Displaying publications 1 - 20 of 128 in total

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  1. Tan MY, Magarey JM, Chee SS, Lee LF, Tan MH
    Health Educ Res, 2011 Oct;26(5):896-907.
    PMID: 21715653 DOI: 10.1093/her/cyr047
    We assessed the effectiveness of a brief structured diabetes education programme based on the concept of self-efficacy on self-care and glycaemic control using single-blind study design. One hundred and sixty-four participants with poorly controlled diabetes from two settings were randomized using computer-generated list into control (n = 82) and intervention (n = 82) groups, of which 151 completed the study. Monthly interventions over 12 weeks addressed the self-care practices of diet, physical activity, medication adherence and self-monitoring of blood glucose (SMBG). These self-care practices were assessed at Weeks 0 and 12 using pre- and post-questionnaires in both groups together with glycated haemoglobin A1c (HbA1c) and diabetes knowledge. In the intention-to-treat analysis (n = 164), the intervention group improved their SMBG (P = <0.001), physical activity (P = 0.001), HbA1c (P = 0.03), diabetes knowledge (P = <0.001) and medication adherence. At Week 12, HbA1c difference adjusted for SMBG frequency, medication adherence and weight change remained significant (P = 0.03) compared with control group. For within group comparisons, diabetes knowledge (P = <0.001), HbA1c level (P = <0.001), SMBG (P = <0.001) and medication adherence (P = 0.008) improved from baseline in the intervention group. In the control group, only diabetes knowledge improved (P = <0.001). These findings can contribute to the development of self-management diabetes education in Malaysia.
    Matched MeSH terms: Diabetes Mellitus, Type 1/therapy*
  2. Fuziah MZ, Hong JY, Zanariah H, Harun F, Chan SP, Rokiah P, et al.
    Med J Malaysia, 2008 Sep;63 Suppl C:37-40.
    PMID: 19230245
    In Malaysia, Diabetes in Children and Adolescents Registry (DiCARE) was launched nationwide in August 2006 to determine and monitor the number, the time trend of diabetes mellitus (DM) patients, their socio-demographic profiles, outcome of intervention and facilitate research using this registry. This is an on going real time register of diabetic patients < or = 20 years old via the e-DiCARE, an online registration system. To date were 240 patients notified from various states in Malaysia. The mean age was 12.51 years (1.08-19.75) and 46.4% were boys. The mean age at diagnosis was 8.31 +/- 4.13 years old with an estimated duration of diabetes of 4.32 +/- 3.55 years. A total of 166/240 (69.2%) have T1DM, 42/240 (17.5%) have T2DM and 18/240 (7.5%) have other types of DM. Basis of diagnosis was known in 162 patients with T1DM and 41 patients with T2DM. In T1DM patients, 6.0% of the girls and 19.1% boys were overweight or obese. As for T2DM, 64.3% had their BMI reported: 66.7% girls and 91.6% boys were overweight or obese. Most patients (80.4%) practiced home blood glucose monitoring. Patients were seen by dietitian (66.7%), diabetes educator (50.0%), and optometrist or ophthalmologist (45.0%). Only 10.8% attended diabetic camps. In the annual census of 117 patients, the mean HbAlc level was 10.0% + 2.2 (range 5.2 to 17.0%). The early results of DiCARE served as a starting point to improve the standard of care of DM among the young in the country.
    Matched MeSH terms: Diabetes Mellitus, Type 1/epidemiology*; Diabetes Mellitus, Type 1/physiopathology
  3. Ataie-Jafari A, Loke SC, Rahmat AB, Larijani B, Abbasi F, Leow MK, et al.
    Clin Nutr, 2013 Dec;32(6):911-7.
    PMID: 23395257 DOI: 10.1016/j.clnu.2013.01.012
    This participant-blinded parallel-group randomized placebo-controlled study demonstrated that alfacalcidol (vitamin D analogue) preserves beta cell function in newly diagnosed type 1 diabetes (T1DM) in children.
    Matched MeSH terms: Diabetes Mellitus, Type 1/blood; Diabetes Mellitus, Type 1/drug therapy*
  4. Tan KT, Fok ACK, Cheah JS
    Family Practitioner, 1988;11:52-55.
    Matched MeSH terms: Diabetes Mellitus, Type 1
  5. ldanerina, M.S., Aniza, I., Jamsiah, M., Mohd. Hasni, J., Idayu, B.
    MyJurnal
    Diabetes mellitus is the most common endocrine defect among children. Good diabetes management is important to give better health for both the children and the whole family. The goal of this study was to identify the level of mother involvement in children type·1 Diabetes Mellitus management, to identify factors related with mother involvement and to determine the relationships between mother
    involvement and glycemic control. A cross·sectional study was carried out with 92 respondents selected by universal sampling from mothers who had diabetic children aged 5-15 years old and from medical visit appointment at University Kebangsaan Malaysia Medical Centre (UKMMC) and Putrajaya Hospital (HP1). Data was obtained through medical record and self reporting questionnaire. The study shown that 58.6% mothers had high involvement and 41.4% mothers had low involvement. Mothers' education level had a significant (p=0.0Z) relationship with a level of mother involvement. Most mothers gave high involvement in diet management (64.1%) and blood glucose monitoring (52. 7%), however most mothers gave low involvement in exercise management (63.0%) and insulin injection (60.9%). Mothers involvement in four management tasks were not statistically significant (p>0,05) with glycemic control. Mothers involvement in children diabetic management was high. There was high mother involvement in children's insulin injection and dietary intake and low mother involvement in children`s blood glucose monitoring and exercise, This study abo showed that there was no significant relationship between level of mother involvement and glycemic control.
    Matched MeSH terms: Diabetes Mellitus, Type 1
  6. Scott EM, Bilous RW, Kautzky-Willer A
    Diabetes Technol Ther, 2018 03;20(3):180-188.
    PMID: 29470094 DOI: 10.1089/dia.2017.0386
    BACKGROUND: Accuracy of the FreeStyle Libre™ Flash Glucose Monitoring System has not been evaluated in pregnant women with diabetes. The aim of this study was to determine accuracy (compared to self-monitoring of blood glucose [SMBG]), clinical safety, and acceptability of the FreeStyle Libre System when used at home by this population.

