Ethical approval was granted from the Research Ethics Committees at the Western Sydney Local Health District and The University of Sydney. The study population was defined as the total number of patients with Type1DiabetesMellitus (Type1 DM) and Type2DiabetesMellitus (Type2 DM) with foot ulcers at initial visit attending our outpatient Foot Wound Clinic at Westmead Hospital between January to December 2011. DiabetesMellitus was defined according to the criteria set by the World Health Organisation (WHO). The current WHO diagnostic criteria for DiabetesMellitus includes a fasting plasma glucose ≥ 7.0 mmol/l (126 mg/dl) or 2-hour plas- ma glucose ≥ 11.1 mmol/l (200 mg/dl) . A foot ulcer was defined as a full-thickness wound located distal to the ankle (level of malleoli) .
This cross-sectional study included 144 eyes of 72 preg- nant women in the third trimester divided into four groups: Group 1 consisted of 27 non-diabetic pregnant women (control group); Group 2 consisted of 15 pregnant women with GDM; Group 3 consisted of 16 pregnant women with type2diabetesmellitus (type2 DM) and Group 4 consisted of 14 pregnant women with type1diabetesmellitus (type1 DM). The participants were recruited between March and September 2016 at the Hospital de Clinicas de Porto Alegre (HCPA), Brazil. All participants received in person a full explanation about the study and provided written informed consent. This study was approved by the HCPA research ethics committee and was conducted in accordance with the Declaration of Helsinki guidelines.
Efficacy and Tolerability of Dianex in Type 2 Diabetes Mellitus A Non Randomized, Open Label Non Comparative Study ORIGINAL ARTICLE Efficacy and Tolerability of Dianex in Type 2 Diabetes Mellitus A No[.]
The increased LS-BMD and FN-BMD found in our patients with type2diabetes in comparison with a population-based control group confirms similar find- ings from epidemiological studies. There is growing evi- dence for an increased risk of fractures in patients with diabetesmellitus despite normal or even high BMD values [3,16,37]. Although our study size was not pow- ered for the assessment of fracture determinants, and the number of patients with fragility fracture was rela- tively low, it was evident that patients with fractures had significantly lower (type1diabetes) or a trend towards lower (type2diabetes) BMD values than patients with- out fractures. However, BMD values were above the T- score of −2.5 SD in most patients with fractures. This suggests that there is an association between fracture risk and BMD in diabetic patients, but the fracture threshold is higher than that associated with non- diabetic populations (T-score < −2.5 SD). Our data sup- port findings of a recent epidemiological study on the association between BMD, FRAX-score and fracture risk in older adults with diabetes , showing that the level for increased fracture risk seems to be about 0.5 SD T-Score higher than in nondiabetics. In contrast, Yamamoto et al., found no relationship between fracture risk and BMD in diabetic patients, although the rate of fractures was rather high (30%) in this study, suggesting some selection bias . Both studies [19,22] focus on patients with type2diabetes, while association studies on fracture risk and BMD in patients with type1 dia- betes are rare . The relatively high rate of low trauma fractures and of low BMD found in our patients with type1diabetesmellitus with a median age of 45 years, underlines the clinical importance of changes in bone metabolism as a complication associated with type1 dia- betes mellitus that is probably underestimated and de- serves more consideration during patient care.
New diabetes susceptibility loci are identified by Genomic analysis. Various genes involved in pancreatic development, beta cell function, insulin synthesis, insulin release and action and these are found to be associated with increased risk of type2 diabetes.The one gene which seems to be important in several populations for an early secretory defect right across the board is Transcription factor 7 like (TCF7L2) which regulates beta cell survival and function. Transcription factors that contain high mobility domains it binds to Beta carotenin & activate receptors, this complex initiate expression of target genes.
The rs5498-ICAM-1 polymorphism was reported to be associated with an increased expression of ICAM-1 in our study in which subjects with T2DM with diabetic retinopathy were enrolled . Namely, significantly higher sICAM-1 serum levels were demonstrated in Caucasian subjects with T2DM with the EE genotype compared with those with other (EK + KK) genotypes (918 ± 104 vs. 664 ± 209 microg/L; P = 0.001) . We presume that the inceased expression of ICAM-1 might lead to an increased leukocytes adhesion to the vessel wall endothelium and the atherosclerotic process . In their study, De Graba et al. found an increased ex- pression of ICAM-1 in symptomatic in comparison to asymptomatic plaques . Contrary to this report, however, Nuotio and co-workers did not report about an increased expression of ICAM 1, VACAM 1, E-selectin and P-selectin in symptomatic carotid plaques . The rs5498 of the ICAM-1 gene results in a change in the amino acid sequence of the immunoglobulin-like do- main 5. This domain is of crucial importance for the ac- tivity of the ICAM-1 protein . We speculate that the EE genotype might affect the development of athero- sclerotic markers via increased sICAM-1 serum activity.
