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  1. Fauzi A, Kifli N, Noor MHM, Hamzah H, Azlan A
    J Ethnopharmacol, 2024 May 10;325:117914.
    PMID: 38360381 DOI: 10.1016/j.jep.2024.117914
    ETHNOPHARMACOLOGICAL RELEVANCE: Traditional uses of Morus alba L. leaf extracts (MLE) have been reported for treating hyperglycaemia and diabetes. Phytochemical compounds in the leaves demonstrated the ability to enhance insulin sensitivity and β-cell secretory function, suggesting their potential value in reducing blood glucose and treating diabetes. However, the phytochemical constituents and safety of the herbal medicines need to be verified in each experimental field from different growing areas. Studies on the phytochemistry and toxicity of Morus alba leaves in Southeast Asia, especially in Brunei, have never been investigated.

    AIM OF THE STUDY: This study aimed to investigate the bioactivity and phytochemistry of Morus alba ethanolic leaf extract from Brunei Darussalam and its subacute toxic effects in the Institute of Cancer Research (ICR) female mice.

    MATERIALS AND METHODS: The phenolic yield and antioxidant of the extract were analysed. Meanwhile, liquid chromatography-mass spectrometry and high-performance liquid chromatography were utilised to determine the phenolic compound of the MLE. In the subacute toxicity study, twenty-five female mice were randomly divided into five groups: the control group, which received oral gavage of 5% dimethyl sulfoxide solvent (DMSO), and the MLE treatment group, which received the extract at a dose of 125, 250, 500 and 1000 mg/kg. Physiology, haematology, biochemistry, and histology were evaluated during the study.

    RESULTS: Morus alba leaf depicted total phenolic 10.93 mg gallic acid equivalents (GAE)/g dry weight (DW), flavonoid 256.67 mg quercetin equivalents (QE)/g DW, and antioxidant bioactivity content of 602.03 IC50 μg/mL and 13.21 mg Fe2+/g DW. Twenty compounds in the Morus alba ethanolic leaf extract were identified, with chlorogenic acid (305.60 mg/100 g DW) as the primary compound. As for subacute toxicity in this study, neither mortality nor haematological changes were observed. On the other hand, administration of 500 and 1000 mg/kg MLE resulted in mild hepatocellular injury, as indicated by a significant (p 

    Matched MeSH terms: Diabetes Mellitus*
  2. Rami M, Ahmadi Hekmatikar A, Rahdar S, Marashi SS, Daud DMA
    Sci Rep, 2024 Mar 26;14(1):7133.
    PMID: 38531890 DOI: 10.1038/s41598-024-57119-6
    T2DM is known to cause disturbances in glucose homeostasis and negative changes in the heart muscle, while aging and diabetes are recognized risk factors for CVD. Given this, our study aims to investigate a method for controlling and managing CVDs induced by T2DM in elderly populations. To achieve this, we categorized 40 rats into 5 groups, including HAD (n = 8), HA (n = 8), AD (n = 8), AHT (n = 8), and ADT (n = 8). The exercise protocol consisted of eight weeks of HIIT (three sessions per week) performed at 90-95% of maximal speed. Following cardiac tissue extraction, we assessed the levels of IGF-1, PI3K, and AKT proteins using Western blot technique, and analyzed the histopathological variations of the heart tissue using H&E, Sudan Black, and Masson's trichrome tissue staining. The histological findings from our study demonstrated that T2DM had a significant impact on the development of pathological hypertrophy and fibrosis in the heart tissue of elderly individuals. However, HIIT not only effectively controlled pathological hypertrophy and fibrosis, but also induced physiological hypertrophy in the AHT and ADT groups compared to the HA and AD groups. Results from Sudan Black staining indicated that there was an increase in lipid droplet accumulation in the cytoplasm of cardiomyocytes and their nuclei in the HA and AD groups, while the accumulation of lipid droplets decreased significantly in the AHT and ADT groups. In both the AHT group and the ADT group, a single HIIT session led to a reduction in collagen fiber accumulation and fibrotic frameworks. Our research also revealed that diabetes caused a significant elevation in the levels of IGF-1, PI3K, and AKT proteins, but after eight weeks of HIIT, the levels of these proteins decreased significantly in the training groups. Overall, our findings suggest that HIIT may be a suitable non-pharmacological approach for improving histological and physiological changes in elderly individuals with T2DM. However, we recommend further research to examine the impact of HIIT training on both healthy and diseased elderly populations.
    Matched MeSH terms: Diabetes Mellitus, Type 2*
  3. Cheah KJ, Abdul Manaf Z, Fitri Mat Ludin A, Razalli NH, Mohd Mokhtar N, Md Ali SH
    JMIR Mhealth Uhealth, 2024 Mar 12;12:e49055.
    PMID: 38532298 DOI: 10.2196/49055
    BACKGROUND: The success of mobile apps in improving the lifestyle of patients with noncommunicable diseases through self-management interventions is contingent upon the emerging growth in this field. While users of mobile health (mHealth) apps continue to grow in number, little is known about the quality of available apps that provide self-management for common noncommunicable diseases such as diabetes, hypertension, and obesity.

