Dipeptidyl Peptidase-4 Inhibitors: An Overview of Their Combination with Oral Hypoglycemic Agents | Chapter 8 | Pharmaceutical Science: New Insights and Developments Vol. 10

 

Type 2 diabetes mellitus (T2DM), the most prevalent form, is characterised by insulin insensitivity as a result of insulin resistance, declining insulin production, and eventual pancreatic beta-cell failure. Dipeptidyl peptidase 4 (DPP-4) inhibitors are a new class of Oral Hypoglycemic Drugs (OHD) that can control T2DM. This chapter aims to provide a critical and systematic update of the specialised literature on the therapeutic effects and safety profile of hypoglycemic drugs, used in combination with DPP-4 inhibitors, in the management of type 2 diabetes mellitus. Given the rapid advances in the field of medicine and the pharmaceutical industry, therapeutic strategies for this pathology have undergone significant changes, oriented not only towards effective glycemic control but also towards reducing cardiovascular risks and mortality associated with the disease. Numerous studies have investigated the impact of different therapeutic combinations on the evolution of patients with type 2 diabetes mellitus, paying particular attention to the associations between metformin and other classes of hypoglycemic drugs. An important part of the research has focused on comparing the classic metformin–sulfonylurea combination with more recent therapeutic regimens, such as metformin associated with DPP-4 inhibitors. The data suggest that the use of sulfonylureas combined with metformin is associated with a significantly increased risk of severe hypoglycemia compared with metformin–DPP-4 inhibitors. Another relevant observation is related to the use of insulin in combination with metformin. According to the analysed data, this therapeutic combination was associated with a higher risk of all-cause mortality, compared with treatment based on DPP-4 inhibitors combined with metformin. In conclusion, the current evidence supports the use of DPP-4 inhibitors in combination with metformin as a safer therapeutic alternative to sulfonylureas or insulin, especially in terms of reducing the risk of severe hypoglycemia, cardiovascular events and mortality. These results highlight the need to integrate recent clinical data into medical practice guidelines and to individualise the treatment for patients with type 2 diabetes.

 

 

Author(s) Details

Nina Filip
Department of Morpho Functional Sciences II, Biochemistry, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, Romania.

 

Cristina Elena Iancu
Department of Biochemistry, Faculty of Pharmacy, Grigore T. Popa University of Medicine and Pharmacy Iasi, Romania.

 

Diana Zamosteanu
Department of Morpho Functional Sciences I, Pathology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, Romania.

 

Cristiana Filip
Department of Morpho Functional Sciences II, Biochemistry, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, Romania.

 

Magdalena Birsan
Department of Drug Industry and Pharmaceutical Biotechnology, Faculty of Pharmacy, Grigore T. Popa University of Medicine and Pharmacy Iasi, Romania.

 

Madalina Mocanu
Department of Dermatology, Grigore T. Popa University of Medicine and Pharmacy Iasi, Romania.

 

Please see the book here :- https://doi.org/10.9734/bpi/psnid/v10/7009

Relevance of Screening Subclinical Cushing’s Syndrome in Patients with Type 2 Diabetes Mellitus | Chapter 4| Medical Science: Updates and Prospects Vol. 4

 

Background: Subclinical Cushing’s syndrome (SCS) is defined as autonomous cortisol secretion in patients devoid of specific clinical symptoms of hypercortisolism, as in the classic CS. Subtle cortisol hypersecretion from adrenal incidentalomas is associated with alterations of the hypothalamic-pituitary-adrenal (HPA) axis due to autonomous adrenal function, occurring in the absence of the typical clinical phenotype of hypercortisolism. This condition has been defined as subclinical Cushing’s syndrome (SCS). Despite the absence of overt symptoms, sustained exposure to chronic, slightly elevated cortisol concentrations may result in some classical metabolic complications of CS, such as impaired glucose tolerance and diabetes. Studies reported a higher frequency of SCS in type 2 diabetics, which can be considered an exacerbating factor for diabetes and poor glycemic control. Currently, the frequency of SCS is widely variable.

 

Aim of the Study: This study intends to prospectively evaluate the prevalence of SCS among type 2 diabetic (T2D) patients with poor control, and to determine whether systematic screening for SCS in T2D patients is worthwhile.

 

Methods: It was a cross-sectional study including 221 T2D patients referred to the National Institute of Nutrition of Tunis for poor glycemic control (HbA1c ≥ 8%). Inclusion criteria were age >40 years and poor glycemic control; patients with a history of adrenal mass or pituitary adenoma were excluded. SCS screening was performed in two steps. The first screening step of SCS was the 1-mg overnight dexamethasone suppression test (ODST) using a revised criterion for cortisol suppression. In the second confirmatory step, patients with abnormal ODST underwent a 48-h, 2-mg low-dose dexamethasone suppression test (LDDST) to confirm the diagnosis. The cut-off for cortisol suppression was 50 nmol/L (1.8 µmol/dL) in the two tests.

 

Results: The mean age ± SD of the patients was 58.7 ± 8.78 years. Overweight and obesity were found in 34% and 47%, respectively. Mean duration of diabetes was 10.84 ± 6.55 years, and mean baseline HbA1c ± SD was 10.9±1.8%. Thirteen patients (5.9%) failed to suppress cortisol levels less than the cut-off after ODST. SCS was confirmed by LDDST in one patient among them (0.45%). The autonomous cortisol secretion was related to a pituitary adenoma. This study revealed that the frequency of SCS of 0.45% did not allow for performing an analytical study in order to identify predictive factors of SCS among T2D patients.

 

Conclusion: SCS is rare among T2D patients. Systematic screening of SCS in T2D patients with poor glycemic control is not worthwhile. The screening should be performed only in patients with specific clinical and/or biological indicators. Further multicenter studies with larger sample sizes are needed to explore potential risk factors for SCS in T2D patients.

