Search results for: type 2 diabetic mellitus

Authors: Jun Ren, Zhen-Hua Ming, He-Feng Huang, Jian-Zhong Sheng

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Adverse intrauterine stimulus during critical or sensitive periods in early life, may lead to health risk not only in later life span, but also further generations. Intrauterine hyperglycaemia, as a major feature of gestational diabetes mellitus (GDM), is a typical adverse environment for both F1 fetus and F1 gamete cells development. However, there is scare information of phenotypic difference of metabolic memory between somatic cells and germ cells exposed by intrauterine hyperglycaemia. The direct transmission effect of intrauterine hyperglycaemia per se has not been assessed either. In this study, we built a GDM mice model and selected male GDM offspring without pre-diabetic phenotype as our founders, to exclude postnatal diabetic influence on gametes, thereby investigate the direct transmission effect of intrauterine hyperglycaemia exposure on F2 offspring, and we further compared the metabolic difference of affected F1-GDM male offspring and F2 offspring. A GDM mouse model of intrauterine hyperglycemia was established by intraperitoneal injection of streptozotocin after pregnancy. Pups of GDM mother were fostered by normal control mothers. All the mice were fed with standard food. Male GDM offspring without metabolic dysfunction phenotype were crossed with normal female mice to obtain F2 offspring. Body weight, glucose tolerance test, insulin tolerance test and homeostasis model of insulin resistance (HOMA-IR) index were measured in both generations at 8 week of age. Some of F1-GDM male mice showed impaired glucose tolerance (p < 0.001), none of F1-GDM male mice showed impaired insulin sensitivity. Body weight of F1-GDM mice showed no significance with control mice. Some of F2-GDM offspring exhibited impaired glucose tolerance (p < 0.001), all the F2-GDM offspring exhibited higher HOMA-IR index (p < 0.01 of normal glucose tolerance individuals vs. control, p < 0.05 of glucose intolerance individuals vs. control). All the F2-GDM offspring exhibited higher ITT curve than control (p < 0.001 of normal glucose tolerance individuals, p < 0.05 of glucose intolerance individuals, vs. control). F2-GDM offspring had higher body weight than control mice (p < 0.001 of normal glucose tolerance individuals, p < 0.001 of glucose intolerance individuals, vs. control). While glucose intolerance is the only phenotype that F1-GDM male mice may exhibit, F2 male generation of healthy F1-GDM father showed insulin resistance, increased body weight and/or impaired glucose tolerance. These findings imply that intrauterine hyperglycaemia exposure affects germ cells and somatic cells differently, thus F1 and F2 offspring demonstrated distinct metabolic dysfunction phenotypes. And intrauterine hyperglycaemia exposure per se has a strong influence on F2 generation, independent of postnatal metabolic dysfunction exposure.

Keywords: inheritance, insulin resistance, intrauterine hyperglycaemia, offspring

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Authors: Parmeet Kaur, Nighat Yaseen Sofi, Shakti Kumar Gupta, Veena Pandey, Rajvaedhan Azad

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Nutritional status and prevailing blood glucose level trends amongst hospitalized patients has been linked to clinical outcome. Therefore, the present study was undertaken to assess hospitalized Diabetic Eye Disease (DED) patients' anthropometric and dietary intake trends. DED patients with type 1 or 2 diabetes > 20 years were enrolled. Actual food intake was determined by weighed food record method. Mifflin St Joer predictive equation multiplied by a combined stress and activity factor of 1.3 was applied to estimate caloric needs. A questionnaire was further administered to obtain reasons of inadequate dietary intake. Results indicated validity of joint analyses of body mass index in combination with waist circumference for clinical risk prediction. Dietary data showed a significant difference (p < 0.0005) between average daily caloric and carbohydrate intake and actual daily caloric and carbohydrate needs. Mean fasting and post-prandial plasma glucose levels were 150.71 ± 72.200 mg/dL and 219.76 ± 97.365 mg/dL, respectively. Improvement in food delivery systems and nutrition educations were indicated for reducing plate waste and to enable better understanding of dietary aspects of diabetes management. A team approach of nurses, physicians and other health care providers is required besides the expertise of dietetics professional. To conclude, findings of the present study will be useful in planning nutritional care process (NCP) for optimizing glucose control as a component of quality medical nutrition therapy (MNT) in hospitalized DED patients.

Keywords: nutritional status, diabetic eye disease, nutrition care process, medical nutrition therapy

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Authors: Li-Ting Kung, Hui-Zhu Chen, Hsin-Tzu Lee, Wan-Yin Hsu

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Patients with spinal cord injury combined with diabetic nephropathy may under a lot of painful conditions due to complications related to the illness itself or treatments, such as recurrent pressure ulcers, autonomic and peripheral neuropathy, as well as dialysis, for long term. This case report illustrated the nursing experience of transferring a spine cord injure patient who received hemodialysis due to adverse lifestyle-induced diabetic nephropathy to the hospice ward. Nursing care was provided in this patient from July 25th to August 30th, 2015. The tool of 'Gordon’s 11-item functional health assessment' and clinical observation, interviews as well as physical examination were used as data collections. Based on results of health assessment as above, the patient’s health problems were identified as the following: impaired skin integrity, chronic pain, and hopeless. Besides to relieve the symptom of pain due to disease or the treatment of hemodialysis and provide wound care, the first author also played a role to assist the patient to achieve his goal of receiving the hospice palliative care. Finally, with much effort of nurses to communicate with medical teams between the surgical and hospice wards, the patient was transferred to the hospice ward to have fulfilled his last wish of having a good death. We hope this nursing experience can be applied to other similar cases in the future.

Keywords: diabetic nephropathy, hospice care, palliative care, spinal cord injury

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Authors: Jamie Lynn Co, Mary Shiela Ariola-Ramos

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Myroides are aerobic, yellow-pigmented, non-motile, non-fermenting gram-negative rods. They are commonly found in the environment such as water and soil. Although found in the environment, Myroides are rare pathogens of humans. Myroides spp. primarily infect immunocompromised patients, often with diabetes mellitus, liver cirrhosis, chronic kidney disease, chronic obstructive pulmonary disease or prolonged corticosteroid therapy. We present a case of a 70-year-old immunocompromised patient with diabetes mellitus, chronic renal failure, diagnosed with sepsis caused by Myroides spp. The primary portal and source of infection were the pustules and boils found on the lower extremities of the patient. Susceptibility testing showed that our isolate was only susceptible to ciprofloxacin and meropenem; and following the treatment, the patient recovered. Myroides continues to be a rare pathogen of humans that is prevalent in our environment. It primarily affects immunocompromised patients such as those with uncontrolled diabetes mellitus, chronic kidney disease, etc. Despite their low virulence, physicians should consider this opportunistic pathogen as possible etiologic agent especially in cases wherein there is lack of response to commonly used antibiotics.