    OBJECTIVE: We aimed to investigate the availability, characteristics, and quality of mHealth apps for common noncommunicable disease health management that included dietary aspects (based on the developer's description), as well as their features for promoting health outcomes and self-monitoring.

    METHODS: A systematic search of English-language apps on the Google Play Store (Google LLC) and Apple App Store (Apple Inc) was conducted between August 7, 2022, and September 13, 2022. The search terms used included weight management, obesity, diabetes, hypertension, cardiovascular diseases, stroke, and diet. The selected mHealth apps' titles and content were screened based on the description that was provided. Apps that were not designed with self-management features were excluded. We analyzed the mHealth apps by category and whether they involved health care professionals, were based on scientific testing, and had self-monitoring features. A validated and multidimensional tool, the Mobile App Rating Scale (MARS), was used to evaluate each mHealth app's quality based on a 5-point Likert scale from 1 (inadequate) to 5 (excellent).

    RESULTS: Overall, 42 apps were identified. Diabetes-specific mHealth apps accounted for 7% (n=3) of the market, hypertension apps for 12% (n=5), and general noncommunicable disease management apps for 21% (n=9). About 38% (n=16) of the apps were for managing chronic diseases, while 74% (n=31) were for weight management. Self-management features such as weight tracking, BMI calculators, diet tracking, and fluid intake tracking were seen in 86% (n=36) of the apps. Most mHealth apps (n=37, 88%) did not indicate whether there was involvement of health professionals in app development. Additionally, none of the apps reported scientific evidence demonstrating their efficacy in managing health. The overall mean MARS score was 3.2 of 5, with a range of 2.0 to 4.1. Functionality was the best-rated category (mean score 3.9, SD 0.5), followed by aesthetics (mean score 3.2, SD 0.9), information (mean score 3.1, SD 0.7), and engagement (mean score 2.9, SD 0.6).

    CONCLUSIONS: The quality of mHealth apps for managing chronic diseases was heterogeneous, with roughly half of them falling short of acceptable standards for both quality and content. The majority of apps contained scant information about scientific evidence and the developer's history. To increase user confidence and accomplish desired health outcomes, mHealth apps should be optimized with the help of health care professionals. Future studies on mHealth content analysis should focus on other diseases as well.

    Matched MeSH terms: Diabetes Mellitus*
  4. Hee NKY, Lim QH, Paramasivam S, Lim LL, Vethakkan S, Ganapathy SS, et al.
    Clin Endocrinol (Oxf), 2024 Mar;100(3):221-229.
    PMID: 38031259 DOI: 10.1111/cen.14999
    OBJECTIVE: Once daily prednisolone taken at predawn has been proposed to be the glucocorticoid replacement of choice in patients with adrenal insufficiency (AI) who intend to fast for the month of Ramadan. However, the effects of prednisolone on metabolic parameters and quality of life during fasting for Ramadan are unknown.

    DESIGN, PATIENTS AND MEASUREMENTS: Patients with AI on twice-daily hydrocortisone, who had low or moderate risk and intended to fast, were recruited. Patients were converted to prednisolone 5 mg once daily taken at sahur (predawn) and Ramadan education given. Weight, sleep duration, biochemical parameters and quality of life measures (SF-36 questionnaire) were analysed at the end of Ramadan and compared against baseline.

    RESULTS: Twenty patients (13 men) were recruited, with a mean age of 59.9 ± 15.0 years. All patients were on hydrocortisone 15 mg daily (in divided doses) as pre-Ramadan glucocorticoid replacement. Half had type 2 diabetes with low IDF-DAR risk. Eighty-five percent of patients completed the full 29 days of fasting with no complications. There was a significant reduction in weight (-1.1 ± 1.6 kg, p = .005), with no significant change in blood pressure or sleep duration. There was a significant increase in urea (0.80 ± 1.1 mmol/L, p = .005) and haematocrit, (0.011 ± 0.019 L/L, p = .019) and decrease in serum sodium (-1.6 ± 3.0 mmol/L, p = .028), with no change in serum creatinine or liver function. Quality of life measures were preserved in all domains with significant improvement in role limitation due to physical health (15.3 ± 21.6, p = .005) and bodily pain (8.8 ± 16.3, p = .031).

    CONCLUSIONS: This study has demonstrated that converting patients with AI who are fasting for Ramadan from twice-daily hydrocortisone to prednisolone 5 mg daily at sahur was safe, with no major short-term adverse effects. Despite the higher equivalent glucocorticoid doses, patients experienced weight loss and no clinically significant change in blood pressure, sleep, biochemical parameters or quality of life. This study paves the way to trial even lower doses of prednisolone once daily in patients fasting for Ramadan with AI.

