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Current Diabetes Reviews - Online First
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Trends in Total Antioxidant Status and Other Biochemical Parameters in Type 2 Diabetes Mellitus: A Case-control Study
Authors: Remah Salih Al-Salman, Mohammad M. Al-Ahmad and Hiba AlameriAvailable online: 09 January 2025More LessObjectivesOwing to the existing evidence of the implication of oxidative stress in the pathophysiology of type 2 diabetes mellitus (T2DM), the present study aims to investigate the correlation of serum total antioxidant status (TAS) with comorbidities, various biochemical parameters, and duration of T2DM. Various factors contributing to disease prevalence and trends in other biochemical parameters are assessed.
MethodsA retrospective observational study of 246 patients with T2DM whose data were retrieved from the Proficiency Health Diagnostic Lab System in Al Ain. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) program.
ResultsThe prevalence of T2DM was found to be higher in gender (male), age (≥45 years), ethnicity (Middle Eastern), BMI (≥25), family history, and metabolic syndrome (hypertension and dyslipidemia). TAS was found to be significantly higher in patients with comorbidities, than in those without, particularly dyslipidemia and micro-albuminuria (p<0.05). TAS was weakly positively correlated with various T2DM biochemical parameters (p<0.05), except for Fasting blood glucose (FBG) (p=0.061). TAS was weakly negatively correlated with BMI (≥25) (p=0.042). Albumin-to-creatinine ratio (ACR) was statistically higher in hypertensives than normotensives (p=0.049). Duration of disease was only significantly correlated with ACR (r=0.325, p=0.001). Uric acid levels were statistically higher in patients with microalbuminuria than in patients without microalbuminuria (p=0.001).
ConclusionTAS was higher in patients with dyslipidemia and microalbuminuria, suggesting the influence of other factors such as uric acid and lipid-lowering agents. TAS could be an important factor in the management of T2DM cases. This needs to be further investigated in future studies to fill the gap found in the literature.
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Health Literacy and Numeracy in Self-monitoring of Capillary Glycemia: A Systematic Review of Mixed Methods
Authors: Luis Angel Cendejas Medina, Maria Girlane Sousa Albuquerque Brandão, Glaubervania Alves Lima, Maria Lucia Zanetti, Ana Emília Pace, Maria del Pilar Serrano Gallardo, Juana Mercedes Gutierrez Valverde, Brena Shellem Bessa de Oliveira, Francisca Elisangela Teixeira Lima and Carla Regina de Souza TeixeiraAvailable online: 09 January 2025More LessObjectiveThe aim of this study was to synthesize scientific evidence on the influence of health literacy and numerical knowledge on self-monitoring of capillary blood glucose.
MethodsAdhering to the PRISMA guidelines and the principles of the Joanna Briggs Institute, a comprehensive search was conducted across multiple databases, including CINAHL, Cochrane, Embase, LILACS, PubMed, Scopus, Web of Science, Google Scholar, OPENGREY, and NDLTD. The review included studies published in any language that examined the relationship between HL, numeracy, and SMBG.
ResultsA total of 12 studies met the inclusion criteria. These studies utilized various assessment tools, such as the Brief Test of Functional Health Literacy in Adults (B-TOFHLA) and the Diabetes Numeracy Test (DNT-15), to evaluate health literacy and numeracy levels. The findings revealed a significant association between adequate HL and numeracy and improved SMBG practices. Specifically, individuals with sufficient health literacy were more likely to monitor their blood glucose levels regularly and make appropriate treatment adjustments based on their readings.
ConclusionThe results indicated that numeracy skills and health literacy are critical determinants of effective SMBG, influencing the frequency and accuracy of self-care practices in diabetes management. These findings highlight the urgent need for educational interventions tailored to enhance these skills, which could lead to improved health outcomes for individuals with diabetes.
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Medicinal Plants Facilitate the Recovery of Diabetic Foot Ulcer by Regulating Macrophages: Latest Evidence and Insights
Authors: Hongping Mo, Zhen Ye, Xudong Wen, Tao Pan, Zejun Chen and Qiaobo YeAvailable online: 23 December 2024More LessDiabetic Foot Ulcer (DFU) is a major complication of diabetes that mostly affects the lower extremities, with a high incidence and recurrence rate in approximately 15% of patients with diabetes. The complexity of diabetic wounds poses a substantial challenge for clinical recovery, underscoring the need to investigate novel therapeutic approaches. Medicinal plants have been used to treat ulcers for centuries. Recently, there has been a growing focus on the development of topical preparations derived from medicinal plants that target macrophages as an adjuvant therapy for DFU. Macrophages have been identified as crucial factors in the DFU healing process. This review aims to introduce the latest evidence and insights into the role of medicinal plants in promoting DFU recovery by targeting macrophages. The molecular mechanisms underlying the preventive effects of medicinal plants on DFU primarily involve promoting M2 polarization of macrophages, inhibition of M1 polarization, and regulation of macrophage function. This review highlights the substantial potential of advancing the field of DFU management by medicinal plants and lays the groundwork for novel therapeutic interventions.
