جستجوی مقالات مرتبط با کلیدواژه « diabetes complications » در نشریات گروه « پزشکی »

 This study appraised the antioxidant potentials, mineral compositions, and antidiabetic activities of pap water (aqua) extract (PWE) and aqueous extract (AE) from Ocimum gratissimum.

 The total phenolic contents (TPC), total flavonoid contents (TFC), ferric reducing antioxidant powers (FRAP), Fe2+-chelating abilities, 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging abilities, and enzymes inhibition potentials of the PWE and AE from O. gratissimum were evaluated. Additionally, mineral contents were determined using absorptive absorbance spectroscopy (AAS).

 The PWE of O. gratissimum exhibited higher TPC of 42.61± 0.04 mg gallic acid equivalent per gram of dried sample (GAE/g) and TFC of 85.7 ± 0.02 µg quercetin equivalent per gram of dried sample (QE/g). In contrast, AE had lower TPC (21.52 ± 0.01 mg GAE/g) and TFC (55.0 ± 0.01 µg QE/g). PWE also displayed a lower FRAP of 2.86 ± 0.01 mg AAE/g, while AE had a higher FRAP of 2.94 ± 0.03 mg AAE/g. PWE of O. gratissimum had IC50 for DPPH: 100.00 µg/mL, Fe2+-chelating ability: 4.41 µg/mL, while AE had IC50 for DPPH: 140.00 µg/mL and Fe2+-chelating ability: 4.90 µg/mL. Similarly, the PWE of O. gratissimum showed a higher α-amylase inhibition (IC50: 0.47 mg/mL) than AE (IC50: 0.78 mg/mL); however, AE (IC50 =3.09 µg/mL) demonstrated a higher α-glucosidase inhibition than PWE (IC50: 9.09 µg/mL). AAS analyses indicated the presence of Ca, Fe, Mg, Cu, Zn, and Mn in different proportions in both extracts.

 Therefore, PWE could be a better alternative in the management of diabetes melitus if properly annexed.

 Diabetes management self-efficacy (DMSE) positively affects diabetes self-care behaviors and can lead to better glycemic control and improved disease outcomes in diabetes patients.

 This study aimed to evaluate DMSE level and its relationship with medication adherence, glycemic control, and diabetes complications among type 2 diabetes (T2D) patients.

 A cross-sectional study was carried out from November 2019 to January 2020 on T2D patients who attended the Diabetes Center of the Kerman University of Medical Sciences. Data were collected using two validated questionnaires including the diabetes management self-efficacy scale (DMSES) to evaluate DMSE level and the eight-item Morisky medication adherence scale (MMAS) to assess adherence to medication. The SPSS statistical software version 22 was employed for data analysis.

 Of 440 T2D patients entering the study, 72% were female with a mean (SD) age of 59.60 (10.48). The mean (SD) DMSE score of the respondents was 5.76 (1.87). A significant negative correlation was observed between DMSE with HbA1c (r = -0.289, P < 0.0001) and also with FBS (r = -0.229, P < 0.0001), but there was a significant positive correlation between DMSE and adherence to medication (r = 0.208, P < 0.0001). FBS level (β = -0.252, P < 0.0001), number of visits by specialty or subspecialty physicians (β = -0.139, P = 0.002), medication adherence score (β = 0.165, P < 0.0001), neuropathy (β = 0.142, P = 0.002), marital status β = 0.125, P = 0.004), household income (β = -0.126, P = 0.004), and blood glucose checks at home (β = 0.109, P = 0.013) were considered predictors of DMSE score.

 Diabetes management self-efficacy is considered suboptimal among T2D patients. Patients with higher DMSE have better adherence to medication, better blood glucose control, lower risk of neuropathy, and fewer visits by specialty and subspecialty physicians.

This study aimed to conduct a systematic review about diabetes mellitus and COVID-19 severity, management, and mortality.

Thirteen studies were included in this review, comprising a total of 1155 COVID-19 patients with diabetes mellitus as a significant comorbidity. Data regarding patient demographics and the prevalence of comorbidities, including smoking, hypertension, cardiovascular disease, chronic kidney disease, and chronic liver disease, were collected.