    Matched MeSH terms: Diabetes Mellitus, Type 2*
  5. Lane MM, Gamage E, Du S, Ashtree DN, McGuinness AJ, Gauci S, et al.
    BMJ, 2024 Feb 28;384:e077310.
    PMID: 38418082 DOI: 10.1136/bmj-2023-077310
    OBJECTIVE: To evaluate the existing meta-analytic evidence of associations between exposure to ultra-processed foods, as defined by the Nova food classification system, and adverse health outcomes.

    DESIGN: Systematic umbrella review of existing meta-analyses.

    DATA SOURCES: MEDLINE, PsycINFO, Embase, and the Cochrane Database of Systematic Reviews, as well as manual searches of reference lists from 2009 to June 2023.

    ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Systematic reviews and meta-analyses of cohort, case-control, and/or cross sectional study designs. To evaluate the credibility of evidence, pre-specified evidence classification criteria were applied, graded as convincing ("class I"), highly suggestive ("class II"), suggestive ("class III"), weak ("class IV"), or no evidence ("class V"). The quality of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework, categorised as "high," "moderate," "low," or "very low" quality.

    RESULTS: The search identified 45 unique pooled analyses, including 13 dose-response associations and 32 non-dose-response associations (n=9 888 373). Overall, direct associations were found between exposure to ultra-processed foods and 32 (71%) health parameters spanning mortality, cancer, and mental, respiratory, cardiovascular, gastrointestinal, and metabolic health outcomes. Based on the pre-specified evidence classification criteria, convincing evidence (class I) supported direct associations between greater ultra-processed food exposure and higher risks of incident cardiovascular disease related mortality (risk ratio 1.50, 95% confidence interval 1.37 to 1.63; GRADE=very low) and type 2 diabetes (dose-response risk ratio 1.12, 1.11 to 1.13; moderate), as well as higher risks of prevalent anxiety outcomes (odds ratio 1.48, 1.37 to 1.59; low) and combined common mental disorder outcomes (odds ratio 1.53, 1.43 to 1.63; low). Highly suggestive (class II) evidence indicated that greater exposure to ultra-processed foods was directly associated with higher risks of incident all cause mortality (risk ratio 1.21, 1.15 to 1.27; low), heart disease related mortality (hazard ratio 1.66, 1.51 to 1.84; low), type 2 diabetes (odds ratio 1.40, 1.23 to 1.59; very low), and depressive outcomes (hazard ratio 1.22, 1.16 to 1.28; low), together with higher risks of prevalent adverse sleep related outcomes (odds ratio 1.41, 1.24 to 1.61; low), wheezing (risk ratio 1.40, 1.27 to 1.55; low), and obesity (odds ratio 1.55, 1.36 to 1.77; low). Of the remaining 34 pooled analyses, 21 were graded as suggestive or weak strength (class III-IV) and 13 were graded as no evidence (class V). Overall, using the GRADE framework, 22 pooled analyses were rated as low quality, with 19 rated as very low quality and four rated as moderate quality.

    CONCLUSIONS: Greater exposure to ultra-processed food was associated with a higher risk of adverse health outcomes, especially cardiometabolic, common mental disorder, and mortality outcomes. These findings provide a rationale to develop and evaluate the effectiveness of using population based and public health measures to target and reduce dietary exposure to ultra-processed foods for improved human health. They also inform and provide support for urgent mechanistic research.

    SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42023412732.