 

 

Author(s) Details

Manel Jemel Hadiji

Department of Endocrinology, National Institute of Nutrition, Tunis, Tunisia.

 

Imen Ksira
Department of Endocrinology, National Institute of Nutrition, Tunis, Tunisia.

 

Emna Haouat
Department of Endocrinology, National Institute of Nutrition, Tunis, Tunisia.

 

Henda Kammoun Jamoussi
Department of Nutrition, National Institute of Nutrition, Tunis, Tunisia.

 

Hajer Kandara
Department of Endocrinology, National Institute of Nutrition, Tunis, Tunisia.

 

Ines Kammoun
Department of Endocrinology, National Institute of Nutrition, Tunis, Tunisia.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v4/6657

Investigation of the Role of Oxidative Stress-Related Genetic Variants in Type 2 Diabetes Mellitus-associated Nephropathy | Chapter 9 | Recent Developments in Chemistry and Biochemistry Research Vol. 3

The present study investigates the role of oxidative stress-related genetic variants in type 2 diabetes mellitus-associated nephropathy. Type 2 diabetes is thought to be associated with microvascular complications that comprise retinopathy, nephropathy, and neuropathy. Oxidative stress is a predominant factor involved in the pathogenesis of DN and alters metabolic endeavour and its hemodynamic pathways, which have varied correlations with renal problems, one of which is diabetic nephropathy, which leads to end-stage renal disease. Renal injury in DN occurs primarily through oxidative stress, which disrupts metabolic and hemodynamic pathways. Hyperglycemia is regarded as a hallmark feature of diabetes that increases reactive oxygen species generation, which eventually leads to increased oxidative stress, and this is considered the most essential event in the onset of DN. To prevent tubular injury in DN, antioxidants can be used to combat oxidative stress, which is primarily caused by several pathways. The most significant antioxidative enzymes are superoxide dismutase, catalase, glutathione-S-transferase, and glutathione peroxidase. As a result, this chapter emphasizes antioxidant gene polymorphisms and hypothesizes that these antioxidant genes may be an essential component of DN pathogenesis. Moreover, this chapter also retorts to the research questions raised by the physicians and illustrates the importance of regional population studies on detecting the SNPs of antioxidant genes and targeting therapeutic approaches aiding to lessen the severity of the disease at its initial stages.

 

 

Author(s) Details

Farhana Begum

Department of Biochemistry, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu 603103, India.

Karpagavel Lakshmanan

Research and Education, Kelambakkam, Tamil Nadu 603103, India.

Please see the book here:- https://doi.org/10.9734/bpi/rdcbr/v3/297

Effects of the TCF7L2 Genetic Variants on Anthropometric, Metabolic and Hormonal Parameters in Type 2 Diabetes Mellitus Patients who Following Diets Enriched with Nopal Tortilla and Wholegrain Bread | Chapter 8 | Medical Science: Trends and Innovations Vol. 13

 Genetic polymorphisms in the human genome may contribute to phenotypic variation and genetic susceptibility to several diseases, with transcription factor 7-like 2 (TCF7L2) being one of the genes that is most consistently associated with T2DM across different studies and populations. The TCF7L2 genetic variants have shown differential effects on low-fat and high-fat diets in obese subjects. Nopal is a Mexican variety of cactus that is a traditional food and has been used in the treatment of diabetes. Its hypoglycaemic effect may be because of its soluble fibre (mucopolysaccharide) content. This study hypothesises that there are hormonal and metabolic differences in T2DM patients who carry different rs7903146 and rs12255372 TCF7L2 genotypes and consume diets containing either nopal or wholegrain fibre. This study analysed the effects of the vs7903146 and vs12255372 TCF7L2 variants on anthropometric, metabolic and hormonal parameters in type 2 diabetes mellitus patients who consumed fibre from either nopal tortilla or wholegrain bread for 8 weeks. Seventy-four patients who consumed an individualised isoenergetic diet that included nopal tortilla (Diet 1) and sixty-three patients with a diet that included wholegrain bread (Diet 2) were followed up. The T2DM patients received an individualised isoenergetic diet based on the 2004 American Diabetes Association (ADA) dietary recommendations. Anthropometric, metabolic and hormonal measures were collected at baseline and final intervention. The size effect and carry-over effect were estimated. To assess the interaction of genotype and diets, a general linear model repeated-measures analysis was used. Minor allele frequency of rs7903146T was 0·27 and for rs12255372T it was 0·13. IBM SPSS Statistics 19.0 software was used for all statistical analyses. At 8 weeks after Diet 1 intake, weight, BMI, waist and hip circumference decreased (P = 0·00015) in rs7903146CC and rs12255372GG genotypes. In particular, patients carrying the rs7903146CC and consuming Diet 1 showed a reduction in waist circumference of more than 2·5 cm compared with Diet 2 (P < 0·001). No significant interaction between rs7903146 or rs12255372 and diet was seen in this study. In conclusion, in the carriers of the vs7303146CC and vs12255372GG wild types, significant changes in all anthropometric measures were observed, and they had a better response to both diets. This result highlights the importance of considering patient genetic patterns when suggesting therapeutic diets. Differences in anthropometric, metabolic and hormonal responses should be considered when adapting and individualising diets of patients to better control T2DM.

 

Author (s) Details

M. M. López-Ortiz
Department of Medicine and Nutrition, Division of Health Sciences, Leon Campus, University of Guanajuato, 37670 Leon, Mexico.

 

M. E. Garay-Sevilla
Department of Medical Science, Division of Health Sciences, Leon Campus, University of Guanajuato, 37320 Leon, Mexico.

 

M. E. Tejero
Laboratory of Nutrigenomics and Nutrigenetics, National Institute of Genomic Medicine, 14610 Distrito Federal, Mexico.

