Search results for: Diabetic Patients.

Authors: Abeer A. Abdelhamed

Abstract:

Background: Diabetic sensorimotor polyneuropathy (DSP) is one of the most common microvascular complications of type 2 diabetes. Loss of sensation is thought to contribute to a lack of static and dynamic stability and increased risk of falling. Purpose: The purpose of this study was to compare the effects of low-level laser (LLL) and monochromatic near-infrared photo energy (MIRE) on pain, cutaneous sensation, static stability, and index of lower limb blood flow in diabetic patients with peripheral neuropathy. Methods: Forty diabetic patients with peripheral neuropathy were recruited for participation in this study. They were divided into two groups: The MIRE group, which contained 20 patients, and the LLL group, which contained 20 patients. All patients who participated in the study had been subjected to various physical assessment procedures, including pain, cutaneous sensation, Doppler flow meter, and static stability assessments. The baseline measurements were followed by treatment sessions that were conducted twice a week for six successive weeks. Results: The statistical analysis of the data revealed significant improvement of pain in both groups, with significant improvement in cutaneous sensation and static balance in the MIRE group compared to the LLL group; on the other hand, the results showed no significant differences in lower limb blood flow between the groups. Conclusion: LLL and MIRE can improve painful symptoms in patients with diabetic neuropathy. On the other hand, MIRE is also useful in improving cutaneous sensation and static stability in patients with diabetic neuropathy.

Keywords: Diabetic neuropathy, Doppler flow meter, –Lowlevel laser, Monochromatic near-infrared photo energy.

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Authors: Syed M. Shahid, Rozeena Shaikh, Syeda N. Nawab, Shah A. Qader, Abid Azhar, Tabassum Mahboob

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This study was designed to investigate the role of serum nitric oxide and sialic acid in the development of diabetic nephropathy as disease marker. Total 210 diabetic patients (age and sex matched) were selected followed by informed consent and divided into four groups (70 each) as I: control; II: diabetic; III: diabetic hypertensive; IV: diabetic nephropathy. The blood samples of all subjects were collected and analyzed for serum nitric oxide, sialic acid, fasting blood glucose, serum urea, creatinine, HbA1c and GFR. The BMI, systolic and diastolic blood pressures, blood glucose, HbA1c and serum sialic acid levels were high (p<0.01) in group II as compared to control subjects. The higher levels (p<0.01) of BMI, systolic and diastolic blood pressures, blood glucose, HbA1c, serum urea, creatinine and sialic acid were observed in group III and IV as compared to controls. Significantly low levels of GFR and serum nitric oxide (p<0.01) were observed in group III and IV as compared to controls. Results indicated that serum nitric oxide and sialic acid are the major biochemical indicators for micro and macrovascular complications of diabetes such as hypertension and nephropathy. These should be taken into account during screening procedures regarding identifications of the diabetic patients to get them rid of progressive renal impairment to ESRD.

Keywords: Diabetic nephropathy, hypertension, nitric oxide, sialic acid.

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Authors: Zarita Zainuddin, Ong Pauline, C. Ardil

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Diabetes Mellitus is a chronic metabolic disorder, where the improper management of the blood glucose level in the diabetic patients will lead to the risk of heart attack, kidney disease and renal failure. This paper attempts to enhance the diagnostic accuracy of the advancing blood glucose levels of the diabetic patients, by combining principal component analysis and wavelet neural network. The proposed system makes separate blood glucose prediction in the morning, afternoon, evening and night intervals, using dataset from one patient covering a period of 77 days. Comparisons of the diagnostic accuracy with other neural network models, which use the same dataset are made. The comparison results showed overall improved accuracy, which indicates the effectiveness of this proposed system.

Keywords: Diabetes Mellitus, principal component analysis, time-series, wavelet neural network.

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Authors: Mukhtar H. Hassan, Muhammed A. Basher, Elhadi E. Saad, Almahdi M. Almahdi

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The aim of this study was to demonstrate the possible effect of some variables such as age, gender, blood sugar level, and duration of diabetes on the serum level of zinc in diabetic individuals from Murzuk area. Serum zinc (Zn), Fasting blood sugar (FBS), hemoglobin HbA1c (HbA1c) were evaluated in 46 type I diabetic subjects (group 1), 48 type II diabetic subjects (group 2) and 43 healthy individuals (control) of both genders aged (30-81) years. Data showed that both diabetic groups have significantly higher (P<0.05) serum levels of Zn, FBS and HbA1c compared with controls. No significant (p>0.05) differences in serum Zn levels were observed between Males and Females. Serum Zn levels were non-significantly decreased with increasing age. In type II diabetic subjects, serum Zn levels were non-significantly decreased with increasing duration of disease whereas those in type I were non-significantly increased.

