Determining the Effect of a High Fructose Diet on Interscapular Brown Adipose Tissue LPL, Cellularity and Lipid Deposition in Aging Congenic Obese-T2DM Rats | Chapter 10 | Contemporary Research and Perspectives in Biological Science Vol. 2

 

The present study aimed to determine the effect of a high fructose diet on brown adipose tissue development in aging congenic obese T2DM rats. The physiological merits of brown adipose tissue (BAT) metabolism as an efficient potential energy buffer that when deficient, may be a contributor to excess fat accretion and to the development of obesity in man and animals.  As such, it offers to be a potential target for therapies that could be developed for its treatment. To determine the effects of dietary fructose consumption on development and cellularity of brown adipose tissue in T2DM, groups of lean and obese SHR/Ntul//-cp rats demonstrating insulin resistance (IR) and heritable T2DM were fed diets containing 54% (w/w) carbohydrate as cornstarch (CS diet) or equal parts CS plus fructose (CSF diet) plus essential proteins, fats, vitamins, minerals, and dietary fiber from one to nine months of age.  The SHR/Ntul//-cp rat is a congenic animal model in which the only genetic difference between the phenotypes is the epigenetic inheritance and natural expression of the obese (-cp) trait, which is distinct from dietary, toxicologic, or pharmacologic factors and is accompanied by the development of chronic insulin resistance (IR) and non-insulin-dependent diabetes (T2DM) shortly after weaning in the obese phenotype.

 

The effects of this study indicate that final weight gain and Interscapular brown adipose tissue mass and cellularity are significantly greater in the obese than in the lean phenotype. In addition, the effects of a high fructose diet resulted in only modest increases in body weight gain, and in differential effects on IBAT cellularity and cell lipid content. Weight gain of obese >> lean and was greater when fed the CSF than the CS diet in both phenotypes; Interscapular brown adipose tissue (IBAT) mass of obese >> Lean and was similar in both phenotypes.  IBAT Mass: Body weight of Obese >> lean, and trended greater in lean CSF vs CS but less in Obese CSF vs CS. IBAT cell size and lipid content of obese >> lean, and the CS vs CSF diet was similar in lean but decreased in the obese phenotype. IBAT cell number of obese >>> lean, while IBAT cell number of lean CSF > lean CS, but IBAT cell number of obese was similar with both diets.  Lipoprotein lipase activity (LPL) of lean >> obese and trended to be greater with the CSF than the CS diet in both phenotypes and IBAT tissue lipid content of obese >> lean with a trend toward CSF > CS in both phenotypes. These results indicate that IBAT development occurs via hyperplasia and hypertrophy in the Obese phenotype of this strain and that long term consumption of the high Fructose diet enhances IBAT cellularity in the lean phenotype while the IBAT cellularity was maximally enhanced by both diets in the obese phenotype.

 

These results further indicate that the impact of long-term consumption of a high fructose diet throughout much of the natural lifespan impacts the development of IBAT mass and cellularity differentially in the lean and obese+T2DM phenotype, likely at least in part due to contributions of longstanding IR in the obese+T2DM animals. Because IR is known to impede cellular glucose uptake in isolated brown adipocytes as an essential process in the expression of cellular thermogenic responses, any potential mechanisms to override or bypass the process or decrease the magnitude of IR would be presumed to exert a beneficial effect. Fructose may increase the potential for the expression of IBAT development and the expression of non-shivering thermogenesis in response to changes in food and environment because it can enter tissues independently of insulin activities, for example, through the GLUT1 and GLUT5 transporters. Nevertheless, in the current investigation, it was discovered that overall fructose consumption was neither significantly advantageous nor ameliorative in resolving crucial parameters of brown adipose tissue expression as contributors to the development of obesity in the obese+T2DM phenotype.

Author (s) Details

Orien L Tulp
Colleges of Medicine and Graduate Studies, University of Science Arts and Technology, Montserrat, BWI MSR1110 and Einstein Medical Institute, N. Palm Beach, FL, 33408, USA.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/crpbs/v2/2210

Relationship of BMI and rs12255372 TCF7L2 Polymorphism on the Conversion to Type 2 Diabetes Mellitus in Lactating Women with Previous Gestational Diabetes | Chapter 2 | Medical Science: Trends and Innovations Vol. 13