    MATERIALS AND METHODS: Seventy-four participants, with type 1 (T1D, n = 24), type 2 (T2D, n = 11), or gestational (n = 39) diabetes, were enrolled across 13 sites (9 in United Kingdom, 4 in Austria). Average gestation was 26.6 ± 6.8 weeks (mean ± standard deviation), age was 30.5 ± 5.1 years, diabetes duration was 13.1 ± 7.3 years for T1D and 3.2 ± 2.5 years for T2D, and 49/74 (66.2%) used insulin to manage their diabetes. Sensors were worn for up to 14 days. Sensor glucose values (masked) were compared with capillary SMBG values (made at least 4 times/day).

    RESULTS: Clinical accuracy of sensor results versus SMBG results was demonstrated, with 88.1% and 99.8% of results within Zone A and Zones A and B of the Consensus Error Grid, respectively. Overall mean absolute relative difference was 11.8%. Sensor accuracy was unaffected by the type of diabetes, the stage of pregnancy, whether insulin was used, age or body mass index. User questionnaires indicated high levels of satisfaction with sensor wear, system use, and comparison to SMBG. There were no unanticipated device-related adverse events.

    CONCLUSIONS: Good agreement was demonstrated between the FreeStyle Libre System and SMBG. Accuracy of the system was unaffected by patient characteristics, indicating that the system is safe and accurate to use by pregnant women with diabetes.