Keywords: Blood sugar, diabetes, HbA1c, zinc.

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Authors: Ireneusz Majsterek, Anna Merecz, Agnieszka Sliwinska, Marcin Kosmalski, Jacek Kasznicki, Jozef Drzewoski

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Oxidative stress is considered to be the cause for onset and the progression of type 2 diabetes mellitus (T2DM) and complications including neuropathy. It is a deleterious process that can be an important mediator of damage to cell structures: protein, lipids and DNA. Data suggest that in patients with diabetes and diabetic neuropathy DNA repair is impaired, which prevents effective removal of lesions. Objective: The aim of our study was to evaluate the association of the hOGG1 (326 Ser/Cys) and XRCC1 (194 Arg/Trp, 399 Arg/Gln) gene polymorphisms whose protein is involved in the BER pathway with DNA repair efficiency in patients with diabetes type 2 and diabetic neuropathy compared to the healthy subjects. Genotypes were determined by PCR-RFLP analysis in 385 subjects, including 117 with type 2 diabetes, 56 with diabetic neuropathy and 212 with normal glucose metabolism. The polymorphisms studied include codon 326 of hOGG1 and 194, 399 of XRCC1 in the base excision repair (BER) genes. Comet assay was carried out using peripheral blood lymphocytes from the patients and controls. This test enabled the evaluation of DNA damage in cells exposed to hydrogen peroxide alone and in the combination with the endonuclease III (Nth). The results of the analysis of polymorphism were statistically examination by calculating the odds ratio (OR) and their 95% confidence intervals (95% CI) using the ¤ç2-tests. Our data indicate that patients with diabetes mellitus type 2 (including those with neuropathy) had higher frequencies of the XRCC1 399Arg/Gln polymorphism in homozygote (GG) (OR: 1.85 [95% CI: 1.07-3.22], P=0.3) and also increased frequency of 399Gln (G) allele (OR: 1.38 [95% CI: 1.03-1.83], P=0.3). No relation to other polymorphisms with increased risk of diabetes or diabetic neuropathy. In T2DM patients complicated by neuropathy, there was less efficient repair of oxidative DNA damage induced by hydrogen peroxide in both the presence and absence of the Nth enzyme. The results of our study suggest that the XRCC1 399 Arg/Gln polymorphism is a significant risk factor of T2DM in Polish population. Obtained data suggest a decreased efficiency of DNA repair in cells from patients with diabetes and neuropathy may be associated with oxidative stress. Additionally, patients with neuropathy are characterized by even greater sensitivity to oxidative damage than patients with diabetes, which suggests participation of free radicals in the pathogenesis of neuropathy.

Keywords: Diabetic neuropathy, oxidative stress, gene polymorphisms, oxidative DNA damage.

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Authors: Arturo Aquino, Manuel Emilio Gegundez, Diego Marin

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In this paper, a new automated methodology to detect the optic disc (OD) automatically in retinal images from patients with risk of being affected by Diabetic Retinopathy (DR) and Macular Edema (ME) is presented. The detection procedure comprises two independent methodologies. On one hand, a location methodology obtains a pixel that belongs to the OD using image contrast analysis and structure filtering techniques and, on the other hand, a boundary segmentation methodology estimates a circular approximation of the OD boundary by applying mathematical morphology, edge detection techniques and the Circular Hough Transform. The methodologies were tested on a set of 1200 images composed of 229 retinographies from patients affected by DR with risk of ME, 431 with DR and no risk of ME and 540 images of healthy retinas. The location methodology obtained 98.83% success rate, whereas the OD boundary segmentation methodology obtained good circular OD boundary approximation in 94.58% of cases. The average computational time measured over the total set was 1.67 seconds for OD location and 5.78 seconds for OD boundary segmentation.

Keywords: Diabetic retinopathy, macular edema, optic disc, automated detection, automated segmentation.

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Authors: E. Nemes-Nagy, E. Fogarasi, M. Croitoru, A. Nyárádi, K. Komlódi, S. Pál, A. Kovács, O. Kopácsy, R. Tripon, Z. Fazakas, C. Uzun, Z. Simon-Szabó, V. Balogh-Sămărghițan, E. Ernő Nagy, M. Szabó, M. Tilinca