 

E. L. Perez-Luque
Department of Medical Science, Division of Health Sciences, Leon Campus, University of Guanajuato, 37320 Leon, Mexico.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v13/4913   

Assessment of Microvascular Complications in Females with Type-2 Diabetes Mellitus through Biochemical Evaluation and Anthropometric Measurements | Chapter 1 | Recent Developments in Chemistry and Biochemistry Research Vol. 9

Background: Diabetes mellitus currently affects millions of people worldwide and projections for the future are alarming.

Objective: This study highlights the role of the biochemical parameters in the prediction of microvascular complications in Type 2 diabetes and non-diabetes female subjects.

Materials and Methods: The present study was conducted in R L Jalappa Hospital attached to Sri Devaraj Urs Medical College a constituent of Sri Devaraj Urs Academy of Higher Education and Research, Kolar. Randomly selected 45 female type 2 diabetes and non-diabetes subjects with the age group of 45-55 years attending the medicine outpatient department for a period of three months were included in the study. Anthropometric and biochemical parameters were analyzed by standard methods.

Results: Among the analysed variables in this study, we observed mean values of obesity index (55.13±6.94, 50.20±11.62), Diastolic BP (78.35±11.08, 78.62±7.91), Fasting Blood Sugar (147±65.75, 90.71±30.53), HbA1c (9.22±2.48, 6.24±1.69), Serum Creatinine (0.84±0.32, 0.65±0.12), urine creatinine (57.73±51.95, 97.60±178.84), HDL (36.44±8.48, 43.46±10.65) and LDL (100.39±40.65, 115.20±24.02) were significantly elevated in female diabetic subjects compared to non diabetes subjects.

Conclusion: The anthropometric measures did not significantly differ between diabetes and non-diabetes. In this study, we observed 26.6% of nephropathy, 13.3% of retinopathy and 6.6% of neuropathy in diabetes females. However, non-diabetic female subjects showed higher significant TC and LDL-C levels. This suggests that those above the age of 45-year females require a comprehensive evaluation of anthropometric and biochemical parameters to avoid micro and macrovascular complications.

 

Author (s) Details

Munilakshmi U
Department of Biochemistry, Sri Devaraj Urs Medical College, Tamaka, Kolar, India.

 

Shashidhar KN
Department of Biochemistry, Sri Devaraj Urs Medical College, Tamaka, Kolar, India.

 

Harish R
Department of Biochemistry, Haveri Institute of Medical Sciences, India.

 

Madhavi Reddy
Clinical Nutrition and Dietetics, Sri Devaraj Urs Medical College, India.

 

Lakshmaiah V.
Department of Medicine, Sri Devaraj Urs Medical College, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/rdcbr/v9/2528

An Overview of T2DM: A Model of Diabetes Mellitus | Chapter 9 | Disease and Health: Research Developments Vol. 2

A large part of the population suffers from a disorder in the metabolism of energy-rich substances (glucose, fats or proteins), diabetes mellitus (DM). A simple model allows us to understand the aetiology, pathophysiology and basic methods of modern treatment of the disease.

In many cases, the disease is caused by a malfunction of hormones, especially insulin.  More than 10% of cases of DM are caused by an absolute or relative lack of insulin, mainly due to an autoimmune process that destroyed insulin-producing cells - type 1 diabetes (DM1) or in the final stages of other types of diabetes due to terminal failure of regulatory mechanisms. In rare cases, DM is due to a decrease in all the effects of insulin - real insulin resistance or due to a real lack of insulin (Mody 2 for example). Metabolism takes place in cells. Hundreds of different enzymes affect the metabolism of energy-rich substances. Each of them can be damaged. However, it seems that the main cause of the disease is an inappropriate lifestyle, which secondarily damages the regulatory systems. This is the cause of type 2 diabetes (DM2). A high energy input/low energy expenditure (HEILEE) lifestyle is not compatible with a human genetic background. Deviations in glucose metabolism initially arise as a feedback, cellular defence against energy-rich substances overload, and are therefore reversible. If energy surplus persists for a long time, irreversible malfunctions occur. Untreated DM1 is characterized by intracellular starvation and lack of ATP. DM2 is characterized by “cellular overeating”. There gradually develop serious collision between intracellular regulatory mechanisms (AMPK, CD36-SR-B2, controlled by the amount of ATP, glycogen, lipid and other energy-rich substances), and cascades of hormone second messengers. Insulin deficiency and insulin resistance in DM2 are emphasized above all today. The question, of which of these disorders (or obesity) is the first, provoking the development of DM2, is discussed in the literature. Neither of them – both are the consequence of a chronic energy surplus. Chronic hyperinsulinemia is present in the early stages of the disease. Insulin ensures a high transfer of glucose from the blood to the tissues in obese people, but it is unable to maintain an adequate level of glucose in the blood. The disease is characterized by a special disorder - “Insulin uncoupling", a defect when there is a simultaneous increase in some effects and a decrease in other effects of the hormone. The ability of insulin to ensure anabolic processes is preserved. The ability to form visceral fat stores or the ability to retain sodium is increased. Hormone synthesis in DM2 gradually decreases, and the patients may become fully dependent on external insulin administration.

What therapy results from the above-mentioned principles? The goal of our efforts should be the complete restoration of the metabolism of energy-rich substances, carbohydrates, fats and other substances. Patients who are unable to synthesize insulin need this hormone (its analogues), in adequate amounts depending on needs. Patients who produce insulin but are unable to release it sufficiently will be optimally treated with sulfonylurea derivatives (MODY 2, MODY 12). Patients who are unable to release insulin depending on food intake will be optimally treated with GLP1 analogues, and incretins. The basic medical treatment for patients suffering from DM 2 reduces energy intake. The anorexic effect of GLP1 agonists is beneficial.  Metformin reduces the metabolism efficiency. This drug increases the amount of glucose processed anaerobically. Subsequently, metabolism in the Cori cycle causes significant energy losses. Currently, there are even drugs available that allow the removal of unnecessarily received energy by removing glucose from the body via urine-gliflozins. Insulin administration is appropriate to restore adequate blood glucose levels. Long-term administration of high doses of insulin is nevertheless not the optimal therapy for early-stage DM2.  A return to a lifestyle that corresponds to the conditions under which the human organism evolved - with limited food intake and relatively high energy expenditure through physical exercise- could prevent the population from developing diabetes mellitus.