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A Review on Hepatoprotective Effect of Chrysin: Preclinical Implications and Molecular Cascades Came into Focus
Available online: 06 December 2024More LessChrysin, a flavone nutraceutical, possesses several beneficial pharmacological properties, which has gained much emphasis in recent years. The biological effects of chrysin are exerted due to impeding or activating multifarious cellular and molecular pathways. Our findings indicated that chrysin inhibited tumor progression in various cancer cell lines by repressing the formation of a sphere and upregulated protein expression of Src homology region 2 domain-containing phosphatase-1 (SHP-1), alleviating phosphorylated-signal transducer and activator of transcription 3 (p-STAT3) and transaction workflow innovation standards team1 (Twist1), sustaining phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2) and endorsing mitogen-activated protein kinase kinase1 (MEK1) overexpression, increasing the cytochrome c release, mitochondrial reactive oxygen species (ROS) formation, matrix metalloproteinases (MMP) collapse, and caspase-3 activity, modulating p53/ B-cell lymphoma-2 (Bcl-2)/caspase-9 cascade, cyclooxygenase-2 (COX-2), nuclear factor kappa B proposition 65 (NF-kB p65) expression and also decreasing the expression of nuclear factor erythroid 2-related factor 2 (Nrf2). Chrysin prevented cyclophosphamide, doxorubicin, cisplatin, methotrexate, paracetamol, alcohol, carbon tetrachloride, tert-butyl hydroperoxide (tBHP) and thioacetamide. Chrysin has protective properties against oxidative stress, inflammation, hepatotoxicity, liver fibrosis, steatosis, and hepatocellular carcinoma.Chrysin's most common hepatoprotective biochemical and molecular mechanisms involve the ability to control enzyme synthesis, scavenge free radicals, boost the antioxidant response, induce apoptosis, and modify the synthesis of proinflammatory and profibrotic cytokines.Chrysin is a valuable nutraceutical with broad therapeutic feasibility, but to confirm its representative hepatoprotective potential, clinical studies are advised. It would also be interesting to use cutting-edge drug delivery techniques or include bio-enhancers.
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Design of a Low-Complexity Deep Learning Model for Diagnosis of Type 2 Diabetes
Authors: Soroush Soltanizadeh, Majid Mobini and Seyedeh Somayeh NaghibiAvailable online: 29 November 2024More LessBackgroundRecent research demonstrates that diabetes can lead to heart problems, neurological damage, and other illnesses.
MethodIn this paper, we design a low-complexity Deep Learning (DL)-based model for the diagnosis of type 2 diabetes. In our experiments, we use the publicly available PIMA Indian Diabetes Dataset (PIDD). To obtain a low-complexity and accurate DL architecture, we perform an accuracy-versus-complexity study on several DL models.
ResultThe results show that the proposed DL structure, including Convolutional Neural Networks and Multi-Layer Perceptron models (i.e., CNN+MLP model) outperforms other models with an accuracy of 93.89%.
ConclusionWith these features, the proposed hybrid model can be used in wearable devices and IoT-based health monitoring applications.
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Diabetes Mellitus: Exploring Biomarkers, Complications, and Therapeutic Strategies with a Spotlight on Cyanobacterial Bioactive Compounds - A Comprehensive Review
Authors: Suhail Ahmad, Salman Akhtar, Mohammad Amjad Kamal and Alvina FarooquiAvailable online: 29 November 2024More LessDiabetes, regarded as a prevalent metabolic disorder with multifactorial origins, contributes to a myriad of global complications. These cumulate an elevated susceptibility to kidney failure, nerve impairment, blindness, atherosclerosis, heart ailments, and even strokes. Recent investigations underscore the diverse roles of associated biomarkers in diabetes progression. Among these are biomarkers for diabetes mellitus such as DPP-4, PPAR-ϒ, SGLT-2, α-amylase, and α-glucosidase, which are linked to the onset of diabetes and its related problems. As a result of undesirable adverse consequences linked to extant synthetic antidiabetic medications, research attention is increasingly directed towards formulating natural antidiabetic drugs, aiming for enhanced efficacy and reduced complications. Cyanobacteria stand out as a pivotal repository of natural bioactive metabolites extensively harnessed for pharmaceutical and nutraceutical development. The potent bioactive compounds sourced from cyanobacteria hold substantial promise, kindling high expectations in scientific research and presenting vast prospects for drug discovery and advancement. Some of these bioactive compounds have demonstrated impressive effectiveness, displaying successful applications across various phases of clinical trials. This review strives to provide a more precise understanding of diabetes mellitus, encompassing its clinical manifestation, epidemiological data, complications, and prevailing treatment modalities. The objective of this review is to contribute researchers and readers an enhanced and accurate understanding of diabetes mellitus by covering its clinical manifestation, epidemiological evidence, difficulties, and prevailing therapeutics possibilities.