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Intense oxidative stress, increased glycated hemoglobin and mineral imbalance represent risk factors for complications in diabetic patients. Cardiovascular complications are most common in these patients, including nephropathy. This study was conducted in 2015 at the Procardia Laboratory in Tîrgu Mureș, Romania on 40 type 2 diabetic adults. Routine biochemical tests were performed on the Konleab 20XTi analyzer (serum glucose, total cholesterol, LDL and HDL cholesterol, triglyceride, creatinine, urea). We also measured serum uric acid, magnesium and calcium concentration by photometric procedures, potassium, sodium and chloride by ion selective electrode, and chromium by atomic absorption spectrometry in a group of patients. Glycated hemoglobin (HbA1c) dosage was made by reflectometry. Urine analysis was performed using the HandUReader equipment. The level of oxidative stress was measured by serum malondialdehyde dosage using the thiobarbituric acid reactive substances method. MDRD (Modification of Diet in Renal Disease) formula was applied for calculation of creatinine-derived glomerular filtration rate. GraphPad InStat software was used for statistical analysis of the data. The diabetic subject included in the study presented high MDA concentrations, showing intense oxidative stress. Calcium was deficient in 5% of the patients, chromium deficiency was present in 28%. The atherogenic cholesterol fraction was elevated in 13% of the patients. Positive correlation was found between creatinine and MDRD-creatinine values (p<0.0001), 68% of the patients presented increased creatinine values. The majority of the diabetic patients had good control of their diabetes, having optimal HbA1c values, 35% of them presented fasting serum glucose over 120 mg/dl and 18% had glucosuria. Intense oxidative stress and mineral deficiencies can increase the risk of cardiovascular complications in diabetic patients in spite of their good metabolic balance. More than two third of the patients present biochemical signs of nephropathy, cystatin C dosage and microalbuminuria could reveal better the kidney disorder, but glomerular filtration rate calculation formulas are also useful for evaluation of renal function.

Keywords: Cardiovascular risk, malondialdehyde, metabolic balance, minerals, type 2 diabetes.

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Authors: Murat Koklu, Yavuz Unal

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Data mining can be called as a technique to extract information from data. It is the process of obtaining hidden information and then turning it into qualified knowledge by statistical and artificial intelligence technique. One of its application areas is medical area to form decision support systems for diagnosis just by inventing meaningful information from given medical data. In this study a decision support system for diagnosis of illness that make use of data mining and three different artificial intelligence classifier algorithms namely Multilayer Perceptron, Naive Bayes Classifier and J.48. Pima Indian dataset of UCI Machine Learning Repository was used. This dataset includes urinary and blood test results of 768 patients. These test results consist of 8 different feature vectors. Obtained classifying results were compared with the previous studies. The suggestions for future studies were presented.

Keywords: Artificial Intelligence, Classifiers, Data Mining, Diabetic Patients.

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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

Abstract:

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.

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Authors: Naoto Suzuki

Abstract:

Many ophthalmologists find it difficult to distinguish between small retinal hemorrhages and dust artifacts when using fundus photography for the diagnosis of diabetic retinopathy. Six patients with diabetic retinopathy underwent fundus photography, which revealed dust artifacts in the photographs of some patients. We constructed an experimental device similar to the optical system of the fundus camera and colored the fundi of the artificial eyes with khaki, sunset, rose and sunflower colors. Using the experimental device, we photographed dust artifacts using each artificial eyes. We used Scilab 5.4.0 and SIVP 0.5.3 softwares to convert the red, green, and blue (RGB) color space to the hue, saturation, and value (HSV) color space. We calculated the differences between the areas of manifestations and perimanifestations and the areas of dust artifacts and periartifacts using average HSVs. The V values in HSV for the manifestations were as follows: hemorrhages, 0.06 ± 0.03; hard exudates, −0.12 ± 0.06; and photocoagulation marks, 0.07 ± 0.02. For dust artifacts, visualized in the human and artificial eyes, the V values were as follows: human eye, 0.19 ± 0.03; khaki, 0.41 ± 0.02; sunset, 0.43 ± 0.04; rose, 0.47 ± 0.11; and sunflower, 0.59 ± 0.07. For the human and artificial eyes, we calculated two sensitivity values of dust artifacts compared to manifestation areas. V values of the HSV color space enabled the differentiation of small hemorrhages, hard exudates, and photocoagulation marks from dust artifacts.

Keywords: Diabetic retinopathy, HSV color space, small hemorrhages, hard exudates, photocoagulation marks.

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Authors: Nneka N. Uchegbu

Abstract:

This study was conducted to investigate the effect of the antioxidant activity of germinated African Yam Bean (AYB) on oxidative stress markers in alloxan induced diabetic rat. Rats were randomized into three groups; control, diabetic and germinated AYB – treated diabetic rats. The Total phenol and flavonoid content and DPPH radical scavenging activity before and after germination were investigated. The glucose level, lipid peroxidation and reduced glutathione of the animals were also determined using standard technique for four weeks. Germination increased the total phenol, flavonoid and antioxidant activity of AYB extract by 19.14%, 32.28% and 57.25% respectively. The diabetic rats placed on germinated AYB diet had a significant decrease in the blood glucose and lipid peroxidation with a corresponding increase in glutathione (p<0.05). These results demonstrate that consumption of germinated AYB can be a good dietary supplement in inhibiting hyperglycemia/ hyperlipidemia and the prevention of diabetic complication associated with oxidative stress.