 

Author (s) Details

 

Kubat K
PN Horni Berkovice, Plesivecka 912/10, 41201 Litomerice, Czech Republic, Europe.

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrd/v2/3640

Yoga and its Relation with Diabetes Prevention | Chapter 8 | Disease and Health: Research Developments Vol. 5

The chances of developing type 2 diabetes depend on a combination of risk factors. People are more likely to develop type 2 diabetes mellitus if they are overweight or obese, over the age of 35, have poor eating and exercise habits, daily stress, and/or have a family history of diabetes. Yoga offers holistic solutions to the management of type 2 diabetes mellitus and its complications involving lifestyle changes such as various asanas, changes in diet, and management of stress and meditation. Various studies suggest that yoga can improve the risk of these complications in adults with type 2 diabetes. Studies also revealed that the human body needs a certain amount of fat in the diet to stay healthy. Eating the wrong kind of fat can trigger health hazards. A well-balanced vegetarian diet has proven to be extraordinarily healthy and cures many diseases including diabetes. The effect of yoga incorporating asanas, pranayam, meditation, kriyas, sattvic diet and mental discipline is beneficial to patients of type 2 DM. Stress and sedentary lifestyle are the leading causes of type 2 diabetes. Yoga has been shown to be quite effective in managing blood sugar levels. It helps activate the internal organs like the pancreas and build strength. Moreover, pranayama exercises are very helpful and beneficial for lowering blood glucose. In the current communication, an attempt has been made to explain the importance of yoga in overcoming problems related to type 2 diabetes.

 

Author (s) Details

 

Wazir C. Vasudeva
Department of Chemistry University of Khartoum, Sudan.

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrd/v5/4305

Investigation of the Role of Oxidative Stress-Related Genetic Variants in Type 2 Diabetes Mellitus-associated Nephropathy | Chapter 9 | Recent Developments in Chemistry and Biochemistry Research Vol. 3

The present study investigates the role of oxidative stress-related genetic variants in type 2 diabetes mellitus-associated nephropathy. Type 2 diabetes is thought to be associated with microvascular complications that comprise retinopathy, nephropathy, and neuropathy. Oxidative stress is a predominant factor involved in the pathogenesis of DN and alters metabolic endeavour and its hemodynamic pathways, which have varied correlations with renal problems, one of which is diabetic nephropathy, which leads to end-stage renal disease. Renal injury in DN occurs primarily through oxidative stress, which disrupts metabolic and hemodynamic pathways. Hyperglycemia is regarded as a hallmark feature of diabetes that increases reactive oxygen species generation, which eventually leads to increased oxidative stress, and this is considered the most essential event in the onset of DN. To prevent tubular injury in DN, antioxidants can be used to combat oxidative stress, which is primarily caused by several pathways. The most significant antioxidative enzymes are superoxide dismutase, catalase, glutathione-S-transferase, and glutathione peroxidase. As a result, this chapter emphasizes antioxidant gene polymorphisms and hypothesizes that these antioxidant genes may be an essential component of DN pathogenesis. Moreover, this chapter also retorts to the research questions raised by the physicians and illustrates the importance of regional population studies on detecting the SNPs of antioxidant genes and targeting therapeutic approaches aiding to lessen the severity of the disease at its initial stages.

Author(s) Details:

Farhana Begum,
Department of Biochemistry, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu 603103, India.

Dr. Karpagavel Lakshmanan
Department of Biochemistry, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu 603103, India.

Please see the link here: https://doi.org/10.9734/bpi/rdcbr/v3/297

Risk Assessment of Coronary Artery Disease Due to Hysterectomy in Type 2 Diabetic Women in Premenopausal Age Group | Chapter 8 | New Visions in Medicine and Medical Science Vol. 2

 Background: Women with diabetes mellitus have twice the risk of myocardial infarction (MI) than non-diabetic women of the same age group and bearing the risk of MI in a non-diabetic male of the same age.

 

Aim: The present study aimed to determine the impact of hysterectomy in women with type 2 diabetes mellitus in premenopausal age, on the risk of CAD.

 

Methods: A total of 181 type 2 diabetic women who underwent exercise treadmill ECG testing in the hospital during a 30 months period were studied. Based on an arbitrary cut off age of 48 yrs subjects were assigned in group 1: age < 48 yrs (premenopausal) and group 2: age

 48 years (postmenopausal). Based on exercise treadmill ECG results, they were sub grouped as without CAD (treadmill ECG test negative) and with CAD (treadmill ECG test positive).

 

Results: Age, duration of diabetes, hypertension and CAD were significantly more in postmenopausal group (p<0.05). Age, HDL-cholesterol and hysterectomy were significantly (p< 0.05) associated with premenopausal CAD. In postmenopausal CAD subgroup age, duration of diabetes, hypertension, HDL-cholesterol, sedentary physical activity and hysterectomy were significantly higher (p<0.05). In the multivariate analysis, hysterectomy was strongly associated (OR = 7.73, p = 0.016) with premenopausal CAD.

 

Conclusion: The study projects hysterectomy as a high risk factor for the CAD in premenopausal type 2 diabetics. More information from prospective long-term clinical trials targeted to answer the questions regarding the loss of premenopausal protection of CAD in diabetes and the optimal treatment strategies for both premenopausal diabetic women and CAD will help to guide therapy in the future.