    Matched MeSH terms: Diabetes Mellitus, Type 2*
  6. Benchoula K, Serpell CJ, Mediani A, Albogami A, Misnan NM, Ismail NH, et al.
    Sci Rep, 2024 Feb 15;14(1):3823.
    PMID: 38360784 DOI: 10.1038/s41598-023-45608-z
    Zebrafish have been utilized for many years as a model animal for pharmacological studies on diabetes and obesity. High-fat diet (HFD), streptozotocin and alloxan injection, and glucose immersion have all been used to induce diabetes and obesity in zebrafish. Currently, studies commonly used both male and female zebrafish, which may influence the outcomes since male and female zebrafish are biologically different. This study was designed to investigate the difference between the metabolites of male and female diabetic zebrafish, using limonene - a natural product which has shown several promising results in vitro and in vivo in treating diabetes and obesity-and provide new insights into how endogenous metabolites change following limonene treatment. Using HFD-fed male and female zebrafish, we were able to develop an animal model of T2D and identify several endogenous metabolites that might be used as diagnostic biomarkers for diabetes. The endogenous metabolites in males and females were different, even though both genders had high blood glucose levels and a high BMI. Treatment with limonene prevented high blood glucose levels and improved in diabesity zebrafish by limonene, through reversal of the metabolic changes caused by HFD in both genders. In addition, limonene was able to reverse the elevated expression of AKT during HFD.
    Matched MeSH terms: Diabetes Mellitus*
  7. Hoe CYW, Ahmad B, Watterson J
    Diabetes Metab Res Rev, 2024 Feb;40(2):e3722.
    PMID: 37690072 DOI: 10.1002/dmrr.3722
    Diabetes prevalence is rising worldwide, calling for public health concerns and interventions to improve prevention and management. Self-care is an important component in reducing the incidence of complications from diabetes, but it must be taught. This systematic review aims to synthesise the evidence for education videos for people with diabetes. Electronic databases, including Ovid (Medline, Embase, EmCare), PsychInfo, CINAHL, Web of Science and Scopus, were searched for studies on educational videos for patients with diabetes that met the inclusion criteria. A total of 36 studies met the inclusion criteria. Data extracted were synthesised through narrative synthesis. Studies examined outcomes including biological (i.e., glycated haemoglobin (HbA1C), weight, BMI), non-biological (health literacy, self-efficacy) and subjective feedback (i.e., acceptability, cultural appropriateness). The most common length of video was ≤10 min. Online dissemination was the most common method of video distribution. A statistically significant decrease (ranging from -0.1% to -2.1%) in HbA1C was noted in 7 of 12 studies examining this outcome. Other studies also found evidence of improvement in health literacy, self-efficacy, physical activity, medication adherence and other outcomes. Feedback from participants was generally positive, and emphasis was placed on the need for cultural appropriateness and representation in the educational videos.
    Matched MeSH terms: Diabetes Mellitus, Type 2*
  8. Finsterer J
    Med J Malaysia, 2024 Jan;79(1):113.
    PMID: 38287767
    No abstract available.
    Matched MeSH terms: Diabetes Mellitus*
  9. Haryanto, Amrullah S, Pratama SF, Agustini F, Pasmawati, Khairillah YN, et al.
    Med J Malaysia, 2024 Jan;79(1):60-67.
    PMID: 38287759
    INTRODUCTION: Research on diabetic foot ulcers (DFU) infection is limited to the first wound. Therefore, this study aimed to evaluate the relationship between wound classification (Wagner and SHID), and foot care against severity infection of DFU recurrent that may contribute to an increased susceptibility to infection among individuals with recurrent DFUs.

    MATERIALS AND METHODS: A cross-sectional design was used in this study involving 245 participants of type 2 diabetes mellitus (T2DM) was conducted at a Kitamura Wound Care Clinic, PKU Muhammadiyah, located in Pontianak, West Kalimantan, Indonesia, between September 2022 and February 2023. The Kruskal-Wallis test was used to assess the relationship between the foot care practices and infection status. A linear regression test to examine the independent risk factors.

    RESULTS: Wounds' characteristics regarding foot care practice group were significantly including more than 5 months wound heal from previous wounds (p = 0.045), the percentage of wound site on dorsal was higher in the foot care practice group (p < 0.001), the percentage had no deformity feet was higher in the foot care practice group (p < 0.001), the percentage had no previous amputation feet was higher in the foot care practice group (p < 0.001). Also, the percentage had grade three was higher in the foot care practice group (p < 0.001), the percentage had grade three was higher in the foot care practice group (p < 0.001), and the percentage had mild infection status was higher in the foot care practice group (p < 0.001). The predictors of diabetic foot infection were Wagner and SHID classification and foot care (p < 0.001, p < 0.001, and p < 0.01) respectively.

    CONCLUSION: This study demonstrated that foot-care behaviour in diabetic patients in Indonesia is poor. In addition, this study also has shown Wagner grading, SHID grading, and foot-care are predictors of infection in recurrent DFUs.

    Matched MeSH terms: Diabetes Mellitus*
  10. Zhang Y, Wang L, Wu W, Zhang S, Zhang M, She W, et al.
    Int J Nurs Stud, 2024 Jan;149:104631.
    PMID: 37963423 DOI: 10.1016/j.ijnurstu.2023.104631
    BACKGROUND: Factors that predict the quality of bowel preparation in older adults are unclear, and current guidelines do not provide specific recommendations.

    OBJECTIVE: This meta-analysis aimed to identify risk factors for inadequate bowel preparation in older patients.

    METHODS: PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases were searched from their inception to February 2023. Cohort and cross-sectional studies exploring the risk factors for inadequate bowel preparation were included in this systematic review. Odds ratio (OR) values from individual studies were pooled using fixed-effects and random-effects models. In addition, a sensitivity analysis and assessment of publication bias were performed.

