower patients in their health journey. Telemedicine and remote patient monitoring are also examined for their role in enhancing accessibility and adherence. Ethical considerations and challenges in implementing personalized medicine are addressed. The review envisions a future where personalized medicine becomes a cornerstone in diabetes management, ensuring improved patient outcomes and fostering more effective and patient-centric care on a global scale.
Collapse
Affiliation(s)
- Fnu Sugandh
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
- Medicine, Civil Hospital Karachi, Karachi, PAK
| | - Maria Chandio
- Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Fnu Raveena
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Lakshya Kumar
- General Medicine, Pandit Deendayal Upadhyay Medical College, Rajkot, IND
| | - Fnu Karishma
- Medical School, Jinnah Sindh Medical University, Karachi, PAK
| | - Sundal Khuwaja
- Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Unaib Ahmed Memon
- Neurology, Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Karoona Bai
- Internal Medicine, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
| | - Maham Kashif
- Medicine, Khawaja Muhammad Safdar Medical College, Sialkot, PAK
| | | | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| |
Collapse
|
2
|
Hu B, Li D, Tang D, Shangguan Y, Cao Y, Guo R, Luan S, Yun C, Morgera S, Hocher B, Krämer BK, Wang Y, Yin L, Dai Y. Integrated proteome and acetylome analyses unveil protein features of gestational diabetes mellitus and preeclampsia. Proteomics 2022; 22:e2200124. [PMID: 36097143 DOI: 10.1002/pmic.202200124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 08/17/2022] [Accepted: 08/25/2022] [Indexed: 12/29/2022]
Abstract
Gestational diabetes mellitus (GDM) and preeclampsia (PE) are associated with maternal and infant health. Although the pathogenesis of PE and GDM remains controversial, oxidative stress is involved in the underlying pathology of GDM and PE. Protein lysine acetylation (Kac) plays an important regulatory role in biological processes. There is little data regarding the association of the maternal acetylome with GDM and PE. This study aimed to assess the potential value of the proteome and acetylome for GDM and PE. In our study, we included placental tissues from healthy individuals (n = 6), GDM patients (n = 6), and PE patients (n = 6) to perform 4D-label free quantification proteomics analysis and PRM analysis. We identified 22 significantly regulated proteins and 192 significantly regulated acetylated proteins between the GDM and PE groups. Furthermore, 192 significantly regulated acetylated proteins were mainly enriched in endoplasmic reticulum stress (ERS) and ferroptosis pathways. Seventeen acetylated sites in these two pathways were verified by PRM analysis. Our comprehensive analysis revealed key features of GDM/PE-significantly regulated acetylated proteins in the placentas from GDM and PE. The results of signaling pathway analysis focused on ERS and ferroptosis. These findings may help explore the underlying pathology, new biomarkers, and therapeutic targets of GDM and PE.
