WorldWideScience

Sample records for diabetes immune-based therapeutic

  1. Tolerating diabetes: an alternative therapeutic approach for diabetic neuropathy

    OpenAIRE

    2010-01-01

    It is becoming apparent that a number of pathogenic mechanisms contribute to diabetic neuropathy, so that therapeutic interventions that target one particular mechanism may have limited success. A recently published preclinical study has adopted an alternative approach by using a novel small molecule to induce heat-shock protein 70. This confers upon neurons, and perhaps other cells of the nervous system, the ability to better tolerate the diverse stresses associated with diabetes rather than...

  2. Tolerating diabetes: an alternative therapeutic approach for diabetic neuropathy

    Directory of Open Access Journals (Sweden)

    Nigel A Calcutt

    2010-09-01

    Full Text Available It is becoming apparent that a number of pathogenic mechanisms contribute to diabetic neuropathy, so that therapeutic interventions that target one particular mechanism may have limited success. A recently published preclinical study has adopted an alternative approach by using a novel small molecule to induce heat-shock protein 70. This confers upon neurons, and perhaps other cells of the nervous system, the ability to better tolerate the diverse stresses associated with diabetes rather than intervening in their production.

  3. Tolerating diabetes: an alternative therapeutic approach for diabetic neuropathy.

    Science.gov (United States)

    Calcutt, Nigel A

    2010-09-09

    It is becoming apparent that a number of pathogenic mechanisms contribute to diabetic neuropathy, so that therapeutic interventions that target one particular mechanism may have limited success. A recently published preclinical study has adopted an alternative approach by using a novel small molecule to induce heat-shock protein 70. This confers upon neurons, and perhaps other cells of the nervous system, the ability to better tolerate the diverse stresses associated with diabetes rather than intervening in their production.

  4. Therapeutic Phytogenic Compounds for Obesity and Diabetes

    Directory of Open Access Journals (Sweden)

    Hee Soong Jung

    2014-11-01

    Full Text Available Natural compounds have been used to develop drugs for many decades. Vast diversities and minimum side effects make natural compounds a good source for drug development. However, the composition and concentrations of natural compounds can vary. Despite this inconsistency, half of the Food and Drug Administration (FDA-approved pharmaceuticals are natural compounds or their derivatives. Therefore, it is essential to continuously investigate natural compounds as sources of new pharmaceuticals. This review provides comprehensive information and analysis on natural compounds from plants (phytogenic compounds that may serve as anti-obesity and/or anti-diabetes therapeutics. Our growing understanding and further exploration of the mechanisms of action of the phytogenic compounds may afford opportunities for development of therapeutic interventions in metabolic diseases.

  5. New therapeutic agents in diabetic nephropathy

    Science.gov (United States)

    Kim, Yaeni; Park, Cheol Whee

    2017-01-01

    Studies investigating diabetic nephropathy (DN) have mostly focused on interpreting the pathologic molecular mechanisms of DN, which may provide valuable tools for early diagnosis and prevention of disease onset and progression. Currently, there are few therapeutic drugs for DN, which mainly consist of antihypertensive and antiproteinuric measures that arise from strict renin-angiotensin-aldosterone system inactivation. However, these traditional therapies are suboptimal and there is a clear, unmet need for treatments that offer effective schemes beyond glucose control. The complexity and heterogeneity of the DN entity, along with ambiguous renal endpoints that may deter accurate appraisal of new drug potency, contribute to a worsening of the situation. To address these issues, current research into original therapies to treat DN is focusing on the intrinsic renal pathways that intervene with intracellular signaling of anti-inflammatory, antifibrotic, and metabolic pathways. Mounting evidence in support of the favorable metabolic effects of these novel agents with respect to the renal aspects of DN supports the likelihood of systemic beneficial effects as well. Thus, when translated into clinical use, these novel agents would also address the comorbid factors associated with diabetes, such as obesity and risk of cardiovascular disease. This review will provide a discussion of the promising and effective therapeutic agents for the management of DN. PMID:28049280

  6. [Therapeutic use of acetylsalicylic acid in diabetics].

    Science.gov (United States)

    Zácková, V

    2003-12-01

    Aterosclerosis is a leading cause of morbidity and mortality in diabetics. Macrovascular diseases--myocardial infarction, cerebral vascular accident, ischemic lower extremities--start in persons with diabetes earlier and in a bigger scope then in non-diabetics. Development of these changes is determined by diabetic vasculopathy which is connected with endothelial dysfunction, hypercoagulation state, and platelet abnormalities. Treatment of a patient with diabetes is based on compensation of diabetes and management of hypertension and dyslipidaemia. Drugs that inhibit platelets constitute an important part of prevention of cardiovascular disabilities in diabetics.

  7. [Proliferative diabetic retinopathy -- therapeutic approach (clinical case)].

    Science.gov (United States)

    Burcea, M; Muşat, Ovidiu; Mahdi, Labib; Gheorghe, Andreea; Spulbar, F; Gobej, I

    2014-01-01

    We present the case of a 54 year old pacient diagnosed with neglected insulin dependent diabetes and proliferative diabetic retinopathy. Surgery was recommended and we practiced posterior vitrectomy, endolaser and heavy silicone oil endotamponade. Post-operative evolution was favorable.

  8. ROCK as a Therapeutic Target of Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Ryoichi Arita

    2010-01-01

    Full Text Available The increasing global prevalence of diabetes is a critical problem for public health. In particular, diabetic retinopathy, a prevalent ocular complication of diabetes mellitus, causes severe vision loss in working population. A better understanding of the pathogenesis and the development of new pharmacologic treatments are needed. This paper describes the relevance between Rho/ROCK pathway and the pathogenesis of diabetic retinopathy from its early to late stages. Moreover, the therapeutic potential of ROCK inhibitor in the total management of diabetic retinopathy is discussed.

  9. Inflammation: therapeutic targets for diabetic neuropathy.

    Science.gov (United States)

    Zhou, Jiyin; Zhou, Shiwen

    2014-02-01

    There are still no approved treatments for the prevention or of cure of diabetic neuropathy, and only symptomatic pain therapies of variable efficacy are available. Inflammation is a cardinal pathogenic mechanism of diabetic neuropathy. The relationships between inflammation and the development of diabetic neuropathy involve complex molecular networks and processes. Herein, we review the key inflammatory molecules (inflammatory cytokines, adhesion molecules, chemokines) and pathways (nuclear factor kappa B, JUN N-terminal kinase) implicated in the development and progression of diabetic neuropathy. Advances in the understanding of the roles of these key inflammatory molecules and pathways in diabetic neuropathy will facilitate the discovery of the potential of anti-inflammatory approaches for the inhibition of the development of neuropathy. Specifically, many anti-inflammatory drugs significantly inhibit the development of different aspects of diabetic neuropathy in animal models and clinical trials.

  10. Autophagy as a Therapeutic Target in Diabetic Nephropathy

    Directory of Open Access Journals (Sweden)

    Yuki Tanaka

    2012-01-01

    Full Text Available Diabetic nephropathy is a serious complication of diabetes mellitus, and its prevalence has been increasing worldwide. Therefore, there is an urgent need to identify a new therapeutic target to prevent diabetic nephropathy. Autophagy is a major catabolic pathway involved in degrading and recycling macromolecules and damaged organelles to maintain intracellular homeostasis. The study of autophagy in mammalian systems is advancing rapidly and has revealed that it is involved in the pathogenesis of various metabolic or age-related diseases. The functional role of autophagy in the kidneys is also currently under intense investigation although, until recently, evidence showing the involvement of autophagy in the pathogenesis of diabetic nephropathy has been limited. We provide a systematic review of autophagy and discuss the therapeutic potential of autophagy in diabetic nephropathy to help future investigations in this field.

  11. [Therapeutic approach in persistent diabetic macular edema].

    Science.gov (United States)

    Brănişteanu, Daniel; Moraru, Andreea

    2014-01-01

    Terminology of persistent diabetic macular edema has been initially reserved to cases unresponsive to conventional laser photocoagulation according to ETDRS criteria. While knowledge about pathophysiology of macular edema evolved and new drugs became available, the terminology of persistent diabetic macular edema expanded to include resistance to most current therapies. The purpose of this paper is to review medical and surgical options in the treatment of such difficult cases according to literature data and personal experience.

  12. Towards microRNA-based therapeutics for diabetic nephropathy.

    Science.gov (United States)

    Alvarez, M L; DiStefano, J K

    2013-03-01

    There is no cure for diabetic nephropathy and the molecular mechanisms underlying disease aetiology remain poorly understood. While current paradigms for clinical management of diabetic nephropathy are useful in delaying disease onset and preventing its progression, they do not do so for a significant proportion of diabetic individuals, who eventually end up developing renal failure. Thus, novel therapeutic targets are needed for the treatment and prevention of the disease. MicroRNAs (miRNAs), a class of non-coding RNAs that negatively regulate gene expression, have recently been identified as attractive targets for therapeutic intervention. It is widely recognised that dysregulation of miRNA expression or action contributes to the development of a number of different human diseases, and evidence of a role for miRNAs in the aetiology of diabetic nephropathy is emerging. The discovery that modulation of miRNA expression in vivo is feasible, combined with recent results from successful clinical trials using this technology, opens the way for future novel therapeutic applications. For instance, inhibition of miRNAs that are commonly upregulated in diabetic nephropathy decreases albuminuria and mesangial matrix accumulation in animal models, suggesting that a therapeutic agent against these molecules may help to prevent the development of diabetic nephropathy. Certain challenges, including the development of safe and reliable delivery systems, remain to be overcome before miRNA-based therapeutics become a reality. However, the findings accumulated to date, in conjunction with newly emerging results, are expected to yield novel insights into the complex pathogenesis of diabetic nephropathy, and may eventually lead to the identification of improved therapeutic targets for treatment of this disease.

  13. Receptor antibodies as novel therapeutics for diabetes

    DEFF Research Database (Denmark)

    Ussar, Siegfried; Vienberg, Sara Gry; Kahn, C Ronald

    2011-01-01

    Antibodies to receptors can block or mimic hormone action. Taking advantage of receptor isoforms, co-receptors, and other receptor modulating proteins, antibodies and other designer ligands can enhance tissue specificity and provide new approaches to the therapy of diabetes and other diseases....

  14. Targeting inflammation in diabetes: Newer therapeutic options

    Institute of Scientific and Technical Information of China (English)

    Neeraj; Kumar; Agrawal; Saket; Kant

    2014-01-01

    Inflammation has been recognised to both decrease beta cell insulin secretion and increase insulin resis-tance. Circulating cytokines can affect beta cell function directly leading to secretory dysfunction and increased apoptosis. These cytokines can also indirectly affect beta cell function by increasing adipocyte inflamma-tion.The resulting glucotoxicity and lipotoxicity further enhance the inflammatory process resulting in a vicious cycle. Weight reduction and drugs such as metformin have been shown to decrease the levels of C-Reactive Protein by 31% and 13%, respectively. Pioglitazone, insulin and statins have anti-inflammatory effects. In-terleukin 1 and tumor necrosis factor-α antagonists are in trials and NSAIDs such as salsalate have shown an improvement in insulin sensitivity. Inhibition of 12-lipo-oxygenase, histone de-acetylases, and activation of sirtuin-1 are upcoming molecular targets to reduce in-flammation. These therapies have also been shown to decrease the conversion of pre-diabetes state to diabe-tes. Drugs like glicazide, troglitazone, N-acetylcysteine and selective COX-2 inhibitors have shown benefit in diabetic neuropathy by decreasing inflammatory mark-ers. Retinopathy drugs are used to target vascular en-dothelial growth factor, angiopoietin-2, various protein-ases and chemokines. Drugs targeting the proteinases and various chemokines are pentoxifylline, inhibitors of nuclear factor-kappa B and mammalian target of rapa-mycin and are in clinical trials for diabetic nephropathy. Commonly used drugs such as insulin, metformin, per-oxisome proliferator-activated receptors, glucagon like peptide-1 agonists and dipeptidyl peptidase-4 inhibitors also decrease inflammation. Anti-inflammatory thera-pies represent a potential approach for the therapy of diabetes and its complications.

  15. Therapeutic perspectives in type-1 diabetes

    CERN Document Server

    SINGH, PRACHI; TUPALLY, KARNAKER R; PODDAR, KINGSHUK; Tan, Aaron; VENKATESAN, VENKY; PAREKH, HARENDRA S; PASTORIN, GIORGIA

    2016-01-01

    This book provides critical insights into and appraisals of recent breakthroughs in type 1 diabetes modulation, with a particular emphasis on the potential impact of current prevention and treatment strategies. It also discusses recent successes and failures in clinical trials. Presenting an comprehensive overview of the disease, it is especially useful for newcomers in the field. It also includes illustrations, which make it easy for the reader to grasp the basic concepts involved. Furthermore, the tables include concise and easy-to-understand information on current clinical trials.

  16. Diabetic Neuropathy and Oxidative Stress: Therapeutic Perspectives

    Directory of Open Access Journals (Sweden)

    Asieh Hosseini

    2013-01-01

    Full Text Available Diabetic neuropathy (DN is a widespread disabling disorder comprising peripheral nerves' damage. DN develops on a background of hyperglycemia and an entangled metabolic imbalance, mainly oxidative stress. The majority of related pathways like polyol, advanced glycation end products, poly-ADP-ribose polymerase, hexosamine, and protein kinase c all originated from initial oxidative stress. To date, no absolute cure for DN has been defined; although some drugs are conventionally used, much more can be found if all pathophysiological links with oxidative stress would be taken into account. In this paper, although current therapies for DN have been reviewed, we have mainly focused on the links between DN and oxidative stress and therapies on the horizon, such as inhibitors of protein kinase C, aldose reductase, and advanced glycation. With reference to oxidative stress and the related pathways, the following new drugs are under study such as taurine, acetyl-L-carnitine, alpha lipoic acid, protein kinase C inhibitor (ruboxistaurin, aldose reductase inhibitors (fidarestat, epalrestat, ranirestat, advanced glycation end product inhibitors (benfotiamine, aspirin, aminoguanidine, the hexosamine pathway inhibitor (benfotiamine, inhibitor of poly ADP-ribose polymerase (nicotinamide, and angiotensin-converting enzyme inhibitor (trandolapril. The development of modern drugs to treat DN is a real challenge and needs intensive long-term comparative trials.

  17. Is tetrahydrobiopterin a therapeutic option in diabetic hypertensive patients?

    Directory of Open Access Journals (Sweden)

    Alberto Francisco Rubio-Guerra

    2010-09-01

    Full Text Available Alberto Francisco Rubio-Guerra1, Hilda Vargas-Robles2, Luz Maria Ramos-Brizuela1, Bruno Alfonso Escalante-Acosta21Metabolic Clinic, Hospital General de Ticomán SS DF, Mexico; 2Department of Molecular Biomedicine, Centro de Investigacion y de Estudios Avanzados del IPN, MexicoAbstract: Nitric oxide (NO is an important regulator of vascular tone, and is also an antithrombotic, anti-inflammatory, antiproliferative, and antiatherogenic factor. Endothelial function is altered in patients with coronary artery disease, stroke, and peripheral artery disease, and endothelial dysfunction correlates with the risk factor profile for a patient. Hypertension and type 2 diabetes are risk factors for vascular disease, and are both pathologies characterized by loss of NO activity. Indeed, endothelial dysfunction is usually present in diabetic and/or hypertensive patients. Tetrahydrobiopterin is an essential cofactor for the NO synthase enzyme, and insufficiency of this cofactor leads to uncoupling of the enzyme, release of superoxide, endothelial dysfunction, progression of hypertension, and finally, proatherogenic effects. Tetrahydrobiopterin is also an important mediator of NO synthase regulation in type 2 diabetes and hypertension, and may be a rational therapeutic target to restore endothelial function and prevent vascular disease in these patients. The aim of this paper is to review the rationale for therapeutic strategies directed to biopterins as a target for vascular disease in type 2 diabetic hypertensive patients.Keywords: tetrahydrobiopterin, endothelial dysfunction, diabetes, hypertension, oxidative stress, nitric oxide, eNOS synthase uncoupling

  18. Skewed Epigenetics: An Alternative Therapeutic Option for Diabetes Complications

    Directory of Open Access Journals (Sweden)

    Gabriele Togliatto

    2015-01-01

    Full Text Available Vascular complications are major causes of morbidity and mortality in type 2 diabetes patients. Mitochondrial reactive oxygen species (ROS generation and a lack of efficient antioxidant machinery, a result of hyperglycaemia, mainly contribute to this problem. Although advances in therapy have significantly reduced both morbidity and mortality in diabetic individuals, diabetes-associated vascular complications are still one of the most challenging health problems worldwide. New healing options are urgently needed as current therapeutics are failing to improve long-term outcomes. Particular effort has recently been devoted to understanding the functional relationship between chromatin structure regulation and the persistent change in gene expression which is driven by hyperglycaemia and which accounts for long-lasting diabetic complications. A detailed investigation into epigenetic chromatin modifications in type 2 diabetes is underway. This will be particularly useful in the design of mechanism-based therapeutics which interfere with long-lasting activating epigenetics and improve patient outcomes. We herein provide an overview of the most relevant mechanisms that account for hyperglycaemia-induced changes in chromatin structure; the most relevant mechanism is called “metabolic memory.”

  19. Therapeutic efficacy of ozone in patients with diabetic foot.

    Science.gov (United States)

    Martínez-Sánchez, Gregorio; Al-Dalain, Saied M; Menéndez, Silvia; Re, Lamberto; Giuliani, Attilia; Candelario-Jalil, Eduardo; Alvarez, Hector; Fernández-Montequín, José Ignacio; León, Olga Sonia

    2005-10-31

    Oxidative stress is suggested to have an important role in the development of complications in diabetes. Because ozone therapy can activate the antioxidant system, influencing the level of glycemia and some markers of endothelial cell damage, the aim of this study was to investigate the therapeutic efficacy of ozone in the treatment of patients with type 2 diabetes and diabetic feet and to compare ozone with antibiotic therapy. A randomized controlled clinical trial was performed with 101 patients divided into two groups: one (n = 52) treated with ozone (local and rectal insufflation of the gas) and the other (n = 49) treated with topical and systemic antibiotics. The efficacy of the treatments was evaluated by comparing the glycemic index, the area and perimeter of the lesions and biochemical markers of oxidative stress and endothelial damage in both groups after 20 days of treatment. Ozone treatment improved glycemic control, prevented oxidative stress, normalized levels of organic peroxides, and activated superoxide dismutase. The pharmacodynamic effect of ozone in the treatment of patients with neuroinfectious diabetic foot can be ascribed to the possibility of it being a superoxide scavenger. Superoxide is considered a link between the four metabolic routes associated with diabetes pathology and its complications. Furthermore, the healing of the lesions improved, resulting in fewer amputations than in control group. There were no side effects. These results show that medical ozone treatment could be an alternative therapy in the treatment of diabetes and its complications.

  20. Nrf2: a potential therapeutic target for diabetic neuropathy.

    Science.gov (United States)

    Kumar, Anil; Mittal, Ruchika

    2017-03-28

    Different aspects involved in pathophysiology of diabetic neuropathy are related to inflammatory and apoptotic pathways. This article summarizes evidence that Nrf2 acts as a bridging link in various inflammatory and apoptotic pathways impacting progression of diabetic neuropathy. Nrf2 is involved in expression of various antioxidant proteins (such as detoxifying enzymes) via antioxidant response element (ARE) binding site. Under normal conditions, Nrf2 is inactive and remains in the cytosol. Hyperglycemia is a strong stimulus for oxidative stress and inflammation that downregulates the activity of Nrf2 through various neuroinflammatory pathways. Acute hyperglycemia increases the expression of Nrf2, but persistent hyperglycemia decreases its expression. This downregulation of Nrf2 causes various microvascular changes, which result in diabetic neuropathy. The key contribution of Nrf2 in progression of diabetic neuropathy has been summarized in the article. Despite involvement of Nrf2 in progression of diabetic neuropathy, targeting Nrf2 activators as a therapeutic potential will provide important new insights into the ways that influence treatment of diabetic neuropathy.

  1. Is tetrahydrobiopterin a therapeutic option in diabetic hypertensive patients?

    Science.gov (United States)

    Rubio-Guerra, Alberto Francisco; Vargas-Robles, Hilda; Ramos-Brizuela, Luz Maria; Escalante-Acosta, Bruno Alfonso

    2010-01-01

    Nitric oxide (NO) is an important regulator of vascular tone, and is also an antithrombotic, anti-inflammatory, antiproliferative, and antiatherogenic factor. Endothelial function is altered in patients with coronary artery disease, stroke, and peripheral artery disease, and endothelial dysfunction correlates with the risk factor profile for a patient. Hypertension and type 2 diabetes are risk factors for vascular disease, and are both pathologies characterized by loss of NO activity. Indeed, endothelial dysfunction is usually present in diabetic and/or hypertensive patients. Tetrahydrobiopterin is an essential cofactor for the NO synthase enzyme, and insufficiency of this cofactor leads to uncoupling of the enzyme, release of superoxide, endothelial dysfunction, progression of hypertension, and finally, proatherogenic effects. Tetrahydrobiopterin is also an important mediator of NO synthase regulation in type 2 diabetes and hypertension, and may be a rational therapeutic target to restore endothelial function and prevent vascular disease in these patients. The aim of this paper is to review the rationale for therapeutic strategies directed to biopterins as a target for vascular disease in type 2 diabetic hypertensive patients. PMID:21949628

  2. Naturally Occurring Anthraquinones: Chemistry and Therapeutic Potential in Autoimmune Diabetes

    Directory of Open Access Journals (Sweden)

    Shih-Chang Chien

    2015-01-01

    Full Text Available Anthraquinones are a class of aromatic compounds with a 9,10-dioxoanthracene core. So far, 79 naturally occurring anthraquinones have been identified which include emodin, physcion, cascarin, catenarin, and rhein. A large body of literature has demonstrated that the naturally occurring anthraquinones possess a broad spectrum of bioactivities, such as cathartic, anticancer, anti-inflammatory, antimicrobial, diuretic, vasorelaxing, and phytoestrogen activities, suggesting their possible clinical application in many diseases. Despite the advances that have been made in understanding the chemistry and biology of the anthraquinones in recent years, research into their mechanisms of action and therapeutic potential in autoimmune disorders is still at an early stage. In this paper, we briefly introduce the etiology of autoimmune diabetes, an autoimmune disorder that affects as many as 10 million worldwide, and the role of chemotaxis in autoimmune diabetes. We then outline the chemical structure and biological properties of the naturally occurring anthraquinones and their derivatives with an emphasis on recent findings about their immune regulation. We discuss the structure and activity relationship, mode of action, and therapeutic potential of the anthraquinones in autoimmune diabetes, including a new strategy for the use of the anthraquinones in autoimmune diabetes.

  3. DIABETIC CARDIOMYOPATHY: INSIGHTS INTO PATHOGENESIS, DIAGNOSTIC CHALLENGES, AND THERAPEUTIC OPTIONS

    Directory of Open Access Journals (Sweden)

    Chintan N. Mehta

    2012-10-01

    Full Text Available Diabetic cardiomyopathy is the presence of myocardial dysfunction in the absence of coronary artery disease and hypertension. Hyperglycemia seems to be central to the pathogenesis of diabetic cardiomyopathy and to trigger a series of maladaptive stimuli that result in myocardial fibrosis and collagen deposition. These processes are thought to be responsible for altered myocardial relaxation characteristics and manifest as diastolic dysfunction on imaging. Sophisticated imaging technologies also have permitted the detection of subtle systolic dysfunction in the diabetic myocardium. In the early stages, these changes appear reversible with tight metabolic control, but as the pathologic processes become organized, the changes are irreversible and contribute to an excess risk of heart failure among diabetic patients independently of common comorbidities, such as coronary artery disease and hypertension. Therapeutic agents specifically targeting processes that lead to these pathophysiologic changes are in the early stages of development. Although glycemic control and early administration of neuro-hormonal antagonists remain the cornerstones of therapeutic approaches, newer treatment targets are currently being explored.

  4. Therapeutic uses of epicatechin in diabetes and cancer

    Directory of Open Access Journals (Sweden)

    Layth Abdulmajeed Abdulkhaleq

    2017-08-01

    Full Text Available Epicatechin is a natural flavonoid found in green tea. It has been reported to possess an immense antioxidant effect which contributes to its therapeutic effect against a handful of ailments. In this review, we discuss its therapeutic role in the management of two of the most important human diseases; diabetes and cancer. The consumption of epicatechin has been shown to reduce blood glucose levels in diabetic patients, while is anticancer effect was attributed to its antioxidant properties, antiangiogenic and direct cytotoxicity to cancer cells. Although the exact mechanism of action of epicatechin is still being explored, there is no doubt that it is a promising candidate as an alternative. The significance of this review is to highlight the importance of the usage of natural products (in this case, epicatechin as an alternative for the treatment of two potentially fatal diseases which is diabetes and cancer. The aim of this review is to educate the scientific community on the role of epicatechin in ameliorating the effects of diabetes and cancers on human while understanding the potential mechanisms of these aforementioned effects.

  5. Diabetic peripheral neuropathy: should a chaperone accompany our therapeutic approach?

    Science.gov (United States)

    Farmer, Kevin L; Li, Chengyuan; Dobrowsky, Rick T

    2012-10-01

    Diabetic peripheral neuropathy (DPN) is a common complication of diabetes that is associated with axonal atrophy, demyelination, blunted regenerative potential, and loss of peripheral nerve fibers. The development and progression of DPN is due in large part to hyperglycemia but is also affected by insulin deficiency and dyslipidemia. Although numerous biochemical mechanisms contribute to DPN, increased oxidative/nitrosative stress and mitochondrial dysfunction seem intimately associated with nerve dysfunction and diminished regenerative capacity. Despite advances in understanding the etiology of DPN, few approved therapies exist for the pharmacological management of painful or insensate DPN. Therefore, identifying novel therapeutic strategies remains paramount. Because DPN does not develop with either temporal or biochemical uniformity, its therapeutic management may benefit from a multifaceted approach that inhibits pathogenic mechanisms, manages inflammation, and increases cytoprotective responses. Finally, exercise has long been recognized as a part of the therapeutic management of diabetes, and exercise can delay and/or prevent the development of painful DPN. This review presents an overview of existing therapies that target both causal and symptomatic features of DPN and discusses the role of up-regulating cytoprotective pathways via modulating molecular chaperones. Overall, it may be unrealistic to expect that a single pharmacologic entity will suffice to ameliorate the multiple symptoms of human DPN. Thus, combinatorial therapies that target causal mechanisms and enhance endogenous reparative capacity may enhance nerve function and improve regeneration in DPN if they converge to decrease oxidative stress, improve mitochondrial bioenergetics, and increase response to trophic factors.

  6. Autophagy: A Novel Therapeutic Target for Diabetic Nephropathy.

    Science.gov (United States)

    Kume, Shinji; Koya, Daisuke

    2015-12-01

    Diabetic nephropathy is a leading cause of end stage renal disease and its occurance is increasing worldwide. The most effective treatment strategy for the condition is intensive treatment to strictly control glycemia and blood pressure using renin-angiotensin system inhibitors. However, a fraction of patients still go on to reach end stage renal disease even under such intensive care. New therapeutic targets for diabetic nephropathy are, therefore, urgently needed. Autophagy is a major catabolic pathway by which mammalian cells degrade macromolecules and organelles to maintain intracellular homeostasis. The accumulation of damaged proteins and organelles is associated with the pathogenesis of diabetic nephropathy. Autophagy in the kidney is activated under some stress conditions, such as oxidative stress and hypoxia in proximal tubular cells, and occurs even under normal conditions in podocytes. These and other accumulating findings have led to a hypothesis that autophagy is involved in the pathogenesis of diabetic nephropathy. Here, we review recent findings underpinning this hypothesis and discuss the advantages of targeting autophagy for the treatment of diabetic nephropathy.

  7. Therapeutic Targets for Management of Periodontitis and Diabetes

    Science.gov (United States)

    Sima, Corneliu; Van Dyke, Thomas E.

    2016-01-01

    The increasing incidence of diabetes mellitus (DM) and chronic periodontitis (CP) worldwide imposes a rethinking of individualized therapy for patients with both conditions. Central to bidirectional links between DM and CP is deregulated systemic inflammation and dysfunctional immune responses to altered-self and non-self. Control of blood glucose levels and metabolic imbalances associated with hyperglycemia in DM, and disruption of pathogenic subgingival biofilms in CP are currently the main therapeutic approaches for these conditions. Mounting evidence suggests the need to integrate immune modulatory therapeutics in treatment regimens that address the unresolved inflammation associated with DM and CP. The current review discusses the pathogenesis of DM and CP with emphasis on deregulated inflammation, current therapeutic approaches and the novel pro-resolution lipid mediators derived from Ω-3 polyunsaturated fatty acids.

  8. Therapeutic Targets for Management of Periodontitis and Diabetes

    Science.gov (United States)

    Sima, Corneliu; Van Dyke, Thomas E.

    2016-01-01

    The increasing incidence of diabetes mellitus (DM) and chronic periodontitis (CP) worldwide imposes a rethinking of individualized therapy for patients with both conditions. Central to bidirectional links between DM and CP is deregulated systemic inflammation and dysfunctional immune responses to altered-self and non-self. Control of blood glucose levels and metabolic imbalances associated with hyperglycemia in DM, and disruption of pathogenic subgingival biofilms in CP are currently the main therapeutic approaches for these conditions. Mounting evidence suggests the need to integrate immune modulatory therapeutics in treatment regimens that address the unresolved inflammation associated with DM and CP. The current review discusses the pathogenesis of DM and CP with emphasis on deregulated inflammation, current therapeutic approaches and the novel pro-resolution lipid mediators derived from n-3 polyunsaturated fatty acids. PMID:26881443

  9. Immune-based Therapeutic Intervention and Treating AIDS with TCM%免疫干预疗法与中医药治疗艾滋病

    Institute of Scientific and Technical Information of China (English)

    关崇芬

    2004-01-01

    In the treatment of AIDS the highly-active anti-retroviral therapy(HAART) is potential and effective,but after one year of practice, many disadvantages appeared: After withdrawal of medication (short or long term) the plasma virus level rapidly rebound to that of before treatment which existed originally in the lymph nodes ; there are different types of HIV susceptible cells, some of them could not be reached or being insensitive by anti-retroviral therapy(ART) ;ART agent's target is designed against different life cycle, they can lower the plasma VL level to undetectable level, but they cannot revive the destroyed immune system to normal immune function, as soon as withdrawaI occurred, the body still couldn't yield immune response to HIV ; the original combination using of ART is to clear the virus and prevent the drug tolerance, but under the pressure of highdosage of ART, the appearance of tolerance is inevitable. After HAART treatment. 4 kinds of treatment occurred: 40 % patients after effective inhibit plasma VL. immune reconstitution appeared; 40% patients VL does not reduce, but CD4 gradually increase ; 5 % patients VL began to lower, but CD4 without recovery: Completely ineffective, without any improvement both in VL and CD4 count. The tolerance of ART and immune impairment are 2 important factors, the latter is more important. Lymphocyte is activated against HIV replication, including HIV specific cytotoxic action, cytokine secretion, etc. But the large amount of infected cells, the specific viral gene and phenotype variation would cause the activated lymphocyte unable to clear-up the HIV and HIV-infected cells, the specific cytotoxic lymphocyte(CTL)and CD4 T helper inactivated. Three kinds of medicine were being used; Immune cell activator (IL-2, IFN-γ), immunosuppressor ( cyclosporin A) and virus replication inlibitor(IL-10,MIP-lα)to activate macrophage and promote immune response. TCM immuno-modulatory effect in treating AIDS: Immune-based

  10. Diabetic retinopathy: variations in patient therapeutic outcomes and pharmacogenomics

    Directory of Open Access Journals (Sweden)

    Agarwal A

    2014-12-01

    Full Text Available Aniruddha Agarwal, Mohamed K Soliman, Yasir J Sepah, Diana V Do, Quan Dong Nguyen Ocular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, USA Abstract: Diabetes and its microvascular complications in patients poses a significant challenge and constitutes a major health problem. When it comes to manifestations in the eye, each case of diabetic retinopathy (DR is unique, in terms of the phenotype, genotype, and, more importantly, the therapeutic response. It is therefore important to identify factors that distinguish one patient from another. Personalized therapy in DR is a new trend aimed at achieving maximum therapeutic response in patients by identifying genotypic and phenotypic factors that may result in less than optimal response to conventional therapy, and consequently, lead to poorer outcome. With advances in the identification of these genetic markers, such as gene polymorphisms and human leucocyte antigen associations, as well as development of drugs that can target their effects, the future of personalized medicine in DR is promising. In this comprehensive review, data from various studies have been analyzed to present what has been achieved in the field of pharmacogenomics thus far. An insight into future research is also provided. Keywords: personalized medicine, therapeutic variation, genomic markers, genotype, phenotype, VEGF mutation, polymorphism, linkage, mutation, responder

  11. Hypusine: a new target for therapeutic intervention in diabetic inflammation.

    Science.gov (United States)

    Maier, Bernhard; Tersey, Sarah A; Mirmira, Raghavendra G

    2010-07-01

    Diabetes, a disorder of glucose homeostasis, has risen to near epidemic proportions world-wide and may be the single most important risk factor for cardiovascular, kidney, and eye disease. Dysfunction and destruction of islet beta cells, caused in part by the systemic or local release of pro-inflammatory cytokines, underlies all forms of diabetes. A major effort in diabetes research in recent years has been to identify new factors or pathways that can be therapeutically targeted to reduce cytokine action on the beta cell. Recent studies have suggested that an ancient and poorly understood protein, eIF5A, may be critical to cytokine release and signaling. Interestingly, eIF5A is the only protein to contain the unique amino acid hypusine, which is a polyamine-derived modification of amino acid lysine residue. This modification is catalyzed by the sequential actions of the inhibitable enzymes deoxyhypusine synthase and deoxyhypusine hydroxylase. Because the hypusine modification is absolutely required for eIF5A action in cytokine signaling, we propose that this modification could serve as a new drug target for islet beta cell protection in the setting of diabetic inflammation.

  12. Inflammation as a Therapeutic Target for Diabetic Neuropathies.

    Science.gov (United States)

    Pop-Busui, Rodica; Ang, Lynn; Holmes, Crystal; Gallagher, Katherine; Feldman, Eva L

    2016-03-01

    Diabetic neuropathies (DNs) are one of the most prevalent chronic complications of diabetes and a major cause of disability, high mortality, and poor quality of life. Given the complex anatomy of the peripheral nervous system and types of fiber dysfunction, DNs have a wide spectrum of clinical manifestations. The treatment of DNs continues to be challenging, likely due to the complex pathogenesis that involves an array of systemic and cellular imbalances in glucose and lipids metabolism. These lead to the activation of various biochemical pathways, including increased oxidative/nitrosative stress, activation of the polyol and protein kinase C pathways, activation of polyADP ribosylation, and activation of genes involved in neuronal damage, cyclooxygenase-2 activation, endothelial dysfunction, altered Na(+)/K(+)-ATPase pump function, impaired C-peptide-related signaling pathways, endoplasmic reticulum stress, and low-grade inflammation. This review summarizes current evidence regarding the role of low-grade inflammation as a potential therapeutic target for DNs.

  13. Microbubbles and Ultrasound: Therapeutic Applications in Diabetic Nephropathy.

    Science.gov (United States)

    Cao, Wei J; Matkar, Pratiek N; Chen, Hao H; Mofid, Azadeh; Leong-Poi, Howard

    2016-01-01

    Diabetic nephropathy (DN) remains one of the most common causes of end-stage renal disease. Current therapeutic strategies aiming at optimization of serum glucose and blood pressure are beneficial in early stage DN, but are unable to fully prevent disease progression. With the limitations of current medical therapies and the shortage of available donor organs for kidney transplantation, the need for novel therapies to address DN complications and prevent progression towards end-stage renal failure is crucial. The development of ultrasound technology for non-invasive and targeted in-vivo gene delivery using high power ultrasound and carrier microbubbles offers great therapeutic potential for the prevention and treatment of DN. The promising results from preclinical studies of ultrasound-mediated gene delivery (UMGD) in several DN animal models suggest that UMGD offers a unique, non-invasive platform for gene- and cell-based therapies targeted against DN with strong clinical translation potential.

  14. AMPK activation: a therapeutic target for type 2 diabetes?

    Directory of Open Access Journals (Sweden)

    Coughlan KA

    2014-06-01

    Full Text Available Kimberly A Coughlan, Rudy J Valentine, Neil B Ruderman, Asish K Saha Endocrinology and Diabetes, Department of Medicine, Boston University Medical Center, Boston, MA, USA Abstract: Type 2 diabetes (T2D is a metabolic disease characterized by insulin resistance, β-cell dysfunction, and elevated hepatic glucose output. Over 350 million people worldwide have T2D, and the International Diabetes Federation projects that this number will increase to nearly 600 million by 2035. There is a great need for more effective treatments for maintaining glucose homeostasis and improving insulin sensitivity. AMP-activated protein kinase (AMPK is an evolutionarily conserved serine/threonine kinase whose activation elicits insulin-sensitizing effects, making it an ideal therapeutic target for T2D. AMPK is an energy-sensing enzyme that is activated when cellular energy levels are low, and it signals to stimulate glucose uptake in skeletal muscles, fatty acid oxidation in adipose (and other tissues, and reduces hepatic glucose production. There is substantial evidence suggesting that AMPK is dysregulated in animals and humans with metabolic syndrome or T2D, and that AMPK activation (physiological or pharmacological can improve insulin sensitivity and metabolic health. Numerous pharmacological agents, natural compounds, and hormones are known to activate AMPK, either directly or indirectly – some of which (for example, metformin and thiazolidinediones are currently used to treat T2D. This paper will review the regulation of the AMPK pathway and its role in T2D, some of the known AMPK activators and their mechanisms of action, and the potential for future improvements in targeting AMPK for the treatment of T2D. Keywords: adenosine monophosphate-activated protein kinase, type 2 diabetes, insulin resistance, drug therapy

  15. Cellular and Molecular Mechanisms of Diabetic Atherosclerosis: Herbal Medicines as a Potential Therapeutic Approach

    Directory of Open Access Journals (Sweden)

    Jinfan Tian

    2017-01-01

    Full Text Available An increasing number of patients diagnosed with diabetes mellitus eventually develop severe coronary atherosclerosis disease. Both type 1 and type 2 diabetes mellitus increase the risk of cardiovascular disease associated with atherosclerosis. The cellular and molecular mechanisms affecting the incidence of diabetic atherosclerosis are still unclear, as are appropriate strategies for the prevention and treatment of diabetic atherosclerosis. In this review, we discuss progress in the study of herbs as potential therapeutic agents for diabetic atherosclerosis.

  16. A novel therapeutic effect of statins on nephrogenic diabetes insipidus.

    Science.gov (United States)

    Bonfrate, Leonilde; Procino, Giuseppe; Wang, David Q-H; Svelto, Maria; Portincasa, Piero

    2015-02-01

    Statins competitively inhibit hepatic 3-hydroxy-3-methylglutaryl-coenzyme A reductase, resulting in reduced plasma total and low-density lipoprotein cholesterol levels. Recently, it has been shown that statins exert additional 'pleiotropic' effects by increasing expression levels of the membrane water channels aquaporin 2 (AQP2). AQP2 is localized mainly in the kidney and plays a critical role in determining cellular water content. This additional effect is independent of cholesterol homoeostasis, and depends on depletion of mevalonate-derived intermediates of sterol synthetic pathways, i.e. farnesylpyrophosphate and geranylgeranylpyrophosphate. By up-regulating the expression levels of AQP2, statins increase water reabsorption by the kidney, thus opening up a new avenue in treating patients with nephrogenic diabetes insipidus (NDI), a hereditary disease that yet lacks high-powered and limited side effects therapy. Aspects related to water balance determined by AQP2 in the kidney, as well as standard and novel therapeutic strategies of NDI are discussed.

  17. Melatonin receptors in diabetes: a potential new therapeutical target?

    Science.gov (United States)

    She, Meihua; Laudon, Moshe; Yin, Weidong

    2014-12-05

    Melatonin is synthesized and secreted mainly by the pineal gland in a circadian fashion, and it thus mediates endogenous circadian rhythms and influences other physiological functions. Both the G-protein coupled receptors MT1 (encoded by MTNR1A) and MT2 (encoded by MTNR1B) in mammals mediate the actions of melatonin. Evidence from in vivo and in vitro studies proved a key role of melatonin in the regulation of glucose metabolism and the pathogenesis of diabetes, as further confirmed by the recent studies of human genetic variants of MTNR1B. Remarkably, it was also suggested that genetic variations within MTNR1B disordered β-cells function directly, i.e. insulin secretion. This indicated the functional link between MT2 and T2D risk at the protein level, and it may represent the prevailing pathomechanism for how impaired melatonin signaling causes metabolic disorders and increases the T2D risk. It is speculated that melatonin and its receptors may be a new therapeutic avenue in diabetes.

  18. AMPK activation: a therapeutic target for type 2 diabetes?

    Science.gov (United States)

    Coughlan, Kimberly A; Valentine, Rudy J; Ruderman, Neil B; Saha, Asish K

    2014-01-01

    Type 2 diabetes (T2D) is a metabolic disease characterized by insulin resistance, β-cell dysfunction, and elevated hepatic glucose output. Over 350 million people worldwide have T2D, and the International Diabetes Federation projects that this number will increase to nearly 600 million by 2035. There is a great need for more effective treatments for maintaining glucose homeostasis and improving insulin sensitivity. AMP-activated protein kinase (AMPK) is an evolutionarily conserved serine/threonine kinase whose activation elicits insulin-sensitizing effects, making it an ideal therapeutic target for T2D. AMPK is an energy-sensing enzyme that is activated when cellular energy levels are low, and it signals to stimulate glucose uptake in skeletal muscles, fatty acid oxidation in adipose (and other) tissues, and reduces hepatic glucose production. There is substantial evidence suggesting that AMPK is dysregulated in animals and humans with metabolic syndrome or T2D, and that AMPK activation (physiological or pharmacological) can improve insulin sensitivity and metabolic health. Numerous pharmacological agents, natural compounds, and hormones are known to activate AMPK, either directly or indirectly - some of which (for example, metformin and thiazolidinediones) are currently used to treat T2D. This paper will review the regulation of the AMPK pathway and its role in T2D, some of the known AMPK activators and their mechanisms of action, and the potential for future improvements in targeting AMPK for the treatment of T2D.

  19. TRP Channels as Therapeutic Targets in Diabetes and Obesity

    Science.gov (United States)

    Zsombok, Andrea; Derbenev, Andrei V.

    2016-01-01

    During the last three to four decades the prevalence of obesity and diabetes mellitus has greatly increased worldwide, including in the United States. Both the short- and long-term forecasts predict serious consequences for the near future, and encourage the development of solutions for the prevention and management of obesity and diabetes mellitus. Transient receptor potential (TRP) channels were identified in tissues and organs important for the control of whole body metabolism. A variety of TRP channels has been shown to play a role in the regulation of hormone release, energy expenditure, pancreatic function, and neurotransmitter release in control, obese and/or diabetic conditions. Moreover, dietary supplementation of natural ligands of TRP channels has been shown to have potential beneficial effects in obese and diabetic conditions. These findings raised the interest and likelihood for potential drug development. In this mini-review, we discuss possibilities for better management of obesity and diabetes mellitus based on TRP-dependent mechanisms. PMID:27548188

  20. Therapeutic management of type 1 diabetes before and during pregnancy

    DEFF Research Database (Denmark)

    Mathiesen, Elisabeth R; Damm, Peter; Nielsen, Lene Ringholm

    2011-01-01

    the risk of malformations. Screening for diabetic retinopathy, diabetic nephropathy and thyroid dysfunction is important, and indications for antihypertensive treatment and treatment of thyroid dysfunction need to be in focus before and during pregnancy.......Introduction: Pregnancy increases the risks of adverse outcomes for mother and infant in women with type 1 diabetes. Obtaining and maintaining adequate glycemic control during pregnancy is crucial for optimizing outcomes. Areas covered: The importance of prepregnancy planning and treatment during...... pregnancy is reviewed. The use of insulin analogues and antihypertensive drugs in diabetic pregnancy are in focus. The reader is presented with evidence discussing the importance of prepregnancy counseling and treatment during pregnancy in women with type 1 diabetes. Expert opinion: Tight glycemic control...

  1. Harnessing the immunological properties of stem cells as a therapeutic option for diabetic nephropathy.

    Science.gov (United States)

    D'Addio, Francesca; Trevisani, Alessio; Ben Nasr, Moufida; Bassi, Roberto; El Essawy, Basset; Abdi, Reza; Secchi, Antonio; Fiorina, Paolo

    2014-12-01

    Diabetic nephropathy is the leading and possibly the most devastating complication of diabetes, with a prevalence ranging from 25 to 40 % in diabetic individuals, and as such represents an important challenge for public health worldwide. As a major cause of end-stage renal disease, diabetic nephropathy also accounts for a large proportion of deaths in diabetic individuals. To date, therapeutic options for overt diabetic nephropathy include medical interventions to reduce blood glucose levels and to control blood pressure and proteinuria. Recent evidence suggests a strong role for inflammation in the development and progression of diabetic nephropathy. Various immune cells, cytokines and chemokines have been implicated in the onset of diabetic nephropathy, while immune-related transcription factors and adhesion molecules have been correlated with the establishment of a renal proinflammatory microenvironment. Both inflammation and immune activation may promote severe distress in the kidney, with subsequent increased local fibrosis, ultimately leading to the development of end-stage renal disease. Stem cells are undifferentiated cells capable of regenerating virtually any organ or tissue and bearing important immunoregulatory and anti-inflammatory properties. Due to the aforementioned considerations, significant interest has been ignited with regard to the use of stem cells as novel therapeutics for diabetic nephropathy. Here, we will be examining in detail how anti-inflammatory properties of different populations of stem cells may offer novel therapy for the treatment of diabetic nephropathy.

  2. Honey: A Potential Therapeutic Agent for Managing Diabetic Wounds

    Directory of Open Access Journals (Sweden)

    Fahmida Alam

    2014-01-01

    Full Text Available Diabetic wounds are unlike typical wounds in that they are slower to heal, making treatment with conventional topical medications an uphill process. Among several different alternative therapies, honey is an effective choice because it provides comparatively rapid wound healing. Although honey has been used as an alternative medicine for wound healing since ancient times, the application of honey to diabetic wounds has only recently been revived. Because honey has some unique natural features as a wound healer, it works even more effectively on diabetic wounds than on normal wounds. In addition, honey is known as an “all in one” remedy for diabetic wound healing because it can combat many microorganisms that are involved in the wound process and because it possesses antioxidant activity and controls inflammation. In this review, the potential role of honey’s antibacterial activity on diabetic wound-related microorganisms and honey’s clinical effectiveness in treating diabetic wounds based on the most recent studies is described. Additionally, ways in which honey can be used as a safer, faster, and effective healing agent for diabetic wounds in comparison with other synthetic medications in terms of microbial resistance and treatment costs are also described to support its traditional claims.

  3. Genetic variations in TCF7L2 influence therapeutic response to sulfonylureas in Indian diabetics.

    Science.gov (United States)

    Dhawan, Dipali; Padh, Harish

    2016-11-01

    Sulfonylureas are widely used to treat type 2 diabetes, with considerable inter-individual variation in the hypoglycaemic response to sulfonylureas. Genetic variants in the gene encoding for transcription factor-7-like 2 (TCF7L2) have been associated with type 2 diabetes. This study aimed to study the effect of variations in TCF7L2 on therapeutic response to sulfonylureas in Type 2 diabetes mellitus patients. The effect of TCF7L2 rs12255372, rs7903146 and rs4506565 genotypes on glycaemic response was observed in 250 diabetic patients treated with sulfonylureas and sulfonylureas along with metformin. The genotyping tests were done by allele-specific multiplex PCR. Glycated haemoglobin (HbA1c) levels were used as phenotypic marker. 60% of sulfonylurea users did not achieve a target HbA1c levels of ⩽6.5% (48mmol/mol) (which denotes good control in diabetics). Genotype influenced response to sulfonylureas, with more treatment failure in the TT homozygotes in case of rs12255372 and rs4506565. The GG genotype at rs12255372 favourably influences treatment success with sulfonylurea therapy in patients with type 2 diabetes (p⩽0.05). At rs12255372, 70.5% GT or TT genotype failed to achieve therapeutic target, an absolute difference of 19% compared to GG homozygotes. Our preliminary data show that genetic variation at rs12255372 has a direct correlation with therapeutic success with sulfonylureas in type 2 diabetes, hence paving the way for better treatment outcomes in diabetics.

  4. Emerging therapeutics for the treatment of diabetic nephropathy.

    Science.gov (United States)

    Brenneman, Jehrod; Hill, Jon; Pullen, Steve

    2016-09-15

    Diabetic nephropathy (DN) is the most common pathology contributing to the development of chronic kidney disease (CKD). DN caused by hypertension and unmitigated inflammation in diabetics, renders the kidneys unable to perform normally, and leads to renal fibrosis and organ failure. The increasing global prevalence of DN has been directly attributed to rising incidences of Type II diabetes, and is now the largest non-communicable cause of death worldwide. Despite the high morbidity, successful new treatments for DN are lacking. This review seeks to provide new insight on emerging clinical candidates under investigation for the treatment of DN.

  5. [Relationships between diabetes mellitus and periodontal disease: current knowledges and therapeutic prospects].

    Science.gov (United States)

    Garofalo, G S

    2008-01-01

    Diabetes mellitus is a disorder of the endocrine system. An important pathology of dental interest to which the diabetic patient can go encounter, especially if not controlled from the metabolic point of view, is the periodontal disease. The aim of this review is to illustrate the relation between diabetes mellitus and periodontal disease estimating the several therapeutic options on hand in the clinical daily practice. Many studies show an important association between diabetes and the pathogenesis of periodontal disease. Vascular changes caused by hyper-glycemia are associated to the development of periodontal pathogens species. Moreover, diabetics show an exacerbate host response with hyperproduction of inflammatory mediators and polymorphonuclear dysfunction. Diabetics with good metabolic control and patients with good oral hygiene show a reduced risk of periodontitis. In conclusion, diabetes mellitus (of type 1 and type 2) is an important risk factor for periodontitis. Diabetes mellitus determines changes in bacterial population and production of inflammatory mediators, and reduces the efficacy of the host response. Good controlled diabetes do not cause a major risk of periodontitis and improve the results of the periodontal initial therapy and of the eventual surgical therapy. Moreover, periodontal therapy may reduce the request of insulin in diabetics. It is reasonable a reciprocal relation between diabetes and periodontal disease.

  6. Adherence to wearing therapeutic shoes among people with diabetes: a systematic review and reflections

    Directory of Open Access Journals (Sweden)

    Jarl G

    2016-08-01

    Full Text Available Gustav Jarl,1,2 Lars-Olov Lundqvist2 1Department of Prosthetics and Orthotics, Faculty of Medicine and Health, 2University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden Introduction: Therapeutic shoes are prescribed to prevent diabetic foot ulcers, but adherence to wearing the shoes is often poor.  Aim: The aim of this study was to review the literature on factors that are associated with adherence to wearing therapeutic shoes and construct a model of adherence to aid future research and development in the field. Methods: We conducted a systematic search in PubMed, CINAHL, and PsycINFO for quantitative studies on factors associated with adherence to wearing therapeutic shoes among people with diabetes. Results: Six studies were included in the review. The studies focused mainly on patient-, therapy-, and condition-related adherence factors. There is some evidence (three to five studies that sex, diabetes duration, and ulcer history are not associated with adherence. The evidence for or against the other factors was weak (only one or two studies or conflicting. Conclusion: There is no conclusive evidence for using any factor to predict adherence to wearing therapeutic shoes, but there is some evidence against using certain factors for predicting adherence. Future studies should include a broader range of factors, including health system and social/economic factors, and they should investigate perceived costs and benefits of wearing therapeutic shoes in comparison with other shoes or no shoes. A seesaw model is presented illustrating the complex phenomenon of adherence. Further research is needed to identify factors associated with adherence to wearing therapeutic shoes, to enable the development of interventions to improve adherence and thereby reduce ulceration rates among people with diabetic foot complications.Keywords: Patient compliance, shoes, foot ulcer, diabetic foot, diabetes

  7. The New Prognostic-Therapeutic Index for Diabetic Foot Surgery--Extended Analysis.

    Science.gov (United States)

    Bobircă, Florin; Mihalache, Octavian; Georgescu, Dragoş; Pătraşcu, Traian

    2016-01-01

    The disproportionate surgical indication in patients with diabetic foot, as well as the large number of major amputations of the pelvic limb have created the necessity of conceiving a therapeutic-prognostic index to guide the physician in establishing the adequate surgical indication. The aim of this analysis is to extend a former research published in 2014, regarding the new prognostic-therapeutic index used in the diabetic foot pathology, that included 929 patients. We have analyzed a number of 1221 patients, that were admitted at the Surgery Clinic of the Cantacuzino Hospital, between January 2013 and June 2015, suffering from diabetes mellitus and associating diabetic foot lesions. The new therapeutic-prognostic index has been calculated for the retrospective lot, resulting into a concordance between the actual surgical intervention and the prognostic index of 79.4%; for the patients evaluated prospectively we have found a confirmation of the relation between the performed surgical intervention and the forecasted surgical intervention, of 86,8%. The new therapeutic-prognostic index is of a major usefulness in recommending an adequate therapeutic conduct correlated to the severity of the lesion, especially in facilities where the pathology of the diabetic foot is less known. Celsius.

  8. The relationship between patients' knowledge of diabetes therapeutic goals and self-management behaviour, including adherence.

    Science.gov (United States)

    Waheedi, Mohammad; Awad, Abdelmoneim; Hatoum, Hind T; Enlund, Hannes

    2017-02-01

    Background The Middle East region has one the highest prevalence rates of diabetes in the world. Little is known about the determinants of adherence and the role of knowledge in diabetes self-management within these populations. Objective To investigate the relationship between patients knowledge of diabetes therapeutic targets with adherence to self-care measures in a sample of patients with type 2 diabetes in Kuwait. Setting Primary care chronic care clinics within the Ministry of Health of Kuwait. Methods A cross sectional survey was carried out with 238 patients from six clinics. A multistage stratified clustered sampling method was used to first randomly select the clinics and the patients. Self-reported adherence to three behaviours: medication taking, diet and physical activity. Results Respondents were able to correctly report a mean (SD) of 1.6 (1.3) out of 5 of the pre-specified treatment targets. Optimal adherence to physical activity, diet and medications was reported in 25, 33 and 47 % of the study cohort, respectively. A structural equation model analysis showed better knowledge of therapeutic goals and own current levels translated into better adherence to medications, diet and physical activity. Conclusion Knowledge of therapeutic goals and own recent levels is associated with adherence to medications, diet, or physical activity in this Kuwaiti cohort of patients with diabetes. Low adherence to self-care management and poor overall knowledge of diabetes is a big challenge to successful diabetes care in Kuwait.

  9. High Density Lipoprotein: A Therapeutic Target in Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Philip J. Barter

    2013-09-01

    Full Text Available High density lipoproteins (HDLs have a number of properties that have the potential to inhibit the development of atherosclerosis and thus reduce the risk of having a cardiovascular event. These protective effects of HDLs may be reduced in patients with type 2 diabetes, a condition in which the concentration of HDL cholesterol is frequently low. In addition to their potential cardioprotective properties, HDLs also increase the uptake of glucose by skeletal muscle and stimulate the synthesis and secretion of insulin from pancreatic β cells and may thus have a beneficial effect on glycemic control. This raises the possibility that a low HDL concentration in type 2 diabetes may contribute to a worsening of diabetic control. Thus, there is a double case for targeting HDLs in patients with type 2 diabetes: to reduce cardiovascular risk and also to improve glycemic control. Approaches to raising HDL levels include lifestyle factors such as weight reduction, increased physical activity and stopping smoking. There is an ongoing search for HDL-raising drugs as agents to use in patients with type 2 diabetes in whom the HDL level remains low despite lifestyle interventions.

  10. Immunity-based diagnosis for a motherboard.

    Science.gov (United States)

    Shida, Haruki; Okamoto, Takeshi; Ishida, Yoshiteru

    2011-01-01

    We have utilized immunity-based diagnosis to detect abnormal behavior of components on a motherboard. The immunity-based diagnostic model monitors voltages of some components, CPU temperatures, and fan speeds. We simulated abnormal behaviors of some components on the motherboard, and we utilized the immunity-based diagnostic model to evaluate motherboard sensors in two experiments. These experiments showed that the immunity-based diagnostic model was an effective method for detecting abnormal behavior of components on the motherboard.

  11. Immunity-Based Diagnosis for a Motherboard

    OpenAIRE

    Yoshiteru Ishida; Takeshi Okamoto; Haruki Shida

    2011-01-01

    We have utilized immunity-based diagnosis to detect abnormal behavior of components on a motherboard. The immunity-based diagnostic model monitors voltages of some components, CPU temperatures, and fan speeds. We simulated abnormal behaviors of some components on the motherboard, and we utilized the immunity-based diagnostic model to evaluate motherboard sensors in two experiments. These experiments showed that the immunity-based diagnostic model was an effective method for detecting abnormal...

  12. Immunity-Based Diagnosis for a Motherboard

    OpenAIRE

    Yoshiteru Ishida; Takeshi Okamoto; Haruki Shida

    2011-01-01

    We have utilized immunity-based diagnosis to detect abnormal behavior of components on a motherboard. The immunity-based diagnostic model monitors voltages of some components, CPU temperatures, and fan speeds. We simulated abnormal behaviors of some components on the motherboard, and we utilized the immunity-based diagnostic model to evaluate motherboard sensors in two experiments. These experiments showed that the immunity-based diagnostic model was an effective method for detecting abnormal...

  13. Biomarkers in Diabetic Retinopathy and the Therapeutic Implications

    Directory of Open Access Journals (Sweden)

    Katarzyna Zorena

    2013-01-01

    Full Text Available The main problem both in type 1 (T1DM and type 2 (T2DM diabetes is the development of chronic vascular complications encompassing micro- as well as macrocirculation. Chronic complications lower the quality of life, lead to disability, and are the cause of premature death in DM patients. One of the chronic vascular complications is a diabetic retinopathy (DR which leads to a complete loss of sight in DM patients. Recent trials show that the primary cause of diabetic retinopathy is retinal neovascularization caused by disequilibrium between pro- and antiangiogenic factors. Gaining knowledge of the mechanisms of action of factors influencing retinal neovascularization as well as the search for new, effective treatment methods, especially in advanced stages of DR, puts special importance on research concentrating on the implementation of biological drugs in DR therapy. At present, it is antivascular endothelial growth factor and antitumor necrosis factor that gain particular significance.

  14. Possible therapeutic potential of berberine in diabetic osteopathy.

    Science.gov (United States)

    Rahigude, A B; Kaulaskar, S V; Bhutada, P S

    2012-10-01

    Diabetic osteopathy is a complication that leads to decreased bone mineral density, bone formation and having high risk of fractures that heals slowly. Diabetic osteopathy is a result of increase in osteoclastogenesis and decrease in osteoblastogenesis. Various factors viz., oxidative stress, increased inflammatory markers, PPAR-γ activation in osteoblast, activation of apoptotic pathway, increased glucose levels and inhibitory effect on parathyroid hormone etc. are mainly responsible for decreased bone mineral density. Berberine is an isoquinoline alkaloid widely used in Asian countries as a traditional medicine. Berberine is extensively reported to be an antioxidant, anti-inflammatory, antidiabetic, and having potential to treat diabetic complications and glucocorticoid induced osteoporosis. The osteoclastogenesis decreasing property of berberine can be hypothesized for inhibiting diabetic osteopathy. In addition, chronic treatment of berberine will be helpful for increasing the osteoblastic activity and expression of the modulators that affect osteoblastic differentiation. The apoptotic pathways stimulated due to increased inflammatory markers and nucleic acid damages could be reduced due to berberine. Another important consideration that berberine is having stimulatory effect on glucagon like peptide release and insulin sensitization that will be helpful for decreasing glucose levels and therefore, may exerts osteogenesis. Thiazolidinediones show bone loss due to activation of PPAR-γ in osteoblasts, whereas berberine stimulates PPAR-γ only in adipocytes and not in osteoblasts, and therefore the decreased bone loss due to use of thiazolidinediones may not be observed in berberine treatment conditions. Berberine decreases the advanced glycation end-products (AGE) formation in diabetic condition which will be ultimately helpful to decrease the stiffness of collagen fibers due to AGE-induced cross linking. Lastly, it is also reported that berberine has

  15. Therapeutic inhibition of mitochondrial reactive oxygen species with mito-TEMPO reduces diabetic cardiomyopathy

    Science.gov (United States)

    Ni, Rui; Cao, Ting; Xiong, Sidong; Ma, Jian; Fan, Guo-Chang; Lacefield, James C.; Lu, Yanrong; Le Tissier, Sydney; Peng, Tianqing

    2016-01-01

    Aims The mitochondria are important sources of reactive oxygen species (ROS) in the heart. Mitochondrial ROS production has been implicated in the pathogenesis of diabetic cardiomyopathy, suggesting that therapeutic strategies specifically targeting mitochondrial ROS may have benefit in this disease. We investigated the therapeutic effects of mitochondria-targeted antioxidant mito-TEMPO on diabetic cardiomyopathy. Methods The mitochondria-targeted antioxidant mito-TEMPO was administrated after diabetes onset in a mouse model of streptozotocin-induced type-1 diabetes and type-2 diabetic db/db mice. Cardiac adverse changes were analyzed and myocardial function assessed. Cultured adult cardiomyocytes were stimulated with high glucose, and mitochondrial superoxide generation and cell death were measured. Results Incubation with high glucose increased mitochondria superoxide generation in cultured cardiomyocytes, which was prevented by mito-TEMPO. Co-incubation with mito-TEMPO abrogated high glucose-induced cell death. Mitochondrial ROS generation, and intracellular oxidative stress levels were induced in both type-1 and type-2 diabetic mouse hearts. Daily injection of mito-TEMPO for 30 days inhibited mitochondrial ROS generation, prevented intracellular oxidative stress levels, decreased apoptosis and reduced myocardial hypertrophy in diabetic hearts, leading to improvement of myocardial function in both type-1 and type-2 diabetic mice. Incubation with mito-TEMPO or inhibition of Nox2-containing NADPH oxidase prevented oxidative stress levels and cell death in high glucose-stimulated cardiomyocytes. Mechanistic study revealed that the protective effects of mito-TEMPO were associated with down-regulation of ERK1/2 phosphorylation. Conclusions Therapeutic inhibition of mitochondrial ROS by mito-TEMPO reduced adverse cardiac changes and mitigated myocardial dysfunction in diabetic mice. Thus, mitochondria-targeted antioxidants may be an effective therapy for diabetic

  16. [Clinical and therapeutic analysis of type 2 diabetics in Portuguese community pharmacies].

    Science.gov (United States)

    Pires, Carla

    2011-12-01

    Diabetes is one of the most important chronic diseases in the world. This observational study was performed in 7 community pharmacies between October 2002 and July 2003. Analysis and characterization of demographic, clinical and therapeutic aspects of a type 2 diabetes group. Systematic selection of 150 patients with questionnaire evaluation. Blood glucose levels, blood pressure, body mass index, family history of diabetes and drug intake were measured. The data were processed using SPSS. Almost all patients had glycemic metabolic decompensation. identification of therapeutic problems and formulation of two study hypotheses: statins could be beneficial to the metabolic control of type 2 diabetes. On the other hand oral intake of sulphonylureas in association with biguanides could be prejudicial.

  17. Therapeutic efficacy of differentiated versus undifferentiated mesenchymal stem cells in experimental type I diabetes in rat

    Directory of Open Access Journals (Sweden)

    M.A. Wassef

    2016-03-01

    Full Text Available Selective MSCs differentiation protocol into pancreatic beta cells was conducted in the present study using exendin-4 and TGF-beta. Differentiated and undifferentiated MSCs were assessed in experimental type I diabetes in rats. Ninety female white albino rats were included in the study and divided equally (n=15/group into 6 groups: healthy control, healthy control rats received acellular tissue culture medium, diabetic rats, diabetic rats received acellular tissue culture medium, diabetic rats received undifferentiated MSCs and diabetic rats received differentiated MSCs. Therapeutic efficacy of undifferentiated versus differentiated MSCs was evaluated via assessment of quantitative gene expressions of insulin1, insulin 2, Smad-2, Smad-3, PDX-1, PAX-4, neuroD. Blood glucose and insulin hormone levels were also assessed. Results showed that quantitative gene expressions of all studied genes showed significant decrease in diabetic rat groups. Use of undifferentiated and differentiated MSCs led to a significant elevation of expression levels of all genes with more superior effect with differentiated MSCs except smad-2 gene. As regards insulin hormone levels, use of either undifferentiated or differentiated MSCs led to a significant elevation of its levels with more therapeutic effect with differentiated MSCs. Blood glucose levels were significantly decreased with both undifferentiated and differentiated MSCs in comparison to diabetic groups but its levels were normalized 2 months after injection of differentiated MSCs. In conclusion, use of undifferentiated or differentiated MSCs exhibited significant therapeutic potentials in experimental type I diabetes in rats with more significant therapeutic effect with the use of differentiated MSCs.

  18. Influence of comorbidities on therapeutic progression of diabetes treatment in Australian veterans: a cohort study.

    Directory of Open Access Journals (Sweden)

    Agnes I Vitry

    Full Text Available BACKGROUND: This study assessed whether the number of comorbid conditions unrelated to diabetes was associated with a delay in therapeutic progression of diabetes treatment in Australian veterans. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective cohort study was undertaken using data from the Australian Department of Veterans' Affairs (DVA claims database between July 2000 and June 2008. The study included new users of metformin or sulfonylurea medicines. The outcome was the time to addition or switch to another antidiabetic treatment. The total number of comorbid conditions unrelated to diabetes was identified using the pharmaceutical-based comorbidity index, Rx-Risk-V. Competing risk regression analyses were conducted, with adjustments for a number of covariates that included age, gender, residential status, use of endocrinology service, number of hospitalisation episodes and adherence to diabetes medicines. Overall, 20,134 veterans were included in the study. At one year, 23.5% of patients with diabetes had a second medicine added or had switched to another medicine, with 41.4% progressing by 4 years. The number of unrelated comorbidities was significantly associated with the time to addition of an antidiabetic medicine or switch to insulin (subhazard ratio [SHR] 0.87 [95% CI 0.84-0.91], P<0.001. Depression, cancer, chronic obstructive pulmonary disease, dementia, and Parkinson's disease were individually associated with a decreased likelihood of therapeutic progression. Age, residential status, number of hospitalisations and adherence to anti-diabetic medicines delayed therapeutic progression. CONCLUSIONS/SIGNIFICANCE: Increasing numbers of unrelated conditions decreased the likelihood of therapeutic progression in veterans with diabetes. These results have implications for the development of quality measures, clinical guidelines and the construction of models of care for management of diabetes in elderly people with comorbidities.

  19. Current therapeutic agents and anesthetic considerations for diabetes mellitus.

    Science.gov (United States)

    Kang, Hyoseok

    2012-09-01

    As the incidence of diabetes mellitus (DM) continues to increase worldwide, more diabetic patients will be presented for surgery and anesthesia. This increase of DM is a consequence of the rise in new patients of type 2 DM, and is likely attributable to rapid economic development, improved living standards, aging population, obesity, and lack of exercise. The primary goal of management in DM is to delay, or prevent the macro- and microvascular complications by achieving good glycemic control. More understanding of the pathophysiology of DM has contributed to the advance of new pharmacological approaches. In addition to the conventional therapy for DM, glucagon-like peptide-1 (GLP-1) mimetics, dipeptidyl peptidase-4 (DPP-4) inhibitors, thiazolidinediones (TZDs), and insulin analogues are currently available effective hypoglycemic agents for the management of the patients with DM in the perioperative period and also consider the adverse effects of newly introduced agents that need more clinical observations.

  20. The role of melatonin in diabetes: therapeutic implications.

    Science.gov (United States)

    Sharma, Shweta; Singh, Hemant; Ahmad, Nabeel; Mishra, Priyanka; Tiwari, Archana

    2015-10-01

    Melatonin referred as the hormone of darkness is mainly secreted by pineal gland, its levels being elevated during night and low during the day. The effects of melatonin on insulin secretion are mediated through the melatonin receptors (MT1 and MT2). It decreases insulin secretion by inhibiting cAMP and cGMP pathways but activates the phospholipaseC/IP3 pathway, which mobilizes Ca2+from organelles and, consequently increases insulin secretion. Both in vivo and in vitro, insulin secretion by the pancreatic islets in a circadian manner, is due to the melatonin action on the melatonin receptors inducing a phase shift in the cells. Melatonin may be involved in the genesis of diabetes as a reduction in melatonin levels and a functional interrelationship between melatonin and insulin was observed in diabetic patients. Evidences from experimental studies proved that melatonin induces production of insulin growth factor and promotes insulin receptor tyrosine phosphorylation. The disturbance of internal circadian system induces glucose intolerance and insulin resistance, which could be restored by melatonin supplementation. Therefore, the presence of melatonin receptors on human pancreatic islets may have an impact on pharmacotherapy of type 2 diabetes.

  1. Diagnostic and therapeutic update on diabetic foot osteomyelitis.

    Science.gov (United States)

    Lázaro-Martínez, José Luis; Tardáguila-García, Aroa; García-Klepzig, José Luis

    2017-02-01

    Diabetic foot osteomyelitis (DFO) is the most common infection associated to diabetic foot ulcers (DFU). This review is designed to provide an update on the diagnosis and treatment of DFO based on an analysis of MEDLINE through PubMed using as search criterion "Diabetic Foot Osteomyelitis". Authors have included in this review the most relevant manuscripts regarding diagnosis and treatment of DFO. After review and critical analysis of publications, it may be concluded that diagnosis of DFO is not simple because of its heterogeneous presentation. Clinical inflammatory signs, probe-to-bone test, and plain X-rays are postulated as the basic tests for clinical diagnosis when DFO is suspected. Diagnosis should be supported by laboratory tests, of which ESR (>70mm/h) has been shown to be most precise. MRI is the most accurate imaging test, especially for differential diagnosis with Charcot foot. Pathogen isolation by bone culture is essential when the patient is treated with ATB only. Medical or surgical treatment should be based on the clinical characteristics of the patient and the lesion. Surgery should always be an option if medical treatment fails. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Diabetes mellitus: new therapeutic approaches to treat an old disease

    Directory of Open Access Journals (Sweden)

    I. Gabanyi

    2009-01-01

    Full Text Available

    Diabetes mellitus is a widespread disease whose frequency increases constantly and is expected to reach alarming levels by the year 2025. Introduction of insulin therapy represented a major breakthrough; however, a very strict regimen is required to maintain blood glucose levels within the normal range and to prevent or postpone chronic complications associated with this disease. Frequent hyper- and hypoglycemia seriously affect the quality of life of these patients. Reversion of this situation can only be achieved through whole organ (pancreas transplant or pancreatic islet transplant, the former being a high-risk surgical procedure, while the latter is a much simpler and may be accomplished in only 20-40 min. The advantages and perspectives of islet cell transplantation will be discussed, in the light of tissue engineering and gene therapy. Ongoing research carried out in our laboratory, aimed at developing clinical cell and molecular therapy protocols for diabetes will also be focused. Keywords: Diabetes mellitus, cell and molecular therapy, human pancreatic islets, degenerative diseases, recombinant biopharmaceuticals.

  3. Biopsy of the pancreas: the predictive value and therapeutic impact on autoimmune diabetes

    Directory of Open Access Journals (Sweden)

    Wael Nassar

    2015-01-01

    Full Text Available Diabetes mellitus is by definition an end-stage organ failure. Type 1 diabetes mellitus is an autoimmune disease. Autoinflammatory infiltrate appears to characterize the insulitis associated with type 1 diabetes mellitus. In recent times, a comprehensive composition of peri-islet capsules and their basement membrane (BM has been described. Lymphocytic infiltration around the islets without invasion of the BM is the first step in disease induction (nondestructive insulitis phase. Invasion of the BM by leukocytic infiltration (destructive insulitis phase occurs over a period of several years, offering good window for therapeutic intervention. Clinical symptoms appear only when 70-90% of β-cell mass are destroyed. These data emphasize on the importance of identification and classification of such pathologic features by performing a biopsy of the pancreas, along with histoimmunochemistry analysis at the prehyperglycemic stage in a high-risk, genetically predisposed, autoimmune-suspected patient, which may at least in part help in achieving new therapeutic approaches and halting the progression to end-stage pancreatic disease known as diabetes mellitus. In this review, we emphasize the predictive role biopsy of the pancreas can have, by building up a solid gold standard tool in the diagnosis, staging, and therapeutic follow-up of autoimmune diabetes mellitus.