Women with previous gestational diabetes mellitus (pGDM) have a high risk of developing postpartum type 2 diabetes mellitus (T2DM). Several reports have shown that approximately 50% of women with GDM will develop diabetes within 5 years. There are other risk factors for postpartum diabetes as a family history of diabetes, pre-pregnancy and postpartum body mass index, dietary patterns, physical activity, and breastfeeding. This study aimed to analyse the relationship between BMI and rs12255372 TCF7L2 polymorphisms in the conversion to T2DM in lactating women with pGDM. One hundred and fifty-three women con pGDM were recruited from public hospitals of León, Guanajuato, México. Three groups: normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and T2DM after the oral glucose tolerance test were formed. All women were interviewed and asked about their glycemic control and the time since their last glucose test. Serum glucose concentrations and lipid profiles were measured using enzymatic methods with an analyser. Metabolic and hormone variables were measured, and genotyping was performed. The questionnaire included data on lactation (yes/no), duration of lactation, and full lactation. After 35 (21–49) months from the last partum, 54% of women had an NGT, 30.7% IGT, and 15% T2DM. BMI and rs12255372 are associated with the risk of conversion to IGT and T2DM [OR = 1.07 (95% IC 1.0–1.14, p = 0 .041, OR = 2.14, 95% IC 1.01–4.55, p = 0 .04 respectively), while the lactation shows a strong protective effects OR = 0.15 (95% IC 0.062–0.39, p = 0.00007), and an apparent interaction with rs12255372T decreasing the risk in carriers (OR = 2.15, 95% IC 0.97–4.7, p = 0 .05). BMI is an independent risk factor of IGT/T2DM development. Both sporadic and long-term breastfeeding are associated with a lower risk of T2DM and a better metabolic profile in women with a history of GDM. The multivariate analysis revealed that both BMI and the rs12255372 predicted the conversion to IGT and T2DM in women with pGDM.  The lactation shows a strong protective effect and a possible interaction with rs12255372 polymorphism. In conclusion, it means that lactation and polymorphism share variability by means of an interaction of an unidentified nature. Further studies are necessary to confirm a possible interaction of rs12255372 TCF7L2 with full breastfeeding and lactation duration.

 

Author (s) Details

 

Ruth Reyes-López
Department of Medical Sciences, Health Sciences Division, University of Guanajuato, Leon Campus, Mexico.

 

Elva Perez-Luque
Department of Medical Sciences, Health Sciences Division, University of Guanajuato, Leon Campus, Mexico.

 

Juan Manuel Malacara
Department of Medical Sciences, Health Sciences Division, University of Guanajuato, Leon Campus, Mexico.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v13/5153

Gut Hormones in T2 Diabetes Mellitus and Emerging Treatment Paradigm | Chapter 14 | Medical Science: Trends and Innovations Vol. 10

Diabetes mellitus (DM) is a chronic metabolic disease of major public health concern worldwide. DM prevalence is more alarming in low and middle-income countries than in high-income countries. DM characterized by insulin resistance (IR) or deficiency is either insulin-dependent (T1DM) or non-insulin-dependent (T2DM). Among the T2DM cases, 50% are not properly medicated due to poor knowledge and coverage of treatment. T2DM is a condition of insensitivity of pancreatic β-cells to glucose-stimulated insulin release and impairment of skeletal muscle cells to insulin-stimulated glucose entry, IR. Impaired regulation of incretin hormones which reduce BG levels is a fundamental defect in the pathogenesis of T2DM. The Gut-brain axis has a key role in the regulation of energy homeostasis and glucose metabolism through the action of various hormones. Gut hormones are peptides synthesized by specialized enteroendocrine cells located in the epithelium of the stomach, small bowel and large bowel. Gut hormones activate neural circuits to signal peripheral organs for coordination of overall energy intake and assimilation. Incretins, Leptin, CCK, Oxyntomodulin, PYY and Gastrin are the major gut hormones involved in glucose metabolism. A group of gut peptides that are secreted after nutrient intake and stimulate insulin secretion together with hyperglycemia are known as incretin hormones. Certain gut hormones like cholecystokinin (CCK) and gastrin are reported to activate pathways that promote islet neogenesis and improve glucose homeostasis in T2DM. Currently, DPP-4-resistant GLP-1 receptor agonists (incretin mimetics), and inhibitors of DPP-4 activity (incretin enhancers) are being successfully used clinically for the treatment of T2diabetes mellitus. Presently, hormonal synergy is of therapeutic interest for the treatment of diabetes mellitus. Gut hormones such as OXM, ghrelin and PYY play a crucial role in the regulation of glucose. Pleiotropic actions of leptin reported to lower glucose is also, an area of investigation for hyperglycemia. Studies have proved that these hormonal actions are a possible platform for therapeutic development in T2DM management. The study also concluded that bariatric surgery has given new thinking on exploiting hormonal changes to target future medical therapies for Type 2 diabetes mellitus. It may be possible to reset metabolism and reverse diabetes taking advantage of knowledge gained from bariatric surgery.