Author(s) Details:

Basab Ghosh,
Dr. Basab's Diabetes Care, Opposite Ramnagar 3, T G Road Extension, Krishnanagar, Agartala – 799001, India.

Please see the link here: https://stm.bookpi.org/NVMMS-V2/article/view/13803

Type 2 Diabetes and Epigenetics: A Comprehensive Review | Chapter 5 | Advancement and New Understanding in Medical Science Vol. 9

Type 2 Diabetes is one of the major public health issues and a complex metabolic disorder strongly associated with genetic predisposition influenced by environmental factors and epigenetic regulation. Around 537 million people were diagnosed as diabetic in 2021 worldwide and it is predicted that the number will rise to 578 million by 2030, and 700 million by 2045. This review paper illustrated the role of epigenetics in the pathogenesis, progression, and detection of Type 2 Diabetes. A review study was performed for the articles published in English from 2000-2023 using Pub Med, and Google Scholar databases. Main underlining mechanisms of Type 2 Diabetes were identified: insulin resistance in the peripheral tissue and disintegrated insulin secretion. Epigenetics is “the study of changes in the gene functions that are mitotically and/or meiotically heritable and that do not entail a change in DNA sequence. Genome Wide Association Studies suggested that epigenetic regulation such as DNA methylation, Histone modification, microRNA strongly co-relates the development and progression of Type 2 Diabetes. Altered DNA methylation patterns in pancreatic islets, skeletal muscle, adipose tissue, from diabetic subjects compare to normal subjects was also found. Other risk factors like obesity, age, gender, impaired glucose tolerance, periconception and intrauterine environment may also have been linked with the possibilities of epigenetic changes. Lifestyle, socioeconomic condition, food habits are contributing to obesity and Type 2 Diabetes. Every year 2.8 million people die worldwide due to obesity and its complications. Epigenetics plays a crucial role by modifying the gene expression and establishing a relationship between the environment and genetic factors. Understanding the epigenetic mechanisms contributing to the development of Type 2 Diabetes is still limited.

Author(s) Details:

Abhijeet Roy,
Institute for Biomedical Sciences, Georgia State University, GA, USA and Center for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Bangladesh.

Please see the link here: https://stm.bookpi.org/ANUMS-V9/article/view/13624

Genetic Basis of Type 2 Diabetes Via the Gene Coding for Angiotensin-converting Enzyme | Chapter 7 | Advancement and New Understanding in Medical Science Vol. 2

Back Ground: Diabetes is a metabolic disease most often associated with complications when the biological parameters are uncontrolled, so management of diabetes remains a challenge in Africa. The increasement of this disease is associated with the ageing population, economic development, increasing urbanization, a less healthy diet and decreased physical activity.

Objective: The aim of this study was to find a relationship between the polymorphism of the gene encoding for angiotensin converting enzyme (ACE) and type 2 diabetes (T2D) in Gabonese subjects.

Method and Materials: This study was carried out in the laboratory of the Research Unit of the University of Health Sciences. The study population consisted of 225 subjects. This panel was composed of 88 controls (normoglycemic and non-hypertensive and not having a family history of diabetes) and 137 type 2 diabetic individuals. The genotypic analysis of the ACE gene of the different subjects was carried out by the technique of Polymerase Chain Reaction (PCR). Categorical and continuous variables were compared between diabetic patients and controls using the Chi-square test (X2) for categorical and the ANOVA test for continuous.

Results: The distribution of DD, ID, and II genotypes in controls and diabetics was 63.6%, 33%; 3.4% respectively and 65.7%; 31.4%; 2.9%. In addition, the allelic distribution showed that the alleles I and D in the controls and the diabetic subjects had proportions of 19.9%; 80.1% vs. 18.6%; 81.4% respectively. The genotypic and allelic differences between the two groups were not significant (p = 0.78).

Discussion and Conclusion: Therefore the allele D would not be the factor involving the I/D polymorphism in the occurrence of type 2 diabetes (T2D) in the Gabonese population. Plasma ACE activity in diabetic patients, as well as analysis of other genes may be related to the onset of the disease in order to highlight a genetic relationship linked to the occurrence of the pathology which can lead to better management of the patients and especially a new clinical approach for an effective diagnosis of diabetics.

Author(s) Details:

Ndong Atome Guy Roger,
Laboratory of Research in Biochemistry (LAREBIO), University of Sciences and Technology of Masuku, Franceville, Gabon.

Ovono Abessolo Felix,
Department of Chemistry and Biochemistry, University of Health Sciences (USS) Libreville, Gabon.

Mbang Bengone Aude Synthia,
Laboratory of Research in Biochemistry (LAREBIO), University of Sciences and Technology of Masuku, Franceville, Gabon and Department of Chemistry and Biochemistry, University of Health Sciences (USS) Libreville, Gabon.

Ollomo Benjamin,
Department of Chemistry and Biochemistry, University of Health Sciences (USS) Libreville, Gabon.

Yacka Laurianne,
Department of Chemistry and Biochemistry, University of Health Sciences (USS) Libreville, Gabon.

Lebibi Jacques,
Laboratory of Research in Biochemistry (LAREBIO), University of Sciences and Technology of Masuku, Franceville, Gabon and Chemistry Unit, Faculty of Science and Technology, University of Sciences and Technology of Masuku, Franceville, Gabon.

Ngou-Milama Edouard,
Department of Chemistry and Biochemistry, University of Health Sciences (USS) Libreville, Gabon.

Please see the link here: https://stm.bookpi.org/ANUMS-V2/article/view/13093

Insights into the Role of Preptin in Diabetes | Chapter 4 | Advanced Concepts in Pharmaceutical Research Vol. 4

 Peptide hormones are a type of signaling molecules that comprise amino acids and are synthesized and secreted by various endocrine glands distributed across the human carcass. Numerous physiological functions, containing development, metabolism, duplication, and stress response, are regulated by these hormones. Preptin is a currently identified peptide hormone combined within the organ meat, predominantly by the testing cells. This hormone is a constituent of a fuller hormone family that contains insulin, amylin, and pramlintide. Preptin seems to be generally involved in amplifying the conduct of insulin. Type 2 diabetes is characterized by insulin resistance. We keep find out how preptin and type 2 diabetes communicate, leading to novel treatments and stop methods.