    RESULTS: This meta-analysis included six studies (n = 1553) on previous abdominal surgery, six studies (n = 1494) on constipation, seven studies (n = 1505) on diabetes, eight studies (n = 2093) on non-compliance with the diet regimen, seven studies (n = 1350) on incomplete intake of laxative, and nine studies (n = 2163) on inadequate exercise during preparation. The pooled analysis showed that history of abdominal surgery (OR = 2.72; 95 % confidence interval, CI: 2.07 to 3.56), constipation (OR = 3.56, 95 % CI: 2.41 to 5.25), diabetes (OR = 2.54, 95 % CI: 1.81 to 3.57), non-compliance with the diet regimen (OR = 2.51, 95 % CI: 1.96 to 3.21), incomplete intake of laxative (OR = 2.43, 95 % CI: 1.60 to 3.67), and inadequate exercise during preparation (OR = 3.13, 95 % CI: 2.39 to 4.11) were independent risk factors for inadequate bowel preparation in older patients undergoing colonoscopy.

    CONCLUSIONS: Three comorbid factors and three behavioral factors were significantly associated with inadequate bowel preparation in older adults. This meta-analysis provides valuable information for developing predictive models of poor bowel preparation.

    Matched MeSH terms: Diabetes Mellitus*
  11. Lim LL, Hussein Z, Noor NM, Raof ASA, Mustafa N, Bidin MBL, et al.
    PLoS One, 2024;19(1):e0296298.
    PMID: 38166049 DOI: 10.1371/journal.pone.0296298
    AIM: Given a lack of data on diabetes care performance in Malaysia, we conducted a cross-sectional study to understand the clinical characteristics, control of cardiometabolic risk factors, and patterns of use of guideline-directed medical therapy (GDMT) among patients with type 2 diabetes (T2D), who were managed at publicly-funded hospitals between December 2021 and June 2022.

    METHODS: Patients aged ≥18 years with T2D from eight publicly-funded hospitals in the Greater Kuala Lumpur region, who had ≥2 outpatient visits within the preceding year and irrespective of treatment regimen, were eligible. The primary outcome was ≥2 treatment target attainment (defined as either HbA1c <7.0%, blood pressure [BP] <130/80 mmHg, or low-density lipoprotein cholesterol [LDL-C] <1.8 mmol/L). The secondary outcomes were the individual treatment target, a combination of all three treatment targets, and patterns of GDMT use. To assess for potential heterogeneity of study findings, all outcomes were stratified according to prespecified baseline characteristics namely 1) history of atherosclerotic cardiovascular disease (ASCVD; yes/no) and 2) clinic type (Diabetes specialist versus General medicine).

    RESULTS: Among 5094 patients (mean±SD age 59.0±13.2 years; T2D duration 14.8±9.2 years; HbA1c 8.2±1.9% (66±21 mmol/mol); BMI 29.6±6.2 kg/m2; 45.6% men), 99% were at high/very high cardiorenal risk. Attainment of ≥2 treatment targets was at 18%, being higher in General medicine than in Diabetes specialist clinics (20.8% versus 17.5%; p = 0.039). The overall statin coverage was 90%. More patients with prior ASCVD attained LDL-C <1.4 mmol/L than those without (13.5% versus 8.4%; p<0.001). Use of sodium-glucose cotransporter-2 (SGLT2) inhibitors (13.2% versus 43.2%), glucagon-like peptide-1 receptor agonists (GLP1-RAs) (1.0% versus 6.2%), and insulin (27.7% versus 58.1%) were lower in General medicine than in Diabetes specialist clinics.

    CONCLUSIONS: Among high-risk patients with T2D, treatment target attainment and use of GDMT were suboptimal.