  4. Gymnema sylvestre for diabetes: From traditional herb to future s therapeutic.

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    Tiwari, Pragya; Ahmad, Khurshid; Baig, Mohammad Hassan

    2016-11-08

    Diabetes has increased at an unprecedented rate and is fast emerging as a global threat worldwide. The focus on pharmacological studies pertaining to diabetes has seen a remarkable shift from conventional medicines to therapeutics employing bioactive phytomolecules from natural sources. The prospective effectiveness of natural products together with their low cost and minimal side effects has revolutionized the entire concept of drug discovery and management programs. One such beneficial herb is Gymnema sylvestre, possessing remarkable hypoglycemic properties and forms the platform of diabetes therapeutics in the traditional system of medication. The present article discusses the significance of G. sylvestre in diabetes management, the herbal-formulations from the herb together with its standardization and clinical trials on animal models, and why Peroxisome Proliferator Activated Receptor gamma (PPAR?) may serve as a prospective molecular target for Gymnemic acid analogs. Such studies would define the molecular basis of bioactive molecules which would aid in the development of natural product based therapeutics in the treatment of diabetes.

  5. Lipids: A Suitable Therapeutic Target in Diabetic Neuropathy?

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    M. C. Perez-Matos

    2017-01-01

    Full Text Available Diabetic polyneuropathy (DPN encompasses multiple syndromes with a common pathogenesis. Glycemic control shows a limited correlation with DPN, arguing in favor of major involvement of other factors, one of which is alterations of lipid and lipoprotein metabolism. Consistent associations have been found between plasma triglycerides/remnant lipoproteins and the risk of DPN. Studies in cultured nerve tissue or in murine models of diabetes have unveiled mechanisms linking lipid metabolism to DPN. Deficient insulin action increases fatty acids flux to nerve cells, inducing mitochondrial dysfunction, anomalous protein kinase C signaling, and perturbations in the physicochemical properties of the plasma membrane. Oxidized low-density lipoproteins bind to cellular receptors and promote generation of reactive oxygen species, worsening mitochondrial function and altering the electrical properties of neurons. Supplementation with specific fatty acids has led to prevention or reversal of different modalities of DPN in animal models. Post hoc and secondary analyses of clinical trials have found benefits of cholesterol reducing (statins and ezetimibe, triglyceride-reducing (fibrates, or lipid antioxidant (thioctic acid therapies over the progression and severity of DPN. However, these findings are mostly hypothesis-generating. Randomized trials are warranted in which the impact of intensive plasma lipids normalization on DPN outcomes is specifically evaluated.

  6. Diabetes and human immunodeficiency virus infection: Epidemiological, therapeutic aspects and patient experience.

    Science.gov (United States)

    Traoré, Youssouf; Bensghir, Rajaa; Ihbibane, Fatima; OuladLashen, Ahd; Sodqi, Mustapha; Marih, Latifa; Chakib, Abdelfattah; Marhoum, Kamal El Filali

    2016-06-01

    Nationally, no data on the association between human immunodeficiency virus infection and diabetes have been published. To review the epidemiological, clinical and therapeutic data and evaluate the experience of people living with HIV and suffering from diabetes. Our study population was composed of 190 outpatients (87 males and 103 females) attending the Infectious Diseases department of the University Hospital Center of Casablanca (Ibn Rochd). Using the computerized medical records, we identified patients with HIV-Diabetes and collected their epidemiological, clinical and therapeutic data. At the enrollment date of each patient, we measured anthropometric parameters (weight, height, waist circumference, hip circumference, and arm circumference). We also asked each patient, about the impression on their bodies' appearance and the degree of concern with regard to the diabetes. The population of patients with HIV, the prevalence of diabetes was 10.5%, among the patients taking an antiretroviral therapy, the prevalence was 13.5%. Diabetes has been diagnosed in 113 patients before the discovery of their HIV infection. At time of recruitment, 111 of them were under antiretroviral therapy for a mean period of 3.1years. Zidovudine was the most prescribed drug followed by lamivudine. Type 2 diabetes was diagnosed in 144 patients. Eighty-seven patients feel conscious about their body appearance which makes them feel bad about the way they look. Metformin was prescribed in 46 cases. The majority of patients (73.1%) considered diabetes as a second health problem. Only 46 patients were well balanced. The multidisciplinary consultation and patient education should enable an appropriate management of diabetes in HIV infected patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  7. New Therapeutic Approaches to Prevent or Delay Beta-Cell Failure in Diabetes

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    Ionica Floriana Elvira

    2015-09-01

    Full Text Available Background and aims: The most recent estimates of International Diabetes Federation indicate that 382 million people have diabetes, and the incidence of this disease is increasing. While in type 1 diabetes mellitus (T1DM beta-cell death is autoimmunemediated, type 2 diabetes mellitus (T2DM results from an interaction between genetic and environmental factors that impair beta-cell function and insulin action. Many people with T2DM remain unaware of their illness for a long time because symptoms may take years to appear or be recognized, while the body is affected by excess blood glucose. These patients are often diagnosed only when diabetes complications have already developed. The aim of this article was to perform a review based on literature data on therapeutic modalities to prevent/delay beta cell function decline. Material and Methods: We searched MEDLINE from 2000 to the present to identify the therapeutic approaches to prevent or delay beta-cell failure in patients with T2DM. Results and conclusions: Several common polymorphisms in genes linked to monogenic forms of diabetes appear to influence the response to T2DM pharmacotherapy. Recent studies report the role of the G protein coupled receptor 40 (GPR40, also known as Free Fatty Acids Receptor 1 (FFAR1 in the regulation of beta-cell function- CNX-011-67 (a GPR40 agonist has the potential to provide good and durable glycemic control in T2DM patients.

  8. Immunity-Based Diagnosis for a Motherboard

    Directory of Open Access Journals (Sweden)

    Yoshiteru Ishida

    2011-04-01

    Full Text Available We have utilized immunity-based diagnosis to detect abnormal behavior of components on a motherboard. The immunity-based diagnostic model monitors voltages of some components, CPU temperatures, and fan speeds. We simulated abnormal behaviors of some components on the motherboard, and we utilized the immunity-based diagnostic model to evaluate motherboard sensors in two experiments. These experiments showed that the immunity-based diagnostic model was an effective method for detecting abnormal behavior of components on the motherboard.

  9. Physical activity in type II Diabetes Mellitus, an effective therapeutic element: review of the clinical impact

    Directory of Open Access Journals (Sweden)

    Pedro Iván Arias-Vázquez

    2015-07-01

    Full Text Available A review was conducted in databases (PubMed, PEDro of type studies clinical trial, cohort study, systematic reviews, meta-analysis and clinical practice guidelines based on evidence they have studied the benefits of physical activity in the prevention , treatment and decreased risk of complications and death in patients with Type II Diabetes Mellitus. Realization regular physical activity is associated with a decreased risk of developing Diabetes Mellitus; likewise was associated with decrease in glycated hemoglobin percentage A1C values. Diabetic patients undergoing high levels of physical activity had decreased risk of complications and death from cardiovascular disease and all causes. At present the scientific evidence on the impact of physical activity in the prevention and treatment of Diabetes Mellitus is solid, so it must be emphasized promoting physical activity as a fundamental part of the therapeutic regimens for this disease.

  10. Management of diabetes mellitus in individuals with chronic kidney disease: therapeutic perspectives and glycemic control

    Directory of Open Access Journals (Sweden)

    Carolina C.R. Betônico

    2016-01-01

    Full Text Available The purpose of this study was to evaluate the therapeutic options for diabetes treatment and their potential side effects, in addition to analyzing the risks and benefits of tight glycemic control in patients with diabetic kidney disease. For this review, a search was performed using several pre-defined keyword combinations and their equivalents: “diabetes kidney disease” and “renal failure” in combination with “diabetes treatment” and “oral antidiabetic drugs” or “oral hypoglycemic agents.” The search was performed in PubMed, Endocrine Abstracts and the Cochrane Library from January 1980 up to January 2015. Diabetes treatment in patients with diabetic kidney disease is challenging, in part because of progression of renal failure-related changes in insulin signaling, glucose transport and metabolism, favoring both hyperglycemic peaks and hypoglycemia. Additionally, the decline in renal function impairs the clearance and metabolism of antidiabetic agents and insulin, frequently requiring reassessment of prescriptions. The management of hyperglycemia in patients with diabetic kidney disease is even more difficult, requiring adjustment of antidiabetic agents and insulin doses. The health team responsible for the follow-up of these patients should be vigilant and prepared to make such changes; however, unfortunately, there are few guidelines addressing the nuances of the management of this specific population.

  11. Management of diabetes mellitus in individuals with chronic kidney disease: therapeutic perspectives and glycemic control.

    Science.gov (United States)

    Betônico, Carolina C R; Titan, Silvia M O; Correa-Giannella, Maria Lúcia C; Nery, Márcia; Queiroz, Márcia

    2016-01-01

    The purpose of this study was to evaluate the therapeutic options for diabetes treatment and their potential side effects, in addition to analyzing the risks and benefits of tight glycemic control in patients with diabetic kidney disease. For this review, a search was performed using several pre-defined keyword combinations and their equivalents: "diabetes kidney disease" and "renal failure" in combination with "diabetes treatment" and "oral antidiabetic drugs" or "oral hypoglycemic agents." The search was performed in PubMed, Endocrine Abstracts and the Cochrane Library from January 1980 up to January 2015. Diabetes treatment in patients with diabetic kidney disease is challenging, in part because of progression of renal failure-related changes in insulin signaling, glucose transport and metabolism, favoring both hyperglycemic peaks and hypoglycemia. Additionally, the decline in renal function impairs the clearance and metabolism of antidiabetic agents and insulin, frequently requiring reassessment of prescriptions. The management of hyperglycemia in patients with diabetic kidney disease is even more difficult, requiring adjustment of antidiabetic agents and insulin doses. The health team responsible for the follow-up of these patients should be vigilant and prepared to make such changes; however, unfortunately, there are few guidelines addressing the nuances of the management of this specific population.

  12. Management of diabetes mellitus in individuals with chronic kidney disease: therapeutic perspectives and glycemic control

    Science.gov (United States)

    Betônico, Carolina C R; Titan, Silvia M O; Correa-Giannella, Maria Lúcia C; Nery, Márcia; Queiroz, Márcia

    2016-01-01

    The purpose of this study was to evaluate the therapeutic options for diabetes treatment and their potential side effects, in addition to analyzing the risks and benefits of tight glycemic control in patients with diabetic kidney disease. For this review, a search was performed using several pre-defined keyword combinations and their equivalents: “diabetes kidney disease” and “renal failure” in combination with “diabetes treatment” and “oral antidiabetic drugs” or “oral hypoglycemic agents.” The search was performed in PubMed, Endocrine Abstracts and the Cochrane Library from January 1980 up to January 2015. Diabetes treatment in patients with diabetic kidney disease is challenging, in part because of progression of renal failure-related changes in insulin signaling, glucose transport and metabolism, favoring both hyperglycemic peaks and hypoglycemia. Additionally, the decline in renal function impairs the clearance and metabolism of antidiabetic agents and insulin, frequently requiring reassessment of prescriptions. The management of hyperglycemia in patients with diabetic kidney disease is even more difficult, requiring adjustment of antidiabetic agents and insulin doses. The health team responsible for the follow-up of these patients should be vigilant and prepared to make such changes; however, unfortunately, there are few guidelines addressing the nuances of the management of this specific population. PMID:26872083

  13. Diabetic Macular Edema: From Old Concepts to New Therapeutic Avenues.

    Science.gov (United States)

    Mansour, Ahmad M; Pulido, Jose S; Arevalo, J Fernando

    2015-01-01

    Diabetic macular edema (DME) is a significant cause of blindness in the working population and is currently challenging to treat. Current interventions include focal laser or intravitreal injections. This article outlines a new treatment protocol based on the theory that peripheral ischemia is the precursor to angiogenesis, which will ultimately gather its momentum at the fovea. Extreme peripheral light laser panretinal photocoagulation (PRP) back to the equator reduces excessive production of the vascular endothelial growth factor (VEGF) in the eye. This decreases VEGF-induced DME and provides long-term protection against the development of neovascularization. Initial exacerbation of DME often accompanies PRP. Therefore, injections of anti-VEGF agents (with or without dexamethasone implants) initially can forestall worsening of DME and prevent loss of vision. However, on the other hand, applying peripheral PRP and intraocular injections can induce posterior vitreous detachment (PVD). This could help release vitreomacular adhesions (VMA) and vitreomacular traction (VMT), thereby decreasing DME severity and improving the response to intravitreal injections. In the current approach, peripheral retinal photocoagulation should stop the drive for VEGF release; moreover, laser ablation should produce secondary, accidental, and beneficial PVD. This approach precludes focal laser therapy and paves the path for prolonged intervals between anti-VEGF therapy.

  14. Neuroprotection as a Therapeutic Target for Diabetic Retinopathy

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    Cristina Hernández

    2016-01-01

    Full Text Available Diabetic retinopathy (DR is a multifactorial progressive disease of the retina and a leading cause of vision loss. DR has long been regarded as a vascular disorder, although neuronal death and visual impairment appear before vascular lesions, suggesting an important role played by neurodegeneration in DR and the appropriateness of neuroprotective strategies. Upregulation of vascular endothelial growth factor (VEGF, the main target of current therapies, is likely to be one of the first responses to retinal hyperglycemic stress and VEGF may represent an important survival factor in early phases of DR. Of central importance for clinical trials is the detection of retinal neurodegeneration in the clinical setting, and spectral domain optical coherence tomography seems the most indicated technique. Many substances have been tested in animal studies for their neuroprotective properties and for possible use in humans. Perhaps, the most intriguing perspective is the use of endogenous neuroprotective substances or nutraceuticals. Together, the data point to the central role of neurodegeneration in the pathogenesis of DR and indicate neuroprotection as an effective strategy for treating this disease. However, clinical trials to determine not only the effectiveness and safety but also the compliance of a noninvasive route of drug administration are needed.

  15. Novel Therapeutics for Diabetes: Uptake, Usage Trends, and Comparative Effectiveness.

    Science.gov (United States)

    Ahuja, Vishal; Chou, Chia-Hung

    2016-06-01

    The number of available therapies for treating type 2 diabetes has grown considerably in recent years. This growth has been fueled by availability of newer medications, whose benefits and risks have not been fully established. In this study, we review and synthesize the existing literature on the uptake, efficacy, safety, and cost-effectiveness of novel antidiabetic agents. Specifically, we focus on three drug classes that were introduced in the market recently: thiazolidinediones (TZDs), dipeptidyl peptidase-4 (DPP-4) inhibitors, and glucagon-like peptide-1 (GLP-1) receptor agonists. Not surprisingly, we find that the usage trends reflect the efficacy and safety profile of these novel drugs. The use of TZDs increased initially but decreased after a black-box warning was issued for rosiglitazone in 2007 that highlighted the cardiovascular risks associated with using the drug. Conversely, DPP-4 inhibitors and GLP-1 receptor agonists gained market shares due to their efficacy in glycemic control as an add-on treatment to metformin. DPP-4 inhibitors were the most commonly prescribed agents among the three novel drug classes, likely because they are relatively less expensive, have better safety profile, are administered orally, and are weight neutral. Sitagliptin was the most preferred DPP-4 inhibitor. The level of evidence on the comparative effectiveness, safety, and cost implications of using novel antidiabetic agents remains low and further studies with long-term follow-ups are needed.

  16. SGLT2 inhibitors: a promising new therapeutic option for treatment of type 2 diabetes mellitus.

    Science.gov (United States)

    Misra, Monika

    2013-03-01

    Hyperglycemia is an important pathogenic component in the development of microvascular and macrovascular complications in type 2 diabetes mellitus. Inhibition of renal tubular glucose reabsorption that leads to glycosuria has been proposed as a new mechanism to attain normoglycemia and thus prevent and diminish these complications. Sodium glucose cotransporter 2 (SGLT2) has a key role in reabsorption of glucose in kidney. Competitive inhibitors of SGLT2 have been discovered and a few of them have also been advanced in clinical trials for the treatment of diabetes. To discuss the therapeutic potential of SGLT2 inhibitors currently in clinical development. A number of preclinical and clinical studies of SGLT2 inhibitors have demonstrated a good safety profile and beneficial effects in lowering plasma glucose levels, diminishing glucotoxicity, improving glycemic control and reducing weight in diabetes. Of all the SGLT2 inhibitors, dapagliflozin is a relatively advanced compound with regards to clinical development. SGLT2 inhibitors are emerging as a promising therapeutic option for the treatment of diabetes. Their unique mechanism of action offers them the potential to be used in combination with other oral anti-diabetic drugs as well as with insulin. © 2012 The Author. JPP © 2012 Royal Pharmaceutical Society.

  17. An augmented reality game to support therapeutic education for children with diabetes.

    Science.gov (United States)

    Calle-Bustos, Andrés-Marcelo; Juan, M-Carmen; García-García, Inmaculada; Abad, Francisco

    2017-01-01

    Therapeutic education in diabetes helps patients take responsibility for self-control of their disease, and providing technological support systems facilitates this education. In this paper, we present an augmented reality game to support therapeutic education for patients with diabetes. Our game helps children (aged 5-14 years) to learn carbohydrate (carb) content of different foods. The game shows virtual foods on a real dish. The number of carb choices corresponding to the visualized food is also shown (1 carb choice = 10 grams of carbs). A study to determine the effectiveness of the game in terms of learning and perceived satisfaction and usability was carried out. A total of seventy children with diabetes participated in the study. From the results, we observed that the initial knowledge about carb choices of the children who participated in the study was low (a mean of 2 on a scale from 0 to 9). This indicates that therapeutic education for patients with diabetes is needed. When the results for the pre-knowledge questionnaire and the post-knowledge questionnaire were compared, it was shown that the children learned about carb choices by playing our game. We used two post-knowledge questionnaires (one post-knowledge questionnaire that contained the same foods as the pre-knowledge questionnaire and a second post-knowledge questionnaire that contained foods that were different from the ones on the pre-knowledge questionnaire). There were no statistically significant differences between these two different post-knowledge questionnaires. Moreover, the knowledge acquired was independent of gender and age. We also evaluated usability and perceived satisfaction. The children were satisfied with the game and considered that the game offers a high degree of usability. This game could be a valuable therapeutic education tool for patients with diabetes.

  18. Therapeutic use of a selective S1P1 receptor modulator ponesimod in autoimmune diabetes.

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    Sylvaine You

    Full Text Available In the present study, we investigated the therapeutic potential of a selective S1P1 receptor modulator, ponesimod, to protect and reverse autoimmune diabetes in non-obese diabetic (NOD mice. Ponesimod was administered orally to NOD mice starting at 6, 10, 13 and 16 weeks of age up to 35 weeks of age or to NOD mice showing recent onset diabetes. Peripheral blood and spleen B and T cell counts were significantly reduced after ponesimod administration. In pancreatic lymph nodes, B lymphocytes were increased and expressed a transitional 1-like phenotype. Chronic oral ponesimod treatment efficiently prevented autoimmune diabetes in 6, 10 and 16 week-old pre-diabetic NOD mice. Treatment withdrawal led to synchronized disease relapse. Ponesimod did not inhibit the differentiation of autoreactive T cells as assessed by adoptive transfer of lymphocytes from treated disease-free NOD mice. In addition, it did not affect the migration, proliferation and activation of transgenic BDC2.5 cells into the target tissue. However, ponesimod inhibited spreading of the T cell responses to islet-specific glucose-6-phosphatase catalytic subunit-related protein (IGRP. Treatment of diabetic NOD mice with ponesimod induced disease remission. However, here again, upon treatment cessation, the disease rapidly recurred. This recurrence was effectively prevented by combination treatment with a CD3 antibody leading to the restoration of self-tolerance. In conclusion, treatment with a selective S1P1 modulator in combination with CD3 antibody represents a promising therapeutic approach for the treatment of autoimmune diabetes.

  19. Lymphopenia is detrimental to therapeutic approaches to type 1 diabetes using regulatory T cells.

    Science.gov (United States)

    Ash, Shifra; Yarkoni, Shai; Askenasy, Nadir

    2014-01-01

    One of the therapeutic approaches to type 1 diabetes (T1D) focuses on enhancement of regulatory T cell (Treg) activity, either by adoptive transfer or supplementation of supporting cytokines such as interleukin-2 (IL-2). In principle, this therapeutic design would greatly benefit of concomitant reduction in pathogenic cell burden. Experimental evidence indicates that physiological recovery from lymphopenia is dominated by evolution of effector and cytotoxic cells, which abolishes the therapeutic efficacy of Treg cells. Targeted and selective depletion of effector T cells has been achieved with killer Treg using Fas ligand protein and a fusion protein composed of IL-2 and caspase-3, which showed remarkable efficacy in modulating the course of inflammatory insulitis in NOD mice. We emphasize a critical consideration in design of therapeutic approaches to T1D, immunomodulation without lymphoreduction to avoid the detrimental consequences of rebound recovery from lymphopenia.

  20. American Diabetes Association--70th scientific sessions--research on novel therapeutics: part 1.

    Science.gov (United States)

    Croasdell, Gary

    2010-09-01

    The American Diabetes Association 70th Scientific Sessions, held in Orlando, FL, USA, included topics covering new therapeutic developments in the field of diabetes research. This conference report highlights selected presentations on new research with novel agents. Investigational drugs discussed include the glucagon-like peptide-1 (GLP-1) agonist taspoglutide (Roche Holding AG/Teijin Ltd/ Chugai Pharmaceutical Co Ltd), the GLP-1 analog SKL-18287 (Sanwa Kagaku Kenkyusho Co Ltd), the sodium glucose transporter-2 (SGLT2) inhibitor ASP-1941 (Astellas Pharma Inc/Kotobuki Pharmaceutical Co Ltd), the dual SGLT2/1 inhibitor LX-4211 (Lexicon Pharmaceuticals Inc), and the selective PPARgamma modulator INT-131 (InteKrin Therapeutics Inc).

  1. CLINICAL OBSERVATION ON THERAPEUTIC EFFECTS OF COMBINED TREATMENT OF NONINSULIN DEPENDENT DIABETES

    Institute of Scientific and Technical Information of China (English)

    ZHU Jin-gui; QU Hui-qing

    2005-01-01

    Objective: To observe the therapeutic effect of combined treatment of diabetes mellitus (DM) and its complications. Methods: 30 cases of noninsulin dependent diabetes were treated by electroacupuncture (EA)of Tianzhu (天柱 BL 10), Dashu (大杼 BL 11), Fengmen (风门 BL 12), Jueyinshu (厥阴俞 BL 14), etc, massage at the acupoints along the Bladder Meridian, point injection of Vitamin B1, B6, B12 plus lidocaine at Neiguan (内关 PC 6) and Sanyinjiao (三阴交 SP 6, once every 3 days), cupping and physiotherapy comprehensively. The therapeutic effect was analyzed after 40 treatments. Results: After treatment, of the 30 cases, 23 (76.7%) experienced remarkable improvement in their symptoms and the rest 7 (23.3%) had improvement, with the total effective rate being 100%. Conclusion: The abovementioned combined treatment method works well in improving clinical symptoms of type Ⅱ DM patients.

  2. Recent Trends in Therapeutic Approaches for Diabetes Management: A Comprehensive Update

    Directory of Open Access Journals (Sweden)

    Pragya Tiwari

    2015-01-01

    Full Text Available Diabetes highlights a growing epidemic imposing serious social economic crisis to the countries around the globe. Despite scientific breakthroughs, better healthcare facilities, and improved literacy rate, the disease continues to burden several sections, especially middle and low income countries. The present trends indicate the rise in premature death, posing a major threat to global development. Scientific and technological advances have witnessed the development of newer generation of drugs like sulphonylureas, biguanides, alpha glucosidase inhibitors, and thiazolidinediones with significant efficacy in reducing hyperglycemia. Recent approaches in drug discovery have contributed to the development of new class of therapeutics like Incretin mimetics, Amylin analogues, GIP analogs, Peroxisome proliferator activated receptors, and dipeptidyl peptidase-4 inhibitor as targets for potential drugs in diabetes treatment. Subsequently, the identification and clinical investigation of bioactive substances from plants have revolutionized the research on drug discovery and lead identification for diabetes management. With a focus on the emerging trends, the review article explores the current statistical prevalence of the disease, discussing the benefits and limitations of the commercially available drugs. Additionally, the critical areas in clinical diabetology are discussed, with respect to prospects of statins, nanotechnology, and stem cell technology as next generation therapeutics and why the herbal formulations are consistently popular choice for diabetes medication and management.

  3. Past and current perspective on new therapeutic targets for Type-II diabetes.

    Science.gov (United States)

    Patil, Pradip D; Mahajan, Umesh B; Patil, Kalpesh R; Chaudhari, Sandip; Patil, Chandragouda R; Agrawal, Yogeeta O; Ojha, Shreesh; Goyal, Sameer N

    2017-01-01

    Loss of pancreatic β-cell function is a hallmark of Type-II diabetes mellitus (DM). It is a chronic metabolic disorder that results from defects in both insulin secretion and insulin action. Recently, United Kingdom Prospective Diabetes Study reported that Type-II DM is a progressive disorder. Although, DM can be treated initially by monotherapy with oral agent; eventually, it may require multiple drugs. Additionally, insulin therapy is needed in many patients to achieve glycemic control. Pharmacological approaches are unsatisfactory in improving the consequences of insulin resistance. Single therapeutic approach in the treatment of Type-II DM is unsuccessful and usually a combination therapy is adopted. Increased understanding of biochemical, cellular and pathological alterations in Type-II DM has provided new insight in the management of Type-II DM. Knowledge of underlying mechanisms of Type-II DM development is essential for the exploration of novel therapeutic targets. Present review provides an insight into therapeutic targets of Type-II DM and their role in the development of insulin resistance. An overview of important signaling pathways and mechanisms in Type-II DM is provided for the better understanding of disease pathology. This review includes case studies of drugs that are withdrawn from the market. The experience gathered from previous studies and knowledge of Type-II DM pathways can guide the anti-diabetic drug development toward the discovery of clinically viable drugs that are useful in Type-II DM.

  4. A Synthetic-Biology-Inspired Therapeutic Strategy for Targeting and Treating Hepatogenous Diabetes.

    Science.gov (United States)

    Xue, Shuai; Yin, Jianli; Shao, Jiawei; Yu, Yuanhuan; Yang, Linfeng; Wang, Yidan; Xie, Mingqi; Fussenegger, Martin; Ye, Haifeng

    2017-02-01

    Hepatogenous diabetes is a complex disease that is typified by the simultaneous presence of type 2 diabetes and many forms of liver disease. The chief pathogenic determinant in this pathophysiological network is insulin resistance (IR), an asymptomatic disease state in which impaired insulin signaling in target tissues initiates a variety of organ dysfunctions. However, pharmacotherapies targeting IR remain limited and are generally inapplicable for liver disease patients. Oleanolic acid (OA) is a plant-derived triterpenoid that is frequently used in Chinese medicine as a safe but slow-acting treatment in many liver disorders. Here, we utilized the congruent pharmacological activities of OA and glucagon-like-peptide 1 (GLP-1) in relieving IR and improving liver and pancreas functions and used a synthetic-biology-inspired design principle to engineer a therapeutic gene circuit that enables a concerted action of both drugs. In particular, OA-triggered short human GLP-1 (shGLP-1) expression in hepatogenous diabetic mice rapidly and simultaneously attenuated many disease-specific metabolic failures, whereas OA or shGLP-1 monotherapy failed to achieve corresponding therapeutic effects. Collectively, this work shows that rationally engineered synthetic gene circuits are capable of treating multifactorial diseases in a synergistic manner by multiplexing the targeting efficacies of single therapeutics. Copyright © 2017 The American Society of Gene and Cell Therapy. Published by Elsevier Inc. All rights reserved.

  5. Diabetic silkworms for evaluation of therapeutically effective drugs against type II diabetes.

    Science.gov (United States)

    Matsumoto, Yasuhiko; Ishii, Masaki; Hayashi, Yohei; Miyazaki, Shinya; Sugita, Takuya; Sumiya, Eriko; Sekimizu, Kazuhisa

    2015-05-29

    We previously reported that sugar levels in the silkworm hemolymph, i.e., blood, increase immediately (within 1 h) after intake of a high-glucose diet, and that the administration of human insulin decreases elevated hemolymph sugar levels in silkworms. In this hyperglycemic silkworm model, however, administration of pioglitazone or metformin, drugs used clinically for the treatment of type II diabetes, have no effect. Therefore, here we established a silkworm model of type II diabetes for the evaluation of anti-diabetic drugs such as pioglitazone and metformin. Silkworms fed a high-glucose diet over a long time-period (18 h) exhibited a hyperlipidemic phenotype. In these hyperlipidemic silkworms, phosphorylation of JNK, a stress-responsive protein kinase, was enhanced in the fat body, an organ that functionally resembles the mammalian liver and adipose tissue. Fat bodies isolated from hyperlipidemic silkworms exhibited decreased sensitivity to human insulin. The hyperlipidemic silkworms have impaired glucose tolerance, characterized by high fasting hemolymph sugar levels and higher hemolymph sugar levels in a glucose tolerance test. Administration of pioglitazone or metformin improved the glucose tolerance of the hyperlipidemic silkworms. These findings suggest that the hyperlipidemic silkworms are useful for evaluating the hypoglycemic activities of candidate drugs against type II diabetes.

  6. A fuzzy approach to evaluation and management of therapeutic procedure in diabetes mellitus treatment

    Directory of Open Access Journals (Sweden)

    Tadić Danijela

    2010-01-01

    Full Text Available In this paper a new fuzzy model (FMOTPD2 is developed and by this model the measures of beliefs are determined so that one of the groups of possible therapeutic procedures is optimal for each patient of type 2 diabetes on hospital treatment. The choice of therapeutic procedure on individual level, which is one of the demands of modern medicine, means that each therapeutic procedure is to be evaluated by multiple and different criteria. In this paper, evaluation criteria are classified into two groups: (1 common criteria by which medicines used by the type 2 diabetes patients are being evaluated and (2 specific criteria, by which the patients' 1h state of health with type 2 diabetes mellitus is being estimated. Generally, the relative importance and values of these criteria are different. It is assumed that (a the relative importance of evaluation criteria is defined by a team of medical experts and described by linguistic expressions and (b the values of evaluation criteria are determined by evidence data, anamnesis and a diagnostic process. They can be crisp or uncertain. The most often used linguistic expressions describing the relative importance of evaluation criteria are modeled by triangular fuzzy numbers. The rest of uncertainties, which exist in developed model are described by discrete fuzzy numbers. A new algorithm for determining a unified fuzzy portrait of treated therapeutic procedures for each patient is given. It enables calculation of the measures of beliefs that some therapeutic procedures are more optimal than the others. The developed model is illustrated by examples with real word data collected in a hospital.

  7. Therapeutic inertia in the treatment of hyperglycaemia in patients with type 2 diabetes: a systematic review.

    Science.gov (United States)

    Khunti, Kamlesh; Gomes, Marilia B; Pocock, Stuart; Shestakova, Marina V; Pintat, Stéphane; Fenici, Peter; Hammar, Niklas; Medina, Jesús

    2017-08-22

    Therapeutic inertia, defined as the failure to initiate or intensify therapy in a timely manner according to evidence-based clinical guidelines, is a key reason for uncontrolled hyperglycaemia in patients with type 2 diabetes. The aims of this systematic review were to identify how therapeutic inertia in the management of hyperglycaemia was measured and to assess its extent over the past decade. Systematic searches for articles published from 1 January 2004 to 1 August 2016 were conducted in MEDLINE and Embase. Two researchers independently screened all of the titles and abstracts, and the full texts of publications deemed relevant. Data were extracted by a single researcher using a standardized data extraction form. The final selection for the review included 53 articles. Measurements used to assess therapeutic inertia varied across studies, making comparisons difficult. Data from low- to middle-income countries were scarce. In most studies, the median time to treatment intensification after a glycated haemoglobin (HbA1c ) measurement above target was more than 1 year (range 0.3 to >7.2 years). Therapeutic inertia increased as the number of antidiabetic drugs rose and decreased with increasing HbA1c levels. Data were mainly available from Western countries. Diversity of inertia measures precluded meta-analysis. Therapeutic inertia in the management of hyperglycaemia in patients with type 2 diabetes is a major concern. This is well documented in Western countries, but corresponding data are urgently needed in low- and middle-income countries, in view of their high prevalence of type 2 diabetes. This article is protected by copyright. All rights reserved.

  8. Physicians′ therapeutic practice and compliance of diabetic patients attending rural primary health care units in Alexandria

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    Nahla Khamis R Ibrahim

    2010-01-01

    Full Text Available Objectives: The objectives of the study were to investigate physician′s therapeutic practice and the compliance of diabetic patients attending rural primary health units in Alexandria. Material and Methods: A cross-sectional study was conducted and a multistage stratified random sample method was used for the selection of 600 diabetic patients. Data were collected by means of an interviewing questionnaire, an observation checklist, review of prescriptions and laboratory investigations. A scoring system was made for a diabetic patient′s knowledge and skills, patient′s compliance, doctor-patient relationship, and glycemic control. Results: About 57% always took their medication as prescribed by doctor and on time, only 2.2% always complied with dietary regimen while no one reported regular compliance with exercise regimen. Complications of the regimen was the commonest cause (63.3% of noncompliance. A highly statistically significant difference was found between compliance with all regimens and patient′s knowledge of diabetes. The scores for doctor-patient relationship were all unsatisfactory. Results of glycosylated hemoglobin (HbA1c revealed that metabolic control of four-fifth of the patients was satisfactory, 12% had fair and 8% had poor metabolic control. Conclusions: Patient′s compliance with most of the diabetes regimen was low. Doctor-patient relationship and patient′s compliance should be improved by conducting educational and training programs.

  9. Regenerative therapeutic potential of adipose stromal cells in early stage diabetic retinopathy.

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    Gangaraju Rajashekhar

    Full Text Available Diabetic retinopathy (DR is the leading cause of blindness in working-age adults. Early stage DR involves inflammation, vascular leakage, apoptosis of vascular cells and neurodegeneration. In this study, we hypothesized that cells derived from the stromal fraction of adipose tissue (ASC could therapeutically rescue early stage DR features. Streptozotocin (STZ induced diabetic athymic nude rats received single intravitreal injection of human ASC into one eye and saline into the other eye. Two months post onset of diabetes, administration of ASC significantly improved "b" wave amplitude (as measured by electroretinogram within 1-3 weeks of injection compared to saline treated diabetic eyes. Subsequently, retinal histopathological evaluation revealed a significant decrease in vascular leakage and apoptotic cells around the retinal vessels in the diabetic eyes that received ASC compared to the eyes that received saline injection. In addition, molecular analyses have shown down-regulation in inflammatory gene expression in diabetic retina that received ASC compared to eyes that received saline. Interestingly, ASC were found to be localized near retinal vessels at higher densities than seen in age matched non-diabetic retina that received ASC. In vitro, ASC displayed sustained proliferation and decreased apoptosis under hyperglycemic stress. In addition, ASC in co-culture with retinal endothelial cells enhance endothelial survival and collaborate to form vascular networks. Taken together, our findings suggest that ASC are able to rescue the neural retina from hyperglycemia-induced degeneration, resulting in importantly improved visual function. Our pre-clinical studies support the translational development of adipose stem cell-based therapy for DR to address both retinal capillary and neurodegeneration.

  10. Natural products as anti-glycation agents: possible therapeutic potential for diabetic complications.

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    Elosta, Abdulhakim; Ghous, Tahseen; Ahmed, Nessar

    2012-03-01

    Diabetes mellitus is characterised by hyperglycaemia, lipidaemia and oxidative stress and predisposes affected individuals to long-term complications afflicting the eyes, skin, kidneys, nerves and blood vessels. Increased protein glycation and the subsequent build-up of tissue advanced glycation endproducts (AGEs) contribute towards the pathogenesis of diabetic complications. Protein glycation is accompanied by generation of free radicals through autoxidation of glucose and glycated proteins and via interaction of AGEs with their cell surface receptors (referred to as RAGE). Glycationderived free radicals can damage proteins, lipids and nucleic acids and contribute towards oxidative stress in diabetes. There is interest in compounds with anti-glycation activity as they may offer therapeutic potential in delaying or preventing the onset of diabetic complications. Although many different compounds are under study, only a few have successfully entered clinical trials but none have yet been approved for clinical use. Whilst the search for new synthetic inhibitors of glycation continues, little attention has been paid to anti-glycation compounds from natural sources. In the last few decades the traditional system of medicine has become a topic of global interest. Various studies have indicated that dietary supplementation with combined anti-glycation and antioxidant nutrients may be a safe and simple complement to traditional therapies targeting diabetic complications. Data for forty two plants/constituents studied for anti-glycation activity is presented in this review and some commonly used medicinal plants that possess anti-glycation activity are discussed in detail including their active ingredients, mechanism of action and therapeutic potential.

  11. Therapeutic Potential of Adipose-Derived SSEA-3-Positive Muse Cells for Treating Diabetic Skin Ulcers.

    Science.gov (United States)

    Kinoshita, Kahori; Kuno, Shinichiro; Ishimine, Hisako; Aoi, Noriyuki; Mineda, Kazuhide; Kato, Harunosuke; Doi, Kentaro; Kanayama, Koji; Feng, Jingwei; Mashiko, Takanobu; Kurisaki, Akira; Yoshimura, Kotaro

    2015-02-01

    Stage-specific embryonic antigen-3 (SSEA-3)-positive multipotent mesenchymal cells (multilineage differentiating stress-enduring [Muse] cells) were isolated from cultured human adipose tissue-derived stem/stromal cells (hASCs) and characterized, and their therapeutic potential for treating diabetic skin ulcers was evaluated. Cultured hASCs were separated using magnetic-activated cell sorting into positive and negative fractions, a SSEA-3+ cell-enriched fraction (Muse-rich) and the remaining fraction (Muse-poor). Muse-rich hASCs showed upregulated and downregulated pluripotency and cell proliferation genes, respectively, compared with Muse-poor hASCs. These cells also released higher amounts of certain growth factors, particularly under hypoxic conditions, compared with Muse-poor cells. Skin ulcers were generated in severe combined immunodeficiency (SCID) mice with type 1 diabetes, which showed delayed wound healing compared with nondiabetic SCID mice. Treatment with Muse-rich cells significantly accelerated wound healing compared with treatment with Muse-poor cells. Transplanted cells were integrated into the regenerated dermis as vascular endothelial cells and other cells. However, they were not detected in the surrounding intact regions. Thus, the selected population of ASCs has greater therapeutic effects to accelerate impaired wound healing associated with type 1 diabetes. These cells can be achieved in large amounts with minimal morbidity and could be a practical tool for a variety of stem cell-depleted or ischemic conditions of various organs and tissues.

  12. Protective and therapeutic effectiveness of taurine in diabetes mellitus: a rationale for antioxidant supplementation.

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    Sirdah, Mahmoud M

    2015-01-01

    Taurine, 2-amino ethanesulfonic acid, is a conditionally essential β amino acid which is not utilized in protein synthesis. Taurine is one of the most abundant free amino acids in mammals tissues and is one of the three well-known sulfur-containing amino acids; the others are methionine and cysteine which are considered as the precursors for taurine synthesis. Different scientific studies emphasize on the cytoprotective properties of taurine which included antioxidation, antiapoptosis, membrane stabilization, osmoregulation, and neurotransmission. Protective and therapeutic ameliorations of oxidative stress-induced pathologies were also attributed to taurine both in experimental and human models. Data demonstrating the beneficial effectiveness of taurine against type 1 and type 2 diabetes mellitus and their complications are growing and providing a better understanding of the underlying molecular mechanisms. Although the clinical studies are limited compared to the experimental ones, the present updated systematic review of the literature is set up to provide experimental and clinical evidences regarding the effectiveness of taurine in the context of diabetes mellitus and its complications. Gathering these scientific effects of taurine on diabetes mellitus could provide the physicians and specially the endocrinologists with a comprehensive overview on possible trends in the prevention and management of the disease and its complications through antioxidant supplementation. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  13. Breath ketone testing: a new biomarker for diagnosis and therapeutic monitoring of diabetic ketosis.

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    Qiao, Yue; Gao, Zhaohua; Liu, Yong; Cheng, Yan; Yu, Mengxiao; Zhao, Lingling; Duan, Yixiang; Liu, Yu

    2014-01-01

    Acetone, β -hydroxybutyric acid, and acetoacetic acid are three types of ketone body that may be found in the breath, blood, and urine. Detecting altered concentrations of ketones in the breath, blood, and urine is crucial for the diagnosis and treatment of diabetic ketosis. The aim of this study was to evaluate the advantages of different detection methods for ketones, and to establish whether detection of the concentration of ketones in the breath is an effective and practical technique. We measured the concentrations of acetone in the breath using gas chromatography-mass spectrometry and β -hydroxybutyrate in fingertip blood collected from 99 patients with diabetes assigned to groups 1 (-), 2 (±), 3 (+), 4 (++), or 5 (+++) according to urinary ketone concentrations. There were strong relationships between fasting blood glucose, age, and diabetic ketosis. Exhaled acetone concentration significantly correlated with concentrations of fasting blood glucose, ketones in the blood and urine, LDL-C, creatinine, and blood urea nitrogen. Breath testing for ketones has a high sensitivity and specificity and appears to be a noninvasive, convenient, and repeatable method for the diagnosis and therapeutic monitoring of diabetic ketosis.

  14. Therapeutics of Diabetes Mellitus: Focus on Insulin Analogues and Insulin Pumps

    Science.gov (United States)

    Valla, Vasiliki

    2010-01-01

    Aim. Inadequately controlled diabetes accounts for chronic complications and increases mortality. Its therapeutic management aims in normal HbA1C, prandial and postprandial glucose levels. This review discusses diabetes management focusing on the latest insulin analogues, alternative insulin delivery systems and the artificial pancreas. Results. Intensive insulin therapy with multiple daily injections (MDI) allows better imitation of the physiological rhythm of insulin secretion. Longer-acting, basal insulin analogues provide concomitant improvements in safety, efficacy and variability of glycaemic control, followed by low risks of hypoglycaemia. Continuous subcutaneous insulin infusion (CSII) provides long-term glycaemic control especially in type 1 diabetic patients, while reducing hypoglycaemic episodes and glycaemic variability. Continuous subcutaneous glucose monitoring (CGM) systems provide information on postprandial glucose excursions and nocturnal hypo- and/or hyperglycemias. This information enhances treatment options, provides a useful tool for self-monitoring and allows safer achievement of treatment targets. In the absence of a cure-like pancreas or islets transplants, artificial “closed-loop” systems mimicking the pancreatic activity have been also developed. Conclusions. Individualized treatment plans for insulin initiation and administration mode are critical in achieving target glycaemic levels. Progress in these fields is expected to facilitate and improve the quality of life of diabetic patients. PMID:20589066

  15. Therapeutics of Diabetes Mellitus: Focus on Insulin Analogues and Insulin Pumps

    Directory of Open Access Journals (Sweden)

    Vasiliki Valla

    2010-01-01

    Full Text Available Aim. Inadequately controlled diabetes accounts for chronic complications and increases mortality. Its therapeutic management aims in normal HbA1C, prandial and postprandial glucose levels. This review discusses diabetes management focusing on the latest insulin analogues, alternative insulin delivery systems and the artificial pancreas. Results. Intensive insulin therapy with multiple daily injections (MDI allows better imitation of the physiological rhythm of insulin secretion. Longer-acting, basal insulin analogues provide concomitant improvements in safety, efficacy and variability of glycaemic control, followed by low risks of hypoglycaemia. Continuous subcutaneous insulin infusion (CSII provides long-term glycaemic control especially in type 1 diabetic patients, while reducing hypoglycaemic episodes and glycaemic variability. Continuous subcutaneous glucose monitoring (CGM systems provide information on postprandial glucose excursions and nocturnal hypo- and/or hyperglycemias. This information enhances treatment options, provides a useful tool for self-monitoring and allows safer achievement of treatment targets. In the absence of a cure-like pancreas or islets transplants, artificial “closed-loop” systems mimicking the pancreatic activity have been also developed. Conclusions. Individualized treatment plans for insulin initiation and administration mode are critical in achieving target glycaemic levels. Progress in these fields is expected to facilitate and improve the quality of life of diabetic patients.

  16. Serotonin and Its Receptor as a New Antioxidant Therapeutic Target for Diabetic Kidney Disease

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    Yu Yang

    2017-01-01

    Full Text Available Diabetic kidney disease (DKD is a widespread chronic microvascular complication of diabetes mellitus (DM, affects almost 30–50% of patients, and represents a leading cause of death of DM. Serotonin or 5-hydroxytryptamine (5-HT is a multifunctional bioamine that has crucial roles in many physiological pathways. Recently, emerging evidence from experimental and clinical studies has demonstrated that 5-HT is involved in the pathogenesis of diabetic vascular complications. The 5-HT receptor (5-HTR antagonists exert renoprotective effects by suppressing oxidative stress, suggesting that 5-HTR can be used as a potential target for treating DKD. In this review, therefore, we summarize the published information available for the involvement of 5-HT and 5-HTR antagonists in the pathogenesis of various diabetic complications with a particular focus of DKD. We conclude that 5-HTR is a potential therapeutic target for treating DKD, as it has been successfully applied in animal models and has currently being investigated in randomized and controlled clinical trials.

  17. Nuevas estrategias terapéuticas en diabetes mellitus tipo 1 New therapeutic strategies for type 1 diabetes mellitus

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    M. Barajas

    2008-12-01

    health and quality of life of individuals with diabetes, safe and effective methods of achieving and maintaining normoglycemia are needed. Unfortunately, intensive insulin therapy does not achieve normal levels of blood glucose, is difficult to implement for many patients, and limited by the accompanying increased frequency of severe hypoglycemia. Hence, the only way at present to restore permanently normoglycemia without hypoglycemia is to provide the patient with additional beta-cells. This can be achieved by transplanting an intact pancreas, or by transplanting islets. The shortage of functional beta-cells from available donors is one of the major limiting factors for the treatment of diabetes by islet transplantation. Therefore, methods to preserve or even promote regeneration of the beta-cell mass are dearly needed. Significant progress has been made over the last decade in stem cell biology. However, the quest for identification of stem cells has been hampered by the lack of appropriate research tools including assays that allow assess their differentiation potential in vitro and in vivo. Therefore, new techniques are necessary in order to develop new therapeutic strategies based on stem cells for the treatment of diabetes mellitus type 1.

  18. Adipokines: Potential Therapeutic Targets for Vascular Dysfunction in Type II Diabetes Mellitus and Obesity

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    Mostafa Wanees Ahmed El husseny

    2017-01-01

    Full Text Available Adipokines are bioactive molecules that regulate several physiological functions such as energy balance, insulin sensitization, appetite regulation, inflammatory response, and vascular homeostasis. They include proinflammatory cytokines such as adipocyte fatty acid binding protein (A-FABP and anti-inflammatory cytokines such as adiponectin, as well as vasodilator and vasoconstrictor molecules. In obesity and type II diabetes mellitus (DM, insulin resistance causes impairment of the endocrine function of the perivascular adipose tissue, an imbalance in the secretion of vasoconstrictor and vasodilator molecules, and an increased production of reactive oxygen species. Recent studies have shown that targeting plasma levels of adipokines or the expression of their receptors can increase insulin sensitivity, improve vascular function, and reduce the risk of cardiovascular morbidity and mortality. Several reviews have discussed the potential of adipokines as therapeutic targets for type II DM and obesity; however, this review is the first to focus on their therapeutic potential for vascular dysfunction in type II DM and obesity.

  19. Glycemic control in diabetes is restored by therapeutic manipulation of cytokines that regulate beta cell stress.

    Science.gov (United States)

    Hasnain, Sumaira Z; Borg, Danielle J; Harcourt, Brooke E; Tong, Hui; Sheng, Yonghua H; Ng, Choa Ping; Das, Indrajit; Wang, Ran; Chen, Alice C-H; Loudovaris, Thomas; Kay, Thomas W; Thomas, Helen E; Whitehead, Jonathan P; Forbes, Josephine M; Prins, Johannes B; McGuckin, Michael A

    2014-12-01

    In type 2 diabetes, hyperglycemia is present when an increased demand for insulin, typically due to insulin resistance, is not met as a result of progressive pancreatic beta cell dysfunction. This defect in beta cell activity is typically characterized by impaired insulin biosynthesis and secretion, usually accompanied by oxidative and endoplasmic reticulum (ER) stress. We demonstrate that multiple inflammatory cytokines elevated in diabetic pancreatic islets induce beta cell oxidative and ER stress, with interleukin-23 (IL-23), IL-24 and IL-33 being the most potent. Conversely, we show that islet-endogenous and exogenous IL-22, by regulating oxidative stress pathways, suppresses oxidative and ER stress caused by cytokines or glucolipotoxicity in mouse and human beta cells. In obese mice, antibody neutralization of IL-23 or IL-24 partially reduced beta cell ER stress and improved glucose tolerance, whereas IL-22 administration modulated oxidative stress regulatory genes in islets, suppressed ER stress and inflammation, promoted secretion of high-quality efficacious insulin and fully restored glucose homeostasis followed by restitution of insulin sensitivity. Thus, therapeutic manipulation of immune regulators of beta cell stress reverses the hyperglycemia central to diabetes pathology.

  20. Sodium-glucose cotransporter inhibition: therapeutic potential for the treatment of type 2 diabetes mellitus.

    Science.gov (United States)

    Raskin, Philip

    2013-07-01

    Results from randomized controlled trials have demonstrated that the risk of microvascular complications can be reduced by intensive glycaemic control in patients with type 2 diabetes mellitus (T2DM). However, only about half of patients with diagnosed diabetes achieve recommended glycaemic goals. New therapies with complementary mechanisms of action that are independent of insulin secretion or action may provide additional therapeutic options to enable patients to achieve glycaemic control. The kidney plays an important role in glucose homeostasis, primarily by the reabsorption of filtered glucose. The sodium-glucose cotransporter 2 (SGLT2), located in the proximal convoluted tubule, is responsible for the majority of glucose reabsorption by the kidney. SGLT2 inhibitors offer a novel approach to treat T2DM and reduce hyperglycaemia by increasing urinary excretion of glucose. Dapagliflozin, an SGLT2 inhibitor recently approved in Europe for the treatment of T2DM, improves glycaemic control in patients with T2DM when used as monotherapy or when added to other diabetes medications, such as metformin, sulfonylureas, pioglitazone, and insulin. As a class, SGLT2 inhibitors are well tolerated and have a low propensity to cause hypoglycaemia. An increase in signs, symptoms, and other events suggestive of genital and, in some studies, urinary tract infections has been reported with SGLT2 inhibitors. Results from ongoing and future clinical trials will help define the role for this new class of investigational compounds, with its unique mechanism of action, as a treatment option for reducing hyperglycaemia in patients with T2DM.

  1. THERAPEUTIC EFFECT OF NON-SURGICAL TREATMENT OF CHRONIC PERIODONTITIS IN DIABETIC CHINESE

    Institute of Scientific and Technical Information of China (English)

    YANG Yun-zhu(杨芸珠); SUN Zhe(孙喆); HU Chun-zhen(胡纯贞); YANG Yu-guo(杨裕国); JIN Li-jian(金力坚); LEUNG Hui-qiang(梁惠强); Esmond F Corbet

    2004-01-01

    Objective To observe the therapeutic effect of non-surgical treatment on diabetic Chinese with chronic periodontitis. Methods Moderate to advanced chronic periodontitis (CP) was studied in 36 diabetes mellitus (DM) patients classified as 20 with high and fiuctuating blood glucose level (DM-H) and 16 with relatively low and stable blood glucose level (DM-L). 28 non-DM CP patients acted as controls (Non-DM). Plaque index (PH), gingival index (Gl), bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (AL)of all patients were recorded at 6 sites on each tooth at the baseline and 1,3 and 6 months after oral hygiene instruction ( OHI) , scaling and root planing. Results It was found that the short-term effect of non-surgical periodontal procedure had resulted in significant resolution of gingival inflammation and pronounced reduction in pocket depth and gain of attachment loss in both DM and Non-DM CP patients. Conclusion The pilot study suggested that non-surgical periodontal treatment allowed for favorable treatment responses in a group of Chinese diabetic subjects with chronic periodontitis and that their various profiles of blood glucose did not influence the short-term healing response to OHI, scaling and root planning.

  2. Accuracy of Billing Codes Used in the Therapeutic Care of Diabetic Retinopathy.

    Science.gov (United States)

    Lau, Marisa; Prenner, Jonathan L; Brucker, Alexander J; VanderBeek, Brian L

    2017-07-01

    Insurance billing claim databases represent a growing field of scientific inquiry within ophthalmology. Validating the accuracy of billing claim codes used during the care of diabetic retinopathy is a necessary precursor to fully understanding the underlying data and subsequent results of these types of studies. To determine the accuracy of diagnostic, procedural, and therapeutic billing codes used in the treatment of diabetic retinopathy. This retrospective medical record review was conducted at 3 clinical practices (1 academic and 2 private). Insured patients with diabetic retinopathy were seen by the practices between 2011 and 2013. Each patient then had every visit for 2 years reviewed twice, once for billing data and the second for data from the medical record. Data were collected and analyzed from October 2015 to July 2016. The positive predictive value (PPV) and negative predictive value (NPV) for each code of interest. Sensitivity and specificity were secondary outcomes. A total of 146 patients (mean [SD] age, 60.3 [12.5] years) from 11 physicians had 1072 encounters reviewed over 2 calendar years. Among the included patients, 49.3% were female (n = 72), 48.6% were white (n = 71), 37.0% were black (n = 54), and 18.5% had type 1 diabetes and a mean (SD) hemoglobin A1C level of 7.7% (1.8) (n = 27). Nearly all codes of interest that were used frequently also had a high PPV (range, 89.5%-100%) and NPV (88.6%-100%) including billing codes for intravitreal injection, focal laser, panretinal photocoagulation, laterality of procedure, ranibizumab, bevacizumab, fundus photographs, fluorescein angiography, and optical coherence tomography. Codes that were used infrequently (codes for aflibercept, triamcinolone, and the dexamethasone implant. Only the codes for infrequently used B-scan ultrasonography (PPV, 69.6%) and subtenon injection (PPV, 100%; NPV, 99.7%, but sensitivity of only 40%) were found to be of questionable accuracy. Other than subtenon

  3. Evolving Insights into the Pathophysiology of Diabetic Neuropathy: Implications of Malfunctioning Glia and Discovery of Novel Therapeutic Targets.

    Science.gov (United States)

    Rahman, Md Habibur; Jha, Mithilesh Kumar; Suk, Kyoungho

    2016-01-01

    Diabetic neuropathy subsequent to chronic high blood glucose-induced nerve damage is one of the most frustrating and debilitating complications of diabetes, which affects the quality of life in patients with diabetes. Approximately 60-70% of patients with diabetes suffer from a distal symmetrical form of mild to severe neuropathy that progresses in a fiber-length-dependent pattern, with sensory and autonomic manifestations predominating. High glucose and oxidative stress-mediated damage in neurons and glial cells, as well as neuroinflammation and crosstalk between these disease processes, have garnered immense attention as the essential mechanisms underlying the development and progression of diabetic neuropathy. Although the metabolic causes of diabetic neuropathy are well understood and documented, treatment options for this disorder are still limited, highlighting the need for further studies to identify new molecular and therapeutic targets. This review covers recent advances in our knowledge of the pathophysiology of diabetic neuropathy, discusses how persistent hyperglycemic conditions and malfunctioning glia drive disease progression, and finally explores the possibilities and challenges offered by several potential novel therapeutic targets for both preventing and reversing diabetic neuropathy.

  4. The vascular smooth muscle cell: a therapeutic target in Type 2 diabetes?

    Science.gov (United States)

    Porter, Karen E; Riches, Kirsten

    2013-08-01

    The rising epidemic of T2DM (Type 2 diabetes mellitus) worldwide is of significant concern. The inherently silent nature of the disease in its early stages precludes early detection; hence cardiovascular disease is often established by the time diabetes is diagnosed. This increased cardiovascular risk leads to significant morbidity and mortality in these individuals. Progressive development of complications as a result of previous exposure to metabolic disturbances appears to leave a long-lasting impression on cells of the vasculature that is not easily reversed and is termed 'metabolic memory'. SMCs (smooth muscle cells) of blood vessel walls, through their inherent ability to switch between a contractile quiescent phenotype and an active secretory state, maintain vascular homoeostasis in health and development. This plasticity also confers SMCs with the essential capacity to adapt and remodel in pathological states. Emerging clinical and experimental studies propose that SMCs in diabetes may be functionally impaired and thus contribute to the increased incidence of macrovascular complications. Although this idea has general support, the underlying molecular mechanisms are currently unknown and hence are the subject of intense research. The aim of the present review is to explore and evaluate the current literature relating to the problem of vascular disease in T2DM and to discuss the critical role of SMCs in vascular remodelling. Possibilities for therapeutic strategies specifically at the level of T2DM SMCs, including recent novel advances in the areas of microRNAs and epigenetics, will be evaluated. Since restoring glucose control in diabetic patients has limited effect in ameliorating their cardiovascular risk, discovering alternative strategies that restrict or reverse disease progression is vital. Current research in this area will be discussed.

  5. Therapeutic approaches to slowing the progression of diabetic nephropathy – is less best?

    Directory of Open Access Journals (Sweden)

    Eva Vivian

    2013-03-01

    Full Text Available Objective: Angiotensin II receptor blockers (ARBs and angiotensin-converting enzyme (ACE inhibitors are known to reduce proteinuria and have been the first-line agents in the management of diabetic nephropathy for the past 20 years. This review covers recent studies that compare the benefit of additional blockage of the renin–angiotensin–aldosterone system through combination therapy with an ACE inhibitor and ARB, or a direct renin inhibitor (DRI, to monotherapy.Design: Primary and review articles that addressed the pathophysiology, diagnosis, and therapeutic options for attenuating the progression of diabetic nephropathy were retrieved through a MEDLINE search (January 1990 to December 2012 and the bibliographies of identified articles were reviewed. English language sources were searched using the following search terms: diabetes mellitus, nephropathy, proteinuria, ACE inhibitors, ARBs, and DRIs.Setting: Randomized, placebo-controlled, short- and long-term studies published in peer-reviewed journals that were determined to be methodologically sound, with appropriate statistical analysis of the results, were selected for inclusion in this review.Participants: Adult (≥18 years patients with diabetic nephropathy.Measurements: Serum creatinine level was used to estimate glomerular filtration rate (GFR. GFR was calculated using the four-variable Modification of Diet in Renal Disease formula. The urine albumin-to-creatinine ratio was measured at baseline and at the conclusion of each study. A value between 3.4 mg/mmol and below 33.9 mg/mmol was defined as microalbuminuria. A value of 33.9 mg/mmol or more (approximately 300 mg/g creatinine was defined as macroalbuminuria.Results: ACE inhibitors and ARBs are now the mainstay of treatment for diabetic nephropathy. However, combination therapy with an ACE inhibitor and an ARB, or DRI, has not been found to be more effective than monotherapy with an ACE inhibitor or ARB, and may increase the risk

  6. Patients' Experience of therapeutic footwear whilst living at risk of neuropathic diabetic foot ulceration: an interpretative phenomenological analysis (IPA).

    Science.gov (United States)

    Paton, Joanne S; Roberts, Anne; Bruce, Graham K; Marsden, Jonathan

    2014-02-22

    Previous work has found that people with diabetes do not wear their therapeutic footwear as directed, but the thinking behind this behaviour is unclear. Adherence to therapeutic footwear advice must improve in order to reduce foot ulceration and amputation risk in people with diabetes and neuropathy. Therefore this study aimed to explore the psychological influences and personal experiences behind the daily footwear selection of individuals with diabetes and neuropathy. An interpretative phenomenological analysis (IPA) approach was used to explore the understanding and experience of therapeutic footwear use in people living at risk of diabetic neuropathic foot ulceration. This study benefited from the purposive selection of a small sample of four people and used in-depth semi structured interviews because it facilitated the deep and detailed examination of personal thoughts and feelings behind footwear selection. Four overlapping themes that interact to regulate footwear choice emerged from the analyses: a) Self-perception dilemma; resolving the balance of risk experienced by people with diabetes and neuropathy day to day, between choosing to wear footwear to look and feel normal and choosing footwear to protect their feet from foot ulceration; b) Reflective adaption; The modification and individualisation of a set of values about footwear usage created in the minds of people with diabetes and neuropathy; c) Adherence response; The realignment of footwear choice with personal values, to reinforce the decision not to change behaviour or bring about increased footwear adherence, with or without appearance management; d) Reality appraisal; A here and now appraisal of the personal benefit of footwear choice on emotional and physical wellbeing, with additional consideration to the preservation of therapeutic footwear. For some people living at risk of diabetic neuropathic foot ulceration, the decision whether or not to wear therapeutic footwear is driven by the

  7. Intestinal microbiota and type 2 diabetes: from mechanism insights to therapeutic perspective.

    Science.gov (United States)

    Han, Jun-Ling; Lin, Hui-Ling

    2014-12-21

    The incidence of type 2 diabetes (T2DM) is rapidly increasing worldwide. However, the pathogenesis of T2DM has not yet been well explained. Recent evidence suggests that the intestinal microbiota composition is associated with obesity and T2DM. In this review, we provide an overview about the mechanisms underlying the role of intestinal microbiota in the pathogenesis of T2DM. There is clear evidence that the intestinal microbiota influences the host through its effect on body weight, bile acid metabolism, proinflammatory activity and insulin resistance, and modulation of gut hormones. Modulating gut microbiota with the use of probiotics, prebiotics, antibiotics, and fecal microbiota transplantation may have benefits for improvement in glucose metabolism and insulin resistance in the host. Further studies are required to increase our understanding of the complex interplay between intestinal microbiota and the host with T2DM. Further studies may be able to boost the development of new effective therapeutic approaches for T2DM.

  8. Glucagon antagonism as a potential therapeutic target in type 2 diabetes

    DEFF Research Database (Denmark)

    Bagger, J I; Knop, F K; Holst, Jens Juul

    2011-01-01

    Glucagon is a hormone secreted from the alpha cells of the pancreatic islets. Through its effect on hepatic glucose production (HGP), glucagon plays a central role in the regulation of glucose homeostasis. In patients with type 2 diabetes mellitus (T2DM), abnormal regulation of glucagon secretion....... This review focuses on the mechanism of action, safety and efficacy of glucagon antagonists in the treatment of T2DM and discusses the challenges associated with this new potential antidiabetic treatment modality....... has been implicated in the development of fasting and postprandial hyperglycaemia. Therefore, new therapeutic agents based on antagonizing glucagon action, and hence blockade of glucagon-induced HGP, could be effective in lowering both fasting and postprandial hyperglycaemia in patients with T2DM...

  9. The paradoxical pro- and antiangiogenic actions of resveratrol: therapeutic applications in cancer and diabetes.

    Science.gov (United States)

    Kamaleddin, Mohammad Amin

    2016-12-01

    Resveratrol, a polyphenol found in grapes, peanuts, and red wine, plays different roles in diseases such as cancer and diabetes. Existing information indicates that resveratrol provides cardioprotection, as evidenced by superior postischemic ventricular recovery, reduced myocardial infarct size, and decreased number of apoptotic cardiomyocytes associated with resveratrol treatment in animal models. Cardiovascular benefits are experienced in humans with routine but not acute consumption of red wine. In this concise review, the paradoxical pro- and antiangiogenic effects of resveratrol are described, and different roles for resveratrol in the formation of new blood vessels are explained through different mechanisms. It is hypothesized that the effects of resveratrol on different cell types are not only dependent on its concentration but also on the physical and chemical conditions surrounding cells. The findings discussed herein shed light on potential therapeutic proapoptotic and antiangiogenic applications of low-dose resveratrol treatment in the prevention and treatment of different diseases. © 2016 New York Academy of Sciences.

  10. The therapeutic potential of manipulating gut microbiota in obesity and type 2 diabetes mellitus.

    Science.gov (United States)

    Kootte, R S; Vrieze, A; Holleman, F; Dallinga-Thie, G M; Zoetendal, E G; de Vos, W M; Groen, A K; Hoekstra, J B L; Stroes, E S; Nieuwdorp, M

    2012-02-01

    Obesity and type 2 diabetes mellitus (T2DM) are attributed to a combination of genetic susceptibility and lifestyle factors. Their increasing prevalence necessitates further studies on modifiable causative factors and novel treatment options. The gut microbiota has emerged as an important contributor to the obesity--and T2DM--epidemic proposed to act by increasing energy harvest from the diet. Although obesity is associated with substantial changes in the composition and metabolic function of the gut microbiota, the pathophysiological processes remain only partly understood. In this review we will describe the development of the adult human microbiome and discuss how the composition of the gut microbiota changes in response to modulating factors. The influence of short-chain fatty acids, bile acids, prebiotics, probiotics, antibiotics and microbial transplantation is discussed from studies using animal and human models. Ultimately, we aim to translate these findings into therapeutic pathways for obesity and T2DM in humans.

  11. The role of butyrate, a histone deacetylase inhibitor in diabetes mellitus: experimental evidence for therapeutic intervention.

    Science.gov (United States)

    Khan, Sabbir; Jena, Gopabandhu

    2015-01-01

    The contribution of epigenetic mechanisms in diabetes mellitus (DM), β-cell reprogramming and its complications is an emerging concept. Recent evidence suggests that there is a link between DM and histone deacetylases (HDACs), because HDAC inhibitors promote β-cell differentiation, proliferation, function and improve insulin resistance. Moreover, gut microbes and diet-derived products can alter the host epigenome. Furthermore, butyrate and butyrate-producing microbes are decreased in DM. Butyrate is a short-chain fatty acid produced from the fermentation of dietary fibers by microbiota and has been proven as an HDAC inhibitor. The present review provides a pragmatic interpretation of chromatin-dependent and independent complex signaling/mechanisms of butyrate for the treatment of Type 1 and Type 2 DM, with an emphasis on the promising strategies for its drugability and therapeutic implication.

  12. Insulin-degrading enzyme: new therapeutic target for diabetes and Alzheimer's disease?

    Science.gov (United States)

    Pivovarova, Olga; Höhn, Annika; Grune, Tilman; Pfeiffer, Andreas F H; Rudovich, Natalia

    2016-12-01

    Insulin-degrading enzyme (IDE) is a major enzyme responsible for insulin degradation. In addition to insulin, IDE degrades many targets including glucagon, atrial natriuretic peptide, and beta-amyloid peptide, regulates proteasomal degradation and other cell functions. IDE represents a pathophysiological link between type 2 diabetes (T2DM) and late onset Alzheimer's disease (AD). Potent and selective modulators of IDE activity are potential drugs for therapies of both diseases. Acute treatment with a novel IDE inhibitor was recently tested in a mouse study as a therapeutic approach for the treatment of T2DM. In contrast, effective IDE activators can be used for the AD treatment. However, because of the pleiotropic IDE action, the sustained treatment with systemic IDE modulators should be carefully tested in animal studies. Development of substrate-selective IDE modulators could overcome possible adverse effects of IDE modulators associated with multiplicity of IDE targets. KEY MESSAGES Insulin-degrading enzyme (IDE) represents a pathophysiological link between type 2 diabetes (T2DM) and Alzheimer's disease (AD). Selective modulators of IDE activity are potential drugs for both T2DM and AD treatment. Development of substrate-selective IDE modulators could overcome possible adverse effects of IDE modulators associated with multiplicity of IDE targets.

  13. Small molecule activators of SIRT1 as therapeutics for the treatment of type 2 diabetes

    Science.gov (United States)

    Milne, Jill C.; Lambert, Philip D.; Schenk, Simon; Carney, David P.; Smith, Jesse J.; Gagne, David J.; Jin, Lei; Boss, Olivier; Perni, Robert B.; Vu, Chi B.; Bemis, Jean E.; Xie, Roger; Disch, Jeremy S.; Ng, Pui Yee; Nunes, Joseph J.; Lynch, Amy V.; Yang, Hongying; Galonek, Heidi; Israelian, Kristine; Choy, Wendy; Iffland, Andre; Lavu, Siva; Medvedik, Oliver; Sinclair, David A.; Olefsky, Jerrold M.; Jirousek, Michael R.; Elliott, Peter J.; Westphal, Christoph H.

    2009-01-01

    Calorie restriction extends lifespan and produces a metabolic profile desirable for treating diseases of ageing such as type 2 diabetes1,2. SIRT1, an NAD+-dependent deacetylase, is a principal modulator of pathways downstream of calorie restriction that produce beneficial effects on glucose homeostasis and insulin sensitivity3–9. Resveratrol, a polyphenolic SIRT1 activator, mimics the anti-ageing effects of calorie restriction in lower organisms and in mice fed a high-fat diet ameliorates insulin resistance, increases mitochondrial content, and prolongs survival10–14. Here we describe the identification and characterization of small molecule activators of SIRT1 that are structurally unrelated to, and 1,000-fold more potent than, resveratrol. These compounds bind to the SIRT1 enzyme—peptide substrate complex at an allosteric site amino-terminal to the catalytic domain and lower the Michaelis constant for acetylated substrates. In diet-induced obese and genetically obese mice, these compounds improve insulin sensitivity, lower plasma glucose, and increase mitochondrial capacity. In Zucker fa/fa rats, hyperinsulinaemic-euglycaemic clamp studies demonstrate that SIRT1 activators improve whole-body glucose homeostasis and insulin sensitivity in adipose tissue, skeletal muscle and liver. Thus, SIRT1 activation is a promising new therapeutic approach for treating diseases of ageing such as type 2 diabetes. PMID:18046409

  14. Evaluation and optimization of therapeutic footwear for neuropathic diabetic foot patients using in-shoe plantar pressure analysis

    NARCIS (Netherlands)

    S.A. Bus; R. Haspels; T.E. Busch-Westbroek

    2011-01-01

    Therapeutic footwear for diabetic foot patients aims to reduce the risk of ulceration by relieving mechanical pressure on the foot. However, footwear efficacy is generally not assessed in clinical practice. The purpose of this study was to assess the value of in-shoe plantar pressure analysis to eva

  15. Mesenchymal Stem Cells as Therapeutic Candidates for Halting the Progression of Diabetic Nephropathy

    Science.gov (United States)

    Paulini, Janaina; Higuti, Eliza; Bastos, Rosana M. C.; Gomes, Samirah A.

    2016-01-01

    Mesenchymal stem cells (MSCs) possess pleiotropic properties that include immunomodulation, inhibition of apoptosis, fibrosis and oxidative stress, secretion of trophic factors, and enhancement of angiogenesis. These properties provide a broad spectrum for their potential in a wide range of injuries and diseases, including diabetic nephropathy (DN). MSCs are characterized by adherence to plastic, expression of the surface molecules CD73, CD90, and CD105 in the absence of CD34, CD45, HLA-DR, and CD14 or CD11b and CD79a or CD19 surface molecules, and multidifferentiation capacity in vitro. MSCs can be derived from many tissue sources, consistent with their broad, possibly ubiquitous distribution. This article reviews the existing literature and knowledge of MSC therapy in DN, as well as the most appropriate rodent models to verify the therapeutic potential of MSCs in DN setting. Some preclinical relevant studies are highlighted and new perspectives of combined therapies for decreasing DN progression are discussed. Hence, improved comprehension and interpretation of experimental data will accelerate the progress towards clinical trials that should assess the feasibility and safety of this therapeutic approach in humans. Therefore, MSC-based therapies may bring substantial benefit for patients suffering from DN. PMID:28058051

  16. Hypoxia in Obesity and Diabetes: Potential Therapeutic Effects of Hyperoxia and Nitrate

    National Research Council Canada - National Science Library

    Reza Norouzirad; Pedro González-Muniesa; Asghar Ghasemi

    2017-01-01

      The prevalence of obesity and diabetes is increasing worldwide. Obesity and diabetes are associated with oxidative stress, inflammation, endothelial dysfunction, insulin resistance, and glucose intolerance...

  17. A structured therapeutic education program for children and adolescents with type 1 diabetes: an analysis of the efficacy of the "Pediatric Education for Diabetes" project.