Author(s) Details:

K. A. Arul Senghor,
Department of Biochemistry, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur – 603203, Kanchipuram, Chennai, Tamil Nadu, India.

V. M. Vinodhni,
Department of Biochemistry, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur – 603203, Kanchipuram, Chennai, Tamil Nadu, India.

P. Renuka,
Department of Biochemistry, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur – 603203, Kanchipuram, Chennai, Tamil Nadu, India.

S. Rooban,
SRM Medical College Hospital and Research Centre, SRM IST, Chengalpattu, Tamil Nadu, India.

Please see the link here: https://stm.bookpi.org/ACPR-V4/article/view/12925

Investigation of Gomphogyne bonii Gagnep. Extract Profile for Antidiabetic Effect in the Experimental Type 2 Diabetes Model | Chapter 5 | Current Progress in Medicine and Medical Research Vol. 5

 This member was designed to evaluate the antidiabetic effect of G. bonii extract in the experimental study. Diabetes mellitus has grown into a global well-being threat to association. Particularly those who have diabetes have continually had to deal with allure problems and the unexpected side effects of artificial medications. As a result, skilled is now a tendency between researchers to uncover novel natural elements that are both more reliable and successful in the situation of diabetes. Gomphogyne bonii Gagnep. extract (G. bonii extract) was a herbal-derivative product of the Pharmacy Department, Vietnam University of Traditional Medicine. In order to judge the antidiabetic effect of G. bonii extract, a type 2 diabetes model was conducted in rodent. The main pathogenesis of type 2 diabetes has been guide peripheral insulin fighting and deficient insulin result due to the dysregulation of insulin discharge. The result of histopathological examination granted that there was a important improvement in the building of the liver after 2-temporal length of event or entity's existence period at the groups discussed with G. bonii extract. In conditions of histopathological concepts of the pancreas, no clear effect was noticed in the groups treated accompanying G. bonii extract as compared accompanying the The results revealed that G. bonii extract at two together doses ameliorated the effects of ALX on the aggregation of glucose, total cholesterol (TC), triglyceride (TG), Low-Density Lipoprotein-Cholesterol (LDL-C) and calculating-histological images of resident.  Additionally, the G. bonii extract's antidiabetic impact was stronger at a prescription of 12 mL/kg b.w./day than it was at a application of 4 mL/kg b.w/day. As a result, it was hypothesised that G. bonii extract ability one day be secondhand in clinical scenes to treat diabetes mellitus.

Author(s) Details:

Pham Quoc Binh,

Vietnam University of Traditional Medicine, Hanoi, Vietnam.

Nguyen Duy Thuan,

Vietnam University of Traditional Medicine, Hanoi, Vietnam.

Vu Viet Hang,

Hanoi Medical University, Hanoi, Vietnam.

Pham Thuy Phuong,

Vietnam University of Traditional Medicine, Hanoi, Vietnam.

Pham Quoc Su,

Vietnam University of Traditional Medicine, Hanoi, Vietnam.

Duong Van Phu,

Vietnam University of Traditional Medicine, Hanoi, Vietnam.

Phuong Thien Thuong,

Vietnam - Korea Institute of Science and Technology, Hanoi, Vietnam.

Dinh Thi Thu Hang,

Hanoi Medical University, Hanoi, Vietnam. 

Pham Thi Van Anh,

Hanoi Medical University, Hanoi, Vietnam.

Please see the link here: https://stm.bookpi.org/CPMMR-V5/article/view/11385

Tentative Definitions of Evolution in Relation with Type 2 Diabetes | Chapter 6 | Research Highlights in Disease and Health Research Vol. 2

 Evolution can be defined in various habits. Evolutionary medicine, as a evolving field is adding new definitions such as metamorphic trade-destroy and ultimate causes of diseases. Type 2 diabetes authorize a good example to metamorphic explanations of diseases. Selfish intelligence theory and economical genotype hypothesis being some of ruling class. The human body is not devised in a way which functions optimally; it has existed evolved accompanying compromises which obligate work-offs that increase the risk of specific diseases as type 2 diabetes.

Author(s) Details:

Cem Turaman,
Izmir Cad. 7/12, Kizilay, Ankara, Turkey.

Please see the link here: https://stm.bookpi.org/RHDHR-V2/article/view/9615

A Randomized Crossover Study Highlighting the Resistant Starch Consumption Effects on Glycemic Control and Glycemic Variability in Type 2 Diabetes Patients | Chapter 2 | Current Overview on Disease and Health Research Vol. 5

 This study was designed to determine the goods of native banana bounce and high- amylose sludge bounce on glycemic control and glycemic variability in cases with type 2 diabetes when treatments were matched for digestible bounce content. In a randomized, crossover study, nonstop glucose monitoring was performed in 17 actors( aged 28 – 65 times, BMI( ge) 25 kg/ m2, both genders) consuming native banana bounce, high- amylose sludge bounce or digestible sludge bounce for 4 days. Native banana bounce and high- amylose sludge bounce convinced an increase in 24 h mean blood glucose during days 2 to 4( p<0.05). nonstop lapping net glycemic action, glycemic threat assessment in diabetes equation and J- indicator values were advanced in high- amylose sludge bounce compared with digestible sludge bounce only at day 4( p<0.05). Yet, native banana bounce input provoked a reduction in fasting glycemia changes from birth compared with digestible sludge bounce( p = 0.0074).