Keywords: bacteremia, immunocompromised, gram negative rods, Myroides

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Authors: Fahad Raj Khan, Suleman Khan

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There is a lack of consensus about the predictive value of raised blood glucose levels in terms of major adverse cardiac events (MACEs) in non-diabetic patients admitted for acute decompensated heart failure. The purpose of this research was to examine the long-term prognosis of acute decompensated heart failure (ADHF) in non-diabetic persons who had increased blood glucose levels, i.e., stress hyperglycemia, at the time of their ADHF hospitalization. The research involved 650 non-diabetic patients. Based on their admission stress hyperglycemia, they were divided into two groups.ie with and without (SHGL). The two groups' one-year outcomes for major adverse cardiac events (MACEs) were compared, and key predictors of MACEs were discovered. For statistical analysis, the two-tailed Mann-Whitney U test, Fisher's exact test, and binary logistic regression analysis were utilized. SHGL was found in 353 (54.3%) individuals. It was more frequent in men than in women. About 27% of patients with SHGL had previously been admitted for ADHF. Almost 62% were hypertensive, whereas 14 % had CKD. MACEs were significantly predicted by SHGL, HTN, prior hospitalization for ADHF, CKD, and cardiogenic shock upon admission. SHGL at the time of ADHF admission, independent of DM status, may be a predictive indication of MACEs.

Keywords: stress hyperglycemia, acute heart failure, major adverse cardiac events, MACEs

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Authors: Murat Toren, Mehmet Çelebi

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Reducing the weight of transformers while providing good performance, cost reduction and increased efficiency is important. Weight is one of the most significant factors in all electrical machines, and as such, many transformer design parameters are related to weight calculations. This study presents a comparison of the weight of oil type transformers and dry type transformer weight. Oil type transformers are mainly used in industry; however, dry type transformers are becoming more widespread in recent years. MATLAB is typically used for designing transformers and design parameters (rated voltages, core loss, etc.) along with design in ANSYS Maxwell. Similar to other studies, this study presented that the dry type transformer option is limited. Moreover, the commonly-used 50 kVA distribution transformers in the industry are oil type and dry type transformers are designed and considered in terms of weight. Currently, the preference for low-cost oil-type transformers would change if costs for dry-type transformer were more competitive. The aim of this study was to compare the weight of transformers, which is a substantial cost factor, and to provide an evaluation about increasing the use of dry type transformers.

Keywords: weight, optimization, oil-type transformers, dry-type transformers

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Authors: Aruma Baduge Kithma Hansanee De Silva

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Haskap (Lonicera caerulea L.), also known as blue honeysuckle, is a recently commercialized berry crop in Canada. Haskap berries are rich in polyphenols, including anthocyanins, which are known for potential health-promoting effects. Cyanidin-3-O-glucoside (C3G) is the most prominent anthocyanin of haskap berries. Recent literature reveals the efficacy of C3G in reducing the risk of type 2 diabetes (T2D), which has become an increasingly common health issue around the world. The T2D is characterized as a metabolic disorder of hyperglycemia and insulin resistance. It has been demonstrated that C3G has anti-diabetic effects in various ways, including improvement in insulin sensitivity, and inhibition of activities of carbohydrate-hydrolyzing enzymes, including alpha-amylase and alpha-glucosidase. The goal of this study was to investigate the influence of variety and harvesting date on haskap composition, biological properties, and antidiabetic properties. The polyphenolic compounds present in four commercially grown haskap cultivars, Aurora, Rebecca, Larissa and Evie among five harvesting stages (H1-H5), were extracted separately in 80% ethanol and analyzed to characterize their phenolic profiles. The haskap berries contain different types of polyphenols including flavonoids and phenolic acids. Anthocyanin is the major type of flavonoid. C3G is the most prominent type of anthocyanin, which accounts for 79% of total anthocyanin in all extracts. The variety Larissa at H5 contained the highest average C3G content, and its ethanol extract had the highest (1212.3±63.9 mg/100g FW) while, Evie at H1 contained the lowest C3G content (96.9±40.4 mg/100g FW). The average C3G content of Larissa from H1 – H5 varies from 208 – 1212 mg/100g FW. Quarcetin-3-Rutinoside (Q3Rut) is the major type of flavonol and highest is observed in Rebecca at H4 (47.81 mg/100g FW). The haskap berries also contained phenolic acids, but approximately 95% of the phenolic acids consisted of chlorogenic acid. The cultivar Larissa has a higher level of anthocyanin than the other four cultivars. The highest total phenolic content is observed in Evie at H5 (2.97±1.03 mg/g DW) while the lowest in Rebecca at H1 (1.47±0.96 mg/g DW). The antioxidant capacity of Evie at H5 was higher (14.40±2.21 µmol TE/ g DW) among other cultivars and the lowest observed in Aurora at H3 (5.69±0.34 µmol TE/ g DW). Furthermore, Larissa H5 shows the greatest inhibition of carbohydrate-hydrolyzing enzymes including alpha-glucosidase and alpha-amylase. In conclusion Larissa, at H5 demonstrated highest polyphenol composition and antidiabetic properties.

Keywords: anthocyanin, cyanidin-3-O-glucoside, haskap, type 2 diabetes

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Authors: Priyanka Mokashi, Aparna Khanna, Nancy Pandita

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Diabetes mellitus is a chronic metabolic disorder which will be the 7th leading cause of death by 2030. The current line of treatment for the diabetes mellitus is oral antidiabetic drugs (biguanides, sulfonylureas, meglitinides, thiazolidinediones and alpha-glycosidase inhibitors) and insulin therapy depending upon the type 1 or type 2 diabetes mellitus. But, these treatments have their disadvantages, ranging from the developing of resistance to the drugs and adverse effects caused by them. Alternative to these synthetic agents, natural products provides a new insight for the development of more efficient and safe drugs due to their therapeutic values. Enicostema littorale blume (A. Raynal) is a traditional Indian plant belongs to the Gentianaceae family. It is widely distributed in Asia, Africa, and South America. There are few reports on Swrtiamarin, major component of this plant for its antidiabetic activity. However, the antidiabetic activity of flavonoids from E. littorale and their mechanism of action have not yet been elucidated. Flavonoids have a positive relationship with disease prevention and can act on various molecular targets and regulate different signaling pathways in pancreatic β-cells, adipocytes, hepatocytes and skeletal myofibers. They may exert beneficial effects in diabetes by (i) improving hyperglycemia through regulation of glucose metabolism in hepatocytes; (ii) enhancing insulin secretion and reducing apoptosis and promoting proliferation of pancreatic β-cells; (iii) increasing glucose uptake in hepatocytes, skeletal muscle and white adipose tissue (iv) reducing insulin resistance, inflammation and oxidative stress. Therefore, we have isolated four flavonoid rich fractions, Fraction A (FA), Fraction B (FB), Fraction C (FC), Fraction D (FD) from crude alcoholic hot (AH) extract from E. littorale, identified by LC/MS. Total eight flavonoids were identified on the basis of fragmentation pattern. Flavonoid FA showed the presence of swertisin, isovitexin, and saponarin; FB showed genkwanin, quercetin, isovitexin, FC showed apigenin, swertisin, quercetin, 5-O-glucosylswertisin and 5-O-glucosylisoswertisin whereas FD showed the presence of swertisin. Further, these fractions were assessed for their antidiabetic activity on stimulating glucose uptake in insulin-resistant HepG2 cell line model (IR/HepG2). The results showed that FD containing C-glycoside Swertisin has significantly increased the glucose uptake rate of IR/HepG2 cells at the concentration of 10 µg/ml as compared to positive control Metformin (0.5mM) which was determined by glucose oxidase- peroxidase method. It has been reported that enhancement of glucose uptake of cells occurs due the translocation of Glut4 vesicles to cell membrane through IR/IRS1/AKT pathway. Therefore, we have studied expressions of three genes IRS1, AKT and Glut4 by real-time PCR to evaluate whether they follow the same pathway or not. It was seen that the glucose uptake rate has increased in FD treated IR/HepG2 cells due to the activation of insulin receptor substrate-1 (IRS1) followed by protein kinase B (AKT) through phosphoinositide 3-kinase (PI3K) leading to translocation of Glut 4 vesicles to cell membrane, thereby enhancing glucose uptake and insulin sensitivity of insulin resistant HepG2 cells. Hence, the up-regulation indicated the mechanism of action through which FD (Swertisin) acts as antidiabetic candidate in the treatment of type 2 diabetes mellitus.