    Science.gov (United States)

    Mauri, Alessandra; Schmidt, Susanna; Sosero, Valentina; Sambataro, Maria; Nollino, Laura; Fabris, Francesco; Corò, Anna; Scantamburlo, Antonella; Cazziola-Merlotto, Michela; Ciani, Tania; Tessarin, Michele; Paccagnella, Agostino

    2017-02-07

    Therapeutic education for Type 1 Diabetes involves the process of transmitting knowledge and developing the skills and behavior required to treat the disease. guidelines agree on stressing the importance of therapeutic educational intervention in teaching self-management skills to children and adolescents with Type 1 Diabetes (T1D). This study presents the results of the "Pediatric Education for Type 1 Diabetes (T1D)" (PED) project, specifically designed for children and adolescents aged 6 to 16, and structured on guidelines indications, as part of a broader clinical-educational intervention for Type 1 diabetes. 24 patients with Type 1 diabetes (mean age: 12,13 y; SD = 1.48 y; range 9- 14) were studied in a 12-month PED structured project followed by a educational summer camp. All the activities were designed and organized by a multidisciplinary team (dietitian, pediatric diabetologist, nurse, psychologist and adult diabetologist). Glycated hemoglobin (HbA1C), knowledge about Type 1 Diabetes (T1D) (self-monitoring and nutrition), self- management (self-monitoring, nutrition and flexibility of medical treatment), and wellbeing were used as outcome measures. Data suggest that the PED had a positive impact on all the targeted levels indicated for recommended care. The results of this study seem to confirm the effectiveness in altering the three levels of "knowing", "know-how" and "wellbeing" required to optimize the quality of life of young patients with Type 1 diabetes. In addition, the proposed model, where a pediatric diabetologist always cooperates with an adult diabetologist, seems to be a permanent solution to the transitional gap widely discussed in the literature.

  18. The Hippo signaling pathway: a potential therapeutic target is reversed by a Chinese patent drug in rats with diabetic retinopathy.

    Science.gov (United States)

    Hao, Gai-Mei; Lv, Tian-Tian; Wu, Yan; Wang, Hong-Liang; Xing, Wei; Wang, Yong; Li, Chun; Zhang, Zi-Jian; Wang, Zheng-Lin; Wang, Wei; Han, Jing

    2017-04-04

    The Hippo signaling pathway is reported to be involved in angiogenesis, but the roles of the Hippo pathway in diabetic retinopathy have not been addressed. Fufang Xueshuantong Capsule has been used to treat diabetic retinopathy in China; however, the effect of Fufang Xueshuantong Capsule on the Hippo pathway has not been investigated. In this study, diabetes was induced in Sprague-Dawley rats with intraperitoneal injection of streptozotocin. Twenty weeks later, Fufang Xueshuantong Capsule was administered for 12 weeks. When the administration ended, the eyes were isolated for western blot and immunohistochemistry analyses. The levels of P- mammalian sterile 20-like (MST), large tumor suppressor homolog (Lats), P- yes-associated protein (YAP), transcriptional co-activator with PDZ binding motif (TAZ) and TEA domain family members (TEAD) were measured. Diabetic rats had a decreased P-MST level in the inner plexiform layer and reduced expression of P-YAP in the photoreceptor layers of their eyes. In addition, diabetic rats displayed remarkable increases in Lats, TAZ and TEAD in their retinas. Furthermore, Fufang Xueshuantong Capsule restored the changes in the Hippo pathway. The Hippo signaling pathway is important for the progression of diabetic retinopathy and will hopefully be a targeted therapeutic approach for the prevention of diabetic retinopathy.

  19. Nuevas estrategias terapéuticas en diabetes mellitus tipo 1 New therapeutic strategies for type 1 diabetes mellitus

    OpenAIRE

    Barajas, M. (Miguel); Príncipe, R.M. (R.M.); Escalada, J.; Prósper, F; J. Salvador

    2008-01-01

    El principal determinante del riesgo de complicaciones derivadas de la diabetes mellitus tipo 1 se debe a los altos niveles de glucosa en sangre mantenidos durante largo tiempo. Para conseguir un beneficio terapéutico en pacientes con diabetes mellitus es necesario desarrollar tratamientos que permitan de manera segura, efectiva y estable mantener la normoglucemia. Lamentablemente, el tratamiento de la diabetes mellitus tipo 1 mediante el aporte exógeno de insulina no es capaz de conseguir ni...

  20. New Therapeutic Window of Regenerative Opportunity in Diabetic Retinopathy by VESGEN Analysis

    Science.gov (United States)

    Parsons-Wingert, Patricia A.

    2012-01-01

    Vascular pattern may serve as a useful new biomarker principle of complex, multi-scale signaling in pathological, physiological angiogenesis and microvascular remodeling. Each angiogenesis stimulator or inhibitor we have analyzed, including VEGF, bFGF, TGF-beta1, angiostatin and triamcinolone acetonide, has induced a novel "fingerprint" or "signature" biomarker vascular pattern that is spatio-temporally unique. Remodeling vasculature thereby provides an informative read-out of dominant molecular signaling, when analyzed by innovative, fractal-based VESsel GENeration (VESGEN) Analysis software. Using VESGEN to analyze ophthalmic clinical vascular images, we recently introduced a potential paradigm shift to the understanding of early-stage progression that suggests new regenerative opportunities for human diabetic retinopathy (DR), the major blinding disease for working-aged adults. In a pilot study, we discovered that angiogenesis oscillates as a surprising, homeostatic-like regeneration of retinal vessels during early progression of DR (IOVS 51(1):498). Results suggest that the term non-proliferative DR may be a misnomer. In new studies, normalization of the vasculature will be determined from the response of vascular pattern to therapeutic monitoring and treatment. We have mapped and quantified in vivo experimental models of angiogenesis, lymphangiogenesis and intravital blood flow from cellular/molecular to higher systems levels that include a murine model of infant retinopathy of prematurity (ROP); developing and pathological coronary and placental-like vessel models; progressive intestinal inflammation, growing murine tumors, and other pathological, physiological and therapeutically treated tissues of transgenic mice and avian embryos. Vascular Alterations, Visual Impairments (VIIP) & Increased Intracranial Pressure (ICP), Immunosuppression & Bone Loss: NASA-defined risk categories for human space exploration and ISS Utilization

  1. Immune based computer virus detection approaches

    Institute of Scientific and Technical Information of China (English)

    TAN Ying; ZHANG Pengtao

    2013-01-01

    The computer virus is considered one of the most horrifying threats to the security of computer systems worldwide.The rapid development of evasion techniques used in virus causes the signature based computer virus detection techniques to be ineffective.Many novel computer virus detection approaches have been proposed in the past to cope with the ineffectiveness,mainly classified into three categories:static,dynamic and heuristics techniques.As the natural similarities between the biological immune system (BIS),computer security system (CSS),and the artificial immune system (AIS) were all developed as a new prototype in the community of anti-virus research.The immune mechanisms in the BIS provide the opportunities to construct computer virus detection models that are robust and adaptive with the ability to detect unseen viruses.In this paper,a variety of classic computer virus detection approaches were introduced and reviewed based on the background knowledge of the computer virus history.Next,a variety of immune based computer virus detection approaches were also discussed in detail.Promising experimental results suggest that the immune based computer virus detection approaches were able to detect new variants and unseen viruses at lower false positive rates,which have paved a new way for the anti-virus research.

  2. Recent and emerging therapeutic medications in type 2 diabetes mellitus: incretin-based, Pramlintide, Colesevelam, SGLT2 Inhibitors, Tagatose, Succinobucol.

    Science.gov (United States)

    Lo, Margaret C; Lansang, M Cecilia

    2013-01-01

    Nearly 285 million people worldwide, with 10% being Americans, suffer from diabetes mellitus and its associated comorbidities. This is projected to increase by 6.5% per year, with 439 million inflicted by year 2030. Both morbidity and mortality from diabetes stem from the consequences of microvascular and macrovascular complications. Of the 285 million with diabetes, over a quarter of a million die per year from related complications, making diabetes the fifth leading cause of death in high-income countries. These startling statistics illustrate the therapeutic failure of current diabetes drugs to retard the progression of diabetes. These statistics further illustrate the continual need for further research and development of alternative drugs with novel mechanisms to slow disease progression and disease complications. The treatment algorithm updated in 2008 by American Diabetes Association and the European Association for the Study of Diabetes currently recommends the traditional medications of metformin, either as monotherapy or in combination with sulfonylurea or insulin, as the preferred choice in the tier 1 option. The algorithm only suggests addition of alternative medications such as pioglitazone and incretin-based drugs as second-line agents in the tier 2 "less well-validated" option. However, these traditional medications have not proven to delay the progressive course of diabetes as evidence of increasing need over time for multiple drug therapy to maintain sufficient glycemic control. Because current diabetes medications have limited efficacy and untoward side effects, the development of diabetes mellitus drugs with newer mechanisms of action continues. This article will review the clinical data on the newly available incretin-based drugs on the market, including glucagon-like peptide agonists and of dipeptidyl peptidase type-4 inhibitors. It will also discuss 2 unique medications: pramlintide, which is indicated for both type and type-2 diabetes, and

  3. [Hospital and general therapeutic patient education practices: example of diabetes and obesity in Belgium].

    Science.gov (United States)

    Pétré, Benoît; Degrange, Sophie; Tittaferante, Séverine; Legrand, Catherine; Vanmeerbeek, Marc; Froidcoeur, Xavier; Guillaume, Michèle

    2016-01-01

    Introduction/Objectives: Therapeutic Patient Education (TPE) is now part of the new medical landscape, including for the prevention and treatment of diabetes and obesity. While some countries, such as France, have decided to give priority to TPE in public health policy by means of legal recognition, no such framework has been developed in Belgium. The purpose of this article is to describe the actual TPE practices of health professionals (HP) in this environment.Methods: 82 face-to-face interviews (20 GPs and 62 hospital healthcare professionals) were conducted according to a semi-structured interview guide developed from the French Health Authority guidelines. Qualitative content analysis was performed on the data collected.Results/Discussion: For the majority of respondents, TPE is limited to brief information about the disease, its risk factors and complications. This representation of TPE determines the practical modalities of the educational activity right from the educational diagnosis. The possibilities for developing the patient’s capacities are limited. Practices reflect a lack of pedagogical structuring and do not correspond to a real multidisciplinary approach.Conclusion: Healthcare professionals must develop a clear vision of the implications of the concept of TPE and must therefore receive adequate training to ensure good quality development and implementation.

  4. [Xenogeneic cell therapeutics: Treatment of type 1 diabetes using porcine pancreatic islets and islet cells].

    Science.gov (United States)

    Godehardt, Antonia W; Schilling-Leiß, Dagmar; Sanzenbacher, Ralf; Tönjes, Ralf R

    2015-11-01

    In view of the existing shortage of human donor organs and tissues, xenogeneic cell therapeutics (xCT) offer an alternative for adequate treatment. In particular, porcine pancreatic islets and islet cells have already entered the field of experimental therapy for type-1 diabetes mellitus (T1DM) patients. Thereby, xCT depict challenging products with a glance on medical, ethical, and regulatory questions. With cross-species transplantation (xenotransplantation), the risk of immunological graft rejection as well as the risk of infectious transmission of microbial and viral pathogens must be considered. This includes the bidirectional transmission of microorganisms from graft to host as well as from host to graft. Crossing the border of species requires a critical risk-benefit evaluation as well as a thorough longtime surveillance of transplant recipients after treatment. The international legal and regulatory requirements for xCT are inter alia based on the World Health Organization criteria summarized in the Changsha Communiqué (2008). In the European Union, they were reflected by the European Medicines Agency (EMA) Guideline on Xenogeneic Cell-based Medicinal Products following the implementation of the Regulation on Advanced Therapies (ATMP). On the basis of this regulation, the first non-clinical and clinical experiences were obtained for porcine islets. The results suggest that supportive treatment of T1DM risk patients with xCT may be an alternative to established allogeneic organ transplantation in the future.

  5. Lipidomics: potential role in risk prediction and therapeutic monitoring for diabetes and cardiovascular disease.

    Science.gov (United States)

    Meikle, Peter J; Wong, Gerard; Barlow, Christopher K; Kingwell, Bronwyn A

    2014-07-01

    Lipidomics has developed rapidly over the past decade to the point where clinical application may soon be possible. Developments including high throughput technologies enable the simultaneous quantification of several hundred lipid species, thereby providing a global assessment of lipid metabolism. Given the key role of lipids in the pathophysiology of diabetes and cardiovascular disease, lipidomics has the potential to: i) Significantly improve prediction of future disease risk, ii) Inform on mechanisms of disease pathogenesis, iii) Identify patient groups responsive to particular therapies and iv) More closely monitor response to therapy. Lipidomic analyses of both whole plasma and lipoprotein subfractions are integral to the current initiative to understand the relationships between lipoprotein composition and function and how these are affected by disease and treatment. This approach will not only aid in appropriate targeting of existing lipid lowering therapies such as statins and fibrates, but will be important in unravelling the controversies surrounding HDL-based therapies which have failed in clinical trials to date. The ultimate utility of lipidomics to clinical practice will depend firstly on the ability of risk prediction models incorporating lipidomic parameters to significantly improve upon conventional clinical risk markers in predicting future disease risk. Secondly, for widespread application, lipidomic-based measurements must be practical and accessible through standard pathology laboratories. This review will cover developments in lipidomics including methodology, bioinformatics/statistics, insights into disease pathophysiology, the effect of therapeutic interventions, the role of large clinical outcome trials in validating lipidomic approaches to patient management and potential applications in clinical practice.

  6. Therapeutic potential of umbilical cord blood cells for type 1 diabetes mellitus.

    Science.gov (United States)

    He, Binbin; Li, Xia; Yu, Haibo; Zhou, Zhiguang

    2015-11-01

    Type 1 diabetes mellitus (T1DM) is a chronic disorder that results from autoimmune-mediated destruction of pancreatic islet β-cells. However, to date, no conventional intervention has successfully treated the disease. The optimal therapeutic method for T1DM should effectively control the autoimmunity, restore immune homeostasis, preserve residual β-cells, reverse β-cell destruction, and protect the regenerated insulin-producing cells against re-attack. Umbilical cord blood is rich in regulatory T (T(reg)) cells and multiple types of stem cells that exhibit immunomodulating potential and hold promise in their ability to restore peripheral tolerance towards pancreatic islet β-cells through remodeling of immune responses and suppression of autoreactive T cells. Recently, reinfusion of autologous umbilical cord blood or immune cells from cord blood has been proposed as a novel therapy for T1DM, with the advantages of no risk to the donors, minimal ethical concerns, a low incidence of graft-versus-host disease and easy accessibility. In this review, we revisit the role of autologous umbilical cord blood or immune cells from cord blood-based applications for the treatment of T1DM.

  7. Therapeutic potential of histamine H3 receptor agonist for the treatment of obesity and diabetes mellitus.

    Science.gov (United States)

    Yoshimoto, Ryo; Miyamoto, Yasuhisa; Shimamura, Ken; Ishihara, Akane; Takahashi, Kazuhiko; Kotani, Hidehito; Chen, Airu S; Chen, Howard Y; Macneil, Douglas J; Kanatani, Akio; Tokita, Shigeru

    2006-09-12

    Histamine H3 receptors (H3Rs) are located on the presynaptic membranes and cell soma of histamine neurons, where they negatively regulate the synthesis and release of histamine. In addition, H3Rs are also located on nonhistaminergic neurons, acting as heteroreceptors to regulate the releases of other amines such as dopamine, serotonin, and norepinephrine. The present study investigated the effects of H3R ligands on appetite and body-weight regulation by using WT and H3R-deficient mice (H3RKO), because brain histamine plays a pivotal role in energy homeostasis. The results showed that thioperamide, an H3R inverse agonist, increases, whereas imetit, an H3R agonist, decreases appetite and body weight in diet-induced obese (DiO) WT mice. Moreover, in DiO WT mice, but not in DiO H3RKO mice, imetit reduced fat mass, plasma concentrations of leptin and insulin, and hepatic triglyceride content. The anorexigenic effects of imetit were associated with a reduction in histamine release, but a comparable reduction in histamine release with alpha-fluoromethylhistidine, an inhibitor of histamine synthesis, increased appetite. Moreover, the anorexigenic effects of imetit were independent of the melanocortin system, because imetit comparably reduced appetite in melanocortin 3 and 4 receptor-deficient mice. The results provide roles of H3Rs in energy homeostasis and suggest a therapeutic potential for H3R agonists in the treatment of obesity and diabetes mellitus.

  8. Histone deacetylase inhibitors: Future therapeutics for insulin resistance and type 2 diabetes.

    Science.gov (United States)

    Sharma, Sorabh; Taliyan, Rajeev

    2016-11-01

    Insulin resistance is a common feature of obesity and predisposes the affected individuals to a variety of pathologies, including type 2 diabetes mellitus (T2DM), dyslipidemias, hypertension, cardiovascular disease etc. Insulin resistance is the primary cause of T2DM and it occurs many years before the disease onset. Although Thiazolidinediones (TZDs) such as rosiglitazone and pioglitazone are outstanding insulin sensitizers and are in clinical use since 1990s, however, their serious side effects such as heart attack and bladder cancer have limited their utilization. Thus, there is an unmet need to identify a new class of drugs with insulin sensitizing activity and minimal side effects. In the recent years, Histone deacetylase (HDAC) has emerged as a new molecular target in the control of insulin resistance and T2DM. The level of histone acetylation/deacetylation has been found to be altered during insulin resistance and T2DM conditions. HDAC inhibitors have been found to effectively manage insulin resistance and T2DM in various preclinical models and clinical trials. In this review we will focus on various aspects related to regulation of insulin signalling by HDACs and the future scope of HDAC inhibitors as therapeutics for insulin resistance.

  9. New Diagnostic and Therapeutic Approaches for Preventing the Progression of Diabetic Retinopathy

    OpenAIRE

    2016-01-01

    Diabetic retinopathy (DR) is a severe sight-threatening complication of diabetes mellitus. Retinal laser photocoagulation, antivascular endothelial growth factors, steroid therapy, and pars plana vitrectomy are now used extensively to treat advanced stages of diabetic retinopathy. Currently, diagnostic devices like ultrawide field fundus fluorescein angiography and the improvement of optical coherence tomography have provided quicker and more precise diagnosis of early diabetic retinopathy. T...

  10. [Effectiveness of the kit Conversation Map in the therapeutic education of diabetic people attending the Diabetes Unit in Carpi, Italy].

    Science.gov (United States)

    Ciardullo, Anna Vittoria; Daghio, Maria Monica; Fattori, Giuseppe; Giudici, Graziella; Rossii, Lorella; Vagnini, Claudio

    2010-12-01

    We implemented the "Diabetes conversations", programme of the International Diabetes Federation-Europe, characterised by the use of the Conversation Map, an educational interactive kit addressed to groups of diabetic patients on: Living with diabetes, What is diabetes, Healthy diet and physical activity, Initiating insulin therapy. After at least three month from the end of the 4-session course, clinical data of 63 participants from the first 10 groups--age (mean +/- std dev) 61.7 +/- 10.2 years, 56% women, 18.5% T1DM-improved: fasting glycemia decreased from 152.9 +/- 55.2 to 138.2 +/- 38.9 mg/dl (P Conversation Maps are useful because: (a) contribute to improve glycometabolic control; (b) educate patients on the main topics related to diabetes; (c) give to the nurse a key and active role in patients'education; (d) facilitate the connection between knowledge and behaviour; (e) involve the volunteers of the diabetic association as tutors; (f) improve the relationship and the communication between the doctor/nurse and the patient.

  11. Down regulation of NF-kappa B as a therapeutic strategy for type 1 diabetes: effect of flavonoids

    Directory of Open Access Journals (Sweden)

    Amin Ardestani

    2007-06-01

    Full Text Available Nuclear factor-kappa B (NF-κB is a redox-sensitive transcription factor that plays a critical role in the regulation of a variety of genes important in cellular responses, including inflammation, innate immunity, growth, and cell death. There are growing evidences that activation of NF-κB by acute oxidative stress may be the critical signal initiating the cascade of events leading to β-cell death and type 1 diabetes. This activation results in an increase in inflammatory and immune responses and leads to an amplification of reactive oxygen species (ROS and nitric oxide (NO production which, in turn, ultimately leads to the destruction of the β-cells, hyperglycemia and the development of type 1 diabetes. The key role of NF-κB in controlling the expression of multiple inflammatory and immune genes involved in type 1 diabetes makes this factor as a central and favorable target for therapeutic intervention of this disease. Polyphenolic plant-derived flavonoids display characteristic inhibitory patterns toward the NF-κB signal transduction pathways. In various types of cells, flavonoids, as natural polyphenolic antioxidants, strongly block cytokine- or LPS-induced NF-κB activation, which is crucial for iNOS expression in β-cells. Recently, we have suggested that a number of flavonoids might exert protective effects on pancreatic β-cell and therefore this could be considered as potential therapeutic agents for type 1 diabetes. On the other hand, studies investigating cytokine-induced pancreatic β-cells death models of type 1 diabetes, have found that flavonoids are effective for type 1 diabetes at least partly through inhibition of NF-κB activation. The importance of NF-κB in β-cell inflammatory responses is underscored by the fact that blockade of NF-κB in in vitro and in vivo models, by means of flavonoids, may prevents β-cell destruction and type 1 diabetes. In view of their anti-inflammatory and antioxidant abilities and their

  12. An immune based dynamic intrusion detection model

    Institute of Scientific and Technical Information of China (English)

    LI Tao

    2005-01-01

    With the dynamic description method for self and antigen, and the concept of dynamic immune tolerance for lymphocytes in network-security domain presented in this paper, a new immune based dynamic intrusion detection model (Idid) is proposed. In Idid, the dynamic models and the corresponding recursive equations of the lifecycle of mature lymphocytes, and the immune memory are built. Therefore, the problem of the dynamic description of self and nonself in computer immune systems is solved, and the defect of the low efficiency of mature lymphocyte generating in traditional computer immune systems is overcome. Simulations of this model are performed, and the comparison experiment results show that the proposed dynamic intrusion detection model has a better adaptability than the traditional methods.

  13. Immune Based Intrusion Detector Generating Algorithm

    Institute of Scientific and Technical Information of China (English)

    DONG Xiao-mei; YU Ge; XIANG Guang

    2005-01-01

    Immune-based intrusion detection approaches are studied. The methods of constructing self set and generating mature detectors are researched and improved. A binary encoding based self set construction method is applied. First,the traditional mature detector generating algorithm is improved to generate mature detectors and detect intrusions faster. Then, a novel mature detector generating algorithm is proposed based on the negative selection mechanism. Accord ing to the algorithm, less mature detectors are needed to detect the abnormal activities in the network. Therefore, the speed of generating mature detectors and intrusion detection is improved. By comparing with those based on existing algo rithms, the intrusion detection system based on the algorithm has higher speed and accuracy.

  14. An immunity based network security risk estimation

    Institute of Scientific and Technical Information of China (English)

    LI Tao

    2005-01-01

    According to the relationship between the antibody concentration and the pathogen intrusion intensity, here we present an immunity-based model for the network security risk estimation (Insre). In Insre, the concepts and formal definitions of self,nonself, antibody, antigen and lymphocyte in the network security domain are given. Then the mathematical models of the self-tolerance, the clonal selection, the lifecycle of mature lymphocyte, immune memory and immune surveillance are established. Building upon the above models, a quantitative computation model for network security risk estimation,which is based on the calculation of antibody concentration, is thus presented. By using Insre, the types and intensity of network attacks, as well as the risk level of network security, can be calculated quantitatively and in real-time. Our theoretical analysis and experimental results show that Insre is a good solution to real-time risk evaluation for the network security.

  15. Adiponectin: a manifold therapeutic target for metabolic syndrome, diabetes, and coronary disease?

    Science.gov (United States)

    2014-01-01

    Adiponectin is the most abundant peptide secreted by adipocytes, being a key component in the interrelationship between adiposity, insulin resistance and inflammation. Central obesity accompanied by insulin resistance is a key factor in the development of metabolic syndrome (MS) and future macrovascular complications. Moreover, the remarkable correlation between coronary artery disease (CAD) and alterations in glucose metabolism has raised the likelihood that atherosclerosis and type 2 diabetes mellitus (T2DM) may share a common biological background. We summarize here the current knowledge about the influence of adiponectin on insulin sensitivity and endothelial function, discussing its forthcoming prospects and potential role as a therapeutic target for MS, T2DM, and cardiovascular disease. Adiponectin is present in the circulation as a dimer, trimer or protein complex of high molecular weight hexamers, >400 kDa. AdipoR1 and AdipoR2 are its major receptors in vivo mediating the metabolic actions. Adiponectin stimulates phosphorylation and AMP (adenosin mono phosphate) kinase activation, exerting direct effects on vascular endothelium, diminishing the inflammatory response to mechanical injury and enhancing endothelium protection in cases of apolipoprotein E deficiency. Hypoadiponectinemia is consistently associated with obesity, MS, atherosclerosis, CAD, T2DM. Lifestyle correction helps to favorably modify plasma adiponectin levels. Low adiponectinemia in obese patients is raised via continued weight loss programs in both diabetic and nondiabetic individuals and is also accompanied by reductions in pro-inflammatory factors. Diet modifications, like intake of fish, omega-3 supplementation, adherence to a Mediterranean dietary pattern and coffee consumption also increase adiponectin levels. Antidiabetic and cardiovascular pharmacological agents, like glitazones, glimepiride, angiotensin converting enzyme inhibitors and angiotensin receptor blockers are also able to

  16. Calcitonin and vitamin D3 have high therapeutic potential for improving diabetic mandibular growth

    Science.gov (United States)

    Abbassy, Mona A; Watari, Ippei; Bakry, Ahmed S; Ono, Takashi; Hassan, Ali H

    2016-01-01

    The goal of this study was to assess the effect of the intermittent combination of an antiresorptive agent (calcitonin) and an anabolic agent (vitamin D3) on treating the detrimental effects of Type 1 diabetes mellitus (DM) on mandibular bone formation and growth. Forty 3-week-old male Wistar rats were divided into four groups: the control group (normal rats), the control C+D group (normal rats injected with calcitonin and vitamin D3), the diabetic C+D group (diabetic rats injected with calcitonin and vitamin D3) and the diabetic group (uncontrolled diabetic rats). An experimental DM condition was induced in the male Wistar rats in the diabetic and diabetic C+D groups using a single dose of 60 mg·kg−1 body weight of streptozotocin. Calcitonin and vitamin D3 were simultaneously injected in the rats of the control C+D and diabetic C+D groups. All rats were killed after 4 weeks, and the right mandibles were evaluated by micro-computed tomography and histomorphometric analysis. Diabetic rats showed a significant deterioration in bone quality and bone formation (diabetic group). By contrast, with the injection of calcitonin and vitamin D3, both bone parameters and bone formation significantly improved (diabetic C+D group) (P < 0.05). These findings suggest that these two hormones might potentially improve various bone properties. PMID:27025264

  17. Calcitonin and vitamin D3 have high therapeutic potential for improving diabetic mandibular growth

    Institute of Scientific and Technical Information of China (English)

    Mona A Abbassy; Ippei Watari; Ahmed S Bakry; Takashi Ono; Ali H Hassan

    2016-01-01

    The goal of this study was to assess the effect of the intermittent combination of an antiresorptive agent (calcitonin) and an anabolic agent (vitamin D3) on treating the detrimental effects of Type 1 diabetes mellitus (DM) on mandibular bone formation and growth. Forty 3-week-old male Wistar rats were divided into four groups: the control group (normal rats), the control C1D group (normal rats injected with calcitonin and vitamin D3), the diabetic C1D group (diabetic rats injected with calcitonin and vitamin D3) and the diabetic group (uncontrolled diabetic rats). An experimental DM condition was induced in the male Wistar rats in the diabetic and diabetic C1D groups using a single dose of 60 mg?kg–1 body weight of streptozotocin. Calcitonin and vitamin D3 were simultaneously injected in the rats of the control C1D and diabetic C1D groups. All rats were killed after 4 weeks, and the right mandibles were evaluated by micro-computed tomography and histomorphometric analysis. Diabetic rats showed a significant deterioration in bone quality and bone formation (diabetic group). By contrast, with the injection of calcitonin and vitamin D3, both bone parameters and bone formation significantly improved (diabetic C1D group) (P < 0.05). These findings suggest that these two hormones might potentially improve various bone properties.

  18. Acute Versus Progressive Onset of Diabetes in NOD Mice: Potential Implications for Therapeutic Interventions in Type 1 Diabetes.

    Science.gov (United States)

    Mathews, Clayton E; Xue, Song; Posgai, Amanda; Lightfoot, Yaima L; Li, Xia; Lin, Andrea; Wasserfall, Clive; Haller, Michael J; Schatz, Desmond; Atkinson, Mark A

    2015-11-01

    Most natural history models for type 1 diabetes (T1D) propose that overt hyperglycemia results after a progressive loss of insulin-secreting β-cell mass and/or function. To experimentally address this concept, we prospectively determined morning blood glucose measurements every other day in multiple cohorts (total n = 660) of female NOD/ShiLtJ mice starting at 8 weeks of age until diabetes onset or 26 weeks of age. Consistent with this notion, a majority of mice that developed diabetes (354 of 489 [72%]) displayed a progressive increase in blood glucose with transient excursions >200 mg/dL, followed by acute and persistent hyperglycemia at diabetes onset. However, 135 of the 489 (28%) diabetic animals demonstrated normal glucose values followed by acute (i.e., sudden) hyperglycemia. Interestingly, diabetes onset occurred earlier in mice with acute versus progressive disease onset (15.37 ± 0.3207 vs. 17.44 ± 0.2073 weeks of age, P reversal of T1D by immunotherapeutic intervention, with increased effectiveness observed in situations of a progressive deterioration in euglycemia. These studies highlight a novel natural history aspect in this animal model, one that may provide important guidance for the selection of subjects participating in human trials seeking disease reversal.

  19. Effect of therapeutic dose of vitamin d on serum adiponectin and glycemia in vitamin d-insufficient or deficient type 2 diabetic patients

    National Research Council Canada - National Science Library

    Baziar, Nima; Jafarian, Kurosh; Shadman, Zhaleh; Qorbani, Mostafa; Khoshniat Nikoo, Mohsen; Abd Mishani, Mahshid

    2014-01-01

    .... The aim of this study was to investigate the effect of therapeutic dose of vitamin D on serum adiponectin and insulin resistance in vitamin D-insufficient or deficient type 2 diabetic patients...

  20. G protein-coupled receptors: potential therapeutic targets for diabetic nephropathy.

    Science.gov (United States)

    Ding, Hai-Hua; Ni, Wei-Jian; Tang, Li-Qin; Wei, Wei

    2015-12-16

    Diabetic nephropathy, a lethal microvascular complication of diabetes mellitus, is characterized by progressive albuminuria, excessive deposition of extracellular matrix, thickened glomerular basement membrane, podocyte abnormalities, and podocyte loss. The G protein-coupled receptors (GPCRs) have attracted considerable attention in diabetic nephropathy, but the specific effects have not been elucidated yet. Likewise, abnormal signaling pathways are closely interrelated to the pathologic process of diabetic nephropathy, despite the fact that the mechanisms have not been explored clearly. Therefore, GPCRs and its mediated signaling pathways are essential for priority research, so that preventative strategies and potential targets might be developed for diabetic nephropathy. This article will give us comprehensive overview of predominant GPCR types, roles, and correlative signaling pathways in diabetic nephropathy.

  1. Ipomoea batatas and Agarics blazei ameliorate diabetic disorders with therapeutic antioxidant potential in streptozotocin-induced diabetic rats.

    Science.gov (United States)

    Niwa, Atsuko; Tajiri, Takashi; Higashino, Hideaki

    2011-05-01

    Ipomoea batatas, Agaricus blazei and Smallanthus sonchifolius are known to favorably influence diabetes mellitus. To clarify their antidiabetic efficacy and hypoglycemic mechanisms, we treated streptozotocin-induced diabetic rats with daily oral feeding of powdered Ipomoea batatas (5 g kg(-1) d(-1)), Agaricus blazei (1 g kg(-1) d(-1)) or Smallanthus sonchifolius (4 g kg(-1) d(-1)) for 2 months. Treatments with Ipomoea batatas or Agaricus blazei, but not Smallanthus sonchifolius, significantly suppressed the increases of fasting plasma glucose and hemoglobin A1c levels, and restored body weight loss during diabetes. Serum insulin levels after oral glucose administration tests increased along the treatments of Ipomoea batatas or Agaricus blazei. Moreover, Ipomoea batatas and Agaricus blazei reduced superoxide production from leukocytes and vascular homogenates, serum 8-oxo-2'-deoxyguanosine, and vascular nitrotyrosine formation of diabetic rats to comparable levels of normal control animals. Stress- and inflammation-related p38 mitogen-activated protein kinase activity and tumor necrosis factor-α production of diabetic rats were significantly depressed by Ipomoea batatas administration. Histological examination also exhibited improvement of pancreatic β-cells mass after treatments with Ipomoea batatas or Agaricus blazei. These results suggest that hypoglycemic effects of Ipomoea batatas or Agaricus blazei result from their suppression of oxidative stress and proinflammatory cytokine production followed by improvement of pancreatic β-cells mass.

  2. TGF-beta 1-induced epithelial-to-mesenchymal transition and therapeutic intervention in diabetic nephropathy

    OpenAIRE

    Hills, Claire E.; Squires, Paul E.

    2010-01-01

    Background/Aims: Epithelial-to-mesenchymal cell transformation (EMT) is the trans-differentiation of tubular epithelial cells into myofibroblasts, an event underlying progressive chronic kidney disease in diabetes, resulting in fibrosis. Mainly reported in proximal regions of the kidney, EMT is now recognized as a key contributor to the loss of renal function throughout the nephron in diabetic nephropathy (DN). Concomitant upregulation of TGF-beta in diabetes makes this pro-fibrotic cytokine ...

  3. RhoA/Rho kinase: a novel therapeutic target in diabetic complications

    Institute of Scientific and Technical Information of China (English)

    ZHOU Hong; LI Yong-jun

    2010-01-01

    Objective To reveal the roles of Rho kinase (ROCK) in the mechanisms of complications in diabetes by reviewing the correlations between ROCK and related complications in diabetes.Data sources The data used in the present article were mainly from PubMed with relevant English articles published from 1998 to 2010. The search terms were "ROCK" and "diabetes".Study selection Original articles including the roles of ROCK or its inhibitors in diabetic complications and review articles about the biological character of ROCK were selected.Results The activity and expression of ROCK were up-regulated in the models of type 1 or type 2 diabetes animals and the cultured cells with concentrations of high glucose, ROCK activation was associated with the development or progression of complications in diabetes. Inhibition of RhoA/ROCK pathway prevented or ameliorated the pathologic changes of diabetic complications, and ROCK has been regarded as a key target for treatment of these complications.Conclusion RhoA/ROCK signaling plays important roles in the pathogenesis of long-term complications in diabetes and ROCK inhibitors are becoming a promising solution to treatments of complications in diabetes.

  4. Colorectal Polyposis and Immune-Based Therapies

    Directory of Open Access Journals (Sweden)

    Pearl Jacobson-Brown

    2004-01-01

    Full Text Available The progression from precancerous (adenomatous colon polyps to malignant colorectal cancer involves the complex actions of various cytokines on T cell proliferation, cell-cell adhesion, apoptosis and host immunity. A broad spectrum of new treatments, including innovative molecular therapies such as gene therapy and treatment with cytokines, is under experimental and preclinical investigation. Nonsteroidal anti-inflammatory drugs and selective cyclooxygenase-2 inhibitors have traditionally been used as inflammation-reducing agents in cases of colon adenoma. Currently, adjuvant immunotherapies such as recombinant gene therapy and antibody-cytokine fusion proteins are assuming a more significant role in the management of colorectal neoplasia. Furthermore, advances in antitumour necrosis factor antibodies for the treatment of ulcerative colitis and Crohn's disease may have potential as chemoprotective agents for the treatment of colon polyposis. The present review aims to discuss the immunological mechanisms underlying colon tumour progression and the molecular and immune-based therapies that are leading to new methods of prognosis and treatment.

  5. Incretin mimetics: a novel therapeutic option for patients with type 2 diabetes - a review

    DEFF Research Database (Denmark)

    Hansen, Katrine Bilberg; Vilsbøll, Tina; Knop, Filip K

    2010-01-01

    Type 2 diabetes mellitus is a metabolic disease associated with low quality of life and early death. The goal in diabetes treatment is to prevent these outcomes by tight glycemic control and minimizing vascular risk factors. So far, even intensified combination regimen with the traditional...

  6. The role of CTGF in diabetic nephropathy : Marker, pathogenic factor and target for therapeutic intervention

    NARCIS (Netherlands)

    Roestenberg, Patricia Maria Henrica

    2007-01-01

    Diabetic nephropathy (DN) is a common complication of diabetes mellitus (DM) and a major cause of end stage renal disease. DN is a progressive fibrotic kidney disease that is structurally characterized by mesangial matrix accumulation and thickening of the glomerular basement membrane (GBM), and fun

  7. Alternative Therapeutic Method for Type Two Diabetes: Whole Body Vibration Therapy: A Mini-Review

    Directory of Open Access Journals (Sweden)

    Erika L Simmerman

    2016-05-01

    Full Text Available Context As the prevalence of obesity and diabetes continues to increase there is a need for new interventions to control this epidemic. Multiple alternative treatment methods exist for type 2 diabetes mellitus such as acupuncture, bariatric surgery, yoga, aromatherapy, herbal remedies, etc. Whole Body Vibration is a relatively new area of interest recently utilized as an adjunctive therapy in type 2 diabetes mellitus, representing a potentially new and novel treatment for type 2 diabetes mellitus. Objective The primary objective of this study was to summarize current literature regarding the effects of whole body vibration on type 2 diabetes mellitus. This review details the effect of whole body vibration on areas of high clinical impact in the treatment of type 2 diabetes mellitus such as glycemic control, body composition, renal function, inflammatory indices, peripheral neuropathy, and wound healing. Methods Reviewers independently screened abstracts and full texts in journal articles and books to extract data from multiple studies and literature to compile a current review on the topic of whole body vibration and diabetes mellitus. Results Current literature in murine and human models reported an overall improvement in glycemic control, renal function, inflammatory indices, and peripheral neuropathy following whole body vibration therapy. Whole body vibration effect on body mass composition is controversial with inconsistent reports of the effect on lean mass, bone density, and fat mass. Conclusions Whole body vibration has demonstrated significant promise in improving multiple systems related to the sequela of type 2 diabetes mellitus, thereby suggesting a new and novel treatment modification in this patient population. Subsequent studies are needed to further analyze the effect of whole body vibration on type 2 diabetes mellitus.

  8. Selecting GLP-1 agonists in the management of type 2 diabetes: differential pharmacology and therapeutic benefits of liraglutide and exenatide

    Directory of Open Access Journals (Sweden)

    Jonathan Pinkney

    2010-08-01

    Full Text Available Jonathan Pinkney1, Thomas Fox1, Lakshminarayan Ranganath21Department of Diabetes and Endocrinology, Peninsula College of Medicine and Dentistry, Plymouth, United Kingdom; 2Department of Clinical Biochemistry and Metabolic Medicine, Royal Liverpool University Hospital, Liverpool, United KingdomAbstract: Failure of secretion of the incretin hormone glucagon-like peptide-1 (GLP-1 plays a prominent role in type 2 diabetes, and restoration of GLP-1 action is an important therapeutic objective. Although the short duration of action of GLP-1 renders it unsuited to therapeutic use, 2 long-acting GLP-1 receptor agonists, exenatide and liraglutide, represent a significant advance in treatment. In controlled trials, both produce short-term glucose-lowering effects, with the reduction in hemoglobin A1c of up to 1.3%. These responses are often superior to those observed with additional oral agents. However, unlike sulfonylureas, thiazolidinediones, or insulin, all of which lead to significant weight gain, GLP-1 receptor agonists uniquely result in long-term weight loss of around 5 kg, and higher doses may enhance this further. Reduction in blood pressure of 2–7 mm Hg also has been observed. Both drugs produce transient mild gastrointestinal side effects; although mild hypoglycemia can occur, this is usually in combination with other hypoglycemic therapies. However, serious hypoglycemia and acute pancreatitis are rare. The once-daily dosage of liraglutide makes it more convenient than twice-daily dosage of prandial exenatide, and a superior glucose-lowering effect was observed in the only head-to-head comparison reported so far. Besides cost, these considerations currently favor liraglutide over exenatide. Further studies are needed to confirm long-term safety, and most importantly, that short-term benefits translate into long-term reductions of diabetes-related cardiovascular events and other complications.Keywords: diabetes, weight loss, glycemic control

  9. Treatment of severe diabetic hypoglycemia with glucagon: an underutilized therapeutic approach

    Directory of Open Access Journals (Sweden)

    Kedia N

    2011-09-01

    Full Text Available Nitil KediaColney Medical Centre, London Colney, Herts, UKAbstract: Tight glycemic control is important in reducing and delaying vascular complications in type 1 and 2 diabetes patients; however, the benefits achieved through strict metabolic control are counterbalanced by an increased risk of hypoglycemia. Glucagon is an effective therapy for treating severe hypoglycemia. Available as an emergency kit, glucagon is an essential tool for rapid response, but remains underappreciated and underused. This article reviews the role of glucagon in treating severe hypoglycemia and discusses the need for better education on glucagon for people with diabetes and their caregivers in order to alleviate fears of hypoglycemia and of administering glucagon in the event of an emergency.Keywords: severe hypoglycemia, glucagon, type 1 diabetes, type 2 diabetes

  10. Interest of the therapeutic education in patients with type 2 diabetes ...

    African Journals Online (AJOL)

    Henda Jamoussi

    2016-01-28

    Jan 28, 2016 ... type 2 diabetes observing the fast of Ramadan. Henda Jamoussi, Rym ... and carbohydrates with high glycemic index.1 Despite the ban on the ... identified as low or medium risk of complications, which were allowed to fast. 2.

  11. Therapeutic miR-21 Silencing Ameliorates Diabetic Kidney Disease in Mice.

    Science.gov (United States)

    Kölling, Malte; Kaucsar, Tamas; Schauerte, Celina; Hübner, Anika; Dettling, Angela; Park, Joon-Keun; Busch, Martin; Wulff, Xaver; Meier, Matthias; Scherf, Kristian; Bukosza, Nóra; Szénási, Gábor; Godó, Mária; Sharma, Amit; Heuser, Michael; Hamar, Peter; Bang, Claudia; Haller, Hermann; Thum, Thomas; Lorenzen, Johan M

    2017-01-04

    Diabetic nephropathy is the main cause of end-stage renal disease. MicroRNAs are powerful regulators of the genome, and global expression profiling revealed miR-21 to be among the most highly regulated microRNAs in kidneys of mice with diabetic nephropathy. In kidney biopsies of diabetic patients, miR-21 correlated with tubulointerstitial injury. In situ PCR analysis showed a specific enrichment of miR-21 in glomerular cells. We identified cell division cycle 25a (Cdc25a) and cyclin-dependent kinase 6 (Cdk6) as novel miR-21 targets in mesangial cells. miR-21-mediated repression of Cdc25a and Cdk6 resulted in impaired cell cycle progression and subsequent mesangial cell hypertrophy. miR-21 increased podocyte motility by regulating phosphatase and tensin homolog (Pten). miR-21 antagonism in vitro and in vivo in streptozotocin-induced diabetic mice decreased mesangial expansion, interstitial fibrosis, macrophage infiltration, podocyte loss, albuminuria, and fibrotic- and inflammatory gene expression. In conclusion, miR-21 antagonism rescued various functional and structural parameters in mice with diabetic nephropathy and, thus, might be a viable option in the treatment of patients with diabetic kidney disease.

  12. Sleep-time blood pressure as a therapeutic target for cardiovascular risk reduction in type 2 diabetes.

    Science.gov (United States)

    Hermida, Ramón C; Ayala, Diana E; Mojón, Artemio; Fernández, José R

    2012-03-01

    Independent studies have found that elevated sleep-time blood pressure (BP) is a better predictor of cardiovascular risk than the awake or 24-h BP means in patients without as well as with diabetes. However, the impact of the alteration over time of ambulatory BP on cardiovascular risk has never been investigated. We evaluated in a subgroup cohort of MAPEC (Monitorización Ambulatoria para Predicción de Eventos Cardiovasculares, i.e., ambulatory blood pressure monitoring for prediction of cardiovascular events) with diabetes whether reduced cardiovascular risk is more related to the progressive decrease of awake vs. asleep BP. We studied 607 patients with type 2 diabetes during a median 5.4 years follow-up. Those with hypertension at baseline (74%) were randomized to ingest all their prescribed hypertension medications upon awakening or ≥1 of them at bedtime. BP was measured for 48 h at baseline, and again annually in all patients, or more frequently (quarterly) after adjustments in treatment. Using baseline data, when asleep BP was adjusted by awake mean, only the former was a significant predictor of outcome in a Cox proportional-hazard model adjusted for sex, age, anemia, and chronic kidney disease. Analyses of changes in BP during follow-up revealed a 20% cardiovascular risk reduction for each 5 mm Hg decrease in asleep systolic BP mean (P < 0.001), independently of changes in clinic or any other ambulatory BP parameter. Sleep-time BP is the most significant independent prognostic marker of cardiovascular events in diabetes. Most important, decreasing sleep-time BP, a novel therapeutic target requiring proper patient evaluation by ambulatory monitoring, was the most significant independent predictor of event-free survival in diabetes. © 2012 American Journal of Hypertension, Ltd.

  13. Therapeutic Target Achievement in Type 2 Diabetic Patients after Hyperglycemia, Hypertension, Dyslipidemia Management

    Directory of Open Access Journals (Sweden)

    Ah Young Kang

    2011-06-01

    Full Text Available BackgroundOur study group established "3H care" in 2002. The meaning of "3H care" attain and maintain adequate controls over hypertension, hyperlipidemia, and hyperglycemia in type 2 diabetic patients. This study evaluated the achievement of target goals after one year or more of "3H care" by specialists in our diabetic clinic.MethodsThis was a retrospective study of 200 type 2 diabetic patients who received "3H care" for one year or more in our diabetic clinic. We evaluated achievement of target goals for metabolic controls as suggested by the American Diabetes Association.ResultsOverall, 200 type 2 diabetes patients were enrolled, of whom 106 were males (53% and 94 were females (47%. After one year of "3H care," the mean HbA1c was 7.2±1.5% and the percentage of patients achieving glycemic control (HbA1c <7% was 51.8%. However only 32.2% of hypertensive patients achieved the recommended target. After one year of "3H care," the percentages of those who achieved the target value for dyslipidemia were 80.0% for total cholesterol, 66.3% for low density lipoprotein cholesterol, 57.9% for triglyceride, and 51.8% for high density lipoprotein cholesterol. The percentage that achieved all three targets level was only 4.4% after one year and 14.8% after two years.ConclusionThe results of this study demonstrate that only a minor proportion of patients with type 2 diabetes achieved the recommended goals despite the implementation of "3H care." It is our suggestion that better treatment strategies and methods should be used to control hypertension, hyperlipidemia and hyperglycemia.

  14. Animal models of diabetic macrovascular complications: key players in the development of new therapeutic approaches.

    Science.gov (United States)

    Heinonen, Suvi E; Genové, Guillem; Bengtsson, Eva; Hübschle, Thomas; Åkesson, Lina; Hiss, Katrin; Benardeau, Agnes; Ylä-Herttuala, Seppo; Jönsson-Rylander, Ann-Cathrine; Gomez, Maria F

    2015-01-01

    Diabetes mellitus is a lifelong, incapacitating metabolic disease associated with chronic macrovascular complications (coronary heart disease, stroke, and peripheral vascular disease) and microvascular disorders leading to damage of the kidneys (nephropathy) and eyes (retinopathy). Based on the current trends, the rising prevalence of diabetes worldwide will lead to increased cardiovascular morbidity and mortality. Therefore, novel means to prevent and treat these complications are needed. Under the auspices of the IMI (Innovative Medicines Initiative), the SUMMIT (SUrrogate markers for Micro- and Macrovascular hard end points for Innovative diabetes Tools) consortium is working on the development of novel animal models that better replicate vascular complications of diabetes and on the characterization of the available models. In the past years, with the high level of genomic information available and more advanced molecular tools, a very large number of models has been created. Selecting the right model for a specific study is not a trivial task and will have an impact on the study results and their interpretation. This review gathers information on the available experimental animal models of diabetic macrovascular complications and evaluates their pros and cons for research purposes as well as for drug development.

  15. TCF7L2 and therapeutic response to sulfonylureas in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Stumvoll Michael

    2011-02-01

    Full Text Available Abstract Background Variants in the TCF7L2 have been shown to be associated with an increased risk for type 2 diabetes (T2D. Since the association with diabetes could be explained by effects on insulin secretion, we investigated whether patients with diabetes risk alleles at rs7903146 might have an altered hypoglycaemic response to sulfonylureas (SUs. Methods We recruited 189 patients with T2D being treated with SUs and determined the rs7903146 diabetes risk genotype. We used a logistic regression with secondary SU failure defined as an A1C ≥7.0% after 6 months of SU treatment. Results In univariate regression analyses, TCF7L2 genotype was the only predictor of SU treatment failure. The rs7903146 T allele was significantly more frequent in the group of patients who failed to respond to SU (36% than in the control group (26% [P = 0.046; odds ratio (OR: 1.57 (1.01-2.45 in an additive mode of inheritance]. Conclusions Our data suggest that patients with diabetes risk alleles in TCF7L2 have an altered hypoglycaemic response to SUs resulting in earlier secondary failure.

  16. Animal Models of Diabetic Macrovascular Complications: Key Players in the Development of New Therapeutic Approaches

    Directory of Open Access Journals (Sweden)

    Suvi E. Heinonen

    2015-01-01

    Full Text Available Diabetes mellitus is a lifelong, incapacitating metabolic disease associated with chronic macrovascular complications (coronary heart disease, stroke, and peripheral vascular disease and microvascular disorders leading to damage of the kidneys (nephropathy and eyes (retinopathy. Based on the current trends, the rising prevalence of diabetes worldwide will lead to increased cardiovascular morbidity and mortality. Therefore, novel means to prevent and treat these complications are needed. Under the auspices of the IMI (Innovative Medicines Initiative, the SUMMIT (SUrrogate markers for Micro- and Macrovascular hard end points for Innovative diabetes Tools consortium is working on the development of novel animal models that better replicate vascular complications of diabetes and on the characterization of the available models. In the past years, with the high level of genomic information available and more advanced molecular tools, a very large number of models has been created. Selecting the right model for a specific study is not a trivial task and will have an impact on the study results and their interpretation. This review gathers information on the available experimental animal models of diabetic macrovascular complications and evaluates their pros and cons for research purposes as well as for drug development.

  17. Dipeptidyl peptidase IV inhibitors: a promising new therapeutic approach for the management of type 2 diabetes

    DEFF Research Database (Denmark)

    Deacon, Carolyn F; Holst, Jens J

    2005-01-01

    of appetite. Glucagon-like peptide-1 is, however, extremely rapidly inactivated by the serine peptidase, dipeptidyl peptidase IV, so that the native peptide is not useful clinically. A new approach to utilise the beneficial effects of glucagon-like peptide-1 in the treatment of type 2 diabetes has been......-12 months duration in patients with type 2 diabetes, dipeptidyl peptidase IV inhibitors have proved efficacious, both as monotherapy and when given in combination with metformin. Fasting and postprandial glucose concentrations were reduced, leading to reductions in glycosylated haemoglobin levels, while...... the development of orally active dipeptidyl peptidase IV inhibitors. Preclinical studies have demonstrated that this approach is effective in enhancing endogenous levels of glucagon-like peptide-1, resulting in improved glucose tolerance in glucose-intolerant and diabetic animal models. In recent studies of 3...

  18. Therapeutic effect of the compound Danshen dripping pill combined with laser acupoint irradiation on early diabetic retinopathy

    Science.gov (United States)

    Liu, Hui-Hui; Xiong, Guo-Xin; Zhang, Li-Ping

    2017-06-01

    To investigate the therapeutic effect of the compound Danshen dripping pill combined with laser acupoint irradiation on early diabetic retinopathy, 19 patients with early diabetic retinopathy were randomly divided into a treatment group and a control group. The TaiYang, YangBai, YuYao and ZanZhu acupoints of patients in the treatment group were irradiated with a semiconductor laser combined with the oral compound Danshen dropping pills, while those in the control group only used the oral compound Danshen dropping pills. The indicators of vision, mean defect of light sensitivity in the visual field, renal function and fasting blood glucose, were examined to evaluate the efficacy. After treatment, the above indicators of patients in the two groups were significantly improved and there was a significant difference between the two groups. This showed that the compound Danshen dripping pills combined with the laser acupoint irradiation can improve the ischemic and anoxic state of early diabetic retinopathy and improve the visual field.

  19. Therapeutic effects of hydrogen saturated saline on rat diabetic model and insulin resistant model via reduction of oxidative stress

    Institute of Scientific and Technical Information of China (English)

    WANG Qi-jin; ZHA Xiao-juan; KANG Zhi-min; XU Mao-jin; HUANG Qin; ZOU Da-jin

    2012-01-01

    Background Molecular hydrogen,as a novel antioxidant,has been proven effective in treating many diseases.This study aimed to evaluate the therapeutic effects of hydrogen saturated saline in treatment of a rat model of diabetes mellitus and a rat model of insulin resistant.Methods A rat diabetes mellitus model was established by feeding a high fat/high carbohydrate diet followed by injection of a small dose of streptozotocin,and an insulin resistant model was induced with a high glucose and high fat diet.Hydrogen saturated saline was administered to rats with both models conditions on a daily basis for eight weeks.A pioglitazone-treated group and normal saline-treated group served as positive and negative controls.The general condition,body weight,blood glucose,blood lipids,and serum insulin levels of rats were examined at the 8th week after treatment.The oxidative stress indices,including serum superoxide dismutase (SOD),glutathione (GSH) and malondialdehyde (MDA) were also evaluated after eight weeks of treatment using the commercial kits.Results Hydrogen saturated saline showed great efficiency in improving the insulin sensitivity and lowering blood glucose and lipids.Meanwhile,the therapeutic effects of hydrogen saturated saline were superior to those of pioglitazone.Hydrogen saturated saline markedly attenuated the MDA level and elevated the levels of antioxidants SOD and GSH.Conclusion Hydrogen saturated saline may improve the insulin resistance and alleviate the symptoms of diabetes mellitus by reducing the oxidative stress and enhancing the anti-oxidant system.

  20. Glucagon-like peptide-1 synthetic analogs: new therapeutic agents for use in the treatment of diabetes mellitus.

    Science.gov (United States)

    Holz, George G; Chepurny, Oleg G

    2003-11-01

    Glucagon-like peptide-1-(7-36)-amide (GLP-1) is a potent blood glucose-lowering hormone now under investigation for use as a therapeutic agent in the treatment of type 2 (adult onset) diabetes mellitus. GLP-1 binds with high affinity to G protein-coupled receptors (GPCRs) located on pancreatic beta-cells, and it exerts insulinotropic actions that include the stimulation of insulin gene transcription, insulin biosynthesis, and insulin secretion. The beneficial therapeutic action of GLP-1 also includes its ability to act as a growth factor, stimulating formation of new pancreatic islets (neogenesis) while slowing beta-cell death (apoptosis). GLP-1 belongs to a large family of structurally-related hormones and neuropeptides that include glucagon, secretin, GIP, PACAP, and VIP. Biosynthesis of GLP-1 occurs in the enteroendocrine L-cells of the distal intestine, and the release of GLP-1 into the systemic circulation accompanies ingestion of a meal. Although GLP-1 is inactivated rapidly by dipeptidyl peptidase IV (DDP-IV), synthetic analogs of GLP-1 exist, and efforts have been directed at engineering these peptides so that they are resistant to enzymatic hydrolysis. Additional modifications of GLP-1 incorporate fatty acylation and drug affinity complex (DAC) technology to improve serum albumin binding, thereby slowing renal clearance of the peptides. NN2211, LY315902, LY307161, and CJC-1131 are GLP-1 synthetic analogs that reproduce many of the biological actions of GLP-1, but with a prolonged duration of action. AC2993 (Exendin-4) is a naturally occurring peptide isolated from the lizard Heloderma, and it acts as a high affinity agonist at the GLP-1 receptor. This review summarizes structural features and signal transduction properties of GLP-1 and its cognate beta-cell GPCR. The usefulness of synthetic GLP-1 analogs as blood glucose-lowering agents is discussed, and the applicability of GLP-1 as a therapeutic agent for treatment of type 2 diabetes is highlighted.

  1. The Potential for Problem-Based Learning in Pharmacy Education: A Clinical Therapeutics Course in Diabetes.

    Science.gov (United States)

    Fisher, Richard C.

    1994-01-01

    A proposed problem-based course in clinical diabetes therapy at a pharmacy school is outlined. The interdisciplinary course requires students to develop or reformulate declarative and procedural knowledge in such a way that students' cognitive strategies are enhanced. Several sample clinical cases are appended. (MSE)

  2. The therapeutic potential of manipulating gut microbiota in obesity and type 2 diabetes mellitus

    NARCIS (Netherlands)

    Kootte, R.S.; Vrieze, A.; Holleman, F.; Zoetendal, E.G.; Vos, de W.M.; Groen, A.K.; Hoekstra, J.B.; Nieuwdorp, M.

    2012-01-01

    Obesity and type 2 diabetes mellitus (T2DM) are attributed to a combination of genetic susceptibility and lifestyle factors. Their increasing prevalence necessitates further studies on modifiable causative factors and novel treatment options. The gut microbiota has emerged as an important

  3. The therapeutic potential of manipulating gut microbiota in obesity and type 2 diabetes mellitus

    NARCIS (Netherlands)

    Kootte, R. S.; Vrieze, A.; Holleman, F.; Dallinga-Thie, G. M.; Zoetendal, E. G.; de Vos, W. M.; Groen, A. K.; Hoekstra, J. B. L.; Stroes, E. S.; Nieuwdorp, M.

    Obesity and type 2 diabetes mellitus (T2DM) are attributed to a combination of genetic susceptibility and lifestyle factors. Their increasing prevalence necessitates further studies on modifiable causative factors and novel treatment options. The gut microbiota has emerged as an important

  4. Aberrant heparan sulfate profile in the human diabetic kidney offers new clues for therapeutic glycomimetics.

    NARCIS (Netherlands)

    Wijnhoven, T.J.M.; Lensen, J.F.M.; Rops, A.L.; Vlag, J. van der; Kolset, S.O.; Bangstad, H.J.; Pfeffer, P.; Hoven, M.J.W. van den; Berden, J.H.M.; Heuvel, L.P.W.J. van den; Kuppevelt, A.H.M.S.M. van

    2006-01-01

    BACKGROUND: Diabetic nephropathy poses an increasing health problem in the Western world, and research to new leads for diagnosis and therapy therefore is warranted. In this respect, heparan sulfates (HSs) offer new possibilities because crude mixtures of these polysaccharides are capable of amelior

  5. Type 2 Diabetes Mellitus : New Genetic Insights will Lead to New Therapeutics

    NARCIS (Netherlands)

    Wolfs, M. G. M.; Hofker, M. H.; Wijmenga, C.; van Haeften, T. W.

    Type 2 diabetes is a disorder of dysregulated glucose homeostasis. Normal glucose homeostasis is a complex process involving several interacting mechanisms, such as insulin secretion, insulin sensitivity, glucose production, and glucose uptake. The dysregulation of one or more of these mechanisms

  6. Type 2 Diabetes Mellitus : New Genetic Insights will Lead to New Therapeutics

    NARCIS (Netherlands)

    Wolfs, M. G. M.; Hofker, M. H.; Wijmenga, C.; van Haeften, T. W.

    2009-01-01

    Type 2 diabetes is a disorder of dysregulated glucose homeostasis. Normal glucose homeostasis is a complex process involving several interacting mechanisms, such as insulin secretion, insulin sensitivity, glucose production, and glucose uptake. The dysregulation of one or more of these mechanisms du

  7. Interest of the therapeutic education in patients with type 2 diabetes observing the fast of Ramadan

    Directory of Open Access Journals (Sweden)

    Henda Jamoussi

    2017-03-01

    Conclusion: Our results justify the interest of patient education centered on the month of Ramadan in all type 2 diabetic patients observing the fast of the holy month. This education should be continued during Ramadan in order to fulfill this religious rite safely.

  8. Histone deacetylases and their inhibitors: molecular mechanisms and therapeutic implications in diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Xiaojie Wang

    2012-08-01

    Full Text Available Epigenetic mechanisms such as DNA methylation, histone modification and microRNA changes have been shown to be important for the regulation of cellular functions. Among them, histone deacetylases (HDACs are enzymes that balance the acetylation activities of histone acetyltransferases in chromatin remodeling and play essential roles in gene transcription to regulate cell proliferation, migration and death. Recent studies indicate that HDACs are promising drug targets for a wide range of diseases including cancer, neurodegenerative and psychiatric disorders, cardiovascular dysfunction, autoimmunity and diabetes mellitus. This review highlights the role of HDACs in diabetes mellitus and outlines several important cellular and molecular mechanisms by which HDACs regulate glucose homeostasis and can be targeted for the treatment of diabetic microvascular complications. It is hoped that our understanding of the role of HDACs in diabetes mellitus will lead to the development of better diagnostic tools and the design of more potent and specific drugs targeting selective HDAC proteins for the treatment of the disease.

  9. The therapeutic potential of manipulating gut microbiota in obesity and type 2 diabetes mellitus

    NARCIS (Netherlands)

    Kootte, R. S.; Vrieze, A.; Holleman, F.; Dallinga-Thie, G. M.; Zoetendal, E. G.; de Vos, W. M.; Groen, A. K.; Hoekstra, J. B. L.; Stroes, E. S.; Nieuwdorp, M.

    2012-01-01

    Obesity and type 2 diabetes mellitus (T2DM) are attributed to a combination of genetic susceptibility and lifestyle factors. Their increasing prevalence necessitates further studies on modifiable causative factors and novel treatment options. The gut microbiota has emerged as an important contributo

  10. The Multifaceted Roles of Adipose Tissue-Therapeutic Targets for Diabetes and Beyond: The 2015 Banting Lecture.

    Science.gov (United States)

    Scherer, Philipp E

    2016-06-01

    The Banting Medal for Scientific Achievement is the highest scientific award of the American Diabetes Association (ADA). Given in memory of Sir Frederick Banting, one of the key investigators in the discovery of insulin, the Banting Medal is awarded annually for scientific excellence, recognizing significant long-term contributions to the understanding, treatment, or prevention of diabetes. Philipp E. Scherer, PhD, of the Touchstone Diabetes Center, The University of Texas Southwestern Medical Center, Dallas, TX, received the prestigious award at the ADA's 75th Scientific Sessions, 5-9 June 2015, in Boston, MA. He presented the Banting Lecture, "The Multifaceted Roles of Adipose Tissue-Therapeutic Targets for Diabetes and Beyond," on Sunday, 7 June 2015.A number of different cell types contribute to the cellular architecture of adipose tissue. Although the adipocyte is functionally making important contributions to systemic metabolic homeostatis, several additional cell types contribute a supportive role to bestow maximal flexibility on the tissue with respect to many biosynthetic and catabolic processes, depending on the metabolic state. These cells include vascular endothelial cells, a host of immune cells, and adipocyte precursor cells and fibroblasts. Combined, these cell types give rise to a tissue with remarkable flexibility with respect to expansion and contraction, while optimizing the ability of the tissue to act as an endocrine organ through the release of many protein factors, critically influencing systemic lipid homeostasis and biochemically contributing many metabolites. Using an example from each of these categories-adiponectin as a key adipokine, sphingolipids as critical mediators of insulin sensitivity, and uridine as an important metabolite contributed by the adipocyte to the systemic pool-I will discuss the emerging genesis of the adipocyte over the past 20 years from metabolic bystander to key driver of metabolic flexibility.

  11. Clustering siRNA conjugates for MMP-responsive therapeutics in chronic wounds of diabetic animals

    Science.gov (United States)

    Kim, Hye Sung; Son, Young Ju; Yoo, Hyuk Sang

    2016-07-01

    The MMP-responsive breakdown of siRNA clusters was translated to site-specific gene transfection and enhanced wound healing in diabetic ulcers. MMP-2 siRNA was chemically tethered to the end of multi-armed PEG via MMP-cleavable linkers (4PEG-siRNA) and subsequently clustered into submicron particles complexed with LPEI. 4PEG-siRNA was more tightly complexed with LPEI and the associated cluster showed higher resistance against RNase attack, in comparison to naked siRNA. Because the size of the clusters increased depending on the increase in charge ratio of LPEI to siRNA, cellular uptake of the 4PEG-siRNA/LPEI cluster was significantly attenuated due to the huge size of the cluster. However, upon MMP treatment, the cluster dissociated into smaller particles and was efficiently endocytosed by cells. An in vivo fluorescence resonance energy transfer (FRET) study also revealed that the clusters were effectively dissociated in MMP-rich environments of dorsal wounds in diabetic animals. In addition, diabetic ulcers treated with the clusters showed a faster wound closure rate and the recovered tissue expressed a larger amount of cytokeratin along with a lower expression level of MMP-2 compared to the other groups.The MMP-responsive breakdown of siRNA clusters was translated to site-specific gene transfection and enhanced wound healing in diabetic ulcers. MMP-2 siRNA was chemically tethered to the end of multi-armed PEG via MMP-cleavable linkers (4PEG-siRNA) and subsequently clustered into submicron particles complexed with LPEI. 4PEG-siRNA was more tightly complexed with LPEI and the associated cluster showed higher resistance against RNase attack, in comparison to naked siRNA. Because the size of the clusters increased depending on the increase in charge ratio of LPEI to siRNA, cellular uptake of the 4PEG-siRNA/LPEI cluster was significantly attenuated due to the huge size of the cluster. However, upon MMP treatment, the cluster dissociated into smaller particles and was

  12. Incretin mimetics: a novel therapeutic option for patients with type 2 diabetes – a review

    Directory of Open Access Journals (Sweden)

    Katrine B Hansen

    2010-05-01

    Full Text Available Katrine B Hansen1, Tina Vilsbøll2, Filip K Knop21Department of Clinical Physiology, Glostrup Hospital, University of Copenhagen, Denmark; 2Diabetes Research Division, Department of Internal Medicine F, Gentofte Hospital, University of Copenhagen, DenmarkAbstract: Type 2 diabetes mellitus is a metabolic disease associated with low quality of life and early death. The goal in diabetes treatment is to prevent these outcomes by tight glycemic control and minimizing vascular risk factors. So far, even intensified combination regimen with the traditional antidiabetes agents have failed to obtain these goals. Incretin mimetics are a new class of antidiabetes drugs which involve modulation of the incretin system. They bind to and activate glucagon-like peptide-1 (GLP-1 receptors on pancreatic beta-cells following which insulin secretion and synthesis are initiated. Since the compounds have no insulinotropic activity at lower glucose concentrations the risk of hypoglycemia – a well-known shortcoming of existing antidiabetes treatments – is low. Additionally, incretin mimetics have been shown to be associated with beneficial effects on cardiovascular risk factors such as weight loss, decrease in blood pressure and changes in lipid profile. Current clinical data on the two available incretin mimetics, exenatide and liraglutide, are evaluated in this review, focusing on pharmacology, efficacy, safety and tolerability. The review is built on a systematic PubMed and Medline search for publications with the key words GLP-1 receptor agonist, exenatide, liraglutide and type 2 diabetes mellitus up to January 2009.Keywords: glucagon-like peptide-1 (GLP-1, exenatide, liraglutide, type 2 diabetes

  13. [Melatonin as a therapeutic factor in gastric ulcer healing under experimental diabetes].

    Science.gov (United States)

    Magierowski, Marcin; Jasnos, Katarzyna; Brzozowska, Iwona; Drozdowicz, Danuta; Sliwowski, Zbigniew; Nawrot, Elizbieta; Szczyrk, Urszula; Kwiecień, Sławomir

    2013-01-01

    Melatonin (N-acetyl-5-methoxytryptamine) is a hormon secreted mostly by the pineal gland in the brain which maintains the body's circadian rhythm. Interestingly, this indol derivative is produced by enterochromaffin-like cells (ECL) in the gastrointestinal tract (GIT) in amount about 400 fold greater than detected in the pinealocytes. Previous studies revealed that melatonin exerts beneficial action against acute gastric damage induced by stress ethanol, aspirin and ischemia-reperfusion. Hyperglycemia, which is the main symptom of diabetes mellitus, is known to induce mitochondrial dysfunction and endoplasmic reticulum stress, both promoting the generation of reactive oxygen species (ROS). ROS were shown to exhibit higher activity than molecular oxygen under basal conditions due to unpaired electron in its outermost shell of electrons. ROS lead to damage of cellular proteins, nucleic acids and membrane polyunsaturated fatty lipids. In this study, we induced diabetes mellitus by the application of strep. tozocin in presence of gastric ulcers. Male Wistar rats were used in this model. 9 days after gastric ulcers and diabetes mellitus induction, groups of rats were treated with saline or melatonin (20 mg/kg i.g.). At the termination of the experiment, rats were anesthetized, abdomen was opened and gastric blood flow (GBF) was measured. Stomachs were removed for determination of gastric ulcers area by planimetry. Tissue samples were collected for biochemical assays. We demonstrated that melatonin significantly accelerates gastric ulcers healing with and without coexistence of diabetes mellitus. This effect was accompanied by increase of GBF level. Moreover, we observed an increase in superoxide dismutase (SOD) activity and an decrease in lipid peroxidation products concentration within gastric tissue homogenates of animals treated with melatonin, as compared with control group. Melatonin application accelerates gastric ulcers healing with and without presence of

  14. Combating the dual burden: therapeutic targeting of common pathways in obesity and type 2 diabetes.

    Science.gov (United States)

    Scheen, André J; Van Gaal, Luc F

    2014-11-01

    The increasing prevalence of obesity is contributing substantially to the ongoing epidemic of type 2 diabetes. Abdominal adiposity, a feature of ectopic fat syndrome, is associated with silent inflammation, abnormal hormone secretion, and various metabolic disturbances that contribute to insulin resistance and insulin secretory defects, resulting in type 2 diabetes, and induce a toxic pattern that leads to cardiovascular disease, liver pathologies, and cancer. Despite the importance of weight control strategies in the prevention and management of type 2 diabetes, long-term results from lifestyle or drug interventions are generally disappointing. Furthermore, most of the classic glucose-lowering drugs have a side-effect of weight gain, which renders the management of most overweight or obese people with type 2 diabetes even more challenging. Many anti-obesity pharmacological drugs targeting central control of appetite were withdrawn from the market because of safety concerns. The gastrointestinal lipase inhibitor orlistat was the only anti-obesity drug available until the recent US, but not European, launch of phentermine-controlled-release topiramate and lorcaserin. Improved knowledge about bodyweight regulation opens new prospects for the potential use of peptides derived from the gut or the adipose tissue. Combination therapy will probably be necessary to avoid compensatory mechanisms and potentiate initial weight loss while avoiding weight regain. New glucose-lowering treatments, especially glucagon-like peptide-1 receptor agonists and sodium glucose cotransporter-2 inhibitors, offer advantages over traditional antidiabetic drugs by promoting weight loss while improving glucose control. In this Review, we explore the overlapping pathophysiology and also how various treatments can, alone or in combination, combat the dual burden of obesity and type 2 diabetes.

  15. Metabonomic analysis of the therapeutic effect of Potentilla discolor in the treatment of type 2 diabetes mellitus.

    Science.gov (United States)

    Li, Yi; Li, Jing-jing; Wen, Xiao-dong; Pan, Rong; He, Yi-sheng; Yang, Jie

    2014-11-01

    Type 2 diabetes mellitus (T2DM) is increased worldwide in parallel with the obesity epidemic. Potentilla discolor is one of the most important crude materials in Traditional Chinese medicine (TCM) for therapy of hyperglycemia and hyperlipidemia. In this work, a plasma metabonomic approach based on the combination of UPLC-Q-TOF with multivariate data analysis was applied to investigate the therapeutic effects of the extract of P. discolor (EPD) and corosolic acid (CA), the main bioactive compounds of P. discolor. Male C57BL/6 mice were fed with high-fat diet (HFD-fed group) for 8 weeks and then treated with EPD (EPD-treated group) or CA (CA-treated group) for another 8 weeks. After the experimental period, samples of plasma were collected and analyzed by ultra-performance liquid chromatography/quadrupole time of flight mass spectrometry (UPLC-Q-TOF). The principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) models were built to find biomarkers of T2DM and investigate the therapeutic effects of EPD and CA. 26 metabolites, which are distributed in several metabolic pathways, were identified as potential biomarkers of T2DM. It was found that EPD and CA could reverse the pathological process of T2DM through regulating the disturbed pathway of metabolism. The metabonomic results are beneficial not only for the evaluation of the therapeutic effect of TCM but also for the elucidation of the underlying molecular mechanism.

  16. 微营养素对糖尿病的防治作用%Preventive and therapeutic effects of micronutrients on diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    施咏梅; 陈著隽

    2011-01-01

    微营养素与糖尿病及其并发症的发生、发展密切相关.本文就目前较为关注的微营养素锌、硒、镁、铬对糖尿病的防治作用做一综述.%Micronutrients are closely associated with the progression of diabetes and its complications. Diabetic patients are susceptible to micronutrient deficiency. In this article, we summarize the preventive and therapeutic effects of micronutrients including zinc, selenium, magnesium, and chromium on diabetes mellitus.