Keywords: African Yam Bean, Antioxidant, Diabetes, Total phenol.

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Authors: Ishtiaq Ahmed, Muhammad Naeem, Abdul Shakoor, Zaheer Ahmed, Hafiz Muhammad Nasir Iqbal

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The present study was conducted to observe the effect of Plantago psyllium on blood glucose and cholesterol levels in normal and alloxan induced diabetic rats. To investigate the effect of Plantago psyllium 40 rats were included in this study divided into four groups of ten rats in each group. One group A was normal, second group B was diabetic, third group C was non diabetic and hypercholesterolemic and fourth group D was diabetic and hypercholesterolemic. Two groups B and D were made diabetic by intraperitonial injection of alloxan dissolved in 1mL distilled water at a dose of 125mg/Kg of body weight. Two groups C and D were made hypercholesterolemic by oral administration of powder cholesterol (1g/Kg of body weight). The blood samples from all the rats were collected from coccygial vein on 1st day, then on 21st and 42nd day respectively. All the samples were analyzed for blood glucose and cholesterol level by using enzymatic kits. The blood glucose and cholesterol levels of treated groups of rats showed significant reduction after 7 weeks of treatment with Plantago psyllium. By statistical analysis of results it was found that Plantago psyllium has anti-diabetic and hypocholesterolemic activity in diabetic and hypercholesterolemic albino rats.

Keywords: Albino rats, alloxan, Plantago psyllium, statistical analysis

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Authors: E. F. Aransiola, M.O. Daramola, E. O. Iwalewa, A. M. Seluwa, O. O. Olufowobi

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Diabetes is a chronic metabolic disorder that affects the quality of life in terms of physical health, social and psychological well-being. In spite of the enormous progress in the treatment of diabetes using existing commercial drugs, such as, insulin and oral hypoglycemic agents, the quest and search for new drugs is imperative due to several limitations of the commercial drugs. In addition, the existing diabetic drugs are expensive and unaffordable by the rural populace in the developing countries. The present study demonstrates the anti-diabetic property of aqueous extract of Bryophyllum pinnatum (BP) leaves using diabetic rats (albino rats) as models. At the same time, the anti-diabetic effect of the aqueous extract was compared to that of a sample containing a mixture of the extract and a commercial diabetic medicine, glibenclamide. A specified dosage of aqueous extract of Bryophyllum pinnatum (BP) leaves was administered on the experimental diabetic rats, and their BGL was measured and recorded. The results showed a significant drop in the BGL of the diabetic rats to a value close to normal blood glucose level within 120 minutes when only aqueous extract from BP leaves was used. When a sample containing a mixture of the aqueous extract and glibenclamide was administered, a further drop in BGL was observed. Therefore, the results reveal that aqueous extract of Bryophyllum pinnatum leaves have significant anti-diabetic properties, and that the performance of the existing drugs (glibenclamide) could be enhanced with the use of the aqueous extract.

Keywords: Anti-diabetics, Bryophyllum pinnatum, Blood glucose level, albino rats.

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Authors: Wehash, F. E., Ismail I. Abo-Ghanema, Rasha Mohamed Saleh

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This study was conducted to evaluate the anti-diabetic properties of ethanolic extract of two plants commonly used in folk medicine, Mormodica charantia (bitter melon) and Trigonella foenum-graecum (fenugreek). The study was performed on STZinduced diabetic rats (DM type-I). Plant extracts of these two plants were given to STZ diabetic rats at the concentration of 500 mg/kg body weight ,50 mg/kg body weight respectively. Cidophage® (metformin HCl) were administered to another group to support the results at a dose of 500 mg/kg body weight, the ethanolic extracts and Cidophage administered orally once a day for four weeks using a stomach tube and; serum samples were obtained for biochemical analysis. The extracts caused significant decreases in glucose levels compared with diabetic control rats. Insulin secretions were increased after 4 weeks of treatment with Cidophage® compared with the control non-diabetic rats. Levels of AST and ALT liver enzymes were normalized by all treatments. Decreases in liver cholesterol, triglycerides, and LDL in diabetic rats were observed with all treatments. HDL levels were increased by the treatments in the following order: bitter melon, Cidophage®, and fenugreek. Creatinine levels were reduced by all treatments. Serum nitric oxide and malonaldehyde levels were reduced by all extracts. GSH levels were increased by all extracts. Extravasation as measured by the Evans Blue test increased significantly in STZ-induced diabetic animals. This effect was reversed by ethanolic extracts of bitter melon or fenugreek.