In conclusion, under the experimental conditions, resistant bounce from two sources didn't ameliorate glycemic control or glycemic variability. unborn longer studies are demanded to determine whether these findings were affected by a different birth microbiota or other environmental factors.

Author(s) Details:

Yolanda Arias-Córdova,
Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico.

Jorge Luis Ble-Castillo,
Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico.

Carlos García-Vázquez,
Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico.

Viridiana Olvera-Hernández,
Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico.

Meztli Ramos-García,
Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico.

Adrián Navarrete-Cortes,
Departamento de Medicina Interna, Hospital General de Zona No. 46, Instituto Mexicano del Seguro Social (IMSS), Villahermosa 86060, Mexico.

Guadalupe Jiménez-Domínguez,
Departamento de Medicina Interna, Hospital General de Zona No. 46, Instituto Mexicano del Seguro Social (IMSS), Villahermosa 86060, Mexico.

Sela Esther Juárez-Rojop,
Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico.

Carlos Alfonso Tovilla-Zárate,
División Académica Multidisciplinaria de Comalcalco (DAMC), Universidad Juárez Autónoma de Tabasco (UJAT), Comalcalco 86650, Mexico.

Mirian Carolina Martínez-López,
Centro de Investigación, División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa 86150, Mexico.

José D. Méndez,
Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México 06703, Mexico.

Please see the link here: https://stm.bookpi.org/CODHR-V5/article/view/8435

Estimation of Fluoride and Sirtuin1 in Patients with Diabetic Nephropathy in Kolar District of Karnataka, India | Book Publisher International

 Introduction: In Asian nations, the prevalence of type-2 diabetes mellitus (DM) and diabetic nephropathy is quickly increasing, impacting low- and middle-income people. Fluorosis is an epidemiological concern in the Kolar district, and the current study includes advanced glycation end products, carboxymethyl lysine (CML), and a protein of interest, Sirtuin1. The main goal of the study was to determine the amount of renal injury by correlating fluoride and CML with sirtuin1 of patients.

Materials and Methods: This is a three-group comparative cross-sectional research.

In comparison to group 3, sirtuin1 levels are considerably lower in group 2. In groups 2 and 3, urine F excretion is lower, which is a sign of declining renal function. All of the metrics in group 2 showed a substantial decrease, with the exception of CML, which showed a significant rise when compared to controls. When compared to Group 1, Group 3 had a significant rise in CML. For all of the criteria, the level of significance between groups was fair to exceptional, supporting the premise and goal of the study.

Conclusion: The severity of damage caused by stress during hyperglycemia and fluoride poisoning is indicated by changes in serum sirtuin1 levels. As a result, sirtuin1 can be used as an ageing biomarker. The link between CML, estimated glomerular filtration rate (eGFR), and fluoride and sirtuin1 suggests that boosting sirtuin1 might help protect against future damage and could be used as a treatment.

Author(s) Details:

R. Sai Deepika
Department of Biochemistry, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India.

K. N. Shashidhar
Department of Biochemistry, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India.

A. Raveesha
Department of General Medicine, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India.

View Book: https://stm.bookpi.org/EFSPDNKDKI/article/view/7155

Nutritional and Pharmacological Therapy Adherence in Type-2 Diabetes Patients in a Mediterranean Region | Chapter 11 | Issues and Developments in Medicine and Medical Research Vol. 9

 Introduction: Patients with type 2 diabetes do not place the same priority on nutritional therapy as they do on other types of interventions. The value that T2DM patients place on nutritional and pharmaceutical therapy was examined in this study, as well as perceived impediments to nutritional therapy adherence.

Methods: A non-random sample of 62 patients receiving health treatment at a Diabetes Clinic in Faro, Portugal's Algarve region, were interviewed using a semi-structured procedure about their sociodemographic factors, lifestyle, physical activity, and dietary preferences. Additional information was gathered from the patient's medical records and through regular anthropometric testing.

Patients' nutritional consumption is low, and the majority are overweight (36 percent; n=22) or obese (53 percent; n=33). Physical exercise is ranked lower than nutritional consumption and pharmaceutical therapy (F=19.6; p0.001). Patients with a higher adherence to the Mediterranean diet perceive their diet to be of higher quality (rSpearman=0.371; p=0.032), while patients with a higher adherence to the Mediterranean diet regard their food to be of higher quality (66 percent; n=41). The importance of dietary intake as a disease treatment is significant, but patients appear to have difficulty following the recommendations and maintaining their compliance. Conclusions: Patients should be given the tools they need to enhance their own health. It is necessary to create and implement appropriate, personalised interventions.

Author(S) Details

Ezequiel Pinto
University of Algarve, School of Health, Portugal.

Nídia Braz
University of Algarve, School of Health, Portugal.

Tânia Nascimento
University of Algarve, School of Health, Portugal.

Eurico Gomes
Association for the Study of Diabetes Mellitus and Support for Diabetic Patients in the Algarve, Aedmada, Portugal.


View Book:- https://stm.bookpi.org/IDMMR-V9/article/view/5846

Integrated Risk Assessment Coupled with Molecular Detection Platform Enhance Personalized Health Care in Metabolic Disorders | Chapter 13 | Emerging Trends in Disease and Health Research Vol. 3