  17. Therapeutic Potential of Adipose-Derived SSEA-3-Positive Muse Cells for Treating Diabetic Skin Ulcers

    OpenAIRE

    Kinoshita, Kahori; Kuno, Shinichiro; Ishimine, Hisako; Aoi, Noriyuki; Mineda, Kazuhide; Kato, Harunosuke; Doi, Kentaro; Kanayama, Koji; Feng, Jingwei; Mashiko, Takanobu; Kurisaki, Akira; Yoshimura, Kotaro

    2015-01-01

    Refractory skin ulcers were generated in severe combined immunodeficiency (SCID) mice with type 1 diabetes and delayed wound healing compared with nondiabetic SCID mice. Treatment with a multilineage differentiating stress-enduring (Muse)-rich cell population significantly accelerated wound healing compared with the Muse-poor cell population, and these cells be achieved in large amounts with minimal morbidity. Adipose-derived Muse cells could be a practical tool for a variety of stem cell-dep...

  18. Atherogenic dyslipidemia in metabolic syndrome and type 2 diabetes: therapeutic options beyond statins

    Directory of Open Access Journals (Sweden)

    Fisman Enrique Z

    2006-09-01

    Full Text Available Abstract Lowering of low-density lipoprotein cholesterol with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins is clearly efficacious in the treatment and prevention of coronary artery disease. However, despite increasing use of statins, a significant number of coronary events still occur and many of such events take place in patients presenting with type 2 diabetes and metabolic syndrome. More and more attention is being paid now to combined atherogenic dyslipidemia which typically presents in patients with type 2 diabetes and metabolic syndrome. This mixed dyslipidemia (or "lipid quartet": hypertriglyceridemia, low high-density lipoprotein cholesterol levels, a preponderance of small, dense low-density lipoprotein particles and an accumulation of cholesterol-rich remnant particles (e.g. high levels of apolipoprotein B – emerged as the greatest "competitor" of low-density lipoprotein-cholesterol among lipid risk factors for cardiovascular disease. Most recent extensions of the fibrates trials (BIP – Bezafibrate Infarction Prevention study, HHS – Helsinki Heart Study, VAHIT – Veterans Affairs High-density lipoprotein cholesterol Intervention Trial and FIELD – Fenofibrate Intervention and Event Lowering in Diabetes give further support to the hypothesis that patients with insulin-resistant syndromes such as diabetes and/or metabolic syndrome might be the ones to derive the most benefit from therapy with fibrates. However, different fibrates may have a somewhat different spectrum of effects. Other lipid-modifying strategies included using of niacin, ezetimibe, bile acid sequestrants and cholesteryl ester transfer protein inhibition. In addition, bezafibrate as pan-peroxisome proliferator activated receptor activator has clearly demonstrated beneficial pleiotropic effects related to glucose metabolism and insulin sensitivity. Because fibrates, niacin, ezetimibe and statins each regulate serum lipids by different

  19. Zinc Transporters, Mechanisms of Action and Therapeutic Utility: Implications for Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Stephen A. Myers

    2012-01-01

    Full Text Available Zinc is an essential trace element that plays a vital role in maintaining many biological processes and cellular homeostasis. Dysfunctional zinc signaling is associated with a number of chronic disease states including cancer, cardiovascular disease, Alzheimer’s disease, and diabetes. Cellular homeostasis requires mechanisms that tightly control the uptake, storage, and distribution of zinc. This is achieved through the coordinated actions of zinc transporters and metallothioneins. Evidence on the role of these proteins in type 2 diabetes mellitus (T2DM is now emerging. Zinc plays a key role in the synthesis, secretion and action of insulin in both physiological and pathophysiological states. Moreover, recent studies highlight zinc’s dynamic role as a “cellular second messenger” in the control of insulin signaling and glucose homeostasis. This suggests that zinc plays an unidentified role as a novel second messenger that augments insulin activity. This previously unexplored concept would raise a whole new area of research into the pathophysiology of insulin resistance and introduce a new class of drug target with utility for diabetes pharmacotherapy.

  20. Zinc transporters, mechanisms of action and therapeutic utility: implications for type 2 diabetes mellitus.

    Science.gov (United States)

    Myers, Stephen A; Nield, Alex; Myers, Mark

    2012-01-01

    Zinc is an essential trace element that plays a vital role in maintaining many biological processes and cellular homeostasis. Dysfunctional zinc signaling is associated with a number of chronic disease states including cancer, cardiovascular disease, Alzheimer's disease, and diabetes. Cellular homeostasis requires mechanisms that tightly control the uptake, storage, and distribution of zinc. This is achieved through the coordinated actions of zinc transporters and metallothioneins. Evidence on the role of these proteins in type 2 diabetes mellitus (T2DM) is now emerging. Zinc plays a key role in the synthesis, secretion and action of insulin in both physiological and pathophysiological states. Moreover, recent studies highlight zinc's dynamic role as a "cellular second messenger" in the control of insulin signaling and glucose homeostasis. This suggests that zinc plays an unidentified role as a novel second messenger that augments insulin activity. This previously unexplored concept would raise a whole new area of research into the pathophysiology of insulin resistance and introduce a new class of drug target with utility for diabetes pharmacotherapy.

  1. Therapeutic insight into molsidomine, a nitric oxide donor in streptozotocin-induced diabetic nephropathy in rats

    Directory of Open Access Journals (Sweden)

    Nathani Minaz

    2016-01-01

    Full Text Available Background: Diabetes-induced oxidative stress and hypertension play a major role in the development of nephropathy. Hence, the present study was undertaken to evaluate the protective effects of molsidomine, a nitric oxide donor in streptozotocin (STZ-induced diabetic nephropathy (DN in rats. Materials and Methods: Type 1 diabetes was induced through a single dose of STZ (52 mg/kg, i.p. in male Wistar rats and then treated with molsidomine (5 and 10 mg/kg; p.o. for 8 weeks. Physical parameters, vital and renal function test including blood glucose, albuminuria, blood urine nitrogen, serum creatinine, and kidney index were determined. Oxidative stress and lipid peroxidation were assessed in the kidney homogenate by means of antioxidant enzymes and malondialdehyde levels. Results: DN rats exhibited a significant renal dysfunction with a reduction in body weight, excessive oxidative stress, and pathological changes. Molsidomine treatment significantly improved vital sign, renal functions, and oxidative stress in DN rats in a dose-dependent manner. The protective effect of molsidomine was also substantiated by pathological changes in the architect of the kidney. Conclusion: Molsidomine shows a significant beneficial effect in Type 1 DN in rats.

  2. A synergistic therapeutic scheme for hyperglycemia and nephrotic disorders in diabetes.

    Science.gov (United States)

    He, Qingyi; Zhang, Xing; Han, Baosan; Xu, Jianzhong; Tang, Kanglai; Fu, Zhiren; Yin, Hao

    2014-01-01

    We previously demonstrated that the utilization of an electrospun scaffold could boost functional outputs of transplanted islets. In this study, we aim to develop a drug-eluting scaffold with a payload of pioglitazone to simultaneously rein in hyperglycemia and recoup lost renal functions in diabetic mice that underwent islet transplantation. The in vivo proliferation of islets was measured by a non-invasive bio-imaging technology whereas the blood insulin, blood glucose and renal proteins were assayed. The local stimulation of transplanted islets by pioglitazone saw an accelerated in vivo proliferation without apoptosis caused by the drug-eluting scaffold. In addition, pioglitazone contributed to an increased secretion of insulin and C-peptide 2, giving rise to an accelerated rein-in of hyperglycemia and enhanced tolerance of sudden oral glucose challenge. Moreover, the accelerated decrease of blood creatinine, urine creatinine and blood urea nitrogen suggested that pioglitazone contributed to the recovery of renal functions compromised by diabetes. Our bioengineering strategy effectively ameliorated hyperglycemia and associated nephrotic disorders, and shed a new light on an engineering approach to combat diabetes.

  3. In vivo delivery of Gremlin siRNA plasmid reveals therapeutic potential against diabetic nephropathy by recovering bone morphogenetic protein-7.

    Directory of Open Access Journals (Sweden)

    Qingxian Zhang

    Full Text Available Diabetic nephropathy is a complex and poorly understood disease process, and our current treatment options are limited. It remains critical, then, to identify novel therapeutic targets. Recently, a developmental protein and one of the bone morphogenetic protein antagonists, Gremlin, has emerged as a novel modulator of diabetic nephropathy. The high expression and strong co-localization with transforming growth factor-beta1 in diabetic kidneys suggests a role for Gremlin in the pathogenesis of diabetic nephropathy. We have constructed a gremlin siRNA plasmid and have examined the effect of Gremlin inhibition on the progression of diabetic nephropathy in a mouse model. CD-1 mice underwent uninephrectomy and STZ treatment prior to receiving weekly injections of the plasmid. Inhibition of Gremlin alleviated proteinuria and renal collagen IV accumulation 12 weeks after the STZ injection and inhibited renal cell proliferation and apoptosis. In vitro experiments, using mouse mesangial cells, revealed that the transfect ion of gremlin siRNA plasmid reversed high glucose induced abnormalities, such as increased cell proliferation and apoptosis and increased collagen IV production. The decreased matrix metalloprotease level was partially normalized by transfection with gremlin siRNA plasmid. Additionally, we observed recovery of bone morphogenetic protein-7 signaling activity, evidenced by increases in phosphorylated Smad 5 protein levels. We conclude that inhibition of Gremlin exerts beneficial effects on the diabetic kidney mainly through maintenance of BMP-7 activity and that Gremlin may serve as a novel therapeutic target in the management of diabetic nephropathy.

  4. SGLT2 inhibitors – an insulin-independent therapeutic approach for treatment of type 2 diabetes: focus on canagliflozin

    Science.gov (United States)

    Seufert, Jochen

    2015-01-01

    Despite the availability of a great variety of medications, a significant proportion of people with type 2 diabetes mellitus (T2DM) are not able to achieve or maintain adequate glycemic control. Beyond improved glucose control, novel treatments would ideally provide a reduction of cardiovascular risk, with a favorable impact on excess weight, and a low intrinsic hypoglycemia risk, as well as a synergistic mechanism of action for broad combination therapy. With the development of sodium glucose cotransporter 2 (SGLT2) inhibitors, an antidiabetic pharmacologic option has recently become available that comes close to meeting these requirements. For the first time, SGLT2 inhibitors offer a therapeutic approach acting directly on the kidneys without requiring insulin secretion or action. Canagliflozin, dapagliflozin, and empagliflozin are the SGLT2 inhibitors approved to date. Taken once a day, these medications can be combined with all other antidiabetic medications including insulin, due to their insulin-independent mechanism of action, with only a minimal risk of hypoglycemia. SGLT2 inhibitors provide additional reductions in body weight and blood pressure due to the therapeutically induced excretion of glucose and sodium through the kidneys. These “concomitant effects” are particularly interesting with regard to the increased cardiovascular risk in T2DM. In many cases, T2DM treatment requires a multidimensional approach where the treatment goals have to be adapted to the individual patient. While there is a consensus on the use of metformin as a first-line drug therapy, various antidiabetics are used for treatment intensification. New mechanisms of action like that of SGLT2 inhibitors such as canagliflozin, which can be used both in early and late stages of diabetes, are a welcome addition to expand the treatment options for patients at every stage of T2DM. The efficacy and tolerability of canagliflozin have been tested in an extensive clinical trial program

  5. SGLT2 inhibitors - an insulin-independent therapeutic approach for treatment of type 2 diabetes: focus on canagliflozin.

    Science.gov (United States)

    Seufert, Jochen

    2015-01-01

    Despite the availability of a great variety of medications, a significant proportion of people with type 2 diabetes mellitus (T2DM) are not able to achieve or maintain adequate glycemic control. Beyond improved glucose control, novel treatments would ideally provide a reduction of cardiovascular risk, with a favorable impact on excess weight, and a low intrinsic hypoglycemia risk, as well as a synergistic mechanism of action for broad combination therapy. With the development of sodium glucose cotransporter 2 (SGLT2) inhibitors, an antidiabetic pharmacologic option has recently become available that comes close to meeting these requirements. For the first time, SGLT2 inhibitors offer a therapeutic approach acting directly on the kidneys without requiring insulin secretion or action. Canagliflozin, dapagliflozin, and empagliflozin are the SGLT2 inhibitors approved to date. Taken once a day, these medications can be combined with all other antidiabetic medications including insulin, due to their insulin-independent mechanism of action, with only a minimal risk of hypoglycemia. SGLT2 inhibitors provide additional reductions in body weight and blood pressure due to the therapeutically induced excretion of glucose and sodium through the kidneys. These "concomitant effects" are particularly interesting with regard to the increased cardiovascular risk in T2DM. In many cases, T2DM treatment requires a multidimensional approach where the treatment goals have to be adapted to the individual patient. While there is a consensus on the use of metformin as a first-line drug therapy, various antidiabetics are used for treatment intensification. New mechanisms of action like that of SGLT2 inhibitors such as canagliflozin, which can be used both in early and late stages of diabetes, are a welcome addition to expand the treatment options for patients at every stage of T2DM. The efficacy and tolerability of canagliflozin have been tested in an extensive clinical trial program

  6. Various therapeutic proportion of the patients with type 2 diabetes mellitus undergone coronary angiography in the era of development in MSCT

    Institute of Scientific and Technical Information of China (English)

    Feng Liang; Zhujun Shen; Dayi Hu; Mingying Wu; Tianchang Li; Chuzhong Tang; Jiyun Wang; Changlin Lu; Xiuhua Ma

    2013-01-01

      Introduction: Diabetic patients are prone to a diffuse and rapidly progressive form of atherosclerosis, which increases their likelihood of requiring revascularization, particularly for CABG. This study was to examin the various therapeutic proportion of the population of the patients with type 2 diabetes mellitus undergone coronary angiography(CAG) in the era of development in MSCT in the real clinical practice.Methods: 1406 consecutive patients were undergone CAG, of which patients, 351 patients with type 2 diabetes mellitus, 1055 without that. By evaluating the coronary angiogram, the patients were not diagnosed to have coronary heart disease(CHD) with less than 50% diameter stenosis of coronary artery; CHD was defned as narrowing of the appropriate lumen of ≥ 50%; the procedure of percutaneous coronary intervention(PCI) were performed in the patients with more than or equal to 70% stenosis lesions, the decision making for PCI mainly based on the clinical demonstration and the coronary lesion morphologies, which were suitable for PCI; the coronary aortic bypass graft(CABG) surgery had been proposed based on the guideline.Results: The baseline characteristics of patients with and without diabetes undergone coronary angiography were as following. The age was signifcantly older in patients with diabetes than without diabetes(60.22±9.70 versus 57.76±9.94, P<0.0005). More femal patients in the diabetes group than non-diabetes group(45.30% versus 35.55%, P< 0.0005). The morbidity rate of UAP (64.96% and 49.86%, P< 0.0005), and Hypertension (80.06% and 69.57%, P<0.0005) were signifcantly higher in patients with diabetes than without diabetes.By evaluating the coronary angiogram, more patients were diagnosed to CHD in the diabetes group than in the non-diabetic group(92.59% versus 79.43%, P<0.0005); the proportion of the population of the patients with CHD not requiring for PCI and performed the procedure of stent implantation were almost idetical in the two

  7. Therapeutic potential of green tea on risk factors for type 2 diabetes in obese adults - a review.

    Science.gov (United States)

    Ferreira, M A; Silva, D M; de Morais, A C; Mota, J F; Botelho, P B

    2016-12-01

    Green tea has been associated with positive effects in the treatment of obesity and other associated comorbidities such as type 2 diabetes. These benefits are thought to be related to the anti-inflammatory and antioxidant effects of green tea and to the reduction in body fat percentage exhibited by its bioactive compounds. The predominant active compounds in green tea are flavonoid monomers known as catechins, in particular epigallocatechin-3-gallate, which is the most abundant and most effective catechin in metabolic care, particularly among obese patients. The objective of this review was to investigate the effects of green tea on body composition, oxidative stress, inflammation and insulin resistance, risk factors for the development of type 2 diabetes in obese individuals and the mechanisms that underlie the modulatory actions of green tea compounds on these risk factors. Although green tea has therapeutic potential in the treatment of obese individuals, the findings of this review demonstrate the need for a greater number of studies to confirm the positive effects of green tea, especially regarding the modulation of obesity. © 2016 World Obesity Federation.

  8. Safety and effectiveness of therapeutic magnetic resonance in the management of postsurgical lesion of the diabetic foot.

    Science.gov (United States)

    Abbruzzese, Lorenza; Iacopi, Elisabetta; Coppelli, Alberto; Bonino, Giovanni; Goretti, Chiara; Piaggesi, Alberto

    2015-03-01

    To evaluate the safety and effectiveness of therapeutic magnetic resonance (TMR) in the management of the diabetic foot (DF), we treated a group of consecutive type 2 diabetic inpatients with wide postsurgical lesions (Group A: N = 10; age 67.7 ± 18.9 years, duration of diabetes 22.3 ± 6.6 years, 8.1 ± 1.1%, body mass index 29.4 ± 2.1 kg/m(2)), for 2 consecutive weeks, while admitted, with a low-intensity magnetic resonance equipment, in addition to standard treatment. Patients, compared with a matched control group with the same clinical characteristics (Group B), were then followed monthly for 6 months to evaluate healing rate (HR), healing time (HT), rate of granulation tissue (GT) at 3 months, and adverse events. HR was of 90% in Group A and 30% in Group B (P < .05); GT was 73.7 ± 13.2% in Group A versus 51.84 ± 18.77% in Group B (P < .05). HT in Group A was 84.46 ± 54.38 days versus 148.54 ± 78.96 days in Group B (P < .01). No difference in adverse events (5 in Group A and 6 in Group B) was observed throughout the study period. In this pilot study, the use of TMR at this dose and duration was safe. The results also permit the observation that TMR plus standard care offered a faster healing rate compared with standard care alone.

  9. Therapeutic potential of human embryonic stem cells in type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Geeta; Shroff

    2016-01-01

    AIM:To evaluate the safety and efficacy of human embryonic stem cells(h ESCs)for the management of type 2 diabetes mellitus(T2DM).METHODS:Patients with a previous history of diabetes and its associated complications were enrolled and injected with hE SC lines as per the defined protocol.The patients were assessed using Nutech functional score(NFS),a numeric scoring scale to evaluate the patients for 11 diagnostic parameters.Patients were evaluated at baseline and at the end of treatment period 1(T1).All the parameters were graded on the NFS scale from 1to 5.Highest possible grade(HPG)of 5 was considered as the grade of best improvement.RESULTS:Overall,94.8%of the patients showed improvement by at least one grade of NFS at the end of T1.For all the 11 parameters evaluated,54%of patients achieved HPG after treatment.The four essential parameters(improvement in glycated hemoglobin(HbA 1c)and insulin level,and fall in number of other oral hypoglycemic drugs with and without insulin)are presented in detail.For Hb A1c,72.6%of patients at the end of T1 met the World Health Organization cut off value,i.e.,6.5%of HbA 1c.For insulin level,65.9%of patients at the end of T1 were able to achieve HPG.After treatment,the improvement was seen in 16.3%of patients who required no more than two medications along with insulin.Similarly,21.5%of patients were improved as their dosage regimen for using oral drugs was reduced to 1-2 from 5.CONCLUSION:hE SC therapy is beneficial in patients with diabetes and helps in reducing their dependence on insulin and other medicines.

  10. The role of netrin-1 in angiogenesis and diabetic retinopathy: a promising therapeutic strategy.

    Science.gov (United States)

    Wu, Wenyi; Lei, Hetian; Shen, Junhui; Tang, Luosheng

    2017-05-01

    Netrin-1 is an axon guidance cue and is necessary for neural and vascular development. It is involved in regulating axon guidance for attraction or repulsion, and it has a dual function in endothelial tip cell migration during angiogenesis. Netrin-1 has been shown to play an important role in angiogenesis, cancer progression, and inflammatory disease. Here we review the role of netrin-1 in retinal and angiogenesis development and the associated signaling pathways in diabetic retinopathy. The currently available data suggest that netrin-1 is a promising target for the development of anti-angiogenesis drugs.

  11. [Diabetes type 2--criteria concerning the recognition and prevention, as well as therapeutic targets in the light of research results and guidelines formulated by the American Diabetes Association in 2012].

    Science.gov (United States)

    Kucharska, Ewa

    2013-01-01

    The article summarizes the current state of knowledge on the detection of pre-diabetic condition and type 2 diabetes, as well as therapeutic purposes. ADA guidelines published in January 2012, in line with the earlier experts' findings allow the detection of diabetes on the basis of HbA1C (> or = 6.5%) marking. Moreover, there are still applicable criteria that impose the following methods of blood glucose level monitoring: fasted, and 2 hours after a 75 gram of oral glucose intake. Screening for diabetes type 2 is indicated especially in obese patients and patients with arterial hypertension. This includes also those, in whom a prediabetic condition is found, and who would benefit most from their lifestyle modification, or from pharmacological diabetes prevention with the use of metformin. The results of clinical trials and recent meta-analyses indicate that for most patients, the therapeutic goal in the treatment of diabetes may be less precise than it was previously thought, and for HbA1C it is < 7.0%. An individualized approach is, however, advised, as patients with respect to whom a short period of time has elapsed after diabetes was diagnosed in them, young people and those with a high life expectancy and low hypoglycemia risk may benefit from a stricter controlling regime (< 6.5%).

  12. Skeletal muscle as a therapeutic target for delaying type 1 diabetic complications

    Institute of Scientific and Technical Information of China (English)

    Samantha; K; Coleman; Irena; A; Rebalka; Donna; M; D’Souza; Thomas; J; Hawke

    2015-01-01

    Type 1 diabetes mellitus(T1DM) is a chronic autoimmune disease targeting the pancreatic beta-cells and rendering the person hypoinsulinemic and hyperglycemic. Despite exogenous insulin therapy, individuals with T1 DM will invariably develop long-term complications such as blindness, kidney failure and cardiovascular disease. Though often overlooked, skeletal muscle isalso adversely affected in T1 DM, with both physical and metabolic derangements reported. As the largest metabolic organ in the body, impairments to skeletal muscle health in T1 DM would impact insulin sensitivity, glucose/lipid disposal and basal metabolic rate and thus affect the ability of persons with T1 DM to manage their disease. In this review, we discuss the impact of T1 DM on skeletal muscle health with a particular focus on the proposed mechanisms involved. We then identify and discuss established and potential adjuvant therapies which, in association with insulin therapy, would improve the health of skeletal muscle in those with T1 DM and thereby improve disease managementultimately delaying the onset and severity of other longterm diabetic complications.

  13. Free fatty acid receptors as therapeutic targets for the treatment of diabetes

    Directory of Open Access Journals (Sweden)

    Atsuhiko eIchimura

    2014-11-01

    Full Text Available Nutrition regulates energy balance; however, dysfunction of energy balance can cause metabolic disorders, such as obesity and diabetes. Fatty acids are an essential energy source and signaling molecules that regulate various cellular processes and physiological functions. Recently, several orphan G protein-coupled receptors were indentified as free fatty acid receptors (FFARs. GPR40/FFAR1 and GPR120/FFAR4 are activated by medium- and/or long-chain fatty acids, whereas GPR41/FFAR3 and GPR43/FFAR2 are activated by short-chain fatty acids. FFARs are regarded as targets for novel drugs to treat metabolic disorders, such as obesity and type 2 diabetes, because recent studies have showed that these receptors are involved in the energy metabolism in various tissues, including adipose, intestinal, and immune tissue. In this review, we summarize physiological roles of the FFARs, provide a comprehensive overview of energy regulation by FFARs, and discuss new prospects for treatment of metabolic disorders.

  14. Therapeutic Effect of Alprostadil in Diabetic Nephropathy: Possible Roles of Angiopoietin-2 and IL-18

    Directory of Open Access Journals (Sweden)

    Changqing Luo

    2014-08-01

    Full Text Available Background/Aims: To investigate the role of angiopoietin-2 (Ang-2 and IL-18 in the pathogenesis of diabetic nephropathy (DN and the molecular mechanisms through which alprostadil protects renal function. Methods: DN was induced by streptozotocin and intraperitoneal injection of alprostadil was given to diabetic mice. After 2, 4 and 8 weeks of alprostadil treatment, the mRNA and protein expression of kidney Ang-2 and IL-18 were detected by reverse transcription PCR, Western blot and immunohistochemistry analyses. Mouse glomerular endothelial cells (GEnCs were cultured in high glucose and treated with alprostadil. After transfection with an Ang-2-pcDNA and Ang-2-siRNA, both Ang-2 and IL-18 expression were measured by Western blot analyses. Results: Alprostadil treatment caused a significant decrease in the renal damage parameters. Both Ang-2 and IL-18 were significantly increased in DN mice and in GEnCs cultured in high glucose; however, their expression was greatly reduced by alprostadil treatment. Ang-2 could also increase IL-18 expression in cultured endothelial cells under high glucose, and this response was partially blocked by Ang-2 siRNA. Conclusions: Ang-2 and IL-18 may be associated with the development and progression of DN in mice. Alprostadil treatment can protect renal function by reducing proteinuria. These effects are mediated, at least in part, through down-regulation of Ang-2 and IL-18 expression.

  15. SGLT2 inhibitors – an insulin-independent therapeutic approach for treatment of type 2 diabetes: focus on canagliflozin

    Directory of Open Access Journals (Sweden)

    Seufert J

    2015-11-01

    Full Text Available Jochen SeufertDepartment of Endocrinology and Diabetology, Clinic for Internal Medicine II, Freiburg University Hospital, Freiburg, GermanyAbstract: Despite the availability of a great variety of medications, a significant proportion of people with type 2 diabetes mellitus (T2DM are not able to achieve or maintain adequate glycemic control. Beyond improved glucose control, novel treatments would ideally provide a reduction of cardiovascular risk, with a favorable impact on excess weight, and a low intrinsic hypoglycemia risk, as well as a synergistic mechanism of action for broad combination therapy. With the development of sodium glucose cotransporter 2 (SGLT2 inhibitors, an antidiabetic pharmacologic option has recently become available that comes close to meeting these requirements. For the first time, SGLT2 inhibitors offer a therapeutic approach acting directly on the kidneys without requiring insulin secretion or action. Canagliflozin, dapagliflozin, and empagliflozin are the SGLT2 inhibitors approved to date. Taken once a day, these medications can be combined with all other antidiabetic medications including insulin, due to their insulin-independent mechanism of action, with only a minimal risk of hypoglycemia. SGLT2 inhibitors provide additional reductions in body weight and blood pressure due to the therapeutically induced excretion of glucose and sodium through the kidneys. These "concomitant effects" are particularly interesting with regard to the increased cardiovascular risk in T2DM. In many cases, T2DM treatment requires a multidimensional approach where the treatment goals have to be adapted to the individual patient. While there is a consensus on the use of metformin as a first-line drug therapy, various antidiabetics are used for treatment intensification. New mechanisms of action like that of SGLT2 inhibitors such as canagliflozin, which can be used both in early and late stages of diabetes, are a welcome addition to expand

  16. Therapeutic effects of entecavir and adefovir dipivoxil in hepatitis B cirrhosis patients with hepatogenous diabetes: a comparative analysis

    Directory of Open Access Journals (Sweden)

    LI Na

    2016-06-01

    Full Text Available ObjectiveTo investigate the therapeutic effect of entecavir or adefovir dipivoxil as the antiviral therapy for hepatitis B cirrhosis patients with hepatogenous diabetes. MethodsA total of 80 hepatitis B cirrhosis patients with hepatogenous diabetes who visited Qingdao Hospital of Infectious Diseases were enrolled, and according to the antiviral drug they chose, they were divided into group A and group B, with 40 patients in each group. The patients in group A were treated with oral administration of entecavir 0.5 mg qd, and those in group B were treated with oral administration of adefovir dipivoxil 10 mg qd. The antiviral therapy lasted for 48 weeks. The patients in both groups were given diabetic diets and insulin to control blood glucose, as well as liver-protecting and transaminase-lowering treatments. The changes in biochemical parameters, viral response, diabetes control, and the improvement in liver stiffness after treatment were observed in both groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThe viral response showed a significant difference between group A (85%, 34/40 and group B (65%, 26/40 (χ2=4.27, P<0.05. Compared with group B, group A showed significant improvements in biochemical parameters (P<0.05. After 48 weeks of treatment, group A had significantly lower levels of blood glucose and glycosylated hemoglobin than group B (blood glucose: 7.53±1.13 mmol/L vs 8.34±1.12 mmol/L, t=3.220, P<0.05; glycosylated hemoglobin: 7.23%±0.64% vs 7.79%±084%, t=3.354; P<0.05. After the treatment, liver stiffness showed a significant difference between group A and group B (16.86±5.67 kPa vs 19.47±5.32 kPa, t=2.123, P<0.05. ConclusionCompared with adefovir dipivoxil, entecavir can improve glycogen metabolism and blood glucose regulation through improving liver function and promoting hepatocyte repair, and

  17. A Novel Therapeutic Agent for Type 2 Diabetes Mellitus: SGLT2 Inhibitor

    Directory of Open Access Journals (Sweden)

    Chang Hee Jung

    2014-08-01

    Full Text Available Type 2 diabetes mellitus (T2DM is a complex endocrine and metabolic disorder, and a major public health problem that is rapidly increasing in prevalence. Although a wide range of pharmacotherapies for glycemic control is now available, management of T2DM remains complex and challenging. The kidneys contribute immensely to glucose homeostasis by reabsorbing glucose from the glomerular filtrate. Sodium-glucose cotransporter 2 (SGLT2 inhibitors, a new class of antidiabetic agents that inhibit glucose absorption from the kidney independent of insulin, offer a unique opportunity to improve the outcomes of patients with T2DM. In this review, we provide an overview of two globally-approved SGLT2 inhibitors, dapagliflozin and canagliflozin, and discuss their effects and safety. This information will help clinicians to decide whether these drugs will benefit their patients.

  18. Novel nervous and multi-system regenerative therapeutic strategies for diabetes mellitus with mTOR

    Directory of Open Access Journals (Sweden)

    Kenneth Maiese

    2016-01-01

    Full Text Available Throughout the globe, diabetes mellitus (DM is increasing in incidence with limited therapies presently available to prevent or resolve the significant complications of this disorder. DM impacts multiple organs and affects all components of the central and peripheral nervous systems that can range from dementia to diabetic neuropathy. The mechanistic target of rapamycin (mTOR is a promising agent for the development of novel regenerative strategies for the treatment of DM. mTOR and its related signaling pathways impact multiple metabolic parameters that include cellular metabolic homeostasis, insulin resistance, insulin secretion, stem cell proliferation and differentiation, pancreatic β-cell function, and programmed cell death with apoptosis and autophagy. mTOR is central element for the protein complexes mTOR Complex 1 (mTORC1 and mTOR Complex 2 (mTORC2 and is a critical component for a number of signaling pathways that involve phosphoinositide 3-kinase (PI 3-K, protein kinase B (Akt, AMP activated protein kinase (AMPK, silent mating type information regulation 2 homolog 1 (Saccharomyces cerevisiae (SIRT1, Wnt1 inducible signaling pathway protein 1 (WISP1, and growth factors. As a result, mTOR represents an exciting target to offer new clinical avenues for the treatment of DM and the complications of this disease. Future studies directed to elucidate the delicate balance mTOR holds over cellular metabolism and the impact of its broad signaling pathways should foster the translation of these targets into effective clinical regimens for DM.

  19. Novel nervous and multi-system regenerative therapeutic strategies for diabetes mellitus with mTOR

    Institute of Scientific and Technical Information of China (English)

    Kenneth Maiese

    2016-01-01

    Throughout the globe, diabetes mellitus (DM) is increasing in incidence with limited therapies presently available to prevent or resolve the signiifcant complications of this disorder. DM impacts multiple organs and affects all components of the central and peripheral nervous systems that can range from demen-tia to diabetic neuropathy. The mechanistic target of rapamycin (mTOR) is a promising agent for the development of novel regenerative strategies for the treatment of DM. mTOR and its related signaling pathways impact multiple metabolic parameters that include cellular metabolic homeostasis, insulin resistance, insulin secretion, stem cell proliferation and differentiation, pancreaticβ-cell function, and programmed cell death with apoptosis and autophagy. mTOR is central element for the protein com-plexes mTOR Complex 1 (mTORC1) and mTOR Complex 2 (mTORC2) and is a critical component for a number of signaling pathways that involve phosphoinositide 3-kinase (PI 3-K), protein kinase B (Akt), AMP activated protein kinase (AMPK), silent mating type information regulation 2 homolog 1 (Saccha-romyces cerevisiae) (SIRT1), Wnt1 inducible signaling pathway protein 1 (WISP1), and growth factors. As a result, mTOR represents an exciting target to offer new clinical avenues for the treatment of DM and the complications of this disease. Future studies directed to elucidate the delicate balance mTOR holds over cellular metabolism and the impact of its broad signaling pathways should foster the translation of these targets into effective clinical regimens for DM.

  20. Role of simvastatin and/or antioxidant vitamins in therapeutic angiogenesis in experimental diabetic hindlimb ischemia: effects on capillary density, angiogenesis markers, and oxidative stress.

    Science.gov (United States)

    El-Azab, Mona F; Hazem, Reem M; Moustafa, Yasser M

    2012-09-05

    Therapeutic angiogenesis has emerged as an attractive approach for the management of peripheral arterial disease in diabetic patients. Oxidative stress generated and aggravated by prolonged hyperglycemia may interfere with and destroy the newly formed blood vessels. Angiogenic effect of simvastatin has been reported; however, its exact mechanism is yet to be evaluated. In addition, the exact role of antioxidant vitamins in diabetic peripheral arterial disease is still controversial. The present study was undertaken to investigate the therapeutic potential of simvastatin and antioxidant vitamins (E and C) and their combined effects on angiogenesis in diabetic hind-limb ischemia. Streptozotocin diabetic rats were treated for 6 weeks with simvastatin either alone or in combination with vitamin E or vitamin C. Parameters of angiogenesis, nitric oxide, heme oxygenase-1 (HO-1), and oxidative stress markers were evaluated. CD31 immunostaining revealed an increased capillary density in ischemic gastrocnemious tissue of diabetic rats treated with either simvastatin or its combination with vitamin C. This effect was accompanied by up-regulated plasma levels of HO-1, nitric oxide, vascular endothelial growth factor (VEGF) and its intra-muscular receptor type-2 (Flk-1). Tissue reduced glutathione and antioxidant enzymes activities were normalized in groups treated with antioxidant vitamins or their combination with simvastatin with concomitant blunting of lipid peroxidation. Vitamins E and C, through their antioxidant effects, evidently enhanced the angiogenic effect of simvastatin in ischemic diabetic muscle. Hence, the use of antioxidant vitamins combined with statins to induce therapeutic angiogenesis is a promising strategy in the management of diabetes-associated peripheral arterial disease.

  1. Pharmacology and therapeutic implications of current drugs for type 2 diabetes mellitus.

    Science.gov (United States)

    Tahrani, Abd A; Barnett, Anthony H; Bailey, Clifford J

    2016-10-01

    Type 2 diabetes mellitus (T2DM) is a global epidemic that poses a major challenge to health-care systems. Improving metabolic control to approach normal glycaemia (where practical) greatly benefits long-term prognoses and justifies early, effective, sustained and safety-conscious intervention. Improvements in the understanding of the complex pathogenesis of T2DM have underpinned the development of glucose-lowering therapies with complementary mechanisms of action, which have expanded treatment options and facilitated individualized management strategies. Over the past decade, several new classes of glucose-lowering agents have been licensed, including glucagon-like peptide 1 receptor (GLP-1R) agonists, dipeptidyl peptidase 4 (DPP-4) inhibitors and sodium/glucose cotransporter 2 (SGLT2) inhibitors. These agents can be used individually or in combination with well-established treatments such as biguanides, sulfonylureas and thiazolidinediones. Although novel agents have potential advantages including low risk of hypoglycaemia and help with weight control, long-term safety has yet to be established. In this Review, we assess the pharmacokinetics, pharmacodynamics and safety profiles, including cardiovascular safety, of currently available therapies for management of hyperglycaemia in patients with T2DM within the context of disease pathogenesis and natural history. In addition, we briefly describe treatment algorithms for patients with T2DM and lessons from present therapies to inform the development of future therapies.

  2. Mechanism of and Therapeutic Strategy for Atrial Fibrillation Associated with Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Yubi Lin

    2013-01-01

    Full Text Available Diabetes mellitus (DM is one of the most important risk factors for atrial fibrillation (AF and is a predictor of stroke and thromboembolism. DM may increase the incidence of AF, and when it is combined with other risk factors, the incidence of stroke and thromboembolism may also be higher; furthermore, hospitalization due to heart failure appears to increase. Maintenance of well-controlled blood glucose and low levels of HbA1c in accordance with guidelines may decrease the incidence of AF. The mechanisms of AF associated with DM are autonomic remodeling, electrical remodeling, structural remodeling, and insulin resistance. Inhibition of the renin-angiotensin system is suggested to be an upstream therapy for this type of AF. Studies have indicated that catheter ablation may be effective for AF associated with DM, restoring sinus rhythm and improving prognosis. Catheter ablation combined with hypoglycemic agents may further increase the rate of maintenance of sinus rhythm and reduce the need for reablation.

  3. Studies on the therapeutic effect of propolis in streptozotocin-induced diabetic mice

    Science.gov (United States)

    Rifa'I, Muhaimin

    2017-05-01

    Propolis oral administration in diabetic mice can increase the expression of TLR-3 and ameliorate homeostatic imbalance. The TLR-3 expression increased in both B cells and T cells. In this study, we also found that propolis may improve insulin expression in pancreatic beta cells. Administering propolis at a dose of 100-200 mg/mL may significantly increase insulin synthesis. Propolis might protect healthy cells from apoptosis in cisplatin exposure. Cisplatin can induce spleen cells to remain in the G0/G1 phase or to reach the apoptosis stage in the absence of propolis. In contrast, cisplatin, when administered together with propolis to a culture of spleen cells, cannot force the cells to undergo apoptosis. In a culture of spleen cells in the presence of propolis, the cells did not show any responses. This suggests that propolis does not disrupt normal cell physiology and supports cell health when cells are exposed to cisplatin. Furthermore, propolis can suppress the production of the pro-inflammatory cytokine interferon-gamma (IFN-γ).

  4. Identification of the critical therapeutic entity in secreted Hsp90α that promotes wound healing in newly re-standardized healthy and diabetic pig models.

    Science.gov (United States)

    O'Brien, Kathryn; Bhatia, Ayesha; Tsen, Fred; Chen, Mei; Wong, Alex K; Woodley, David T; Li, Wei

    2014-01-01

    Chronic and non-healing skin wounds represent a significant clinical, economic and social problem worldwide. Currently, there are few effective treatments. Lack of well-defined animal models to investigate wound healing mechanisms and furthermore to identify new and more effective therapeutic agents still remains a major challenge. Pig skin wound healing is close to humans. However, standardized pig wound healing models with demonstrated validity for testing new wound healing candidates are unavailable. Here we report a systematic evaluation and establishment of both acute and diabetic wound healing models in pigs, including wound-creating pattern for drug treatment versus control, measurements of diabetic parameters and the time for detecting delayed wound healing. We find that treatment and control wounds should be on the opposite and corresponding sides of a pig. We demonstrate a strong correlation between duration of diabetic conditions and the length of delay in wound closure. Using these new models, we narrow down the minimum therapeutic entity of secreted Hsp90α to a 27-amino acid peptide, called fragment-8 (F-8). In addition, results of histochemistry and immunohistochemistry analyses reveal more organized epidermis and dermis in Hsp90α-healed wounds than the control. Finally, Hsp90α uses a similar signaling mechanism to promote migration of isolated pig and human keratinocytes and dermal fibroblasts. This is the first report that shows standardized pig models for acute and diabetic wound healing studies and proves its usefulness with both an approved drug and a new therapeutic agent.

  5. Identification of the critical therapeutic entity in secreted Hsp90α that promotes wound healing in newly re-standardized healthy and diabetic pig models.

    Directory of Open Access Journals (Sweden)

    Kathryn O'Brien

    Full Text Available Chronic and non-healing skin wounds represent a significant clinical, economic and social problem worldwide. Currently, there are few effective treatments. Lack of well-defined animal models to investigate wound healing mechanisms and furthermore to identify new and more effective therapeutic agents still remains a major challenge. Pig skin wound healing is close to humans. However, standardized pig wound healing models with demonstrated validity for testing new wound healing candidates are unavailable. Here we report a systematic evaluation and establishment of both acute and diabetic wound healing models in pigs, including wound-creating pattern for drug treatment versus control, measurements of diabetic parameters and the time for detecting delayed wound healing. We find that treatment and control wounds should be on the opposite and corresponding sides of a pig. We demonstrate a strong correlation between duration of diabetic conditions and the length of delay in wound closure. Using these new models, we narrow down the minimum therapeutic entity of secreted Hsp90α to a 27-amino acid peptide, called fragment-8 (F-8. In addition, results of histochemistry and immunohistochemistry analyses reveal more organized epidermis and dermis in Hsp90α-healed wounds than the control. Finally, Hsp90α uses a similar signaling mechanism to promote migration of isolated pig and human keratinocytes and dermal fibroblasts. This is the first report that shows standardized pig models for acute and diabetic wound healing studies and proves its usefulness with both an approved drug and a new therapeutic agent.

  6. The vascular endothelin system in obesity and type 2 diabetes: pathophysiology and therapeutic implications.

    Science.gov (United States)

    Campia, Umberto; Tesauro, Manfredi; Di Daniele, Nicola; Cardillo, Carmine

    2014-11-24

    Obesity, the metabolic syndrome (MetS), and type 2 diabetes (T2DM) are associated with heightened cardiovascular risk. Given the vasoconstrictor and proatherogenic properties of endothelin (ET)-1, increased ET-1 activity has been postulated to participate in the derangement of adiposity-related vascular homeostasis. This concept is supported by human studies using receptor antagonists to show that the activity of endogenous ET-1 is indeed enhanced in overweight and obesity, the MetS, and T2DM. Also, increased ET-1 contributes to endothelial dysfunction related to obesity, the MetS, and T2DM, whereas decreasing ET-1 vasoconstrictor tone in these patients corrects the defective endothelium-dependent vasodilation. In addition, in patients with central adiposity and the MetS, enhanced intravascular ET-1 activity coexists with decreased nitric oxide (NO)-dependent vasodilator capacity, suggesting a prevalence of vasoconstrictor mediators in vessels of obese individuals. One mechanism evoked to explain the development of vascular abnormalities in obesity deals with the derangement of the physiological vascular effects of insulin in insulin-resistant states. Thus, in conditions of adiposity, defective insulin-mediated vasodilation leads to impaired ability of the hormone to enhance its delivery and that of substrates to peripheral tissues. An important role of ET-1 in this abnormality is supported by studies showing that upregulation of the ET-1 system impairs NO-mediated vasodilation in insulin-resistant patients, whereas NO bioactivity is restored following ET-1 antagonism. In conclusion, considerable evidence supports a mechanistic role of ET-1 in the pathophysiology of adiposity-related vascular dysfunction. Targeting the ET-1 system, therefore, might have the potential for effective cardiovascular prevention in obesity, the MetS, and T2DM. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Determinants of intensive insulin therapeutic regimens in patients with type 1 diabetes: data from a nationwide multicenter survey in Brazil

    Science.gov (United States)

    2014-01-01

    Background To evaluate the determinants of intensive insulin regimens (ITs) in patients with type 1 diabetes (T1D). Methods This multicenter study was conducted between December 2008 and December 2010 in 28 public clinics in 20 Brazilian cities. Data were obtained from 3,591 patients (56.0% female, 57.1% Caucasian). Insulin regimens were classified as follows: group 1, conventional therapy (CT) (intermediate human insulin, one to two injections daily); group 2 (three or more insulin injections of intermediate plus regular human insulin); group 3 (three or more insulin injections of intermediate human insulin plus short-acting insulin analogues); group 4, basal-bolus (one or two insulin injections of long-acting plus short-acting insulin analogues or regular insulin); and group 5, basal-bolus with continuous subcutaneous insulin infusion (CSII). Groups 2 to 5 were considered IT groups. Results We obtained complete data from 2,961 patients. Combined intermediate plus regular human insulin was the most used therapeutic regimen. CSII was used by 37 (1.2%) patients and IT by 2,669 (90.2%) patients. More patients on IT performed self-monitoring of blood glucose and were treated at the tertiary care level compared to CT patients (p < 0.001). The majority of patients from all groups had HbA1c levels above the target. Overweight or obesity was not associated with insulin regimen. Logistic regression analysis showed that economic status, age, ethnicity, and level of care were associated with IT (p < 0.001). Conclusions Given the prevalence of intensive treatment for T1D in Brazil, more effective therapeutic strategies are needed for long term-health benefits. PMID:24920963

  8. Diabetes

    OpenAIRE

    Smith, Paul

    2003-01-01

    Derbyshire general practitioner Stuart Bootle has had diabetes for 20 years. He speaks to Paul Smith, who has type 1 diabetes himself, about the trials and tribulations of being on the receiving end of NHS care

  9. Endothelial Microparticles Act as Novel Diagnostic and Therapeutic Biomarkers of Diabetes and Its Complications: A Literature Review

    Directory of Open Access Journals (Sweden)

    Fan Deng

    2016-01-01

    Full Text Available Diabetes mellitus- (DM- related vascular diseases attract increased attention due to their high morbidity and mortality. The incidence of obesity, atherosclerosis, coronary heart disease, hypertension, and dyslipidemia is significantly higher in DM patients, with an earlier onset and faster progression compared with non-DM patients. DM-related vascular diseases including macrovascular and microvascular complications are characterized by endothelial dysfunction. Therefore, a better understanding of the etiology and mechanisms of endothelial dysfunction is important for the diagnosis and treatment of DM. Endothelial microparticles (EMPs are new diagnostic and therapeutic targets and biomarkers in DM-related vascular disease. Circulating EMPs containing biologically active substances act as intercellular signals under physiological and pathological conditions. They serve as biological markers of altered vascular endothelium and reflect the pathological progression and diminished endothelial function of blood vessels. Recent evidence suggests that the plasma level of EMPs is significantly higher in DM patients than in healthy population and is significantly correlated with DM-related complications. These observations have prompted speculation that EMPs play a crucial role in the pathophysiology of DM. This review summarizes the known and potential roles of EMPs in the diagnosis, staging, treatment, and clinical prognosis of DM and related vascular diseases.

  10. Hepatic Monoacylglycerol O-acyltransferase 1 as a Promising Therapeutic Target for Steatosis, Obesity, and Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Yasuhiro Hayashi

    2014-01-01

    Full Text Available Over the past decade, considerable advances have been made in the discovery of gene targets in metabolic diseases. However, in vivo studies based on molecular biological technologies such as the generation of knockout mice and the construction of short hairpin RNA vectors require considerable effort and time, which is a major limitation for in vivo functional analysis. Here, we introduce a liver-specific nonviral small interfering RNA (siRNA delivery system into rapid and efficient characterization of hepatic gene targets in metabolic disease mice. The comparative transcriptome analysis in liver between KKAy diabetic and normal control mice demonstrated that the expression of monoacylglycerol O-acyltransferase 1 (Mogat1, an enzyme involved in triglyceride synthesis and storage, was highly elevated during the disease progression. The upregulation of Mogat1 expression in liver was also found in other genetic (db/db and diet-induced obese mice. The silencing of hepatic Mogat1 via a liver-specific siRNA delivery system resulted in a dramatic improvement in blood glucose levels and hepatic steatosis as well as overweight with no apparent overall toxicities, indicating that hepatic Mogat1 is a promising therapeutic target for metabolic diseases. The integrated approach with transcriptomics and nonviral siRNA delivery system provides a blueprint for rapid drug discovery and development.

  11. Endothelial Microparticles Act as Novel Diagnostic and Therapeutic Biomarkers of Diabetes and Its Complications: A Literature Review

    Science.gov (United States)

    Deng, Fan

    2016-01-01

    Diabetes mellitus- (DM-) related vascular diseases attract increased attention due to their high morbidity and mortality. The incidence of obesity, atherosclerosis, coronary heart disease, hypertension, and dyslipidemia is significantly higher in DM patients, with an earlier onset and faster progression compared with non-DM patients. DM-related vascular diseases including macrovascular and microvascular complications are characterized by endothelial dysfunction. Therefore, a better understanding of the etiology and mechanisms of endothelial dysfunction is important for the diagnosis and treatment of DM. Endothelial microparticles (EMPs) are new diagnostic and therapeutic targets and biomarkers in DM-related vascular disease. Circulating EMPs containing biologically active substances act as intercellular signals under physiological and pathological conditions. They serve as biological markers of altered vascular endothelium and reflect the pathological progression and diminished endothelial function of blood vessels. Recent evidence suggests that the plasma level of EMPs is significantly higher in DM patients than in healthy population and is significantly correlated with DM-related complications. These observations have prompted speculation that EMPs play a crucial role in the pathophysiology of DM. This review summarizes the known and potential roles of EMPs in the diagnosis, staging, treatment, and clinical prognosis of DM and related vascular diseases. PMID:27803933

  12. [Diabetic neuropathy].

    Science.gov (United States)

    Lechleitner, Monika; Abrahamian, Heidemarie; Francesconi, Claudia; Kofler, Markus

    2016-04-01

    These are the guidelines for diagnosis and treatment of diabetic neuropathy. This diabetic late complication comprises a number of mono- and polyneuropathies, plexopathies, radiculopathies and autonomic neuropathy. The position statement summarizes characteristic clinical symptoms and techniques for diagnostic assessment of diabetic neuropathy. Recommendations for the therapeutic management of diabetic neuropathy, especially for the control of pain in sensorimotor neuropathy, are provided.

  13. The new prognostic-therapeutic index – an easy method of establishing surgical indication in the pathology of the diabetic foot

    Science.gov (United States)

    Bobircă, F; Catrina, E; Mihalache, O; Georgescu, D; Pătrașcu, T

    2014-01-01

    Hypothesis and aim. The large number of invalidating surgical interventions in patients suffering from lesions of the diabetic foot, the late recognition of the lesions and sometimes the wrongful interpretation of their severity, have made necessary a multi-parameter study of these types of patients and the elaboration of a therapeutic-prognostic index to guide the physician in adopting the adequate method of treatment. Starting with the therapeutic-prognostic index imagined by professor Traian Patrascu, we have elaborated a new therapeutic prognostic index, by adding new, statistically significant parameters, for the purpose of facilitating the surgical indication, depending on the lesion type. Methods. A number of 929 patients who were admitted at the Surgery Clinic of the “Dr. I. Cantacuzino” Hospital, between January 2013 and June 2014, have been analyzed, of whom 450 were evaluated retrospectively and 479 prospectively. Results. The new therapeutic prognostic index has been calculated for the retrospective lot, resulting into a concordance between the actual surgical intervention and the prognostic index of 79.4% and, for the patients evaluated prospectively, we have found a confirmation of the relation of 82.6% between the performed surgical intervention and the forecasted surgical intervention, by calculating the index. Discussion. The new therapeutic-prognostic index represents an easy method of establishing the therapeutic conduct of the patient suffering from lesions of the diabetic foot. It is of major use in preventing the execution of such surgical interventions that may be disproportionate compared to the severity of the lesions, especially in facilities where the pathology of the diabetic foot is less known. PMID:25870688

  14. Diabetes tipo 2 en niños y adolescentes: aspectos clínico-epidemiológicos, patogénicos y terapéuticos Type 2 diabetes mellitus in children and adolescents: clinicoepidemiological, pathogenic and therapeutic aspects

    Directory of Open Access Journals (Sweden)

    Manuel Emiliano Licea Puig

    2008-04-01

    Full Text Available OBJETIVO: debido al incremento sostenido en la incidencia de la diabetes mellitus tipo 2 en personas OBJECTIVE: due to the sustained increase in the incidence of type 2 diabetes mellitus in persons under 20, the clinicoepidemiological, pathogenic and therapeutic aspects of type 2 diabetes mellitus in children and adolescents were reviewed. DEVELOPMENT: in children, it is estimated that type 2 diabetes mellitus accounts for 2-3 % of all cases. However, in the last years, there has been a ten-fold increase. Its prevalence is higher among Afro-Americans, Hispanics and native Americans, in puberty and in those with history of type 2 maternal diabetes mellitus. Type 2 diabetes mellitus is the result of the interaction of genetic and environmental factors (obesity, physical inactivity, poor nutritional habits, among others. There is a wide range of clinical manifestations: severe hyperglycaemia with ketonuria and ketosis to a mild hyperglycaemia. 50 % may be asymptomatic. Obesity, Acantosis nigricans, family history of type 2 diabetes mellitus, puberty, and type 2 maternal diabetes mellitus are risk factors. It prevails in females, autoimmunity is rare and the dependence on insulin may be episodic. Those with the highest hyperglycaemia have lower levels of insulinemia and peptide C. When hyperglycaemia is mild, diet, physical exercise and, in some cases, the administration of oral drugs, such as metformin, may be useful. CONCLUSIONS: type 2 diabetes mellitus in children and adolescents is a reality. Evolutively, most of them do not need insulin therapy. They may have retinopathy, microalbuminuria, dyslipidemia and arterial hypertension on diagnosis. Risk populations should be actively screened.

  15. Thioglycosides as inhibitors of hSGLT1 and hSGLT2: Potential therapeutic agents for the control of hyperglycemia in diabetes

    Directory of Open Access Journals (Sweden)

    Francisco Castaneda, Antje Burse, Wilhelm Boland, Rolf K-H. Kinne

    2007-01-01

    Full Text Available The treatment of diabetes has been mainly focused on maintaining normal blood glucose concentrations. Insulin and hypoglycemic agents have been used as standard therapeutic strategies. However, these are characterized by limited efficacy and adverse side effects, making the development of new therapeutic alternatives mandatory. Inhibition of glucose reabsorption in the kidney, mediated by SGLT1 or SGLT2, represents a promising therapeutic approach. Therefore, the aim of the present study was to evaluate the effect of thioglycosides on human SGLT1 and SGLT2. For this purpose, stably transfected Chinese hamster ovary (CHO cells expressing human SGLT1 and SGLT2 were used. The inhibitory effect of thioglycosides was assessed in transport studies and membrane potential measurements, using α-methyl-glucoside uptake and fluorescence resonance energy transfer, respectively. We found that some thioglycosides inhibited hSGLT more strongly than phlorizin. Specifically, thioglycoside I (phenyl-1'-thio-β-D-glucopyranoside inhibited hSGLT2 stronger than hSGLT1 and to a larger extent than phlorizin. Thioglycoside VII (2-hydroxymethyl-phenyl-1'-thio-β-D-galacto-pyranoside had a pronounced inhibitory effect on hSGLT1 but not on hSGLT2. Kinetic studies confirmed the inhibitory effect of these thioglycosides on hSGLT1 or hSGLT2, demonstrating competitive inhibition as the mechanism of action. Therefore, these thioglycosides represent promising therapeutic agents for the control of hyperglycemia in patients with diabetes.

  16. Pituitary Adenylate Cyclase Activating Polypeptide, A Potential Therapeutic Agent for Diabetic Retinopathy in Rats: Focus on the Vertical Information Processing Pathway.

    Science.gov (United States)

    Szabadfi, K; Reglodi, D; Szabo, A; Szalontai, B; Valasek, A; Setalo, Gy; Kiss, P; Tamas, A; Wilhelm, M; Gabriel, R

    2016-04-01

    Pituitary adenylate cyclase activating polypeptide (PACAP) is a neurotrophic and neuroprotective peptide that has been shown to exert protective effects in different neuronal injuries, such as retinal degenerations. Diabetic retinopathy (DR), the most common complication of diabetes, affects the microvasculature and neuronal architecture of the retina. We have proven earlier that PACAP is also protective in a rat model of DR. In this study, streptozotocin-induced DR was treated with intravitreal PACAP administration in order to further analyze the synaptic structure and proteins of PACAP-treated diabetic retinas, primarily in the vertical information processing pathway. Streptozotocin-treated Wistar rats received intravitreal PACAP injection three times into the right eye 2 weeks after the induction of diabetes. Morphological and molecular biological (qRT-PCR; Western blot) methods were used to analyze retinal synapses (ribbons, conventional) and related structures. Electron microscopic analysis revealed that retinal pigment epithelium, the ribbon synapses and other synaptic profiles suffered alterations in diabetes. However, in PACAP-treated diabetic retinas more bipolar ribbon synapses were found intact in the inner plexiform layer than in DR animals. The ribbon synapse was marked with C-terminal binding protein 2/Bassoon and formed horseshoe-shape ribbons, which were more retained in PACAP-treated diabetic retinas than in DR rats. These results are supported by molecular biological data. The selective degeneration of related structures such as bipolar and ganglion cells could be ameliorated by PACAP treatment. In summary, intravitreal administration of PACAP may have therapeutic potential in streptozotocin-induced DR through maintaining synapse integrity in the vertical pathway.

  17. A vascular endothelial growth factor activating transcription factor increases the endothelial progenitor cells population and induces therapeutic angiogenesis in a type 1 diabetic mouse with hindlimb ischemia

    Institute of Scientific and Technical Information of China (English)

    Diao Yongpeng; Lian Lishan; Guo Lilong; Chen Houzao; Chen Yuexin; Song Xiaojun; Li Yongjun

    2014-01-01

    Background Therapeutic angiogenesis has been shown to promote blood vessel growth and improve tissue perfusion.Vascular endothelial growth factor (VEGF) plays an important role in angiogenesis.However,it has side effects that limit its therapeutic utility in vivo,especially at high concentrations.This study aimed to investigate whether an intramuscular injection of a genetically engineered zinc finger VEGF-activating transcription factor modulates the endothelial progenitor cells (EPC) and promotes therapeutic angiogenesis in a hindlimb ischemia model with type 1 diabetes.Methods Alloxan (intravenous injection) was used to induce type Ⅰ diabetes in C57BL/6 mice (n=58).The ischemic limb received ZFP-VEGF (125 μg ZFP-VEGF plasmid in 1% poloxamer) or placebo (1% poloxamer) intramuscularly.Mice were sacrificed 3,5,10,or 20 days post-injection.Limb blood flow was monitored using laser Doppler perfusion imaging.VEGF mRNA and protein expression were examined using real-time PCR and ELISA,respectively.Capillary density,proliferation,and apoptosis were examined using immunohistochemistry techniques.Flow cytometry was used to detect the EPC population in bone marrow.Two-tailed Student's paired t test and repeated-measures analysis of variance were used for statistical analysis.Results ZFP-VEGF increased VEGF mRNA and protein expression at 3 and 10 days post-injection,and increased EPC in bone marrow at day 5 and 20 post-injection compared with controls (P<0.05).ZFP-VEGF treatment resulted in better perfusion recovery,a higher capillary density and proliferation,and less apoptosis compared with controls (P<0.05).Conclusions Intramuscular ZFP-VEGF injection promotes therapeutic angiogenesis in an ischemic hindlimb model with type 1 diabetes.This might be due to the effects of VEGF on cell survival and EPC recruitment.

  18. Therapeutic effects of ghrelin and growth hormone releasing peptide 6 on gastroparesis in streptozotocin-induced diabetic guinea pigs in vivo and in vitro

    Institute of Scientific and Technical Information of China (English)

    QIU Wen-cai; WANG Zhi-gang; WANG Wei-gang; YAN Jun; ZHENG Qi

    2008-01-01

    Background Diabetic gastroparesis is a disabling condition with no consistently effective treatment.In normal animals,both ghrelin and its synthetic peptide,growth hormone releasing peptide 6(GHRP-6),increase gastric emptying.Thus,we investigated the potential therapeutic significance of ghrelin and GHRP-6 in diabetic guinea pigs with gastric motility disorders.Methods A diabetic guinea pig model was produced by intraperitoneal(i.p.)injection of streptozotocin(STZ,280 mg/kg).Diabetic guinea pigs were injected i.p.with ghrelin or GHRP-6(10-100 pg/kg),and the effects on gastric emptying were measured after intragastric application of phenol red.The effect of atropine or a growth hormone secretagogue receptor(GHS-R)antagonist,D-Lys3-GHRP-6,on the gastroprokinetic effects of ghrelin or GHRP-6(100 μg/kg)was also investigated.Further,the in vitro effects of ghrelin or GHRP-6(0.01-10 μmol/L)on spontaneous or carbachol-induced contractile amplitude in gastric fundic circular strips taken from diabetic guinea pigs were examined.Growth hormone secretagogue receptor transcripts in the fundic strips of diabetic guinea pigs were detected by reverse transcriptase polymerase chain reaction(RT-PCR).Results We established a guinea pig model of delayed gastric emptying.Ghrelin(20,50,or 100 μg/kg)and GHRP-6 (20,50,or 1 00 μg/kg)accelerated gastric emptying in diabetic guinea pigs with gastroparesis(n=-6,P<0.05).In the presence of atropine,which delayed gastric emptying,ghrelin and GHRP-6(100 μg/kg)failed to accelerate gastric emptying(n=6,P<0.05).D-Lys3-GHRP-6 also delayed gastric emptying induced by the GHS-R agonist(n=6,P<0.05).Ghrelin and GHRP-6 increased the carbachol-induced contractile amplitude in gastric fundic strips taken from diabetic guinea pigs(n=6,P<0.05).RT-PCR confirmed the presence of GHS-R mRNA in the strip preparations.Conclusions Ghrelin and GHRP-6 increased gastric emptying in diabetic guinea pigs with gastroparesis,potentially,by activating the

  19. Diabetes.

    Science.gov (United States)

    Lomberk, Gwen

    2009-01-01

    Pancreatologists have often divided research of the pancreas based upon the origin of the function or disease, namely the endocrine or exocrine pancreas. In fact, as a result, many of our meetings and conferences have followed separate paths. Interestingly, among patients with chronic pancreatitis and pancreatic cancer, both disorders of the exocrine pancreas, diabetes is common. However, the clinical features of the diabetes associated with these two differ. Peripheral insulin resistance and hyperinsulinemia are the predominant diabetic traits in pancreatic cancer, while reduced islet cell mass and impaired insulin secretion are observed more often in chronic pancreatitis. The causal relationship between diabetes and pancreatic cancer remains an intriguing but unanswered question. Since diabetes often precedes pancreatic cancer, it is regarded as a potential risk factor for malignancy. On the other hand, there remains the possibility that pancreatic cancer secretes diabetogenic factors. Regardless of how the science ultimately illuminates this issue, there is increasing interest in utilizing screening for diabetes to aid early detection of pancreatic tumor lesions. Therefore, in this issue of Pancreatology and the Web, we explore the topic of diabetes to keep us alert to this very important association, even if we study diseases of the exocrine pancreas.

  20. Diabetes

    DEFF Research Database (Denmark)

    Damm, Peter; Mathiesen, Elisabeth R

    2015-01-01

    For >30 years, insulin has been the drug of choice for the medical treatment of gestational diabetes mellitus. However, the use of oral hypoglycaemic agents has increased during the past 1–2 decades, so a recent comparison of treatment with glibenclamide, metformin or insulin in women with gestat......For >30 years, insulin has been the drug of choice for the medical treatment of gestational diabetes mellitus. However, the use of oral hypoglycaemic agents has increased during the past 1–2 decades, so a recent comparison of treatment with glibenclamide, metformin or insulin in women...... with gestational diabetes mellitus is highly relevant....

  1. Knowledge-based identification of the ERK2/STAT3 signal pathway as a therapeutic target for type 2 diabetes and drug discovery.

    Science.gov (United States)

    Kinoshita, Takayoshi; Doi, Kentaro; Sugiyama, Hajime; Kinoshita, Shuhei; Wada, Mutsuyo; Naruto, Shuji; Tomonaga, Atsushi

    2011-09-01

    Many existing agents for diabetes therapy are unable to restore or maintain normal glucose homeostasis or prevent the eventual emergence of hyperglycemia-related complication. Therefore, agents based on novel mechanisms are sought to complement and extend the current therapeutic approaches. Based on the initial paper research, we focused on active STAT3 as an attractive pharmacological target for type 2 diabetes. The subsequent text mining with a unique query to identify suppressors but not activators of STAT3 revealed the ERK2/STAT3 pathway as a novel diabetes target. The description of ERK2 inhibitors as diabetes target had not been found in our text mining research at present. The mechanism-based peptide inhibitor for ERK2 was identified using the knowledge of the KIM sequence, which has an important role in the recognition of cognate kinases, phosphatases, scaffold proteins, and substrates. The peptide inhibitor was confirmed to exert effects in vitro and in vivo. The peptide inhibitor conferred a significant decrease in HOMA-IR levels on Day 28 compared with that in the vehicle group. Besides lowering the fasting blood glucose level, the peptide inhibitor also attenuated the blood glucose increment in the fed state, as compared with the vehicle group.

  2. Thrice-daily biphasic insulin aspart 30 may be another therapeutic option for Chinese patients with type 2 diabetes inadequately controlled with oral antidiabetic agents

    Institute of Scientific and Technical Information of China (English)

    YANG Wen-ying; JI Qiu-he; ZHU Da-long; YANG Jin-kui; CHEN Lu-lu; LIU Zhi-min; YU De-min; YAN Li

    2009-01-01

    In subjects with type 2 diabetes inadequately controlled with oral antidiabetic agents (OADs), insulin therapy is usually started to improve glycaemic control after failure of diet, exercise and OADs.1 Although there is no standard way to introduce insulin treatment, premixed formulations are a popular option. They offer an alternative to basal-bolus therapy and provide basal and prandial coverage with a single injection. Indeed, Koivisto et al2 in 1999 reported that 39% of patients with type 2 diabetes worldwide used premixed insulin as part of their therapeutic regimen. The modem premixed insulins, such as biphasic insulin aspart 30 (BIAsp 30) are most frequently prescribed twice-daily (BID) in clinical Department of Endocrinology, China-Japan Friendship Hospital, Beijing 100029, China (Yang WY)

  3. Diabetes

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — These datasets provide de-identified insurance data for diabetes. The data is provided by three managed care organizations in Allegheny County (Gateway Health Plan,...

  4. Liraglutide: A review of its therapeutic use as a once daily GLP-1 analog for the management of type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Mala Dharmalingam

    2011-01-01

    Full Text Available Type 2 diabetes mellitus (T2DM is a progressive disease associated with significant morbidity and mortality. Even though progress have been accomplished in the management of type 2 diabetes, current treatment preferences for patients with this disease still fall short to address disease progression. With the present therapy, glycaemic control remains suboptimal and are often associated with weight gain and hypoglycaemia. Glucagon like peptide-1 (GLP-1 is an incretin hormone secreted from the small intestine that lowers fasting and postprandial glucose through multiple mechanisms including glucose-dependent insulin secretion, reduction of glucagon secretion, delaying gastric emptying and increased satiety. Liraglutide, a human glucagon-like peptide 1 (GLP-1 analogue is a treatment for T2DM that is administered as a once-daily subcutaneous injection. The efficacy and tolerability of liraglutide at doses of 0.6, 1.2, and 1.8 mg for T2DM, in combination with, and compared with, other T2DM treatments were investigated in the Liraglutide Effect and Action in Diabetes (LEAD Phase III clinical trial program. In the LEAD trial, treatment with liraglutide was associated with substantial improvements in glycaemic control and low risk of hypoglycaemia. In addition liraglutide significantly improved β-cell function, reduced systolic blood pressure (BP and induced weight loss. Overall, liraglutide was well tolerated. Recent data on safety and efficacy of liraglutide from real-life clinical practice settings also reiterate the better therapeutic profile of this molecule. Based on results from the LEAD programme, and real-life clinical experience, liraglutide has been demonstrated as an effective therapeutic intervention even at the early stage of diabetes regardless of with what, it has been used.

  5. Decreases in Dietary Glycemic Index Are Related to Weight Loss among Individuals following Therapeutic Diets for Type 2 Diabetes1234

    Science.gov (United States)

    Turner-McGrievy, Gabrielle M.; Jenkins, David J. A.; Barnard, Neal D.; Cohen, Joshua; Gloede, Lise; Green, Amber A.

    2011-01-01

    This study assessed the effect of changes in glycemic index (GI) and load (GL) on weight loss and glycated hemoglobin (HbA1c) among individuals with type 2 diabetes beginning a vegan diet or diet following the 2003 American Diabetes Association (ADA) recommendations. The study was a 22-wk, randomized trial of 99 participants with type 2 diabetes who were counseled to follow 1 of 2 diet treatments. GI and GL changes were assessed based on 3-d dietary records. The relationships between GI/GL and changes in weight and HbA1C were calculated. In an intention-to-treat analysis (n = 99), the vegan group reduced GI to a greater extent than the ADA group (P vegan group (P vegan or ADA diet in reducing body weight among people with type 2 diabetes. The reduction of body weight, in turn, was predictive of decreasing HbA1C. PMID:21653575

  6. Therapeutic Options for the Management of Postprandial Glucose in Patients With Type 2 Diabetes on Basal Insulin

    OpenAIRE

    Hinnen, Debbie A.

    2015-01-01

    In Brief For patients with type 2 diabetes who require add-on therapy to metformin plus basal insulin, GLP-1 receptor agonists may be a favorable option because they effectively manage postprandial glucose, reduce body weight, and have an overall favorable safety profile compared to other agents. Given the wide range of treatment combinations available for type 2 diabetes management, health professionals must partner with patients to determine the best choices based on patients’ individual li...

  7. Kinetic and molecular docking studies of loganin and 7-O-galloyl-D-sedoheptulose from Corni Fructus as therapeutic agents for diabetic complications through inhibition of aldose reductase.

    Science.gov (United States)

    Lee, Chan Mee; Jung, Hyun Ah; Oh, Sang Ho; Park, Chan Hum; Tanaka, Takashi; Yokozawa, Takako; Choi, Jae Sue

    2015-06-01

    Aldose reductase (AR) is a key enzyme in the polyol pathway that is strongly implicated in the pathogenesis of diabetic complications. AR inhibitors have been proposed as therapeutic agents for diabetic complications through suppression of sorbitol formation and accumulation. In this study, we evaluated whether two major compounds of Corni Fructus, loganin and 7-O-galloyl-D-sedoheptulose, had an inhibitory effect on diabetic complications through AR inhibition. Because the iridoid glycoside loganin and the low-molecular-weight polyphenol 7-O-galloyl-D-sedoheptulose showed marginal inhibitory activities against rat lens AR (RLAR) and human recombinant AR (HRAR) in inhibition assays, we performed enzyme kinetic analyses and molecular simulation of the interaction of these two compounds with AR to further investigate their potential as inhibitors of diabetic complications. In kinetic analysis using Lineweaver-Burk plots and Dixon plots, loganin and 7-O-galloyl-D-sedoheptulose were both mixed inhibitors of RLAR with inhibition constants (K i) of 27.99 and 128.68 μΜ, respectively. Moreover, molecular docking simulation of both compounds demonstrated negative binding energies (Autodock 4.0 = -6.7; -7.5 kcal/mol; Fred 2.0 = -59.4; -63.2 kcal/mol) indicating a high affinity and tight binding capacity for the active site of the enzyme. Iridoid nucleus and aromatic ring systems and glycoside and sedoheptulose moieties were found to bind tightly to the specificity pocket and the anion binding pocket in RLAR through Phe123, His111, Trp21, Tyr49, His111, and Trp112 residues. Our results clearly indicate that loganin and 7-O-galloyl-D-sedoheptulose have great promise for the treatment of diabetic complications through inhibition of AR.

  8. Using data mining techniques to explore physicians' therapeutic decisions when clinical guidelines do not provide recommendations: methods and example for type 2 diabetes.

    Science.gov (United States)

    Toussi, Massoud; Lamy, Jean-Baptiste; Le Toumelin, Philippe; Venot, Alain

    2009-06-10

    Clinical guidelines carry medical evidence to the point of practice. As evidence is not always available, many guidelines do not provide recommendations for all clinical situations encountered in practice. We propose an approach for identifying knowledge gaps in guidelines and for exploring physicians' therapeutic decisions with data mining techniques to fill these knowledge gaps. We demonstrate our method by an example in the domain of type 2 diabetes. We analyzed the French national guidelines for the management of type 2 diabetes to identify clinical conditions that are not covered or those for which the guidelines do not provide recommendations. We extracted patient records corresponding to each clinical condition from a database of type 2 diabetic patients treated at Avicenne University Hospital of Bobigny, France. We explored physicians' prescriptions for each of these profiles using C5.0 decision-tree learning algorithm. We developed decision-trees for different levels of detail of the therapeutic decision, namely the type of treatment, the pharmaco-therapeutic class, the international non proprietary name, and the dose of each medication. We compared the rules generated with those added to the guidelines in a newer version, to examine their similarity. We extracted 27 rules from the analysis of a database of 463 patient records. Eleven rules were about the choice of the type of treatment and thirteen rules about the choice of the pharmaco-therapeutic class of each drug. For the choice of the international non proprietary name and the dose, we could extract only a few rules because the number of patient records was too low for these factors. The extracted rules showed similarities with those added to the newer version of the guidelines. Our method showed its usefulness for completing guidelines recommendations with rules learnt automatically from physicians' prescriptions. It could be used during the development of guidelines as a complementary source from

  9. Endocrine and autocrine/paracrine modulators of brown adipose tissue mass and activity as novel therapeutic strategies against obesity and type 2 diabetes.