Collapse
Affiliation(s)
- Biying Hu
- Clinical Medical Research Center, Guangdong Clinical Medical Research Center of Birth Defects, the Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Jinan University, Shenzhen, Guangdong, China.,Institute of Nephrology and Blood Purification, the First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, Guangdong, China
| | - Dandan Li
- Clinical Medical Research Center, Guangdong Clinical Medical Research Center of Birth Defects, the Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Jinan University, Shenzhen, Guangdong, China
| | - Donge Tang
- Clinical Medical Research Center, Guangdong Clinical Medical Research Center of Birth Defects, the Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Jinan University, Shenzhen, Guangdong, China
| | - Yu Shangguan
- Clinical Medical Research Center, Guangdong Clinical Medical Research Center of Birth Defects, the Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Jinan University, Shenzhen, Guangdong, China
| | - Yuzhi Cao
- Department of Obstetrics and Gynecology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Ruonan Guo
- Department of Obstetrics and Gynecology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Shaodong Luan
- Department of Nephrology, Shenzhen Longhua District Central Hospital, Guangdong, Guangdong, China
| | - Chen Yun
- Charité -Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.,Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Heidelberg, Germany
| | | | - Berthold Hocher
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Bernhard K Krämer
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Yinglan Wang
- Department of Obstetrics and Gynecology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Lianghong Yin
- Institute of Nephrology and Blood Purification, the First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, Guangdong, China
| | - Yong Dai
- Clinical Medical Research Center, Guangdong Clinical Medical Research Center of Birth Defects, the Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Jinan University, Shenzhen, Guangdong, China
| |
Collapse
|
3
|
Jia X, Wang A, Yang L, Cheng Y, Wang Y, Ba J, Dou J, Mu Y, Zhao D, Lyu Z. Clinical Significance of Lifetime Maximum Body Mass Index in Predicting the Development of T2DM: A Prospective Study in Beijing. Front Endocrinol (Lausanne) 2022; 13:839195. [PMID: 35721732 PMCID: PMC9201965 DOI: 10.3389/fendo.2022.839195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 04/12/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Overweight and obesity are well-known risk factors for type 2 diabetes mellitus (T2DM). The effect of the maximum body mass index (BMImax), which indicates the highest body weight before the diagnosis of T2DM, is not fully understood. This study aimed to explore the predictive value of BMImax in the progression of diabetes. METHODS This prospective study recruited 2018 subjects with normal glucose tolerance in Beijing, China. The subjects were followed up for eight years, and the association between BMImax and glucose outcomes was evaluated. RESULTS Ninety-seven of the 2,018 participants developed diabetes by the end of the study. Compared to individuals with normal glucose tolerance, those who developed diabetes were characterized by higher levels of fasting plasma glucose (FPG), 2 h postload glucose (PBG), glycosylated hemoglobin (HbA1c), systolic blood pressure (SBP), and low-density lipoprotein cholesterol (LDL-c), a higher prevalence of a familial history of diabetes and a lower level of high-density lipoprotein cholesterol (HDL-c). Multivariate regression analysis of sex-stratified groups suggested that FPG, HbA1c, SBP and familial history of diabetes were independent risk factors for diabetes, but that BMImax was a unique indicator for female patients. CONCLUSIONS BMImax might be an independent predictor of T2DM in females, but it does not seem to be associated with the risk of diabetes in males. BMImax could be regarded as an indicator in the prevention and management of diabetes.
Collapse
Affiliation(s)
- Xiaomeng Jia
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
- Center for Endocrine Metabolism and Immune Disease, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Anping Wang
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Longyan Yang
- Center for Endocrine Metabolism and Immune Disease, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Yu Cheng
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yajing Wang
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jianming Ba
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jingtao Dou
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yiming Mu
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Dong Zhao
- Center for Endocrine Metabolism and Immune Disease, Beijing Luhe Hospital, Capital Medical University, Beijing, China
- *Correspondence: Dong Zhao, ; Zhaohui Lyu,
| | - Zhaohui Lyu
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
- *Correspondence: Dong Zhao, ; Zhaohui Lyu,
| |
Collapse
|
4
|
Forouzan P, Cohen PR. Incipient Diabetes Mellitus and Nascent Thyroid Disease Presenting as Beard Alopecia Areata: Case Report and Treatment Review of Alopecia Areata of the Beard. Cureus 2020; 12:e9500. [PMID: 32766019 PMCID: PMC7398044 DOI: 10.7759/cureus.9500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Alopecia areata is a non-scarring hair loss that commonly presents on the scalp. In men, when this condition results in facial hair loss on the cheek, jaw, and neck, it is referred to as beard alopecia areata. Beard alopecia areata can be associated with autoimmune conditions, such as diabetes mellitus, thyroid disorders, and vitiligo. A 28-year-old man presented with a five-month history of facial hair loss; his condition was diagnosed as beard alopecia areata after clinical examination. Treatment with twice daily topical 0.1% triamcinolone acetonide cream led to complete regrowth of his beard hair after six months. There are several potential agents and modalities for the treatment of individuals with beard alopecia areata. Treatment options include corticosteroid therapy (intralesional or topical), immunotherapy, Janus kinase (JAK) inhibitors, lasers, photodynamic therapy, platelet-rich plasma therapy, and treatment of an underlying Helicobacter pylori infection. Laboratory evaluation, prompted by our patient’s diagnosis of beard alopecia areata, suggested incipient diabetes mellitus and nascent thyroid disease; specifically, he had elevated fasting blood glucose and elevated thyroid-stimulating hormone levels. Therefore, in patients with beard alopecia areata, laboratory evaluation for concomitant or incipient autoimmune diseases should be considered.