Keywords: Cidophage®, Diabetic rats, Mormodica charantia, Trigonella foenum-graecum

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Authors: Naoto Suzuki

Abstract:

To distinguish small retinal hemorrhages in early diabetic retinopathy from dust artifacts, we analyzed hue, lightness, and saturation (HLS) color spaces. The fundus of 5 patients with diabetic retinopathy was photographed. For the initial experiment, we placed 4 different colored papers on the ceiling of a darkroom. Using each color, 10 fragments of house dust particles on a magnifier were photographed. The colored papers were removed, and 3 different colored light bulbs were suspended from the ceiling. Ten fragments of house dust particles on the camera-s object lens were photographed. We then constructed an experimental device that can photograph artificial eyes. Five fragments of house dust particles under the ocher fundus of the artificial eye were photographed. On analyzing HLS color space of the dust artifact, lightness and saturation were found to be highly sensitive. However, hue was not highly sensitive.

Keywords: Dust artifact, HLS color space, Retinal hemorrhage, and Diabetic retinopathy

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Authors: Daniela Matei, Radu Matei

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In this paper a class of analog algorithms based on the concept of Cellular Neural Network (CNN) is applied in some processing operations of some important medical images, namely retina images, for detecting various symptoms connected with diabetic retinopathy. Some specific processing tasks like morphological operations, linear filtering and thresholding are proposed, the corresponding template values are given and simulations on real retina images are provided.

Keywords: Diabetic retinopathy, pathology detection, cellular neural networks, analog algorithms.

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Authors: Okolie Uchenna, Ehiemere Ijeoma, Ezenduka Pauline, Ogbu Sylvester

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A cross sectional survey design was used to collect data from 370 diabetic patients. Two instruments were used in obtaining data; in-depth interview guide and researchers- developed questionnaire. Fisher's exact test was used to investigate association between the identified factors and nonadherence. Factors identified were: socio-demographic factors such as: gender, age, marital status, educational level and occupation; psychosocial obstacles such as: non-affordability of prescribed diet, frustration due to the restriction, limited spousal support, feelings of deprivation, feeling that temptation is inevitable, difficulty in adhering in social gatherings and difficulty in revealing to host that one is diabetic; health care providers obstacles were: poor attitude of health workers, irregular diabetes education in clinics , limited number of nutrition education sessions/ inability of the patients to estimate the desired quantity of food, no reminder post cards or phone calls about upcoming patient appointments and delayed start of appointment / time wasting in clinics.

Keywords: Behavior change, diabetes mellitus, dietarymanagement, diet adherence.

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Authors: Syed Dawood Md. Taimur, Saidur Rahman Khan, Farzana Islam

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To evaluate the factors which predetermine the coronary artery disease in patients having positive Exercise Tolerance Test (ETT) that is treadmill results and coronary artery findings. This descriptive study was conducted at Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from 1st January, 2014 to 31st August, 2014. All patients who had done ETT (treadmill) for chest pain diagnosis were studied. One hundred and four patients underwent coronary angiogram after positive treadmill result. Patients were divided into two groups depending upon the angiographic findings, i.e. true positive and false positive. Positive treadmill test patients who have coronary artery involvement these are called true positive and who have no involvement they are called false positive group. Both groups were compared with each other. Out of 104 patients, 81 (77.9%) patients had true positive ETT and 23 (22.1%) patients had false positive ETT. The mean age of patients in positive ETT was 53.46± 8.06 years and male mean age was 53.63±8.36 years and female was 52.87±7.0 years. Sixty nine (85.19%) male patients and twelve (14.81%) female patients had true positive ETT, whereas 15 (65.21%) males and 8 (34.79%) females had false positive ETT, this was statistically significant (p<0.032) in the two groups (sex) in comparison of true and false positive ETT. The risk factors of these patients like diabetes mellitus, hypertension, dyslipidemia, family history and smoking were seen among these patients. Hypertensive patients having true positive which were statistically significant (p<0.004) and diabetic, dyslipidemic patients having true positive which were statistically significant (p<0.032 & 0.030).True positive patients had family history were 68(83.95%) and smoking were 52 (64.20%), where family history patients had statistically significant (p<0.017) between two groups of patients and smokers were significant (p<0.012). 46 true positive patients achieved THR which was not statistically significant (P<0.138) and 79 true patients had abnormal resting ECG whether it was significant (p<0.036). Amongst the vessels involvement the most common was LAD 55 (67.90 %) followed by LCX 42 (51.85%), RCA 36 (44.44%), and the LMCA was 9 (11.11%). 40 patients (49.38%) had SVD, 26 (30.10%) had DVD, 15(18.52%) had TVD and 23 had normal coronary arteries. It can be concluded that among the female patients who have positive ETT with normal resting ECG, who had achieved target heart rate are likely to have a false positive test result. Conversely male patients, resting abnormal ECG who had not achieved THR, symptom limited ETT, have a hypertension, diabetes, dyslipidemia, family history and smoking are likely to have a true positive treadmill test result.