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An Association between Bilirubin and Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus: An Effect Modification by Nrf2 Polymorphisms
Authors: Qiwei Fan, Shanshan Feng, Jianrong Chen, Yan Zhang, Jixiong Xu and Jiancheng WangAvailable online: 29 November 2024More LessBackgroundiabetic retinopathy (DR) is a persistent microvascular complication associated with diabetes, and it constitutes a significant cause of visual impairment and blindness.
AimsThis study aimed to assess the correlation between serum bilirubin levels and the prevalence of DR in patients diagnosed with type 2 diabetes mellitus (T2DM). Additionally, we sought to establish whether the polymorphisms of Nuclear Factor E2-Related Factor 2 (Nrf2) might modify this relationship.
MethodsA cross-sectional study was undertaken in Jiangxi, China, from May, 2012 to December, 2014. Serum bilirubin levels were assessed in 558 subjects, and the correlation between bilirubin and DR was analyzed using generalized linear models with a logit link. The study utilized odds ratios (OR) and 95% confidence intervals (CI) to evaluate the relationship, both with and without the consideration of clinical risk factors.
ResultsThere was a significant inverse association between serum total bilirubin (TBiL) and the risk of DR (per 1-μmol/L increment; OR, 0.89; 95% CI: 0.84-0.94). Accordingly, when TBiL was categorized into tertiles, individuals in tertiles 2 and 3 exhibited significantly lower risks of DR compared to those in tertile 1. The OR for these tertiles was 0.54 (95% CI: 0.34-0.87) and 0.31 (95% CI: 0.19-0.52), respectively. Moreover, a stronger inverse relationship between TBiL and DR was observed in individuals carrying the CC and AC genotypes compared to those with the AA genotype. The OR for individuals with the CC/AC genotype was 0.87 (95% CI: 0.82, 0.92), while that for the AA genotype was 1.17 (95% CI: 0.95, 1.45). This difference was statistically significant (p for interaction = 0.001).
ConclusionThere was a significant inverse association between bilirubin and DR in participants with CC or AC genotype. However, this inverse association was not seen in AA genotype participants.
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Self-efficacy, Knowledge and Outcomes Expectations Foot Self-care among Diabetic Patients with High-Risk Feet in Jordan
Available online: 29 November 2024More LessBackgroundPatients with high-risk feet and diabetes are prone to develop diabetes-related foot ulcers (DFUs). To prevent DFUs and their costs and impacts on diabetes mellitus (DM) patients’ productivity and quality of life, patients’ foot self-care (FSC) practices are essential to screen for DFUs. Our study aimed to assess the self-efficacy and outcome expectations about FSC and evaluate the knowledge about DFUs among patients with DM in Jordan.
MethodsA cross-sectional study was conducted with DM patients who attended two diabetes clinical centers in Jordan in the period from October 2022 to April 2023 in which data were collected through a self-administered questionnaire developed to assess patients’ understanding of DFUs, foot care outcomes expectations (FCOE), and self-efficacy about FSC.
ResultsThe final sample included data from 107 patients. Patient awareness of DFUs and FCOE was good, and the level of self-efficacy for FSC was moderate to high. Multiple linear regression revealed that age was negatively associated with lower self-efficacy for FSC (β = -0.22, p = 0.03) and both confidence (self-efficacy) in FSC and living arrangements (i.e., living with family) were positively associated with higher FCOE (β = 0.19, p = 0.04 and β = 0.39, p <0.001, respectively). Diagnosis of renal failure, diagnosis of retinopathy, elevated levels of glycated hemoglobin, and the settings in which the patient is receiving care for DM were positively associated with an understanding of DFUs. Both age and history of heart attacks and coronary artery disease were negatively associated with realizing DFUs (β = -0.26, p = 0.007, and β = -0.18, p = 0.045, respectively).
ConclusionPatients with diabetes mellitus in Jordan have good FCOE, good awareness of DFUs, and a moderate degree of self-efficacy to execute FSC. Health education and self-efficacy programs should focus on older adults with a history of heart attacks to boost their understanding of DFUs and raise their sense of self-efficacy around FSC.
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The Effect of a Health Education Program on Knowledge, Medication Adherence, and Glycosylated Hemoglobin in Rural Patients with Type 2 Diabetes
Authors: Zeinab Elyasi, Nasrin Ghiasi, Ali Khorshidi, Salar Bakhtiyari and Mohsen JalilianAvailable online: 29 November 2024More LessBackgroundImproving medication adherence plays a crucial role in preventing adverse complications of type 2 diabetes.