Keywords: E. littorale, glucose transporter, glucose uptake rate, insulin resistance

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Authors: R. P. Hewawasam, M. H. A. D. de Silva, M. A. G. Iresha

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Obesity is associated with an increased risk of developing insulin resistance. Insulin resistance often progresses to type-2 diabetes mellitus and is linked to a wide variety of other pathophysiological features including hypertension, hyperlipidemia, atherosclerosis (metabolic syndrome) and polycystic ovarian syndrome. Macrosomia is common in infants born to not only women with gestational diabetes mellitus but also non-diabetic obese women. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age (LGA) are more likely to be obese in childhood. It is also established from previous studies that Asian populations have higher percentage body fat at a lower body mass index compared to Caucasians. High leptin levels in cord blood have been reported to correlate with fetal adiposity at birth. Previous studies have also shown that cord blood C-peptide and insulin levels are significantly and positively correlated with birth weight. Therefore, the objective of this preliminary study was to determine the relationship between parameters of fetal insulin resistance such as leptin, C-peptide and insulin and the birth weight of the newborn in a study population in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns and the concentration of insulin, leptin, and C-peptide were measured by ELISA technique. Birth weight, length, occipital frontal, chest, hip and calf circumferences of newborns were measured and characteristics of the mother such as age, height, weight before pregnancy and weight gain were collected. The relationship between insulin, leptin, C-peptide, and anthropometrics were assessed by Pearson’s correlation while the Mann-Whitney U test was used to assess the differences in cord blood leptin, C-peptide, and insulin levels between groups. A significant difference (p < 0.001) was observed between the insulin levels of infants born LGA (18.73 ± 0.64 µlU/ml) and AGA (13.08 ± 0.43 µlU/ml). Consistently, A significant increase in concentration (p < 0.001) was observed in C-peptide levels of infants born LGA (9.32 ± 0.77 ng/ml) compared to AGA (5.44 ± 0.19 ng/ml). Cord blood leptin concentration of LGA infants (12.67 ng/mL ± 1.62) was significantly higher (p < 0.001) compared to the AGA infants (7.10 ng/mL ± 0.97). Significant positive correlations (p < 0.05) were observed among cord leptin levels and the birth weight, pre-pregnancy maternal weight and BMI between the infants of AGA and LGA. Consistently, a significant positive correlation (p < 0.05) was observed between the birth weight and the C peptide concentration. Significantly high concentrations of leptin, C-peptide and insulin levels in the cord blood of LGA infants suggest that they may be involved in regulating fetal growth. Although previous studies suggest comparatively high levels of body fat in the Asian population, values obtained in this study are not significantly different from values previously reported from Caucasian populations. According to this preliminary study, maternal pre-pregnancy BMI and weight may contribute as significant indicators of cord blood parameters of insulin resistance and possibly the birth weight of the newborn.

Keywords: large for gestational age, leptin, C-peptide, insulin

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Authors: Zine Kechrid

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This study was carried out to investigate the antioxidant effect of vitamin C on oxidative stress induced by dietary Zn-deficiency in albino diabetic rats. Thirty two males alloxan-diabetic rats divided into two groups of 16 individuals each; the first group was fed a zinc adequate diet (54 mg zinc/kg). The second group had given low zinc diet (1 mg zinc/kg). Then, half of each group was treated with vitamin C (1 g/l) in drinking water. After four weeks, animals were sacrificed and different parameters were determined. The findings showed that dietary deficiency zinc intake significantly increased serum glucose. Zn-deficiency was also led to an increase in oxidative stress, which was indicated by an increase of MDA level and glutathione-S-transferase activity. Meanwhile it was result in a decrease of reduced glutathione (GSH) content, glutathione peroxidase GSH-Px and catalase activities in liver. However, the administration of vitamin C restored all the previous parameters approximately to their normal values. In conclusion, vitamin C probably played a key role strong as antioxidant factor against oxidative stress provoked by dietary zinc inadequate. Therefore, it might be contributed in reduction diabetes complications.

Keywords: vitamin C, oxidative stress, zinc, experimental diabetes, rats

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Authors: Souheila Zemmouchi

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Introduction: Diabetes is currently the leading cause of end-stage chronic kidney disease and dialysis, so it adds additional complexity to the management of chronic hemodialysis patients. These patients are extremely fragile because of their multiple cardiovascular and metabolic comorbidities. Clear and complete description of the experience: the management of a diabetic on hemodialysis is particularly difficult due to frequent hypoglycaemia and significant inter and perdialyticglycemic variability that is difficult to predict. The aim of our study is to describe the clinical-biological profile and to assess the cardiovascular risk of diabetics undergoing chronic hemodialysis, and compare them with non-diabetic hemodialysis patients. Methods: This cross-sectional, descriptive, and analytical study was carried out between January 01 and December 31, 2018, involving 309 hemodialysis patients spread over 4 centersThe data were collected prospectively then compiled and analyzed by the SPSS Version 10 software The FRAMINGHAM RISK SCORE has been used to assess cardiovascular risk in all hemodialysis patients Results: The survey involved 309 hemodialysis patients, including 83 diabetics, for a prevalence of 27% The average age 53 ± 10.2 years. The sex ratio is 1.5. 50% of diabetic hemodialysis patients retained residual diuresis against 32% in non-diabetics. In the group of diabetics, we noted more hypertension (70% versus 38% non-diabetics P 0.004), more intradialytichypoglycemia (15% versus 3% non-diabetics P 0.007), initially, vascular exhaustion was found in 4 diabetics versus 2 non-diabetics. 70% of diabetics with anuria had postdialytichyperglycemia. The study found a statistically significant difference between the different levels of cardiovascular risk according to the diabetic status. Conclusion: There are many challenges in the management of diabetics on hemodialysis, both to optimize glycemic control according to an individualized target and to coordinate comprehensive and effective care.