    Matched MeSH terms: Diabetes Mellitus, Type 2*
  12. Nguyen Thi YV, Ho TT, Caglayan S, Ramasamy TS, Chu DT
    Prog Mol Biol Transl Sci, 2024;203:287-300.
    PMID: 38360004 DOI: 10.1016/bs.pmbts.2023.12.013
    Diabetes is an ongoing global problem as it affects health of more than 537 million people around the world. Diabetes leaves many serious complications that affect patients and can cause death if not detected and treated promptly. Some of the complications of diabetes include impaired vascular system, increased risk of stroke, neurological diseases that cause pain and numbness, diseases related to the retina leading to blindness, and other complications affecting kidneys, heart failure, muscle weakness, muscle atrophy. All complications of diabetes seriously affect the health of patients. Recently, gene therapy has emerged as a viable treatment strategy for various diseases. DNA and RNA are among the target molecules that can change the structure and function of proteins and are effective methods of treating diseases, especially genetically inherited diseases. RNA therapeutics has attracted deep interest as it has been approved for application in the treatment of functional system disorders such as spinal muscular atrophy, and muscular dystrophy. In this review, we cover the types of RNA therapies considered for treatment of diabetes. In particular, we delve into the mechanism of action of RNA therapies for diabetes, and studies involving testing of these RNA therapies. Finally, we have highlighted the limitations of the current understanding in the mechanism of action of RNA therapies.
    Matched MeSH terms: Diabetes Mellitus*
  13. Tan LK, Chua EH, Mohd Ghazali S, Cheah YK, Jayaraj VJ, Kee CC
    Nutrients, 2023 Dec 08;15(24).
    PMID: 38140302 DOI: 10.3390/nu15245043
    The healthy eating plate concept has been introduced in many countries, including Malaysia, as a visual guide for the public to eat healthily. The relationship between Malaysian Healthy Plate (MHP) and adequate fruit and vegetable (FV) intake among morbid Malaysian adults is unknown. Hence, we investigated the relationship between awareness of the MHP and FV intake among morbid Malaysian adults. National survey data on 9760 morbid Malaysian adults aged 18 years and above were analyzed. The relationship between awareness of MHP and FV intake among Malaysian adults with obesity, diabetes mellitus, hypertension, and hypercholesterolemia were determined using multivariable logistic regression controlling for sociodemographic characteristics and lifestyle risk factors. Our data demonstrated that MHP awareness is associated with adequate FV intake among the Malaysian adults with abdominal obesity (adjusted odds ratio (aOR): 1.86, 95% confidence interval (CI): 1.05-3.29), diabetes mellitus (aOR: 4.88, 95% CI: 2.13-22.18), hypertension (aOR: 4.39, 95% CI: 1.96-9.83), and hypercholesterolemia (aOR: 4.16, 95% CI: 1.48-11.72). Our findings indicated the necessity for ongoing efforts by policymakers, healthcare professionals, and nutrition educators to promote the concept of MHP and ensure that morbid Malaysian adults consume a sufficient intake of FV or adopt a healthy eating pattern to achieve and maintain optimal health.
    Matched MeSH terms: Diabetes Mellitus*
  14. Tehrany PM, Rahmanian P, Rezaee A, Ranjbarpazuki G, Sohrabi Fard F, Asadollah Salmanpour Y, et al.
    Environ Res, 2023 Dec 01;238(Pt 1):117087.
    PMID: 37716390 DOI: 10.1016/j.envres.2023.117087
    Hydrogels represent intricate three-dimensional polymeric structures, renowned for their compatibility with living systems and their ability to naturally degrade. These networks stand as promising and viable foundations for a range of biomedical uses. The practical feasibility of employing hydrogels in clinical trials has been well-demonstrated. Among the prevalent biomedical uses of hydrogels, a significant application arises in the context of wound healing. This intricate progression involves distinct phases of inflammation, proliferation, and remodeling, often triggered by trauma, skin injuries, and various diseases. Metabolic conditions like diabetes have the potential to give rise to persistent wounds, leading to delayed healing processes. This current review consolidates a collection of experiments focused on the utilization of hydrogels to expedite the recovery of wounds. Hydrogels have the capacity to improve the inflammatory conditions at the wound site, and they achieve this by diminishing levels of reactive oxygen species (ROS), thereby exhibiting antioxidant effects. Hydrogels have the potential to enhance the growth of fibroblasts and keratinocytes at the wound site. They also possess the capability to inhibit both Gram-positive and Gram-negative bacteria, effectively managing wounds infected by drug-resistant bacteria. Hydrogels can trigger angiogenesis and neovascularization processes, while also promoting the M2 polarization of macrophages, which in turn mitigates inflammation at the wound site. Intelligent and versatile hydrogels, encompassing features such as pH sensitivity, reactivity to reactive oxygen species (ROS), and responsiveness to light and temperature, have proven advantageous in expediting wound healing. Furthermore, hydrogels synthesized using environmentally friendly methods, characterized by high levels of biocompatibility and biodegradability, hold the potential for enhancing the wound healing process. Hydrogels can facilitate the controlled discharge of bioactive substances. More recently, there has been progress in the creation of conductive hydrogels, which, when subjected to electrical stimulation, contribute to the enhancement of wound healing. Diabetes mellitus, a metabolic disorder, leads to a slowdown in the wound healing process, often resulting in the formation of persistent wounds. Hydrogels have the capability to expedite the healing of diabetic wounds, facilitating the transition from the inflammatory phase to the proliferative stage. The current review sheds light on the biological functionalities of hydrogels, encompassing their role in modulating diverse mechanisms and cell types, including inflammation, oxidative stress, macrophages, and bacteriology. Additionally, this review emphasizes the significance of smart hydrogels with responsiveness to external stimuli, as well as conductive hydrogels for promoting wound healing. Lastly, the discussion delves into the advancement of environmentally friendly hydrogels with high biocompatibility, aimed at accelerating the wound healing process.
    Matched MeSH terms: Diabetes Mellitus*
  15. Teh HX, Phang SJ, Looi ML, Kuppusamy UR, Arumugam B
    Life Sci, 2023 Dec 01;334:122228.
    PMID: 37922981 DOI: 10.1016/j.lfs.2023.122228
    Diabetic wounds are slow healing wounds characterized by disordered healing processes and frequently take longer than three months to heal. One of the defining characteristics of impaired diabetic wound healing is an abnormal and unresolved inflammatory response, which is primarily brought on by abnormal macrophage innate immune signaling activation. The persistent inflammatory state in a diabetic wound may be attributed to inflammatory pathways such as nuclear factor kappa B (NF-ĸB) and nod-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, which have long been associated with inflammatory diseases. Despite the available treatments for diabetic foot ulcers (DFUs) that include debridement, growth factor therapy, and topical anti-bacterial agents, successful wound healing is still hampered. Further understanding of the molecular mechanism of these pathways could be useful in designing potential therapeutic targets for diabetic wound healing. This review provides an update and novel insights into the roles of NF-ĸB and NLRP3 pathways in the molecular mechanism of diabetic wound inflammation and their potential as therapeutic targets in diabetic wound healing.
    Matched MeSH terms: Diabetes Mellitus*
  16. Lim GP, Appalasamy JR, Ahmad B, Quek KF, Ramadas A
    Curr Nutr Rep, 2023 Dec;12(4):721-732.
    PMID: 37976017 DOI: 10.1007/s13668-023-00507-7
    PURPOSE OF REVIEW: There is a lack of synthesized evidence on social media-delivered lifestyle interventions for managing and preventing diabetes. This scoping review aims to evaluate recently reported lifestyle interventions delivered on social media for individuals with diabetes and prediabetes.