Among COVID-19 patients with diabetes mellitus, the majority were male (57.1%) compared to females (42.9%). The prevalence of comorbidities in COVID-19 are varied, with smokers accounting for 1-12.6%, hypertension ranging from 8-41.6%, diabetes mellitus ranging from 7.4-70.8%, cardiovascular disease ranging from 1.6-23.0%, chronic kidney disease ranging from 0.7-2.9%, and chronic liver disease ranging from 0.5-4.6%. In comparison to COVID-19 patients without diabetes, a higher proportion of patients with diabetes mellitus were admitted to the intensive care unit (36.8%). Among COVID-19 patients with diabetes mellitus, the survival rate was significantly higher at 62.2% compared to a lower rate of 13.4% observed among non-survivors with diabetes mellitus.

This systematic review emphasizes the significance of diabetes mellitus as a comorbidity in COVID-19 patients, increasing the risk of ICU admission. These findings emphasize the importance of identifying and effectively managing diabetes mellitus as a comorbidity in COVID-19 patients to enhance overall outcomes.

Clinical guidelines and expert committees have recently suggested that the hemoglobin A1C (HbA1c) should be individualized based on various criteria. Data regarding the achievement of individualized glycemic targets in type 2 diabetes mellitus (T2DM) patients is scant in Iran. We intended to provide information found on real-world outcomes from the perspective of an individualized recommendation. A cross-sectional analysis was conducted in 15 diabetes centers in Iran between 2013-2017. Two steps cluster sampling selection was used to recruit 1591 patients with T2DM. Considering Ismail-Beigi’s individualized strategy, the study population was categorized into five treatment intensities of HbA1c: most intensive (≤6.5%), intensive (6.5–7.0%), less intensive (~7.0%), not intensive (7.0–8.0%), and moderated (~8.0%). The percentage of patients who met their group individualized glycemic targets was estimated as the degree of achievement of each treatment intensity. The cumulative incidence rate of early microvascular, advanced microvascular, and macrovascular complications was 53%, 25%, and 34%, respectively. Besides, 78% [77.6-79%] of patients did not achieve individualized glycemic targets.  The outcome showed poor individualized glycemic control and a high incidence of diabetes complications. Considering individualized HbA1c targets for Iranian patients with T2DM is an urgent need.

Sexual life can be affected through different aspects of living with diabetes. This study aimed to explore the perception and experiences of Iranian women with diabetes at reproductive age regarding the impact of diabetes on their sexual life. This qualitative study was conducted from August 2018 to February 2019 in five diabetes centers in Tehran. Purposeful sampling method was used to select the participants, and data were collected by in-depth semi-structured interviews. Data were analyzed manually using the conventional content analysis method. Data saturation occurred after interviewing 24 women with diabetes. Three themes were identified. The first theme was “diabetes-related threatened sexual life” with three categories: change in sexual functioning, negative sexual self-evaluation, and concern in sexual relationships. The second theme was “diabetes treatment challenges in sexual life,” which included two categories: adverse effects of diabetes treatment in sexual life and the psychosocial distress related to diabetes treatment. “Couples’ relationship adjustment to diabetes,” was identified as the third theme, including four categories: the need for spouse’s understanding of living with diabetes problems, perceived need for spouse’s support, perceived need for intimacy, and the need to cope with diabetes-related childbearing challenges. According to the participants’ perception and experiences, in addition to sexual problems, diabetes had affected their sexual life through diabetes treatment challenges in sexual life and the way the couples’ relationships adjust to diabetes. Therefore, sexual problems screening and providing counseling services in community-based diabetes care planning are recommended.

Anal abscess is considered as a relatively common compilation in type 2 diabetes mellitus (T2DM) patients. This study aimed to determine the risk factors of recurrent anal abscess in T2DM patients.

In this 4-year retrospective cross-sectional study, T2DM patients hospitalized due to anal abscess in Shahid Modar- res Hospital, Tehran, Iran from December 2016 to December 2020 were studied. The independent risk factors of disease recurrence were determined among demographic factors, underlying diseases, diabetes-related factors, clinical factors, laboratory parameters, abscess type, and culture using multivariate stepwise logistic regression analysis.