    Science.gov (United States)

    Scheideler, Marcel; Herzig, Stephan; Georgiadi, Anastasia

    2017-08-29

    The dramatically increasing world-wide prevalence of obesity is recognized as a risk factor for the development of various diseases. The growing research on the role of adipose tissue in controlling energy homeostasis and insulin sensitivity has revealed that the promotion of brown adipose tissue (BAT) activity and the browning of white adipose tissue (WAT) leads to multiple health benefits and prevents obesity and type 2 diabetes (T2D). Inducible thermogenic adipocytes do exist in adult humans and are linked with increased energy combustion and lower body fat mass. Thus brown adipocytes are currently placed at the center of attention for novel therapeutic strategies against metabolic diseases such as obesity and diabetes. Besides the classical, norepinephrine-mediated sympathetic recruitment and activation of thermogenic adipocytes, a number of novel circulating factors have been recently identified to have a positive or negative impact on thermogenic adipocyte formation and activity. In this review their mechanism of action and the plausible therapeutic applications will be summarized and discussed.

  10. National observatory on the therapeutic management in ambulatory care patients aged 65 and over, with type 2 diabetes, chronic pain or atrial fibrillation.

    Science.gov (United States)

    Becquemont, Laurent; Benattar-Zibi, Linda; Bertin, Philippe; Berrut, Gilles; Corruble, Emmanuelle; Danchin, Nicolas; Delespierre, Tiba; Derumeaux, Geneviève; Falissard, Bruno; Forette, Francoise; Hanon, Olivier; Pasquier, Florence; Pinget, Michel; Ourabah, Rissane; Piedvache, Céline

    2013-01-01

    The primary objective of the S.AGES cohort is to describe the real-life therapeutic care of elderly patients. Patients and methods. This is a prospective observational cohort study of 3 700 non-institutionalized patients over the age of 65 years with either type 2 diabetes mellitus (T2DM), chronic pain or atrial fibrillation (AF) recruited by French general practitioners (GPs). Follow-up is planned for 3 years. Baseline characteristics. In the chronic pain sub-cohort, 33% of patients are treated with only grade 1 analgesics, 29% with grade 2 analgesics and 3% with grade 3 analgesics, and 22% have no pain treatment. In the T2DM sub-cohort, 61% of patients have well-controlled diabetes (Hb1c<7%) and 18% are treated with insulin. In the AF sub-cohort, 65% of patients have a CHADS2 score greater than 2, 77% are treated with oral anticoagulants, 17% with platelet inhibitors, 40% with antiarrhythmic drugs and 56% with rate slowing medications. Conclusion. The S.AGES cohort presents a unique opportunity to clarify the real-life therapeutic management of ambulatory elderly subjects and will help to identify the factors associated with the occurrence of major clinical events.

  11. Therapeutic potential of the anti-diabetic agent metformin in targeting the skin cancer stem cell diaspora.

    Science.gov (United States)

    Reddi, Anand; Powers, Matthew A; Dellavalle, Robert P

    2014-05-01

    Type II diabetes is associated with increased prevalence of cancer including both melanoma and squamous cell carcinoma (SCC) of the skin. Emerging evidence from epidemiological studies suggest that diabetic patients on metformin have a lower risk of cancer incidence and mortality in a broad range of neoplasms. In both melanoma and SCC, populations of cancer stem cells (CSC) contribute to tumor initiation and metastasis. We propose that metformin constitutes a new class of targeted therapy that acts on the skin CSC diaspora. We posit that metformin selectively and simultaneously targets CSCs of the primary tumor as well as in metastatic niches thereby disrupting the dynamic dispersal of circulating CSCs between the primary tumor and metastatic site. This hypothesis suggests a new concept in dermato-oncology that treatment of type II diabetes and prevention of skin cancer are two sides of the same coin.

  12. Lipid accumulation is ahead of epithelial-to-mesenchymal transition and therapeutic intervention by acetyl-CoA carboxylase 2 silence in diabetic nephropathy.

    Science.gov (United States)

    Xu, Ying; Huang, Jing; Xin, Wei; Chen, Liyong; Zhao, Xu; Lv, Zhimei; Liu, Yi; Wan, Qiang

    2014-05-01

    The study investigated the relationship between epithelial-to-mesenchymal transition (EMT) and lipotoxicity in diabetic nephropathy as well as the protective effect of acetyl-CoA carboxylase 2 (ACC2) silence. High glucose (30mmol/L) cultured human proximal tubular epithelial cells (HK-2 cells) were used. Triglyceride content, fatty acid β-oxidation rate, malonyl CoA content, and marker proteins of EMT, including E-cadherin (E-cad), α-smooth muscle actin (α-SMA) and transforming grow factor-β (TGF-β), were assessed. Silence of ACC2 was achieved by ACC2-shRNA lentivirus transfection. In cultured human proximal tubular cells, high glucose induced fatty acid deposit before phenotypical and morphological changes of EMT. At 48h, more triglyceride content, more malonyl CoA content and lower fatty acid β-oxidation rate were detected. However, increased expression of TGF-β, accompanied by loss of E-cad and acquisition of α-SMA, was observed at 98h but not at 48h. The silence of ACC2 in HK-2 cells led to restored cell morphology with less lipid deposition and less malonyl-CoA content, which resulted from faster β-oxidation rate. The progress of lipotoxicity participates in the development of diabetic nephropathy in early stage before EMT. The manipulation of lipid metabolism might act as a promising therapeutic intervention for diabetic nephropathy. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. 2型糖尿病的运动治疗机制研究进展%The Research Progress of Exercise Therapeutic Mechanisms of Type 2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    徐国琴; 陈建才; 林文弢

    2012-01-01

    Using the literature review method, this paper reviews the pathogenesis of type 2 diabetes and exercise therapeutic mechanisms. The study results have shown that the disorders of glucose and lipid metabolism, oxidative stress, low-grade in- flammation and endoplasmic reticulum stress are related with the development of type 2 diabetes. Exercise can improve glucose and lipid metabolism status, insulin resistance, endocrine disorder status, inflammatory status, oxidative stress and endoplasmic reticulum stressqnduced factors to treat diabetes.%应用文献资料法对2型糖尿病的发病机制和运动治疗机制进行综述,研究表明糖脂代谢紊乱、氧化应激、低度炎症和内质网应激均与2型糖尿病的发生发展有关。运动可通过改善糖脂代谢状态、外周组织胰岛素抵抗、内分泌紊乱状态、炎症状态、氧化应激状态和内质网应激相关诱发因子等途径治疗糖尿病。

  14. Therapeutic effect of phytoecdysteroids rich extract from Ajuga iva on alloxan induced diabetic rats liver, kidney and pancreas.

    Science.gov (United States)

    Hamden, Khaled; Ayadi, Fatma; Jamoussi, Kamel; Masmoudi, Hatem; Elfeki, Abdelfattah

    2008-01-01

    In the current study, the effect of Ajuga iva extract on blood glucose, lipid profile, hepatic and renal toxicity and antioxidant enzyme activities in alloxan-induced diabetic rats was investigated. Diabetes was confirmed by measuring the glucoserua concentration 15 days after alloxan administration. Ajuga iva extract was administrated orally 3 weeks after alloxan injection. Our results investigate that Ajuga iva extract supplementation increased the levels of both enzymatic antioxidant (superoxide dismutase, catalase and glutathione peroxidase) and metals antioxidants (iron, copper, magnesium, calcium) and decreased lipid peroxidation level (TBARs). Besides Ajuga iva ameliorated diabetes provoked hepatic and renal toxicity appeared by a lower level in total and direct bilirubin, urea, creatinine, triglyceride (TG), cholesterol and a higher level in HDL-cholesterol. Besides, the activities of phosphatase alkalines (PAL), aspartate and lactate transaminase (AST & ALT) were decreased. The benefices effects of phytoecdysteroids of Ajuga iva confirmed by histological observation in pancreatic tissues. In conclusion, Ajuga iva phytoecdysteroids supplements seem to be beneficial for correcting the hyperglycemia and preventing diabetic complications in liver, pancreas and kidneys.

  15. Difficulties in reaching therapeutic goals for hypertension and dysplipidaemia in patients with type 2 diabetes in general practice

    DEFF Research Database (Denmark)

    Knudsen, Søren Tang; Mosbech, Thomas Hammershaimb; Hansen, Birtha Petrea

    2013-01-01

    National guidelines recommend strict control of blood pressure (BP) and plasma low-density lipoprotein cholesterol (LDL) in type 2 diabetes (T2DM), aiming at a BP ≤ 130/80 mmHg and an LDL concentration ≤ 2.5 mmol/l. Angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II-receptor blockers...

  16. Is the current therapeutic armamentarium in diabetes enough to control the epidemic and its consequences? What are the current shortcomings?

    DEFF Research Database (Denmark)

    Giugliano, Dario; Standl, Eberhard; Vilsbøll, Tina;

    2009-01-01

    glycated haemoglobin targets, trial data show that such interventions reduce the incidence of macrovascular events; however, intensive lowering may be detrimental in patients with existing cardiovascular disease. Currently available oral drugs do not address the key driver of type 2 diabetes...

  17. Patients' empowerment , physicians' perceptions, and achievement of therapeutic goals in patients with type 1 and type 2 diabetes mellitus in Mexico

    Directory of Open Access Journals (Sweden)

    Lavalle-González FJ

    2016-07-01

    Full Text Available Fernando J Lavalle-González,1 Erwin Chiquete2 On behalf of the IDMPS-3W Collaborative Group (Mexico 1Department of Endocrinology, Hospital Universitario Dr José Eleuterio González, Monterrey, NL, 2Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico Background: Physicians’ perception may not parallel objective measures of therapeutic targets in patients with diabetes. This is an issue rarely addressed in the medical literature. We aimed to analyze physicians’ perception and characteristics of adequate control of patients with diabetes.Patients and methods: We studied information on physicians and their patients who participated in the third wave of the International Diabetes Management Practices Study registry in Mexico. This analysis was performed on 2,642 patients, 203 with type 1 diabetes mellitus (T1DM and 2,439 with type 2 diabetes mellitus (T2DM, treated by 200 physicians.Results: The patients perceived at target had lower hemoglobin A1c (HbA1c and fasting blood glucose than those considered not at target. However, overestimation of the frequency of patients with HbA1c <7% was 41.5% in patients with T1DM and 31.7% in patients with T2DM (underestimation: 2.8% and 8.0%, respectively. The agreement between the physicians’ perception and the class of HbA1c was suboptimal (κ: 0.612. Diabetologists and endocrinologists tested HbA1c more frequently than primary care practitioners, internists, or cardiologists; however, no differences were observed in mean HbA1c, for both T1DM (8.4% vs 7.2%, P=0.42 and T2DM (8.03% vs 8.01%, P=0.87 patients. Nevertheless, insulin users perceived at target, who practiced self-monitoring and self-adjustment of insulin, had a lower mean HbA1c than patients without these characteristics (mean HbA1c in T1DM: 6.8% vs 9.6%, respectively; mean HbA1c in T2DM: 7.0% vs 10.1%, respectively.Conclusion: Although there is a significant

  18. Potential therapeutic applications of multifunctional host-defense peptides from frog skin as anti-cancer, anti-viral, immunomodulatory, and anti-diabetic agents.

    Science.gov (United States)

    Conlon, J Michael; Mechkarska, Milena; Lukic, Miodrag L; Flatt, Peter R

    2014-07-01

    Frog skin constitutes a rich source of peptides with a wide range of biological properties. These include host-defense peptides with cytotoxic activities against bacteria, fungi, protozoa, viruses, and mammalian cells. Several hundred such peptides from diverse species have been described. Although attention has been focused mainly on antimicrobial activity, the therapeutic potential of frog skin peptides as anti-infective agents remains to be realized and no compound based upon their structures has yet been adopted in clinical practice. Consequently, alternative applications are being explored. Certain naturally occurring frog skin peptides, and analogs with improved therapeutic properties, show selective cytotoxicity against tumor cells and viruses and so have potential for development into anti-cancer and anti-viral agents. Some peptides display complex cytokine-mediated immunomodulatory properties. Effects on the production of both pro-inflammatory and anti-inflammatory cytokines by peritoneal macrophages and peripheral blood mononuclear cells have been observed so that clinical applications as anti-inflammatory, immunosuppressive, and immunostimulatory agents are possible. Several frog skin peptides, first identified on the basis of antimicrobial activity, have been shown to stimulate insulin release both in vitro and in vivo and so show potential as incretin-based therapies for treatment of patients with Type 2 diabetes mellitus. This review assesses the therapeutic possibilities of peptides from frogs belonging to the Ascaphidae, Alytidae, Pipidae, Dicroglossidae, Leptodactylidae, Hylidae, and Ranidae families that complement their potential role as anti-infectives for use against multidrug-resistant microorganisms.

  19. Therapeutic efficacy of melatonin in reducing retinal damage in an experimental model of early type 2 diabetes in rats.

    Science.gov (United States)

    Salido, Ezequiel M; Bordone, Melina; De Laurentiis, Andrea; Chianelli, Mónica; Keller Sarmiento, María Inés; Dorfman, Damián; Rosenstein, Ruth E

    2013-03-01

    Diabetic retinopathy (DR) is a leading cause of acquired blindness in adults, mostly affected by type 2 diabetes mellitus (T2DM). We have developed an experimental model of early T2DM in adult rats which mimics some features of human T2DM at its initial stages and provokes significant retinal alterations. The aim of this work was to analyze the effect of melatonin on retinal changes induced by the moderate metabolic derangement. For this purpose, adult male Wistar rats received a control diet or 30% sucrose in the drinking water. Three weeks after this treatment, animals were injected with vehicle or streptozotocin (STZ, 25 mg/kg). One day or 3 wk after vehicle or STZ injection, animals were subcutaneously implanted with a pellet of melatonin. Fasting and postprandial glycemia, and glucose, and insulin tolerance tests were analyzed. At 12 wk of treatment, animals which received a sucrose-enriched diet and STZ showed significant differences in metabolic tests, as compared with control groups. Melatonin, which did not affect glucose metabolism in control or diabetic rats, prevented the decrease in the electroretinogram a-wave, b-wave, and oscillatory potential amplitude, and the increase in retinal lipid peroxidation, NOS activity, TNFα, Müller cells glial fibrillary acidic protein, and vascular endothelial growth factor levels. In addition, melatonin prevented the decrease in retinal catalase activity. These results indicate that melatonin protected the retina from the alterations observed in an experimental model of DR associated with type 2 diabetes.

  20. [Construction of yeast strains expressing long-acting glucagon-like peptide-1 (GLP-1) and their therapeutic effects on type 2 diabetes mellitus mouse model].

    Science.gov (United States)

    Ri, Wu; Chao, Ma; Xiaodan, Li; Huikun, Duan; Yanli, Ji; Yu, Wang; Pingzhe, Jiang; Haisong, Wang; Peipei, Tu; Miao, Li; Ganggang, Ni; Baicheng, Ma; Minggang, Li

    2015-02-01

    Probiotics, i.e., bacteria expressing therapeutic peptides (protein), are used as a new type of orally administrated biologic drugs to treat diseases. To develop yeast strains which could effectively prevent and treat type 2 diabetes mellitus, we firstly constructed the yeast integrating plasmid pNK1-PGK which could successfully express green fluorescent protein (GFP) in Saccharomyces cerevisiae. The gene encoding ten tandem repeats of glucagon-like peptide-1(10 × GLP-1) was cloned into the vector pNK1-PGK and the resulting plasmids were then transformed into the S. cerevisiae INVSc1. The long-acting GLP-1 hypoglycemic yeast (LHY) which grows rapidly and expresses 10 × GLP-1 stably was selected by nutrition screening and Western blotting. The amount of 10 × GLP-1 produced by LHY reached 1.56 mg per gram of wet cells. Moreover, the oral administration of LHY significantly reduced blood glucose level in type 2 diabetic mice induced by streptozotocin plus high fat and high sugar diet.

  1. Therapeutic properties of VO(dmpp)2 as assessed by in vitro and in vivo studies in type 2 diabetic GK rats.

    Science.gov (United States)

    Domingues, N; Pelletier, J; Ostenson, C-G; Castro, M M C A

    2014-02-01

    The bis(1,2-dimethyl-3-hydroxy-4-pyridinonato)oxidovanadium(IV), VO(dmpp)2, has shown anti-diabetic effects by in vitro studies in Wistar (W) rat adipocytes and in vivo in obese Zucker rats. The aim of this work is to confirm the therapeutic properties of VO(dmpp)2 in non-obese type 2 diabetic Goto-Kakizaki (GK) rats. An in vivo study was carried out, treating W and GK rats during 21 days with a daily dose of VO(dmpp)2 (44 μmol/kg). It was shown that VO(dmpp)2 doesn't affect the normal increase of body weight of both W and GK rats, after 8 days of treatment ameliorates glycemia in GK rats (8.4 ± 0.3 vs 10.1 ± 0.2 mM in GK control, Pdmpp)2 significantly enhances [3-(3)H]-glucose uptake by W and GK rat adipocytes (non-toxic concentration of 100 μM: respectively 193 ± 20 and 254 ± 21%, Pdmpp)2 significantly promotes IRS2 (P<0.05) and p-AKT expression (P<0.001 and P<0.05, respectively, relative to the respective controls) and in GK animals reduces the increase of PTP1β expression (P<0.001, relative to GK control).

  2. Genotype Phenotype Correlation of Genetic Polymorphism of PPAR Gamma Gene and Therapeutic Response to Pioglitazone in Type 2 Diabetes Mellitus- A Pilot Study

    Science.gov (United States)

    Sankaran, Ramalingam; Ramalingam, Sudha; Sairam, Thiagarajan; Somasundaram, LS

    2016-01-01

    Introduction Pro12Ala polymorphism is a missense mutation at codon 12 in peroxisome proliferator-activated receptor γ gene (PPARG). This polymorphism is known to be associated with increased insulin sensitivity. Pioglitazone, a thiazolidinedione, is an anti-diabetic drug which acts as an agonist at PPAR γ receptor. Aim To determine the association between Pro12Ala polymorphism of the PPARG and variation in therapeutic response to the PPARγ agonist, pioglitazone. Materials and Methods The study was done as a hospital based pilot project in 30 patients with type 2 diabetes mellitus, on treatment with sulfonylurea or metformin but without adequate glycaemic control. They were started on pioglitazone as add on therapy for a period of 12 weeks. The participants were categorized as responders and non-responders based on the change in HbA1C level after 12 weeks. Pro12Ala polymorphism was analysed by polymerase chain reaction-restriction fragment length polymorphism. Statistical Analysis Logistic regression analysis was done to evaluate the associations between age, baseline body weight, BMI, waist circumference, waist-hip ratio and Pro12Ala variants with the response to pioglitazone. The p-valuePro12Ala polymorphism and glycaemic response to pioglitazone. PMID:27042481

  3. Observation on the Therapeutic Effect of Diabetes Mellitus Complicated With Hyperthyroidism%关于糖尿病合并甲亢的治疗效果观察

    Institute of Scientific and Technical Information of China (English)

    刘秀娟; 周晓佳

    2016-01-01

    Objective To investigate the treatment of diabetes mellitus complicated with hyperthyroidism (hyperthyroidism). Methods Combining humulin treatment 50 cases of our hospital treatment of diabetes complicated with hyperthyroidism patients, control group of 25 cases treated with hydrochloric acid metformin tablets in the treatment, the experimental group 25 patients in this foundation, comparative analysis of the therapeutic effect of two groups of patients. Results The effective rate of treatment in the experimental group was 96%, the effective rate of the control group was 56%, the difference between the two groups was statistically signiifcant. Conclusion The combined treatment effect of metformin hydrochloride tablets and the superior and the combined treatment of the patients with diabetes and hyperthyroidism is obvious, which is the ifrst choice for clinical treatment.%目的探讨糖尿病合并甲状腺功能亢进症(甲亢)的治疗。方法选择我院治疗的糖尿病合并甲亢患者50例,对照组25例口服盐酸二甲双胍片治疗,实验组25例患者在此基础上结合优泌林治疗,对比分析两组患者的治疗效果。结果实验组患者治疗有效率是96%,对照组治疗有效率是56%,两组的治疗有效率对比差异具有统计学意义。结论临床中为糖尿病合并甲亢患者采取盐酸二甲双胍片联合优泌林治疗具有非常好的效果,是临床治疗的首选药物。

  4. Rare sugar D-allulose: Potential role and therapeutic monitoring in maintaining obesity and type 2 diabetes mellitus.

    Science.gov (United States)

    Hossain, Akram; Yamaguchi, Fuminori; Matsuo, Tatsuhiro; Tsukamoto, Ikuko; Toyoda, Yukiyasu; Ogawa, Masahiro; Nagata, Yasuo; Tokuda, Masaaki

    2015-11-01

    Obesity and type 2 diabetes mellitus (T2DM) are the leading worldwide risk factors for mortality. The inextricably interlinked pathological progression from excessive weight gain, obesity, and hyperglycemia to T2DM, usually commencing from obesity, typically originates from overconsumption of sugar and high-fat diets. Although most patients require medications, T2DM is manageable or even preventable with consumption of low-calorie diet and maintaining body weight. Medicines like insulin, metformin, and thiazolidinediones that improve glycemic control; however, these are associated with weight gain, high blood pressure, and dyslipidemia. These situations warrant the attentive consideration of the role of balanced foods. Recently, we have discovered advantages of a rare sugar, D-allulose, a zero-calorie functional sweetener having strong anti-hyperlipidemic and anti-hyperglycemic effects. Study revealed that after oral administration in rats D-allulose readily entered the blood stream and was eliminated into urine within 24h. Cell culture study showed that D-allulose enters into and leaves the intestinal enterocytes via glucose transporters GLUT5 and GLUT2, respectively. In addition to D-allulose's short-term effects, the characterization of long-term effects has been focused on preventing commencement and progression of T2DM in diabetic rats. Human trials showed that D-allulose attenuates postprandial glucose levels in healthy subjects and in borderline diabetic subjects. The anti-hyperlipidemic effect of D-allulose, combined with its anti-inflammatory actions on adipocytes, is beneficial for the prevention of both obesity and atherosclerosis and is accompanied by improvements in insulin resistance and impaired glucose tolerance. Therefore, this review presents brief discussions focusing on physiological functions and potential benefits of D-allulose on obesity and T2DM.

  5. Achieving therapeutic goals in insulin-using diabetic patients with non-insulin-dependent diabetes mellitus. A weight reduction-exercise-oral agent approach.

    Science.gov (United States)

    Lucas, C P; Patton, S; Stepke, T; Kinhal, V; Darga, L L; Carroll-Michals, L; Spafford, T R; Kasim, S

    1987-09-18

    Non-insulin-dependent diabetes mellitus (NIDDM) is the most common form of diabetes in the civilized world. Its consequences include microvascular and macrovascular disease, both of which appear to evolve from a common background of obesity and physical inactivity. The current study was undertaken in obese patients with NIDDM to see whether improvements could be made in glycemic control as well as in many cardiovascular risk factors (obesity, hypertension, lipid abnormalities, and physical inactivity) that are typical of this condition. Fifteen obese insulin-using patients with NIDDM (average body mass index, 34.0) were treated with a 500-calorie formula diet for eight to 12 weeks. Administration of insulin and diuretics was discontinued at the onset of the study. A eucaloric diet was begun at eight to 12 weeks and maintained until Week 24. A behaviorally oriented nutrition-exercise program was instituted at the beginning of the study. Glipizide or placebo was added (randomized) at Week 15 if the fasting plasma glucose level in patients exceeded 115 mg/dl. Patients lost an average of 22 pounds over the course of 24 weeks. Frequency and duration of physical activity increased significantly from baseline, as did the maximal oxygen consumption rate. Glycemic control by 15 weeks (without insulin) was similar to baseline (with insulin). With the addition of glipizide at Week 15, both fasting plasma glucose and glucose tolerance improved significantly. This improvement was not observed with placebo. In addition, both systolic and diastolic blood pressure decreased by about 10 mm Hg. There were no significant changes in the levels of serum lipids or glycosylated hemoglobin. In conclusion, a multifaceted intervention program, employing weight reduction, exercise, diet, and glipizide therapy, can be instituted in insulin-using patients with NIDDM, with improvement in glycemic control and in certain risk factors (hypertension, obesity, physical inactivity) for cardiovascular

  6. Greater clinical benefit of more intensive oral antiplatelet therapy with prasugrel in patients with diabetes mellitus in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel-Thrombolysis in Myocardial Infarction 38.

    NARCIS (Netherlands)

    Wiviott, S.D.; Braunwald, E.; Angiolillo, D.J.; Meisel, S.; Dalby, A.J.; Verheugt, F.W.A.; Goodman, S.G.; Corbalan, R.; Purdy, D.A.; Murphy, S.A.; McCabe, C.H.; Antman, E.M.

    2008-01-01

    BACKGROUND: Patients with diabetes mellitus (DM) are at high risk for recurrent cardiovascular events after acute coronary syndromes, in part because of increased platelet reactivity. The Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel-Thrombolysi

  7. Salacinol and Related Analogs: New Leads for Type 2 Diabetes Therapeutic Candidates from the Thai Traditional Natural Medicine Salacia chinensis

    Directory of Open Access Journals (Sweden)

    Toshio Morikawa

    2015-02-01

    Full Text Available The antidiabetic effect of a hot water extract of stems of Salacia chinensis (SCE was evaluated in vivo in KK-Ay mice, a typical type 2 diabetes mellitus mice model. Administration of CE-2 dietary feed containing 0.25 and/or 0.50% of SCE for three weeks to KK-Ay mice significantly suppressed the elevation of both blood glucose and HbA1c levels without significant changes in body weight or food intake. Glucose tolerance was improved by administration to KK-Ay mice for 27 days of AIN93M purified dietary feed containing 0.12% of SCE. No suppressive effect with respect to HbA1c level was observed when AIN93M/Glc dietary feed in which all digestible glucides were replaced with glucose was administered with SCE. Thus, α-glucosidase inhibitory activity approved as the mechanism of action of the antidiabetic effect of SCE by in vitro investigation was reconfirmed also in in vivo studies. Evaluation of the α-glucosidase inhibitory activity of the active constituents, salacinol (1, kotalanol (3, and neokotalanol (4, by employing human α-glucosidases revealed that these compounds inhibited them as potently (IC50 = 3.9–4.9 μM for maltase as they inhibited rat small intestinal α-glucosidase. The principal sulfonium constituents (1–4 were highly stable in an artificial gastric juice. In addition, 1–4 were hardly absorbed from the intestine in an experiment using the in situ rat ligated intestinal loop model. The results indicate that these sulfoniums are promising leads for a new type of anti-diabetic agents.

  8. Salacinol and Related Analogs: New Leads for Type 2 Diabetes Therapeutic Candidates from the Thai Traditional Natural Medicine Salacia chinensis

    Science.gov (United States)

    Morikawa, Toshio; Akaki, Junji; Ninomiya, Kiyofumi; Kinouchi, Eri; Tanabe, Genzoh; Pongpiriyadacha, Yutana; Yoshikawa, Masayuki; Muraoka, Osamu

    2015-01-01

    The antidiabetic effect of a hot water extract of stems of Salacia chinensis (SCE) was evaluated in vivo in KK-Ay mice, a typical type 2 diabetes mellitus mice model. Administration of CE-2 dietary feed containing 0.25 and/or 0.50% of SCE for three weeks to KK-Ay mice significantly suppressed the elevation of both blood glucose and HbA1c levels without significant changes in body weight or food intake. Glucose tolerance was improved by administration to KK-Ay mice for 27 days of AIN93M purified dietary feed containing 0.12% of SCE. No suppressive effect with respect to HbA1c level was observed when AIN93M/Glc dietary feed in which all digestible glucides were replaced with glucose was administered with SCE. Thus, α-glucosidase inhibitory activity approved as the mechanism of action of the antidiabetic effect of SCE by in vitro investigation was reconfirmed also in in vivo studies. Evaluation of the α-glucosidase inhibitory activity of the active constituents, salacinol (1), kotalanol (3), and neokotalanol (4), by employing human α-glucosidases revealed that these compounds inhibited them as potently (IC50 = 3.9–4.9 μM for maltase) as they inhibited rat small intestinal α-glucosidase. The principal sulfonium constituents (1–4) were highly stable in an artificial gastric juice. In addition, 1–4 were hardly absorbed from the intestine in an experiment using the in situ rat ligated intestinal loop model. The results indicate that these sulfoniums are promising leads for a new type of anti-diabetic agents. PMID:25734563

  9. In vitro design of a novel lytic bacteriophage cocktail with therapeutic potential against organisms causing diabetic foot infections.

    Science.gov (United States)

    Mendes, João J; Leandro, Clara; Mottola, Carla; Barbosa, Raquel; Silva, Filipa A; Oliveira, Manuela; Vilela, Cristina L; Melo-Cristino, José; Górski, Andrzej; Pimentel, Madalena; São-José, Carlos; Cavaco-Silva, Patrícia; Garcia, Miguel

    2014-08-01

    In patients with diabetes mellitus, foot infections pose a significant risk. These are complex infections commonly caused by Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter baumannii, all of which are potentially susceptible to bacteriophages. Here, we characterized five bacteriophages that we had determined previously to have antimicrobial and wound-healing potential in chronic S. aureus, P. aeruginosa and A. baumannii infections. Morphological and genetic features indicated that the bacteriophages were lytic members of the family Myoviridae or Podoviridae and did not harbour any known bacterial virulence genes. Combinations of the bacteriophages had broad host ranges for the different target bacterial species. The activity of the bacteriophages against planktonic cells revealed effective, early killing at 4 h, followed by bacterial regrowth to pre-treatment levels by 24 h. Using metabolic activity as a measure of cell viability within established biofilms, we found significant cell impairment following bacteriophage exposure. Repeated treatment every 4 h caused a further decrease in cell activity. The greatest effects on both planktonic and biofilm cells occurred at a bacteriophage : bacterium input multiplicity of 10. These studies on both planktonic cells and established biofilms allowed us to better evaluate the effects of a high input multiplicity and a multiple-dose treatment protocol, and the findings support further clinical development of bacteriophage therapy. © 2014 The Authors.

  10. The effects of structured self-monitoring of blood glucose on therapeutic effectiveness and adherence in patients with type 2 diabetes mellitus initiating insulin treatment

    Directory of Open Access Journals (Sweden)

    Lyudmila Aleksandrovna Suvorova

    2013-12-01

    Full Text Available Aim. To compare the efficiency of standard and structured approaches to self-monitoring of blood glucose (SMBG in patients with type 2 diabetes mellitus (T2DM initiating insulin treatment.Materials and Methods. This open prospective randomized clinical trial included 51 T2DM patients who initiated insulin therapy in either outpatient or inpatient setting. Subjects were randomized in standard and structured SMBG groups, the structured group used an advanced Accu-Chek 360 View protocol. Evaluation included clinical examination and laboratory testing of HbA1c levels at the beginning of the treatment and after 3 months of the follow-up period.Results. 70% of the structured self-monitoring group and 32% of the control group achieved therapeutic goals (p=0.008. Higher adherence was associated with better glycemic control in both groups – and vice versa. However, among patients with low adherence, 73% of advanced SMBG group managed to achieve therapeutic goals vs. 19% in the control group (p=0.005. In addition, patients in the structured monitoring group gained less weight as compared to the control (1.0±2.88 kg vs. 3.2±2.56 kg; p=0.005.Conclusion. Structured SMBG commenced at the initiation of insulin therapy improves glycemic control in a greater fraction of patients, especially in those with low adherence to treatment. Structured SMBG also partially alleviates weight gain as side effect of insulin treatment.

  11. Connexin-Based Therapeutics and Tissue Engineering Approaches to the Amelioration of Chronic Pancreatitis and Type I Diabetes: Construction and Characterization of a Novel Prevascularized Bioartificial Pancreas

    Directory of Open Access Journals (Sweden)

    J. Matthew Rhett

    2016-01-01

    Full Text Available Total pancreatectomy and islet autotransplantation is a cutting-edge technique to treat chronic pancreatitis and postoperative diabetes. A major obstacle has been low islet cell survival due largely to the innate inflammatory response. Connexin43 (Cx43 channels play a key role in early inflammation and have proven to be viable therapeutic targets. Even if cell death due to early inflammation is avoided, insufficient vascularization is a primary obstacle to maintaining the viability of implanted cells. We have invented technologies targeting the inflammatory response and poor vascularization: a Cx43 mimetic peptide that inhibits inflammation and a novel prevascularized tissue engineered construct. We combined these technologies with isolated islets to create a prevascularized bioartificial pancreas that is resistant to the innate inflammatory response. Immunoconfocal microscopy showed that constructs containing islets express insulin and possess a vascular network similar to constructs without islets. Glucose stimulated islet-containing constructs displayed reduced insulin secretion compared to islets alone. However, labeling for insulin post-glucose stimulation revealed that the constructs expressed abundant levels of insulin. This discrepancy was found to be due to the expression of insulin degrading enzyme. These results suggest that the prevascularized bioartificial pancreas is potentially a tool for improving long-term islet cell survival in vivo.

  12. Cross-talk between the Immune System and Tuberculosis Pathogenesis; a Review with Emphasis on the Immune Based Treatment

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Javan

    2016-11-01

    Full Text Available As a globally major health problem, tuberculosis (TB causes almost two million cases of death annually. Epidemiological studies demonstrate that a third of the world’s individuals is infected with Mycobacterium tuberculosis. Approximately 10% of infected patients with M. tuberculosis develop chronic manifestation as TB. Due to HIV coinfection and emerging the drug-resistant TB, the disease has been increasing and its control has been frustrated in several parts of the world.Current diagnostic techniques and therapeutic tools for TB are not satisfactory. Consequently, it is urgently essential to establish new therapies concerning vaccines, immunotherapeutic agents to provide prosperous attempts for TB controlling. To achieve this goal, it is required to be armed with comprehensive understanding of immunobiology and immunopathogenesis of TB. This would be beneficial in designing new immune-based protections, drug discoveries, personalized medicine by choosing highly-effective immunotherapeutic interventions, identification and development of novel drug candidates. Hopefully, immunotherapies could be advantageous in modulating the immune system in patients with TB, providing efficient control of M. tuberculosis infection perpetuation and, therefore, its pathogenesis. This review herein attempts to describe the function of immune system in response to TB that is of the therapeutical and clinical importance. Moreover, new insights based on therapeutics to resolve TB with immunological orientation will be discussed.

  13. A pessoa com diabete: do enfoque terapêutico ao existencial La persona con diabetes: del enfoque terapéutico al existencial The person with diabetes: from a therapeutic to an existential focus

    Directory of Open Access Journals (Sweden)

    Aracely Diaz Oviedo

    2009-12-01

    Full Text Available Realizou-se este estudo diante da inquietação com a pessoa com Diabetes, as implicações da doença em sua vida;. fundamentalmente, buscando um deslocamento da doença sob a ótica de um fato para a de um fenômeno, que requer desvelamentos. Conduzido sob o referencial da investigação fenomenológica, com vistas à apreensão da essência do significado de conviver com a doença. O estudo foi realizado obtendo depoimentos de pessoas que experienciam a doença. O contexto da investigação foi uma Instituição de Saúde, localizada na cidade de San Luis Potosí, no México. A análise dos dados possibilitou a construção de categorias temáticas, que revelam facetas importantes do existir dessas pessoas. Abriu perspectivas para um olhar para além da doença, contemplando a pessoa diabética em sua situcionalidade. E assim norteando alguns caminhos para políticas de assistência.Delante de la inquietud con la persona con Diabetes, de las implicaciones de la enfermedad en su vida y, fundamentalmente, buscando comprender la enfermedad como un fenómeno, ya que hasta ahora ha sido observada como un hecho, se realizó este estudio, tratando de obtener de revelaciones la información que ayuden a alcanzar el objetivo pretendido. Conducido bajo el marco de la investigación fenomenológica, con el objetivo de aprehender la esencia del significado de convivir con la enfermedad, el estudio fue realizado obteniendo declaraciones de personas que experimentan la enfermedad. El contexto de la investigación fue una Institución de Salud, localizada en la ciudad de San Luis Potosí, en México. El análisis de los datos posibilitó construir categorías temáticas que revelaron facetas importantes de la existencia de esas personas, abriendo perspectivas para observar más allá de la enfermedad, contemplando a la persona diabética en su situación integral, mostrando, así, algunos caminos para la creación de políticas de asistencia.This study was

  14. [Therapeutic education didactic techniques].

    Science.gov (United States)

    Valverde, Maite; Vidal, Mercè; Jansa, Margarida

    2012-10-01

    This article includes an introduction to the role of Therapeutic Education for Diabetes treatment according to the recommendations of the American Diabetes Association (ADA), the Diabetes Education Study Group (DESG) of the "European Association for Study of Diabetes (EASD) and the clinical Practice Guidelines (CPG) of the Spanish Ministry of Health. We analyze theoretical models and the differences between teaching vs. learning as well as current trends (including Internet), that can facilitate meaningful learning of people with diabetes and their families and relatives. We analyze the differences, similarities, advantages and disadvantages of individual and group education. Finally, we describe different educational techniques (metaplan, case method, brainstorming, role playing, games, seminars, autobiography, forums, chats,..) applicable to individual, group or virtual education and its application depending on the learning objective.

  15. [Diabetes mellitus in teenagers].

    Science.gov (United States)

    Isla Pera, Pilar

    2010-01-01

    Diabetes Mellitus during infancy childhood or adolescence does not differ from adult diabetes mellitus in terms of basic principles nor therapeutic treatment methods but the characteristics patients have during those ages signify that diabetes has a special repercussion and becomes harder to treat in patients during those ages.

  16. Mixed-meal tolerance test versus glucagon stimulation test for the assessment of beta-cell function in therapeutic trials in type 1 diabetes

    DEFF Research Database (Denmark)

    Greenbaum, Carla J; Mandrup-Poulsen, Thomas; McGee, Paula Friedenberg

    2008-01-01

    OBJECTIVE: Beta-cell function in type 1 diabetes clinical trials is commonly measured by C-peptide response to a secretagogue in either a mixed-meal tolerance test (MMTT) or a glucagon stimulation test (GST). The Type 1 Diabetes TrialNet Research Group and the European C-peptide Trial (ECPT) Stud...

  17. Increased protein aggregation in Zucker Diabetic Fatty rat brain : identification of key mechanistic targets and the therapeutic application of hydrogen sulfide

    NARCIS (Netherlands)

    Talaei, Fatemeh; Van Praag, Veroniek M; Shishavan, Mahdi H; Landheer, Sjoerd W; Buikema, Henk; Henning, Robert H

    2014-01-01

    Background: Diabetes and particularly high blood glucose levels are implicated in neurodegeneration. One of the hallmarks of neurodegeneration is protein aggregation. We investigated the presence of protein aggregation in the frontal brain of Zucker diabetic fatty (ZDF) rats, an animal model for dia

  18. Therapeutic itinerary of the family and adolescent with type i mellitus diabetes El itinerario terapéutico del adolescente con diabetes mellitus tipo i y sus familiares Itinerário terapêutico do adolescente com diabetes mellitus tipo 1 e seus familiares

    Directory of Open Access Journals (Sweden)

    Mariza Maria Serafim Mattosinho

    2007-12-01

    Full Text Available This is a qualitative assistential convergent study. Its main objective is to understand the therapeutic itinerary of adolescents with type 1 mellitus diabetes, as well as that of their families. The sample was composed of adolescents, between 15 and 25 years old, involved with a health institution in Florianópolis through the Health Care model that includes professional, family, and popular subsystems. Data were obtained through in-depth interviews and field observation of 20 people (relatives and adolescents with diabetes. The data analysis included data codification and categorization. Two categories were constructed: Decisions and negotiations about health, care and treatment; and the journey through the three subsystems of health care. The study permitted to understand that the treatment and care within the professional subsystem are not the only ones available. There are different practices in health performed from the evaluation each family makes, of what they believe adequate for their adolescent with diabetes.Estudio de naturaleza cualitativa, de tipo convergente-asistencial, tuvo como objetivo comprender el camino terapéutico de los adolescentes con diabetes mellitus tipo I y sus familiares, vinculados a una institución de salud de Florianópolis, entre las edades de 15 y 25 años, a través del modelo del Cuidado para la Salud, que incluye los subsistemas profesional, familiar y popular. Los datos fueron obtenidos a través de la entrevista en profundidad y la observación de campo con 20 personas (familiares y adolescentes con diabetes. El análisis incluye la codificación y la categorización de los datos. Fueron construidos dos categorias: Las decisiones y negociaciones sobre la salud, los cuidados y los tratamientos y El percurso en los tres subsistemas de la salud. El estudio permitió comprender que los tratamientos y los cuidados del subsistema profesional no son los únicos, existiendo diferentes prácticas en la salud que

  19. Sitagliptin as add-on therapy in insulin deficiency: biomarkers of therapeutic efficacy respond differently in type 1 and type 2 diabetes

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    Giampietro O

    2013-02-01

    Full Text Available Ottavio Giampietro, Chiara Giampietro, Luca Della Bartola, Maria Chiara Masoni, Elena MatteucciDepartment of Clinical and Experimental Medicine, University of Pisa, Pisa, ItalyBackground: Sitagliptin has been proven to be effective and safe as add-on to insulin in adult patients with type 2 diabetes and absolute insulin deficiency. Recently, it has been suggested to extend the use of dipeptidyl-peptidase-4 inhibitors to type 1 diabetes. The aim of this study was to evaluate and compare the effects of a long-term, fixed-dose combination of sitagliptin and metformin as add-on to insulin on body mass index, fasting plasma glucose, fructosamine, HbA1c, lipids, and daily dose of insulin in both type 1 diabetes and insulin-treated type 2 diabetes.Methods: We recruited 25 patients with type 1 diabetes (mean age 51 ± 10 years, mean disease duration 26 ± 13 years and 31 insulin-treated type 2 diabetic patients (mean age 66 ± 8 years, mean disease duration 19 ± 9 years, who received sitagliptin with metformin as a fixed-dose combination (50/1000 mg once or twice daily or sitagliptin (100 mg once daily, if intolerant to metformin in addition to ongoing insulin therapy for 46 ± 19 weeks and 56 ± 14 weeks, respectively.Results: After 21 ± 9 weeks, patients with type 1 diabetes had a significantly lower body mass index, fasting plasma glucose, fructosamine, HbA1c, and daily insulin requirement. After 49 ± 17 weeks, they maintained their weight loss and total daily insulin dose and showed a significant reduction in low-density lipoprotein cholesterol levels, whereas their HbA1c had returned to baseline values. In patients with type 2 diabetes, long-term treatment remained weight-neutral but had persistent beneficial effects on short-term, intermediate-term, and long-term biomarkers of metabolic control, as well as on low-density lipoprotein cholesterol levels and insulin requirement.Conclusion: Clinical outcomes differed according to type of diabetes

  20. Oral Administration of N-Acetyl-seryl-aspartyl-lysyl-proline Ameliorates Kidney Disease in Both Type 1 and Type 2 Diabetic Mice via a Therapeutic Regimen.

    Science.gov (United States)

    Nitta, Kyoko; Shi, Sen; Nagai, Takako; Kanasaki, Megumi; Kitada, Munehiro; Srivastava, Swayam Prakash; Haneda, Masakazu; Kanasaki, Keizo; Koya, Daisuke

    2016-01-01

    Kidney fibrosis is the final common pathway of progressive kidney diseases including diabetic nephropathy. Here, we report that the endogenous antifibrotic peptide N-acetyl-seryl-aspartyl-lysyl-proline (AcSDKP), the substrate of angiotensin-converting enzyme (ACE), is an orally available peptide drug used to cure kidney fibrosis in diabetic mice. We utilized two mouse models of diabetic nephropathy, streptozotocin- (STZ-) induced type 1 diabetic CD-1 mice and type 2 diabetic nephropathy model db/db mice. Intervention with the ACE inhibitor imidapril, oral AcSDKP, or imidapril + oral AcSDKP combination therapy increased urine AcSDKP levels. AcSDKP levels were significantly higher in the combination group compared to those of the other groups. AcSDKP oral administration, either AcSDKP alone or in addition to imidapril, ameliorated glomerulosclerosis and tubulointerstitial fibrosis. Plasma cystatin C levels were higher in both models, at euthanasia, and were restored by all the treatment groups. The levels of antifibrotic miRs, such as miR-29 or let-7, were suppressed in the kidneys of both models; all treatments, especially the combination of imidapril + oral AcSDKP, restored the antifibrotic miR levels to a normal value or even higher. AcSDKP may be an oral antifibrotic peptide drug that would be relevant to combating fibroproliferative kidney diseases such as diabetic nephropathy.

  1. Prevalence of Obesity and Its Influence on Achievement of Cardiometabolic Therapeutic Goals in Chinese Type 2 Diabetes Patients: An Analysis of the Nationwide, Cross-Sectional 3B Study.

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    Xianghai Zhou

    Full Text Available There are few data on the prevalence of obesity and its influence on achieving blood glucose, blood pressure, and blood lipid (3B goals in Chinese type 2 diabetes outpatients.Patient demographic data, anthropometric measurements, medications, and blood glucose and lipid profiles of 24,512 type 2 diabetes patients from a large, geographically diverse study (CCMR-3B were analyzed. Using cut-points for body mass index (BMI and waist circumference (WC recommended by the Working Group on Obesity in China, overweight and obesity were defined as BMIs of 24-27.9 kg/m2 and ≥28.0 kg/m2. Central obesity was defined as a waist circumference ≥80 cm in women and ≥85 cm in men. The 3B therapeutic goals were HbA1c<7.0%, BP<140/90 mmHg and LDL-C<2.6 mmol/L.Overall, 43.0% of type 2 diabetes patients were overweight and 16.7% were obese; 13.3% of overweight and and 10.1% of obese patients achieved all the 3B target goals. Overweight or obese patients were less likely to achieve 3B goals than those with normal BMIs. More than a half the overweight or obese patients (69.6% were centrally obese. Patients with abdominal obesity were less likely to achieve cardiometabolic targets than those without abdominal obesity. In multivariate logistic regression analysis, female, higher BMI and waist circumference, smoking, drinking, sedentary lifestyle, and longer diabetes duration were significantly correlated with failure to achieve 3B control goals.Obesity is highly prevalent and associated with poor 3B control in Chinese type 2 diabetes patients. In clinical practice, more attention and resources should focus on weight loss for such patients.

  2. The effect of the photon therapeutic apparatus on type 2 diabetic peripheral neuropathy%光子治疗仪治疗2型糖尿病周围神经病变的疗效观察

    Institute of Scientific and Technical Information of China (English)

    梁潇; 刘智平; 程庆丰; 袁娟; 吴成云; 赵庆华; 李启富

    2014-01-01

    Objective To observe the clinical efficacy of the photon therapeutic apparatus on type 2 diabetic patients with periph-eral neuropathy .Methods While giving conventional nerve nourishing ,improving microcirculation treatment and nursing ,adjuvant therapy with Carnation-11 photon therapeutic apparatus was applied to one lower limb only of the 20 diabetes mellitus patients with peripheral neuropathy and compare the curative effects by paired observation of the two lower limbs .Results The evaluation score of peripheral neuropathy dropped obviously with ankle reflex and thumb vibration sensation improved greatly after 10 days of treat-ment and remained an unchanged follow -up test 30 days later ,which means the clinical therapeutic effect of the treated limb was significantly superior to the comparison limb .The difference of the curative effects is statistically significant ( P < 0 .05 ) . Conclusion Conventional therapy accompanied by adjuvant treatment of photon therapy can relieve the clinical symptoms and phys-ical signs of diabetic patients with peripheral neuropathy ,which could improve curative effect on diabetic peripheral neuropathy .%目的:研究光子治疗仪治疗2型糖尿病周围神经病变(DPN )的临床疗效。方法收集该院DPN患者20例,采用Carnation-11光子治疗仪对患者一侧足部进行辅助治疗,与另一侧足部进行自身对照观察,比较两侧足部的临床疗效。结果照射足部10 d后周围神经病变评分[包括神经缺陷评分(NDS),神经症状评分(NSS)]明显降低,差异有统计学意义(P<0.05),30 d后再次随访仍维持在10 d水平。照射足部10 d后NDS中踝反射和大拇指振动觉改善明显,临床治疗效果明显优于对照足部,差异有统计学意义(P<0.05)。结论常规治疗结合光子治疗仪辅助照射治疗DPN ,可改善患者的临床症状及缓解部分体征,提高临床治疗效果。

  3. NMDA Receptors as Potential Therapeutic Targets in Diabetic Nephropathy: Increased Renal NMDA Receptor Subunit Expression in Akita Mice and Reduced Nephropathy Following Sustained Treatment With Memantine or MK-801.

    Science.gov (United States)

    Roshanravan, Hila; Kim, Eun Young; Dryer, Stuart E

    2016-10-01

    N-methyl-d-aspartate (NMDA) receptors are expressed throughout the kidney, and the abundance of these receptors and some of their endogenous agonists are increased in diabetes. Moreover, sustained activation of podocyte NMDA receptors induces Ca(2+) influx, oxidative stress, loss of slit diaphragm proteins, and apoptosis. We observed that NMDA receptor subunits and their transcripts are increased in podocytes and mesangial cells cultured in elevated glucose compared with controls. A similar increase in NMDA subunits, especially NR1, NR2A, and NR2C, was observed in glomeruli and tubules of Akita mice. Sustained continuous treatment with the strong NMDA receptor antagonist dizocilpine (MK-801) for 28 days starting at 8 weeks of age reduced 24-h albumin excretion and mesangial matrix expansion and improved glomerular ultrastructure in Akita mice. MK-801 did not alleviate reduced Akita mouse body weight and had no effect on kidney histology or ultrastructure in DBA/2J controls. The structurally dissimilar NMDA antagonist memantine also reduced diabetic nephropathy, although it was less effective than MK-801. Inhibition of NMDA receptors may represent a valid therapeutic approach to reduce renal complications of diabetes, and it is possible to develop well-tolerated agents with minimal central nervous system effects. Two such agents, memantine and dextromethorphan, are already in widespread clinical use.

  4. Diabetic angiopathy and angiogenic defects

    Directory of Open Access Journals (Sweden)

    Xu Ling

    2012-08-01

    Full Text Available Abstract Diabetes is one of the most serious health problems in the world. A major complication of diabetes is blood vessel disease, termed angiopathy, which is characterized by abnormal angiogenesis. In this review, we focus on angiogenesis abnormalities in diabetic complications and discuss its benefits and drawbacks as a therapeutic target for diabetic vascular complications. Additionally, we discuss glucose metabolism defects that are associated with abnormal angiogenesis in atypical diabetic complications such as cancer.

  5. Therapeutic communication between health workers and patients concerning diabetes mellitus care La comunicación terapéutica entre profesionales y pacientes en la atención en diabetes mellitus A comunicação terapêutica entre profissionais e pacientes na atenção em diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Marta Maria Coelho Damasceno

    2012-08-01

    Full Text Available The objective of this cross-sectional study was to analyze therapeutic communication techniques used by health workers with patients under care for diabetes mellitus. Data were collected in 2010 in a public facility in the interior of Ceará, Brazil using video camera equipment and direct observation. Results showed that the most frequently used techniques within the "expression" group were: asking questions, voicing interest, and using descriptive phrases. The most frequently used technique within the "clarification" group was: asking the patient to specify the agent of action. Finally, in regard to the "validation" group, only the technique "summarizing content of the interaction" was employed. The conclusion is that despite the use of communication techniques on the part of professionals, there is still an alarming gap concerning communication skills. Such skills should be allied with technical expertise to enable the delivery of qualified care to individuals with diabetes mellitus.Este estudio transversal tuvo como objetivo analizar las técnicas de comunicación terapéutica entre profesionales y pacientes en la atención en diabetes mellitus. Los datos se recogieron en una institución pública de Ceará-Brasil, en 2010, con equipos de video y observación directa. Los resultados mostraron que las técnicas del grupo de expresión más utilizadas fueron: hacer preguntas, expresar interés y usar frases descriptivas. Con relación a las del grupo de clarificación sobresalió solicitar al paciente que necesite el agente de la acción. Con relación a las de validación, apenas se utilizó las de organizar el contenido de la interacción. Se concluye que a pesar del uso de técnicas de comunicación por los profesionales, aun es preocupante la laguna con relación a la habilidad en comunicación, que debe ser aliada a la capacidad técnica, para así propiciar el cuidado calificado a las personas con diabetes mellitus.Objetivou-se, por este

  6. Adherence to recommendations and effectiveness of glucose-lowering treatment in type 2 diabetes patients receiving insulin based in the Nizhny Novgorod region on data of mobile diagnostic and therapeutic centre "Diabetes mellitus"

    Directory of Open Access Journals (Sweden)

    Panova S.Yu.

    2016-03-01

    Full Text Available Adherence to treatment is an important factor in diabetes management. Poor adherence may cause ineffective control, especially in insulin-treated patients. Aim of the study: to evaluate the adherence to nutrition, physical activity and self-monitoring in T2DM patients who do and do not receive insulin treatment. Materials and methods. 550 T2DM patients were examined as a part of mobile diabetes center in different areas of the Nizhny Novgorod region. Clinical examination results, HbA1c, creatinine and microalbuminuria were assessed. Adherence to treatment was evaluated by questionnaire Diabetes Self-Care Activities. Results. Insulin-treated patients had longer diabetes duration and worse HbA1 с level and similar levels of adherence related to diet, physical activity, foot care. Only for glucose self-monitoring was adherence higher. Best HbA1c values were observed in patients with adherence in middle region of 3-5 days. Conclusion. Long diabetes duration and worse glycemic control in insulin-treated T2DM patients is not associated with better adherence to treatment. This may be viewed as evidence on insufficient patients education and can be a potential target for improvement of glycemic control.

  7. Adherence to recommendations and effectiveness of glucose-lowering treatment in type 2 diabetes patients receiving insulin based in the Nizhny Novgorod region on data of mobile diagnostic and therapeutic centre "Diabetes mellitus"

    OpenAIRE

    Panova S.Yu.; Petrov A.V.; Strongin L.G.

    2016-01-01

    Adherence to treatment is an important factor in diabetes management. Poor adherence may cause ineffective control, especially in insulin-treated patients. Aim of the study: to evaluate the adherence to nutrition, physical activity and self-monitoring in T2DM patients who do and do not receive insulin treatment. Materials and methods. 550 T2DM patients were examined as a part of mobile diabetes center in different areas of the Nizhny Novgorod region. Clinical examination results, HbA1c, creat...

  8. 313例糖尿病足患者临床特点及疗效分析%Analysis of the clinical characteristics and therapeutic efficacy in 313 patients with diabetic foot

    Institute of Scientific and Technical Information of China (English)

    袁南兵; 刘大凤; 余婷婷; 王艳; 王维萍; 王椿; 冉兴无

    2009-01-01

    目的 了解住院糖尿病(DM)患者糖尿病足(DF)的患病率,并分析其临床特点和治疗效果.方法 调查我院1996年1月至2006年12月共313例住院DF病患者的临床资料,并比较1996年1月-2003年12月(A组)和2004年1月-2006年12月(B 组) 两个时间段患者的治疗效果.结果 DF患者占同期住院DM总人数的2.79%,平均DM病程9.33±6.52年,DF病程8.13±17.06月.DF患者总的治愈率为28.1%,好转率为40.6%,无效率为31.3%;DF分级越高,治疗效果越差.B 组治愈率(37.04%)显著高于A组(18.54%).结论 DF的发生率不断升高,多学科合作团队有利于提高DF的治愈率.%Objective To investigate the prevalence of diabetic foot(DF) in the hospitalized diabetic patients and analyze the clinical characteristics and therapeutic efficacy of patients with diabetic foot. Methods The 313 patients (180 males and 133 females) were divided into two groups:group A (1/1996-12/2003) and group B (1/2004-12/2006). Results 2.79% of the hospitalized diabetic patients had diabetic foot. The mean age and duration of diabetes were 66±10 years old and 9.33±6.52 years respectively, the mean duration of diabetic foot was 8.13±17.06 months and the average days in hospital was 29.62±28.36d. Many patients suffered from diabetic nephropathy, cataracts, retinopathy, neuropathy, vascular disease, hypertension, infection, and so on. The blood pressure and blood glucose were poorly controlled in many of the patients. Of all patients, 28.1% were completely healed, 40.6% were improved without amputation and 31.3% had not healed at the time of death or follow-up (including 9.3 % of them were amputated in leg and 6.2% were dead). But group B versus group A showed higher cure rates of DF (37.04 % vs 18.54 %). Conclusions The prevalence of DF in the hospitalized diabetic patients is gradually increased, most patients with DF accompany with one or multiple other complications. A multifactorial treatment by a multidisciplinary foot care

  9. Behandling af diabetes mellitus med biologiske laegemidler

    DEFF Research Database (Denmark)

    Larsen, Claus Morten; Mandrup-Poulsen, Thomas

    2008-01-01

    Biologic therapeutics are currently not approved for the treatment of patients with type 1 and type 2 diabetes. However, promising results from recent randomized controlled studies suggest that biologic therapeutics have therapeutic potential. This article summarizes the causal steps of the patho......Biologic therapeutics are currently not approved for the treatment of patients with type 1 and type 2 diabetes. However, promising results from recent randomized controlled studies suggest that biologic therapeutics have therapeutic potential. This article summarizes the causal steps...... of the pathogenesis of type 1 and type 2 diabetes which are targeted by biologic therapeutics and reviews the treatment results. Udgivelsesdato: 2008-Jun-9...

  10. [Therapeutic superiority of regional retrograde venous antibiotic pressure infusion versus systemic venous infusions in diabetic patients with infected neuropathic plantar ulcers].

    Science.gov (United States)

    Seidel, C; Bühler-Singer, S; Tacke, J; Hornstein, O P

    1994-02-01

    Since systemic treatment of neuropathic plantar ulcers in diabetics (DNPU) has so far been rather ineffective, recent reports of successful management of DNPU by short-term retrograde transvenous leg perfusion (RVP) by South American angiologists encouraged us to apply this treatment method in diabetics suffering from chronic DNPU. Hence, in a prospective comparative clinical trial started in 1989 we have treated 45 male diabetics suffering from DNPU with the same daily doses of netilmycin, administered either in systemic venous infusions (SVI: n = 21, three times/day) or in RVP (n = 24, once/day). After 10 consecutive days of treatment, ulcers had closed in 8 of the 24 patients treated with RVP, as against 3 of the 21 treated with SVI. Diminution of the ulcer area by > 30% including full debridement was achieved in 10/24 of the RVP cases (SVI: 4/21). During 6 months of follow-up, amputation of toes or forefoot was necessary in only 1 patient in the RVP group, but in 4 in the SVI group. Partial restitution of osteolytic damage was observed in some cases after RVP. Our results show that regional netilmycin therapy given by the RVP procedure is clearly superior to equal netilmycin doses administered by SVI for the treatment of DNPU. RVP can be recommended in DNPU, particularly when the ulcers are complicated by infections.

  11. The therapeutic effects of community health education on diabetes patients%社区健康教育对糖尿病患者的治疗效果影响

    Institute of Scientific and Technical Information of China (English)

    许明红; 徐周红; 郑晓丽

    2015-01-01

    目的:探讨社区健康教育对糖尿病患者的治疗效果。方法:对64例Ⅱ型糖尿病患者在社区健康教育前、后,采用自行设计的调查表对患者进行问卷调查,了解患者对糖尿病相关知识的掌握情况,并将患者空腹和餐后2h血糖、糖化血红蛋白等监测情况进行统计比较。结果:社区健康教育后,掌握糖尿病相关知识的患者人数明显上升;患者空腹、餐后2h血糖及糖化血红蛋白的监测值改善良好,以上这些指标与教育前进行比较,差异均有统计学意义(P<0.05)。结论:社区健康教育可提高糖尿病患者对相关知识的掌握程度,有效控制血糖,提高患者的生活质量。%Objective:To investigate the therapeutic effect of community health education on diabetes patients. Methods:In 64 patients with type II diabetes in the community before and after health education, using the self-designed questionnaire survey of patients, patients understand the diabetes related knowledge, and 2H blood glucose and glycosylated hemoglobin monitoring in patients with fasting and postprandial statistical comparisons. Results:Community health education, grasp the number of patients with diabetes related knowledge was significantly increased;fasting, postprandial blood glucose and glycated hemoglobin monitoring of 2H changes the value of the good, these indexes and education before the comparison, the difference was statistically signiifcant (P<0.05). Conclusion:Community health education can improve the degree of diabetic patients to master the related knowledge, effective control of blood glucose, improve the quality of life of patients.

  12. Beneficio a largo plazo del Programa Terapéutico de la Nefropatía Diabética Long-term benefit of the Therapeutic Program of Diabetic Nephropathy

    Directory of Open Access Journals (Sweden)

    Emilio Bustillo Solano

    2001-12-01

    Full Text Available Se aplicó el programa terapéutico de la nefropatía diabética a 2 grupos diferentes de pacientes diabéticos tipo 1 (grupo A: 1990-1999, grupo B: 1995-1999, ambos en etapas proteinúricas. Se comprobó que una década después de haber comenzado el programa terapéutico, a un subgrupo de pacientes del grupo A (etapa proteinúrica tardía se les retrasó su evolución hacia la insuficiencia renal crónica terminal. La mortalidad acumulativa de estos pacientes fue del 44,7 % (LC. 95 %: 28,9 - 60,5. Se halló como su principal causa de muerte, la uremia. En los 5 primeros años de tratamiento, exponer a los pacientes diabéticos al programa terapéutico en la etapa proteinúrica tardía, representó un riesgo relativo de insuficiencia renal crónica terminal y/o tratamiento sustitutivo renal de: 5,3 % (LC-95 %: 1,23-22,8 y un mayor riesgo de muerte (RR:2,6 (LC-95 %: 1,01-6,7 con respecto a los pacientes no expuestos (grupo B. Se concluyó que el programa terapéutico ha favorecido a un mejoramiento de la supervivencia y calidad de la vida a un subgrupo de pacientes diabéticos tipo 1 con nefropatía diabética clínica.A therapeutic program of diabetic nephropathy was applied to 2 different groups of type I diabetic patients (group A: 1990-1999, group B: 1995-1999, both in proteinuric stages. It was proved that a decade after the beginning of the therapeutic program, a subgroup of patients from group A (late proteinuric stage delayed their evolution towards end-stage chronic kidney failure. The accumulative mortality of these patients was 44.7 % LC-95 %: 28.9-60.5 %. Uremia was considered as the main cause of death. Applying the threapeutic program to diabetic patients in the late proteinuric stage, during the first 5 years of treatment, represented a relative risk for end-stage chronic kidney failure and/or kidney substitutive treatment of 5.3 (LC-95 %: 1.23-22.8 and a higher death risk (RR:2.6 LC-95 %: 1.01-6.7 compared with those patients

  13. Therapeutics for Equine Endocrine Disorders.

    Science.gov (United States)

    Durham, Andy E

    2017-04-01

    Equine endocrine disease is commonly encountered by equine practitioners. Pituitary pars intermedia dysfunction (PPID) and equine metabolic syndrome (EMS) predominate. The most logical therapeutic approach in PPID uses dopamine agonists; pergolide mesylate is the most common. Bromocryptine and cabergoline are alternative drugs with similar actions. Drugs from other classes have a poor evidence basis, although cyproheptadine and trilostane might be considered. EMS requires management changes as the primary approach; reasonable justification for use of drugs such as levothyroxine and metformin may apply. Therapeutic options exist in rare cases of diabetes mellitus, diabetes insipidus, hyperthyroidism, and critical illness-related corticosteroid insufficiency. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Observation on the Therapeutic Effect of Nephropathy in Treating Diabetic Nephropathy%肾病方治疗糖尿病肾病水肿疗效探讨

    Institute of Scientific and Technical Information of China (English)

    李晓强; 李燕

    2015-01-01

    Objective To analyze and explore the clinical effect of the treatment of diabetic nephropathy in the treatment of diabetic nephropathy. Methods 60 cases of diabetic nephropathy edema patients in our hospital were collected in April 2014 April 2015 this period of time. These patients were randomly divided into two groups, control group (30 cases) and observation group (30 cases). The control group was treated with routine western medicine, and the observation group was treated with traditional Chinese medicine. The clinical efficacy of the two groups were compared and analyzed. Results The total effective rate of the observation group was significantly higher than that of the control group, the clinical efficacy of the observation group was significantly better than that of the control group,it was statistically significant (P<0.05). Conclusion In patients with diabetic nephropathy edema, in the conventional treatment on the treatment of diabetic nephropathy in the treatment of diabetic nephropathy can improve the patient's condition, with good clinical efficacy, it is worth promoting the use of clinical medicine.%目的 分析并探讨肾病方治疗糖尿病肾病水肿的临床疗效. 方法 收集该院在2014年4月—2015年4月时间段内收治的60例糖尿病肾病水肿患者.将这些患者随机分为两组,分别为对照组(30例)和观察组(30例).给予对照组患者常规西药,进行降高血压及降血糖治疗,而观察组在使用常规治疗的基础上再添加中药肾病方进行治疗,比较并分析两组患者治疗后的临床疗效. 结果 研究表明,观察组患者的总有效率高于对照组患者,显然观察组的临床疗效明显优于对照组,差异有统计学意义(P<0.05). 结论 对于糖尿病肾病水肿患者而言,在常规治疗上添加中药肾病方治疗糖尿病肾病水肿可以改善患者病情状况,具有良好的临床疗效,值得在临床医学界推广运用.

  15. DPP-4 Inhibitors as Therapeutic Modulators of Immune Cell Function and Associated Cardiovascular and Renal Insulin Resistance in Obesity and Diabetes.

    Science.gov (United States)

    Aroor, Annayya; McKarns, Susan; Nistala, Ravi; Demarco, Vincent; Gardner, Michael; Garcia-Touza, Mariana; Whaley-Connell, Adam; Sowers, James R

    2013-04-01

    The prevalence of obesity and diabetes continues to rise in the United States and worldwide. These findings parallel the expansion of childhood obesity and diabetes. Obesity is a central component of the cardiorenal metabolic syndrome (CRS) which increases the risk for cardiovascular disease (CVD) and chronic kidney disease (CKD). The hallmark of obesity, CRS, and early type 2 diabetes is insulin resistance, a result of decreased insulin metabolic signaling due, in part, to enhanced serine phosphorylation and/or proteasome-mediated degradation of the insulin receptor substrate. Cardiovascular and renal insulin resistance significantly contributes to endothelial dysfunction, impaired cardiac diastolic and vascular relaxation, glomerular injury, and tubular dysfunction. In this context, multiple factors including oxidative stress, increased inflammation, and inappropriate activation of the renin-angiotensin-aldosterone and the sympathetic nervous system contribute to overweight- and obesity-induced systemic and tissue insulin resistance. One common link between obesity and the development of insulin resistance appears to be a low-grade inflammatory response resulting from dysfunctional innate and adaptive immunity. In this regard, there has been recent work on the role of dipeptidyl peptidase-4 (DPP-4) in modulating innate and adaptive immunity. The direct effects of DPP-4 on immune cells and the indirect effects through GLP-1-dependent and -independent pathways suggest effects of DPP-4 inhibition may have beneficial effects beyond glycemic control in improving CVD and renal outcomes. Accordingly, this review addresses new insights into the role of DPP-4 in immune modulation and the potential beneficial effects of DPP-4 inhibitors in insulin resistance and associated CVD and CKD prevention.

  16. Therapeutic Efficacy of Retinal Photocoagulation for Diabetic Retinopathy%激光光凝治疗糖尿病视网膜病变的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王遵敬

    2015-01-01

    Objective To observe the laser photocoagulation for treatment of diabetic retinopathy.Methods104 cases (208 eyes) with diabetic retinopathy patients clinical data were concluded. Record retinal neovascularization, retinal hemorrhage oozy and vitreous hemorrhage,and so on and so forth.Results After treatment, the total effective rate was 85.57% (178 eyes), eight eye macular edema, 10 eyes vitreous hemorrhage after 1 years, we did not ifnd the retina stripped or glaucoma. Conclusion Laser photocoagulation treatment for patients with diabetic retinopathy can improve visual acuity, high safety.%目的:观察激光光凝治疗糖尿病视网膜病变的临床效果。方法回顾性总结我院收治的104例(208眼)糖尿病视网膜病变患者临床资料。记录眼底新生血管、视网膜出血渗出以及玻璃体积血等情况。结果治疗后,总有效率为85.57%(178眼);1年后出现8眼黄斑水肿,10眼玻璃体积血,未发现视网膜剥脱或青光眼。结论激光光凝术治疗糖尿病视网膜病变能够有效改善患者视力,安全性高。

  17. Metformin alters the gut microbiome of individuals with treatment-naive type 2 diabetes, contributing to the therapeutic effects of the drug

    DEFF Research Database (Denmark)

    Wu, Hao; Esteve, Eduardo; Tremaroli, Valentina

    2017-01-01

    Metformin is widely used in the treatment of type 2 diabetes (T2D), but its mechanism of action is poorly defined. Recent evidence implicates the gut microbiota as a site of metformin action. In a double-blind study, we randomized individuals with treatment-naive T2D to placebo or metformin for 4......, and many of the metformin-regulated genes in these species encoded metalloproteins or metal transporters. Our findings provide support for the notion that altered gut microbiota mediates some of metformin's antidiabetic effects....

  18. Therapeutic outcomes of transplanting autologous granulocyte colony-stimulating factor-mobilised peripheral mononuclear cells in diabetic patients with critical limb ischaemia.

    Science.gov (United States)

    Mohammadzadeh, L; Samedanifard, S H; Keshavarzi, A; Alimoghaddam, K; Larijani, B; Ghavamzadeh, A; Ahmadi, A S; Shojaeifard, A; Ostadali, M R; Sharifi, A M; Amini, M R; Mahmoudian, A; Fakhraei, H; Aalaa, M; Mohajeri-Tehrani, M R

    2013-01-01

    The efficacy and safety of transplanting autologous mesenchymal stem cells (MSCs), from granulocyte-colony-stimulating factor (G-CSF)-mobilised peripheral blood, was investigated in diabetic patients with critical limb ischaemia (CLI). After 3 months, the transplanted group of patients (n=7) showed a significant improvement in ischaemia manifestations, including pain and neurological signs, wound healing and the rate of lower-limb amputation, compared to the control group of patients (n=14). Pain was significantly reduced in the transplanted group compared to controls (P=0.014). The ankle-brachial index (ABI) and the pulse strength within ischaemic tissues of the transplanted group were significantly improved (P=0.035 and P=0.01, respectively). Importantly, 50% of the control group (7/14 patients) faced major amputation of a limb at the study's conclusion, compared to none of 7 patients in the transplanted group (P=0.047). The safety of transplantation was confirmed by observing no adverse reactions among the transplanted group, including infection and immunological rejection. Hence, this study provides further evidence that transplantation of autologous peripheral blood MSCs, mobilised by G-CSF, induces angiogenesis and improves the wound healing process in diabetic patients with CLI.

  19. An in silico insight into novel therapeutic interaction of LTNF peptide-LT10 and design of structure based peptidomimetics for putative anti-diabetic activity.

    Directory of Open Access Journals (Sweden)

    Sonali Gopichand Chavan

    Full Text Available Lethal Toxin Neutralizing Factor (LTNF obtained from Opossum serum (Didephis virginiana is known to exhibit toxin-neutralizing activity for envenomation caused by animals, plants and bacteria. Small synthetic peptide- LT10 (10mer derived from N-terminal fraction of LTNF exhibit similar anti-lethal and anti-allergic property. In our in silico study, we identified Insulin Degrading Enzyme (IDE as a potential target of LT10 peptide followed by molecular docking and molecular dynamic (MD simulation studies which revealed relatively stable interaction of LT10 peptide with IDE. Moreover, their detailed interaction analyses dictate IDE-inhibitory interactions of LT10 peptide. This prediction of LT10 peptide as a novel putative IDE-inhibitor suggests its possible role in anti-diabetic treatment since IDE- inhibitors are known to assist treatment of Diabetes mellitus by enhancing insulin signalling. Furthermore, series of structure based peptidomimetics were designed from LT10 peptide and screened for their inhibitory interactions which ultimately led to a small set of peptidomimetic inhibitors of IDE. These peptidomimetic thus might provide a new class of IDE-inhibitors, those derived from LT10 peptide.

  20. Bioactive constituents of Corni Fructus: The therapeutic use of morroniside, loganin, and 7-O-galloyl-D-sedoheptulose as renoprotective agents in type 2 diabetes.