 

Author (s) Details

 

S S Sreenivas
ICAR-CTRI, Research Station, Hunsur 571105, Karnataka, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v10/4748

Impact of Luminal α-Glucosidase Inhibition on Lipogenic and Glycaemic Enzymes in Obese Diabetic Rats: Consequences for the Treatment of Type 2 Diabetes | Chapter 5 | Medical Science: Trends and Innovations Vol. 10

The global prevalence of obesity+T2DM is approaching endemic proportions throughout much of Industrializes society, with no easy resolution on the horizon. In these conditions, the activities of certain insulin-linked glycemic and lipogenic enzymes including glucokinase, malic enzyme, and glucose-6-phosphate dehydrogenase typically become elevated, as consistent contributors to the elevations in plasma lipid profiles and relative adiposity that are also typically observed in such individuals. The use of miglitol, an alpha-glucosidase inhibitor, has been shown to cause a dose-related delay in luminal sucrose digestion in the upper regions of the small intestine, and in an attenuated and delayed response in the glycemic excursions that normally follow a carbohydrate meal. This study aims to determine the effect of delayed carbohydrate (sucrose) digestion in type 2 diabetes mellites on the activity of glycemic and lipogenic enzyme parameters. Groups (n=6-8/group, mean BW 264±5g vs 263±4g) of young adult male obese T2DM (diabetic) SHR/Ntul//-cp rats were fed a nutritionally complete USDA-formulated diet containing 54% sucrose (CONTROL) or the same diet with 150 mg of the luminal α-glucosidase inhibitor miglitol (MIG) for up to 8 weeks. Standardized analytical procedures established in our laboratory were utilized to quantify the findings. All the collected data were analyzed via standard statistical procedures including student t-test, ANOVA, and Pages L test for trend analysis. All animals demonstrated profound (4+) glycosuria by 8 weeks of age to confirm T2 DM. Body Weight Gain (BWG), relative adiposity and glycosuria were elevated in control animals but decreased significantly following miglitol. Measures of oral Glucose Tolerance (OGT, 250 mg glucose/kg BW, via gavage), AUC for glucose and insulin response to OGT and glycated hemoglobin (HbA1c) were elevated in controls and decreased by 20% after miglitol treatment. Hepatic Glucokinase (GK), malic enzyme (ME) and glucose-6-phosphate dehydrogenase (G6PD) were elevated in the Controls and decreased toward normalization following miglitol treatment. In conclusion, these observations indicate that an 8-week course of miglitol is an effective agent in improving the magnitude of the elevated glycemic and lipogenic enzymes and their impact on developing adiposity in the SHR/Ntul//-cp genetic rat strain of obesity+T2DM and may be an effective adjunct in clinical management of obesity, hyperlipidemia and T2DM. In future studies, it would be productive to extend the luminal therapeutic options beyond the post-adolescent life stage of this investigation to more fully determine the long-term potential of the physiological benefits of luminal α-glucosidase inhibition health and longevity in an animal model predisposed to early onset obesity, insulin resistance and T2DM.

 

Author (s) Details

Orien Lee Tulp
University of Science, Arts and Technology, USA.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v10/4703

A Comprehensive Review on Evolving Landscape of Drug Therapies for Diabetes | Chapter 2 | Medical Research and Its Applications Vol. 4

 