Collapse
Affiliation(s)
- Parnia Forouzan
- Dermatology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, USA
| | - Philip R Cohen
- Dermatology, San Diego Family Dermatology, National City, USA
| |
Collapse
|
5
|
Inanc M, Kiziltoprak H, Hekimoglu R, Tekin K, Ozalkak S, Koc M, Bayramoglu E, Zirh S, Yuruker S, Aycan Z. Alterations of Tear Film and Ocular Surface in Children with Type 1 Diabetes Mellitus. Ocul Immunol Inflamm 2020; 28:362-369. [PMID: 30806526 DOI: 10.1080/09273948.2019.1571212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To investigate whether diabetes mellitus (DM) affects ocular surface of children with well-controlled type 1 DM.Methods: Sixty-five diabetic patients and 55 age-matched controls enrolled to study. Detailed ocular surface assessment including, ocular surface disease index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test, and conjunctival impression cytologic analysis were performed.Results: Schirmer test and TBUT results were significantly lower in DM group than controls (p = 0.001, for all). OSDI scores of all participants were within normal range. Impression cytology analysis showed grade 0 changes in all participants and there was no difference between groups for goblet cell density (p > 0.05). The TBUT results were significantly associated with duration of DM (r = -0.309, p = 0.036).Conclusion: Diabetic children without symptoms, signs, and definite diagnosis of dry eye still had lower TBUT and Schirmer test results than controls; however, impression cytology analysis was similar in both groups.
Collapse
Affiliation(s)
- Merve Inanc
- Ophthalmology Department, Ercis State Hospital, Van, Turkey
| | - Hasan Kiziltoprak
- Department is Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Rumeysa Hekimoglu
- Histology and Embryology Department, Kastamonu University, Kastamonu, Turkey
| | - Kemal Tekin
- Ophthalmology Department, Ercis State Hospital, Van, Turkey
| | - Servan Ozalkak
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
| | - Mustafa Koc
- Department is Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Elvan Bayramoglu
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
| | - Selim Zirh
- Histology and Embryology Department, Hacettepe University, Ankara, Turkey
| | - Sinan Yuruker
- Histology and Embryology Department, Usak University, Usak, Turkey
| | - Zehra Aycan
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
6
|
Ritzel R. [GLP-1 Analogs: Recommendations for Clinical Practice]. MMW Fortschr Med 2020; 162:51-54. [PMID: 32291661 DOI: 10.1007/s15006-020-0390-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Robert Ritzel
- Klinik für Endokrinologie, Diabetologie und Angiologie, München Klinik Schwabing und Bogenhausen, Kölner Platz 1, D-80804, München, Deutschland.