    RECENT FINDINGS: Twelve studies were included in this review. A team of multidisciplinary healthcare professionals coordinated most interventions, half of which lasted for 6 months, and used a combination of videos, texts, images or audio to deliver the educational materials. The glycosylated hemoglobin (HbA1c) level improved in most of the studies, followed by diabetes self-care and fasting plasma glucose. The dietary intakes were only assessed in two interventions among the individuals with prediabetes and showed promising improvements. This scoping review provides a holistic overview of the recent designs of lifestyle interventions for diabetes management and prevention on social media. This is essential for various healthcare professionals and stakeholders to formulate and implement population-based, cost-effective interventions in combating diabetes using social media.

    Matched MeSH terms: Diabetes Mellitus*
  17. Sim R, Chong CW, Loganadan NK, Saidoung P, Adam NL, Hussein Z, et al.
    Value Health Reg Issues, 2023 Nov;38:9-17.
    PMID: 37419012 DOI: 10.1016/j.vhri.2023.05.006
    OBJECTIVES: This study aims to evaluate the cost-effectiveness of various glucose-lowering therapies as add-on to standard care for people with type 2 diabetes (T2D) in Malaysia.

    METHODS: A state-transition microsimulation model was developed to compare the clinical and economic outcomes of 4 treatments: standard care, dipeptidyl peptidase-4 inhibitors, sodium-glucose cotransporter-2 inhibitors (SGLT2is), and glucagon-like peptide-1 receptor agonists. Cost-effectiveness was assessed from a healthcare provider's perspective over a lifetime horizon with 3% discount rate in a hypothetical cohort of people with T2D. Data input were informed from literature and local data when available. Outcome measures include costs, quality-adjusted life-years, incremental cost-effectiveness ratios, and net monetary benefits. Univariate and probabilistic sensitivity analyses were performed to assess uncertainties.

    RESULTS: Over a lifetime horizon, the costs to treat a person with T2D ranged from RM 12 494 to RM 41 250, whereas the QALYs gains ranged from 6.155 to 6.731, depending on the treatment. Based upon a willingness-to-pay threshold of RM 29 080 per QALY, we identified SGLT2i as the most cost-effective glucose-lowering treatment, as add-on to standard care over patient's lifetime, with the net monetary benefit of RM 176 173 and incremental cost-effectiveness ratios of RM 12 279 per QALY gained. The intervention also added 0.577 QALYs and 0.809 LYs compared with standard care. Cost-effectiveness acceptability curve showed that SGLT2i had the highest probability of being cost-effective in Malaysia across varying willingness-to-pay threshold. The results were robust to various sensitivity analyses.

    CONCLUSIONS: SGLT2i was found to be the most cost-effective intervention to mitigate diabetes-related complications.

    Matched MeSH terms: Diabetes Mellitus, Type 2*
  18. Dasrilsyah AM, Wan Abdul Halim WH, Mustapha M, Tang SF, Kaur B, Ong EY, et al.
    Cornea, 2023 Nov 01;42(11):1395-1403.
    PMID: 37267451 DOI: 10.1097/ICO.0000000000003308
    PURPOSE: The aim of this study was to measure and compare the effect of topical insulin (0.5 units, 4 times per day) versus artificial tears (Vismed, sodium hyaluronate 0.18%, 4 times per day) for the healing of postoperative corneal epithelial defects induced during vitreoretinal surgery in diabetic patients.

