DIABETES RESEARCH: OPEN ACCESS
About this Journal
Diabetes Research: Open Access is an Open Access Journal which releases Scholarly Articles featuring the content about Diabetes and Endocrinology.
The extent of the journal incorporates endocrine organs, hormonal discharges, hormonal receptors and the hormone controlled metabolic pathways. It also includes the clinical investigation of disorders related to Diabetes.
The articles including diabetes featured symptoms, causes, pathophysiology, conclusion,…
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Author(s): Masaki OKADA, Hiroshi BANDO*, Noboru IWATSUKI, Kazuki SAKAMOTO, Tomoya OGAWA
Background: Imeglimin (Twymeeg) has been effective for patients with type 2 diabetes (T2D).
Case Presentation: The patient is an 82-year-old female with T2D, arthralgia, and depression.
Results: She was given duloxetine hydrochloride (Cymbalta) and Twymeeg, leading to improved symptoms of low back pain (LBP), knee osteoarthritis, osteoporosis, depression, and possible mild cognitive impairment (MCI). HbA1c decreased from 8.8% to 7.1% for 4 months with a single administration of Twymeeg 2000mg/day.
Discussion: In recent clinical practice, elderly cases often tend to have simultaneously these problems, which are medical and social crucial problems. Twymeeg and Cymbalta may be indispensable agents for future practice.
Hyperglycemia has been the primary metabolic condition for the origin of diabetic complications. The glucose in the cell is underutilized due to diminished entry of glucose into the cell and down-regulation of the Pentose Phosphate Pathway. The PPP is the potential pathway in maintaining the defense of the cell through GPx, GR, GSH, and GSSG. Particularly, GPx and GSH levels diminish in diabetes. Constipation in diabetes also plays an important role in decreasing the immune system as the excess glucose in the gut lining enhances the number of gut bacteria and fungi. Antioxidants have not been proved to enhance the immune and defense of cells in diabetes but the exhibitory roles of herbal medicines have been potential in exaggerating the immune and defense system by their unknown modulators and enhancers molecules. Turmeric and black pepper have been proven to enhance the immune and defense of the body in diabetics.
Background: Recent diabetic treatments include Insulin Degludec/liraglutide (IDeg/Lira, Xultophy) in clinical practice. Authors have continued clinical research concerning diabetes, chronic renal failure, dialysis, and others.
Subjects and Methods: Ten patients with type 2 diabetes mellitus (T2DM) undergoing hemodialysis were investigated. They showed that ages 74.5 ± 5.9 years, M/F=6/4, BMI 21.1± 3.8kg/m2, hemodialysis duration 8.1± 5.7 years. At the beginning, fundamental data were Cre 8.2 ± 1.9 mg/dL, HbA1c 6.5 ± 0.8%. Xultophy was started on 5-12 doses and continued for 6 months with the same or 1-4 increased doses for better glycemic variability.
Results: Out of 10 subjects, the changes in HbA1c showed a decrease in 7, stable in 2, and an increase in 1. HbA1c value was 6.2 ± 0.8% in average at 6 months. There were no remarkable adverse effects by Xultophy for 6 months.
Discussion and Conclusion: Xultophy was started at 5-12 doses, which were remarkably lower doses than usual doses with satisfactory efficacy. One of the reasons may be from the characteristic of the patients, who were diabetic with undergoing hemodialysis. Another factor is possibly from liraglutide, which has hepatic clearance with potential vascular protective effects. These results are expected to become reference data for future research.
Background: It is unclear whether metformin should be continued or discontinued in patients with coronavirus disease 2019 (COVID-19) admitted to the hospital.
Objective: To review metformin safety, particularly its impact on mortality among hospitalized patients with COVID-19.
Methods: Review of English literature by PUBMED search until September 11, 2020. Search terms included diabetes, COVID-19, metformin, Retrospective studies, meta-analyses, pertinent reviews, pre-print articles, and consensus guidelines are reviewed.