| |
Collapse
|
7
|
Abstract
Approximately 60% of patients with type 2 diabetes mellitus (T2D) develop hypertension. Recent work also indicates greater blood pressure (BP) excursions throughout the day in T2D. Collectively, these findings suggest altered BP control in T2D. Although muscle sympathetic nerve activity (MSNA) recordings in T2D have provided equivocal results, quantification of MSNA alone does not account for ensuing vasoconstriction and BP responses elicited by MSNA. Thus, we tested the hypothesis that patients with T2D exhibit enhanced sympathetic transduction to BP. MSNA (microneurography) and beat-to-beat BP (Finometer) were measured at rest in 21 T2D and 13 age-matched and body mass index-matched control subjects and, signal-averaging was performed to quantify the mean arterial pressure and total vascular conductance responses to spontaneous bursts of MSNA. The peak mean arterial pressure and total vascular conductance responses to spontaneous MSNA were similar between T2D and control (both P>0.05). However, further analysis, separating T2D into those taking statins (n=13, T2D +statin) and not taking statins (n=8, T2D -statin), indicated that T2D -statin patients (4.2±0.6 mm Hg) exhibited greater peak mean arterial pressure responses compared with both T2D +statin patients (2.5±0.3 mm Hg, P=0.01) and control (control: 2.8±0.3 mm Hg, P=0.02). Likewise, nadir total vascular conductance responses to spontaneous MSNA bursts were greater in T2D -statin patients (T2D -statin: -3.3±0.6 mL/(min·mm Hg), T2D +statin: -1.6±0.3 mL/(min·mm Hg), P=0.03; control -2.2±0.3 mL/(min·mm Hg), P=0.08). Notably, T2D +statin patients exhibited similar peak mean arterial pressure and total vascular conductance responses to MSNA compared with control. Collectively, these findings demonstrate, for the first time, that patients with T2D exhibit augmented sympathetic transduction and this effect seems to be offset by statin therapy.
Collapse
Affiliation(s)
- Benjamin E Young
- From the Department of Kinesiology, University of Texas at Arlington (B.E.Y., D.M.K., P.J.F.)
| | - Seth W Holwerda
- Department of Health and Human Physiology, University of Iowa (S.W.H.)
| | - Jennifer R Vranish
- Department of Integrative Physiology and Health Science, Alma College, MI (J.R.V.)
| | - David M Keller
- From the Department of Kinesiology, University of Texas at Arlington (B.E.Y., D.M.K., P.J.F.)
| | - Paul J Fadel
- From the Department of Kinesiology, University of Texas at Arlington (B.E.Y., D.M.K., P.J.F.)
| |
Collapse
|
8
|
Yoshinaga T, Niou T, Niihara T, Kajiya Y, Hori E, Tomiyoshi A, Tokudome E, Nishimata H, Takei T, Yoshida M. Angiopoietin-like Protein 2 is a Useful Biomarker for Pancreatic Cancer that is Associated with Type 2 Diabetes Mellitus and Inflammation. J Cancer 2018; 9:4736-4741. [PMID: 30588259 PMCID: PMC6299393 DOI: 10.7150/jca.25404] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 08/28/2018] [Indexed: 12/13/2022] Open
Abstract
Pancreatic cancer is one of the tumors with the worst prognosis, with the 5-year survival rate reported to be 6%. The number of patients suffering from pancreatic cancer in recent years has continued to increase dramatically. Carbohydrate antigen 19-9 is an established biomarker of pancreatic cancer, but it does not have sufficient ability to detect pancreatic cancer at an early stage. We focused on angiopoietin-like protein 2 (ANGPTL2), which has been reported to be related to chronic inflammation and Type 2 diabetes mellitus. In this study, whether ANGPTL2 can detect early pancreatic cancer was evaluated. It was found that the concentration of serum ANGPTL2 was significantly higher in pancreatic cancer patients and tumor stage 0-I patients than in healthy individuals (5.84 ± 1.82 ng/mL vs 3.61 ± 0.64 ng/mL; P < 0.001) (5.68 ± 0.79 ng/mL vs 3.61 ± 0.64 ng/mL; P = 0.010). In addition, the diagnostic capability of serum ANGPTL2 levels for pancreatic cancer was evaluated using receiver operating characteristic (ROC) curve analysis. The area under the ROC curve (AUC) for ANGPTL2 was 0.906 (95% confidence interval (CI): 0.815-0.997; P < 0.001). To identify the risk factors for pancreatic cancer, multivariate regression models were used. Ten factors were included, and increasing age (odds ratio (OR), 1.318, 95% CI, 1.058-1.642; P = 0.014) and high ANGPTL2 levels (OR, 22.219, 95% CI, 1.962-251.659, P = 0.012) were found to be independent risk factors for pancreatic cancer, with ANGPTL2 having the strongest relationship. In addition, serum ANGPTL2 levels were strongly correlated with inflammatory markers, with blood sugar levels showing the strongest correlation with serum ANGPTL2 levels. In conclusion, this study suggested that an elevated serum ANGPTL2 level has the potential to be a biomarker capable of early detection of pancreatic cancer, and it was correlated with inflammation of the pancreas and the risk of developing diabetes mellitus.