Type2Diabetesmellitus is a metabolic syndrome which is relatively common in most countries including India which is now being referred to as “Diabetes Capital of the world” and risk of becoming diabetic for individual increases by two to four times if he has positive family history. The present study in offspring of diabetic parents suggests the presence of certain risk factor of the disease at an early age.
According to Hiba A Bawadi (2009), Trigonella foenum-groecum has been reported to be beneficial for treating Type II DiabetesMellitus. The study was conducted to investigate the postprandial hypoglycemic effect of fenugreek seeds on clients with Type II DiabetesMellitus. Pretest - posttest control group design was used to test the hypothesis that fenugreek may have a hypoglycemic effect on blood sugar. One hundred sixty-six Type II DiabetesMellitus clients were assigned into Fenugreek 0 (control group placebo drink), fenugreek 2.5 gm and fenugreek 5gm. The participants were instructed to drink the extract and chew the seeds. Postprandial plasma glucose level was measured before and 2 hours after the administration of the treatment. The clients in fenugreek 5gm group showed the greatest decrease postprandial glucose with a pretest-posttest difference of 41±6.1 mg/dl. Two hour plasma glucose dropped. Fenugreek seeds appear to have significant hypoglycemic activity in Type II DiabetesMellitus clients.
A total of 15 quantitative analyses were completed for the insertion/deletion (I/D) polymorphism located within ACE in eight phenotypes, details of which are included in online supplementary table S4. Three quan- titative analyses returned a significant result. The first analysis comprised 11 publications, each studying an East Asian population with type2diabetes and nephrop- athy (T2DN) and compared with type2diabetesmellitus without nephropathy (T2DM). Figure 2A displays these results, p=0.009; OR 0.74; 95% CI 0.59 to 0.93, I 2 =55%,
Another contrast that can be dealt with in these studies is comparing children and ad- olescents with each other: As a child enters school or the society, his/her dependence on parents decreases and instead relies more on friends. This trend grows more as his/her age increases so much so that a teenager communicates more with friends and is affected more by them (3). Children accept their parents’ advices to manage their disease and this enables the parents to control them. However, the advantage of the relationship between a teenager and his/her friends is the amount of intimacy that exists among the teenagers (2). Teen- agers tend to speak over their own issues with each other, receive a part of their so- cial approval from their peers, spend more time together, cooperate more with each other in different fields, such as sports and education and can consequently speak about their disease with their friends and share their information. As a result, teenag- ers’ friends provide more emotional sup- port than a baby’s friends (2).
Among 62% patients in Study Group and 46% subjects in Control Group had serum free testosterone levels between 0.00–5.00 pg/ml. 30% patients in Study Group and 46% subjects in Control Group had serum free testosterone levels between 5.00-10.00 pg/ml. 7% patients in Study Group and 6% subjects in Control Group had serum free testosterone levels between 10.00- 15.00 pg/ml. 1% patients in Study Group and 2% subjects in Control Group had serum free testosterone levels between 15.00-20.00 pg/ml. Mean serum free testosterone levels in Study Group were found to be 4.12±3.43 pg/ml which were significantly lower than that in Control Group i.e. 6.05±3.24 pg/ml (p value = 0.001). The study by Satish Chaudhary et al. also determined serum total and free testosterone levels in type2diabetesmellitus male patients and concluded that type2diabetesmellitus is associated with low levels of total and free testosterone. 10
A previously developed and detailed case report form (see Additional file 1: Supplementary file S1) will be used for collecting data. A medical history will be obtained from participants via a structured interview using the case report form at baseline and follow-up visits. The case report form will be used to collect information on: Demographic details; history of significant medical con- ditions and treatments; medication history; ethnicity, particularly in relation to indigenous status ; diabetes history, such as duration of diabetes and family history of diabetes [20, 21]; smoking history ; walking and exercise habits ; and footwear use . Participants will be interviewed by a single researcher (MEF). The hospital or clinical charts of patients with type2diabetes will also be reviewed. Medical conditions recorded will include: Hypertension, defined as history of diagnosis or treatment with antihypertensive medication; dyslipidae- mia, based on history or treatment with hypolipidemic agents; stroke, defined as a history of an ischemic or haemorrhagic stroke; coronary heart disease, defined as history of stable angina or unstable angina or myocardial infarction; chronic heart failure, based on clinical history of congestive heart failure; chronic pulmonary disease, based on clinical history and/ or treatment; chronic liver disease, based on clinical record; chronic kidney disease, defined as an estimated glomerular filtration rate (eGFR) of <60 ml/min/1.73 m 2 for 3 months recorded in the medical records. These risk factors are either known to influence foot ulcer development or healing , are considered as complications or conditions associated with type2diabetes [21, 26, 27], or are related to general health and function .