Keywords: hemodialysis, diabetes, chronic renal failure, glycemic control

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Authors: Tamer M. Shehata

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Objective: Currently, mucoadhesive microparticles acquired a high interest in both research and pharmaceutical technology fields. Recently, BÜCHI lunched its latest fourth generation nano spray dryer B-90 used for nanoparticle production. B-90 offers an elegant technology combined particle engineering and drying in one step. In our laboratory, we successfully developed a new formulation for metformin hydrochloride, mucoadhesive microparticles utilizing B-90 technology for treatment of type 2-diabetis. Method: Gelatin or sodium alginate, natural occurring polymers with mucoadhesive properties, solely or in combination was used in our formulation trials. Preformulation studies (atomization head mesh size, flow rate, head temperature, polymer solution viscosity and surface tension) and postformulation characters (particle size, flowability, surface scan and dissolution profile) were evaluated. Finally, hypoglycemic effect of the selected formula was evaluated in streptozotocin-induced diabetic rats. Spray head with 7 µm hole, flow rate of 3.5 mL/min and head temperature 120 ºC were selected. Polymer viscosity was less than 11.5 cP with surface tension less than 70.1 dyne/cm. Result: Discrete, non aggregated particles and free flowing powders with particle size was less than 2000 nm were obtained. Gelatin and sodium alginate combination in ratio 1:3 were successfully sustained the in vitro release profile of the drug. Hypoglycemic evaluation of the previous formula, showed a significant reduction of blood glucose level over 24 h. Conclusion: B-90 technology can open a new era of , mucoadhesive microparticles preparation offering convenient dosage form that can enhance compliance of type 2 diabetic patients.

Keywords: mucoadhesive, microparticles, technology, diabetis

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Authors: Kemal Polat

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In this paper, three feature weighting methods have been used to improve the classification performance of diabetic retinopathy (DR). To classify the diabetic retinopathy, features extracted from the output of several retinal image processing algorithms, such as image-level, lesion-specific and anatomical components, have been used and fed them into the classifier algorithms. The dataset used in this study has been taken from University of California, Irvine (UCI) machine learning repository. Feature weighting methods including the fuzzy c-means clustering based feature weighting, subtractive clustering based feature weighting, and Gaussian mixture clustering based feature weighting, have been used and compered with each other in the classification of DR. After feature weighting, five different classifier algorithms comprising multi-layer perceptron (MLP), k- nearest neighbor (k-NN), decision tree, support vector machine (SVM), and Naïve Bayes have been used. The hybrid method based on combination of subtractive clustering based feature weighting and decision tree classifier has been obtained the classification accuracy of 100% in the screening of DR. These results have demonstrated that the proposed hybrid scheme is very promising in the medical data set classification.

Keywords: machine learning, data weighting, classification, data mining

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Authors: Rajnish Gupta, R. S. Gupta

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Present research was aimed to investigate antidiabetic and antioxidant status of Lupeol in streptozotocin induced diabetes. Rats were divided into following groups mainly: control, diabetic, normal group as well as diabetic treated with Lupeol at 25 and 35 mg/kg b.wt./day for 21 days, diabetic group treated with glibenclamide. Tissue (pancreas, kidney and liver) as well as serum biochemical parameters were analysed for any abnormal behavior. Lupeol administration reduced diabetes onset with significant improvement in serum insulin level also strengthened by increase in β-Cell counts. A significant decrease was observed in serum glucose level. Furthermore, Lupeol treatment increased the antioxidant enzymes, glycolytic enzymes and also protein levels with a decrease in the level of thiobarbituric acid-reactive oxygen species and gluconeogenic enzymes. Present study proves that Lupeol administration significantly reinstated serum and tissue biochemical parameters and thus strengthening its antidiabetic potential.

Keywords: oxidative stress, pterostilbene, thiobarbituric acid, reactive oxygen species

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Authors: Rashmi Shukla, Yamini Bhusan Tripathi

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Diabetic nephropathy (DN) is characterized as diabetic kidney disease which involves many pathways e.g. hyperactivated protein kinase c (PKC), polyol pathway, excess production of advanced glycation end product (AGEs) & free radical accumulation etc. All of them results to hypoxia followed by apoptosis of podocytes, glomerulosclerosis, extracellular matrix (ECM) accumulation and fibrosis resulting to irreversible changes in kidney. This is continuously rising worldwide and there are not enough specific drugs, to retard its progress. Due to increasing side effects of allopathic drugs, interest in herbal remedies is growing. Earlier, we have reported that PTY-2 (a phytomedicine, derived from Pueraria tuberosa Linn.) inhibits the accumulation of extracellular matrix (ECM) through activation of MMP-9. Present study exhibited the therapeutic potential of Pueraria tuberosa in the prevention of podocytes apoptosis and modulation of nephrin expression in streptozotocin (STZ) induced DN rats. DN rats were produced by maintaining persistent hyperglycemia for 8 weeks by intra-peritoneal injection of 55 mg/kg streptozotocin (STZ). These rats were randomly divided in 2 groups, i.e. DN control, and DN+ water extract of Pueraria tuberosa (PTW). One group of age-matched normal rats served as non-diabetic control (group-1), The STZ induced DN rats (group-2) and DN+PTW treated rats (group-3). The PTW was orally administered (0.3g/kg) daily to group-2 rats and drug vector (1 ml of 10% tween 20) in control rats. The treatments were continued for 20 days and blood and urine samples were collected. Rats were then sacrificed to investigate the expression Bcl2, Bax and nephroprotective protein i.e. nephrin in kidney glomerulus. The effect of PTW was evaluated, we have found that the PTW significantly(p < .001) reversed the raised serum urea, serum creatinine, urine protein and improved the creatinine clearance in STZ induce diabetic nephropathy in rats and also significantly(p < .001) prevented the rise in urine albumin excretion. The Western blot analysis of kidney tissue homogenate showed increased expression of Bcl2 in PTW treated rats. The RT-PCR showed the increased expression and accumulation of nephrin mRNA. The confocal photomicrographs also supported the reduction of Bax and a simultaneous increase in Bcl2 and nephrin in glomerular podocytes. Hence, our finding suggests that the nephroprotective role of PTW is mediated via restoration of nephrin thus prevents the podocytes apoptosis and ameliorates diabetic nephropathy. The clinical trial of PTW would prove to be a potential food supplement/ drug of alternative medicine for patients with diabetic nephropathy in early stage.