Collapse
Affiliation(s)
- Takuma Yoshinaga
- Division of Clinical Application, Nanpuh Hospital, Kagoshima, Japan
| | | | - Toru Niihara
- Gastroenterology, Nanpuh Hospital, Kagoshima, Japan
| | - Yoriko Kajiya
- Department of Radiology, Nanpuh Hospital, Kagoshima, Japan
| | - Emiko Hori
- Division of Clinical Application, Nanpuh Hospital, Kagoshima, Japan
| | - Ayako Tomiyoshi
- Division of Clinical Application, Nanpuh Hospital, Kagoshima, Japan
| | - Erena Tokudome
- Division of Clinical Application, Nanpuh Hospital, Kagoshima, Japan
| | | | - Takayuki Takei
- Department of Chemical Engineering, Graduate School of Science and Engineering, Kagoshima, Japan
| | - Masahiro Yoshida
- Department of Chemical Engineering, Graduate School of Science and Engineering, Kagoshima, Japan
| |
Collapse
|
9
|
McGee-Lawrence ME, Pierce JL, Yu K, Culpepper NR, Bradley EW, Westendorf JJ. Loss of Hdac3 in osteoprogenitors increases bone expression of osteoprotegerin, improving systemic insulin sensitivity. J Cell Physiol 2017; 233:2671-2680. [PMID: 28840938 DOI: 10.1002/jcp.26148] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 08/14/2017] [Indexed: 12/22/2022]
Abstract
Type 2 diabetes is an emerging global health epidemic. Foundations for new therapies are arising from understanding interactions between body systems. Bone-derived factors that reduce RANKL (receptor activator of NF-kappa B ligand) signaling in the liver may prevent insulin resistance and the onset of type 2 diabetes. Here we demonstrate that deletion of the epigenetic regulator, Hdac3, in Osx1-expressing osteoprogenitors prevents insulin resistance induced by high fat diet by increasing serum and skeletal gene expression levels of osteoprotegerin (Opg), a natural inhibitor of RANKL signaling. Removal of one Opg allele in mice lacking Hdac3 in Osx1+ osteoprogenitors increases the insulin resistance of the Hdac3-deficient mice on a high fat diet. Thus, Hdac3-depletion in osteoblasts increases expression of Opg, subsequently preserving insulin sensitivity. The Hdac inhibitor vorinostat also increased Opg transcription and histone acetylation of the Opg locus. These results define a new mechanism by which bone regulates systemic insulin sensitivity.
Collapse
Affiliation(s)
- Meghan E McGee-Lawrence
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, Georgia.,Department of Orthopaedic Surgery, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Jessica L Pierce
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Kanglun Yu
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Natasha R Culpepper
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, Georgia
| | | | - Jennifer J Westendorf
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.,Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
10
|
Zuniga JA, Easley KA, Shenvi N, Nguyen ML, Holstad M. The impact of diabetes on CD4 recovery in persons with HIV in an urban clinic in the United States. Int J STD AIDS 2017; 29:63-71. [PMID: 28661233 DOI: 10.1177/0956462417717650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to exam the impact of type 2 diabetes mellitus (T2DM) on CD4 cell count trends in adults with HIV. In a longitudinal retrospective study in an urban primary care HIV clinic in the southeastern United States from 2010 to 2012, patients with HIV medical charts were audited to obtain their CD4 cell count, diabetes status, weight, and demographic information. Rates of increase of CD4 T cell count (i.e. slopes) were obtained using a linear mixed-effects model. Most of the HIV-T2DM cohort (n = 262) and HIV-only cohort (n = 2399) were African American (76%) and male (77%). The CD4 T cell counts were consistently higher in the HIV-T2DM cohort ( p < .0001). The mean rate of CD4 T cell count increase (mean ± SE) was 63 ± 9 cells/µl/year in HIV-T2DM African American women and 28 ± 7 cells/µl/year in HIV-T2DM African American men ( p = 0.003). In the multivariable slope analysis, the CD4 T cell count increase was significantly faster for HIV-T2DM African American women than for all other patients (mean difference = 30/cells/µl/year, 95% CI: 13-47; p < 0.001). Gender, race/ethnicity, and the diagnosis of diabetes influenced the recovery of CD4 cell counts.