203 patients were enrolled in the study. 58 (28.6%) patients had at least one re-occurrence of anal abscess during four years. The recurrent episodes had occurred more frequently in the first year after the initial treatment (55.2%). The prevalence of comorbidities such as metabolic syndrome, coronary artery dis- ease, chronic kidney disease, end stage renal disease, and peripheral vascular disease was significantly higher amongst patients with abscess recurrence. The patients with recurrent anal abscess had statically significant poor glycemic control (HbA1C > 7.5), decreased levels of Estimated Glomerular Filtration Rate (e-GFR), and higher C-reactive Protein (CRP) upon the first admission. Presence of metabolic syndrome, HbA1c > 7.5%, WBC > 11.0 ×109/L, and CRP > 5 mg/l were amongst the independent risk factors of recurrence. HbA1c > 7.5% was the greatest independent risk factor of anal abscess recurrence (OR=2.68, 95% CI: 1.37-5.25; p < 0.001). The area under the receiver operating characteristic (ROC) curve (AUC) of HbA1C, CRP, and WBC in predicting the risk of abscess recurrence was 0.81, 0.71, and 0.64, respectively.

Th recurrence rate of anal abscess in this series was 28.6 %. It seems that in T2DM patients with uncontrolled diabetes who have metabolic syndrome and increased CRP and WBC in their routine tests, the probability of anal abscess reoccurrence is high

ype 2 diabetes mellitus (T2DM) is a chronic metabolic abnormality leading to microvascular and macrovascular complications. Non-insulin Incretin mimic synthetic peptide exendin-4 was introduced as an anti-diabetic drug which helped diabetic patients with triggering insulin secretion; further researches have revealed an effective role of exendin-4 in treatment of T2DM related diseases. Exendin-4 is approximately similar to Glucagon-like peptide, thus it can bind to the glucagon-like peptide-1 receptor (GLP-1R) and activated different signaling pathways that are involved in various bioactivities such as apoptosis, insulin secretion and inactivation of microglial. In this review, we investigated the interesting role of exendin-4 in various kinds of T2DM related disorders through the activation of different signaling pathways.

Oxidative stress has a prominent role in the pathogenesis of diabetes complications. Pramlintide is an injectional amylin analogue used for the treatment of type 1 and type 2 diabetic patients. The present investigation evaluated the effect of pramlintide against oxidative damage induced by hydrogen peroxide (H2 O2 ) in human umbilical vein endothelial cells (HUVECs).

Cell viability was assessed using 3‑(4,5‑dimethylthiazol‑2‑yl)‑2,5‑diphenyltetrazolium bromide method. Hydroperoxides level, ferric reducing antioxidant power (FRAP), and expression of transcription factor NF‑κB were measured in HUVECs that pretreated with pramlintide and, then exposed to H2 O2 .

Pramlintide significantly decreased the cytotoxicity caused by H2 O2 at the concentrations of 5 and 10 µg/mL. Pretreatment of HUVECs with pramlintide reduced hydroperoxides and increased FRAP value in intra‑ and extra‑cellular mediums at different concentration ranges compared with H2 O2 stimulated cells. Pramlintide (10 µg/mL) remarkably ameliorated the expression of NF‑κB gene after 1, 3 and 24 h exposure to H2 O2 .

Findings of the current investigation displayed that pramlintide may act as a protective against oxidative conditions in endothelial cells through modulation of oxidative markers and transcription factor NF‑κB.

Diabetes mellitus, if is not well taken care and treated, may exacerbate complications such as ulcers, infections, and amputations. Accordingly, preventive measures and timely treatment are of paramount importance.

This study sought to collect profound experiences about diabetic ulcer care management with an emphasis on community-based care.

The study was carried out using the qualitative content analysis method during 2017 - 2018 in Semnan Province, Iran. The study encompassed 14 participants, including six caregivers, two family members, one nurse, one nursing supervisor, one manager of counseling and nursing care service centers (CNCSCs), one head nurse, and two physicians, who were selected using the purposive sampling method. The analysis process was performed based on Graneheim and Lundma’s approach.