Keywords: Pueraria tuberosa, diabetic nephropathy, anti-apoptosis, nephrin

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Authors: L. S. Godlevsky, N. V. Kresyun, V. P. Martsenyuk, K. S. Shakun, T. V. Tatarchuk, K. O. Prybolovets, L. F. Kalinichenko, M. Karpinski, T. Gancarczyk

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Structures of eye bottom were extracted using multiscale texture gradient method and color characteristics of macular zone and vessels were verified in CIELAB scale. The difference of average values of L*, a* and b* coordinates of CIE (International Commision of Illumination) scale in patients with diabetes and healthy volunteers was compared. The average value of L* in diabetic patients exceeded such one in the group of practically healthy persons by 2.71 times (P < 0.05), while the value of a* index was reduced by 3.8 times when compared with control one (P < 0.05). b* index exceeded such one in the control group by 12.4 times (P < 0.05). The integrated index on color difference (ΔE) exceeded control value by 2.87 times (P < 0.05). More pronounced differences with ΔE were followed by a shorter period of MA appearance with a correlation level at -0.56 (P < 0.05). The specificity of diagnostics raised by 2.17 times (P < 0.05) and negative prognostic index exceeded such one determined with the expert method by 2.26 times (P < 0.05).

Keywords: diabetic retinopathy, multiscale texture gradient, color spectrum analysis, medical diagnostics

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Authors: Mengistu G. Woldu, Hani Y. Zaki, Areeg Faggad, Badreldin E. Abdalla

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Background: Type 2 diabetes mellitus (T2DM) is a complex, degenerative, and multi-factorial disease, which is culpable for huge mortality and morbidity worldwide. Even though relatively significant numbers of studies are conducted on the genetics domain of this disease in the developed world, there is huge information gap in the sub-Saharan Africa region in general and in Eritrea in particular. Objective: The principal aim of this study was to investigate the association of common variants of the Insulin Receptor Substrate 1 (IRS1) and Transcription Factor 7-Like 2 (TCF7L2) genes with T2DM in the Eritrean population. Method: In this cross-sectional case control study 200 T2DM patients and 112 non-diabetes subjects were participated and genotyping of the IRS1 (rs13431179, rs16822615, 16822644rs, rs1801123) and TCF7L2 (rs7092484) tag SNPs were carries out using PCR-RFLP method of analysis. Haplotype analyses were carried out using Plink version 1.07, and Haploview 4.2 software. Linkage disequilibrium (LD), and Hardy-Weinberg equilibrium (HWE) analyses were performed using the Plink software. All descriptive statistical data analyses were carried out using SPSS (Version-20) software. Throughout the analysis p-value ≤0.05 was considered statistically significant. Result: Significant association was found between rs13431179 SNP of the IRS1 gene and T2DM under the recessive model of inheritance (OR=9.00, 95%CI=1.17-69.07, p=0.035), and marginally significant association found in the genotypic model (OR=7.50, 95%CI=0.94-60.06, p=0.058). The rs7092484 SNP of the TCF7L2 gene also showed markedly significant association with T2DM in the recessive (OR=3.61, 95%CI=1.70-7.67, p=0.001); and allelic (OR=1.80, 95%CI=1.23-2.62, p=0.002) models. Moreover, eight haplotypes of the IRS1 gene found to have significant association withT2DM (p=0.013 to 0.049). Assessments made on the interactions of genotypes of the rs13431179 and rs7092484 SNPs with various parameters demonstrated that high density lipoprotein (HDL), low density lipoprotein (LDL), waist circumference (WC), and systolic blood pressure (SBP) are the best T2DM onset predicting models. Furthermore, genotypes of the rs7092484 SNP showed significant association with various atherogenic indexes (Atherogenic index of plasma, LDL/HDL, and CHLO/HDL); and Eritreans carrying the GG or GA genotypes were predicted to be more susceptible to cardiovascular diseases onset. Conclusions: Results of this study suggest that IRS1 (rs13431179) and TCF7L2 (rs7092484) gene polymorphisms are associated with increased risk of T2DM in Eritreans.

Keywords: IRS1, SNP, TCF7L2, type 2 diabetes

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Authors: Yu Chen

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Auricular-magnet therapy is the development of auricular acupuncture. It is a powerful, convenient, and quick result-achieving therapeutic method. This therapy works by using magnetic discs to be placed on acupuncture points on the ears to treat diseases and improve health. In this study, the fundamental principles, indications, and contraindications of this therapy are discussed. Five examples, including reducing blood glucose levels, healing gangrene for diabetes patients, and treating Bell's palsy, are presented. Auricular-magnet therapy is a powerful development in acupuncture.

Keywords: auricular-magnet therapy, Bell’s palsy, diabetes mellitus, food craving, insomnia, nausea, obesity

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Authors: Nuran Nur Aypar, Merlinda Alus Tokat

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The aim of the study is to determine the knowledge level of pregnant women with Gestational Diabetes Mellitus (GDM) about the disease and affecting factors. The data of this descriptive study were collected from 184 pregnant women who were followed up in Dokuz Eylul University Hospital (n=34), Izmir Ege Maternity Hospital, Gynecology Training and Research Hospital (n=133), and Egepol Private Hospital (n=17). Data collection forms were prepared by the researcher according to the literature. ANOVA test, Kruskal Wallis test, Mann-Whitney U test, Student’s t-test, and Pearson correlation test were used for statistical analyses. Average GDM knowledge score of pregnant women was 40.10±19.56. The GDM knowledge scores were affected by factors such as age, educational level, working status, income status, educational level of the spouse, and the GDM background. It has been shown in our study that the GDM knowledge scores were negatively affected by factors such as young age, low educational level, low-income level, unemployment, having a spouse with low educational level, the absence of the GDM story. It has been identified that 86.4% of the pregnant women were trained about GDM. The education provided in the antenatal period significantly increased GDM knowledge scores of pregnant women (p=0.000, U=515.0). It has been determined that GDM knowledge of the pregnant women with GDM is affected by various factors. These factors must be considered in order to determine new strategies.

Keywords: affecting factors, gestational diabetes mellitus (GDM), knowledge level, nursing, pregnancy

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Authors: Gholam Hossein Javanmard, Roghayeh Mohammadi Garegozlo

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The present study was a randomized three-group double-blind clinical trial with repeated measures designs which aimed to determine the pure effect and combined effect of mindfulness based-relaxation (MBR) technique and Transcranial Electrical Simulation (tCES) on psychological distress decreasing of patients with type-2 diabetes. The sample of the study consisted of 30 patients with type-2 diabetes who were selected from the Diabetes Association of Bonab city in Iran. The participants were matched and then randomly assigned to the three groups of 10 subjects (MBR, CES, MBR+CES). The subjects received interventions related to their group in 10 individual sessions. Pre-test, post-test, and one-month follow-up were conducted using DASS-42. Analysis of variance with repeated measures showed a significant change in psychological distress. Multivariate covariance analysis and the paired interpersonal comparative test of Ben Foruni indicated that both interventions of MBR and CES have a similar effect on psychological distress decreasing in the post-test and follow-up phase. But, the combined therapy of MBR+CES was more efficient, and it had a more stable effect. However, all three interventions, especially combined intervention of MBR+CES, as efficient and stable treatment, are suggested for improving the psychological status of diabetic patients.