Collapse
Affiliation(s)
- Julie A Zuniga
- 1 School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Kirk A Easley
- 2 Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Neeta Shenvi
- 2 Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Minh L Nguyen
- 3 School of Medicine, Emory University, Atlanta, GA, USA
| | | |
Collapse
|
11
|
Abstract
OBJECTIVE Urocortin, a novel identified corticotropin-releasing factor-related endocrinal peptide, has been shown to play an essential role in cardioprotection. Until recently, whether urocortin can protect the heart against diabetic cardiomyopathy (DCM) remained unclear. Herein, we evaluated the cardioprotective effect of urocortin on cardiac dysfunction, inflammation, and fibrosis and demonstrated the potential mechanism in a diabetic rat model. METHODS Diabetic rats were randomly divided into 4 groups: diabetic control group, urocortin, urocortin + astressin (a selective CRF receptor 2 antagonist) and urocortin + triciribine (an Akt pathway blocker). Cardiac catheterization was performed to evaluate cardiac function. The levels of creatine phosphokinase isoenzyme (CK-MB), plasma brain natriuretic peptide (BNP), myocardial collagen volume fraction (CVF) and left ventricular mass index (LVWI) were measured. Inflammatory factors (transforming growth factor beta 1, TGF-β1; connective tissue growth factor, CTGF) and activation of signaling proteins (Akt, GSK-3β) were also detected using western blot. RESULTS DCM was successfully induced by the injection of streptozotocin (STZ) as evidenced by abnormal heart mass and cardiac function as well as the imbalance of extracellular matrix homeostasis. Rats in the DCM group showed increased mRNA and protein levels of LVWI, BNP, CK-MB, CVF, TGF-β1 and CTGF compared to the control group, which were accompanied with diminished phosphorylation of Akt and GSK-3β. Interestingly, myocardial dysfunction, cardiac fibrosis, and inflammation were suppressed by urocortin in the heart of diabetic rats. Moreover, inhibition of phosphorylation of Akt and GSK-3β was also reversed by urocortin. These effects of urocortin were suppressed by astressin. In addition, triciribine partially reduced the effects of urocortin on myocardial dysfunction, inflammation, and cardiac fibrosis. CONCLUSIONS These results suggest that urocortin exhibits a therapeutic benefit in the treatment of DCM by attenuating fibrosis and inflammation. Furthermore, inhibition of the Akt/GSK-3β signaling pathway may be partially responsible for these effects.
Collapse
Affiliation(s)
- Xinyu Liu
- a The First Affiliated Hospital of Liaoning Medical University , Jinzhou , China
- b Department of Endocrinology , Provincial Hospital Affiliated to Shandong University , Jinan , China
| | - Chunna Liu
- c Department of Pharmacology , Liaoning Medical University , Jinzhou , China
| | - Jian Li
- a The First Affiliated Hospital of Liaoning Medical University , Jinzhou , China
| | - Xiaoyan Zhang
- a The First Affiliated Hospital of Liaoning Medical University , Jinzhou , China
| | - Feiran Song
- a The First Affiliated Hospital of Liaoning Medical University , Jinzhou , China
| | - Jin Xu
- b Department of Endocrinology , Provincial Hospital Affiliated to Shandong University , Jinan , China
| |
Collapse
|
12
|
Abstract
Insulin therapy is still the primary therapy for all diabetic dogs and cats. Several insulin options are available for each species, including veterinary registered products and human insulin preparations. The insulin chosen depends on the individual patient’s requirements. Intermediate-acting insulin is usually the first choice for dogs, and longer-acting insulin is the first choice for cats. Once the insulin type is chosen, the best method of insulin administration should be considered. Traditionally, insulin vials and syringes have been used, but insulin pen devices have recently entered the veterinary market. Pens have different handling requirements when compared with standard insulin vials including: storage out of the refrigerator for some insulin preparations once pen cartridges are in use; priming of the pen to ensure a full dose of insulin is administered; and holding the pen device in place for several seconds during the injection. Many different types of pen devices are available, with features such as half-unit dosing, large dials for visually impaired people, and memory that can display the last time and dose of insulin administered. Insulin pens come in both reusable and disposable options. Pens have several benefits over syringes, including improved dose accuracy, especially for low insulin doses.