Two main categories were as follows: (1) "Dispersion in preventive measures," with subcategories of ‘vague perception of disease symptoms’, ‘inability in self-management’ and ‘low-efficient preventive care’, and (2) "Gradual access to outpatient services" with subcategories of ‘gradual expansion of outpatient ulcer care’, ‘complexity of financial transactions’, ‘improving inter-sectoral cooperation’ and ‘ambiguous professional boundaries’.

Care facilities offering services to diabetic foot ulcers, especially community-based nursing care centers, are gradually expanding, and new wound care methods are being adopted. However, lack of self-care management, insufficient support, treatment-oriented approaches, and all clients’ insufficient access to these services are some of the problems that still exist in the care management of diabetic ulcers.

Moringa oleifera has been used in many regions of the world at the level of folk medicine as a remedy for numerous diseases including the treatment of type 2 diabetes. This study aims to investigate the antidiabetic activity of the methanolic extract of M. oleifera leaves in type 2 diabetes mellitus in animal model induced by fat rich diet and the use of the diabetogenic agent, streptozotocin (STZ) in male Wistar rats. A daily dose of 300 mg/kg of M. oleifera extract (MOE) was administered to diabetic male Wistar rats that had been induced by high fat diet feeding for one month followed by intraperitoneal injection of 40mg/kg of streptozotocin. After three weeks of MOE treatment, blood glucose concentration, lipid profile markers, urea, and creatinine were assayed. Food intake was measured daily and body weight was measured weekly. After three weeks of treatment, MOE significantly decreased the blood glucose of the tested rats, and a marked decrease of triglyceride also was noticed. Regarding renal function indicators, MOE significantly decreased the serum urea level of diabetic rats. However, no change has been noticed in the serum creatinine level in all experimental groups. The findings in the present study suggest that M. oleifera can significantly alleviate hyperglycemia, and hyperlipidemia in diabetic rats. M. oleifera could be a potential treatment of type 2 diabetic patients.

COVID-19 is a viral infection that causes pneumonia with dyspnea, cough, and fever. Its outcomes are more severe in patients with diabetes, hypertension, and other disorders than in healthy people. New-onset diabetes and diabetic ketoacidosis (DKA) have been reported as the complications of COVID-19 in several studies. It seems that the prevalence of DKA due to Covid-19 is increasing. Therefore, two cases of individuals with DKA due to COVID-19 are presented in this study to inform other researchers about the details of this phenomenon.

Demographic characteristics, medical histories, physical examinations, laboratory investigations, real-time RT-PCR tests, computed tomography (CT) imaging studies, given treatments, clinical courses, and management outcomes were documented prospectively.

In the present experience, the manifestation of COVID-19 disease in the second case with a history of diabetes was more severe than in the first case. In the second case, with underlying diabetes and COVID-19, the DKA manifestation was associated with consciousness loss, severe restlessness, and respiratory distress; however, in the first case, with COVID-19 without diabetes, the DKA manifestation was associated with anorexia, weight loss, and lack of respiratory distress, which were milder symptoms than the second case.

Due to the high prevalence of diabetes mellitus and COVID-19 in Iran, it is recommended to raise awareness of DKA symptoms among health professionals.

The awareness about bidirectional relationship between periodontitis and diabetes mellitus (DM) is not well known among the Malaysian population. This study aimed to evaluate the level of awareness of periodontal disease (PD)-DM interrelationship and self-reported periodontal health among patients with DM.

Patients who attended the diabetic clinic were systematically and randomly invited to participate in this cross-sectional study. Consented participants completed a validated self-administered questionnaire and provided information on socio-demographic background, oral hygiene practice, periodontal health status, and awareness about whether there is relationship between PD and DM. The level of hemoglobin A1c (HbA1c) was obtained from the medical record. Descriptive and logistic regression analyses were carried out using SPSS software with P < 0.05 considered as significant.