In patients with diabetic gastroparesis, hyperglycemia that is associated with a mismatch between the emptying of nutrients and preprandial insulin administration should be proactively managed. Increasingly, it is recommended that management of both type1 and type2diabetesmellitus should be ‘personalized’, that is, targeted towards individual patient characteristics. One of the phenotypic variants that impacts glycemic control is gastric emptying. It is conceivable that, in the future, gastric emptying will be measured more ‘routinely’ to optimize preprandial insulin dosing. The availability of a validated gastric emptying breath test that is standardized and allows measurement at the point of care suggests that such measurements are feasible. An additional benefit of such a management strategy is the early identification of gastroparesis, thus providing an earlier opportunity for treatment. 173
Type 1A diabetesmellitus (T1ADM) is a progressive autoimmune disease mediated by T lymphocytes with destruction of beta cells. Up to now, we do not have precise methods to assess the beta cell mass, "in vivo" or "ex-vivo". The studies about its genetic susceptibility show strong association with class II antigens of the HLA system (particularly DQ). Others genetics associations are weaker and depend on the population studied. A combination of precipitating events may occur at the beginning of the disease. There is a silent loss of immune-mediated beta cells mass which velocity has an inverse relation with the age, but it is influenced by genetic and metabolic factors. We can predict the development of the disease primarily through the determination of four biochemically islet auto antibodies against antigens like insulin, GAD65, IA2 and Znt8. Beta cell destruction is chronically progressive but at clinical diagnosis of the disease a reserve of these cells still functioning. The goal of secondary disease prevention is halt the autoimmune attack on beta cells by redirecting or dampening the immune system. It is remains one of the foremost therapeutic goals in the T1ADM. Glycemic intensive control and immunotherapeutic agents may preserve beta- cell function in newly diagnosed patients with T1ADM. It may be assessed through C-peptide values, which are important for glycemic stability and for the prevention of chronic complications of this disease. This article will summarize the etiopathogenesis mechanisms of this disease and the factors can influence on residual C-peptide and the strategies to it preservation.
Latent autoimmune diabetes in adults (LADA) is a slowly progressing form of autoimmune diabetes with older age at onset compared with classical type1diabetes (T1DM) and also characterized by β -cell associated antigen positivity. 1 Some studies have reported that the decreasing rate of islet β -cell function in LADA was highly heterogeneous, and was approximately three times higher than that in patients with type2diabetesmellitus (T2DM). 2 It is typically challenging to distinguish LADA from T2DM because they share a similar initial clinical pre- sentation; however, LADA requires earlier insulin treatment compared with T2DM. 3 Early insulin therapy leads to better preservation of metabolic control
DiabetesMellitus (DM) is a metabolic disorder characterized by the occurrence of unceasing hyperglycemia each immune-mediated (Type1diabetes), insulin resistance (Type2), gestational or others (surroundings, hereditary defect, infection as well as assured drugs). Here be tons of chemical agents available to control and to treat diabetic patients, but total recovery from diabetes has not been reported up to this date. The modern oral hypoglycemic agents produce undesirable side effects. Plants by virtue of its composition of containing multiple constituents developed during its growth under various environmental stresses providing a plethora of chemical families with medicinal utility. Herbal formulations are becoming popular now days particularly in the treatment of diabetes due to lesser side effect and low cost. This review focuses on the potential of different polyherbal formulation in the treatment of diabetes and also reviews their pharmacological investigations.
diabetes dataset and in the analyses in the current archival study. The average score for medication/insulin intake was used in the analyses. If there was only one score for either medication or insulin intake, this single score was used in the analyses in place of an average score. The second measure was adapted from the Diabetes Care Profile (Fitzgerald et al., 1996). Five items asked about DSMB completed over the past six months in the domains of medication taking, engaging in exercise, following a prescribed diet, measuring blood glucose levels, and checking feet. Participants were asked to rate: “Over the past six months, how difficult has it been to do each of the following exactly as the doctor who takes care of your diabetes suggested?” Each domain was measured on a Likert scale ranging from 1 to 5, with 1 = so difficult that I could not do it at all, and 5 = not difficult, I got it exactly right. A mean total score on this scale was used in the present study with higher scores indicating less difficulty with DSMB completion. Internal consistency for the total score was found to be adequate (α = .71, Heisler et al., 2007).
Thorough systematic review of the published literature on exercise testing and training in patients with predia- betes and type2diabetes revealed no evidence of any PA-related deaths and a very low incidence of non–life- threatening adverse events. This seems to suggest that nonvigorous (mild to moderate) PA is relatively safe in these individuals, despite their increased baseline risk of microvascular and macrovascular conditions, including CVD, nephropathy, and retinopathy. However, probably because of the perceived risks of exercise in this population, most published randomized control research studies carefully screened out their “high- risk” participants and included only those patients with few comorbidities (and specifically excluded individuals with advanced CVD). Moreover, exercise was generally limited to either mild or moderate intensity, with close clinical supervision. These caveats must be considered when assessing the evidence on the risks of PA for this class of patients.
1. Anjana RM, Deepa M, Pradeepa R, Mahanta J, Narain K, Das HK, et al. Prevalence of diabetes and prediabetes in 15 states of India: Results from the ICMR- INDIAB population-based cross-sectional study. Lancet Diabetes Endocrinol. 2017; 5:585–596.