Keywords: mindfulness based-relaxation, transcranial electrical simulation, type 2 diabetes, psychological distress

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Authors: Haaris Khan, Farhad Udwadia

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South Asians are the fastest-growing immigrant population in Canada and are 3-4 times more likely to develop diabetes. In a primary care setting, language barriers continue to persist as a prominent obstacle when delivering crucial health information. Given the abundance of languages in the South Asian community and the varying levels of English fluency, there is compelling evidence that these language barriers can adversely impact health outcomes. The microvascular and macrovascular complications of poor diabetic management are well established and universally recognized. However, these are often difficult concepts to grasp for even individuals fluent in English. In order to lessen the burden of language barriers, we developed a comprehensive guide in various languages that discuss the complications and screening guidelines for diabetic and prediabetic patients. The guide is presented in the form of a pamphlet, with an electronic version being constructed as well, that provides basic information on diabetic retinopathy, neuropathy and nephropathy as well as the screening recommendations. We also conducted a review of the literature around the topic and incorporated our findings into our project. Our goal is for primary care physicians to have this resource and to be able to provide the link or pamphlet to patients in need. Our presentation also provides a comprehensive overview of some of the other barriers that individuals in the South Asian community face when seeking care. Given the staggering number of individuals in the South Asian community with diabetes and the morbidity and mortality associated with diabetes and its complications, effective community-specific strategies are needed to mitigate the potential consequences of poor diabetes management.

Keywords: diabetes, patient education, ophthalmology, vascular surgery

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Authors: Li-Ching Lin, Yu-Tzu Dai

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Recurrent foot ulcers or foot amputation have a major impact on patients with diabetes mellitus (DM), medical professionals, and society. A critical procedure for foot care is foot self-monitoring. Medical professionals’ understanding of patients’ foot self-monitoring knowledge, attitude, and practice is beneficial for raising patients’ disease awareness. This study investigated these and related factors among patients with DM through a descriptive study of the correlations. A scale for measuring the foot self-monitoring knowledge, attitude, and practice of patients with DM was used. Purposive sampling was adopted, and 100 samples were collected from the respondents’ self-reports or from interviews. The statistical methods employed were an independent-sample t-test, one-way analysis of variance, Pearson correlation coefficient, and multivariate regression analysis. The findings were as follows: the respondents scored an average of 12.97 on foot self-monitoring knowledge, and the correct answer rate was 68.26%. The respondents performed relatively lower in foot health screenings and recording, and awareness of neuropathy in the foot. The respondents held a positive attitude toward self-monitoring their feet and a negative attitude toward having others check the soles of their feet. The respondents scored an average of 12.64 on foot self-monitoring practice. Their scores were lower in their frequency of self-monitoring their feet, recording their self-monitoring results, checking their pedal pulse, and examining if their soles were red immediately after taking off their shoes. Significant positive correlations were observed among foot self-monitoring knowledge, attitude, and practice. The correlation coefficient between self-monitoring knowledge and self-monitoring practice was 0.20, and that between self-monitoring attitude and self-monitoring practice was 0.44. Stepwise regression analysis revealed that the main predictive factors of the foot self-monitoring practice in patients with DM were foot self-monitoring attitude, prior experience in foot care, and an educational attainment of college or higher. These factors predicted 33% of the variance. This study concludes that patients with DM lacked foot self-monitoring practice and advises that the patients’ self-monitoring abilities be evaluated first, including whether patients have poor eyesight, difficulties in bending forward due to obesity, and people who can assist them in self-monitoring. In addition, patient education should emphasize self-monitoring knowledge and practice, such as perceptions regarding the symptoms of foot neurovascular lesions, pulse monitoring methods, and new foot self-monitoring equipment. By doing so, new or recurring ulcers may be discovered in their early stages.

Keywords: diabetic foot, foot self-monitoring attitude, foot self-monitoring knowledge, foot self-monitoring practice

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Authors: Mohammadjavad Sotoudeheian, Navid Farahmandian

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Cardiac hypertrophy arises in response to persistent increases in hemodynamic loads. In comparison, diabetic cardiomyopathy is defined by an abnormal myocardial changes without other cardiac-related risk factors. Pathological cardiac hypertrophy and myocardial remodeling are hallmarks of cardiovascular diseases and are risk factors for heart failure. The transcription factor forkhead box class O (FOXOs) can protect heart tissue by hostile oxidative stress and stimulating apoptosis and autophagy. FOXO proteins, as sensitive elements and mediators in response to environmental changes, have been revealed to prevent and inverse cardiac hypertrophy. FOXOs are inhibited by insulin and are critical mediators of insulin action. Insulin deficiency and uncontrolled diabetes lead to a catabolic state. FOXO1 acts downstream of the insulin-dependent pathways, which are dysregulated in diabetes. It regulates cardiomyocyte hypertrophy downstream of IGF1R/PI3K/Akt activation, which are critical regulators of cardiac hypertrophy. The complex network of signaling pathways comprising insulin/IGF-1 signaling, AMPK, JNK, and Sirtuins regulate the development of cardiovascular dysfunction by modulating the activity of FOXOs. Insulin receptors and IGF1R act via the PI3k/Akt and the MAPK/ERK pathways. Activation of Akt in response to insulin or IGF-1 induces phosphorylation of FOXOs. Increased protein synthesis induced by activation of the IGF-I/Akt/mTOR signaling pathway leads to hypertrophy. This pathway and the myostatin/Smad pathway are potent negative muscle development regulators. In cardiac muscle, insulin receptor substrates (IRS)-1 or IRS-2 activates the Akt signaling pathway and inactivate FOXO1. Under metabolic stress, p38 MAPK promotes degradation of IRS-1 and IRS-2 in cardiac myocytes and activates FOXO1, leading to cardiomyopathy. Sirt1 and FOXO1 interaction play an essential role in starvation-induced autophagy in cardiac metabolism. Inhibition of Angiotensin-II induced cardiomyocyte hypertrophy is associated with reduced FOXO1 acetylation and activation of Sirt1. The NF-κB, ERK, and FOXOs are de-acetylated by SIRT1. De-acetylation of FOXO1 induces the expression of genes involved in autophagy and stimulates autophagy flux. Therefore, under metabolic stress, FOXO1 can cause diabetic cardiomyopathy. The overexpression of FOXO1 leads to decreased cardiomyocyte size and suppresses cardiac hypertrophy through inhibition of the calcineurin–NFAT pathway. Diabetes mellitus is associated with elevation of O-GlcNAcylation. Some of its binding partners regulate the substrate selectivity of O-GlcNAc transferase (OGT). O-GlcNAcylation of essential contractile proteins may inhibit protein-protein interactions, reduce calcium sensitivity, and modulate contractile function. Uridine diphosphate (UDP)-GlcNAc is the obligatory substrate of OGT, which catalyzes a reversible post-translational protein modification. The increase of O-GlcNAcylation is accompanied by impaired cardiac hypertrophy in diabetic hearts. Inhibition of O-GlcNAcylation blocks activation of ERK1/2 and hypertrophic growth. O-GlcNAc modification on NFAT is required for its translocation from the cytosol to the nucleus, where NFAT stimulates the transcription of various hypertrophic genes. Inhibition of O-GlcNAcylation dampens NFAT-induced cardiac hypertrophic growth. Transcriptional activity of FOXO1 is enriched by improved O-GlcNAcylation upon high glucose stimulation or OGT overexpression. In diabetic conditions, the modification of FOXO1 by O-GlcNAc is promoted in cardiac troponin I and myosin light chain 2. Therefore targeting O-GlcNAcylation represents a potential therapeutic option to prevent hypertrophy in the diabetic heart.