Keywords: Exercise tolerance test, Coronary artery disease, Coronary angiography, True positive, False positive.

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Authors: J. Fernandez, N. Aguilar, R. Fernandez de Canete, J. C. Ramos-Diaz

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In this paper, a simulation model of the glucose-insulin system for a patient undergoing diabetes Type 1 is developed by using a causal modeling approach under system dynamics. The OpenModelica simulation environment has been employed to build the so called causal model, while the glucose-insulin model parameters were adjusted to fit recorded mean data of a diabetic patient database. Model results under different conditions of a three-meal glucose and exogenous insulin ingestion patterns have been obtained. This simulation model can be useful to evaluate glucose-insulin performance in several circumstances, including insulin infusion algorithms in open-loop and decision support systems in closed-loop.

Keywords: Causal modeling, diabetes, glucose-insulin system, diabetes, causal modeling, OpenModelica software.

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Authors: Nneka N. Uchegbu

Abstract:

Physical, sensory properties and hypoglycemic effect of crackers produced from sprouted pigeon pea, unripe plantain and brewers’ spent grain fed to diabetic rats were investigated. Different composite flours were used to produce crackers. Physical and sensory properties of the crackers, the blood serum of the rats and changes in the rat body weight were measured. Spread ratio and break strength of the crackers from different flour blends ranges from 7.01 g to 8.51 g and 1.87 g to 3.01 g respectively. The acceptability of the crackers revealed that Sample A (100% wheat crackers) was not significantly (p>0.05) different from Samples C and D. Feeding the rats with formulated crackers caused an increase in the body weight of the rats but a reduced body weight was observed in diabetic rats fed with normal rat feed. The result indicated that cracker produced from the formulated flour blends caused a significant hypoglycemic effect in diabetic rats and led to a reduction of measured biochemical indices. Therefore, this work showed that consumption of crackers from the above formulated flour blend was able to decrease hyperglycemia in diabetic rats.

Keywords: Hypoglycemia, hyperlipidemia, total lipid, triglyceride, total cholesterol.

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Authors: Ismail I. Abo Ghanema, Kadry M. Sadek

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Oxidative stress and overwhelming free radicals associated with diabetes mellitus are likely to be linked with development of certain complication such as retinopathy, nephropathy and neuropathy. Treatment of diabetic subjects with antioxidant may be of advantage in attenuating these complications. Olive leaf (Oleaeuropaea), has been endowed with many beneficial and health promoting properties mostly linked to its antioxidant activity. This study aimed to evaluate the significance of supplementation of Olive leaves extract (OLE) in reducing oxidative stress, hyperglycemia and hyperlipidemia in Sterptozotocin (STZ)- induced diabetic rats. After induction of diabetes, a significant rise in plasma glucose, lipid profiles except High density lipoproteincholestrol (HDLc), malondialdehyde (MDA) and significant decrease of plasma insulin, HDLc and Plasma reduced glutathione GSH as well as alteration in enzymatic antioxidants was observed in all diabetic animals. During treatment of diabetic rats with 0.5g/kg body weight of Olive leaves extract (OLE) the levels of plasma (MDA) ,(GSH), insulin, lipid profiles along with blood glucose and erythrocyte enzymatic antioxidant enzymes were significantly restored to establish values that were not different from normal control rats. Untreated diabetic rats on the other hand demonstrated persistent alterations in the oxidative stress marker (MDA), blood glucose, insulin, lipid profiles and the antioxidant parameters. These results demonstrate that OLE may be of advantage in inhibiting hyperglycemia, hyperlipidemia and oxidative stress induced by diabetes and suggest that administration of OLE may be helpful in the prevention or at least reduced of diabetic complications associated with oxidative stress.

Keywords: Diabetes mellitus, olive leaves, oxidative stress, red blood cells

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Authors: Ceren Kaya, Okan Erkaymaz, Orhan Ayar, Mahmut Özer

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Diabetes Mellitus (Diabetes) is a disease based on insulin hormone disorders and causes high blood glucose. Clinical findings determine that diabetes can be diagnosed by electrophysiological signals obtained from the vital organs. 'Diabetic Retinopathy' is one of the most common eye diseases resulting on diabetes and it is the leading cause of vision loss due to structural alteration of the retinal layer vessels. In this study, features of horizontal and vertical Video-Oculography (VOG) signals have been used to classify non-proliferative and proliferative diabetic retinopathy disease. Twenty-five features are acquired by using discrete wavelet transform with VOG signals which are taken from 21 subjects. Two models, based on multi-layer perceptron and radial basis function, are recommended in the diagnosis of Diabetic Retinopathy. The proposed models also can detect level of the disease. We show comparative classification performance of the proposed models. Our results show that proposed the RBF model (100%) results in better classification performance than the MLP model (94%).