Collapse
Affiliation(s)
- Ann Thompson
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Patty Lathan
- College of Veterinary Medicine Mississippi State University, Starkville, MS, USA
| | - Linda Fleeman
- Animal Diabetes Australia, Melbourne, VIC, Australia,
| |
Collapse
|
13
|
Das Choudhury S, Das SK, Hazra A. Survey of knowledge-attitude-practice concerning insulin use in adult diabetic patients in eastern India. Indian J Pharmacol 2015; 46:425-9. [PMID: 25097283 PMCID: PMC4118538 DOI: 10.4103/0253-7613.135957] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 04/02/2014] [Accepted: 05/19/2014] [Indexed: 12/11/2022] Open
Abstract
Objectives: The study was conducted to assess knowledge, attitude, and practice regarding insulin use among diabetic patients in tertiary care hospitals. Materials and Methods: Type 1 and 2 diabetic patients, aged 18 years and above, attending the Medicine/Endocrinology out-patient department or admitted as in-patients in three hospitals in and around Kolkata were enrolled. A pretested structured questionnaire comprising of 51 items was administered through face-to-face interview. Responses from 385 subjects were analyzed. Results: Both higher educational and higher economic standards were associated with better understanding of insulin use. Longer duration of diabetes and its treatment (oral anti-diabetic drugs and insulin) were associated with better knowledge of some parameters. Female subjects were less aware of HbA1c as a monitoring tool. Among current insulin users, 70% had never used a glucometer; only 27.33% carried simple carbohydrates for use in hypoglycemic attacks; and 32% failed to rotate sites for insulin injection. Conclusion: Knowledge and attitude were satisfactory on the whole but deficiencies in practice were pronounced, which can potentially be removed through appropriate counseling.
Collapse
Affiliation(s)
- Sourav Das Choudhury
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Somak Kumar Das
- Department of Medicine, College of Medicine and Jawaharlal Nehru Memorial Hospital, West Bengal University of Health Sciences, Kalyani, West Bengal, India
| | - Avijit Hazra
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| |
Collapse
|
14
|
Nickavar B, Amin G. Enzyme Assay Guided Isolation of an α-Amylase Inhibitor Flavonoid from Vaccinium arctostaphylos Leaves. Iran J Pharm Res 2011; 10:849-53. [PMID: 24250422 PMCID: PMC3813050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The management of postprandial hyperglycemia is an important strategy in the control of diabetes mellitus and complications associated with the disease, especially in the diabetes type 2. Therefore, inhibitors of carbohydrate hydrolyzing enzymes can be useful in the treatment of diabetes and medicinal plants can offer an attractive strategy for the purpose. Vaccinium arctostaphylos leaves are considered useful for the treatment of diabetes mellitus in some countries. In our research for antidiabetic compounds from natural sources, we found that the methanol extract of the leaves of V. arctostaphylos displayed a potent inhibitory activity on pancreatic α-amylase activity (IC50 = 0.53 (0.53 - 0.54) mg/mL). The bioassay-guided fractionation of the extract resulted in the isolation of quercetin as an active α-amylase inhibitor. Quercetin showed a dose-dependent inhibitory effect with IC50 value 0.17 (0.16 - 0.17) mM.