    Science.gov (United States)

    Yokozawa, T; Kang, K S; Park, C H; Noh, J S; Yamabe, N; Shibahara, N; Tanaka, T

    2010-08-01

    Corni Fructus, the fruit of Cornus officinalis Sieb. et Zucc. (Cornaceae), is an important crude herb used in Chinese medicine to exhibit several biological activities, including hypoglycemic, antineoplastic, and antimicrobial effects, and to improve liver and kidney functions. We have been investigating the mechanism and bioactive constituents of Corni Fructus using diabetic animal models. Morroniside, loganin, and 7-O-galloyl-D-sedoheptulose, the main active compounds of Corni Fructus, exhibit the same lowering effects of elevated triglyceride, oxidative stress and advanced glycation endproduct (AGE) formation in the kidney of db/db mice. The effects of morroniside and 7-O-galloyl-D-sedoheptulose were mediated through modulation by renal sterol regulatory element binding proteins and nuclear factor-kappa B expression, but the effect of loganin was presumably mediated by hypoglycemic and antioxidant effects in the kidney, and also indirectly by the amelioration of metabolic disorders in other organs such as the liver. These findings led us to conclude that morroniside, loganin, and 7-O-galloyl-D-sedoheptulose would synergistically contribute to the inhibition of metabolic disorders (hyperglycemia and dyslipidemia), oxidative stress, inflammation, as well as AGE formation in the diabetic kidney.

  1. Clinical Observation of Qi and Yin Deficiency Diabetes of Traditional Chinese Medical Dietary Therapeutic Schedule%气阴两虚型消渴病中医饮食治疗方案的临床观察

    Institute of Scientific and Technical Information of China (English)

    唐铁梅

    2015-01-01

    目的 研究气阴两虚型消渴病患者制定中医饮食治疗方法 的临床效果.方法 选择120例气阴两虚型消渴病患者分为两组,对照组实施常规饮食方案,观察组实施中医饮食干预,比较两组患者的血糖、糖化血红蛋白以及生存质量变化.结果 观察组空腹血糖,餐后2 h血糖、糖化血红蛋白以及生存质量优于对照组,P<0.05,差异具有统计学意义.结论 气阴两虚型消渴病患者通过中医饮食治疗方案能够有效的降低患者的空腹血糖、餐后血糖以及糖化血红蛋白水平,提升患者的治疗效果,改善糖尿病患者的生存质量.%Objective Clinical observation of qi and yin deficiency diabetes of traditional Chinese medical dietary therapeutic schedule. Methods Selected 120 cases of type of deficiency of both qi and Yin of diabetes patients who had diagnosis and treatment, were divided into two groups, the control group underwent routine diet plan, implementation of TCM diet intervention of patients in the observation group, compared two groups of patients with blood glucose, glycosylated hemoglobin and quality of life changes.Results The observation group, the fasting blood glucose, postprandial 2 hours blood glucose, glycosylated hemoglobin, and quality of life were better than the control group,P<0.05, was difference had statistically significance.Conclusion Patients with deficiency of both qi and yin type diabetes by TCM diet therapy can effectively reduce patients with fasting blood glucose, postprandial blood glucose and glycated hemoglobin levels, improve therapeutic effect of patients and the quality of life.

  2. Improved pregnancy outcome in type 1 diabetic women with microalbuminuria or diabetic nephropathy: effect of intensified antihypertensive therapy?

    DEFF Research Database (Denmark)

    Nielsen, Lene Ringholm; Damm, Peter; Mathiesen, Elisabeth R

    2009-01-01

    To describe pregnancy outcome in type 1 diabetic women with normoalbuminuria, microalbuminuria, or diabetic nephropathy after implementation of an intensified antihypertensive therapeutic strategy.......To describe pregnancy outcome in type 1 diabetic women with normoalbuminuria, microalbuminuria, or diabetic nephropathy after implementation of an intensified antihypertensive therapeutic strategy....

  3. Fatores terapêuticos em grupo de diabéticos Factores terapéuticos en grupo de diabéticos Therapeutic factors in a group of people with diabetes

    Directory of Open Access Journals (Sweden)

    Nunila Ferreira de Oliveira

    2009-09-01

    Full Text Available O objetivo da presente pesquisa foi analisar os fatores terapêuticos presentes nos relatos dos participantes de um grupo de diabéticos. Pesquisa exploratória, de avaliação, cujos dados foram obtidos por meio de entrevista semiestruturada, cuja análise permitiu a identificação dos seguintes fatores terapêuticos: oferecimento de informações (100%; coesão (100%; universalidade (86%; aprendizagem interpessoal (57%; desenvolvimento de técnicas de socialização (57%; altruísmo (28,5%; comportamento imitativo (28,5% e instilação de esperança (28,5%. Intervenções grupais, realizadas na promoção do autocuidado às pessoas portadoras de diabetes, podem promover interação benéfica entre os membros, permitindo troca de experiências, compreensão de uma dimensão maior do problema e outras vivências positivas evidenciadas pela presença dos fatores terapêuticos.El objetivo de la presente investigación fue analizar los factores terapéuticos presentes en los relatos de los participantes de un grupo de diabéticos. Investigación exploratoria, de evaluación, cuyos datos fueron obtenidos por medio de entrevista semiestructurada; el análisis permitió la identificación de los siguientes factores terapéuticos: ofrecimiento de informaciones (100%; cohesión (100%; universalidad (86%; aprendizaje interpersonal (57%; desarrollo de técnicas de socialización (57%; altruismo (28,5%; comportamiento imitativo (28,5% e introducción de esperanza (28,5%. Las intervenciones grupales realizadas en la promoción del auto cuidado a las personas portadoras de diabetes pueden promover una interacción benéfica entre los miembros, permitiendo el intercambio de experiencias, la comprensión de una dimensión mayor del problema y de otras vivencias positivas evidenciadas por la presencia de los factores terapéuticos.The objective of the present research was to analyze the therapeutic factors identified in the accounts of the participants of a

  4. Comparison between the therapeutic effect of metformin, glimepiride and their combination as an add-on treatment to insulin glargine in uncontrolled patients with type 2 diabetes.

    Directory of Open Access Journals (Sweden)

    Cheol-Young Park

    Full Text Available To compare the commonly prescribed oral anti-diabetic drug (OAD combinations to use as an add-on therapy with insulin glargine in patients with uncontrolled type 2 diabetes despite submaximal doses of OADs.People with inadequately controlled type 2 diabetes (n = 99 were randomly assigned on a 1∶1∶1 basis to receive insulin glargin, with fixed doses of glimepiride, metformin, and glimepiride plus metformin. Outcomes assessed included HbA1c, the changes in fasting glucose levels, body weight, serum lipids values, insulin dose and symptomatic hypoglycemia.After 24 weeks, HbA1C levels improved from (mean ± SD 8.5±0.9% to 7.7±0.8% (69.0±10.0 mmol/mol to 60.8±8.6 mmol/mol with insulin glargine plus metformin, from 8.4±1.0% to 7.7±1.3% (68.8±10.6 mmol/mol to 61.1±14.4 mmol/mol with insulin glargine plus glimepiride and from 8.7±0.9% to 7.3±0.6% (71.7±9.8 mmol/mol to 56.2±6.7 mmol/mol with insulin glargine plus glimepirde plus metformin. The decrease in HbA1c was more pronounced with insulin glargine plus glimepiride plus metformin than with insulin glargine plus metformin (0.49% [CI, 0.16% to 0.82%]; P = 0.005 (5.10 mmol/mol [CI, 1.64 to 8.61]; P = 0.005 and insulin glargine plus glimepiride (0.59% [CI, 0.13% to 1.05%]; P = 0.012 (5.87 mmol/mol [CI, 1.10 to 10.64]; P = 0.012 (overall P = 0.02. Weight gain and the risk of hypoglycemia of any type did not significantly differ among the treatment groups.The combination therapy of metformin and glimepiride plus glargine insulin resulted in a significant improvement in overall glycemic control as compared with the other combinations.ClinicalTrials.gov, NCT00708578. The approval number of Kangbuk Samsung hospital's institutional review board (IRB: C0825.

  5. Diabetic Neuropathy: Mechanisms to Management

    OpenAIRE

    2008-01-01

    Neuropathy is the most common and debilitating complication of diabetes and results in pain, decreased motility, and amputation. Diabetic neuropathy encompasses a variety of forms whose impact ranges from discomfort to death. Hyperglycemia induces oxidative stress in diabetic neurons and results in activation of multiple biochemical pathways. These activated pathways are a major source of damage and are potential therapeutic targets in diabetic neuropathy. Though therapies are available to al...

  6. Iodine-123-metaiodobenzylguanidine cardiac scintigraphy in patients with diabetes mellitus. Therapeutic effects of aldose reductase inhibitor and vitamin B{sub 12}

    Energy Technology Data Exchange (ETDEWEB)

    Utsunomiya, Keita [Osaka Medical Coll., Takatsuki (Japan)

    1997-12-01

    Twenty normal volunteers (C group) and 56 patients with non-insulin-dependent diabetes mellitus (NIDDM) who did not have ischemic heart diseases (DM group), were evaluated by means of iodine-123-metaiodobenzylguanidine (MIBG) scintigraphy. The uptake ratio between the cardiac muscle and the upper mediastinum was calculated. The ratio determined from the initial I-123-MIBG scintigraphy image was expressed as HMi, and that determined from the delayed image was expressed as HMd. The washout rate percentage (%WR) was calculated. At least one instance of either the HMi, the HMd, or %WR was outside the mean{+-}1 standard deviation of C group in 34 DM group patients. Aldose reductase inhibitor (ARI) was administered to 17 of the 34 patients and Vitamin B{sub 12} (VB{sub 12}) to the remaining 17 patients, for 3 to 5 months. Before and after treatment, scintigraphic studies with I-123-MIBG were carried out, and the HMi, HMd, and %WR were calculated. There were no significant differences found in FBG, HbA1c, or 1.5-AG levels after treatment with either drug, when compared to the pretreatment values. Both HMi and HMd in the DM group were significantly lower, and %WR was significantly higher than in the C group. The changes in HMi, HMd, and %WR after treatment with ARI were not significant. After treatment with VB{sub 12}, the HMi and HMd levels were significantly increased (p<0.01). Thus, measurement of myocardial MIBG accumulation is a promising new method to detect cardiac sympathetic denervation in diabetic patients. With these changes in treatment, VB{sub 12} was shown to be effective for improvement of HMi and HMd in NIDDM. (author)

  7. Is exercise a therapeutic tool for improvement of cardiovascular risk factors in adolescents with type 1 diabetes mellitus? A randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Salem Mona A

    2010-07-01

    Full Text Available Abstract Background Type 1 diabetes mellitus (T1DM is associated with a high risk for early atherosclerotic complications especially risk of coronary heart disease. Objective To evaluate the impact of six months exercise prgram on glycemic control, plasma lipids values, blood pressure, severity and frequency of hypoglycemia, anthropometric measurements and insulin dose in a sample of adolescents with T1DM. Research design and methods A total of 196 type 1 diabetic patients participated in the study. They were classified into three groups: Group (A did not join the exercise program(n = 48, group (B attended the exercise sessions once/week (n = 75, group (C attended the exercise sessions three times/week (n = 73. Studied parameters were evaluated before and six months after exercise programe. Results Exercise improved glycemic control by reducing HbA1c values in exercise groups (P = 0.03, P = 0.01 respectively and no change in those who were not physically active (P = 0.2. Higher levels of HbA1c were associated with higher levels of cholesterol, LDL-c, and triglycerides (P = 0.000 each. In both groups, B and C, frequent exercise improved dyslipidemia and reduced insulin requirements significantly (P = 0.00 both, as well as a reduction in BMI (P = 0.05, P = 0.00 respectively and waist circumference(P = 0.02, P = 0.00 respectively. The frequency of hypoglycemic attacks were not statistically different between the control group and both intervention groups (4.7 ± 3.56 and 4.82 ± 4.23, P = 0.888 respectively. Reduction of blood pressure was statistically insignificant apart from the diastolic blood presure in group C (P = 0.04. Conclusion Exercise is an indispensable component in the medical treatment of patients with T1DM as it improves glycemic control and decreases cardiovascular risk factors among them.

  8. Combination of designed immune based classifiers for ERP assessment in a P300-based GKT

    Directory of Open Access Journals (Sweden)

    Mohammad Hassan Moradi

    2012-08-01

    Full Text Available Constructing a precise classifier is an important issue in pattern recognition task. Combination the decision of several competing classifiers to achieve improved classification accuracy has become interested in many research areas. In this study, Artificial Immune system (AIS as an effective artificial intelligence technique was used for designing of several efficient classifiers. Combination of multiple immune based classifiers was tested on ERP assessment in a P300-based GKT (Guilty Knowledge Test. Experiment results showed that the proposed classifier named Compact Artificial Immune System (CAIS was a successful classification method and could be competitive to other classifiers such as K-nearest neighbourhood (KNN, Linear Discriminant Analysis (LDA and Support Vector Machine (SVM. Also, in the experiments, it was observed that using the decision fusion techniques for multiple classifier combination lead to better recognition results. The best rate of recognition by CAIS was 80.90% that has been improved in compare to other applied classification methods in our study.

  9. AN IMMUNITY-BASED SECURITY ARCHITECTURE FOR MOBILE AD HOC NETWORKS

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    This paper focuses on investigating immunological principles in designing a multi-agent security architecture for intrusion detection and response in mobile ad hoc networks. In this approach, the immunity-based agents monitor the situation in the network. These agents can take appropriate actions according to the underlying security policies. Specifically, their activities are coordinated in a hierarchical fashion while sensing,communicating, decision and generating responses. Such an agent can learn and adapt to its environment dynamically and can detect both known and unknown intrusions. The proposed intrusion detection architecture is designed to be flexible, extendible, and adaptable that can perform real-time monitoring. This paper provides the conceptual view and a general framework of the proposed system. In the end, the architecture is illustrated by an example to show it can prevent the attack efficiently.

  10. Preventive and Therapeutic Effect of Diet and Nutrition Intervention on Gestational Diabetes Mellitus%饮食及营养干预对妊娠期糖尿病疾病的防治作用

    Institute of Scientific and Technical Information of China (English)

    王东辉

    2015-01-01

    Objective To study and analyze the preventive and therapeutic effect and safety of diet and nutrition intervention mea-sures in the treatment of gestational diabetes mellitus with hypertension. Methods 200 pregnant women with<14 gestational weeks underwent examination in the clinic of our hospital from December 2012 to December 2013 were selected as the subjects of clini-cal trials and divided into two groups randomly. 100 pregnant women in the experimental group were given diet and nutrition in-tervention measures, while 100 pregnant women in the control group were not and they only underwent regularly prenatal exami-nation. The two groups of pregnant women were followed up until the end of delivery. The number of pregnant women with gesta-tional diabetes mellitus and hypertension before the labor in the two groups were compared and analyzed. Results In the experi-mental group, there were 2 cases had gestational diabetes mellitus, which accounted for 2.00% of the total cases; in the control group, there were 9 cases had gestational diabetes mellitus, which accounted for 9.00% of the total cases, the comparison showed that the difference in the incidence of gestational diabetes mellitus between the two groups was statistically significant, P<0.05. Conclusion For pregnant women, scientific and effective diet and nutrition intervention measures can efficaciously improve the pregnant women’s own nutrition condition, promote the healthy development of maternal and infant body and mind and reduce the incidence of gestational diabetes mellitus, so it is worthy of wide clinical application.%目的:研究分析饮食及营养干预措施对妊娠期高血压糖尿病的防治疗效及安全性。方法选择2012年12月—2013年12月期间在该院门诊进行检查的200例<14周的孕妇作为临床试验研究对象,随机分为两组。实验组100例孕妇接受饮食及营养干预措施,对照组100例孕妇仅定期进行产检,不接受饮食及营养

  11. Therapeutical Significance of Ligustrazine for Treating Streptozotocin-Induced Diabetic Nephropathy%川芎嗪对链脲佐菌素诱导糖尿病肾病的治疗意义

    Institute of Scientific and Technical Information of China (English)

    谭明珠; 刘长山; 苏绍娟; 马璐璐

    2014-01-01

    Objective To research the therapeutical significance of ligustrazine for diabetic nephropathy. Methods 30 Wistar rats were selected, in which 10 rats were randomly taken as the normal control group ( A ) and remaining 20 rats were given streptozotocin ( STZ ) 60 mg/kg ) by intraperitoneal injection. After inducing diabetes, these model rats were equally divided into the two groups. The ligustrazine treatment group ( C ) was given ligustrazine 100 mg/ ( kg · d ) , while the diabetes control group ( B ) and the normal control group were given normovolemic normal saline 1 mL/100 g. Blood sugar and 24 h urine albumin quantity were measured at 4, 8, 12, 16 weeks. The rats were killed after 16 weeks for separating kidney. The aldose reductase ( AR ) activity in tissue was detected. The immuno-histochemical method was adopted to observe the expression of Bcl-2 and Bax. The partial renal cortex was taken for conducting the pathological observation and the electronic microscopic observation on the morphologic change of renal cell apoptosis. Results The ex-pression of Bcl-2 protein in the ligustrazine treatment group was increased compared with the diabetes control group, while the ex-pression of Bax protein was decreased;the AR activity in the ligustrazine treatment group was significantly decreased compared with the diabetes control group ( P=0. 000 ) , and higher than that in the normal control group without statistical difference ( P>0. 05 ) . The blood sugar and AR activity in the diabetes control group were significantly higher than those in the normal control group ( P0.05)。B组血糖、醛糖还原酶活性均显著高于A组( P<0.01);C组电镜下凋亡形态学改变不明显,而B组呈典型的凋亡形态学改变,A组中未见凋亡性改变;B组肾小球基底膜增厚、系膜区域扩大,C组病变减轻;16周末,C组24 h尿白蛋白定量较B组显著下降( P=0.000)。结论川芎嗪能通过抑制醛糖还原酶活性

  12. Analysis of cost-effectiveness of 3 therapeutic schemes for type 2 diabetes mellitus%3种方案治疗2型糖尿病的成本-效果分析

    Institute of Scientific and Technical Information of China (English)

    于丹; 拾倩

    2016-01-01

    Objective To compare the curative effects and pharmacoeconomic costs of 3 therapeutic schemes in the treatment of type 2 diabetes mellitus. Methods By a retrospective survey method, 150 cases of type 2 diabetes mellitus patients were randomly divided into 3 groups. The 50 patients in group A were given Metformin hydrochloride sustained-release tablets, the 50 patients in group B were given Acarbose tablets, and the 50 patients in group C were given Mitiglinide calcium tablets for 12 weeks. The levels of fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG) and HbA1c were observed in the 3 groups before and after treatment. The cost-effectiveness was evaluated by pharmacoeconomic method. Results After 12 weeks, the FPG, 2-h PBG and HbAlc of the 3 groups were decreased to some extent. The costs of the 3 therapeutic schemes were 208.32, 529.20 and 609.84 yuan, respectively. The total effective rate of the groups A, B and C were 70.00%, 74.00% and 82.00%, respectively. The cost-effectiveness ratio of the groups A, B and C was 2.98, 7.15 and 7.44 respectively. Using the group A as a reference, ∆C/∆E for the groups B and C were 80.22 and 33.46 yuan respectively. Conclusions Among the 3 therapeutic schemes, Mitiglinide for the group C has pharmacoeconomic advantage in treating type 2 diabetes mellitus.%目的:比较3种方案治疗2型糖尿病的临床疗效并进行药物经济学成本-效果分析。方法采用回顾性调查方法,150例糖尿病患者随机分为二甲双胍组(A)、阿卡波糖组(B)、米格列奈组(C),疗程均为12周。观察3组患者治疗前后空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白值(HbA1c),运用成本-效果分析方法进行评价。结果治疗12周后,3组患者的FBG、2hPBG、HbA1c均不同程度降低。3种治疗糖尿病方案的成本分别为208.32、529.20和609.84元;总有效率分别为70.00%、74.00%和82.00%;成本-效果比分别为2.98、7

  13. [Therapeutic patient education revisited].

    Science.gov (United States)

    Ruiz, Juan

    2014-06-04

    The therapeutic patient education is an absolute necessity in the management of chronic diseases including diabetes. This discipline promotes personal autonomy to live optimally, to achieve personal and professional projects, despite the constraints of the disease and treatments. The DAWN2 study demonstrates the systemic effects of this disease that goes beyond simple glycemic control. The biopsychosocial dimension needs to be better explored. Other assessment tools should be used to better manage these patients. Exploring the health literacy and numeracy are other tools that can explore the problems for socially disadvantaged patients. The main goal is development of patient capabilities and his environment for the development of the human person.

  14. Therapeutic effect of glargine insulin combined with acarbose in elderly diabetic patients%甘精胰岛素联合阿卡波糖在老年糖尿病患者中的应用

    Institute of Scientific and Technical Information of China (English)

    罗小勇

    2013-01-01

    Objective To investigate the clinical efficacy and safety of glargine insulin combined with protamine zinc recombinant lispro insulin in elderly diabetic patients.Methods 96 cases of elderly diabetic were divided into the observation group (52 cases) and control group (44 cases),the control group was given protamine zinc recombinant insulin lispro treatment,and therapeutic effect was observed.Results After treatment FEG,2PBG and HbAlc were significantly lower than those before treatment (P<0.05); after treatment,glycemic index showed no significant difference between the two groups (P>0.05); the observation group' s hypoglycemia was 3.64%,significantly lower than 15.91% of the control group (P<0.05).Conclusion The combined therapy of the glargine insulin and acarbose treatment for senile diabetes is secure,effective,and patients are easier to accept.%目的 探讨甘精胰岛素联合阿卡波糖治疗老年糖尿病的临床疗效及安全性.方法 将96例老年糖尿病患者分为观察组52例和对照组44例,观察组给予甘精胰岛素联合阿卡波糖治疗,对照组给予精蛋白锌重组赖脯胰岛素治疗,观察两组患者治疗效果.结果 两组患者治疗后FEG、2PBG及HbAlc均明显低于治疗前(P<0.05);两组患者治疗后各血糖指标比较差异无统计学意义(P>0.05).观察组低血糖发生率为3.64%,明显低于对照组的15.91% (P<0.05).结论 甘精胰岛素联合阿卡波糖治疗老年糖尿病安全、有效,更易被患者接受.

  15. Diagnostic and Therapeutic Strategies of Gastric Motility Disorder in Different Stages of Diabetes%不同阶段糖尿病胃运动障碍诊治对策

    Institute of Scientific and Technical Information of China (English)

    蓝宇; 路国涛

    2012-01-01

    Gastric motility disorder is common in patients with diabetes. The cardinal symptoms include bloating, early satiety, epigastric discomfort, nausea, vomiting and delayed gastric emptying. Delayed gastric emptying affects pharmacokinetics of hypoglycemic agents, causes mismatch of peak postprandial blood glucose level and peak concentration of insulin and oral hypoglycemic agents, thereby affects glycemic control. There are different patterns of gastric motility disorder in different stages of diabetes. The most commonly used diagnostic method for gastric emptying is scintigraphic measurement. Treatment of gastric motility disorder in diabetes includes dietary modifications and prokinetic agents to ameliorate symptoms and improve glycemic control. Therapeutic approaches of gastroparesis include gastric electrical stimulation, endoscopic pyloric injection of botulinum toxin A, endoscopic placement of nasal-jejunum nutrient feeding tube and percutaneous endoscopic gastrostomy/jejunostomy and surgical therapy.%糖尿病患者常见胃运动障碍,表现为上腹胀、早饱、上腹不适、恶心、呕吐等症状以及胃排空延迟,胃排空延迟影响降血糖药的药代动力学,造成餐后血糖升高与降血糖药或胰岛素的血浓度高峰不匹配,进而影响血糖的控制与稳定.糖尿病不同阶段胃运动障碍表现形式不同.核素法是最常用的胃排空诊断方法.糖尿病胃运动障碍的处理包括饮食调节、促动力药以减轻症状、控制血糖,针对胃轻瘫的治疗包括胃电刺激、内镜下幽门注射肉毒杆菌毒素A、内镜下放置鼻胃空肠营养管或经皮内镜下胃(空肠)造瘘、外科手术等.

  16. Diabetes - resources

    Science.gov (United States)

    Resources - diabetes ... The following sites provide further information on diabetes: American Diabetes Association -- www.diabetes.org Juvenile Diabetes Research Foundation International -- www.jdrf.org National Center for Chronic Disease Prevention and Health Promotion -- ...

  17. Diabetic Retinopathy

    Science.gov (United States)

    ... Disease > Facts About Diabetic Eye Disease Facts About Diabetic Eye Disease Points to Remember Diabetic eye disease ... existing therapies for different patient groups. What is diabetic eye disease? Diabetic eye disease can affect many ...

  18. Therapeutic effects of thymopetidum on pulmonary tuberculosis complicated by diabetes mellitus%肺结核合并糖尿病患者应用胸腺五肽辅助治疗效果观察

    Institute of Scientific and Technical Information of China (English)

    王钧; 任瑞华; 李香兰; 张春艳

    2016-01-01

    目的:评价胸腺五肽联合抗结核药物治疗肺结核合并糖尿病的临床疗效。方法对92例初治涂阳肺结核合并2型糖尿病患者随机分为观察组和对照组,每组46例。观察组在行常规一线抗结核和降糖治疗的同时加用胸腺五肽2 mg/d静脉滴注,共30 d,对照组仅给予降糖及常规一线抗结核治疗方案,比较2组在病变吸收、痰菌转阴情况的差异,测定治疗前及治疗1个月后外周血T淋巴细胞亚群: CD3+细胞、CD4+细胞、CD8+细胞及血清IFN-γ、IL-10变化并作比较。结果观察组痰菌阴转、病灶吸收情况、空洞闭合及缩小等方面,均优于对照组,同时伴CD3+细胞、CD4+细胞回升,CD8+细胞下降,CD4+/CD8+回升,IL-10降低和IFN-γ升高( P <0|.05)。结论抗结核治疗的同时加用胸腺五肽,可提高初治涂阳肺结核合并糖尿病患者的痰菌阴转率、促进病变吸收、增强机体免疫力,并有利于外周血IFN-γ水平的提高,促进IL-10下降,使Th1/Th2恢复平衡。%Objective To observe and evaluate the therapeutic effects of thymopetidum on pulmonary tuberculosis ( TB ) complicated by diabetes mellitus .Methods Ninety -two patients with TB complicated by diabetes mellitus were randomly divided into two groups:observation group and control group ,with 46 patients in each group .The patients in control group were treated by conventional anti-TB therapeutic schedule and hypoglycemics , however , the patients in observation group,on the basis of control group ,were given thymopetidum (2mg/d) by intravenous drip ,with a treatment course of 30 days for both groups.The changes of T lymphocyte subsets (CD3+,CD4+,CD8+) and IFN-γ,IL-10 were detected before treatment and after 1-month treatment ,moreover , the therapeutic effects were observed and compared between two groups .Results The sputum negative conversion rate , remission of pulmonary lesion and diminution or closure of

  19. Symptoms, syndrome types and therapeutic principles in medical records of diabetes differentiated and treated by Professor LV Ren-he%吕仁和辨治糖尿病医案症状、证候和治则解析

    Institute of Scientific and Technical Information of China (English)

    肖永华; 王世东; 李靖; 高菁; 赵进喜; 吕仁和

    2011-01-01

    目的 通过对吕仁和治疗糖尿病医案中医辨证要素的统计分析,总结吕仁和教授分期辨治糖尿病的学术思想.方法 128例经吕仁和教授诊治的糖尿病医案,经过“解析和标引”预处理,借助“中医医案数据库”的统计分析功能,将医案分成脾瘅期、消渴期、消瘅期三期,分别统计分析其症状体征、证候和治则.结果 脾瘅期症状以倦怠乏力、口干最突出,气阴两虚证可能在脾瘅期较为常见.消渴期黄苔出现几率最高,瘀血阻络证居证候统计的第2位,提示热证与血瘀证均是消渴期常见的重要标实证候,肝肾阴虚和气阴亏虚是消渴期常见的本虚证型,吕仁和教授既往总结的脾肾阳虚证相对少见.消瘅期症状以倦怠乏力、腰酸痛、目昏较常见,提示肝肾两虚在此期尤为明显,湿热、痰饮、瘀血在消瘅期普遍存在,彼此胶结,共同酿成“浊毒”;证候统计显示瘀血阻络证居首位,与前两期的证候统计结果相比,表明随着病程进展,瘀血阻络证出现频次明显增加,符合吕仁和教授的“微型癥瘕”病理假说;治则的统计结果与吕仁和教授认识的此期“气血阴阳俱虚、浊毒内停”的证候特点相吻合.结论 糖尿病三期医案的症状、证候和治则分析内在吻合度良好,且与吕仁和教授糖尿病分期理论相符合.%Objective To sum up the academic thought of Professor LV Ren-he's in differentiation and treatment of diabetes at stages through the statistical analysis on the factors of TCM syndrome differentiation of diabetes in cases treated by Professor LV Ren-he. Methods The diabetic cases treated by Professor LV Ren-he ( n - 128) were classified into Pidan stage, Xiaoke stage and Xiaodan stage based on the statistical function of TCM Medical Record Database after the pretreatment with resolution and indexing. The symptoms, signs, syndromes and therapeutic principles were analysed respectively

  20. Therapies for diabetic dyslipidaemia.

    Science.gov (United States)

    Bell, D S H; Al Badarin, F; O'Keefe, J H

    2011-04-01

    Correction of diabetic dyslipidaemia in diabetic patients is the most important factor in reducing cardiac risk. Diabetic dyslipidaemia is characterized by elevated triglycerides, low total high-density lipoprotein (HDL) and small dense low-density lipoprotein (LDL) particles. The most important therapeutic goal in diabetic dyslipidaemia is correction of the non-HDL-cholesterol (HDL-C) level. Glycaemic control with particular attention to postprandial glucose control plays a role not only in improving dyslipidaemia but also in lowering cardiac events. Pioglitazone is particularly effective for improving the manifestations of diabetic dyslipidaemia, in addition to its favorable effects on systemic inflammation and hyperglycaemia. Use of statins in addition to lifestyle change is recommended in most if not all type 2 diabetic patients and the goal should be to lower the LDL to a level recommended for the patient with existing cardiovascular disease (CVD) (non-HDL-C level HDL and triglyceride levels should be deployed. Most patients with type 2 diabetes (T2D) will require combining a lipid-lowering therapy with therapeutic lifestyle changes to achieve optimal lipid levels. Combinations usually include two or more of the following: a statin, nicotinic acid, omega-3 fats and bile acid sequestrants (BASs). Fibrates may also be of use in diabetic patients with persistently elevated triglycerides and depressed HDL-C levels, although their role in lowering adverse CV events is questionable. © 2011 Blackwell Publishing Ltd.

  1. Diabetes and Pancreatic Cancer

    Science.gov (United States)

    Li, Donghui

    2011-01-01

    Type 2 diabetes mellitus is likely the third modifiable risk factor for pancreatic cancer after cigarette smoking and obesity. Epidemiological investigations have found that long-term type 2 diabetes mellitus is associated with a 1.5- to 2.0-fold increase in the risk of pancreatic cancer. A causal relationship between diabetes and pancreatic cancer is also supported by findings from prediagnostic evaluations of glucose and insulin levels in prospective studies. Insulin resistance and associated hyperglycemia, hyperinsulinemia, and inflammation have been suggested to be the underlying mechanisms contributing to development of diabetes-associated pancreatic cancer. Signaling pathways that regulate the metabolic process also play important roles in cell proliferation and tumor growth. Use of the antidiabetic drug metformin has been associated with reduced risk of pancreatic cancer in diabetics and recognized as an antitumor agent with the potential to prevent and treat this cancer. On the other hand, new-onset diabetes may indicate subclinical pancreatic cancer, and patients with new-onset diabetes may constitute a population in whom pancreatic cancer can be detected early. Biomarkers that help define high-risk individuals for clinical screening for pancreatic cancer are urgently needed. Why pancreatic cancer causes diabetes and how diabetes affects the clinical outcome of pancreatic cancer have yet to be fully determined. Improved understanding of the pathological mechanisms shared by diabetes and pancreatic cancer would be the key to the development of novel preventive and therapeutic strategies for this cancer. PMID:22162232

  2. Therapeutic effect of PGE-1 combined with mecobalamin treatment for diabetic peripheral neuropathy%前列腺素E1联合弥可保治疗糖尿病周围神经病变的疗效

    Institute of Scientific and Technical Information of China (English)

    裴先锋

    2012-01-01

    Objective To study the clinical therapeutic effect of PGE-1 combined with mecobalamin on diabetic peripheral neuropathy. Methods 108 patients with diabetic peripheral neuropathy in our department from February 2008 to December 2011 were divided into two groups randomly. In addition to control blood glucose,50 cases were treated with mecobalamin (control group) ,58 cases were treated with PGE-1 combined with mecobalamin on the basis of the treatment of control group (treatment group) . The clinical effect and nerve conduction velocity of the two groups were compared. Results After treatment, the total effective rate of treatment group (89. 65 % ) was significantly higher than that of control group(72% ,P<0. 05) ;The motor nerve conduction velocity and sensory nerve conduction velocity of median nerve and peroneal nerve in treatment group were significantly higher than those in control group (P < 0. 01 ). Conclusion PGE-1 combined with mecobalamin can be used to improve the nerve conduction velocity and clinical efficiency, it is worthy of clinical application.%目的 探讨前列腺素E1联合弥可保治疗糖尿病周围神经病变(DPN)的临床疗效.方法 2008年2月至2011年12月在我院内分泌科住院治疗的108例DPN患者随机分为2组,对照组50例采用常规治疗和弥可保治疗,实验组58例在对照组的基础上应用前列腺素E1.比较两组的临床疗效及治疗前后神经传导速度.结果 实验组的临床总有效率为89.65%,明显高于对照组的72% (P<0.05).治疗后,对照组正中神经和腓总神经的MNCV和SNCV传导速度明显提高(P<0.05);实验组的正中神经和腓总神经的MNCV和SNCV传导速度明显高于治疗前及对照组(P<0.01).结论 前列腺素E1联合弥可保治疗DPN,能有效改善神经传导速度,临床有效率高,值得在临床上推广应用.

  3. Diagnosis and classification of autoimmune diabetes mellitus.

    Science.gov (United States)

    Canivell, Silvia; Gomis, Ramon

    2014-01-01

    Diabetes mellitus is increasing in prevalence worldwide. The economic costs and burden of the disease are considerable given the cardiovascular complications and co-morbidities that it may entail. Two major groups of diabetes mellitus have been defined, type 1, or immune-based, and type 2. In recent years, other subgroups have been described in-between these major groups. Correct classification of the disease is crucial in order to ascribe the most efficient preventive, diagnostic and treatment strategies for each patient. In the present review, we discuss the epidemiology, etiopathogenesis, diagnostic criteria and clinical classification of what is currently known as autoimmune diabetes. In addition, the other groups of diabetes mellitus will be regarded in relation to their pathogenesis and potential autoimmunity features.

  4. 胃旁路术联合营养干预对肥胖型2型糖尿病的疗效观察%Therapeutic Effects of Laparoscopic Gastric Bypass and Nutritional Intervention on Type 2 Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    邱小文; 金迪; 刘慧

    2013-01-01

    Objective To observe the therapeutic effects of laparoscopic Roux-en-Y gastric bypass and nutritional intervention in type 2 diabetes mellitus (T2DM).Methods A total of 76 T2DM patients were randomly assigned into treatment group and control group B with or without nutritional supplements.Three months and six months after the surgery,the index of glycometabolism,islet cell function,nutrition status,and other related indicators or complications were observed and recorded.Results After surgery,the clinical complete remission rate was 84.21% (64/76),and the partial remission rate was 15.79% (12/76).In both groups the levels of fasting blood glucose,glycated hemoglobin and serum iron levels were decreased (P<0.01),the fasting insulin and C peptide were increased (P<0.01).Compared with the control group,the serum iron and ferritin levels were significantly increased (P<0.01),the incidence of alopecia and anemia were lower (P<0.05).Conclusion Therapeutic effect of laparoscopic Roux-en-Y gastric bypass on T2DM is satisfactory.Nutritional interventions helps the patients to maintain good nutrition status,and can reduce the occurrence of the complications.%目的 观察胃旁路术(gastric bypass,GBP)联合营养干预,对肥胖型2型糖尿病(type 2 diabetes mellitus,T2DM)的疗效.方法 76例实施GBP的肥胖型T2DM患者,随机分为联合营养治疗组与对照组,每组38例.于术后3个月、6个月观察其糖代谢、胰岛细胞功能、营养状态等相关指标和并发症.结果 术后,患者临床完全缓解率为84.21%(64/76),部分缓解率15.79%(12/76);两组空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、血清铁水平显著下降(P<0.01),空腹胰岛素和空腹C肽显著升高(P<0.01).与对照组比较:联合营养治疗组血清铁、血清铁蛋白水平显著升高(P<0.01);脱发、贫血等发生率显著减少(P<0.05).结论 GBP对肥胖型T2DM病情控制疗效满意

  5. 4种方案治疗2型糖尿病的成本-效果分析%Cost-effectiveness Analysis of 4 Therapeutic Schemes in the Treatment of Type 2 Diabetes Meilitus

    Institute of Scientific and Technical Information of China (English)

    沈万香; 张邦升

    2011-01-01

    目的:比较4种方案治疗2型糖尿病的成本-效果.方法:将2009-2010年入选的2型糖尿病患者随机分为A组(72例,阿卡波糖)、B组(72例,格列美脲)、C组(71例,二甲双胍)、D组(71例,瑞格列奈+二甲双胍)并进行治疗.评价其疗效并进行成本-效果分析.结果:治疗后,4组空腹血糖及餐后2h血糖的总有效率两两比较差异均无统计学意义(P>0.05);4组成本分别为798.32、258.54、184.55、210.32元;对空腹血糖的成本-效果比分别为942.53、310.37、225.89、240.92;对餐后2h血糖的成本-效果比分别为845.68、300.28、214.84、237.11;A、B、D组相对于C组对空腹血糖的增量成本-效果比分别为20 459、4 624.38、460.18,对餐后2h血糖的增量成本-效果比分别为7 220.82、36 995.00、920.36.结论:二甲双胍治疗2型糖尿病成本较低,但瑞格列奈联合二甲双胍控制2型糖尿病患者空腹血糖和餐后2h血糖的成本-效果比较优.%OBJECTIVE: To compare the cost-effectiveness of four treatment schemes on type 2 diabetes mellitus. METHODS: Included type 2 diabetes mellitus patients during 2009 - 2010 were randomly divided into group A (72 cases, acarbose), group B (72 cases, glimepride), group C (71 case, metformin), group D (71 cases, repaglinide+metformin). Therapeutic efficacies of those groups were evaluated and cost-effect analysis was conducted. RESULTS: There was no statistical significance in the total effective rate of fasting blood glucose and 2 h blood glucose after meal among 4 groups after treatment (p>0.05). The costs of 4 groups were 798.32 yuan, 258.54 yuan, 184.55 yuan and 210.32 yuan, respectively. The cost-effectiveness ratios of fasting blood sugar were 942.53, 310.37, 225.89 and 240.92. The cost-effectiveness ratio of blood sugar 2 h after meal were 845.68, 300.28, 214.84 and 237.11; The incremental cost-effectiveness ratios of fasting blood glucose in group A, B, D were 20 459, 4 624.38, 460.18, compared with

  6. Combined therapeutic effect of alprostadil and mecobalamin on 128 patients with diabetic peripheral neuropathy%前列地尔联合甲钴胺治疗糖尿病周围神经病变128例

    Institute of Scientific and Technical Information of China (English)

    王志宏; 陈海燕; 郭瑞清

    2009-01-01

    Objective To observe the clinical effect of combined treatment of alprostadil and mecobalamin on diabetic peripheral neuropathy (DPN). Methods One hundred and twenty eight patients of DPN were divided into four groups: the alprostadil combined mecobalamine treated group, the alprostadil treated group, the meeobalamine treated group and the underline treated group, randomly. The therapeutic effect and nerve conduction velocity were compared between the four groups prior treatment and post-treatment. Results The alprostadil combined mecobalamine treated group gain an advantage than the alprostadil treated group or the mecobalamine treated group at clinical effectiveness and nerve conduction velocity(P<0.05). Conclusions Alprostadil combined meeobalamine treated can improve DPN more effective than alprostadil treated or mecobalamine treated only.%目的 观察前列地尔联合甲钴胺治疗糖尿病周围神经病变的效果.方法 128例糖尿病神经病变患者,随机分为前列地尔联合甲钴胺治疗组、单用前列地尔治疗组、单用甲钴胺治疗组及基础治疗组,比较四组患者治疗前后肌电图改变及临床疗效.结果 前列地尔联合甲钴胺治疗组在临床疗效及神经传导速度方面明显优于单用前列地尔组或单用甲钴胺治疗组(P<0.05).结论 前列地尔联合甲钴胺治疗比单用前列地尔或甲钴胺治疗可更有效改善糖尿病周围神经病变.

  7. Women and Diabetes -- Diabetes Medicines

    Science.gov (United States)

    ... Audience For Women Women's Health Topics Women and Diabetes - Diabetes Medicines Share Tweet Linkedin Pin it More sharing ... 1-800-332-1088 to request a form. Diabetes Medicines The different kinds of diabetes medicines are ...

  8. HDAC inhibition induces HIV-1 protein and enables immune-based clearance following latency reversal

    DEFF Research Database (Denmark)

    Wu, Guoxin; Swanson, Michael; Talla, Aarthi

    2017-01-01

    Promising therapeutic approaches for eradicating HIV include transcriptional activation of provirus from latently infected cells using latency-reversing agents (LRAs) and immune-mediated clearance to purge reservoirs. Accurate detection of cells capable of producing viral antigens and virions, an...

  9. Immunity-based detection, identification, and evaluation of aircraft sub-system failures

    Science.gov (United States)

    Moncayo, Hever Y.

    This thesis describes the design, development, and flight-simulation testing of an integrated Artificial Immune System (AIS) for detection, identification, and evaluation of a wide variety of sensor, actuator, propulsion, and structural failures/damages including the prediction of the achievable states and other limitations on performance and handling qualities. The AIS scheme achieves high detection rate and low number of false alarms for all the failure categories considered. Data collected using a motion-based flight simulator are used to define the self for an extended sub-region of the flight envelope. The NASA IFCS F-15 research aircraft model is used and represents a supersonic fighter which include model following adaptive control laws based on non-linear dynamic inversion and artificial neural network augmentation. The flight simulation tests are designed to analyze and demonstrate the performance of the immunity-based aircraft failure detection, identification and evaluation (FDIE) scheme. A general robustness analysis is also presented by determining the achievable limits for a desired performance in the presence of atmospheric perturbations. For the purpose of this work, the integrated AIS scheme is implemented based on three main components. The first component performs the detection when one of the considered failures is present in the system. The second component consists in the identification of the failure category and the classification according to the failed element. During the third phase a general evaluation of the failure is performed with the estimation of the magnitude/severity of the failure and the prediction of its effect on reducing the flight envelope of the aircraft system. Solutions and alternatives to specific design issues of the AIS scheme, such as data clustering and empty space optimization, data fusion and duplication removal, definition of features, dimensionality reduction, and selection of cluster/detector shape are also

  10. Bioactive Compounds and Their Neuroprotective Effects in Diabetic Complications

    OpenAIRE

    Oh, Yoon Sin

    2016-01-01

    Hyperglycemia, hyperlipidemia and impaired insulin signaling during the development of diabetes can cause diabetic complications, such as diabetic neuropathy, resulting in significant morbidity and mortality. Although various therapeutics are available for the treatment of diabetic neuropathy, no absolute cure exists, and additional research is necessary to comprehensively understand the underlying pathophysiological pathways. A number of studies have demonstrated the potential health benefit...

  11. 神经干细胞移植治疗糖尿病大鼠神经源性膀胱的实验研究%The therapeutic effect of neural stem cells implantation for rat model of diabetic neurogenic bladder caused by diabetes

    Institute of Scientific and Technical Information of China (English)

    陈潮江; 周兴; 郑煜; 符厚圣

    2013-01-01

    Objectives To evaluate the therapeutic effect of Neural Stem Cells (NSCs) implantation for Diabetic Neurogenic Bladder(DNB) caused by Diabetes.Methods The SD rat model of DNB,induced by streptozocin(STZ) intraperitoneal injection,were transplanted via femoral vein or bladder muscles according to their group with cultured NSCs deriving from hippocampus of neonatal SD rat,then followed by urodynamics to evaluate their urinary function of different group after 8 weeks of cells implantation.Results The impaired nerve of DNB rat got better recovery for their improved urinary function as the result of NSCs injection to bladder muscles.Conclusions NSCs transplantation could be the potential therapy for DNB rat.%目的 研究神经干细胞(Neural Stem Cells,NSCs)移植对于治疗糖尿病引起的神经源性膀胱(diabetic neurogenic bladder,DNB)的实验疗效.方法 SD大鼠腹腔注射链脲佐菌素(Streptozotocin,STZ)制造出糖尿病大鼠神经源性膀胱模型,用胰岛素控制血糖后,将从新生SD大鼠海马组织分离培养出的NSCs,通过股静脉注射、膀胱肌肉注射移植入2组糖尿病SD大鼠神经源性膀胱模型中,通过尿流动力学观察移植后8周各组SD大鼠的排尿情况.结果 膀胱肌肉注射NSCs,能更好修复糖尿病大鼠神经源性膀胱的受损神经,改善排尿功能.结论 NSCs移植可作为糖尿病大鼠DNB的一种治疗方法.

  12. Heat Shock Proteins and Diabetes.

    Science.gov (United States)

    Zilaee, Marzie; Shirali, Saeed

    2016-12-01

    Diabetes is a chronic disease, and its prevalence continues to rise and can increase the risk for the progression of microvascular (such as nephropathy, retinopathy and neuropathy) and also macrovascular complications. Diabetes is a condition in which the oxidative stress and inflammation rise. Heat shock proteins (HSPs) are a highly conserved family of proteins that are expressed by all cells exposed to environmental stress, and they have diverse functions. In patients with diabetes, the expression and levels of HSPs decrease, but these chaperones can aid in improving some complications of diabetes, such as oxidative stress and inflammation. (The suppression of some HSPs is associated with a generalized increase in tissue inflammation.) In this review, we summarize the current understanding of HSPs in diabetes as well as their complications, and we also highlight their potential role as therapeutic targets in diabetes. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  13. Therapeutic ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Crum, Lawrence A [Center for Industrial and Medical Ultrasound, 1013 NE 40th Street, University of Washington, Seattle, WA 98105 (United States)

    2004-01-01

    The use of ultrasound in medicine is now quite commonplace, especially with the recent introduction of small, portable and relatively inexpensive, hand-held diagnostic imaging devices. Moreover, ultrasound has expanded beyond the imaging realm, with methods and applications extending to novel therapeutic and surgical uses. These applications broadly include: tissue ablation, acoustocautery, lipoplasty, site-specific and ultrasound mediated drug activity, extracorporeal lithotripsy, and the enhancement of natural physiological functions such as wound healing and tissue regeneration. A particularly attractive aspect of this technology is that diagnostic and therapeutic systems can be combined to produce totally non-invasive, imageguided therapy. This general lecture will review a number of these exciting new applications of ultrasound and address some of the basic scientific questions and future challenges in developing these methods and technologies for general use in our society. We shall particularly emphasize the use of High Intensity Focused Ultrasound (HIFU) in the treatment of benign and malignant tumors as well as the introduction of acoustic hemostasis, especially in organs which are difficult to treat using conventional medical and surgical techniques. (amum lecture)

  14. Mechanisms by which diabetes increases cardiovascular disease

    OpenAIRE

    Gleissner, Christian A.; Galkina, Elena; Nadler, Jerry L.; Ley, Klaus

    2007-01-01

    Diabetes mellitus is one of the major risk factors for cardiovascular disease which is the leading cause of death in the U.S. Increasing prevalence of diabetes and diabetic atherosclerosis makes identification of molecular mechanisms by which diabetes promotes atherogenesis an important task. Targeting common pathways may ameliorate both diseases. This review focuses on well known as well as newly discovered mechanisms which may represent promising therapeutic targets.

  15. Vaccines: A review of immune-based interventions to prevent and treat disease.

    Science.gov (United States)

    Alemayehu, Demissie; Utt, Eric; Knirsch, Charles

    2015-03-01

    The enormous gains made in public health during the 20th century, through the prevention and treatment of infectious disease, have contributed to dramatic improvements in the quality and length of the human lifespan. Continued advances in medicine are dependent on addressing several challenges including the increase in existing and new resistance to antibiotics, the decrease in productivity of the research and development (R&D) ecosystem, uncertain regulatory pathways, and an economic environment that rewards innovation for developing therapeutics that involve long cycle times from idea to a product. In this article, we consider important issues pertaining to the development of vaccines with particular emphasis on preclinical requirements, optimal dose selection, design, execution, and reporting of clinical trials for regulatory submission, planning and implementation of post-approval life-cycle programs, and emerging themes in therapeutic vaccines. © 2015, The American College of Clinical Pharmacology.

  16. Diabetes mellitus

    OpenAIRE

    Nessim Dayan, Edgard; Fundación Valle de Lili

    1996-01-01

    ¿Qué es la diabetes?/¿Cuantos tipos o formas de diabetes existen?/¿Cuáles son los síntomas de la diabetes?/¿cuál es la causa de la diabetes?/¿Quién tiene mayor riesgo de desarrollar diabetes?/¿Cómo se diagnostica la diabetes?/¿Cuál es el tratamiento de la diabetes?/¿Cuándo y cómo se controlan los niveles de glicemia?/¿Cuáles son las complicaciones de la diabetes?/Recomendaciones actuales y futuro de la diabetes.

  17. Diabetic Nephropathy without Diabetes

    Directory of Open Access Journals (Sweden)

    Katia López-Revuelta

    2015-07-01

    Full Text Available Diabetic nephropathy without diabetes (DNND, previously known as idiopathic nodular glomerulosclerosis, is an uncommon entity and thus rarely suspected; diagnosis is histological once diabetes is discarded. In this study we describe two new cases of DNND and review the literature. We analyzed all the individualized data of previous publications except one series of attached data. DNND appears to be favored by recognized cardiovascular risk factors. However, in contrast with diabetes, apparently no factor alone has been demonstrated to be sufficient to develop DNND. Other factors not considered as genetic and environmental factors could play a role or interact. The most plausible hypothesis for the occurrence of DNND would be a special form of atherosclerotic or metabolic glomerulopathy than can occur with or without diabetes. The clinical spectrum of cardiovascular risk factors and histological findings support this theory, with hypertension as one of the characteristic clinical features.

  18. Diabetes and Wound Angiogenesis

    Science.gov (United States)

    Okonkwo, Uzoagu A.; DiPietro, Luisa A.

    2017-01-01

    Diabetes Mellitus Type II (DM2) is a growing international health concern with no end in sight. Complications of DM2 involve a myriad of comorbidities including the serious complications of poor wound healing, chronic ulceration, and resultant limb amputation. In skin wound healing, which has definite, orderly phases, diabetes leads to improper function at all stages. While the etiology of chronic, non-healing diabetic wounds is multi-faceted, the progression to a non-healing phenotype is closely linked to poor vascular networks. This review focuses on diabetic wound healing, paying special attention to the aberrations that have been described in the proliferative, remodeling, and maturation phases of wound angiogenesis. Additionally, this review considers therapeutics that may offer promise to better wound healing outcomes. PMID:28671607

  19. Diabetes and Wound Angiogenesis

    Directory of Open Access Journals (Sweden)

    Uzoagu A. Okonkwo

    2017-07-01

    Full Text Available Diabetes Mellitus Type II (DM2 is a growing international health concern with no end in sight. Complications of DM2 involve a myriad of comorbidities including the serious complications of poor wound healing, chronic ulceration, and resultant limb amputation. In skin wound healing, which has definite, orderly phases, diabetes leads to improper function at all stages. While the etiology of chronic, non-healing diabetic wounds is multi-faceted, the progression to a non-healing phenotype is closely linked to poor vascular networks. This review focuses on diabetic wound healing, paying special attention to the aberrations that have been described in the proliferative, remodeling, and maturation phases of wound angiogenesis. Additionally, this review considers therapeutics that may offer promise to better wound healing outcomes.

  20. Diabetic bladder dysfunction

    Institute of Scientific and Technical Information of China (English)

    Guiming Liu; Firouz Daneshgari

    2014-01-01

    Objective To review studies on diabetic bladder dysfunction (DBD),a common and bothersome complication of diabetes mellitus.Data sources We performed a search of the English literature through PubMed.The key words used were "diabetes" and "bladder dysfunction" or "cystopathy".Our own data and perspective are included in the discussion.Study selection Studies containing data relevant to DBD were selected.Because of the limited length of this article,we also referenced reviews that contain comprehensive amalgamations of relevant literature.Results The classic symptoms of DBD are decreased bladder sensation,increased bladder capacity,and impaired bladder emptying with resultant elevated post-void residual urine.However,recent clinical and experimental evidence indicate a strong presence of storage problems such as urge incontinence in diabetes.Recent studies of DBD in animal models of type 1 diabetes have revealed temporal effects of diabetes,causing an early phase of compensatory bladder function and a later phase of decompensated bladder function.The pathophysiology of DBD is multifactorial,including disturbances of the detrusor,urothelium,autonomic nerves,and urethra.Polyuria and hyperglycemia play important but distinctive roles in induction of bladder dysfunction in type 1 diabetes.Polyuria causes significant bladder hypertrophy in the early stage of diabetes,whereas oxidative stress in the bladder caused by chronic hyperglycemia may play an important role in the late stage failure of bladder function.Conclusions DBD includes time-dependent and mixed manifestations.The pathological alterations include muscle,nerve,and urothelium.Polyuria and hyperglycemia independently contribute to the pathogenesis of DBD.Treatments for DBD are limited.Future clinical studies on DBD in type 1 and type 2 diabetes should be investigated separately.Animal studies of DBD in type 2 diabetes are needed,from the natural history to mechanisms.Further understanding of the molecular

  1. 瑞格列奈治疗2型糖尿病并动脉硬化患者的疗效%Therapeutic effect of repaglinide on patients with type 2 diabetes mellitus complicated atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    简强; 李佳; 李鹏飞

    2016-01-01

    目的:探讨瑞格列奈治疗2型糖尿病合并动脉粥样硬化患者的临床效果.方法:选择2012年3月~2014年5月入我院就诊的2型糖尿病合并动脉粥样硬化患者120例,随机被均分为瑞格列奈组[接受瑞格列奈(诺和龙)治疗]和格列吡嗪组[接受吡磺环己脲(格列吡嗪)治疗].分析比较两组患者治疗前后空腹血糖、餐后2h血糖水平,治疗后血清高敏C反应蛋白(hsCRP)、氧化型低密度脂蛋白(oxLDL)水平以及患者对治疗的满意度.结果:与治疗前比较,治疗后两组的空腹血糖、餐后2h血糖水平均显著降低(P均<0.01);与格列吡嗪组比较,瑞格列奈组治疗后空腹血糖[(6.94±0.41)mmol/L比(6.05±0.54)mmol/L],餐后2h血糖[(8.03±0.74)mmol/L比(7.66±0.78)mmol/L],血清hsCRP[(5.75±0.26)mg/L比(4.71±0.32)mg/L]和血清oxLDL水平[(98.30±25.05)μg/dl比(52.21±17.50)μg/dl]均显著降低,P均<0.01.瑞格列奈组满意率(93.33%比60.00%)显著高于格列吡嗪组(P<0.01).结论:瑞格列奈治疗2型糖尿病合并动脉硬化患者效果显著,可显著降低血糖血脂和血清hsCRP水平.%Objective:To explore therapeutic effect of repaglinide on patients with type 2 diabetes mellitus (T2DM) complicated atherosclerosis (AS).Methods:A total of 120 T2DM + AS patients treated in our hospital from Mar 2012 to May 2014 were selected.They were randomly and equally divided into repaglinide group (received repaglin- ide treatment)and glipizide group (received glipizide treatment).Fasting blood glucose (FBG)and 2h postprandial blood glucose (2hPG)levels before and after treatment,serum levels of high sensitive C reactive protein (hsCRP) and oxidized low density lipoprotein (oxLDL)after treatment,and patients'satisfaction on treatment were com- pared and analyzed between two groups.Results:Compared with before treatment,there were significant reductions in levels of FBG and 2hPG in both groups after treatment (P<0.01 all);compared with glipizide group

  2. Diabetes Medicines

    Science.gov (United States)

    Diabetes means your blood glucose, or blood sugar, levels are too high. If you can't control your diabetes with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends ...

  3. Analysis of the therapeutic effect of different drugs in diabetic peripheral neuropathy%糖尿病周围神经病变应用不同药物疗效分析

    Institute of Scientific and Technical Information of China (English)

    魏巧兰

    2016-01-01

    目的 分析糖尿病周围神经病变应用不同药物治疗的临床疗效.方法 选取我院收治的糖尿病周围神经病变患者96例,根据用药不同随机分成三组,甲钴胺组采取甲钴胺治疗,依帕司他组采取依帕司他治疗,联合组采取甲钴胺联合依帕司他治疗,比较三组临床疗效.结果 甲钴胺组总有效率56.25%,依帕司他组总有效率62.50%,联合组总有效率84.38%,三组总有效率差异有统计学意义(P<0.05).三组治疗后运动及感觉神经传导速度均优于治疗前,差异有统计学意义(P<0.05);联合组治疗后运动及感觉神经传导速度均优于甲钴胺组,差异有统计学意义(P<0.05).三组均未发生严重不良反应.结论 依帕司他、甲钴胺均是治疗糖尿病周围神经病变的有效药物,并且推荐进行联合用药,可在保证安全的情况下提高治疗效果.%Objective To analyze the clinical curative effect of different drugs in the treatment of diabetic peripheral neuropathy (DPN).Methods A total of 96 patients with DPN admitted to our hospital were randomly divided into 3 groups according to different medication.Mecobalamin group took mecobalamin,epalrestat group took epalrestat,and combined-treatment group took mecobalamin and epalrestat.Compared the clinical curative effect among three groups.Results The total efficiency of mecobalamin group,epalrestat group,and combinedtreatment group were 56.25%,62.50%,84.38%,with statistically significant difference (P<0.05).Motor and sensory nerve conduction velocity in three groups after treatment were better than those before treatment,with statistically significant differences (P<0.05);motor and sensory nerve conduction velocity in combined-treatment group after treatment were better than those in mecobalamin group,with statistically significant differences (P<0.05).There were no serious adverse reactions in 3 groups.Conclusion Epalrestat and mecobalamin are effective drug

  4. diabetic patients

    Directory of Open Access Journals (Sweden)

    Mehraban Falahati

    2016-09-01

    candiduria and female gender, high FBS and urine glucose, uncontrolled diabetes (HbA1c ≥8, and acidic urine pH (P<0.05. Conclusion: Considering the high incidence rate of candiduria in diabetic patients, control of diabetes, predisposing factors, and causal relationships between diabetes and candiduria should be highlighted.

  5. [Autonomic nervous system in diabetes].

    Science.gov (United States)

    Emdin, M

    2001-08-01

    Hyperglycemia and hyperinsulinemia have a primary role in determining the early functional and later anatomic changes at the level of the autonomic pathways controlling the circulation, and besides in directly influencing cardiac and vascular cellular targets and feed-back baroreceptor system sensitivity to neurohumoral modulation in patients with diabetes mellitus. The basic mechanisms of dysfunction and damage, and the clinical and prognostic value of diabetic cardiovascular dysautonomia are discussed together with the diagnostic apparatus and the possible therapeutic approaches.

  6. Exercise therapy in Type 2 diabetes

    NARCIS (Netherlands)

    S.F.E. Praet (Stephan); L.J.C. van Loon (Luc)

    2009-01-01

    textabstractStructured exercise is considered an important cornerstone to achieve good glycemic control and improve cardiovascular risk profile in Type 2 diabetes. Current clinical guidelines acknowledge the therapeutic strength of exercise intervention. This paper reviews the wide pathophysiologica

  7. Prevalence of Obesity and Its Influence on Achievement of Cardiometabolic Therapeutic Goals in Chinese Type 2 Diabetes Patients: An Analysis of the Nationwide, Cross-Sectional 3B Study.

    NARCIS (Netherlands)

    Zhou, X.; Ji, L.; Ran, X.; Su, B.; Ji, Q.; Pan, C.; Weng, J.; Ma, C.; Hao, C.; Zhang, D.; Hu, D.

    2016-01-01

    BACKGROUND: There are few data on the prevalence of obesity and its influence on achieving blood glucose, blood pressure, and blood lipid (3B) goals in Chinese type 2 diabetes outpatients. METHODS: Patient demographic data, anthropometric measurements, medications, and blood glucose and lipid

  8. New Approaches to Planning Diabetic Diets Workshop.

    Science.gov (United States)

    Kimmel, Georgia

    Instructional materials are provided for a workshop to enable participants to educate patients and food service staff regarding diabetic diets, incorporating current therapeutic recommendations and allowing variation and flexibility. Representative topics are facts about diabetes mellitus, high risk groups, symptoms, treatment and goals of diet…

  9. [Mental disorders and diabetes mellitus].

    Science.gov (United States)

    Abrahamian, Heidemarie; Kautzky-Willer, Alexandra; Rießland-Seifert, Angelika; Fasching, Peter; Ebenbichler, Christoph; Hofmann, Peter; Toplak, Hermann

    2016-04-01

    Psychiatric disorders and psychological problems are common in patients with diabetes mellitus. There is a twofold increase in depression which is associated with suboptimal glycemic control and increased morbidity and mortality. Other psychiatric disorders with a higher incidence of diabetes mellitus are cognitive impairment, dementia, disturbed eating behaviour, anxiety disorders, schizophrenia, bipolar disorders and borderline personality disorder. The coincidence of mental disorders and diabetes mellitus has unfavourable influences on metabolic control and micro- and macroangiopathic late complications. Improvement of therapeutic outcome is a challenge in the modern health care system. The intentions behind this position paper are to rise awareness of this special set of problems, to intensify cooperation between involved health care providers and to reduce incidence of diabetes mellitus as well as morbidity and mortality from diabetes in this patient group.

  10. [Diabetes mellitus].

    Science.gov (United States)

    Ahdi, M; Gerdes, V E A; Hoekstra, J B L; Meesters, E W

    2012-02-01

    Currently there are over 740,000 patients with diabetes mellitus in the Netherlands, and this number will increase further in the coming years. Approximately 90% of patients has type 2 diabetes, a metabolic disorder that is often associated with obesity, hypertension and increased cholesterol levels. Treatment of diabetes mellitus is essential to reduce the risk of severe complications with irreversible organ damage in the long-term. Gingivitis and periodontitis are more common in patients with diabetes mellitus and are now also considered as complications of diabetes. Collaboration among healthcare professionals is important for effective diabetes care.

  11. Exubera. Inhale therapeutic systems.

    Science.gov (United States)

    Bindra, Sanjit; Cefalu, William T

    2002-05-01

    Inhale, in colaboration with Pfizer and Aventis Pharma (formerly Hoechst Marion Roussel; HMR), is developing an insulin formulation utilizing its pulmonary delivery technology for macromolecules for the potential treatment of type I and II diabetes. By July 2001, the phase III program had been completed and the companies had begun to assemble data for MAA and NDA filings; however, it was already clear at this time that additional data might be required for filing. By December 2001, it had been decided that the NDA should include an increased level of controlled, long-term pulmonary safety data in diabetic patients and a major study was planned to be completed in 2002, with the NDA filed thereafter (during 2002). US-05997848 was issued to Inhale Therapeutic Systems in December 1999, and corresponds to WO-09524183, filed in February 1995. Equivalent applications have appeared to date in Australia, Brazil, Canada, China, Czech Republic, Europe, Finland, Hungary, Japan, Norway, New Zealand, Poland and South Africa. This family of applications is specific to pulmonary delivery of insulin. In February 1999, Lehman Brothers gave this inhaled insulin a 60% probability of reaching market, with a possible launch date of 2001. The analysts estimated peak sales at $3 billion in 2011. In May 2000, Aventis predicted that estimated peak sales would be in excess of $1 billion. In February 2000, Merrill Lynch expected product launch in 2002 and predicted that it would be a multibillion-dollar product. Analysts Merril Lynch predicted, in September and November 2000, that the product would be launched by 2002, with sales in that year of e75 million, rising to euro 500 million in 2004. In April 2001, Merrill Lynch predicted that filing for this drug would occur in 2001. Following the report of the potential delay in regulatory filing, issued in July 2001, Deutsche Banc Alex Brown predicted a filing would take place in the fourth quarter of 2002 and launch would take place in the first

  12. Frecuencia, características clínicas y resultados terapéuticos de la hipertensión arterial en diabéticos tipo 2 de un área de salud Frequency, clinical characteristics and therapeutic results of arterial hypertension in type 2 diabetics from a health area

    Directory of Open Access Journals (Sweden)

    Manuel E. Licea Puig

    2002-08-01

    Full Text Available Se determinó frecuencia, características clínicas y resultados terapéuticos de la HTA en diabéticos tipo 2 del área de salud «19 de Abril», de Ciudad de La Habana. Se realizó un estudio descriptivo y transversal a 683 pacientes. Se les confeccionó una historia clínica completa: edad, sexo, talla, peso, índice de masa corporal, índice cintura/cadera (ICC, hábito de fumar, tiempo de evolución, tipo de tratamiento y control metabólico de su enfermedad, severidad y control de la HTA. Se indicó glucemia en ayunas, excreción urinaria de albúmina (EUA, ECG y estudio oftalmológico. Se comprobó que utilizaba insulina el 19,65 % de los normotensos y el 29,3 % de los hipertensos (p 0,9 cm, a los niveles elevados de EUA, y al antecedente familiar de primera línea de HTA y/o ND. Muchos diabéticos no saben que son hipertensos, su control no es adecuado o no llevan tratamiento, lo cual sugiere que la atención terapéutica de la HTA en la DM2 aún dista mucho del ideal. La ND aislada o asociada a RD y a CI es frecuente en el diabético tipo 2 con HTA.The frequency, clinical characteristics and therapeutic results of AHT were determined in type 2 diabetics from the “19 de Abril” health area, in Havana City. A descriptive cross-sectional study was conducted to 683 patients. A complete medical history of each of them was made. Age, sex, height, weight, body mass index, waist/hip index (WHI, smoking habit, time of evolution, type of treatment and metabolic control of their disease, severity and control of AHT were included. Fasting glycaemia, urinary albumin excretion (UAE, ECG and ophthalmological examination were indicated. It was found that 19.65 % of the normotensive and 29.3 % of the hypertensive used insulin (p 0.9 cm, with the elevated levels of UAE and with the first line family history of AHT and/or DN .Many diabetics do not know they are hypertensives, their control is not adequate or they have no treatment, which suggests that

  13. Diabetic Eye Disease

    Science.gov (United States)

    ... Other Dental Problems Diabetes & Sexual & Urologic Problems Diabetic Eye Disease What is diabetic eye disease? Diabetic eye disease is a group of ... loss can occur. How does diabetes affect my eyes? Diabetes affects your eyes when your blood glucose, ...

  14. Diabetes Complications

    Science.gov (United States)

    If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can cause problems with other body ... as your kidneys, nerves, feet, and eyes. Having diabetes can also put you at a higher risk ...

  15. Diabetes Insipidus

    Science.gov (United States)

    Diabetes insipidus (DI) causes frequent urination. You become extremely thirsty, so you drink. Then you urinate. This ... is almost all water. DI is different from diabetes mellitus (DM), which involves insulin problems and high ...

  16. Diabetic Emergencies

    Science.gov (United States)

    ... Emergencies A-Z Share this! Home » Emergency 101 Diabetic Emergencies It is estimated that more than 20 ... they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through ...

  17. Diabetic ketoacidosis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000320.htm Diabetic ketoacidosis To use the sharing features on this page, please enable JavaScript. Diabetic ketoacidosis is a life-threatening problem that affects ...

  18. Diabetes Myths

    Science.gov (United States)

    ... Disease (Nephropathy) Gastroparesis Mental Health Step On Up Treatment & Care Blood Glucose Testing Medication Doctors, Nurses & More ... us get closer to curing diabetes and better treatments for those living with diabetes. Other Ways to ...

  19. Impact of glucose level on morbidity and mortality inelderly with diabetes and pre-diabetes

    Institute of Scientific and Technical Information of China (English)

    Orit Twito; Meir Frankel; Dan Nabriski

    2015-01-01

    The prevalence of type 2 diabetes mellitus (DM)increases with age and reaches 25% in those olderthan age 65 years. Pre-diabetes status is also verycommon in the elderly, and is present in about half ofthose age 75 years and older. Many physicians care forelderly patients with diabetes and pre-diabetes, dealingwith the challenge of controlling glucose levels andimproving health with minimal adverse events. Over thelast decade, research on diabetes among the elderlypopulation has proliferated, adding new information onthis topic. This review summarizes the updated medicalliterature on diabetes and pre-diabetes in the elderly,including the significance of pre-diabetic conditions,new-onset DM in the elderly and long-standing DM.The role of therapeutic intervention and the level ofglycemic control for this population are discussed inparticular.

  20. [Pathogenesis and significance of diabetic dyslipidemia].

    Science.gov (United States)

    Zeman, M; Zák, A

    2004-01-01

    Patients with type 2 diabetes mellitus are at the higher risk of development of on arteriosclerosis based cardiovascular diseases. Epidemiological studies have shown that diabetic dislipidemia with hypertriglyceridemia, presence of small dense LDL subfraction, low concentration of HDL-cholesterol and increased postprandial lipemia can represent a serious threat. Several studies have found significant decrease of cardiovascular morbidity and mortality after a treatment of diabetic dislipidemia, namely by statins and fibrates. Contemporary therapeutic algorhithms of European and American professional societies for the hyperlipidemia treatment classify diabetes mellitus as an equivalent of already developed complication of atherosclerosis. Our article presents pathophysiology of the diabetic dislipidemia, recommended target values of pasma lipids in diabetic patients and an overview of present possibilities of pharmacotherapy of the diabetic dislipidemia.

  1. Monogenic Diabetes

    Science.gov (United States)

    ... form of monogenic diabetes? • What type of monogenic diabetes does my child (or do I) have? • What are the treatment options? • What are the advantages and disadvantages of each treatment option? • Should I see a diabetes educator? • Should I see an endocrinologist? Resources • Find- ...

  2. DNA as therapeutics; an update

    Directory of Open Access Journals (Sweden)

    Saraswat P

    2009-01-01

    Full Text Available Human gene therapy is the introduction of new genetic material into the cells of an individual with the intention of producing a therapeutic benefit for the patient. Deoxyribonucleic acid and ribonucleic acid are used in gene therapy. Over time and with proper oversight, human gene therapy might become an effective weapon in modern medicine′s arsenal to help fight diseases such as cancer, acquired immunodeficiency syndrome, diabetes, high blood pressure, coronary heart disease, peripheral vascular disease, neurodegenerative diseases, cystic fibrosis, hemophilia and other genetic disorders. Gene therapy trials in humans are of two types, somatic and germ line gene therapy. There are many ethical, social, and commercial issues raised by the prospects of treating patients whose consent is impossible to obtain. This review summarizes deoxyribonucleic acid-based therapeutics and gene transfer technologies for the diseases that are known to be genetic in origin. Deoxyribonucleic acid-based therapeutics includes plasmids, oligonucleotides for antisense and antigene applications, deoxyribonucleic acid aptamers and deoxyribonucleic acidzymes. This review also includes current status of gene therapy and recent developments in gene therapy research.

  3. DNA as therapeutics; an update.

    Science.gov (United States)

    Saraswat, P; Soni, R R; Bhandari, A; Nagori, B P

    2009-09-01

    Human gene therapy is the introduction of new genetic material into the cells of an individual with the intention of producing a therapeutic benefit for the patient. Deoxyribonucleic acid and ribonucleic acid are used in gene therapy. Over time and with proper oversight, human gene therapy might become an effective weapon in modern medicine's arsenal to help fight diseases such as cancer, acquired immunodeficiency syndrome, diabetes, high blood pressure, coronary heart disease, peripheral vascular disease, neurodegenerative diseases, cystic fibrosis, hemophilia and other genetic disorders. Gene therapy trials in humans are of two types, somatic and germ line gene therapy. There are many ethical, social, and commercial issues raised by the prospects of treating patients whose consent is impossible to obtain. This review summarizes deoxyribonucleic acid-based therapeutics and gene transfer technologies for the diseases that are known to be genetic in origin. Deoxyribonucleic acid-based therapeutics includes plasmids, oligonucleotides for antisense and antigene applications, deoxyribonucleic acid aptamers and deoxyribonucleic acidzymes. This review also includes current status of gene therapy and recent developments in gene therapy research.