Keywords: diabetes, cardiac hypertrophy, O-GlcNAcylation, FOXO1, Akt, PI3K, AMPK, insulin

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Authors: Evija Silina, Maris Taube, Maksims Zolovs

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Background: Type 1 diabetes mellitus (T1D) is the most common chronic endocrine pathology in children. The management of type 1 diabetes requires a strong diet, physical activity, lifelong insulin therapy, and proper self-monitoring of blood glucose and is usually complicated and, therefore, may result in a variety of psychosocial problems for children, adolescents, and their families. Metabolic control of the disease is determined by glycated haemoglobin (HbA1c), the main criterion for diabetes compensation. A correlation was observed between anxiety and depression levels and glycaemic control in many previous studies. It is assumed that anxiety and depression symptoms negatively affect glycaemic control. Parental psychological distress was associated with higher child self-report of stress and depressive symptoms, and it had negative effects on diabetes management. Objective: The main objective of this paper is to evaluate the relationship between parental mental health conditions (depression and anxiety) and metabolic control of their adolescents with T1DM. Methods: This cross-sectional study recruited adolescents with T1D (N=251) and their parents (N=251). The respondents completed questionnaires. The 7-item Generalized Anxiety Disorder (GAD-7) scale measured anxiety level; The Patient Health Questionnaire – 9 (PHQ-9) measured depressive symptoms. Glycaemic control of patients was assessed using the last glycated haemoglobin (HbA1c) values. GLM mediation analysis was performed to determine the potential mediating effect of the parent’s mental health conditions (depression and anxiety) on the relationship between the mental health conditions (depression and anxiety) of a child on the level of glycated hemoglobin (HbA1c). To test the significance of the mediated effect (ME) for non-normally distributed data, bootstrapping procedures (10,000 bootstrapped samples) were used. Results: 502 respondents were eligible for screening to detect anxiety and depression symptoms. Mediation analysis was performed to assess the mediating role of parent GAD-7 on the linkage between a dependent variable (HbA1c) and independent variables (child GAD-7 un child PHQ-9). The results revealed that the total effect of child GAD-7 (B = 0.479, z = 4.30, p < 0.001) on HbA1c was significant but the total effect of child PHQ-9 (B = 0.166, z = 1.49, p = 0.135) was not significant. With the inclusion of the mediating variable (parent GAD-7), the impact of child GAD-7 on HbA1c was found insignificant (B = 0.113, z=0.98, p = 0.326), the impact of child PHQ-9 on HbA1c was found also insignificant (B = 0.068, z=0.74, p = 0.458). The indirect effect of child GAD-7 on HbA1c through parent GAD-7 was found significant (B = 0.366, z = 4.31, p < 0.001) and the indirect effect of child PHQ-9 on HbA1c through parent GAD-7 was found also significant (B = 0.098, z = 2.56, p = 0.010). This indicates that the relationship between a dependent variable (HbA1c) and independent variables (child GAD-7 un child PHQ-9) is fully mediated by parent GAD-7. Conclusion: The main result suggests that glycated haemoglobin in adolescents with Type 1 diabetes is related to adolescents’ mental health via parents’ anxiety. It means that parents’ anxiety plays a more significant role in the level of glycated haemoglobin in adolescents than depression and anxiety in the adolescent.

Keywords: type 1 diabetes, adolescents, parental diabetes-specific mental health conditions, glycated haemoglobin, anxiety, depression

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Authors: Sania Bashir

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A promising approach to healthcare delivery, telemedicine makes use of communication technology to reach out to remote regions of the world, allowing for beneficial interactions between diabetic patients and healthcare professionals as well as the provision of affordable and easily accessible medical care. The emergence of contemporary care models, fueled by the pervasiveness of mobile devices, provides better information, offers low cost with the best possible outcomes, and is known as digital health. It involves the integration of collected data using software and apps, as well as low-cost, high-quality outcomes. The goal of this study is to assess how well telemedicine works for diabetic patients and how it impacts their HbA1c levels. A questionnaire-based survey of 300 diabetics included 150 patients in each of the groups receiving usual care and via telemedicine. A descriptive and observational study that lasted from September 2021 to May 2022 was conducted. HbA1c has been gathered for both categories every three months. A remote monitoring tool has been used to assess the efficacy of telemedicine and continuing therapy instead of the customary three monthly meetings like in-person consultations. The patients were (42.3) 18.3 years old on average. 128 men were outnumbered by 172 women (57.3% of the total). 200 patients (66.6%) have type 2 diabetes, compared to over 100 (33.3%) candidates for type 1. Despite the average baseline BMI being within normal ranges at 23.4 kg/m², the mean baseline HbA1c (9.45 1.20) indicates that glycemic treatment is not well-controlled at the time of registration. While patients who use telemedicine experienced a mean percentage change of 10.5, those who visit the clinic experienced a mean percentage change of 3.9. Changes in HbA1c are dependent on several factors, including improvements in BMI (61%) after 9 months of research and compliance with healthy lifestyle recommendations for diet and activity. More compliance was achieved by the telemedicine group. It is an undeniable reality that patient-physician communication is crucial for enhancing health outcomes and avoiding long-term issues. Telemedicine has shown its value in the management of diabetes and holds promise as a novel technique for improved clinical-patient communication in the twenty-first century.