Keywords: Diabetic retinopathy, discrete wavelet transform, multi-layer perceptron, radial basis function, video-oculography.

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Authors: T. Wresdiyati, S. Sa’diah, A. Winarto

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Diabetes mellitus (DM) is a metabolic disease that can be indicated by the high level of blood glucose. The objective of this study was to observe the antidiabetic properties of ethanolic extract of Indonesian Swietenia mahagoni Jacq. seed on the profile of pancreatic superoxide dismutase and β-cells in the alloxan- experimental diabetic rats. The Swietenia mahagoni seed was obtained from Leuwiliang-Bogor, Indonesia. Extraction of Swietenia mahagoni was done by using ethanol with maceration methods. A total of 25 male Sprague dawley rats were divided into five groups; (a) negative control group, (b) positive control group (DM), (c) DM group that was treated with Swietenia mahagoni seed extract, (d) DM group that was treated with acarbose, and (e) non-DM group that was treated with Swietenia mahagoni seed extract. The DM groups were induced by alloxan (110 mg/kgBW). The extract was orally administrated to diabetic rats 500 mg/kg/BW/day for 28 days. The extract showed hypoglycemic effect, increased body weight, increased the content of superoxide dismutase in the pancreatic tissue, and delayed the rate of β-cells damage of experimental diabetic rats. These results suggested that the ethanolic extract of Indonesian Swietenia mahagoni Jacq. seed could be proposed as a potential anti-diabetic agent.

Keywords: β-cell, diabetes mellitus, superoxide dismutase, Swietenia mahagoni.

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Authors: A. Sopharak, B. Uyyanonvara, S. Barman

Abstract:

Microaneurysm is a key indicator of diabetic retinopathy that can potentially cause damage to retina. Early detection and automatic quantification are the keys to prevent further damage. In this paper, which focuses on automatic microaneurysm detection in images acquired through non-dilated pupils, we present a series of experiments on feature selection and automatic microaneurysm pixel classification. We found that the best feature set is a combination of 10 features: the pixel-s intensity of shade corrected image, the pixel hue, the standard deviation of shade corrected image, DoG4, the area of the candidate MA, the perimeter of the candidate MA, the eccentricity of the candidate MA, the circularity of the candidate MA, the mean intensity of the candidate MA on shade corrected image and the ratio of the major axis length and minor length of the candidate MA. The overall sensitivity, specificity, precision, and accuracy are 84.82%, 99.99%, 89.01%, and 99.99%, respectively.

Keywords: Diabetic retinopathy, microaneurysm, naive Bayes classifier

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Authors: Sh. Yasini, M. B. Naghibi-Sistani, A. Karimpour

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This paper employs a new approach to regulate the blood glucose level of type I diabetic patient under an intensive insulin treatment. The closed-loop control scheme incorporates expert knowledge about treatment by using reinforcement learning theory to maintain the normoglycemic average of 80 mg/dl and the normal condition for free plasma insulin concentration in severe initial state. The insulin delivery rate is obtained off-line by using Qlearning algorithm, without requiring an explicit model of the environment dynamics. The implementation of the insulin delivery rate, therefore, requires simple function evaluation and minimal online computations. Controller performance is assessed in terms of its ability to reject the effect of meal disturbance and to overcome the variability in the glucose-insulin dynamics from patient to patient. Computer simulations are used to evaluate the effectiveness of the proposed technique and to show its superiority in controlling hyperglycemia over other existing algorithms

Keywords: Insulin Delivery rate, Q-learning algorithm, Reinforcement learning, Type I diabetes.

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Authors: Muhammad Zeeshan UlHaque, Peng Du, Leo K. Cheng, Marc D. Jacobs

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Sensory nerves in the foot play an important part in the diagnosis of various neuropathydisorders, especially in diabetes mellitus.However, a detailed description of the anatomical distribution of the nerves is currently lacking. A computationalmodel of the afferent nerves inthe foot may bea useful tool for the study of diabetic neuropathy. In this study, we present the development of an anatomically-based model of various major sensory nerves of the sole and dorsal sidesof the foot. In addition, we presentan algorithm for generating synthetic somatosensory nerve networks in the big-toe region of a right foot model. The algorithm was based on a modified version of the Monte Carlo algorithm, with the capability of being able to vary the intra-epidermal nerve fiber density in differentregionsof the foot model. Preliminary results from the combinedmodel show the realistic anatomical structure of the major nerves as well as the smaller somatosensory nerves of the foot. The model may now be developed to investigate the functional outcomes of structural neuropathyindiabetic patients.