  4. Purinergic Signalling: Therapeutic Developments

    Directory of Open Access Journals (Sweden)

    Geoffrey Burnstock

    2017-09-01

    Full Text Available Purinergic signalling, i.e., the role of nucleotides as extracellular signalling molecules, was proposed in 1972. However, this concept was not well accepted until the early 1990’s when receptor subtypes for purines and pyrimidines were cloned and characterised, which includes four subtypes of the P1 (adenosine receptor, seven subtypes of P2X ion channel receptors and 8 subtypes of the P2Y G protein-coupled receptor. Early studies were largely concerned with the physiology, pharmacology and biochemistry of purinergic signalling. More recently, the focus has been on the pathophysiology and therapeutic potential. There was early recognition of the use of P1 receptor agonists for the treatment of supraventricular tachycardia and A2A receptor antagonists are promising for the treatment of Parkinson’s disease. Clopidogrel, a P2Y12 antagonist, is widely used for the treatment of thrombosis and stroke, blocking P2Y12 receptor-mediated platelet aggregation. Diquafosol, a long acting P2Y2 receptor agonist, is being used for the treatment of dry eye. P2X3 receptor antagonists have been developed that are orally bioavailable and stable in vivo and are currently in clinical trials for the treatment of chronic cough, bladder incontinence, visceral pain and hypertension. Antagonists to P2X7 receptors are being investigated for the treatment of inflammatory disorders, including neurodegenerative diseases. Other investigations are in progress for the use of purinergic agents for the treatment of osteoporosis, myocardial infarction, irritable bowel syndrome, epilepsy, atherosclerosis, depression, autism, diabetes, and cancer.

  5. Diabetes insipidus - nephrogenic

    Science.gov (United States)

    Nephrogenic diabetes insipidus; Acquired nephrogenic diabetes insipidus; Congenital diabetes insipidus; NDI ... of very dilute urine. NDI is rare. Congenital diabetes insipidus is present at birth. It is a ...

  6. Clinical Application of Detecting Fasting Blood Glucose and Glycosylated Hemoglobin on Diagnosis and Therapeutic Effect of Diabetes%糖化血红蛋白、空腹血糖检测在糖尿病诊断及其疗效评价的临床应用

    Institute of Scientific and Technical Information of China (English)

    续燕

    2013-01-01

    目的:探讨空腹血糖、糖化血红蛋白检测在糖尿病诊断及疗效评价中的临床价值。方法:随机选择我院住院2型糖尿病患者150例和健康体检者100例,分别采用葡萄糖氧化酶法测定空腹血糖水平,采用免疫透射比浊法测定HbA1c。结果:2型糖尿病患者空腹血糖水平与其糖化血红蛋白水平呈正相关(r=0.723,P<0.05),2型糖尿病患者和健康体检者空腹血糖水平差异显著(t=2.67,P<0.05)。结论:空腹血糖、糖化血红蛋白的检测对糖尿病的诊断及疗效评价具有重要临床价值。%Objective:To investigate clinical value of fasting blood glucose and glycosylated hemoglobin testing on the diagnosis and treatment of diabetes mellitus. Methods:100 healthy people and 150 patients with type 2 diabetic were randomly selected in our hospital. Fasting blood glucose levels were detected by using glucose oxidase method, and HbA1c were detected by using immune turbidimetric method. Results:There was a positive correlation about fasting blood glucose concentration and glycated hemoglobin level in type 2 diabetic patients( r=0.723, P<0.05). Fasting blood glucose levels was significantly different between type 2 diabetes patients and healthy people (t=2.67,P<0.05). Conclusion:Detecting fasting blood glucose and glycosylated hemoglobin had an important clinical value on diagnosis and therapeutic effect of diabetes, worthy of large-scale use in clinical.

  7. Neuroprotective effect of RYGB in Zucker fatty diabetic rats

    OpenAIRE

    2014-01-01

    The aim of this study is to explore the therapeutic potential of RYGB, a common used bariatric surgery, on diabetic polyneuropathy (DPN) in streptozotocin (STZ)-induced diabetic rats. In animal model experiments, rats were made diabetic by STZ administration, and after 12 weeks of diabetes, two groups were studied: RYGB and sham surgery control (PF). Change in oral glucose tolerance, insulin sensitivity, and the plasma concentrations of insulin, glucagon, glucagon-like peptide-1 (GLP-1) were ...

  8. Vitamin D and diabetes mellitus

    National Research Council Canada - National Science Library

    Harinarayan, Chittari Venkata

    2014-01-01

    .... Both forms of immunity, namely adaptive and innate, are regulated by 1,25(OH)2D3. The immune-modulatory properties of vitamin D suggest that it could play a potential therapeutic role in prevention of type 1 diabetes mellitus (T1DM...

  9. Diabetic Neuropathies.

    Science.gov (United States)

    Izenberg, Aaron; Perkins, Bruce A; Bril, Vera

    2015-08-01

    Diabetes mellitus is a common condition and diabetics are prone to develop a spectrum of neuropathic complications ranging from symmetric and diffuse to asymmetric and focal neuropathies that may be associated with significant morbidity. Diabetic sensorimotor polyneuropathy is the most common of these complications, occurring in patients with type 1 and 2 diabetes mellitus, as well as in those with prediabetes and glucose intolerance. In this review, the authors discuss the wide variety of neuropathies that can present in the context of diabetes, including the clinical manifestations, diagnostic features, and approach to management. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  10. Risk factors for occurrence and recurrence of diabetic foot ulcers among Iraqi diabetic patients

    Directory of Open Access Journals (Sweden)

    Samer I. Mohammed

    2016-03-01

    Full Text Available There are a few studies that discuss the medical causes for diabetic foot (DF ulcerations in Iraq, one of them in Wasit province. The aim of our study was to analyze the medical, therapeutic, and patient risk factors for developing DF ulcerations among diabetic patients in Baghdad, Iraq.

  11. Is diabetes self-management education still the Cinderella of diabetes care?

    DEFF Research Database (Denmark)

    Hurley, Lorna; O'Donnell, Máire; O'Hara, Mary Clare

    2017-01-01

    This paper reflects on the status of diabetes self-management education (DSME) as a branch of diabetology in Europe and discusses some opportunities for better supporting DSME delivery. DSME (also commonly known as Therapeutic Patient Education) has been evolving as a therapy for diabetes for dec...

  12. Comparison of the Therapeutic Effect of General Practice in Patients With Type 2 Diabetes Mellitus%2型糖尿病患者的全科医学治疗效果比较

    Institute of Scientific and Technical Information of China (English)

    张斌

    2016-01-01

    目的探讨全科医学治疗在2型糖尿病患者的疾病治疗过程的效果。方法选取我院康复中心2015年1月~2016年3月收治的2型糖尿病患者148例,按治疗方案的差异均分为对照组(常规糖尿病治疗模式)、实验组(全科医学治疗模式),评价两组患者治疗3个月后的临床效果。结果3个月后,实验组的各组临床效果数据均优于对照组,差异具有统计学意义(P<0.05);实验组的治疗有效率、疾病控制率、患者对疾病的认知率及患者的满意度均优于对照组,差异具有统计学意义(P<0.05)。结论有效的全科医学治疗模式在治疗2型糖尿病的过程,可显著提高临床效果,增加糖尿病的治疗有效率、疾病控制率、患者对疾病的认知率及患者的满意度,为糖尿病社区规范化治疗提供了可操作性经验。%Objective To study the general medical treatment in patients with type 2 diabetes disease process.Methods 148 cases patients with type 2 diabetes who were admitted to our hospital from January 2015 to March 2016 were divided into control group (conventional diabetes treatment mode) according to the difference of the treatment plan, experimental group (general medical treatment mode), to evaluate the clinical effect of two groups of patients after 3 months of treatment.Results After 3 months, the clinical data of the experimental group were better than those of the control group, the difference was statistically signiifcant (P<0.05). Effective treatment of experimental group, disease control rate, patients' cognition rate of disease and patients' satisfaction were better than those of the control group, the difference was statistically signiifcant (P<0.05). ConclusionEffective general medical treatment mode in the treatment of type 2 diabetes, which can signiifcantly improve clinical results, to increase the effciency of the treatment of diabetes, disease control rate, cognition

  13. Observation on the Therapeutic Effect of Metformin in Treatment of Type 2 Diabetes Mellitus%二甲双胍治疗2型糖尿病的疗效观察

    Institute of Scientific and Technical Information of China (English)

    任艳莉

    2015-01-01

    Objective To investigate the clinical efifcacy of metformin in treatment of type 2 diabetes mellitus. Methods selected 50 cases treated with metformin in patients with type 2 diabetes, and the clinical data were retrospectively analyzed. Results the patients treated by metformin after the total efifciency was 92%;and after treatment of patients with FBG, PG2h, HbAlc were signiifcantly improved (P<0.05), patients with adverse reaction rate of 14%. Conclusion The use of metformin in treatment of type 2 diabetes desirable good effect, and less adverse reactions, should be widely applied.%目的:探讨二甲双胍治疗2型糖尿病的临床疗效。方法选取我50例行二甲双胍治疗的2型糖尿病患者,并对其临床资料进行回顾性分析。结果本组患者采用二甲双胍治疗后总有效率为92.0%;且治疗后患者FBG、PG2h、HbAlc均较治疗前有所改善(P<0.05);患者发生不良反应率14.0%。结论采用二甲双胍治疗2型糖尿病可取的较好的效果,且不良反应少。

  14. [Classification of diabetes: an increasing heterogeneity].

    Science.gov (United States)

    Corcillo, Antonella; Corcillo Vionnet, Antonella; Jornayvaz, François R

    2015-06-03

    Diabetes mellitus is usually subdivided into type 1 and type 2. Despite precise criteria, distinction between these two types of diabetes can be difficult because of cases with superposition of the two classes. Adults aged 20 to 40 are particularly at risk of presenting an intermediary type of diabetes and thus are subject to misclassification. The distinction between these subtypes is relevant because of the therapeutic decision and the outcome which relies on insulin supply and therefore the evolution to insulin dependence. Thus, it seems important to review a new and more accurate classification of diabetes to offer a more appropriated care to patients.

  15. Association of Intercellular Adhesion Molecule 1 (ICAM1 with Diabetes and Diabetic Nephropathy

    Directory of Open Access Journals (Sweden)

    Harvest F Gu

    2013-01-01

    Full Text Available Diabetes and diabetic nephropathy are complex diseases affected by genetic and environmental factors. Identification of the susceptibility genes and investigation of their roles may provide useful information for better understanding of the pathogenesis and for developing novel therapeutic approaches. Intercellular adhesion molecule 1 (ICAM1 is a cell surface glycoprotein expressed on endothelial cells and leukocytes in the immune system. The ICAM1 gene is located on chromosome 19p13 within the linkage region of diabetes. In the recent years, accumulating reports have implicated that genetic polymorphisms in the ICAM1 gene are associated with diabetes and diabetic nephropathy. Serum ICAM1 levels in diabetes patients and the icam1 gene expression in kidney tissues of diabetic animals are increased compared to the controls. Therefore, ICAM1 may play a role in the development of diabetes and diabetic nephropathy. In this review, we present genomic structure, variation and regulation of the ICAM1 gene, summarized genetic and biological studies of this gene in diabetes and diabetic nephropathy and discussed about the potential application using ICAM1 as a biomarker and target for prediction and treatment of diabetes and diabetic nephropathy.

  16. Gestational diabetes: A clinical update

    Science.gov (United States)

    Kampmann, Ulla; Madsen, Lene Ring; Skajaa, Gitte Oeskov; Iversen, Ditte Smed; Moeller, Niels; Ovesen, Per

    2015-01-01

    Gestational diabetes mellitus (GDM) is increasing in prevalence in tandem with the dramatic increase in the prevalence of overweight and obesity in women of childbearing age. Much controversy surrounds the diagnosis and management of gestational diabetes, emphasizing the importance and relevance of clarity and consensus. If newly proposed criteria are adopted universally a significantly growing number of women will be diagnosed as having GDM, implying new therapeutic challenges to avoid foetal and maternal complications related to the hyperglycemia of gestational diabetes. This review provides an overview of clinical issues related to GDM, including the challenges of screening and diagnosis, the pathophysiology behind GDM, the treatment and prevention of GDM and the long and short term consequences of gestational diabetes for both mother and offspring. PMID:26240703

  17. Cardiovascular autonomic neuropathy in diabetes

    DEFF Research Database (Denmark)

    Spallone, Vincenza; Ziegler, Dan; Freeman, Roy

    2011-01-01

    Cardiovascular Autonomic Neuropathy (CAN) Subcommittee of Toronto Consensus Panel on Diabetic Neuropathy worked to update CAN guidelines, with regard to epidemiology, clinical impact, diagnosis, usefulness of CAN testing, and management. CAN is the impairment of cardiovascular autonomic control i....... Evidence on the cost-effectiveness of CAN testing is lacking. Apart from the preventive role of intensive glycaemic control in type 1 diabetes, recommendations cannot be given for most therapeutic approaches to CAN. Copyright © 2011 John Wiley & Sons, Ltd....... in the setting of diabetes after exclusion of other causes. The prevalence of confirmed CAN is around 20%, and increases up to 65% with age and diabetes duration. Established risk factors for CAN are glycaemic control in type 1 and a combination of hypertension, dyslipidemia, obesity and glycaemic control...

  18. Therapeutic Effect of Fasudil Combined With Mecobalamin in Treatment of Diabetic Peripheral Neuropathy%法舒地尔与甲钴胺联合治疗在糖尿病周围神经病变中的治疗效果

    Institute of Scientific and Technical Information of China (English)

    张俊峰

    2015-01-01

    目的:探讨法舒地尔与甲钴胺联合治疗在糖尿病周围神经病变中的治疗效果。方法选择我社区治疗的78例糖尿病周围神经病变患者,随机分为实验组和对照组。两组均给予常规处理,对照组常规治疗同时给予甲钴胺,实验组常规治疗同时给予甲钴胺联合法舒地尔,均连续应用1个月,评价两组的治疗效果。结果实验组总有效率为92.31%高于对照组总有效率74.36%,差异有统计学意义(P <0.05)。结论法舒地尔与甲钴胺联合治疗可以改善糖尿病周围神经病变患者的症状,临床效果显著。%Objective To explore the therapeutic effect in patients with diabetic peripheral neuropathy treated with combination of fasudil and Mecobalamin. Methods 78 cases of patients with diabetes in community governance I talk of peripheral neuropathy, were randomly divided into experimental group and control group. Two groups were given conventional treatment, the control group was given conventional treatment and mecobalamin, the experimental group received routine treatment also treated with mecobalamin combined with fasudil hydrochloride, are continuous application one month, to evaluate the therapeutic effect of the two groups. Results The experimental group total efficiency was 92.31%was significantly higher than that of the control group, the total efficiency of 74.36%, the difference was statistically significant (P<0.05). Conclusion Fasudil and Mecobalamin Combined treatment can obviously improve the symptoms of patients with diabetic peripheral neuropathy, clinical effect significantly.

  19. Potential Biochemical Mechanisms of Lung Injury in Diabetes

    Science.gov (United States)

    Zheng, Hong; Wu, Jinzi; Jin, Zhen; Yan, Liang-Jun

    2017-01-01

    Accumulating evidence has shown that the lung is one of the target organs for microangiopathy in patients with either type 1 or type 2 diabetes mellitus (DM). Diabetes is associated with physiological and structural abnormalities in the diabetic lung concurrent with attenuated lung function. Despite intensive investigations in recent years, the pathogenic mechanisms of diabetic lung injury remain largely elusive. In this review, we summarize currently postulated mechanisms of diabetic lung injury. We mainly focus on the pathogenesis of diabetic lung injury that implicates key pathways, including oxidative stress, non-enzymatic protein glycosylation, polyol pathway, NF-κB pathway, and protein kinase c pathway. We also highlight that while numerous studies have mainly focused on tissue or cell damage in the lung, studies focusing on mitochondrial dysfunction in the diabetic lung have remained sketchy. Hence, further understanding of mitochondrial mechanisms of diabetic lung injury should provide invaluable insights into future therapeutic approaches for diabetic lung injury.

  20. Evaluation on Therapeutic Efficacy of Periodontal Disease and Its Influencing Factors in Patients with Type 2 Diabetes Mellitus%2型糖尿病患者牙周病治疗效果评估及其影响因素研究

    Institute of Scientific and Technical Information of China (English)

    胡运苑; 谢明峰

    2012-01-01

    目的 探讨2型糖尿病患者的牙周病治疗效果及其影响因素. 方法 选择2009年1月-2011年6月东莞市石碣医院口腔科收治的2型糖尿病合并牙周病患者165例,根据牙周治疗是否有效,将患者分为有效组和无效组,收集两组患者的临床资料进行比较分析. 结果 有效组和无效组的年龄、患糖尿病年限、有无吸烟习惯、既往是否接受过牙周治疗、牙周治疗依从性、牙周治疗期间空腹血糖浓度控制情况、口腔卫生状况、精神压力状况间比较,差异有统计学意义(P<0.05).Logistic回归分析结果显示年龄、有无吸烟习惯、牙周治疗依从性、牙周治疗期间空腹血糖浓度控制情况是影响2型糖尿病患者牙周病治疗效果的独立因素. 结论 年龄、有无吸烟习惯、牙周治疗依从性、牙周治疗期间空腹血糖浓度控制情况是影响2型糖尿病患者牙周病治疗效果的独立因素.%Objective To explore the curative effects of periodontal disease and its influencing factors in patients with type 2 diabetes mellitus. Methods One hundred and sixty- five patients with type 2 diabetes mellitus complicated by periodontal disease who were hospitalized in Department of Stomatology, Shijie Hospital of Dongguan City from January 2009 to June 2011 were enrolled in the study. According to the therapeutic efficacy of periodontal disease, all the patients were divided into effective ' group and ineffective group. The clinical data of the patients of the two groups were compared. Results There were statistically significant differences in the patients' ages, the length of suffering from diabetes mellitus, with or without smoking habit, receiving or not receiving treatment for periodontal disease in the past, the compliance of periodontal disease treatment, fasting blood glucose level during the period of periodontal disease treatment, oral hygiene status, and the status of mental pressure between the two groups

  1. [Diabetic neuropathy].

    Science.gov (United States)

    Chudzik, Wiesław; Kaczorowska, Beata; Przybyła, Monika; Chudzik, Bartosz; Gałka, Małgorzata

    2007-01-01

    Diabetic neuropathy is most common chronic complication of diabetes mellitus. It is responsible for substantial morbidity, increased mortality and impaired quality of life. Patogenesis of diabetic neuropathy is complex. Chronic hyperglycemia is a major factor induces nerve fibers injury. High level of glucose stimulate the polyol pathway causing osmotic stress and enhance reactive oxygen species generation, as well as it play an important role in diabetic angiopathy development. Distal symmetric polineuropathy is most common type of diabetic neuropathy. Many patient may develop combinations of neuropathies concerning somatic and autonomic system. Early diagnosis and administered suitable treatment are necessary to reduce severe complication of diabetic neuropathy as well as strict glycemic control and risk factor increased.

  2. Metabolomics in diabetic complications.

    Science.gov (United States)

    Filla, Laura A; Edwards, James L

    2016-04-01

    With a global prevalence of 9%, diabetes is the direct cause of millions of deaths each year and is quickly becoming a health crisis. Major long-term complications of diabetes arise from persistent oxidative stress and dysfunction in multiple metabolic pathways. The most serious complications involve vascular damage and include cardiovascular disease as well as microvascular disorders such as nephropathy, neuropathy, and retinopathy. Current clinical analyses like glycated hemoglobin and plasma glucose measurements hold some value as prognostic indicators of the severity of complications, but investigations into the underlying pathophysiology are still lacking. Advancements in biotechnology hold the key to uncovering new pathways and establishing therapeutic targets. Metabolomics, the study of small endogenous molecules, is a powerful toolset for studying pathophysiological processes and has been used to elucidate metabolic signatures of diabetes in various biological systems. Current challenges in the field involve correlating these biomarkers to specific complications to provide a better prediction of future risk and disease progression. This review will highlight the progress that has been made in the field of metabolomics including technological advancements, the identification of potential biomarkers, and metabolic pathways relevant to macro- and microvascular diabetic complications.

  3. 5’-Monophosphate-activated protein kinase (AMPK) improves autophagic activity in diabetes and diabetic complications

    Institute of Scientific and Technical Information of China (English)

    Fan Yao; Ming Zhang; Li Chen

    2016-01-01

    Diabetes mellitus(DM),an endocrine disorder,will be one of the leading causes of death world-wide in about two decades.Cellular injuries and disorders of energy metabolism are two key factors in the pathogenesis of diabetes,which also become the important causes for the process of diabetic complications.AMPK is a key enzyme in maintaining metabolic homeostasis and has been implicated in the activation of autophagy in distinct tissues.An increasing number of researchers have confirmed that autophagy is a potential factor to affect or induce diabetes and its complications nowadays,which could remove cytotoxic proteins and dysfunctional organelles.This review will summarize the regulation of autophagy and AMPK in diabetes and its complications,and explore how AMPK stimulates autophagy in different diabetic syndromes.A deeper understanding of the regulation and activity of AMPK in autophagy would enhance its development as a promising therapeutic target for diabetes treatment.

  4. The role of the complement system in diabetic nephropathy

    DEFF Research Database (Denmark)

    Flyvbjerg, Allan

    2017-01-01

    , which manifests clinically as microvascular and macrovascular complications. One microvascular complication, diabetic nephropathy, is the most common cause of end-stage renal disease in developed countries. Although several available therapeutic interventions can delay the onset and progression......The development of type 1 and type 2 diabetes mellitus has a substantial negative impact on morbidity and mortality and is responsible for substantial individual and socioeconomic costs worldwide. One of the most serious consequences of diabetes mellitus is the development of diabetic angiopathy...... of diabetic nephropathy, morbidity associated with this disease remains high and new therapeutic approaches are needed. In addition, not all patients with diabetes mellitus will develop diabetic nephropathy and thus new biomarkers are needed to identify individuals who will develop this life...

  5. Increasing incidence of diabetes after gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller;

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  6. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930047 Relationship between diabetic cardiacautonomic disturbances and Q-Tc interval pro-longation and its clinical significance.XIANGMingzhu(向明珠),et al.Dept Med,1st PeopleHosp,Shashi,Hubei Prov,Shashi,434000.Chin J Endocrinol & Metabol 1992;8(3):149-151.Autonomic cardiovascular function tests andelectrocardiograms were performed in 61 pa-tients with diabetes mellitus.The result showedthat Q-Tc interval in diabetic patients with ab-

  7. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005179 The association of LMNA1908C/T polymorphism with insulin resistance and dyslipidemia in diabetic patients. SU Ben-li (苏本利), et al. Dept Endocrinol, 2nd Affili Hosp, Dalian Med Univ, Dalian 116027. Chin J Diabetes, 2005;13(1) :27-30. Objective: To study the association of LMhlA 1908 C/T polymorphism with insulin resistance and dyslipidemia in type 2 diabetic patients. Methods:

  8. Therapeutic Organism Research Advance in Diabetic Peripheral Pathologic Change Treated with Acupunture%针刺治疗糖尿病周围神经病变的疗效机理研究进展

    Institute of Scientific and Technical Information of China (English)

    陈丹; 邓新旦; 吴荣华

    2005-01-01

    @@ 糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)是糖尿病最常见的慢性并发症之一.近年来,胰岛素及多种新型降糖药物的广泛应用,使糖尿病酮症酸中毒等急性并发症的出现大为减少,而多种慢性并发症,尤其是糖尿病周围神经病变已成为致残和过早死亡的主要原因.目前,DPN的发病机理尚未完全阐明,且缺乏理想的治疗药物与手段,而采用针刺治疗DPN则显示出一定的优势.

  9. Diabetes Movie (For Parents)

    Medline Plus

    Full Text Available ... Your Child What Kids Say About: Handling Stress Anxiety, Fears, and Phobias Community Service: A Family's Guide ... Diabetes: Lindsey's Story (Video) Diabetes Center Movie: Endocrine System Diabetes Center Diabetes: DJ's Story (Video) Diabetes: Marco's ...

  10. Genetics of Diabetes

    Science.gov (United States)

    ... A A A Listen En Español Genetics of Diabetes You've probably wondered how you developed diabetes. ... to develop diabetes than others. What Leads to Diabetes? Type 1 and type 2 diabetes have different ...

  11. Types of Diabetes

    Science.gov (United States)

    ... Dental Problems Diabetes & Sexual & Urologic Problems What is Diabetes? Diabetes is a disease that occurs when your ... is serious. What are the different types of diabetes? The most common types of diabetes are type ...

  12. Diabetes eye exams

    Science.gov (United States)

    Diabetic retinopathy - eye exams; Diabetes - eye exams; Glaucoma - diabetic eye exam; Macular edema - diabetic eye exam ... if the doctor who takes care of your diabetes checks your eyes, you need an eye exam ...

  13. Women and Diabetes

    Medline Plus

    Full Text Available ... How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take diabetes ... with your health care provider about your diabetes treatment. Diabetes Medicines - easy-to-read booklet for women ...

  14. Diabetes and Kidney Disease

    Science.gov (United States)

    ... disease of diabetes, or diabetic nephropathy. How does diabetes cause kidney disease? High blood glucose , also called ... I keep my kidneys healthy if I have diabetes? The best way to slow or prevent diabetes- ...

  15. Women and Diabetes

    Medline Plus

    Full Text Available ... How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take diabetes ... with your health care provider about your diabetes treatment. Diabetes Medicines - easy-to-read booklet for women ...

  16. Diabetic Ketoacidosis

    Science.gov (United States)

    ... adrenaline or cortisol. Unfortunately, these hormones counter the effect of insulin — sometimes triggering an episode of diabetic ketoacidosis. Pneumonia and urinary tract infections are common culprits. A ...

  17. Curcumin and diabetes: a systematic review.

    Science.gov (United States)

    Zhang, Dong-Wei; Fu, Min; Gao, Si-Hua; Liu, Jun-Li

    2013-01-01

    Turmeric (Curcuma longa), a rhizomatous herbaceous perennial plant of the ginger family, has been used for the treatment of diabetes in Ayurvedic and traditional Chinese medicine. The active component of turmeric, curcumin, has caught attention as a potential treatment for diabetes and its complications primarily because it is a relatively safe and inexpensive drug that reduces glycemia and hyperlipidemia in rodent models of diabetes. Here, we review the recent literature on the applications of curcumin for glycemia and diabetes-related liver disorders, adipocyte dysfunction, neuropathy, nephropathy, vascular diseases, pancreatic disorders, and other complications, and we also discuss its antioxidant and anti-inflammatory properties. The applications of additional curcuminoid compounds for diabetes prevention and treatment are also included in this paper. Finally, we mention the approaches that are currently being sought to generate a "super curcumin" through improvement of the bioavailability to bring this promising natural product to the forefront of diabetes therapeutics.

  18. Curcumin and Diabetes: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Dong-wei Zhang

    2013-01-01

    Full Text Available Turmeric (Curcuma longa, a rhizomatous herbaceous perennial plant of the ginger family, has been used for the treatment of diabetes in Ayurvedic and traditional Chinese medicine. The active component of turmeric, curcumin, has caught attention as a potential treatment for diabetes and its complications primarily because it is a relatively safe and inexpensive drug that reduces glycemia and hyperlipidemia in rodent models of diabetes. Here, we review the recent literature on the applications of curcumin for glycemia and diabetes-related liver disorders, adipocyte dysfunction, neuropathy, nephropathy, vascular diseases, pancreatic disorders, and other complications, and we also discuss its antioxidant and anti-inflammatory properties. The applications of additional curcuminoid compounds for diabetes prevention and treatment are also included in this paper. Finally, we mention the approaches that are currently being sought to generate a “super curcumin” through improvement of the bioavailability to bring this promising natural product to the forefront of diabetes therapeutics.

  19. The Adenosinergic System in Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    J. Vindeirinho

    2016-01-01

    Full Text Available The neurodegenerative and inflammatory environment that is prevalent in the diabetic eye is a key player in the development and progression of diabetic retinopathy. The adenosinergic system is widely regarded as a significant modulator of neurotransmission and the inflammatory response, through the actions of the four types of adenosine receptors (A1R, A2AR, A2BR, and A3R, and thus could be revealed as a potential player in the events unfolding in the early stages of diabetic retinopathy. Herein, we review the studies that explore the impact of diabetic conditions on the retinal adenosinergic system, as well as the role of the said system in ameliorating or exacerbating those conditions. The experimental results described suggest that this system is heavily affected by diabetic conditions and that the modulation of its components could reveal potential therapeutic targets for the treatment of diabetic retinopathy, particularly in the early stages of the disease.

  20. Increasing incidence of diabetes after gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.......To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  1. Increasing incidence of diabetes after gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.......To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  2. Pancreatic β-cell identity in diabetes.

    Science.gov (United States)

    Remedi, M S; Emfinger, C

    2016-09-01

    Recovery of functional β-cell mass continues to be an ongoing challenge in treating diabetes. Initial work studying β-cells suggested apoptotic β-cell death as a main contributor for the loss of β-cell mass in diabetes. Restoration of β-cells either by transplant or stimulating proliferation of remaining β-cells or precursors would then logically be a viable therapeutic option for diabetes. However, recent work has highlighted the inherent β-cell plasticity and the critical role of loss of β-cell identity in diabetes, and has suggested that β-cells fail to maintain a fully differentiated glucose-responsive and drug-responsive state, particularly in diabetic individuals with poorly controlled, long-lasting periods of hyperglycaemia. Understanding the underlying mechanisms of loss of β-cell identity and conversion in other cell types, as well as how to regain their mature differentiated functional state, is critical to develop novel therapeutic strategies to prevent or reverse these processes. In this review, we discuss the role of plasticity and loss of β-cell identity in diabetes, the current understanding of mechanisms involved in altering this mature functional β-cell state and potential progresses to identify novel therapeutic targets providing better opportunities for slowing or preventing diabetes progression.

  3. The impact of therapeutic regimen on the depression in type 2 diabetes mellitus: A cross-sectional study%治疗方案对2型糖尿病患者抑郁情绪影响的调查研究

    Institute of Scientific and Technical Information of China (English)

    吴冰; 陈璇; 杨莉; 周方圆; 陈娜; 吴静

    2015-01-01

    To explore the depression in type 2 diabetic patients treated with insulin and compared to those treated with oral anti-diabetic drugs.283 type 2 diabetics were seclected randomly from outpatient and inpatient departments of endocrionology in Jiangsu Province Hospital of Traditional Chinese Medicine,with the self-designed questionnaire and Zung self-rating depression scale to conduct the survey.Comparisons between the two groups were carried out with t-test or x2 test for quantitative and qualitative data,respectively.Logistic regression were used for the analysis of the relationship between the therapeutic regimen and depression.Overall,43.1% of the type 2 diabetic subjects showed depressive symptoms in different degrees.Compared to the oral drug group,the insulin group showed a significantly higher prevalence of depressive symptoms (insulin group,53.5%,oral drug group,30.5%;P<0.01)and higher self-rating depression scale scores (insulin group,51.7 ± 12.4,oral drug group,44.8 ± 10.6;P<0.01).Moreover,after an adjustment for age,sex,body mass index,diabetic duration,complications,HbA1Cand so on,the insulin group showed a significantly higher frequency of depression (OR=4.218,95% CI 1.764-13.285,P=0.004),compared to the oral drug group.The data showed that insulin treatment is an independent risk factor to the presence of depressive symptoms in type 2 diabetics,and it is necessary to pay more attention to their psychological support.%探讨胰岛素与口服降糖药物治疗对2型糖尿病患者抑郁情绪的影响.随机抽取江苏省中医院内分泌科门诊及住院的2型糖尿病患者283例,使用自行设计的问卷和Zung抑郁自评量表(SDS)开展横断面调查.利用t检验或x2比较不同治疗方案组患者的基本情况.应用logistic回归分析治疗方案与抑郁情绪的关系.结果显示43.1%的2型糖尿病患者存在不同程度的抑郁症状.与口服药物组相比,胰岛素组存在抑

  4. Diabetes and Pregnancy: Gestational Diabetes

    Centers for Disease Control (CDC) Podcasts

    2007-11-14

    Gestational diabetes happens in a woman who develops diabetes during pregnancy. This podcast discusses its potential effects and action steps to avoid complications.  Created: 11/14/2007 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Diabetes Translation (DDT) and National Center on Birth Defects and Developmental Disabilities (NCBDDD), Prevention Research Branch.   Date Released: 11/27/2007.

  5. Easily obtainable clinical features increase the diagnostic accuracy for later autoimmune diabetes in adults. An evidence based report

    NARCIS (Netherlands)

    Lutgens, M.W.M.D.; Meijer, M.; Peeters, B.; Poulsen, M.N.F.; Rutten, M.J.; Bots, M.L.; Heijden, van der G.J.M.G.; Soedamah-Muthu, S.S.

    2008-01-01

    Background Latent autoimmune diabetes in adults (LADA) represents a subgroup of diabetes mellitus. LADA is characterised by adult-onset diabetes and circulating autoimmune antibodies. LADA patients may need a different therapeutic approach than the usual type 2 diabetes mellitus. When LADA is inadeq

  6. 2型糖尿病三种治疗方案的成本-效果分析%Cost-Effectiveness Analysis of 3 Therapeutic Schemes in the Treatment of Type2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    张建柱

    2013-01-01

    Objective:To evaluate the clinical and economic effects of three hypoglycemic drugs for type 2 diabetes. Methods:273 cases of type 2 diabetes were randomly divided into 3 groups,each group 91 persons.Group A was treated by Metformin combined with Glibenclamide;Group B was treated by Metformin combined with Acarbose; Group C was treated by Acarbose combined with Repaglinide. The blood glucose level of patients in each group was regularly monitored.The economic effectiveness,adverse reactions,and medication effects were analyzed before treatment and after 6 months treatment.Results:The FPG, PBG and HbA1c of three groups were ideally controlled.The total effective rates of group A, B and C were 82.4%,84.6% and 85.7%, respectively (P>0. 05).The cost-effect ratio of group A、B、C is respectively:1.376、16.276 and 23.733.The overrun cost-effect ratio of group B、C to group A is 574.36 and 582.0, respectively.Conclusion:The three groups of treatment of type 2 diabetes have better efficacy of the program.However,considering from cost and total effective rate,the scheme Metformin combined with Glibenclamide is the better choice.%  目的:评价我院三种治疗2型糖尿病方法的临床疗效及经济成本.方法:选择我院273例2型糖尿病患者,随机分为三组,实施三种联合用药治疗方案.A组二甲双胍+格列本脲,B组二甲双胍+阿卡波糖,C组阿卡波糖+瑞格列奈;定期对各组患者的血糖水平进行监测,经过6个月的治疗,进行经济效果、不良反应及药物疗效分析.结果:三组在治疗后的FPG、PGB、HbA1c均得到较理想的控制.A、B、C组总有效率分别为82.4%,84.6%和85.7%(P>0.05)无显著性差异;A、B、C、组成本-效果比(C/E)分别为1.376、16.276和23.733,B、C组对于A组的增量成本-效果比(△C/△E)分别为74.36和582.0.结论:各组治疗2型糖尿病的用药方案疗效均较好,但从经济成本及总有效率等方面综合考虑,二甲双胍+格列本脲方案为较佳选择.

  7. Research on the therapeutic effect of Vitamin D3 in gestational diabetes factor%维生素 D3对妊娠糖尿病炎性因子及胰岛素抵抗的影响

    Institute of Scientific and Technical Information of China (English)

    侯雪晶; 路春梅

    2014-01-01

    Objective To explore the effect of Vitamin D3 in gestational diabetes inflammation factor.Methods Sixty pa-tients with gestational diabetes were randomly divided into two groups:30 cases of control group ( treatment group) , 30 cases of obser-vation group ( foundation treatment group plus vitamin D3) .On the basis of the control group, treatment observation group was given o-ral vitamin D3 1000 U/d for 4 weeks.Before and after treatment, high-sensitivity c-reactive protein ( Hs-CRP) , tumor necrosis factor alpha and insulin resistance were compared between two groups.Results Before and after treatment ,observation group hs-CRP ( mg/L) was decreased obviously, respectively 6.18 ±2.99,3.80 ±1.60;control group was 5.78 ±2.24, 5.05 ±1.90.There was statisti-cally significant difference (P<0.05).Before and after treatment ,observation group TNF-α(pg/ml) was decreased obviously, re-spectively 36.33 ±5.45,27.45 ±5.01;control group was 40.25 ±19.25,35.35 ±14.50.There was statistically significant difference (P<0.05).After treatment, insulin resistance of observation group was improved (P<0.05).Conclusions High Vitamin D3 level in blood can improve glucose metabolism during pregnancy through increasing insulin sensitivity.%目的:探讨妊娠糖尿病( gestational diabetes mellitus,GDM)患者应用维生素D3后,对体内炎性因子水平及胰岛素抵抗的影响。方法选择我院GDM患者60例,随机等量分为对照组(基础治疗)30例,观察组(基础治疗加维生素D3)30例。观察组在对照组治疗基础上给予口服维生素D31000 U/d,疗程4周,比较2组治疗前后高敏C反应蛋白( high-sensitivity c-reactive protein,Hs-CRP)、肿瘤坏死因子α( tumor necrosis factor alpha,TNF-α)及胰岛素抵抗变化。结果观察组治疗后hs-CRP较对照组明显降低[(3.80±1.60) mg/L vs (5.05±1.90) mg/L],差异有统计学意义(P<0.05)。观察组治疗后TNF-

  8. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008395 Evaluating the feature of hypoglycemia detected by continuous glucose monitoring system during temporary continuous subcutaneous insulin infusion in type 2 diabetes patients. LI Ming(李鸣), et al.Shanghai Diabet Clin Center, Dept Endocrinol & Metab, Shanghai Jiaotong Univ, Shanghai 200233. Natl Med J China 2008;88(24):1679-1682.

  9. Olympic diabetes.

    Science.gov (United States)

    Gallen, Ian W; Redgrave, Ann; Redgrave, Steven

    2003-01-01

    Winning an Olympic gold medal represents the pinnacle of achievement in any sporting event, to do so with diabetes is almost miraculous. This report outlines the history and management of Steven Redgrave's diabetes, and describes the physiology associated with the extremes of human endurance and the difficulties that this presents.

  10. Diabetes and ageing-induced vascular inflammation.

    Science.gov (United States)

    Assar, Mariam El; Angulo, Javier; Rodríguez-Mañas, Leocadio

    2016-04-15

    Diabetes and the ageing process independently increase the risk for cardiovascular disease (CVD). Since incidence of diabetes increases as people get older, the diabetic older adults represent the largest population of diabetic subjects. This group of patients would potentially be threatened by the development of CVD related to both ageing and diabetes. The relationship between CVD, ageing and diabetes is explained by the negative impact of these conditions on vascular function. Functional and clinical evidence supports the role of vascular inflammation induced by the ageing process and by diabetes in vascular impairment and CVD. Inflammatory mechanisms in both aged and diabetic vasculature include pro-inflammatory cytokines, vascular hyperactivation of nuclear factor-кB, increased expression of cyclooxygenase and inducible nitric oxide synthase, imbalanced expression of pro/anti-inflammatory microRNAs, and dysfunctional stress-response systems (sirtuins, Nrf2). In contrast, there are scarce data regarding the interaction of these mechanisms when ageing and diabetes co-exist and its impact on vascular function. Older diabetic animals and humans display higher vascular impairment and CVD risk than those either aged or diabetic, suggesting that chronic low-grade inflammation in ageing creates a vascular environment favouring the mechanisms of vascular damage driven by diabetes. Further research is needed to determine the specific inflammatory mechanisms responsible for exacerbated vascular impairment in older diabetic subjects in order to design effective therapeutic interventions to minimize the impact of vascular inflammation. This would help to prevent or delay CVD and the specific clinical manifestations (cognitive decline, frailty and disability) promoted by diabetes-induced vascular impairment in the elderly. © 2015 The Authors. The Journal of Physiology © 2015 The Physiological Society.

  11. Experimental Diabetes Mellitus in Different Animal Models

    Directory of Open Access Journals (Sweden)

    Amin Al-awar

    2016-01-01

    Full Text Available Animal models have historically played a critical role in the exploration and characterization of disease pathophysiology and target identification and in the evaluation of novel therapeutic agents and treatments in vivo. Diabetes mellitus disease, commonly known as diabetes, is a group of metabolic disorders characterized by high blood glucose levels for a prolonged time. To avoid late complications of diabetes and related costs, primary prevention and early treatment are therefore necessary. Due to its chronic symptoms, new treatment strategies need to be developed, because of the limited effectiveness of the current therapies. We overviewed the pathophysiological features of diabetes in relation to its complications in type 1 and type 2 mice along with rat models, including Zucker Diabetic Fatty (ZDF rats, BB rats, LEW 1AR1/-iddm rats, Goto-Kakizaki rats, chemically induced diabetic models, and Nonobese Diabetic mouse, and Akita mice model. The advantages and disadvantages that these models comprise were also addressed in this review. This paper briefly reviews the wide pathophysiological and molecular mechanisms associated with type 1 and type 2 diabetes, particularly focusing on the challenges associated with the evaluation and predictive validation of these models as ideal animal models for preclinical assessments and discovering new drugs and therapeutic agents for translational application in humans.

  12. Educação terapêutica para diabéticos: os cuidados com os pés na realidade de pacientes e familiares Therapeutic education for diabetics: foot care in the reality of patients and family members

    Directory of Open Access Journals (Sweden)

    Ligia de Loiola Cisneros

    2011-01-01

    Full Text Available Conhecer a realidade da prática dos cuidados com os pés ensinados nos programas educativos para diabéticos pode contribuir para um melhor resultado da educação terapêutica. Este estudo apresenta significados atribuídos por pacientes diabéticos e seus familiares aos cuidados primários que visam prevenir complicações nos pés. Foi realizada uma pesquisa qualitativa exploratória sobre amostra intencional de trinta diabéticos, neuropatas, com risco de lesão nos pés e familiares de onze deles, que participaram de um programa de prevenção em uma unidade de saúde pública do município de Porto Alegre (RS. Foi aplicada uma entrevista semidirigida com questões abertas sobre a experiência dos cuidados com os pés. O material transcrito foi submetido à análise qualitativa de conteúdo. Os pacientes precisam de ajuda para realizar os cuidados com os pés. Uma rede de solidariedade e interações é formada por trás dos pacientes, percebida como um apoio ou uma ameaça à liberdade. É a experiência própria ou alheia de uma complicação que evidencia a importância da prevenção. A educação terapêutica para prevenção de complicações nos pés de diabéticos deve levar em conta as relações de assistência formadas em torno do doente. É preciso romper o silêncio da evolução da doença para motivar o paciente à adoção das medidas preventivas.Knowing the reality of foot care practice taught in educational programs for diabetics can enhance the therapeutic education success. This study presents the perceptions of diabetics and their family members about primary cares to prevent complications on foot. A qualitative exploratory study was conducted in an intentional sample of 30 diabetic with neuropathic risk of foot injuries as well as 11 of their family members, participants of a preventive program offered in a public health center in the city of Porto Alegre, Rio Grande do Sul State, Brazil. A semi-structured interview

  13. Cost-effectiveness Analysis of Two Therapeutic Schemes in the Treatment of Type 2 Diabetes%两种方案治疗2型糖尿病的效价比分析

    Institute of Scientific and Technical Information of China (English)

    宋安民

    2016-01-01

    Objective To analyze the use of repaglinide and rosiglitazone combined with repaglinide in treatment of type 2 diabetes potency ratio. Methods 2 patients with type 190 diabetes who were treated in our hospital from January 2014 to October were selected and treated by diet and exercise therapy. Randomly divided into control group and observation group of 95 cases. Two groups were treated with basic treatment of diabetes diet, exercise therapy, the control group was taken with repaglinide, the observation group in the service of repaglinide and rosiglitazone. The course of treatment was 12 weeks. Before and after treatment, routine examination of blood, liver and kidney function, ECG, fasting blood glucose, meal 2 hours blood glucose and glycosylated hemoglobin. Efficacy evaluation after 1 courses of treatment. Results The observa-tion group, 95 cases, 54 cases were markedly improved, 56.8%, effective in 38 cases, accounted for 40.08%, 3 cases were ineffective, 3.2%, the total efficiency of 96.8%;control group (95 cases) in 43 cases were markedly effective, accounted for 45.3%, 33 cases were effective, accounting for 34.7%, 19 cases were ineffective and 20.0% (and the total effective rate was 80.0%. The total effective rate of the observation group (96.8%) was significantly higher than that of the control group (80%), P<0.05. Cost effectiveness analysis showed that the cost of treatment in the treatment group was 1.1 less than that of the control group, and the same results were still obtained after the sensitivity analysis. Conclusion repaglinide and rosigli-tazone is preferred in the treatment of type 2 diabetes.%目的:分析单用瑞格列奈和瑞格列奈联合罗格列酮治疗2型糖尿病的效价比。方法选择2014年1月-2015年10月该院门诊诊治的2型糖尿病患者190例,经饮食、运动疗法,未能凑效。随机分为对照组和观察组各95例。两组均采用糖尿病饮食、运动疗法等基础治疗,对照组加服瑞格列奈,

  14. Angiotensin II inhibitor facilitates epidermal wound regeneration in diabetic mice

    Directory of Open Access Journals (Sweden)

    Maria eKamber

    2015-06-01

    Full Text Available Tissue regeneration and wound healing are severely impaired in diabetes and are associated with poor circulation and dysfunctional blood vessels. Angiotensin II inhibitors are anti-hypertensive drugs used in clinical practice to regulate blood pressure and could affect tissue remodeling. We hypothesize that blocking angiotensin II, using Losartan, could facilitate tissue regeneration in diabetic mice. To this end, we established an experimental model of wound healing in streptozotocin-induced diabetic mice. Our data demonstrated that Losartan accelerates wound repair and normalizes wound stromal responses, having a beneficial role in diabetic wounds. Our findings highlight a potential therapeutic use of Losartan in improving wound repair in diabetic conditions.

  15. [Aspects of perioperative care in patients with diabetes].

    Science.gov (United States)

    Pestel, G; Closhen, D; Zimmermann, A; Werner, C; Weber, M M

    2013-01-01

    Diabetes is a common disease in Germany. Due to diabetes-associated end-organ disease, such as large and small vessel disease and neuropathy, diabetic patients require more intense anesthesia care during the perioperative phase. An in-depth and comprehensive medical history focusing on hemodynamic alterations, gastroparesis, neuropathy and stiff joint syndrome is a cornerstone of perioperative care and may affect outcome of diabetes patients more than specific anesthetic medications or the anesthetic procedure. Intraoperative anesthetic care needs to focus on preservation of hemodynamic stability, perioperative infection control and maintenance of glucose homeostasis. Whereas some years ago strict glucose control by aggressive insulin therapy was adamantly advocated, the results of recent studies have put the risk of such therapeutic algorithms into perspective. Therefore, optimized perioperative care of diabetic patients consists of setting a predefined targeted blood glucose level, evidence-based therapeutic approaches to reach that goal and finally adequate and continuous monitoring and amendment of the therapeutic approach if required.

  16. Diabetic neuropathies: diagnosis and management.

    Science.gov (United States)

    Deli, Gabriella; Bosnyak, Edit; Pusch, Gabriella; Komoly, Samuel; Feher, Gergely

    2013-01-01

    Changes in human behaviour and lifestyle over the last century have resulted in a dramatic increase in the incidence of diabetes worldwide. Neuropathy is a common and costly complication of both type 1 and type 2 diabetes. The prevalence of neuropathy is estimated to be about 8% in newly diagnosed patients and greater than 50% in patients with long-standing disease. There are two main types of diabetic neuropathies, named as sensorimotor and autonomic neuropathies. Sensorimotor neuropathy is marked by pain, paraesthesia and sensory loss, and autonomic neuropathy may contribute to myocardial infarction, malignant arrhythmia and sudden death. In this article we reviewed the pathogenesis, clinical manifestations diagnosis and treatment of diabetic neuropathies. Sensorimotor and autonomic neuropathies (cardiovascular, gastrointestinal and genitourinary autonomic neuropathies) are common in diabetic patients. Apart from strict glycaemic control, no further therapeutic approach exists in the prevention of this phenomenon. Intensive diabetes therapy, intensive multifactorial cardiovascular risk reduction and lifestyle intervention are recommended in patients with cardiovascular autonomic neuropathy. Gastroparesis is the most debilitating complication of gastrointestinal autonomic neuropathy and genitourinary autonomic neuropathy can cause sexual dysfunction and neurogenic bladder; these conditions are hard to manage. The symptomatic treatment of sensory symptoms includes tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors, gabapentin, pregabalin and opioids. Other treatment strategies are not so effective. © 2013 S. Karger AG, Basel.

  17. Bipolar Disorder and Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Sermin Kesebir

    2010-04-01

    Full Text Available Comorbid endocrine and cardiovascular situations with bipolar disorder usually result from the bipolar disorder itself or as a consequence of its treatment. With habits and lifestyle, genetic tendency and side effects, this situation is becoming more striking. Subpopulations of bipolar disorders patients should be considered at high risk for diabetes mellitus. The prevalence of diabetes mellitus in bipolar disorder may be three times greater than in the general population. Comorbidity of diabetes causes a pathophysiological overlapping in the neurobiological webs of bipolar cases. Signal mechanisms of glycocorticoid/insulin and immunoinflammatory effector systems are junction points that point out the pathophysiology between bipolar disorder and general medical cases susceptible to stress. Glycogen synthetase kinase (GSK-3 is a serine/treonine kinase and inhibits the transport of glucose stimulated by insulin. It is affected in diabetes, cancer, inflammation, Alzheimer disease and bipolar disorder. Hypoglycemic effect of lithium occurs via inhibiting glycogen synthetase kinase. When comorbid with diabetes, the other disease -for example bipolar disorder, especially during its acute manic episodes-, causes a serious situation that presents its influences for a lifetime. Choosing pharmacological treatment and treatment adherence are another important interrelated areas. The aim of this article is to discuss and review the etiological, clinical and therapeutic properties of diabetes mellitus and bipolar disorder comorbidity.

  18. 来氟米特治疗糖尿病肾病蛋白尿疗效初步观察及评估%Preliminary observation and evaluation of the therapeutic effect of leflunomide in the treatment of diabetic nephropa-thy proteinuria

    Institute of Scientific and Technical Information of China (English)

    符俊祖

    2016-01-01

    Objective:To investigate the therapeutic effect of leflunomide in the treatment of diabetic nephropathy proteinuria. Methods:150 patients with diabetic nephropathy proteinuria were selected.They were divided into the two groups on average.The reference group was treated with routine insulin and angiotensin receptor antagonists,while the study group was treated with leflunomide on the basis of the reference group.We evaluated the relevant indicators.Results:The study group compared with the reference group,the clinical efficacy was higher(P<0.05).After 4 weeks of treatment,the study group compared to the reference group of 24 hours urinary protein,endogenous creatinine clearance level,urea nitrogen,serum creatinine improved more significantly(P<0.05).Conclusion:The effect of leflunomide therapy on diabetic nephropathy proteinuria is exact,which can effectively improve the clinical symptoms and renal function index,with no obvious liver and kidney damage,which has high safety.%目的:研究来氟米特治疗糖尿病肾病蛋白尿的疗效。方法:收治糖尿病肾病蛋白尿患者150例。平分为两组。参照组以常规胰岛素、血管紧张素受体拮抗剂等进行治疗;研究组在此基础上增加来氟米特治疗。评估相关指标。结果:研究组对比参照组临床疗效更高,(P<0.05);治疗4周研究组对比参照组24 h 尿蛋白、内生肌酐清除水平、尿素氮、血肌酐改善更显著(P<0.05)。结论:来氟米特治疗糖尿病肾病蛋白尿效果确切,可有效改善患者临床症状和肾功能指标,无明显肝肾损害,安全性高。

  19. Research advances in relationship between diabetes and pancreatic cancer

    Directory of Open Access Journals (Sweden)

    HE Xiangyi

    2014-08-01

    Full Text Available Pancreatic cancer (PC is one of common malignant digestive diseases. It is mostly diagnosed at advanced stage, with an extremely poor progression. The relationship between diabetes and PC was shown by numerous epidemiological studies for decades. Retrospective clinical studies and research on molecular mechanisms in recent years have led to a new understanding of the relationship between diabetes, especially new-onset diabetes, and PC, the effect of antidiabetic medication on PC, and the molecular mechanisms underlying the connection between diabetes and PC. It is suggested by recent data that long-standing diabetes is one of the risk factors for PC development, new-onset diabetes may facilitate early diagnosis of PC, diabetes may have an impact on the prognosis of PC, the option of antidiabetic medication may influence the incidence of PC, and exploring the molecular mechanisms underlying the association between diabetes and PC may help to identify the new therapeutic target for PC.

  20. Therapeutic effects of Jingwanhong ointment (京万红软膏)on healing of chronic diabetic wound in mice%京万红软膏治疗糖尿病慢性创面的实验研究

    Institute of Scientific and Technical Information of China (English)

    姜玉峰; 黄沙; 邹吉平; 许樟荣; 高虹; 付小兵

    2013-01-01

    Objective: To explore the promoting effect of Jingwanhong ointment ( 京万红软膏 ) in healing of chronic open wound and its mechanism in diabetic mice. Methods: Fifty-four clean-grade male C57 mice were randomly divided into Jingwanhong ointment group, compound sulfadiazine zinc gel group (medicine control group) and blank control group (n = 18). The model of diabetes was replicated by consecutive administration of 1 % strep-tozotocin intraperitoneally 60 mg/kg for 3 days. Then, on the back of mice, round full-thickness skin wounds with diameter of 1 cm were produced. Jingwanhong ointment or compound sulfadiazine zinc gel was applied on the wounds of the two medicine treatment groups after the second day of wound formation, and vaseline gauze was applied on all the wounds of the three groups. Dressing-change was done daily. On the 3rd, 7th, 10th, 17th, 21st days after treatment, the circumference of the wounds was drawn on transparent plastic films for the estimation of the rate of wound healing. On 7th and 17th day after treatment, 3 mice of every group were sacrificed respectively, and gross morphological changes,histopathological changes in skin and granulation tissue within 2 mm of edge of the wounds were examined. Results:The wound healing rate of the two treatment groups increased on the 7th day after treatment, but the difference was not significant among the three groups (P>0. 05). On the 10th, 17th, 21st day after treatment, the wound healing rate in medicine control group [(81. 00 ± 0. 85) % , (95. 00 ± 0. 29) % , (97.00 ± 0.37)% ] was significantly higher than those of the blank control group [(77. 00 ±1. 35) % ,(87. 00 ± 1. 17)% , (90. 00 ± 0. 96)%,P0.05).给药后10、17和21 d,对照药物组创面愈合率[(81.00±0.85)%,(95.00±0.29)%,(97.00±0.37)% ]明显高于空白对照组[(77.00±1.35)%,(87.00±1.17)%,(90.00±0.96)%,P<0.05],而京万红软膏组愈合率[(85.00±1.93)%,(100.00±0)%,(100.00±0)% ]明显高于对照药物组(P<0.05).

  1. The Prevalance of Diabetes in Psoriatic Patients Versus the Prevalance of Psoriasis in Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Nahide Onsun

    2010-03-01

    Full Text Available Background and Design: Previous studies reported that there are some relations between psoriasis and the diabetes mellitus. However, incidence rates of diabetes mellitus in psoriasis and also incidence rates of psoriasis in diabetes mellitus are lacking.Our aim was to assess and compare incidence rates of diabetes mellitus in patients with psoriasis and incidence rates of psorasis in diabetes mellitus and also evaluate the role of psoriasis as a risk factor for diabetes mellitus. Material and Method: Four hundred eighteen patients with psoriasis and one hundred fifty four patients with diabetes were included. Blood glucose, oral glucose tolerance test (OGTT, glycolised hemoglobine (HbA1C were performed in psoriatic patients and these results were consulted with diabetes clinic. Psoriasis screening by clinical history, dermatologic examination, skin biopsy; if it is necessary were held for patients with diabetes. Results: Prevalance of diabetes was 9.3% in psoriatic patients; prevalance of psoriasis was 1.3% in diabetic patients. The proportion of diabetes was significantly higher in psoriatic patients compared to the proportion of psoriasis in diabetic patients (odds ratio (OR: 7.82, confidence interval (CI: 1.86-32.79, p=0.001. The age and sex-adjusted proportion of diabetes was significantly higher in psoriatic patients as compared the proportion of psoriasis in diabetic patients (OR: 18.35, p<0.001. Differences of mean duration of disease and mean PASİ (psorasis area severity index were not significant between the psoriatic patients without diabetes mellitus and with diabetes mellitus.Conclusion: Risk rate of diabetes is increased in psoriatic patients. Chronic inflammation may lead insulin resistance and diabetes. We think that development of diabetes in patients with psoriasis depends on chronic inflammation. Unfortunately we could not assess the role of therapeutical agents especially effect of potent corticosteroids in development of

  2. Diabetic nephropathy – complications and treatment

    OpenAIRE

    Lim AK

    2014-01-01

    Andy KH Lim1–3 1Department of Nephrology, Monash Medical Center, Monash Health, 2Department of General Medicine, Dandenong Hospital, Monash Health, 3Department of Medicine, Monash University, Clayton, VIC, Australia Abstract: Diabetic nephropathy is a significant cause of chronic kidney disease and end-stage renal failure globally. Much research has been conducted in both basic science and clinical therapeutics, which has enhanced understanding of the pathophysiology of diabetic ne...

  3. Pathogenesis and treatment of diabetic glomerulopathy; Pathogenie et traitement de la glomerulopathie diabetique

    Energy Technology Data Exchange (ETDEWEB)

    Marre, M.; Le Jeune, J.J. [Centre Hospitalier Universitaire, 49 - Angers (France)

    1995-12-31

    Diabetic glomerulopathy is the consequence, at the glomerular level, of diabetes. Diagnosis is based on the association of proteinuria, arterial hypertension and an early reduction of glomerular filtration in a diabetic patient, generally insulin-dependent. Diabetic glomerulopathy is a complication of type I diabetes, which begins in childhood or adolescence, but can also be discovered in type II diabetes. A definite diagnosis requires histological evidences ; glomerular clearance measurements ({sup 125}I-iodothalamate or {sup 51}Cr-EDTA) yield important information concerning glomerular filtration. The authors subsequently address pathogenesis and therapeutic regimens, and they report on the particularities of this condition in type II diabetes. (authors). 30 refs., 2 tabs.

  4. Engineered Skin Cells Control Type 2 Diabetes in Mice

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_167588.html Engineered Skin Cells Control Type 2 Diabetes in Mice: Study 'Therapeutic ... technique, heralded as a major breakthrough in genetic engineering, allows scientists to make precision "edits" in DNA -- ...

  5. Diabetic nephropathy

    Directory of Open Access Journals (Sweden)

    Zelmanovitz Themis

    2009-09-01

    Full Text Available Abstract Diabetic nephropathy is the leading cause of chronic renal disease and a major cause of cardiovascular mortality. Diabetic nephropathy has been categorized into stages: microalbuminuria and macroalbuminuria. The cut-off values of micro- and macroalbuminuria are arbitrary and their values have been questioned. Subjects in the upper-normal range of albuminuria seem to be at high risk of progression to micro- or macroalbuminuria and they also had a higher blood pressure than normoalbuminuric subjects in the lower normoalbuminuria range. Diabetic nephropathy screening is made by measuring albumin in spot urine. If abnormal, it should be confirmed in two out three samples collected in a three to six-months interval. Additionally, it is recommended that glomerular filtration rate be routinely estimated for appropriate screening of nephropathy, because some patients present a decreased glomerular filtration rate when urine albumin values are in the normal range. The two main risk factors for diabetic nephropathy are hyperglycemia and arterial hypertension, but the genetic susceptibility in both type 1 and type 2 diabetes is of great importance. Other risk factors are smoking, dyslipidemia, proteinuria, glomerular hyperfiltration and dietary factors. Nephropathy is pathologically characterized in individuals with type 1 diabetes by thickening of glomerular and tubular basal membranes, with progressive mesangial expansion (diffuse or nodular leading to progressive reduction of glomerular filtration surface. Concurrent interstitial morphological alterations and hyalinization of afferent and efferent glomerular arterioles also occur. Podocytes abnormalities also appear to be involved in the glomerulosclerosis process. In patients with type 2 diabetes, renal lesions are heterogeneous and more complex than in individuals with type 1 diabetes. Treatment of diabetic nephropathy is based on a multiple risk factor approach, and the goal is retarding the

  6. Mining the Genome for Therapeutic Targets.

    Science.gov (United States)

    Florez, Jose C

    2017-07-01

    Current pharmacological options for type 2 diabetes do not cure the disease. Despite the availability of multiple drug classes that modulate glycemia effectively and minimize long-term complications, these agents do not reverse pathogenesis, and in practice they are not selected to correct the molecular profile specific to the patient. Pharmaceutical companies find drug development programs increasingly costly and burdensome, and many promising compounds fail before launch to market. Human genetics can help advance the therapeutic enterprise. Genomic discovery that is agnostic to preexisting knowledge has uncovered dozens of loci that influence glycemic dysregulation. Physiological investigation has begun to define disease subtypes, clarifying heterogeneity and suggesting molecular pathways for intervention. Convincing genetic associations have paved the way for the identification of effector transcripts that underlie the phenotype, and genetic or experimental proof of gain or loss of function in select cases has clarified the direction of effect to guide therapeutic development. Genetic studies can also examine off-target effects and furnish causal inference. As this information is curated and made widely available to all stakeholders, it is hoped that it will enhance therapeutic development pipelines by accelerating efficiency, maximizing cost-effectiveness, and raising ultimate success rates. © 2017 by the American Diabetes Association.

  7. Diabetic retinopathy - ocular complications of diabetesmellitus

    Institute of Scientific and Technical Information of China (English)

    Martin M Nentwich; Michael W Ulbig

    2015-01-01

    In industrialized nations diabetic retinopathy is the mostfrequent microvascular complication of diabetes mellitusand the most common cause of blindness in the workingagepopulation. In the next 15 years, the number ofpatients suffering from diabetes mellitus is expected toincrease significantly. By the year 2030, about 440 millionpeople in the age-group 20-79 years are estimated to besuffering from diabetes mellitus worldwide (prevalence7.7%), while in 2010 there were 285 million people withdiabetes mellitus (prevalence 6.4%). This accounts foran increase in patients with diabetes in industrialized nations by 20% and in developing countries by 69% until the year 2030. Due to the expected rise in diabetic patients, the need for ophthalmic care of patients (i.e. , exams and treatments) will also increase and represents a challenge for eye-care providers. Development of optimized screening programs, which respect available resources of the ophthalmic infrastructure, will become even more important. Main reasons for loss of vision in patients with diabetes mellitus are diabetic macular edema and proliferative diabetic retinopathy. Incidence or progression of these potentially blinding complications can be greatly reduced by adequate control of blood glucose and blood pressure levels. Additionally, regular ophthalmic exams are mandatory for detecting ocular complications and initiating treatments such as laser photocoagulation in case of clinical significant diabetic macular edema or early proliferative diabetic retinopathy. In this way, the risk of blindness can considerably be reduced. In advanced stages of diabetic retinopathy, pars-plana vitrectomy is performed to treat vitreous hemorrhage and tractional retinal detachment. In recent years, the advent of intravitreal medication has improved therapeutic options for patients with advanced diabetic macular edema.

  8. Diabetes and ageing‐induced vascular inflammation

    Science.gov (United States)

    Assar, Mariam El; Angulo, Javier

    2015-01-01

    Abstract Diabetes and the ageing process independently increase the risk for cardiovascular disease (CVD). Since incidence of diabetes increases as people get older, the diabetic older adults represent the largest population of diabetic subjects. This group of patients would potentially be threatened by the development of CVD related to both ageing and diabetes. The relationship between CVD, ageing and diabetes is explained by the negative impact of these conditions on vascular function. Functional and clinical evidence supports the role of vascular inflammation induced by the ageing process and by diabetes in vascular impairment and CVD. Inflammatory mechanisms in both aged and diabetic vasculature include pro‐inflammatory cytokines, vascular hyperactivation of nuclear factor‐кB, increased expression of cyclooxygenase and inducible nitric oxide synthase, imbalanced expression of pro/anti‐inflammatory microRNAs, and dysfunctional stress‐response systems (sirtuins, Nrf2). In contrast, there are scarce data regarding the interaction of these mechanisms when ageing and diabetes co‐exist and its impact on vascular function. Older diabetic animals and humans display higher vascular impairment and CVD risk than those either aged or diabetic, suggesting that chronic low‐grade inflammation in ageing creates a vascular environment favouring the mechanisms of vascular damage driven by diabetes. Further research is needed to determine the specific inflammatory mechanisms responsible for exacerbated vascular impairment in older diabetic subjects in order to design effective therapeutic interventions to minimize the impact of vascular inflammation. This would help to prevent or delay CVD and the specific clinical manifestations (cognitive decline, frailty and disability) promoted by diabetes‐induced vascular impairment in the elderly. PMID:26435167

  9. Chicanoizing the Therapeutic Community

    Science.gov (United States)

    Aron, William S.; And Others

    1974-01-01

    Focusing on the drug addiction problem and its antecedent conditions in a Chicano population, the article examines several therapeutic interventions suggested by these conditions and indicates how they might be incorporated into a drug addiction Therapeutic Community treatment program designed to meet the needs of Chicano drug addicts. (Author/NQ)

  10. Diabetic nephropathy; principles of diagnosis and treatment of diabetic kidney disease.

    Science.gov (United States)

    Nazar, Chaudhary Muhammad Junaid

    2014-01-01

    Diabetes mellitus is a leading epidemic of the present world. It is considered the leading cause of death among end-stage renal disease (ESRD) patients. The complications associated with diabetes mellitus have boosted the number of deaths in the last years. These complications are the result of long lasting effects of diabetes mellitus on the glomerular microvasculature of the kidney. Diabetic nephropathy (DN) develops in patients with several years' medical history of diabetes and renal failure. However, research shows that patients with type 1 diabetes progress early to ESRD as compared to those with type 2. DN is more prevalent in ethnic minorities as compared to other groups in society. There are new and different treatment options available since medical science has progressed due to increased research efforts. Unfortunately, there is no permanent cure. The aim of this article is to explore the research of therapeutic strategies currently in use by medical practitioners in order to increase understanding of DN.

  11. Sulphonylurea monotherapy for patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Hemmingsen, Bianca; Schroll, Jeppe B; Lund, Søren

    2013-01-01

    Type 2 diabetes mellitus (T2DM) is a growing health problem worldwide. Whether sulphonylureas show better, equal or worse therapeutic effects in comparison with other antidiabetic interventions for patients with T2DM remains controversial.......Type 2 diabetes mellitus (T2DM) is a growing health problem worldwide. Whether sulphonylureas show better, equal or worse therapeutic effects in comparison with other antidiabetic interventions for patients with T2DM remains controversial....

  12. Therapeutic effect of medical nutrition therapies with different frequency of nutritional guidance on gestational diabetes mellitus%不同的医学营养治疗方法对妊娠糖尿病的疗效评价

    Institute of Scientific and Technical Information of China (English)

    曾媛; 袁丽佳; 王琳; 康莉; 万婧; 孟珊; 糜漫天

    2013-01-01

    目的 医学营养治疗(medical nutrition therapy,MNT)前后,通过检测妊娠期糖尿病(gestational diabetes mellitus,GDM)患者空腹和餐后2h血糖水平,比较不同的治疗方法对GDM的治疗效果.方法 将90名诊断为GDM的孕妇采用随机数字表法分为一次宣教组和持续干预组,每组各45名.2组按标准体质量法给予个体化的MNT治疗方案,限制每日能量摄入,调整膳食结构,用食物交换份法安排食谱.一次性宣教组营养治疗的实施方式仅采用1次面对面的营养宣教;持续干预组则进行持续性的治疗,即在干预期内保持密切联系,加强对营养治疗的监控,包括面对面、电话和定期营养门诊随访教育,并根据孕周、孕期体质量增长以及血糖水平动态调整饮食方案.观察2组1个月后空腹和餐后2h血糖的控制效果.结果 持续干预组较一次性宣教组餐后2h血糖值的下降更为显著(P<0.05).持续干预组血糖控制合格率显著高于一次性宣教组(55.6% vs 28.9%,P<0.05).持续干预组尿酮体阳性率低于一次性宣教组(6.7% vs 17.8%),但差异无统计学意义(P>0.05).结论 对GDM孕妇实施个体化的MNT,采用持续性治疗的方法,能更有效的控制血糖水平.

  13. Therapeutic effect of alprostadil combined with sulodexide in treatment of stage-Ⅳ diabetic nephropathy%前列地尔联合舒洛地特治疗Ⅳ期糖尿病肾病的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张海红; 谭晓军

    2015-01-01

    目的:观察前列地尔联合舒洛地特治疗Ⅳ期糖尿病肾病的疗效。方法收集2014年1月至11月本科室住院的Ⅳ期糖尿病肾病患者86例,随机数字法分为治疗组(n=45)与对照组(n=41)。两组患者均进行严格糖尿病饮食控制,口服舒洛地特250 LSU,2次/d;14 d后治疗组此基础上加用前列地尔20μg加入生理盐水100 ml中静脉滴注,2次/d,持续10 d后结束治疗。治疗前后两组患者的收缩压、舒张压、糖化血红蛋白、血清肌酐、尿微量白蛋白、尿蛋白定量、尿白蛋白排泄率等指标进行组内和组间比较。结果治疗前两组患者的收缩压、舒张压、糖化血红蛋白、血清肌酐、尿微量白蛋白、尿蛋白定量、尿白蛋白排泄率差异均无统计学意义(均P>0.05)。与治疗前比较,治疗后两组患者的尿微量白蛋白、尿蛋白定量、尿白蛋白排泄率均降低(均P0.05). After treatment,the both groups showed reduction in microalbuminuria,urinary protein quantity and UAER, as compared with pretreatment(all P<0.05);and compared with the control group,the treatment group show more dramatical reduction in these indexes (all P<0.05). Conclusion Combination treatment with alprostadil and sulodexide for diabetic nephropathy can be more effective in improving the patient outcomes.

  14. Epigenetic modifications and diabetic nephropathy

    Directory of Open Access Journals (Sweden)

    Marpadga A. Reddy

    2012-09-01

    Full Text Available Diabetic nephropathy (DN is a major complication associated with both type 1 and type 2 diabetes, and a leading cause of end-stage renal disease. Conventional therapeutic strategies are not fully efficacious in the treatment of DN, suggesting an incomplete understanding of the gene regulation mechanisms involved in its pathogenesis. Furthermore, evidence from clinical trials has demonstrated a “metabolic memory” of prior exposure to hyperglycemia that continues to persist despite subsequent glycemic control. This remains a major challenge in the treatment of DN and other vascular complications. Epigenetic mechanisms such as DNA methylation, nucleosomal histone modifications, and noncoding RNAs control gene expression through regulation of chromatin structure and function and post-transcriptional mechanisms without altering the underlying DNA sequence. Emerging evidence indicates that multiple factors involved in the etiology of diabetes can alter epigenetic mechanisms and regulate the susceptibility to diabetes complications. Recent studies have demonstrated the involvement of histone lysine methylation in the regulation of key fibrotic and inflammatory genes related to diabetes complications including DN. Interestingly, histone lysine methylation persisted in vascular cells even after withdrawal from the diabetic milieu, demonstrating a potential role of epigenetic modifications in metabolic memory. Rapid advances in high-throughput technologies in the fields of genomics and epigenomics can lead to the identification of genome-wide alterations in key epigenetic modifications in vascular and renal cells in diabetes. Altogether, these findings can lead to the identification of potential predictive biomarkers and development of novel epigenetic therapies for diabetes and its associated complications.

  15. Travelling diabetics.

    Science.gov (United States)

    Chełmińska, Katarzyna; Jaremin, Bogdan

    2002-01-01

    During the past several decades, the number of both business and tourist travels has greatly increased. Among them are persons suffering from chronic diseases, including diabetics for whom travels pose the additional health-hazard. Irrespective of better education, self-control and constantly improving quality of specialistic equipment available, diabetics still are the group of patients requiring particular attention. In the case of travelling diabetics, problems may occur concerning the transport and storage of insulin, as well as control of glycaemia, all caused by irregularity of meals, variable diet, physical activity, stress, kinetosis (sea voyages), and the change of time zones. The travel may as well evoke ailments caused by the change of climate and concomitant diseases such as traveller's diarrhoea, malaria, etc. Apart from avoiding glycaemia fluctuations, important for retaining health of diabetics is the prevention of other diseases and carrying the necessary drugs.

  16. Diabetes Insipidus

    Science.gov (United States)

    ... Health Information Kidney Disease Diabetes Inspidus Related Topics Section Navigation Kidney Disease Acquired Cystic Kidney Disease Amyloidosis & ... for a Child with Kidney Disease Ectopic Kidney Medullary Sponge Kidney Kidney Dysplasia Kidney Failure Choosing a ...

  17. [Diabetes insipidus].