    METHODS: This is a double-blind randomized controlled hospital-based study involving diabetic patients with postoperative corneal epithelial defects after vitreoretinal surgery. Diabetic patients were randomized into 2 different groups and received either 0.5 units of topical insulin (DTI) or artificial tears (Vismed, sodium hyaluronate 0.18%; DAT). The primary outcome measured was the rate of corneal epithelial wound healing (mm 2 /h) over a preset interval and time from baseline to minimum size of epithelial defect on fluorescein-stained anterior segment digital camera photography. The secondary outcome measured was the safety of topical insulin 0.5 units and artificial tears (Vismed, sodium hyaluronate 0.18%). Patients were followed up until 3 months postoperation.

    RESULTS: A total of 38 eyes from 38 patients undergoing intraoperative corneal debridement during vitreoretinal surgery with resultant epithelial defects (19 eyes per group) were analyzed. DTI was observed to have a significantly higher healing rate compared with the DAT group at rates over 36 hours ( P = 0.010), 48 hours ( P = 0.009), and 144 hours ( P = 0.009). The rate from baseline to closure was observed to be significantly higher in the DTI group (1.20 ± 0.29) (mm 2 /h) compared with the DAT group (0.78 ± 0.20) (mm 2 /h) as well ( P < 0.001). No adverse effect of topical insulin and artificial tears was reported.

    CONCLUSIONS: Topical insulin (0.5 units, 4 times per day) is more effective compared with artificial tears (Vismed, sodium hyaluronate 0.18%, 4 times per day) for the healing of postoperative corneal epithelial defects induced during vitreoretinal surgery in diabetic patients, without any adverse events.

    Matched MeSH terms: Diabetes Mellitus*
  19. Sadikan MZ, Abdul Nasir NA, Lambuk L, Mohamud R, Reshidan NH, Low E, et al.
    BMC Ophthalmol, 2023 Oct 19;23(1):421.
    PMID: 37858128 DOI: 10.1186/s12886-023-03155-1
    Diabetic retinopathy (DR), one of the leading causes of visual impairment and blindness worldwide, is one of the major microvascular complications in diabetes mellitus (DM). Globally, DR prevalence among DM patients is 25%, and 6% have vision-threatening problems among them. With the higher incidence of DM globally, more DR cases are expected to be seen in the future. In order to comprehend the pathophysiological mechanism of DR in humans and discover potential novel substances for the treatment of DR, investigations are typically conducted using various experimental models. Among the experimental models, in vivo models have contributed significantly to understanding DR pathogenesis. There are several types of in vivo models for DR research, which include chemical-induced, surgical-induced, diet-induced, and genetic models. Similarly, for the in vitro models, there are several cell types that are utilised in DR research, such as retinal endothelial cells, Müller cells, and glial cells. With the advancement of DR research, it is essential to have a comprehensive update on the various experimental models utilised to mimic DR environment. This review provides the update on the in vitro, in vivo, and ex vivo models used in DR research, focusing on their features, advantages, and limitations.
    Matched MeSH terms: Diabetes Mellitus*
  20. Mohammadi S, Asbaghi O, Dolatshahi S, Omran HS, Amirani N, Koozehkanani FJ, et al.
    Nutr J, 2023 Oct 06;22(1):49.
    PMID: 37798798 DOI: 10.1186/s12937-023-00878-1
    BACKGROUND: It is suggested that supplementation with milk protein (MP) has the potential to ameliorate the glycemic profile; however, the exact impact and certainty of the findings have yet to be evaluated. This systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) assessed the impact of MP supplementation on the glycemic parameters in adults.

    METHODS: A systematic search was carried out among online databases to determine eligible RCTs published up to November 2022. A random-effects model was performed for the meta-analysis.

    RESULTS: A total of 36 RCTs with 1851 participants were included in the pooled analysis. It was displayed that supplementation with MP effectively reduced levels of fasting blood glucose (FBG) (weighted mean difference (WMD): -1.83 mg/dL, 95% CI: -3.28, -0.38; P = 0.013), fasting insulin (WMD: -1.06 uU/mL, 95% CI: -1.76, -0.36; P = 0.003), and homeostasis model assessment of insulin resistance (HOMA-IR) (WMD: -0.27, 95% CI: -0.40, -0.14; P  8 weeks) with high or moderate doses (≥ 60 or 30-60 g/d) of MP or whey protein (WP). Serum FBG levels were considerably reduced upon short-term administration of a low daily dose of WP (

    Matched MeSH terms: Diabetes Mellitus, Type 2*
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