Collapse
Affiliation(s)
- Bahman Nickavar
- Department of Pharmacognosy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Corresponding author: E-mail:
| | - Gholamreza Amin
- Department of Pharmacognosy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
15
|
Abstract
PURPOSE Severe hypoglycemia can result in neural damage, impaired cognitive function, coma, seizures, or death. The decision to admit diabetic patients after initial treatment in the emergency department remains unclear. Our purpose is to identify risk factors for developing recurrent hypoglycemia in diabetic patients admitted for severe hypoglycemia. MATERIALS AND METHODS We reviewed the records of 233 subjects (92 males, 141 females; mean age, 74.1 +/- 9.8 years) with type 2 diabetes treated at a tertiary care teaching hospital and hospitalized for severe hypoglycemia. RESULTS Seventy-four (31.8%) patients were categorized with recurrent hypoglycemia and 159 (68.2%) with non-recurrent. Multivariate logistic regression analysis revealed that patients with loss of a recent meal, coronary artery disease, infection, and poor renal function (lower estimated glomerular filtration rate) were at risk for recurrent hypoglycemia. The use of calcium-channel blockers appeared to be a protective factor for the development of recurrent hypoglycemia. CONCLUSION There may be a subset of patients with severe hypoglycemia and certain risk factors for recurrent hypoglycemia that should be admitted.
Collapse
Affiliation(s)
- Yen-Yue Lin
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chin-Wang Hsu
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | | | - Shi-Jye Chu
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chin-Pyng Wu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shih-Hung Tsai
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| |
Collapse
|
16
|
Abstract
There is a worldwide epidemic of type 2 diabetes, with numbers predicted to reach over 210 million by the year 2010. Important risk factors for type 2 diabetes are obesity, physical inactivity and dietary factors. Recent evidence shows that type 2 diabetes can certainly be delayed, and possibly prevented, by intensive lifestyle intervention, and therapies including acarbose, metformin, orlistat and the glitazones in selected populations. However, the UK has not had a successful record in trials which aim to prevent diabetes, and therefore implementation of effective and successful intensive lifestyle intervention to prevent diabetes may prove difficult in the UK. Other 'non-glucose lowering' agents, such as statins, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, may have a role to play in the prevention of diabetes.
Collapse
|
17
|
Abstract
Literature reports have suggested that hemodynamic response toward organic nitrates may be reduced in obese patients, but this effect has not been studied. We compared the mean arterial pressure (MAP) responses toward single doses of nitroglycerin (NTG, 0.5-50 micro g) in conscious Zucker obese (ZOB), Zucker lean (ZL), and Sprague-Dawley (SD) rats. NTG tolerance development in these animal groups was separately examined. Rats received 1 and 10 micro g/min of NTG or vehicle infusion, and the maximal MAP response to an hourly 30 micro g NTG IVchallenge dose (CD) was measured. Steady-state NTG plasma concentrations were measured during 10 micro g/min NTG infusion. The Emax and ED50 values obtained were 33.9 +/- 3.6 and 3.5 +/- 1.7 micro g for SD rats, 33.2 +/- 4.1 and 3.0 +/- 1.4 micro g for ZL rats, and 34.8 +/- 3.9 and 5.3 +/- 2.8 micro g for ZOB rats, respectively. No difference was found in the dose-response curves among these 3 groups (P >.05, 2-way ANOVA). Neither the dynamics of NTG tolerance development, nor the steady-state NTG plasma concentrations, were found to differ among these 3 animal groups. These results showed that ZOB rats are not more resistant to the hemodynamic effects of organic nitrates compared with their lean controls. Thus, the acute and chronic hemodynamic effects induced by NTG are not sensitively affected by the presence of obesity in a conscious animal model of genetic obesity.
Collapse
Affiliation(s)
- Ellen Q Wang
- Department of Pharmacokinetics, Dynamics, & Metabolism, Pfizer Global Research & Development, Eastern Point Road, MS4111, Groton, CT 06340, USA.
| | | |
Collapse
|