The last decade has seen the advent of new medications for lowering blood glucose levels. These medications also exhibit a remarkable capacity to alleviate cardiovascular risk factors. This comprehensive review highlights the evolving landscape of pharmacotherapy in diabetes, the drugs currently available for treating diabetes, their effectiveness and efficacy, the impact on target organs, and side effects. This review also provides an overview of oral and injectable non-insulin medications used to improve blood glucose levels. This work also provides insights that can support the customization of treatment strategies. We delve into the concept of precision medicine and explore the role of older drugs in patient management. Furthermore, we present a proposal for a groundbreaking approach to the treatment of type 2 diabetes, with an emphasis on striving for a cure for the disease. The treatment of type 2 diabetes (T2D) necessitates a multifaceted approach that combines behavioral and pharmacological interventions to mitigate complications and sustain a high quality of life. Treatment encompasses the management of glucose levels, weight, cardiovascular risk factors, comorbidities, and associated complications through medication and lifestyle adjustments. Metformin, a standard in diabetes management, continues to serve as the primary, first-line oral treatment across all age groups due to its efficacy, versatility in combination therapy, and cost-effectiveness. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) offer notable benefits for HbA1c and weight reduction, with significant cardiovascular benefits. Sodium-glucose cotransporter inhibitors (SGLT-2i) lower glucose levels independently of insulin while conferring notable benefits for cardiovascular, renal, and heart-failure outcomes. Combined therapies emphasizing early and sustained glycemic control are promising options for diabetes management. As insulin therapy remains pivotal, metformin and non-insulin agents such as GLP-1 RA and SGLT-2i offer compelling options. Notably, exciting novel treatments like the dual GLP-1/ glucose-dependent insulinotropic polypeptide (GIP) agonist show promise for substantially reducing glycated hemoglobin and body weight. Recent studies have highlighted a clear correlation between reducing HbA1c to less than 6.5% and a significant decrease in microvascular and macrovascular complications. Studies also suggest the potential benefits of primary combined therapy for glycemic management in diabetes compared to monotherapy with metformin across a wide range of baseline HbA1c levels. The most effective way to manage diabetes is to treat it with a combination therapy from the time of initial diagnosis. To help medical staff choose the ideal drug combination for each patient, the National Diabetes Council in Israel developed a calculator that recommends the most appropriate combination therapy based on the patient’s BMI, HbA1c levels, and risk for ischemic heart disease, stroke, renal function, and heart failure. Along with the most appropriate drug treatment, a healthy lifestyle is extremely important.

 

Author(s)details:-

 

Roni Weinberg Sibony
Faculty of Medicine, Ben-Gurion University, Beer Sheva 8443944, Israel.

 

Omri Segev
Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.

Saar Dor
Faculty of Medicine, Ben-Gurion University, Beer Sheva 8443944, Israel.

 

Itamar Raz
Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112001, Israel and Department of Endocrinology and Metabolism, Diabetes Unit, Hadassah Medical Center, Jerusalem 91240, Israel.

 

Please See the book here :- https://doi.org/10.9734/bpi/mria/v4/11972F

A Comprehensive Review on Evolving Landscape of Drug Therapies for Diabetes | Chapter 2 | Medical Research and Its Applications Vol. 4

 

The last decade has seen the advent of new medications for lowering blood glucose levels. These medications also exhibit a remarkable capacity to alleviate cardiovascular risk factors. This comprehensive review highlights the evolving landscape of pharmacotherapy in diabetes, the drugs currently available for treating diabetes, their effectiveness and efficacy, the impact on target organs, and side effects. This review also provides an overview of oral and injectable non-insulin medications used to improve blood glucose levels. This work also provides insights that can support the customization of treatment strategies. We delve into the concept of precision medicine and explore the role of older drugs in patient management. Furthermore, we present a proposal for a groundbreaking approach to the treatment of type 2 diabetes, with an emphasis on striving for a cure for the disease. The treatment of type 2 diabetes (T2D) necessitates a multifaceted approach that combines behavioral and pharmacological interventions to mitigate complications and sustain a high quality of life. Treatment encompasses the management of glucose levels, weight, cardiovascular risk factors, comorbidities, and associated complications through medication and lifestyle adjustments. Metformin, a standard in diabetes management, continues to serve as the primary, first-line oral treatment across all age groups due to its efficacy, versatility in combination therapy, and cost-effectiveness. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) offer notable benefits for HbA1c and weight reduction, with significant cardiovascular benefits. Sodium-glucose cotransporter inhibitors (SGLT-2i) lower glucose levels independently of insulin while conferring notable benefits for cardiovascular, renal, and heart-failure outcomes. Combined therapies emphasizing early and sustained glycemic control are promising options for diabetes management. As insulin therapy remains pivotal, metformin and non-insulin agents such as GLP-1 RA and SGLT-2i offer compelling options. Notably, exciting novel treatments like the dual GLP-1/ glucose-dependent insulinotropic polypeptide (GIP) agonist show promise for substantially reducing glycated hemoglobin and body weight. Recent studies have highlighted a clear correlation between reducing HbA1c to less than 6.5% and a significant decrease in microvascular and macrovascular complications. Studies also suggest the potential benefits of primary combined therapy for glycemic management in diabetes compared to monotherapy with metformin across a wide range of baseline HbA1c levels. The most effective way to manage diabetes is to treat it with a combination therapy from the time of initial diagnosis. To help medical staff choose the ideal drug combination for each patient, the National Diabetes Council in Israel developed a calculator that recommends the most appropriate combination therapy based on the patient’s BMI, HbA1c levels, and risk for ischemic heart disease, stroke, renal function, and heart failure. Along with the most appropriate drug treatment, a healthy lifestyle is extremely important.