Results: Retrospective studies suggest that metformin use prior to hospital admission may be associated with decreased mortality in patients with diabetes admitted to the hospital with COVID-19. Continuing metformin use after hospital admission did not have a significant impact on 28-day all-cause mortality. Metformin use after hospitalization of patients with COVID-19 was associated with approximately 4.6 times increase risk of lactic acidosis in patients with severe symptoms of COVID-19, patients taking 2 gm/d of metformin or higher, and patients with estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 kg/m2. Metformin use in the hospital was associated with a significant decrease in the risk of heart failure and acute respiratory distress syndrome (ARDS).
Conclusions: In patients with diabetes and COVID-19 admitted to the hospital, metformin should not be used in presence of severe symptoms of COVID-19, kidney dysfunction (eGFR < 60 ml/min/1.73 m2), and with daily doses of 2 gm or more due to increased risk of lactic acidosis.
This research aims to analyze income-related mortality by diabetes mellitus in a municipality inside the state of Sao Paulo, Brazil, from 2010 to 2014. It is about an ecological study and temporal tendency, it was analyzed, descriptively and spatially, the income-related deaths by diabetes mellitus from 2010 to 2014. There were 583 deaths, mostly (55.06%) in sex female. It highlights, the negative spatial relation between the incomes of up to two minimum wages per capita and mortality rate by diabetes mellitus (I= -0.13). The southern region was identified as a protection area (RR= 0.39; 95%CI= 0.29-0.54) for the occurrence of mortality by diabetes mellitus in both sexes. It is hoped that the findings in this study may foster and guide prevention strategies, and health care advance for the low-income groups and residents in risk areas.
Objective: Liraglutide (LIRA), a Glucagon-like peptide-1 (GLP-1) receptor agonist, showed potential vascular protective effects with the mechanism remained incompletely understood. Therefore, this study aimed to investigate whether LIRA exerts its effect on vascular endothelial function in rats with type 2 diabetes mellitus (T2DM) via caveolin-1/ endothelial oxide synthase (eNOS) expression.
Methods: T2DM rats were used as study subjects and randomly divided into four groups: 1) Veh group, 2) Veh+LIRA group, 3) T2DM group, and 4) T2DM+LIRA group. All rats received either saline or LIRA 0.2 mg/kg (by i.p. injection) per day for 4 weeks. After the model was successfully established, vascular endothelial function was determined the effect of vasodilator to mesenteric artery rings. Immunofluorescence and western blot were performed to understand the molecular mechanism. Cultured HUVECs with small interfering RNA (siRNA) under high glucose (HG), NO concentration, and western blot were performed to understand the molecular mechanism between LIRA and vascular endothelial function.
Results: Based on our results, the LIRA reduced hyperglycemia and ameliorated vascular endothelial dysfunction in type 2 diabetic mice. LIRA activated eNOS phosphorylation, suppressing oxidative stress and enhancing endothelium-dependent vasorelaxation of mesenteric arteries. Besides, from its anti-oxidative capacity, LIRA activated eNOS to dilate the mesenteric arteries via the downregulation of Cav-1.
Conclusion: LIRA ameliorates vascular endothelial dysfunction in rats with type 2 diabetes mellitus via anti-oxidative and activated eNOS by downregulated Cav-1.
This study aims to explore the possibility of the existence of dyslipidemia among prediabetics in India and to find the correlation if any, present between their glycated hemoglobin (HbA1c) levels and their lipid profile, and to identify the risk factor(s) if any, for the onset of diabetes. A cross-sectional study involving 212 individuals in Bangalore of Karnataka State, India from the period of August 2017 to February 2019 was considered for the study. Within the lipid profile, High-Density Lipoprotein (HDL) and the ratio of cholesterol to HDL displayed statistically significant differences between the means of the population of healthy nondiabetics and prediabetics. In prediabetics, HbA1c was negatively correlated with HDL. so, testing of HDL and cholesterol to HDL ratio at regular intervals for prediabetics should be made mandatory, as they fall in the risk category for developing type 2 Diabetes and this regular screening of HDL and Cholesterol to HDL ratio will prevent prediabetics from progressing into type2 diabetes later on. Regarding demographic factors, abdominal obesity was found to be statistically significantly associated with prediabetes. Hence prediabetics should follow a regular exercise regime to prevent themselves from progressing into diabetes in their later years.