A total of 123 patients with DM with a mean age of 62.20 ± 9.55 years participated in the study. The mean duration of living with DM was 10.62 ± 6.52 years and that for HbA1c level was 9.08 ± 2.24 mmol/l. About 53% of the participants had signs of PD, but only 22% perceived that they had PD. Only 15% were aware of the PD-DM interrelationship. The odds of knowing the definition and cause of PD and believing that oral health could be better without DM were greater in participants who had the awareness compared to those without awareness (P < 0.01).

This study showed that patients with DM had a low level of awareness about PD-DM interrelationship which could be due to a lack of understanding about PD. It is recommended that patients with DM should be referred to a dental clinic for oral health counselling.

Duqqa is a condiment, consisting of black pepper, cumin, sesame, coriander and high amount of salt. Reducing salt and adding other beneficial items to traditional duqqa can make it suitable dietary supplement for diabetes management. The current study aimed to assess the effect of a modified duqqa on diabetes and its complications in diabetic rats.

The modified duqqa was formulated by mixing grounded fermented wheat, sesame, coriander, cumin, chicory leaves, cinnamon, turmeric and date seeds powder and studied in diabetic rats which were developed by streptozotocin-nicotinamide injection. Thirty-two rats were divided into four groups (n = 8) including non-diabetic, diabetic control and the other two groups fed on balanced diet supplemented with either 10 or 20% of duqqa prior the induction of diabetes (for one week) to the end of the experiment (8 weeks).

The dietary supplementation with 10 and 20% of the formulated duqqa prior the induction of diabetes did not delay the onset of diabetes in rats but produced reduction (32.56% and 50.47%, respectively) in the glucose levels of diabetic rats. Also, diabetic rats fed on the formulated duqqa showed insulin concentrations higher than that of diabetic control rats. Feeding diabetic rats on the formulated duqqa reversed the elevation of kidney lipid peroxidation and nitric oxide, limited the disturbance in the lipid profile as well as liver and kidney functions and elevated both serum and femur magnesium concentrations.

The results indicated the hypoglycemic effect of the formulated duqqa and its efficiency in delaying diabetes complications.

Hyperglycemia induces cellular senescence in various body cells, such as vascular endothelial cells. Since the vessels are highly distributed in the body and nourish all tissues, vascular damages cause diabetes complications such as kidney failure and visual impairment. Alpha-mangostin is a xanthone found in mangosteen fruit with protective effects in metabolic syndrome and diabetes. This paper has investigated the protective effect of this xanthone against high glucose-induced memory senescence in human vascular endothelial cells (HUVECs) in the presence of metformin, as a positive control. To induce the memory senescence model, HUVECs, after three days incubation with high glucose, were incubated with normal glucose for another three days, and for whole six days, cells were treated with metformin (50 µM) or alpha-mangostin (1.25 µM). On the last day, cell viability by MTT assay, oxidative stress by fluorimetric assay, the number of senescent cells by SA beta-galactosidase staining kit, and secretory interleukin-6 by ELISA kit were measured. SIRT1 and P53 proteins were also evaluated by Western blotting. Metformin and alpha-mangostin significantly increased cell viability, decreased reactive oxygen species, and senescence-associated beta-galactosidase in HUVECs incubated in metabolic memory condition. Generally, metabolic memory increased p53 and acetyl-P53 and decreased SIRT1 proteins in HUVECs, which were reversed by alpha-mangostin and metformin. These data exhibit that alpha-mangostin, comparable to metformin, protects endothelial cells against metabolic memory-induced senescence, which is likely via SIRT1.

Diabetic Foot Ulcer (DFU) as one of the main complications of diabetes mellitus has serious outcomes such as infection, foot amputation, low quality of life, and premature death.

This study was conducted to assess the DFU prevalence and its related factors among diabetic patients.

The population of this cross-sectional study included adult diabetic patients in the Diabetes Center of Kerman University of Medical Sciences. The data were recorded in a questionnaire using patients’ medical records, interviews with them, and physical examination. The collected data were imported to SPSS version 22 software and analyzed.

