Current Diabetes Reviews - Volume 9, Issue 6, 2013

Rapidly increasing number of diabetic patients across the world is a great challenge to the current therapeutic approach. Although the traditional method of rendering exogenous insulin is an established method of treatment, it is not sufficient and often causes lethal hypoglycemia. There is also a good amount of success with whole organ transplantation or Islet cells' transplantation. But this technique is limited with regards the availability of donors. Currently, many clinicians and researchers are involved in clinical studies using various different stem cells from embryonic as well as adult sources for the treatment of diabetes. In this review we have tried to discuss the results of various clinical trials using stem cells. We have also tried to look at various stem cell types and the routes of injections that are currently being followed world wide.

The diabetes burden is growing in Sub-Saharan Africa (SSA). The low overall access to health care has been documented to contribute to the high diabetes-related mortality. Due to economic, demographic, epidemiological and nutrition transitions in SSA, the growing prevalence of diabetes appears to be related to obesogenic lifestyles and the intergenerational impact of malnutrition in women of childbearing age. Both overnutrition and undernutrition have been associated with the development of diabetes and other chronic diseases. Africans are also suspected of being genetically predisposed to diabetes. According to existing data in developed countries, exposure to pesticides, particularly organochlorines and metabolites, is associated with a higher risk of developing type 2 diabetes and its comorbidities. In African countries, pesticide exposure levels often appear much higher than in developed countries. Furthermore, undernutrition, which is still highly prevalent in SSA, could increase susceptibility to the adverse effects of organic pollutants. Therefore, the growing and inadequate use of pesticides may well represent an additional risk factor for diabetes in SSA. Additionally, high exposure to pesticides in African infants in utero and during the perinatal period may increase the intergenerational risk of developing diabetes in SSA.

Oxytocin (OXT) is a neurohypophysial hormone which is synthesized in the paraventricular and supraoptic nuclei of the hypothalamus. OXT is currently attracting considerable attention because it has been discovered that it regulates various functions of behavior especially in the context of social interactions. OXT is a key component in bone formation, glycemia, male sexuality, cardiac differentiation and pregnancy and thus it is important to be further explored. The authors review various aspects of gestational diabetes, including definition, screening, diagnostic procedures, complications, clinical evaluation, indications of delivery and neonatal aspects. Not only the relation among diabetes mellitus, oxytocin and neurophysiology concerning erectile dysfunction, but also the role of OXT in the activity of arginine and vasopressin is investigated. It is imperative to develop technological and experimental methods that will be able to reveal the oxytocin and its potential.

Physical activity (PA) is prescribed as an important method of treatment for type 2 diabetes (T2DM), but is neglected in a majority of patients. Walking is an appropriate and safe form of PA which improves glucose utilization in inactive people diagnosed with T2DM. Pedometers have been successfully used to motivate and track progress in many types of walking programs, but there is no current review of their effectiveness compared to other methods to increase PA in people with T2DM. A systematic literature review was performed using MEDLINE, CINAHL, SPORTDiscus, ERIC, and Academic Search Premier to determine the effectiveness of pedometer-based walking interventions at increasing PA in free-living adults with T2DM. Ten studies from 2004 to 2011 were included. All studies were randomized controlled trials except for one quasi-experimental design. Interventions lasted from 6 weeks to 6 months and only 2 studies showed significant improvements in blood glucose control following the intervention. Nine of the ten interventions were able to produce an increase in PA using a pedometer and/or other methods. Pedometers are effective means of increasing PA among T2DM patients in the short-term while several other intervention methods beyond normal treatment are also successful. Future research should include longer intervention durations, low cost methods, larger sample sizes, and dietary intervention components to further understand successful intervention techniques for patients with T2DM.

It has been known that chronic liver treatments interfere with blood glucose metabolism. It was recognized that diabetes mellitus among chronic hepatitis C was greater in other types of chronic liver diseases. Hepatitis C directly promotes insulin resistance through the proteosomal degradation of insulin resistance substrate. It suppressed hepatocyte glucose uptake through down-regulation of surface expression of glucose transporter. Long-term exposure to cytokine over expression seems to be cytotoxic to both beta cells of the pancreas and to hepatocytes. Elevated tumor necrosis factor-a, or its neutralization, increased insulin sensitivity. Interferon-a may also elevate the serum level of interleukin-1 which is cytotoxic to pancreatic islet cells. Both Diabetes mellitus and resistance to interferon-a therapy are abnormally mediated by over-expression of suppressor of cytokine signaling-1 in hepatocytes of chronic hepatitis C patients. Conclusion: These data suggest that interferon-a therapy should be administered with caution in patients showing any predisposition to Diabetes mellitus. Anti inflammatory therapy is critically recommended as a protector against disease development due to cytokine mediated Diabetes mellitus during hepatitis C therapy, since inflammation seems to be a main candidate to interferon suspected diabetogenesis.

Diabetes Mellitus is a chronic metabolic disease affecting wide range of people across the globe. In India the rate of subjects being suffered from diabetes is continuously increasing. So, the development of drugs for its effective treatment is essential. Thereby, various attempts have been made to discover newer drugs, to reduce the rate of anti diabetic occurrence. Anti-diabetic drugs were found to treat diabetes mellitus by lowering glucose levels in the blood. Both the use antidiabetic drugs as well as the changes in lifestyle and proper diet can significantly affect the severity of diabetes mellitus and also reduces the symptoms and occurrence of the disease. Researches in the past few years on diabetes mellitus showed that this disease is spreading at a very faster rate, thereby; various attempts have been made to treat it efficaciously. Development and approval of antidiabetic drugs is quite necessary. There are different classes of anti-diabetic drugs reported to treat diabetes. The objective of the present review is to explore Invokana as a newly approved antidiabetic drug for the effective treatment of type 2 diabetes. This review focuses mainly on the various aspects of diabetes mellitus and its treatment perspectives. From the various clinical studies done on Invokana, it was concluded that and Invokana was found to be very effective for the efficacious therapy of diabetes mellitus.

The management of diabetic macular edema (DME) has been revolutionized in recent years. Focal and focal/ grid laser photocoagulation have been the mainstay of treatment for DME for much time. However, nowadays, there is growing evidence that intravitreal VEGF-inhibitors (combined or not with laser photocoagulation) provide better visual outcome in patients with diabetic retinopathy. Hence, anti-VEGF injections are considered the new gold standard to treat diabetic macular edema and eyes with a reduced visual function. Further studies assessing different treatment regimens are underway to define better clinical care pathways.

Many studies have demonstrated evidence of the health benefits of natural products. Plant extracts have been tested on a variety of physiological disorders, including diabetes mellitus. Studies have tested aqueous extracts, plant fractions extracts, families of active of compounds, and specific active compounds. In this review, we describe the antidiabetic effects of vegetable oils. Information was collected from ScienceDirect and PubMed databases using the following key words: Diabetes mellitus, Oils, Vegetable oils, Type 1 diabetes, type 2 diabetes, antidiabetic effect, antihyperglycemic, antidiabetic oil. We have compiled approximately ten vegetable oils with including experimental studies that have demonstrated benefits on diabetes mellitus. There are soybean, argan, olive, palm, walnut, black cumin, safflower, Colocynth, Black seed, Rice bran, Cinnamom, and Rocket oils. For each vegetable oil, we investigated on the plant’s traditional uses, their pharmacological activities and their antidiabetic effects. It seems that many vegetable oils are really interesting and can be used in the improvement of human health, particularly, to prevent or to treat diabetes mellitus complications.