 

Author(s)details:-

 

Roni Weinberg Sibony
Faculty of Medicine, Ben-Gurion University, Beer Sheva 8443944, Israel.

 

Omri Segev
Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.

Saar Dor
Faculty of Medicine, Ben-Gurion University, Beer Sheva 8443944, Israel.

 

Itamar Raz
Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112001, Israel and Department of Endocrinology and Metabolism, Diabetes Unit, Hadassah Medical Center, Jerusalem 91240, Israel.

 

Please See the book here :- https://doi.org/10.9734/bpi/mria/v4/11972F

Low Carb High Protein Diets to Treat Insulin Resistance in Patients with Obesity and/or Type 2 Diabetes Mellitus| Chapter 7 | Current Overview on Disease and Health Vol. 7

Low carbohydrate, high protein diets have been prescribed since 1797 and are taken seriously by many researchers and health professionals, though the diet is still met with skepticism in mainstream dietetics and medicine. Insulin resistance (IR) is caused by a series of physiological events that begin with hyperfagia and progress to a positive energy balance and weight gain. Because of their high insulin levels, patients with IR gain weight easily and have difficulty losing weight on diets with a normal carbohydrate content. A diet for patients with IR must therefore tackle this problem to make weight loss possible. Recently, developments in the management of type 2 diabetes mellitus incline towards lowering of carbohydrate intakes to put T2DM in remission, making it even more important to look carefully at the evidence, because patients may benefit from it in a direct way. This review discusses the evidence on the diet's short and long-term effects, effects on comorbidities, and differences from the Mediterranean diet. A search was carried out in Pubmed for articles of obesity management, IR, low carb/high protein diets and weight loss combined with comorbidities, several nutrients and the Mediterranean diet between 1995 and July 2017. In weight loss management, the outcomes were compared to patient observations from dietary practice.

Waist circumference measurement makes diagnosis simple. The diet should be low in carbohydrates and rich in protein without inducing ketosis; each person's needs for energy and macronutrients should be considered. Focusing on unsaturated fats, fat is neither too high nor excessively low. Magnesium, iodine, and vitamin D intake must be at recommended levels. Alcohol consumption is not included in the diet's initial phase. Exercise is a crucial component of treatment because it builds endurance and resistance. Patients taking type 2 diabetes medication need to carefully monitor their food and glucose levels. Low carbohydrate/high protein diets should be considered as a serious treatment option for all obese patients with and without comorbidities. They should be administered by specialized dietitians as part of a multidisciplinary team. Low carbohydrate/high protein diets should be considered as a serious treatment option for all obese patients with and without comorbidities. They should be administered by specialised dietitians working in a multi-disciplinary team.

Author(s) Details:

Elisabeth Govers,
Dutch Knowledge Centre for Dietitians on Obesity, Amsterdam, The Netherlands and European Specialist Dietetic Network on Obesity, European Federation of the Associations of Dietitians (EFAD), Naarden, The Netherlands and Nutrition Working Group, European Association for the Study of Obesity (EASO), Teddington, UK.

Please see the link here: https://stm.bookpi.org/CODH-V7/article/view/9081

Diabetes Mellitus | Chapter 3 | Current Practice in Medical Science Vol. 6

High blood glucose levels brought on by a relative or absolute lack of insulin in the bloodstream are the hallmark of diabetes mellitus, which is regarded as a chronic condition. Diabetes, one of the most chronic diseases in the world, is brought on by an inherited and/or acquired shortage in pancreatic insulin production (type 1) or by insulin inefficiency (type 2). A number of biological variables can contribute to T2DM, and hyperlipidemia and hyperglycemia are both correlated with insulin resistance and insulin insufficiency, respectively. Frequent urination, increased thirst, and increased appetite are common symptoms. Diabetes has a number of health consequences if untreated. Diabetes not only increases the risk of death, but also the development of numerous chronic disorders such nephropathy, neuropathy, and a number of vascular diseases affecting the kidney, retinal, heart, brain, and peripheral blood vessels. The main hormone, insulin, controls how much glucose enters most body cells from the blood.

 

Author (s) Details

Ehab Tousson

Zoology Department, Faculty of Science, Tanta University, Egypt.

Manal Elbandrawy

Chemistry Department, Faculty of Science, Tanta University, Egypt.

 

View Book :-  https://stm.bookpi.org/CPMS-V6/article/view/7676