Of 400 diabetic patients enrolled in the study, 69% (n = 276) were female. The mean (± SD) of their age was 57.1 (± 11.9) years and 72% (n = 288) were younger than 65. The frequency of DFU during the total course of the disease and its annual prevalence were 17.3% (n = 69) and 11.8% (n = 49) among diabetic patients, respectively. More than one-third (37.7%) of the DFU patients and 6.6% of all the patients were admitted to a hospital due to DFU. Major or minor amputation was performed for 14.5% (n = 10) of the total DFU patients and 2.5% of the total patients. Having diabetes-related complications was determined as the strongest predictor of DFU (OR = 7.016, 95% CI = 2.67 - 18.38), followed by smoking (OR = 3. 80, 95% CI = 2.06 - 6.99) and age over 64 years (OR = 3.70, 95% CI = 1.299 - 10.568).

The frequency of DFU was high among diabetic patients attending the Diabetes Center of Kerman University of Medical Sciences. Also, hospital admission and foot amputation due to DFU had a considerable frequency. Therefore, there is a crucial need to improve the quality of foot care services and emphasize foot self-care as essential components of diabetes self-management at all levels of the health service delivery system to decrease the risk of DFU.

Peripheral arterial disease (PAD) is an important marker of cardiovascular (CV) risk and the risk of PAD is markedly increased in patients with type 2 diabetes mellitus (T2DM). Consequently, early diagnosis and treatment of PAD in patients with T2DM are critically important to reduce the risk of CV events. The aim of this study was to determine the prevalence of asymptomatic PAD in patients with T2DM and to investigate the demographic and clinical associations of PAD among them. This cross‑sectional study included 2423 diabetic patients >20 years old, who were regularly followed up at the regional diabetes clinic, Galle, Sri Lanka. Data were obtained using structured questionnaires for information on demographic characteristics and risk factors. Assessment of ankle‑brachial pressure index (ABPI) was performed in all. PAD was diagnosed when ABPI was < 0.9 on either leg. The overall prevalence of PAD was 15.3% with no signifcant age
or gender difference. Patients with PAD had signifcantly higher systolic blood pressure (SBP) (127 vs 125 mmHg, P = 0.002) and diastolic blood pressure (DPB) (80 vs 78 mmHg, P = <0.001) and signifcantly lower estimated glomerular fltration rate (eGFR) (80 vs 84 ml/min, P = 0.007) than those without PAD. No signifcant relationships were found between the duration of diabetes mellitus, hypertension, dyslipidemia, and PAD. Prevalence of PAD was relatively high in the
diabetic population of this study when compared with fndings from other countries. There is a signifcant association of subclinical PAD with reduced eGFR among patients with T2DM.

The aim of this study was to investigate the effect of vitamin D on glucose metabolism, as well as the expression of five key genes involved in the development of diabetes complications in liver tissue of diabetic rats. Twenty-four male Sprague–Dawley rats were randomly divided into three groups (8 rats in each group). The first group served as control and the other two groups received an intraperitoneal injection of 45 mg/kg streptozotocin to develop diabetes. Groups were treated for four weeks either with placebo or vitamin D (two injections of 20000 IU/kg). Thereafter, serum levels of glucose, insulin and HbA1c were assessed. Liver tissue was examined for the level of advanced glycation end products (AGEs) and the gene expression of AGE cellular receptor (AGER), glyoxalase-1 (GLO-1), aldose reductase (AR), O-linked N-acetylglucosamine transferase (OGT) and glutamine/ fructose-6-phosphate aminotransferase (GFAT). Vitamin D injection resulted in a significant increase in plasma level of 25-hydroxycholecalciferol, which could improve hyperglycemia about 11% compared to placebo-receiving diabetic rats (P=0.005). Insulin level increased as a result of vitamin D treatment compared to control (3.31±0.65 vs. 2.15±0.79; P= 0.01). Serum HbA1c and liver AGE concentrations had a slight but insignificant reduction following vitamin D intake. Moreover, a significant decline was observed in gene expression of AGER and OGT in liver tissue (P=0.04 and P Vitamin D might contribute in ameliorating diabetes complications not only by improving blood glucose and insulin levels, but also by suppressing AGER and OGT gene expression in the liver.