    Science.gov (United States)

    Krysiak, Robert; Handzlik-Orlik, Gabriela; Okopień, Bogusław

    2014-01-01

    Diabetes insipidus is an uncommon disorder of water-electrolyte balance characterized by the excretion of abnormally large volumes of diluted urine (polyuria) and increased fluid intake (polydipsia). The disease may result from the insufficient production of vasopressin, its increased degradation, an impaired response of kidneys to vasopressin, or may be secondary to excessive water intake. Patients with severe and uncompensated symptoms may develop marked dehydration, neurologic symptoms and encephalopathy, and therefore diabetes insipidus can be a life-threatening condition if not properly diagnosed and managed. Patients with diabetes insipidus require treatment with desmopressin or drugs increasing sensitivity of the distal nephron to vasopressin, but this treatment may be confusing because of the disorder's variable pathophysiology and side-effects of pharmacotherapy. This review summarizes the current knowledge on different aspects of the pathophysiology, classification, clinical presentation, diagnosis, and management of diabetes insipidus. The reader is also provided with some practical recommendations on dealing with patients suffering from this disease.

  18. Gestational diabetes

    Science.gov (United States)

    ... first few days of life. Mothers with gestational diabetes have an increased risk for high blood pressure during pregnancy . After delivery: Your high blood sugar (glucose) level often goes back to normal. You should be ...

  19. Diabetes Insipidus

    Science.gov (United States)

    ... Download PDFs English Espanol Editors Anne Klibanski, MD Janet Schlechte, MD Nicholas Tritos, MD What is diabetes ... Desmopressin (nasal spray or pill) What is the long-term outlook for people with DI? Long-term ...

  20. Diabetic Coma

    Science.gov (United States)

    ... Sometimes, people with diabetes who also have an eating disorder choose not to use their insulin as directed ... 22, 2015 Original article: ... of Nondiscrimination Advertising Mayo Clinic is a not-for-profit organization ...

  1. Gestational diabetes

    African Journals Online (AJOL)

    metabolism. In normal pregnancy fasting glucose declines to ... changes in lifestyle. The cause .... disease phenotype and requires interaction of environmental factors for ... lifestyle.'8. Gestational diabetes is a clinical event with conseque~ces.

  2. Cell-Based Therapies for Diabetic Complications

    Science.gov (United States)

    Bernardi, Stella; Severini, Giovanni Maria; Zauli, Giorgio; Secchiero, Paola

    2012-01-01

    In recent years, accumulating experimental evidence supports the notion that diabetic patients may greatly benefit from cell-based therapies, which include the use of adult stem and/or progenitor cells. In particular, mesenchymal stem cells and the circulating pool of endothelial progenitor cells have so far been the most studied populations of cells proposed for the treatment of vascular complications affecting diabetic patients. We review the evidence supporting their use in this setting, the therapeutic benefits that these cells have shown so far as well as the challenges that cell-based therapies in diabetic complications put out. PMID:21822425

  3. Cell-Based Therapies for Diabetic Complications

    Directory of Open Access Journals (Sweden)

    Stella Bernardi

    2012-01-01

    Full Text Available In recent years, accumulating experimental evidence supports the notion that diabetic patients may greatly benefit from cell-based therapies, which include the use of adult stem and/or progenitor cells. In particular, mesenchymal stem cells and the circulating pool of endothelial progenitor cells have so far been the most studied populations of cells proposed for the treatment of vascular complications affecting diabetic patients. We review the evidence supporting their use in this setting, the therapeutic benefits that these cells have shown so far as well as the challenges that cell-based therapies in diabetic complications put out.

  4. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008025 Peroxisome proliferator activated receptor-γ agonists improves arterial stiffness in type 2 diabetic patients with coronary artery disease. YU Jie(于婕), et al. Dept Cardiovasc Med, Peking Univ 3rd Hosp, Beijing 100083. Chin Cir J 2007;22(6):418-422. Objective Arterial stiffness is an independent risk factor for cardiovascular events in diabetic patients, and it may be assessed by measurement of pulse wave velocity(PWV).

  5. Diabetes gestacional

    OpenAIRE

    Rodrigues, Marília da Costa Soares

    2010-01-01

    Introduction: Gestational diabetes mellitus is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. This condition is associated with an increase of important outcomes in the fetus and newborn. Objectives: Review of gestational diabetes mellitus physiopathology and the metabolic/hormonal changes that happen in the fetal environment. Review of the impact in the mother, intrauterine environment, fetus and newborn. Results: The maternal metabolic d...

  6. Diabetes gestacional

    OpenAIRE

    Rodrigues, Marília da Costa Soares

    2010-01-01

    Introduction: Gestational diabetes mellitus is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. This condition is associated with an increase of important outcomes in the fetus and newborn. Objectives: Review of gestational diabetes mellitus physiopathology and the metabolic/hormonal changes that happen in the fetal environment. Review of the impact in the mother, intrauterine environment, fetus and newborn. Results: The maternal metabolic d...

  7. Diabetic retinopathy

    DEFF Research Database (Denmark)

    Wong, Tien Y; Cheung, Chui Ming Gemmy; Larsen, Michael

    2016-01-01

    , and diabetic macular oedema, in which there is exudation and oedema in the central part of the retina. DR is strongly associated with a prolonged duration of diabetes, hyperglycaemia and hypertension. It is traditionally regarded as a microvascular disease, but retinal neurodegeneration is also involved....... Complex interrelated pathophysiological mechanisms triggered by hyperglycaemia underlie the development of DR. These mechanisms include genetic and epigenetic factors, increased production of free radicals, advanced glycosylation end products, inflammatory factors and vascular endothelial growth factor...

  8. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008256 Role of heparanase in the pathogenesis of proteinuria in diabetic nephropathy rats.TANG Lin(唐琳),et al.Dept Nephrol,1st Affili Hosp,Zhengzhou Univ,Zhengzhou 450052.Chin J Nephrol 2008;24(4):277-281.Objective To observe the expression of heparanase (HPA)in kidney of diabetic nephropathy(DN)rats and to investigate the role of HPA in the pathogenesis of proteinuria in DN rats.Methods DM rat models induced

  9. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    2010297 Effect of 4-phenylbutyric acid on diabetic nephropathy rats.LUO Zhifeng(罗志锋),et al.Dept Nephrol,Xinqiao Hosp,3rd Milit Med Univ,Chongqing 400037.Chin J Nephrol 2010;26(5):358-363. Objective To investigate the effect of 4-phenylbutyric acid (4-PBA) on the renal pathogenesis of rats with streptozotocin-induced diabetes and its mechanism.Methods

  10. [Adolescents with diabetes type 1 in adolescent psychiatry and psychotherapy].

    Science.gov (United States)

    Walter, Joachim

    2013-01-01

    Psychiatric comorbidity, family and biographical risk factors, and individual motivational aspects influence the therapeutic adherence and treatment motivation in Diabetes Type 1. The article provides basis diabetological knowledge for adolescent psychotherapists and describes practical out- and inpatient experiences and deliberations with especially problematic comorbid patients. In psychiatrically comorbid patients family conflicts and individual psychopathology is often reflected and manifested in selfharming diabetes management.

  11. Peripheral Neuropathy in Mouse Models of Diabetes.

    Science.gov (United States)

    Jolivalt, Corinne G; Frizzi, Katie E; Guernsey, Lucie; Marquez, Alex; Ochoa, Joseline; Rodriguez, Maria; Calcutt, Nigel A

    2016-09-01

    Peripheral neuropathy is a frequent complication of chronic diabetes that most commonly presents as a distal degenerative polyneuropathy with sensory loss. Around 20% to 30% of such patients may also experience neuropathic pain. The underlying pathogenic mechanisms are uncertain, and therapeutic options are limited. Rodent models of diabetes have been used for more than 40 years to study neuropathy and evaluate potential therapies. For much of this period, streptozotocin-diabetic rats were the model of choice. The emergence of new technologies that allow relatively cheap and routine manipulations of the mouse genome has prompted increased use of mouse models of diabetes to study neuropathy. In this article, we describe the commonly used mouse models of type 1 and type 2 diabetes, and provide protocols to phenotype the structural, functional, and behavioral indices of peripheral neuropathy, with a particular emphasis on assays pertinent to the human condition. © 2016 by John Wiley & Sons, Inc.

  12. Impact of Diabetes and Peripheral Arterial Occlusive Disease on the Functional Microcirculation at the Plantar Foot

    Directory of Open Access Journals (Sweden)

    Mohammad Kabbani, MD

    2013-10-01

    Conclusions: Functional microcirculation at the plantar foot differs between healthy subjects and patients suffering from diabetes or PAOD of the same age. Patients with either diabetes or PAOD demonstrate deteriorated cutaneous oxygen saturation with equivalent blood perfusion at the plantar foot. More clinical studies have to be conducted to evaluate therapeutical methods that might ameliorate cutaneous oxygen saturation within diabetic foot disease and PAOD.

  13. 77 FR 29676 - National Institute of Diabetes and Digestive and Kidney Disorders; Notice of Closed Meetings

    Science.gov (United States)

    2012-05-18

    ... Federal Domestic Assistance Program Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848... Diabetes and Digestive and Kidney Disorders; Notice of Closed Meetings Pursuant to section 10(d) of the... requests for preclinical development resources for potential new therapeutics for type 1 diabetes....

  14. Does Glucagon-like Peptide-1 Ameliorate Oxidative Stress in Diabetes?

    DEFF Research Database (Denmark)

    Petersen, Karen Ekkelund; Rakipovski, Günaj; Raun, Kirsten

    2016-01-01

    a controversial topic but could hold a therapeutic potential against micro- and macrovascular diabetic complications. This review discusses the presently available knowledge from experimental and clinical studies on the effects of GLP-1 on oxidative stress in diabetes and diabetes-related complications....

  15. 赖脯胰岛素50联合二甲双胍治疗新诊断超重/肥胖2型糖尿病的疗效分析%The therapeutic effect of insulin lispro mix 50/50 combined with metformin in newly diagnosed overweight/obese type 2 diabetic mellitus patients

    Institute of Scientific and Technical Information of China (English)

    杨萍; 魏祎

    2014-01-01

    Objective To evaluate the therapeutic effect and safety of insulin lispro mix 50/50 combined with mefformin in newly diagnosed overweight/obese type 2 diabetic mellitus patients.Methods Sixty-two patients with newly diagnosed overweight/obsess type 2 diabetic mellitus were randomly divided into observation group (32 cases) and control group (30 cases) by systematic sampling method.The observation group received insulin lispro mix 50/50 combined with metformin,and the control group received recombinant human insulin and insulin glargine.The therapeutic effect and safety were compared between the 2 groups.Results There were no statistical differences in the blood glucose before eating,before retiring and at mane primo 3:00 between the 2 groups (P > 0.05).There were no statistical differences in the time of blood glucose standard and rate of hypoglycaemia between the 2 groups (P > 0.05).Daily insulin dosage and costs in the observation group were lower than those in the control group [(0.6 ± 0.1) U/kg vs.(0.8 ± 0.1) U/kg and (15.8 ±2.1) yuan/d vs.(21.3 ±2.6) yuan/d],and there were statistical differences (P <0.05).Conclusion Insulin lispro mix 50/50 combined with mefformin provides a convenient,effective and safe therapy for newly diagnosed overweight/obese type 2 diabetic mellitus patients and high cost performance.%目的 对新诊断的超重/肥胖2型糖尿病(T2DM)患者进行赖脯胰岛素50联合二甲双胍的短期强化治疗,评价其疗效和安全性.方法 62例新诊断的超重/肥胖T2DM患者按机械抽样法随机分为研究组(32例)和对照组(30例),研究组予以赖脯胰岛素50联合二甲双胍治疗,对照组予以重组人胰岛素及甘精胰岛素治疗,收集疗效及安全性数据进行统计学分析.结果 两组治疗后餐前、睡前、凌晨3:00血糖比较差异无统计学意义(P>0.05).两组血糖达标时间、低血糖发生率比较差异无统计学意义(P>0.05).研究组胰岛素

  16. Therapeutic effects of St. John's Wort extract on depressive disorder in elderly patients with diabetes%圣·约翰草提取物对老年2型糖尿病患者并存抑郁症的疗效观察

    Institute of Scientific and Technical Information of China (English)

    任晓军; 崔景秋; 李鸿梅; 王瑜; 李京艳; 刘金泉

    2008-01-01

    目的 探讨抗抑郁植物药圣·约翰草提取物对并存抑郁症的老年2型糖尿病患者的临床疗效及对血糖的影响. 方法 将并存抑郁症的老年2型糖尿病患者118例随机分为5组,圣·约翰草提取物组(26例)、劳拉西泮组(22例)、心理组(24例)、物理组(24例)和对照组(22例),均治疗12周.以汉密尔顿抑郁量表(HAMD)减分率评定疗效,采用糖化血红蛋白(HbAlc)水平监测血糖控制情况. 结果 (1)治疗12周后,4个治疗组HAMD减分率分别为80.8%、63.6%、62.5%、58.3%,与对照组(18.2%)比较,差异有统计学意义(P<0.01),圣·约翰草提取物组疗效优于其他3组(P<0.05);(2)治疗12周后,圣·约翰草提取物组HbAIt(6.5±0.6)%,比治疗前明显下降(P<0.01),且优于其他3组[分别为(7.5±0.8)%、(7.4±0.8)%和(7.4±1.0)%]. 结论 圣·约翰草提取物能显著改善老年2型糖尿病患者伴发的抑郁症状,且有利于患者的血糖控制.%Objective To explore the clinical therapeutic effects of St. John's Wort exact (SWE)on depressive disorder and blood glucose in elderly type 2 diabetic patients Methods 118 patients with type 2 diabetes and depressive disorder were randomly assigned to SWE group (26 cases),lorazepam group (22 cases ), psychotherapy group (24 cases), physicotherapy group (24 cases) and control group (routine therapy,22 cases) for 12 weeks' treatment. The clinical effects were evaluated with the percentage reduction in HAMD score after the treatment, HbAlc levels were obtained to monitor glycemic control. Results (1) The percentage reduction in HAMD score in SWE group was the highest (80. 8%), and it was lower in lorazepam group ( 63. 6%), psychotherapy group (62. 5%) and physicotherapy group(58. 3%). The percent decrease in H AMD score was higher in four groups than in control group ( 18. 2%) and the difference was significant (P < 0. 01). The therapeutic effect of SWE was better than the others(P0. 05). (2) The level of HbAlc in SWE group

  17. Diabetes and Pregnancy

    Science.gov (United States)

    Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. When ... pregnant women in the United States get gestational diabetes. Gestational diabetes is diabetes that happens for the ...

  18. Women and Diabetes

    Science.gov (United States)

    ... Audience For Women Women's Health Topics Women and Diabetes Share Tweet Linkedin Pin it More sharing options ... Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take ...

  19. Diabetes and nerve damage

    Science.gov (United States)

    Diabetic neuropathy; Diabetes - neuropathy; Diabetes - peripheral neuropathy ... In people with diabetes, the body's nerves can be damaged by decreased blood flow and a high blood sugar level. This condition is ...

  20. Women and Diabetes

    Medline Plus

    Full Text Available ... Audience For Women Women's Health Topics Women and Diabetes Share Tweet Linkedin Pin it More sharing options ... Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take ...

  1. Diabetes Movie (For Parents)

    Medline Plus

    Full Text Available ... Diabetes: Lindsey's Story (Video) Diabetes Center Movie: Endocrine System Diabetes Center Diabetes: DJ's Story ... About KidsHealth Nemours.org Reading BrightStart! Contact Us ...

  2. Diabetes: Dental Tips

    Science.gov (United States)

    ... Diabetes and Oral Health > Diabetes: Dental Tips Diabetes: Dental Tips Main Content Diabetes can cause serious problems ... FOIA Web Policies Privacy Policy National Institute of Dental and Craniofacial Research National Institutes of Health Bethesda, ...

  3. Women and Diabetes

    Medline Plus

    Full Text Available ... Beware of Illegally Sold Diabetes Treatments Diabetes and Pregnancy Some women develop diabetes for the first time ... care provider about how to manage diabetes during pregnancy. Medicine and Pregnancy Fact Sheet Pregnancy Registries - Sign- ...

  4. National Diabetes Education Program

    Science.gov (United States)

    ... Living Tips About WIN NIDDK Information Clearinghouses National Diabetes Education Program Together with more than 200 partners ... type 2 diabetes. Learn more about NDEP . National Diabetes Month You are the center of your diabetes ...

  5. Cardiovascular Disease and Diabetes

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Cardiovascular Disease & Diabetes Updated:Apr 14,2017 The following statistics speak ... disease. This content was last reviewed August 2015. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...

  6. Diabetes and kidney disease

    Science.gov (United States)

    Diabetic nephropathy; Nephropathy - diabetic; Diabetic glomerulosclerosis; Kimmelstiel-Wilson disease ... 26696680 . Tong LL, Adler S. Prevention and treatment of diabetic nephropathy. In: Johnson RJ, Feehally J, Floege J, eds. ...

  7. Women and Diabetes

    Medline Plus

    Full Text Available ... Audience For Women Women's Health Topics Women and Diabetes Share Tweet Linkedin Pin it More sharing options ... Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take ...

  8. The role of IL-18 in type 1 diabetic nephropathy: The problem and future treatment.

    Science.gov (United States)

    Elsherbiny, Nehal M; Al-Gayyar, Mohammed M H

    2016-05-01

    Diabetic vascular complication is a leading cause of diabetic nephropathy, a progressive increase in urinary albumin excretion coupled with elevated blood pressure leading to declined glomerular filtration and eventually end stage renal failure. There is growing evidence that activated inflammation is contributing factor to the pathogenesis of diabetic nephropathy. Meanwhile, IL-18, a member of the IL-1 family of inflammatory cytokines, is involved in the development and progression of diabetic nephropathy. However, the benefits derived from the current therapeutics for diabetic nephropathy strategies still provide imperfect protection against renal progression. This imperfection points to the need for newer therapeutic agents that have potential to affect primary mechanisms contributing to the pathogenesis of diabetic nephropathy. Therefore, the recognition of IL-18 as significant pathogenic mediators in diabetic nephropathy leaves open the possibility of new potential therapeutic targets.

  9. Role of Endothelial Nitric Oxide Synthase in Diabetic Nephropathy: Lessons from Diabetic eNOS Knockout Mice

    OpenAIRE

    Takamune Takahashi; Harris, Raymond C.

    2014-01-01

    Diabetic nephropathy (DN) is the leading cause of end-stage renal disease in many countries. The animal models that recapitulate human DN undoubtedly facilitate our understanding of this disease and promote the development of new diagnostic markers and therapeutic interventions. Based on the clinical evidence showing the association of eNOS dysfunction with advanced DN, we and others have created diabetic mice that lack eNOS expression and shown that eNOS-deficient diabetic mice exhibit advan...

  10. [Gestational Diabetes Mellitus].

    Science.gov (United States)

    Krejčí, Hana

    2016-01-01

    is taken over by specialist centres. The early and appropriate treatment of gestational diabetes demonstrably reduces the risk of complications. The base for therapy is formed by regimen-related measures: the therapeutic diet and increased physical activity. The best results of the dietary therapy are achieved with foods low on glycemic index and glycemic load that can also act as efficient prevention of GDM and subsequent development of T2DM. A small number of cases require adding of pharmacological therapy: insulin and newly also metformin. Metformin is the drug of choice primarily in obese patients, however in almost half of the cases insulin must be added. Medication, in particular with insulin, must be introduced carefully, following re-education and elimination of dietary mistakes. The aim of the treatment is not only to achieve normoglycemia, but also to improve, or at least to not further worsen insulin resistance. Insulin resistance alone without diabetes, e.g. due to obesity or a great weight gain, may lead to macrosomia and epigenetic changes. In this regard, the prevention within the whole population of pregnant women needs to be improved and the vicious circle of the causation of metabolic disorders among the population needs to be broken.Key words: recommended procedure - epigenetic changes - gestation diabetes mellitus - macrosomia - screening.

  11. The endocannabinoid system and plant-derived cannabinoids in diabetes and diabetic complications.

    Science.gov (United States)

    Horváth, Béla; Mukhopadhyay, Partha; Haskó, György; Pacher, Pál

    2012-02-01

    Oxidative stress and inflammation play critical roles in the development of diabetes and its complications. Recent studies provided compelling evidence that the newly discovered lipid signaling system (ie, the endocannabinoid system) may significantly influence reactive oxygen species production, inflammation, and subsequent tissue injury, in addition to its well-known metabolic effects and functions. The modulation of the activity of this system holds tremendous therapeutic potential in a wide range of diseases, ranging from cancer, pain, neurodegenerative, and cardiovascular diseases to obesity and metabolic syndrome, diabetes, and diabetic complications. This review focuses on the role of the endocannabinoid system in primary diabetes and its effects on various diabetic complications, such as diabetic cardiovascular dysfunction, nephropathy, retinopathy, and neuropathy, particularly highlighting the mechanisms beyond the metabolic consequences of the activation of the endocannabinoid system. The therapeutic potential of targeting the endocannabinoid system and certain plant-derived cannabinoids, such as cannabidiol and Δ9-tetrahydrocannabivarin, which are devoid of psychotropic effects and possess potent anti-inflammatory and/or antioxidant properties, in diabetes and diabetic complications is also discussed.

  12. COST-EFFECTIVENESS ANALYSIS OF ANTI-DIABETIC THERAPY IN A UNIVERSITY TEACHING HOSPITAL

    OpenAIRE

    Giwa Abdulganiyu; Tayo Fola

    2014-01-01

    Purpose: To conduct cost-effectiveness analysis of anti-diabetic therapy in a University Teaching Hospital in 2010. Methods: A retrospective review of selected case-notes was conducted. World Health Organization Defined Daily Dose Method of evaluating drug use and probability method for potential effectiveness of antidiabetic therapeutic options from literature analysis was employed in determining cost-effectiveness of each anti-diabetic therapeutic option identified from anti-diabetic dru...

  13. 度洛西汀联合硫辛酸治疗糖尿病周围神经病变性疼痛的疗效观察%Therapeutic effect analysis of duloxetine hydrochloride combined with alpha-lipoic acid in treatment of diabetic peripheral neuropathic pain

    Institute of Scientific and Technical Information of China (English)

    沈柿芬; 郭道骝

    2016-01-01

    目的:探讨度洛西汀联合硫辛酸治疗糖尿病周围神经病变性疼痛的有效性及安全性。方法:将78例糖尿病周围神经病变性疼痛患者随机分为两组,西汀组口服度洛西汀,联合组口服度洛西汀和静脉滴注硫辛酸,比较两组疗效。结果:两组治疗后正中神经感觉传导速度(median nerve conduction velocity,MNCV)、腓总神经感觉传导速度(phil nerve conduction velocity,PNCV)、尺神经感觉传导速度(ulnar nerve conduction velocity,UNCV)均显著提高(P0.05);两组治疗前、治疗8周后胆固醇(TC)、甘油三酯(TG)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、血肌酐(SCr)指标水平均无显著性变化(P>0.05)。结论:度洛西汀联合硫辛酸治疗糖尿病周围神经病变性疼痛,能有效改善患者神经功能,减轻疼痛症状,且安全可靠。%Objective:By comparing duloxetine combination with alpha-lipoic acid and duloxetine in the therapeutic effect of painful diabetic neuropathy, to explore the efficacy and safety of duloxetine combination with alpha-lipoic acid treatment on diabetic peripheral neuropathic pain (DPNP) is optimal.Methods:78 cases with painful diabetic neuropathy of type 2 diabetes were recruited from our department and randomly divided into two groups, which were duloxetine in combination with alpha-lipoic acid group and duloxetine treatment group.Results: Compared to baseline, median nerve sensory conduction velocity (MNCV), Phil nerve conduction velocity (PNCV) and ulnar nerve conduction velocity (UNCV) of both groups were better (P0.05). Before treatment, no statistically signiifcant differences were detected in total cholesterol (TC), triglycerides (TG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and serum creatinine (SCr) between two groups (P>0.05).Conclusion:Duloxetine hydrochloride combined with alpha-lipoic acid has a good

  14. Self-reported discrimination, diabetes distress, and continuous blood glucose in women with type 2 diabetes.

    Science.gov (United States)

    Wagner, Julie A; Tennen, Howard; Feinn, Richard; Osborn, Chandra Y

    2015-04-01

    We investigated whether self-reported racial discrimination was associated with continuous glucose levels and variability in individuals with diabetes, and whether diabetes distress mediated these associations. Seventy-four Black and White women with type 2 diabetes completed the Experience of Discrimination scale, a measure of lifetime racial discrimination, and the Problem Areas in Diabetes, a measure of diabetes distress. Participants wore a continuous glucose monitor for 24 h after 8 h of fasting, a standard meal, and a 4-h run in period. Higher discrimination predicted higher continuous mean glucose and higher standard deviation of glucose. For both mean and standard deviation of glucose, a race × discrimination interaction indicated a stronger relationship between discrimination and glucose for Whites than for Blacks. Diabetes distress mediated the discrimination-mean glucose relationship. Whites who report discrimination may be uniquely sensitive to distress. These preliminary findings suggest that racial discrimination adversely affects glucose control in women with diabetes, and does so indirectly through diabetes distress. Diabetes distress may be an important therapeutic target to reduce the ill effects of racial discrimination in persons with diabetes.

  15. Therapeutic antimicrobial peptides may compromise natural immunity.

    Science.gov (United States)

    Habets, Michelle G J L; Brockhurst, Michael A

    2012-06-23

    Antimicrobial peptides (AMPs) have been proposed as a promising new class of antimicrobials despite warnings that therapeutic use could drive the evolution of pathogens resistant to our own immunity peptides. Using experimental evolution, we demonstrate that Staphylococcus aureus rapidly evolved resistance to pexiganan, a drug-candidate for diabetic leg ulcer infections. Evolved resistance was costly in terms of impaired growth rate, but costs-of-resistance were completely ameliorated by compensatory adaptation. Crucially, we show that, in some populations, experimentally evolved resistance to pexiganan provided S. aureus with cross-resistance to human-neutrophil-defensin-1, a key component of the innate immune response to infection. This unintended consequence of therapeutic use could drastically undermine our innate immune system's ability to control and clear microbial infections. Our results therefore highlight grave potential risks of AMP therapies, with implications for their development.

  16. Diabetes Movie (For Parents)

    Science.gov (United States)

    ... For Parents > Diabetes Movie Print A A A Kids who have diabetes have trouble taking energy from food and delivering ... to learn more about diabetes. For Teens For Kids For Parents MORE ON THIS TOPIC Diabetes Center Diabetes: Marco's Story (Video) Diabetes: Grace's Story ( ...

  17. Diabetes Movie (For Parents)

    Medline Plus

    Full Text Available ... For Parents > Diabetes Movie Print A A A Kids who have diabetes have trouble taking energy from food and delivering ... to learn more about diabetes. For Teens For Kids For Parents MORE ON THIS TOPIC Diabetes Center Diabetes: Marco's Story (Video) Diabetes: Grace's Story ( ...

  18. Therapeutic Exercise and Hypertension

    African Journals Online (AJOL)

    Nekky Umera

    focus of this review is to discuss the therapeutic efficacy of exercise on ... as high level of sodium in diet, alcohol consumption, obesity, physical inactivity, age, and .... idiopathic (essential) hypertension, there are two modes or approaches.

  19. Antiviral Polymer Therapeutics

    DEFF Research Database (Denmark)

    Smith, Anton Allen Abbotsford

    2014-01-01

    The field of drug delivery is in essence an exercise in engineered pharmacokinetics. Methods of doing so have been developed through the introduction of a vehicle carrying the drug, either by encapsulation or covalent attachment. The emergence of polymer therapeutics in anticancer therapy has...... the examples of polymer therapeutics being applied as an antiviral treatment are few and far in-between. This work aims to explore antiviral therapeutics, specifically in context of hepatitis virus C (HCV) and HIV. The current treatment of hepatitis C consists of a combination of drugs, of which ribavirin....... Curiously, the therapeutic window of ribavirin was vastly improved in several of these polymers suggesting altered pharmacodynamics. The applicability of liver-targeting sugar moieties is likewise tested in a similarly methodical approach. The same technique of synthesis was applied with zidovudine to make...

  20. Diabetic dyslipidemia.

    Science.gov (United States)

    Wu, Liya; Parhofer, Klaus G

    2014-12-01

    Diabetic dyslipidemia is characterized by elevated fasting and postprandial triglycerides, low HDL-cholesterol, elevated LDL-cholesterol and the predominance of small dense LDL particles. These lipid changes represent the major link between diabetes and the increased cardiovascular risk of diabetic patients. The underlying pathophysiology is only partially understood. Alterations of insulin sensitive pathways, increased concentrations of free fatty acids and low grade inflammation all play a role and result in an overproduction and decreased catabolism of triglyceride rich lipoproteins of intestinal and hepatic origin. The observed changes in HDL and LDL are mostly sequence to this. Lifestyle modification and glucose control may improve the lipid profile but statin therapy mediates the biggest benefit with respect to cardiovascular risk reduction. Therefore most diabetic patients should receive statin therapy. The role of other lipid lowering drugs, such as ezetimibe, fibrates, omega-3 fatty acids, niacin and bile acid sequestrants is less well defined as they are characterized by largely negative outcome trials. This review examines the pathophysiology of diabetic dyslipidemia and its relationship to cardiovascular diseases. Management approaches will also be discussed.

  1. Subclinical Diabetes

    Directory of Open Access Journals (Sweden)

    LUÍS M.T.R. LIMA

    Full Text Available ABSTRACT Type 2 diabetes mellitus (T2DM is increasing in prevalence worldwide, and those non-diagnosed or misdiagnosed comprise a significant group compared to those diagnosed. Accumulated scientific evidence indicate that the current diagnostic markers (fasting glycemia, 2h glycemia after an oral glucose load and HbA1c are indeed late diagnostic criteria when considering the incidence of diabetes-related complications and comorbidities, which are also at high risk in some groups among normoglycemic individuals. Additionally, the earlier identification of future risk of diabetes is desirable since it would allow better adherence to preventive actions such as lifestyle intervention, ultimately avoiding complications and minimizing the economic impact/burden on health care expenses. Insulin resistance and hyperhormonemia (insulin, amylin, glucagon are non-disputable hallmarks of T2DM, which already takes place among these normoglycemic, otherwise health subjects, characterizing a state of subclinical diabetes. Insulin resistance and hyperinsulinemia can be computed from fasting plasma insulin as an independent variable in normoglycemia. An overview of the current diagnostic criteria, disease onset, complications, comorbidities and perspectives on lifestyle interventions are presented. A proposal for early detection of subclinical diabetes from routine evaluation of fasting plasma insulin, which is affordable and robust and thus applicable for the general population, is further suggested.

  2. Role of BKCa channels in diabetic vascular complications

    Institute of Scientific and Technical Information of China (English)

    Qian Lingling; Liu Xiaoyu; Wang Ruxing

    2014-01-01

    Objective This review focuses on the role of the large conductance calcium-activated potassium (BKCa) channels in diabetic vascular complications.Data sources Relevant articles published in English or Chinese from 1981 to present were selected from PubMed.The search terms were "BKCa channels" and "diabetes".Important references from selected articles were also retrieved.Study selection Articles regarding the role of BKCa channels in diabetic vascular complications and relevant mechanisms were selected.Results The BKCa channels are abundantly expressed in vascular smooth cells and play an important role in regulation of vascular tone.Multiple studies indicated that the expression and function of BKCa channels are altered by different mechanisms in diabetic vascular diseases such as coronary arterial disease,cerebral arterial disease,and diabetic retinopathy.Conclusion BKCa channels may play an important role in diabetic vascular complications and may be an effective therapeutic target for relieving and reducing the burden of diabetic vascular complications.

  3. Epidermal Nerve Fiber Quantification in the Assessment of Diabetic Neuropathy

    Science.gov (United States)

    Beiswenger, Kristina K.; Calcutt, Nigel A.; Mizisin, Andrew P.

    2008-01-01

    Summary Assessment of cutaneous innervation in skin biopsies is emerging as a valuable means of both diagnosing and staging diabetic neuropathy. Immunolabeling, using antibodies to neuronal proteins such as protein gene product 9.5, allows for the visualization and quantification of intraepidermal nerve fibers. Multiple studies have shown reductions in intraepidermal nerve fiber density in skin biopsies from patients with both type 1 and type 2 diabetes. More recent studies have focused on correlating these changes with other measures of diabetic neuropathy. A loss of epidermal innervation similar to that observed in diabetic patients has been observed in rodent models of both type 1 and type 2 diabetes and several therapeutics have been reported to prevent reductions in intraepidermal nerve fiber density in these models. This review discusses the current literature describing diabetes-induced changes in cutaneous innervation in both human and animal models of diabetic neuropathy. PMID:18384843

  4. Bioactive Compounds and Their Neuroprotective Effects in Diabetic Complications.

    Science.gov (United States)

    Oh, Yoon Sin

    2016-07-30

    Hyperglycemia, hyperlipidemia and impaired insulin signaling during the development of diabetes can cause diabetic complications, such as diabetic neuropathy, resulting in significant morbidity and mortality. Although various therapeutics are available for the treatment of diabetic neuropathy, no absolute cure exists, and additional research is necessary to comprehensively understand the underlying pathophysiological pathways. A number of studies have demonstrated the potential health benefits of bioactive compounds, i.e., flavonoids and vitamins, which may be effective as supplementary treatments for diabetes and its complications. In this review, we highlight the most recent reports about the mechanisms of action of bioactive compounds (flavonoids and vitamins) possessing potential neuroprotective properties in diabetic conditions. Additional clinical studies are required to determine the appropriate dose and duration of bioactive compound supplementation for neuroprotection in diabetic patients.

  5. Influence of diabetes mellitus on heart failure risk and outcome

    Directory of Open Access Journals (Sweden)

    Van Belle Eric

    2003-01-01

    Full Text Available Abstract Our aim is to summarize and discuss the recent literature linking diabetes mellitus with heart failure, and to address the issue of the optimal treatment for diabetic patients with heart failure. The studies linking diabetes mellitus (DM with heart failure (HF The prevalence of diabetes mellitus in heart failure populations is close to 20% compared with 4 to 6% in control populations. Epidemiological studies have demonstrated an increased risk of heart failure in diabetics; moreover, in diabetic populations, poor glycemic control has been associated with an increased risk of heart failure. Various mechanisms may link diabetes mellitus to heart failure: firstly, associated comorbidities such as hypertension may play a role; secondly, diabetes accelerates the development of coronary atherosclerosis; thirdly, experimental and clinical studies support the existence of a specific diabetic cardiomyopathy related to microangiopathy, metabolic factors or myocardial fibrosis. Subgroup analyses of randomized trials demonstrate that diabetes is also an important prognostic factor in heart failure. In addition, it has been suggested that the deleterious impact of diabetes may be especially marked in patients with ischemic cardiomyopathy. Treatment of heart failure in diabetic patients The knowledge of the diabetic status may help to define the optimal therapeutic strategy for heart failure patients. Cornerstone treatments such as ACE inhibitors or beta-blockers appear to be uniformly beneficial in diabetic and non diabetic populations. However, in ischemic cardiomyopathy, the choice of the revascularization technique may differ according to diabetic status. Finally, clinical studies are needed to determine whether improved metabolic control might favorably influence the outcome of diabetic heart failure patients.

  6. 地特胰岛素联合格列齐特缓释片与诺和锐30治疗2型糖尿病的疗效比较%Comparison of therapeutic effects between insulin detemir combined with gliclazide sustained-release tablets and insulin aspart30 in treating type 2 diabetes melitus

    Institute of Scientific and Technical Information of China (English)

    薛萌; 周宇

    2013-01-01

      目的比较地特胰岛素联合格列齐特缓释片与诺和锐30治疗2型糖尿病患者的疗效。方法选择80例继发性磺脲类降糖药失效的2型糖尿病患者,随机分为地特胰岛素联合格列齐特缓释片组和诺和锐30治疗组。观察两组治疗前后血糖及HbA1c变化,以及低血糖发生率。结果两组各监测点血糖及HbA1c治疗后与治疗前比较均明显下降(P0.05)。结论地特胰岛素联合格列齐特缓释片与诺和锐30均能有效控制血糖,两组低血糖发生率低且相近。%Objective To study the therapeutic effects of insulin detemir combined with gliclazide sustained-release tablets and insulin aspart30 in treating type 2 diabetes melitus. Methods 80 type 2 diabetes patients with secondary failure to sulfonylureas(SFS) were grouped randomly by insulin detemir combined with gliclazide sustained-release tablets ,insulin aspart30 for 3 months. The blood glucose and HbA1c before and after treatment were observed. And the incidence of hypoglycemia were compared. Result There were statisticaly significant differences in blood glucose at various points in 24 hours and in HbA1c between the two groups before and after treatment (P0.05) .Conclusion The above two treatments can reduce the blood glucose and HbA1c effectively. The incidence of hypoglycemia in insulin detemir combined with gliclazide sustained-release tablets was as low as in insulin aspart30.

  7. Diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    A. Moreno

    Full Text Available This paper describes the importance of diabetic retinopathy in the loss of visual function. We exposed the most important risk factors, such as diabetes duration, poor metabolic control, pregnancy, puberty, hypertension, poor control of blood lipids, renal disease, and sleep apnea syndrome. We describe the pathogenesis of the disease, small retinal vessel microangiopathies which produce extravasation, edema and ischemia phenomena. We put special emphasis on the vascular endothelial growth factor (VEGF and its pathogenic importance. They are also described the main clinical symptoms as microaneurysms, intraretinal hemorrhages, hard and soft exudates, intraretinal microvascular abnormalities (IRMA, venous disorders, formation of new vessels and diabetic macular edema (the latter being the most common cause of vision loss. Finally we describe the latest diagnostic techniques and eye treatment, with special emphasis on obesity surgery importance as more important preventive factor to eliminate the predisposing and precipitating disease symptoms.

  8. Monogenic Forms of Diabetes: Neonatal Diabetes Mellitus and Maturity-Onset Diabetes of the Young

    Science.gov (United States)

    ... Diabetes Monogenic Forms of Diabetes Monogenic Forms of Diabetes The most common forms of diabetes, type 1 ... is inherited from each parent. Monogenic Forms of Diabetes Some rare forms of diabetes result from mutations ...

  9. [Type 2 diabetes in children and adolescents].

    Science.gov (United States)

    Hinneburg, Iris

    2014-10-01

    Obesity is one of the main risk factors for developing impaired glucose tolerance and type 2 diabetes in the youth. The patients are at high risk for cardiovascular complications. Yet, meeting therapeutical goals is hard to achieve in many children and adolescents.

  10. Overexpression of Mafb in podocytes protects against diabetic nephropathy.

    Science.gov (United States)

    Morito, Naoki; Yoh, Keigyou; Ojima, Masami; Okamura, Midori; Nakamura, Megumi; Hamada, Michito; Shimohata, Homare; Moriguchi, Takashi; Yamagata, Kunihiro; Takahashi, Satoru

    2014-11-01

    We previously showed that the transcription factor Mafb is essential for podocyte differentiation and foot process formation. Podocytes are susceptible to injury in diabetes, and this injury leads to progression of diabetic nephropathy. In this study, we generated transgenic mice that overexpress Mafb in podocytes using the nephrin promoter/enhancer. To examine a potential pathogenetic role for Mafb in diabetic nephropathy, Mafb transgenic mice were treated with either streptozotocin or saline solution. Diabetic nephropathy was assessed by renal histology and biochemical analyses of urine and serum. Podocyte-specific overexpression of Mafb had no effect on body weight or blood glucose levels in either diabetic or control mice. Notably, albuminuria and changes in BUN levels and renal histology observed in diabetic wild-type animals were ameliorated in diabetic Mafb transgenic mice. Moreover, hyperglycemia-induced downregulation of Nephrin was mitigated in diabetic Mafb transgenic mice, and reporter assay results suggested that Mafb regulates Nephrin directly. Mafb transgenic glomeruli also overexpressed glutathione peroxidase, an antioxidative stress enzyme, and levels of the oxidative stress marker 8-hydroxydeoxyguanosine decreased in the urine of diabetic Mafb transgenic mice. Finally, Notch2 expression increased in diabetic glomeruli, and this effect was enhanced in diabetic Mafb transgenic glomeruli. These data indicate Mafb has a protective role in diabetic nephropathy through regulation of slit diaphragm proteins, antioxidative enzymes, and Notch pathways in podocytes and suggest that Mafb could be a therapeutic target.

  11. Diabetic peripheral neuropathy: current perspective and future directions.

    Science.gov (United States)

    Singh, Randhir; Kishore, Lalit; Kaur, Navpreet

    2014-02-01

    Diabetic neuropathy is a heterogeneous group of disorders with extremely complex pathophysiology and affects both somatic and autonomic components of the nervous system. Neuropathy is the most common chronic complication of diabetes mellitus. Metabolic disruptions in the peripheral nervous system, including altered protein kinase C activity, and increased polyol pathway activity in neurons and Schwann cells resulting from hyperglycemia plays a key role in the development of diabetic neuropathy. These pathways are related to the metabolic and/or redox state of the cell and are the major source of damage. Activation of these metabolic pathways leads to oxidative stress, which is a mediator of hyperglycemia induced cell injury and a unifying theme for all mechanisms of diabetic neuropathy. The therapeutic intervention of these metabolic pathways is capable of ameliorating diabetic neuropathy but therapeutics which target one particular mechanism may have a limited success. Available therapeutic approaches are based upon the agents that modulate pathogenetic mechanisms (glycemic control) and relieve the symptoms of diabetic neuropathy. This review emphasizes the pathogenesis, presently available therapeutic approaches and future directions for the management of diabetic neuropathy.

  12. Therapeutic effect of α-lipoic acid combined with mecobalamin and alprostadil on diabetic peripheral neuropathy%α-硫辛酸联合甲钴胺及前列地尔治疗糖尿病周围神经病变的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张菁; 邓晓龙; 王敏哲

    2011-01-01

    目的 评价α-硫辛酸联合甲钴胺及前列地尔治疗糖尿病周围神经病变(DPN)的疗效.方法 将32例患者随机分为两组:治疗组予α-硫辛酸、甲钴胺及前列地尔,对照组予甲钴胺及前列地尔,治疗2周.观察两组临床疗效及神经传导速度(NCV).结果 治疗组总有效率达87.5%,明显高于对照组的50%(P<0.05);两组患者的神经病变主觉症状问卷(TSS)评分明显改善(P<0.05);治疗组NCV较对照组有显著提高(P< 0.01).结论 临床使用α-硫辛酸联合甲钴胺及前列地尔治疗DPN安全有效.%Objective To evaluate the therapeutic effect of α-lipoic acid combined with mecobalamin and alprostadil on diabetic peripheral neuropathy(DPN). Methods The 32 DPN patients receiving a 2 weeks of therapy were randomly divided into two groups: treatment group treated with α-lipoic acid combined with mecobalamin and alprostadil and control group treated with mecobalamin and alprostadil.The therapeutic effect and nerve conduction velocity(NCV)were observed. Results The total efficacious rate was higher in treatment group than in control group (87. 5% vs 50. 0%, P<0. 05). TSS score improvement in treatment group was superior to control group (P<0. 05). NCV acceleration was more in treatment group than in control (P<0.01). Conclusions Treatment with α-lipoic acid combined with mecobalamin and alprostadil in patients with DPN is safe and effective.

  13. 双黄连颗粒治疗小儿上呼吸道感染合并糖尿病效果的临床研究%Clinical Study on the Therapeutic Effect of Shuanghuanglian Particles on Upper Respiratory Tract infection and Diabetes

    Institute of Scientific and Technical Information of China (English)

    于海丰

    2015-01-01

    Objective To investigate the therapeutic effect of Shuanghuanglian particles on respiratory tract infection and diabetes. Methods 80 cases were collected on the diagnosis and treatment of pediatric outpatient respiratory infection asso-ciated with diabetes in children for the study were randomly divided into control and study groups with 40 patients in the control group were given routine treatment, the study group Shuanghuanglian particles while taking treatment, observation and comparison the therapeutic effect of the two groups of children. Results Children in the control group, 17 cases markedly effective in 16 cases, 7 cases, the total effective rate was 82.50%; the children in the study group, 21 cases markedly effective in 17 cases, 2 cases, total effective rate was 95.00 percent, two groups of children efficacy and efficiency of the overall differences were statistically significant between(P<0.05), the study group no adverse reactions associated with Shuanghuanglian particles. Conclusion Shuanghuanglian particles on the treatment of respiratory tract infections play an important role, efficacy is satisfactory, worthy of clinical application.%目的:观察双黄连颗粒治疗小儿上呼吸道感染和并糖尿病的效果。方法收集2009—2014年大安市市级医院儿科门诊诊治的80例上呼吸感染合并糖尿病患儿为研究对象,随机分为对照组和研究组各40例,对照组给予常规综合治疗,研究组同时服用双黄连颗粒进行治疗,观察并比较两组患儿的治疗效果。结果对照组患儿中,显效17例,有效16例,无效7例,总有效率为82.50%;研究组患儿中,显效21例,有效17例,无效2例,总有效率为95.00%,两组患儿疗效和总有效率之间的差异有统计学意义(P<0.05),研究组未见与双黄连颗粒有关的不良反应。结论双黄连颗粒在小儿上呼吸道感染治疗中具有重要作用,疗效较为满意,值得临床推广应用。

  14. 瑞舒伐他汀联合依折麦布治疗冠心病伴早期糖尿病肾病疗效观察%Therapeutic effects of rosuvastatin combined with ezetimibe on coronary heart disease complicated by early diabetic nephropathy

    Institute of Scientific and Technical Information of China (English)

    杨海燕; 杨圣俊; 王志爽; 徐素芝; 赵勇军; 李军伟; 张玉

    2015-01-01

    Objective To observe the therapeutic effects of rosuvastatin combined with ezetimibe on coronary heart disease complicated by early diabetic nephropathy in order to look for more effective therapy to prevent the pathogenesis of acute cardiovascular events and end-stage nephropathy. Methods Eighty patients with stable angina pectoris complicated by early diabetic nephropathy diagnosed in Hebei Province Geriatric Hospital from July 2013 to January 2014 were enrolled in the study,including 42 male patients and 38 female patients,whose age was over 60 years and whose blood sugar was controlled effectively,without blood relationship each other. There patients were randomly divided into observation group and control group,with 40 patients in each group. On the basis of routine therapy,the patients in control group were treated by rosuvastatin 10mg/ d,however,the patients in observation group,on the basis of routine therapy,were treated by rosuvastatin 10mg/ d +ezetimibe 10mg/ d. Results After 12-week treatment,the levels of LDL in observation group were significantly decreased,as compared with those in control group( P 0. 05). Conclusion In the treatment of coronary heart disease complicated by early diabetic nephropathy,the combined application of rosuvastatin with ezetimibe can significantly reduce the frequency and duration of angina pectoris attacks,and can promote the improvement of myocardial ischemia,at the same time,can decrease microalbuminuria and reduce more effectively the levels of LDL and TC,without increasing the incidence of adverse events,with better safety.%目的:本研究通过瑞舒伐他汀联合依折麦布治疗冠心病伴早期糖尿病肾病,以寻找冠心病伴早期糖尿病肾病更好的治疗方法,预防急性心血管事件及终末期肾病的发生。方法选择2013年7月至2014年1月河北省老年病医院明确诊断为血糖控制良好的稳定型心绞痛合并早期糖尿病肾病患者80例。男42例,女38

  15. Analysis of therapeutic effect of hyperbaric oxygen therapy on neuropsychological disorders in senile patients with type 2 diabetes mellitus combined with cerebral infarction%高压氧治疗老年2型糖尿病并存脑梗死患者神经心理障碍的疗效分析

    Institute of Scientific and Technical Information of China (English)

    陈灶萍; 刘军; 查英; 盛励; 史莉华

    2008-01-01

    Objective To explore the therapeutic effect of hyperbaric oxygen therapy (HBO) in the treatment of neuropsychological disorders in senile patients with type 2 diabetes mellitus combined with cerebral infarction. Methods A total of 70 senile patients with type 2 diabetes mellitus combined with cerebral infarction were randomly divided into two groups: treatment group receiving HBO plus routine medicine treatment and control group receiving routing medicine treatment only. A suit of senile neuropsychological tests was administered pre and post treatment by an experienced psychometrician who was blinded to treatment group assignments. Results Neuropsychological disorders were improved partly in control group while the efficacy in treatment group was markedly improved(P<0.01). Spearman rank correlation analysis revealed that the improvement degree of neuropsychological disorders was positively correlated with hyperbaric oxygen therapy (HBO) (r= 0.502,P<0.05), the time of test before therapy (r=0.260, P<0.05) and the time of test after therapy (r=0.386, P<0.05), and was negatively correlated with hyperlipoidemia (r=-0.261, P< 0.05), glycosylated hemoglobin(GHbAlc) (r=-0.321,P<0.05) and body mass index(BMI) (r= 0.360,P<0.05). Multiple stepwise regression analysis showed that HBO and hyperlipoidemia were the independent predictors for the improvement degree of neuropsychological disorders. Conclusions HBO is an efficacious way to treat neuropsychological disorders in senile patients with type 2 diabetes mellitus combined with cerebral infarction.%目的 探讨高压氧治疗老年2型糖尿病并存脑梗死患者神经心理障碍的有效性. 方法 将70例入选患者随机分为治疗组和对照组,治疗组在常规药物治疗基础上联合10次高压氧治疗.选用老年成套心理测验,对所有患者治疗前后进行测试. 结果 对照组患者神经心理障碍得到部分改善,治疗组患者改善程度明显提高(P<0.01).Spearman相关分析显示

  16. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970258 Relationship between non-insulin dependent diabetes mellitus and lipoprotein(a)in aged patients.CHI Jiamin(迟家敏), et al. Dept Endocrinol, BeijingHosp, Beijing, 100730. Chin J Geriatr 1997; 16(1): 39-42.

  17. Type 2 diabetes mellitus and hypertension: an update.

    Science.gov (United States)

    Lastra, Guido; Syed, Sofia; Kurukulasuriya, L Romayne; Manrique, Camila; Sowers, James R

    2014-03-01

    Patients with hypertension and type 2 diabetes are at increased risk of cardiovascular and chronic renal disease. Factors involved in the pathogenesis of both hypertension and type 2 diabetes include inappropriate activation of the renin-angiotensin-aldosterone system, oxidative stress, inflammation, impaired insulin-mediated vasodilatation, augmented sympathetic nervous system activation, altered innate and adaptive immunity, and abnormal sodium processing by the kidney. The renin-angiotensin-aldosterone system blockade is a key therapeutic strategy in the treatment of hypertension in type 2 diabetes. Emerging therapies for resistant hypertension as often exists in patients with diabetes, include renal denervation and carotid body denervation. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Type 1 diabetes and gut microbiota: Friend or foe?

    Science.gov (United States)

    Hu, Changyun; Wong, F Susan; Wen, Li

    2015-08-01

    Type 1 diabetes is a T cell-mediated autoimmune disease. Environmental factors play an important role in the initiation of the disease in genetically predisposed individuals. With the improved control of infectious disease, the incidence of autoimmune diseases, particularly type 1 diabetes, has dramatically increased in developed countries. Increasing evidence suggests that gut microbiota are involved in the pathogenesis of type 1 diabetes. Here we focus on recent advances in this field and provide a rationale for novel therapeutic strategies targeting gut microbiota for the prevention of type 1 diabetes.

  19. Lymphedema and Therapeutic Lymphangiogenesis

    Directory of Open Access Journals (Sweden)

    Yukihiro Saito

    2013-01-01

    Full Text Available Lymphedema is a disorder of the lymphatic vascular system characterized by impaired lymphatic return and swelling of the extremities. Lymphedema is divided into primary and secondary forms based on the underlying etiology. Despite substantial advances in both surgical and conservative techniques, therapeutic options for the management of lymphedema are limited. Although rarely lethal, lymphedema is a disfiguring and disabling condition with an associated decrease in the quality of life. The recent impressive expansion of knowledge on the molecular mechanisms governing lymphangiogenesis provides new possibilities for the treatment of lymphedema. This review highlights the lymphatic biology, the pathophysiology of lymphedema, and the therapeutic lymphangiogenesis using hepatocyte growth factor.

  20. Pancreatic Pseudocyst: Therapeutic Dilemma

    Directory of Open Access Journals (Sweden)

    A. K. Khanna

    2012-01-01

    Full Text Available Pancreatic pseudocyst develops in both acute and chronic pancreatitis. It is an entity likely to either remain asymptomatic or develop devastating complications. Despite being diagnosed easily, treatment exercise is still at crossroads whether in the form of internal or external drainage or endoscopic, laparoscopic, or open intervention with a good radiological guidance. The therapeutic dilemma whether to treat a patient with a pancreatic pseudocyst, as well as when and with what technique, is a difficult one. This paper is intended to get information about diagnostic and therapeutic exercises most appropriate for acute and chronic pancreatic pseudocyst.

  1. Therapeutic HIV Peptide Vaccine

    DEFF Research Database (Denmark)

    Fomsgaard, Anders

    2015-01-01

    Therapeutic vaccines aim to control chronic HIV infection and eliminate the need for lifelong antiretroviral therapy (ART). Therapeutic HIV vaccine is being pursued as part of a functional cure for HIV/AIDS. We have outlined a basic protocol for inducing new T cell immunity during chronic HIV-1...... infection directed to subdominant conserved HIV-1 epitopes restricted to frequent HLA supertypes. The rationale for selecting HIV peptides and adjuvants are provided. Peptide subunit vaccines are regarded as safe due to the simplicity, quality, purity, and low toxicity. The caveat is reduced immunogenicity...

  2. Long-term abrogation of autoimmune diabetes in nonobese diabetic mice by immunotherapy with anti-lymphocyte serum.

    OpenAIRE

    T. Maki; Ichikawa, T.; R. Blanco; Porter, J.

    1992-01-01

    We investigated the therapeutic effect of anti-lymphocyte serum (ALS) on clinically overt diabetes by using a nonobese diabetic (NOD) mouse model of type I diabetes mellitus. ALS given within 14 days of disease onset gradually reversed hyperglycemia with a 76% cumulative incidence of remission. Combined use of anti-CD4 and anti-CD8 monoclonal antibodies, but not anti-CD4 or anti-CD8 antibody alone, was also effective with overall 64% remission. Diabetic NOD mice that failed to respond to ALS ...

  3. Fats for diabetics. (Letter).

    NARCIS (Netherlands)

    Katan, M.B.

    1994-01-01

    Opinion. Comments on the treatment of type 2 diabetes from the interaction between nature and nurture. Effective form of treatment for type 2 diabetes; Composition of the diet for diabetics; Identification of unsaturated fats in the diabetic diet; Risks faced by diabetic patients.

  4. Pregnancy in Type 1 Diabetes Mellitus: How Special are Special Issues?

    Science.gov (United States)

    Magon, Navneet; Chauhan, Monica

    2012-06-01

    India leads the world with largest number of diabetics earning the dubious distinction of "the diabetes capital of the world." Diabetes is associated with maternal and perinatal morbidity and mortality. The number of pregnant women with pre-existing diabetes is increasing, mainly from an increase in type 2 diabetes, but also an increase in type 1 diabetes. Overall, type 1 diabetes accounts for approximately 5% to 10% of all diabetes outside of pregnancy, and in pregnancy put together with type 2 account for 10% of diabetic pregnancies. Management of the pregnant diabetic woman is a complex task that ideally begins before conception. Specific attention is required for diabetic pregnancies in different trimesters of pregnancy. Diabetes, especially type 1 diabetes, can be a challenge in pregnancy, but with education, close monitoring, and latest therapeutic modalities, these women can have healthy newborns. Close attention to diet, glycemic control, metabolic stresses, and early diagnosis and monitoring of complications can make pregnancy a successful experience for women with diabetes. A MedLine search was done to review relevant articles in English literature on diabetes and pregnancy, and specific issues related to pregnancy in type 1 diabetes were reviewed.

  5. Pregnancy in type 1 diabetes mellitus: How special are special issues?

    Directory of Open Access Journals (Sweden)

    Navneet Magon

    2012-01-01

    Full Text Available India leads the world with largest number of diabetics earning the dubious distinction of "the diabetes capital of the world." Diabetes is associated with maternal and perinatal morbidity and mortality. The number of pregnant women with pre-existing diabetes is increasing, mainly from an increase in type 2 diabetes, but also an increase in type 1 diabetes. Overall, type 1 diabetes accounts for approximately 5% to 10% of all diabetes outside of pregnancy, and in pregnancy put together with type 2 account for 10% of diabetic pregnancies. Management of the pregnant diabetic woman is a complex task that ideally begins before conception. Specific attention is required for diabetic pregnancies in different trimesters of pregnancy. Diabetes, especially type 1 diabetes, can be a challenge in pregnancy, but with education, close monitoring, and latest therapeutic modalities, these women can have healthy newborns. Close attention to diet, glycemic control, metabolic stresses, and early diagnosis and monitoring of complications can make pregnancy a successful experience for women with diabetes. A MedLine search was done to review relevant articles in English literature on diabetes and pregnancy, and specific issues related to pregnancy in type 1 diabetes were reviewed.

  6. Measuring Therapeutic Effectiveness.

    Science.gov (United States)

    Callister, Sheldon L.

    In the recent past, there has been a great deal of effort directed toward developing techniques for documenting therapeutic outcome. Funding sources and the general public seem to be demanding more meaningful data which indicate, in a clear manner, whether or not the services they are paying for are of value. Mental health centers, like other…

  7. Therapeutic Recombinant Monoclonal Antibodies

    Science.gov (United States)

    Bakhtiar, Ray

    2012-01-01

    During the last two decades, the rapid growth of biotechnology-derived techniques has led to a myriad of therapeutic recombinant monoclonal antibodies with significant clinical benefits. Recombinant monoclonal antibodies can be obtained from a number of natural sources such as animal cell cultures using recombinant DNA engineering. In contrast to…

  8. Therapeutic Recombinant Monoclonal Antibodies

    Science.gov (United States)

    Bakhtiar, Ray

    2012-01-01

    During the last two decades, the rapid growth of biotechnology-derived techniques has led to a myriad of therapeutic recombinant monoclonal antibodies with significant clinical benefits. Recombinant monoclonal antibodies can be obtained from a number of natural sources such as animal cell cultures using recombinant DNA engineering. In contrast to…

  9. Measuring Therapeutic Effectiveness.

    Science.gov (United States)

    Callister, Sheldon L.

    In the recent past, there has been a great deal of effort directed toward developing techniques for documenting therapeutic outcome. Funding sources and the general public seem to be demanding more meaningful data which indicate, in a clear manner, whether or not the services they are paying for are of value. Mental health centers, like other…

  10. Rethinking therapeutic action.

    Science.gov (United States)

    Gabbard, Glen O; Westen, Drew

    2003-08-01

    Like other core psychoanalytic constructs, the theory of therapeutic action is currently in flux, as theorists of differing persuasions propose different mechanisms. In this article, the authors attempt to integrate developments within and without psychoanalysis to provide a working model of the multifaceted processes involved in producing change in psychoanalysis and psychoanalytic psychotherapy. A theory of therapeutic action must describe both what changes (the aims of treatment) and what strategies are likely to be useful in facilitating those changes (technique). The authors believe that single-mechanism theories of therapeutic action, no matter how complex, are unlikely to prove useful at this point because of the variety of targets of change and the variety of methods useful in effecting change in those targets (such as techniques aimed at altering different kinds of conscious and unconscious processes). Interventions that facilitate change may be classified into one of three categories: those that foster insight, those that make use of various mutative aspects of the treatment relationship and a variety of secondary strategies that can be of tremendous importance. They propose that, in all forms of psychoanalytic treatment, we would be more accurate to speak of the therapeutic actions, rather than action.

  11. Advances in Murine Models of Diabetic Nephropathy

    Science.gov (United States)

    Kong, Li-li; Wu, Hao; Cui, Wen-peng; Zhou, Wen-hua; Luo, Ping; Sun, Jing; Yuan, Hang; Miao, Li-ning

    2013-01-01

    Diabetic nephropathy (DN) is one of the microvascular complications of both type 1 and type 2 diabetes, which is also associated with a poor life expectancy of diabetic patients. However, the pathogenesis of DN is still unclear. Thus, it is of great use to establish appropriate animal models of DN for doing research on pathogenesis and developing novel therapeutic strategies. Although a large number of murine models of DN including artificially induced, spontaneous, and genetically engineered (knockout and transgenic) animal models have been developed, none of them develops renal changes sufficiently reflecting those seen in humans. Here we review the identified murine models of DN from the aspects of genetic background, type of diabetes, method of induction, gene deficiency, animal age and gender, kidney histopathology, and phenotypic alterations in the hope of enhancing our comprehension of genetic susceptibility and molecular mechanisms responsible for this disease and providing new clues as to how to choose appropriate animal models of DN. PMID:23844375

  12. Pathogenesis of diabetic cerebral vascular diseasecomplication

    Institute of Scientific and Technical Information of China (English)

    Ren-Shi Xu

    2015-01-01

    Diabetes mellitus is one of the most potent independentrisk factors for the development of diabetic cerebralvascular disease (CVD). Many evidences suggested thathyperglycemia caused excess free fatty acids, the lossof endothelium-derived nitric oxide, insulin resistance,the prothrombotic state, endothelial dysfunction,the abnormal release of endothelial vasoactivators,vascular smooth muscle dysfunction, oxidative stress,and the downregulation of miRs participated in vesselgeneration and recovery as well as the balance ofendotheliocytes. In turn, these abnormalities, mainly viaphosphatidylinositol 3 kinase, mitogen-activated proteinkinase, polyol, hexosamine, protein kinase C activation,and increased generation of advanced glycosylation endproducts pathway, play an important role in inducingdiabetic CVD complication. A deeper comprehensionof pathogenesis producing diabetic CVD could offerbase for developing new therapeutic ways preventingdiabetic CVD complications, therefore, in the paper wemainly reviewed present information about the possiblepathogenesis of diabetic CVD complication.

  13. Ghrelin reverses experimental diabetic neuropathy in mice

    Energy Technology Data Exchange (ETDEWEB)

    Kyoraku, Itaru; Shiomi, Kazutaka [Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki 889-1692 (Japan); Kangawa, Kenji [Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565 (Japan); Nakazato, Masamitsu, E-mail: nakazato@med.miyazaki-u.ac.jp [Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki 889-1692 (Japan)

    2009-11-20

    Ghrelin, an acylated peptide produced in the stomach, increases food intake and growth hormone secretion, suppresses inflammation and oxidative stress, and promotes cell survival and proliferation. We investigated the pharmacological potential of ghrelin in the treatment of polyneuropathy in uncontrolled streptozotocin (STZ)-induced diabetes in mice. Ghrelin or desacyl-ghrelin was administered daily for 4 weeks after STZ-induced diabetic polyneuropathy had developed. Ghrelin administration did not alter food intake, body weight gain, blood glucose levels, or plasma insulin levels when compared with mice given saline or desacyl-ghrelin administration. Ghrelin administration ameliorated reductions in motor and sensory nerve conduction velocities in diabetic mice and normalized their temperature sensation and plasma concentrations of 8-isoprostaglandin {alpha}, an oxidative stress marker. Desacyl-ghrelin failed to have any effect. Ghrelin administration in a mouse model of diabetes ameliorated polyneuropathy. Thus, ghrelin's effects represent a novel therapeutic paradigm for the treatment of this otherwise intractable disorder.

  14. Advances in Murine Models of Diabetic Nephropathy

    Directory of Open Access Journals (Sweden)

    Li-li Kong

    2013-01-01

    Full Text Available Diabetic nephropathy (DN is one of the microvascular complications of both type 1 and type 2 diabetes, which is also associated with a poor life expectancy of diabetic patients. However, the pathogenesis of DN is still unclear. Thus, it is of great use to establish appropriate animal models of DN for doing research on pathogenesis and developing novel therapeutic strategies. Although a large number of murine models of DN including artificially induced, spontaneous, and genetically engineered (knockout and transgenic animal models have been developed, none of them develops renal changes sufficiently reflecting those seen in humans. Here we review the identified murine models of DN from the aspects of genetic background, type of diabetes, method of induction, gene deficiency, animal age and gender, kidney histopathology, and phenotypic alterations in the hope of enhancing our comprehension of genetic susceptibility and molecular mechanisms responsible for this disease and providing new clues as to how to choose appropriate animal models of DN.

  15. Aberrant angiogenesis: The gateway to diabetic complications

    Directory of Open Access Journals (Sweden)

    Sunil K Kota

    2012-01-01

    Full Text Available Diabetes Mellitus is a metabolic cum vascular syndrome with resultant abnormalities in both micro- and macrovasculature. The adverse long-term effects of diabetes mellitus have been described to involve many organ systems. Apart from hyperglycemia, abnormalities of angiogenesis may cause or contribute toward many of the clinical manifestations of diabetes. These are implicated in the pathogenesis of vascular abnormalities of the retina, kidneys, and fetus, impaired wound healing, increased risk of rejection of transplanted organs, and impaired formation of coronary collaterals. A perplexing feature of the aberrant angiogenesis is that excessive and insufficient angiogenesis can occur in different organs in the same individual. The current article hereby reviews the molecular mechanisms including abnormalities in growth factors, cytokines, and metabolic derangements, clinical implications, and therapeutic options of dealing with abnormal angiogenesis in diabetes.

  16. Carbohydrates in therapeutics.

    Science.gov (United States)

    Kilcoyne, Michelle; Joshi, Lokesh

    2007-07-01

    Awareness of the importance of carbohydrates in living systems and medicine is growing due to the increasing understanding of their biological and pharmacological relevance. Carbohydrates are ubiquitous and perform a wide array of biological roles. Carbohydrate-based or -modified therapeutics are used extensively in cardiovascular and hematological treatments ranging from inflammatory diseases and anti-thrombotic treatments to wound healing. Heparin is a well-known and widely used example of a carbohydrate-based drug but will not be discussed as it has been extensively reviewed. We will detail carbohydrate-based and -modified therapeutics, both those that are currently marketed or in various stages of clinical trials and those that are potential therapeutics based on promising preclinical investigations. Carbohydrate-based therapeutics include polysaccharide and oligosaccharide anti-inflammatory, anti-coagulant and anti-thrombotic agents from natural and synthetic sources, some as an alternative to heparin and others which were designed based on known structure-functional relationships. Some of these compounds have multiple biological effects, showing anti-adhesive, anti-HIV and anti-arthrithic activities. Small molecules, derivatives or mimetics of complement inhibitors, are detailed for use in limiting ischemia/ reperfusion injuries. Monosaccharides, both natural and synthetic, have been investigated for their in vivo anti-inflammatory and cardioprotective properties. Modification by glycosylation of natural products, or glycosylation-mimicking modification, has a significant effect on the parent molecule including increased plasma half-life and refining or increasing desired functions. It is hoped that this review will highlight the vast therapeutic potential of these natural bioactive molecules.

  17. Cancer stem cell as therapeutic target for melanoma treatment.

    Science.gov (United States)

    Alamodi, Abdulhadi A; Eshaq, Abdulaziz M; Hassan, Sofie-Yasmin; Al Hmada, Youssef; El Jamal, Siraj M; Fothan, Ahmed M; Arain, Omair M; Hassan, Sarah-Lilly; Haikel, Youssef; Megahed, Mosaad; Hassan, Mohamed

    2016-12-01

    Human malignant melanoma is a highly aggressive skin tumor that is characterized by its extraordinary heterogeneity, propensity for dissemination to distant organs and resistance to cytotoxic agents. Although chemo- and immune-based therapies have been evaluated in clinical trials, most of these therapeutics do not show significant benefit for patients with advanced disease. Treatment failure in melanoma patients is attributed mainly to the development of tumor heterogeneity resulting from the formation of genetically divergent subpopulations. These subpopulations are composed of cancer stem-like cells (CSCs) as a small fraction and non-cancer stem cells that form the majority of the tumor mass. In recent years, CSCs gained more attention and suggested as valuable experimental model system for tumor study. In melanoma, intratumoral heterogeneity, progression and drug resistance result from the unique characteristics of melanoma stem cells (MSCs). These MSCs are characterized by their distinct protein signature and tumor growth-driving pathways, whose activation is mediated by driver mutation-dependent signal. The molecular features of MSCs are either in a causal or consequential relationship to melanoma progression, drug resistance and relapse. Here, we review the current scientific evidence that supports CSC hypothesis and the validity of MSCs-dependent pathways and their key molecules as potential therapeutic target for melanoma treatment.

  18. Type 2 diabetes mellitus as a disorder of galanin resistance.

    Science.gov (United States)

    Fang, Penghua; Shi, Mingyi; Zhu, Yan; Bo, Ping; Zhang, Zhenwen

    2016-01-01

    The increasing prevalence of type 2 diabetes mellitus with its high morbidity and mortality becomes an important health problem. The multifactorial etiology of type 2 diabetes mellitus is relative to many gene and molecule alterations, and increased insulin resistance. Besides these, however, there are still other predisposing and risk factors accounting for type 2 diabetes mellitus not to be identified and recognized. Emerging evidence indicated that defects in galanin function played a crucial role in development of type 2 diabetes mellitus. Galanin homeostasis is tightly relative to insulin resistance and is regulated by blood glucose. Hyperglycemia, hyperinsulinism, enhanced plasma galanin levels and decreased galanin receptor activities are some of the characters of type 2 diabetes mellitus. The discrepancy between high insulin level and low glucose handling is named as insulin resistance. Similarly, the discrepancy between high galanin level and low glucose handling may be denominated as galanin resistance too. In this review, the characteristic milestones of type 2 diabetes mellitus were condensed as two analogical conceptual models, obesity-hyper-insulin-insulin resistance-type 2 diabetes mellitus and obesity-hyper-galanin-galanin resistance-type 2 diabetes mellitus. Both galanin resistance and insulin resistance are correlative with each other. Conceptualizing the etiology of type 2 diabetes mellitus as a disorder of galanin resistance may inspire a new concept to deepen our knowledge about pathogenesis of type 2 diabetes mellitus, eventually leading to novel preventive and therapeutic interventions for type 2 diabetes mellitus.

  19. Epigenetics: deciphering its role in diabetes and its chronic complications.

    Science.gov (United States)

    Villeneuve, Louisa M; Reddy, Marpadga A; Natarajan, Rama

    2011-07-01

    1. Increasing evidence suggests that epigenetic factors might regulate the complex interplay between genes and the environment, and affect human diseases, such as diabetes and its complications. 2. Clinical trials have underscored the long lasting beneficial effects of strict glycaemic control for reducing the progression of diabetic complications. They have also shown that diabetic complications, such as diabetic nephropathy, a chronic kidney disorder, can continue even after blood glucose normalization, suggesting a metabolic memory of the prior glycaemic state. 3. Dysregulation of epigenetic post-transcriptional modifications of histones in chromatin, including histone lysine methylation, has been implicated in aberrant gene regulation associated with the pathology of diabetes and its complications. Genome-wide studies have shown cell-type specific changes in histone methylation patterns under diabetic conditions. In addition, studies in vascular cells have shown long lasting changes in epigenetic modifications at key inflammatory gene promoters after prior exposure to diabetic conditions, suggesting a possible mechanism for metabolic memory. 4. Recent studies have shown roles for histone methylation, DNA methylation, as well as microRNA in diabetic nephropathy. Whether these epigenetic factors play a role in metabolic memory of diabetic kidney disease is less well understood. 5. The incidence of diabetes is growing rapidly, as also the cost of treating the resulting complications. A better understanding of metabolic memory and the potential involvement of epigenetic mechanisms in this phenomenon could enable the development of new therapeutic targets for the treatment and/or prevention of sustained diabetic complications.

  20. Potential mechanisms of neuropathic pain in diabetes.

    Science.gov (United States)

    Calcutt, Nigel A

    2002-01-01

    Abnormal sensations and pain are features of approximately 10% of all cases of diabvetic neuropathy and can cause marked diminution in the quality of life for these patients. The quality and distribution of pain are variable, although descriptions of burning pain in the hands and feet are commonly reported. Like other neuropathic pain states, painful diabetic neuropathy has an unknown pathogenesis and, in many cases, is not alleviated by nonsteriodal anti-inflammatory drugs or opiates. In the last decase, a number of behavioral and physiologic studies have revealed indices of sensory dysfunction in animal models of diabetes. These include hyperalgesia to mechanical and noxious chemical stimuli and allodynia to light touch. Animal models of painful diabetic neuropathy have been used to investigate the therapeutic potential of a range of experimental agents and also to explore potential etiologic mechanisms. There is relatively little evidence to suggest that the peripheral sensory nerves of diabetic rodents exhibit spontaneous activity or increased responsiveness to peripheral stimuli. Indeed, the weight of eveidence suggests that sensory input to the spinal cord is decreased rather than increased in diabetic rodents. Aberrant spinal or supraspinal modulation of sensory processing may therefore be involved in generating allodynia and hyperalgesia in these models. Studies have supported a role for spinally mediated hyeralgesia in diabetic rats that may reflect either a response to diminished peripheral input or a consequence of hyperglycemia on local or descending modulatory systems. Elucidating the affects of diabetes on spinal sensory processing may assist development of novel therapeutic strategies for preventing and alleviating painful diabetic neuropathy.