Keywords: diabetes, digital health, mobile app, telemedicine

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Authors: Zulfa D. Putri, Jumayanti Jumayanti, Hatiefah T. I. Melati, Kiki Indriati, Farah U. Mauhibah

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Momordica charantia is a food that is often used for nutrition therapy for patients with Diabetes Mellitus (DM) because of its effect as antihiperglicemia. However, the bitter taste of Momordica charantia may be an obstacle to consume. Some people remove the bitter taste of this by boiling it with salt water. The purpose of this study was to determine the effect of Momordica charantia boiling with salt water in lowering blood glucose levels. This study is a quasi-experimental study with pre-post test with control group design. The research sample consisted of 25 rats Sprague-Dawley were divided into 5 groups: Control group of healthy, control group of DM, control group of DM with the addition of Momordica charantia are boiled by salt for 3 minutes, 6 minutes, and 9 minutes. Blood glucose levels were measured after 4 weeks using a spectrophotometer. These results indicate that there is the effect of bitter taste from Momordica charantia in lowering blood glucose levels in rats significantly. The conclusion of this study is giving a Momordica charantia juice in Sprague-Dawley rats that induced by alloxan has meaningful statistically proven by One Way ANOVA test (p = 0.00) in lowering blood glucose levels of rats.

Keywords: antihiperglicemia, diabetes mellitus, momordica charantia, salt

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Authors: Sidra Islam, Moin Uddin, Mir A. Rouf

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A wide variety of pathological disorders owing to hyperglycemic conditions involves structural rearrangements and condensations of proteins. The implication of methylglyoxal (MG) modified immunoglobulin G (IgG) in the onset and progression of diabetes type 2 (T2DM) is studied in the present study. Using biophysical and biochemical approaches MG was found to perturb the structure of IgG, effect its microenvironment and leads to aggregate formation. Furthermore, MG-IgG was found to be highly immunogenic inducing high titre antibodies in female rabbits. Clinical studies revealed the presence of circulating anti-MG-IgG antibodies as analyzed by direct binding ELISA. The circulating auto antibodies were highly specific for MG-IgG as revealed by inhibition ELISA. Thus it can be concluded that MG is a powerful agent with a high damaging potential. To IgG. It is highly capable of generating immune response that contributes to the immunopathology associated with diabetes. Dicarbonyl adducts may emerge as potential biomarkers for T2DM.

Keywords: immunogenicity, Immunoglobulin G, methylglyoxal, Type 2 Diabetes Mellitus

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Authors: Sogand Moshfeghi, Alireza Biglari

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Diabetes is an endocrine disorder that is commonly treated with insulin. However, long-term usage of insulin and hypoglycemic chemical drugs can result in various side effects. Therefore, it is crucial to explore effective compounds with minimal side effects for diabetes treatment. This study aimed to compare the hypoglycemic effects of hydroalcoholic extracts derived from Silybum marianum, Camellia sinensis (green tea), and Urtica dioica plants. Male Wistar rats were allocated to 5 groups. Group 1 received normal Salin. Other groups were diabetic (induced by Streptozotocin 65 mg/kg Ip), group 2 received normal Salin (Ip, qod. 21 days). Group 3 received Silybum Marianum L, hydroalcoholic extract (100 mg/kg, ip.qod, 21 days). Group 4 received Camellia sinesis L, hydroalcoholic extract (100mg/kg,ip,qod,21 days), and group 5 received Urtica dioica L. hydroalcoholic extract (100mg/kg, ip,qod,21 days). Blood samples were collected at 14 and 21 days after the initial injection to evaluate the blood glucose levels. On the fourteenth day, the blood glucose levels for the diabetic groups were as follows: Group 2: 424.7±34.5, Group 3: 390.7±10.5, Group 4: 350.4±16.9, and Group 5: 340±20.5. On the 21st day, the respective blood glucose levels were: Group 2: 432±5.0, Group 3: 410.16±5.0, Group 4: 264.3±17.5, and Group 5: 270.7±24.5. Statistical analysis using the Tukey Anova test indicated that on the fourteenth day, both the green tea and Urtica groups exhibited significant hypoglycemic effects. Furthermore, on the 21st day, Urtica dioica extract demonstrated comparable effects to Camellia Sinensis extract, while Silybum Marianum extract did not significantly lower blood glucose levels compared to the diabetic group. In conclusion, the hydroalcoholic extracts from Camellia sinensis and Urtica dioica plants exhibited promising hypoglycemic effects in diabetic rats. These findings provide valuable insights into the potential use of natural plant extracts as alternative or complementary treatments for diabetes, warranting further investigation to harness their therapeutic benefit effectively.

Keywords: Camellia sinesis, glucose, Silybum marianum, Urtica dioica

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Authors: Jian-Ping Yu, Wen-Xiu Ma, Yong-Li Sun, Chaudry Masood Khalique

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In this paper, a 2d Toda equation is studied, which is a classical integrable system and plays a vital role in mathematics, physics and other areas. New lump-type solution is constructed by using the Hirota bilinear method. One interesting feature of this research is that this lump-type solutions possesses two types of multiple-lump-type waves, which are one- and two-lump-type waves. Moreover, the corresponding 3d plots, density plots and contour plots are given to show the dynamical features of the obtained multiple-lump-type solutions.

Keywords: 2d Toda equation, Hirota bilinear method, Lump-type solution, multiple-lump-type solution

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Authors: Mwenya Mubanga, Sula Mazimba

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Background: In Zambia, much of the focus on nutrition and health has been on reducing micronutrient deficiencies, wasting and underweight malnutrition and not on the rising global projections of trends in obesity and type 2 diabetes. The aim of this review was to identify and collate studies on the prevalence of obesity, diabetes and diabetes-related cardiovascular disease conducted in Zambia, to summarize their findings and to identify areas that need further research. Methods: The Medical Literature Analysis and Retrieval System (MEDLINE) database was searched for peer-reviewed articles on the prevalence of, and factors associated with obesity, type 2 diabetes, and diabetes-related cardiovascular disease amongst Zambian residents using a combination of search terms. The period of search was from 1 January 2000 to 31 December 2016. We expanded the search terms to include all possible synonyms and spellings obtained in the search strategy. Additionally, we performed a manual search for other articles and references of peer-reviewed articles. Results: In Zambia, the current prevalence of Obesity and Type 2 diabetes is estimated at 13%-16% and 2.0 – 3.0% respectively. Risk factors such as the adoption of western dietary habits, the social stigmatization associated with rapid weight loss due to Tuberculosis and/ or the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and rapid urbanization have all been blamed for fueling the increased risk of obesity and type 2 diabetes. However, unlike traditional Western populations, those with no formal education were less likely to be obese than those who attained secondary or tertiary level education. Approximately 30% of those surveyed were unaware of their diabetes diagnosis and more than 60% were not on treatment despite a known diabetic status. Socio-demographic factors such as older age, female sex, urban dwelling, lack of tobacco use and marital status were associated with an increased risk of obesity, impaired glucose tolerance and type 2 diabetes. We were unable to identify studies that specifically looked at diabetes-related cardiovascular disease. Conclusion: Although the prevalence of Obesity and Type 2 diabetes in Zambia appears low, more representative studies focusing on parts of the country outside of the main industrial zone need to be conducted. There also needs to be research on diabetes-related cardiovascular disease. National surveillance, monitoring and evaluation on all non-communicable diseases need to be prioritized and policies that address underweight, obesity and type 2 diabetes developed.

Keywords: type 2 diabetes, Zambia, obesity, cardiovascular disease

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