 Type 2 diabetes mellitus (T2DM) is characterised by multidimensional metabolic dysfunction caused by endothelium and beta cell malfunction, as well as regulatory molecular dysfunction caused by stress, lifestyle, food, and physical inactivity anchored in the insulin signalling network. It is caused by both environmental and genetic changes, which may play a role in the development of secondary disease as a risk barrier for microvascular disorders such coronary artery disease, hypertension, obesity, stroke, and dyslipidemia. It's also worth noting that T2DM is a risk factor for mental illness accompanied by cognitive impairment, such as Alzheimer's disease (AD). Using integrated multi-omics techniques, new evidence suggests that the interrelationship between metabolic syndrome and mental disorders involves multiple biological interfaces and connectivity. This review summarises that these categories include core omics strategy, genomics, transcriptomic, and proteomics; advanced omics applications, such as nutrigenomics, and metabolomics, to better understand pathobiology in metabolic illness and improve prediction skill set of T2DM with complicated genetic background and heterogeneity traits. Diagnostic indicators such as glucose concentrations and haemoglobin A1c are being employed in the blood to predict the state of metabolic surveillance. The human whole genome sequencing project ushered in the post-genomic era. Diet and lifestyle have exhibited dual qualities to be employed in customised dietary medicine as treatment guidance and precision medicine for health surveillance, both of which are dependent on genetic diversity as illustrated by gene-diet interaction. Molecular-based risk assessment using Omics methods such as nutrigenomics and metabolomics can help forecast and prevent health difficulties caused by environmental risk and exposure in people who have adapted to the new post-industrialized niche.

Author(S) Details

Sylvester Ndimele
Department of Environmental Health Science, School of Health Sciences and Practice, New York Medical College, Valhalla, NY, 10595, USA.

Miranda L. Carpenter
Department of Environmental Health Science, School of Health Sciences and Practice, New York Medical College, Valhalla, NY, 10595, USA.

Jae-Hyeon Cho
Institute of Agriculture and Life Science, Collegeof Veterinary Medicine, Gyeongsang National University, Jinju, 660-701, Korea.

Diane E. Heck
Department of Environmental Health Science, School of Health Sciences and Practice, New York Medical College, Valhalla, NY, 10595, USA.

Hong Duck Kim
Department of Environmental Health Science, School of Health Sciences and Practice, New York Medical College, Valhalla, NY, 10595, USA.

View Book:- https://stm.bookpi.org/ETDHR-V3/article/view/5889

Does Cinnamomum Zeylanicum Attenuates Insulin Resistance in Type 2 Diabetes Mellitus? | Chapter 04 | Emerging Trends in Disease and Health Research Vol. 3

 Background: After China, India has the second highest population of adults with diabetes. Despite the fact that contemporary diabetic medicines efficiently treat the condition, long-term use has negative consequences. Plants have been used as a source of medicine since the dawn of humanity. Cinnamon's inner bark is recognised as a traditional remedy among spices.

The goal of this trial was to see if cinnamon infusions improved blood glucose levels in people with type 2 diabetes.

Materials and Methods: The effects of 75 ml of Cinnamomum zeylanicum infusion on plasma glucose, serum fructosamine, and serum insulin of chosen type 2 diabetes individuals were evaluated for 45 days in the current study. The supplemental intervention was conducted using a within-subjects design.

Cinnamon zeylanicum has been demonstrated to boost glucose absorption and glycogen production. Cinnamon zeylanicum also helps to activate the insulin receptor cascade system. Fasting glucose fell from 144.53 to 115.43 mg/dL after 45 days of treatment (p 0.001). Postprandial glucose fell from 205.66 to 164.33 mg/dL (p0.001). Serum fructosamine and insulin levels both improved significantly.

Conclusion: Supplementing participants with increased blood glucose with Cinnamomum Zeylanicum infusion for 45 days reduced fasting glucose, fructosamine, and insulin levels.

Author(S) Details

T. Sivapriya
Department of Food Technology, Hindustan Institute of Technology and Science, Chennai, India.

S. John
Department of Home Science, Womens Christian College, Chennai, India.

View Book:- https://stm.bookpi.org/ETDHR-V3/article/view/5873

A Review on the Management of Insulin Resistance | Chapter 13 | New Frontiers in Medicine and Medical Research Vol. 15

Introduction: Interventions for weight loss and relapse prevention have had mixed results. Furthermore, comorbidities such as type 2 diabetes, hypertension, hypercholesterolemia, hypertriglyceridemia, and gout have been treated as separate diseases until now, despite accumulating evidence that these morbidities are the result of a malfunctioning metabolism caused by insulin resistance.

The goal of this study is to gather evidence that treating obesity with weight loss lowers comorbidities and improves quality of life.

Obesity and its comorbidities require a comprehensive approach to treatment. It's possible to accomplish it in primary care. A low carbohydrate diet and exercise should be widely acknowledged as the two key parts of treatment that contribute to the desired result: significant weight loss and reduction of comorbidities, as evidenced by improved blood parameters and improved quality of life. Dietitians, with the help of psychologists, physiotherapists, and fitness trainers, can play a significant role in diet management due to the diet's intricacy. Diet and lifestyle play an essential impact in health, and family physicians and nurse practitioners should be aware of this. Medication is not the ideal treatment for insulin resistance and should be avoided as much as possible.

Conclusions: Health professionals can influence the prevalence and implications of obesity and its comorbidities by identifying and treating insulin resistance in primary care, lowering health care costs significantly. Fasting insulin levels are the best way to diagnose IR. Additional tools include measuring waist circumference and calculating BMI. Weight loss should be prioritised by management, which should include a low-carbohydrate diet with adequate fat, protein, vitamins, and minerals. Exercise is an important aspect of relapse prevention and management. Insulin-resistant people may be able to regain their health by following these guidelines. They will always be insulin resistant to some level, and they will be unable to consume the typical amounts of carbs recommended in general dietary guidelines.

Author (S) Details

E. Govers
President of KDOO, the Netherlands; vice-chair of ESDN Obesity of the European Federation of Associations of Dietitians (EFAD),Germany.

E. Slof
EetOké, dietitian, member of KDOO Advisory Board, The Netherlands.

H. Verkoelen
Prima-Vita, dietitian and diabeteic nurse, KDOO Board, The Netherlands.

N. M. Ten Hoor-Aukema
Bon Appetit Dietitians, The Netherlands.

View Book :- https://stm.bookpi.org/NFMMR-V15/article/view/3873