ObjectivesThis study aimed to determine the effect of a health education program on knowledge, medication adherence, and HbA1c in rural patients with type 2 diabetes.
MethodsThis experimental study was conducted in Ilam County, Iran. Participants were selected via multistage cluster sampling and randomly assigned to either the intervention group (n=43) or the control group (n=42). The intervention group underwent a one-month educational program based on self-regulation theory, consisting of 12 sessions, while the control group received no educational intervention. Data were collected at baseline, three months, and six months using a diabetes knowledge test (DKT), the Iranian version of the Morisky Medication Adherence Scale-8 (IVMMAS-8), and laboratory measurements of HbA1c. Statistical analysis was performed using SPSS version 16, employing chi-square tests, independent sample t-tests, repeated-measures ANOVA, and Bonferroni correction at a significance level of 0.05.
ResultsAfter 3 and 6 months, the intervention group showed significant improvements in diabetes knowledge and medication adherence and a significant reduction in HbA1c levels compared to the control group (p<0.001). No significant changes were observed in the control group over time (p>0.05).
ConclusionThis study demonstrated that health education based on self-regulation theory can effectively increase knowledge, improve treatment adherence, and decrease HbA1c levels in rural patients with type 2 diabetes.
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A Mechanism-based Perspective on the Use of Flavonoids in the Treatment of Diabetes and its Complications
Authors: Sandesh Kumar Pattanaik, Manisha Prajapati Anil, Sudipta Jena and Diptirani RathAvailable online: 29 November 2024More LessDiabetes is a chronic, irreversible, non-infectious metabolic syndrome associated with low insulin production by the pancreas or due to insulin resistance. The management landscape for diabetes is swiftly evolving due to ongoing advancements. Conventional treatment approaches have struggled to fully address the root causes of the disease while also carrying significant risks of adverse effects. Flavonoids are an extensive class of phytonutrients present in grains, vegetables, fruits, cocoa, tea, wine, and nuts. Many studies have reported that flavonoids have shown diversified pharmacological activity in recent years. Thus, this review will give you an overview of the significant anti-diabetic potential of promising flavonoids. Various search engines such as PubMed, Scopus, Google Scholar, and WoS have been explored by using the keywords “apigenin,” “luteolin,” “naringenin,” “hesperidin,” “kaempferol,” “quercetin,” “myricetin” and “taxifolin” with “anti-diabetic.” The anti-diabetic activity of flavonoids is attributed to various mechanisms, including α glucosidase, α-amylase inhibitory effects, GLUT4 expression, antioxidant, and apoptosis. However, their inadequate biopharmaceutical qualities make their effectiveness in clinical translation constrained. This review aims to highlight plant-derived flavonoids through in-vitro, in-vivo, and clinical insights. Additionally, the review highlights the recent advancement in the drug delivery system in diabetes to overcome the limitation of flavonoids.
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Deciphering the Interlinked CXCR4-Mediated Feedback Loop Among Signaling Pathways in Diabetic Wound Healing
Available online: 29 November 2024More LessDiabetic chronic wounds and amputations are very serious complications of diabetes mellitus (DM) that result from an integration factor, including oxygen deprivation, elevated reactive oxygen species (ROS), reduced angiogenesis, and microbial invasion. These causative factors lead to tenacious wounds in an inflammatory state, which eventually results in tissue aging and necrosis. Wound healing in DM potentially targets C-X-C chemokine receptor type 4 (CXCR4) regulates several signalling pathways. The CXCR4 signalling pathway integrated with phospholipase C (PLC)/protein kinase-C (PKC) Ca2+ pathways, stromal cell-derived factor-1 (SDF-1), and mitogen-activated protein kinases (MAPKs) pathway for enhancing cell chemotaxis, proliferation, and survival. The dysregulated CXCR4 pathway is connected with poor wound healing in DM patients. Therapeutic strategies targeting CXCR4-based molecules such as UCUF-728, UCUF-965, and AMD3100 have been shown to enhance diabetic wound healing by altering miRNA expression, promoting angiogenesis, and accelerating wound closure. This study indicates that CXCR4 participation in various signalling pathways makes it essential for Understanding the healing of diabetic wounds. Using specific compounds to target CXCR4 offers a potentially effective treatment strategy to improve wound healing in diabetes. Our understanding of CXCR4 signalling and its regulation processes will enable us to develop more potent wound care solutions for diabetic chronic wounds. This report concludes that CXCR4's potential therapeutic targeting shows improvements in diabetic wound repair. This review will demonstrate that CXCR4 plays a major role in wound healing through its various signalling pathways. Targeting CXCR4 with certain agonist molecules shows a therapeutic approach to potentially increasing wound healing in diabetes. By enhancing our understanding of the CXCR4 signalling mechanism in future studies, we can develop more potential treatments for chronic diabetic wounds.
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