Keywords: Diabetic neuropathy, Finite element modeling, Monte Carlo Algorithm, Somatosensory nerve networks

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Authors: Raad Nari, Maura Moriaty, Maha T. Barakat

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Introduction: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs with a unique mechanism of action. They are used to improve glycaemic control in adults with type 2 diabetes by enhancing urinary glucose excretion. In the UAE, there has been certainly an increased use of these medications. As with any new medication, there are safety considerations related to their use in patients with type two diabetes. A retrospective study was conducted at the three main centres of the Imperial College London Diabetes Centre. Methodology: All patients in electronic database (Diamond) from October 2014 to October 2017 were included with a minimum of six months usage of sodium glucose co-transporter inhibitors that comprise canagliflozin, dapagliflozin and empagliflozin. There were 15 paired sample biochemical and clinical correlations. The analysis was done at the start of the study, three months and six months apart. SPSS version 24 was used for this study. Conclusion: This study of sodium glucose co-transporter-2 inhibitors used showed significant reductions in weight, glycated haemoglobin A1C, systolic and diastolic blood pressures. As the case with systematic reviews, there were similar changes in liver enzymes, raised total cholesterol, low density lipopoptein and high density lipoprotein. There was slight improvement in estimated glomerular filtration rate too. Our analysis also showed that they increased in the incidence of urinary tract symptoms and incidence of urinary tract infections.

Keywords: SGLT2 inhibitors dapagliflozin empagliflozin canagliflozin, adverse effects, amputation diabetic ketoacidosis DKA, urinary tract infection.

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Authors: A. Biran, P. Sobhe Bidari, A. Almazroe V. Lakshminarayanan, K. Raahemifar

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Diabetic Retinopathy (DR) is a severe retinal disease which is caused by diabetes mellitus. It leads to blindness when it progress to proliferative level. Early indications of DR are the appearance of microaneurysms, hemorrhages and hard exudates. In this paper, an automatic algorithm for detection of DR has been proposed. The algorithm is based on combination of several image processing techniques including Circular Hough Transform (CHT), Contrast Limited Adaptive Histogram Equalization (CLAHE), Gabor filter and thresholding. Also, Support Vector Machine (SVM) Classifier is used to classify retinal images to normal or abnormal cases including non-proliferative or proliferative DR. The proposed method has been tested on images selected from Structured Analysis of the Retinal (STARE) database using MATLAB code. The method is perfectly able to detect DR. The sensitivity specificity and accuracy of this approach are 90%, 87.5%, and 91.4% respectively.

Keywords: Diabetic retinopathy, fundus images, STARE, Gabor filter, SVM.

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Authors: Tayyab Hassan, Talha Rehman, Qasim Abdul Aziz, Ahmad Salman

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The constant monitoring of blood glucose level is necessary for maintaining health of patients and to alert medical specialists to take preemptive measures before the onset of any complication as a result of diabetes. The current clinical monitoring of blood glucose uses invasive methods repeatedly which are uncomfortable and may result in infections in diabetic patients. Several attempts have been made to develop non-invasive techniques for blood glucose measurement. In this regard, the existing methods are not reliable and are less accurate. Other approaches claiming high accuracy have not been tested on extended dataset, and thus, results are not statistically significant. It is a well-known fact that acetone concentration in breath has a direct relation with blood glucose level. In this paper, we have developed the first of its kind, reliable and high accuracy breath analyzer for non-invasive blood glucose measurement. The acetone concentration in breath was measured using MQ 138 sensor in the samples collected from local hospitals in Pakistan involving one hundred patients. The blood glucose levels of these patients are determined using conventional invasive clinical method. We propose a linear regression classifier that is trained to map breath acetone level to the collected blood glucose level achieving high accuracy.

Keywords: Blood glucose level, breath acetone concentration, diabetes, linear regression.

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Authors: Hala O. El-Mesallamy, Salwa M. Suwailem, Mae M. Seleem

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Visfatin and apelin are two new adipokines that recently gained a special interest in diabetes research. This study was conducted to study the interplay between these two adipokines and their correlation with other inflammatory and biochemical parameters in type 2 diabetic (T2D) postmenopausal women with CAD. Visfatin and apelin were measured by enzyme-linked immunoassay (ELISA). Visfatin was found to be significantly higher in the following groups: T2D patients without CAD, non-obese and obese T2D patients with CAD when compared to control group. Apelin was found to be significantly lower in non-obese and obese T2D patients with CAD when compared to control group. Visfatin and apelin were found to be significantly associated with each other and with other biochemical parameters. The current study provides evidence for the interplay between visfatin and apelin through the inflammatory milieu characteristic of T2D and their possible role in the pathogenesis of CAD complication of T2D. 

Keywords: Apelin, Coronary artery disease, Inflammation, Type 2 diabetes, Visfatin.

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