    Matched MeSH terms: Diabetes Mellitus, Type 1/blood*; Diabetes Mellitus, Type 1/drug therapy
  7. Helen CCT, Tajunisah I, Reddy SC
    Int J Ophthalmol, 2011;4(4):443-6.
    PMID: 22553697 DOI: 10.3980/j.issn.2222-3959.2011.04.23
    AIM: To report maternal and fetal adverse outcomes, in spite of appropriate treatment and regular follow up, in diabetic pregnant women with proliferative diabetic retinopathy.
    METHODS: Case series of four young pregnant diabetics aged between 20 and 25 years with type I diabetes mellitus and proliferative diabetic retrinopathy.
    RESULTS: The maternal adverse outcomes were abortion in one patient, pre-eclampsia and preterm delivery in one patient, and renal failure requiring dialysis in one patient. The fetal adverse outcomes were neonatal death in one case and premature baby in another case.
    CONCLUSION: These cases highlight the fact that diabetic pregnant women should be closely followed up by the obstetricians and physicians when they have proliferative retinopathy. The proliferative diabetic retinopathy should be considered as a part of the assessment when counseling a diabetic woman in antenatal check up and also in the follow up visits during pregnancy.
    KEYWORDS: pregnancy; proliferative diabetic retinopathy; type I diabetes mellitus; vitreous haemorrhage
    Study site: Eye clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Diabetes Mellitus, Type 1
  8. Osman M, Adnan A, Salmah Bakar N, Alashkham F
    Pol J Pathol, 2012 Dec;63(4):248-54.
    PMID: 23359194 DOI: 10.5114/pjp.2012.32772
    The research purpose was to experimentally investigate the effect of allicin administration on the levels of main type 1 diabetes (IDDM) autoantibodies which are anti-islet cell antibodies (ICA) with an attempt to find a relation between this immunological effect and histological and/or biochemical findings. We have evaluated, with the help of ELISA kits, the levels of ICA and serum insulin in male Sprague-Dawley rats with Streptozotocin-induced IDDM in addition to pancreatic histological findings. The four groups (6 rats each) under study received or not different intraperitoneal doses of allicin for a period of 30 days. Daily intraperitoneal administration of allicin (either at as low dose of 8 mg/kg or high dose of 16 mg/kg) for up to 30 days to type 1 diabetic rats effectively reduces levels of anti-islet cell antibodies and in addition, reduced the level of insulin due to damaged Langerhans islet cell was significantly increased in the serum due to a repairing tissue process in pancreatic tissues. These experimental results suggest that allicin treatment has a therapeutic protective effect against autoimmune reactions occurring in IDDM. The data may provide new strategies for using allicin to be recommended as an excellent candidate in the clinical management, control, and prevention of IDDM.
    Matched MeSH terms: Diabetes Mellitus, Type 1/blood; Diabetes Mellitus, Type 1/immunology
  9. Indran M, Rokiah P, Chan SP, Kuppusamy UR
    Med J Malaysia, 2004 Jun;59(2):166-70.
    PMID: 15559165 MyJurnal
    The present study was designed to explore the relationship between lipid peroxidation and antioxidant enzymes in young Malaysian insulin dependant diabetes mellitus (IDDM) patients. Indicative parameters of lipid peroxidation, activities of antioxidant enzymes and diabetes parameters were evaluated in single blood samples from 30 young type 1 diabetic patients and 30 healthy control subjects. Antioxidant enzymes namely superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) were significantly decreased while plasma malondialdehyde (MDA), an indicator for lipid peroxidation was significantly increased in IDDM patients compared to control subjects. Positive correlations between HbA1c and MDA; fasting blood glucose (FBG) and MDA and negative correlations between HbA1c and SOD; MDA and SOD were observed in these patients. No significant correlation existed between HbA1c and fasting blood glucose, GPx or CAT in the diabetic patients. The strong correlations found between lipid peroxidation, antioxidant enzymes and diabetes parameters confirms the existence of oxidative stress in our IDDM patients.
    Matched MeSH terms: Diabetes Mellitus, Type 1/blood*; Diabetes Mellitus, Type 1/complications*
  10. Mieczkowska A, Mansur SA, Irwin N, Flatt PR, Chappard D, Mabilleau G
    Bone, 2015 Jul;76:31-9.
    PMID: 25813583 DOI: 10.1016/j.bone.2015.03.010
    Type 1 diabetes mellitus (T1DM) is a severe disorder characterized by hyperglycemia and hypoinsulinemia. A higher occurrence of bone fractures has been reported in T1DM, and although bone mineral density is reduced in this disorder, it is also thought that bone quality may be altered in this chronic pathology. Vibrational microscopies such as Fourier transform infrared microspectroscopy (FTIRM) represent an interesting approach to study bone quality as they allow investigation of the collagen and mineral compartment of the extracellular matrix in a specific bone location. However, as spectral feature arising from the mineral may overlap with those of the organic component, the demineralization of bone sections should be performed for a full investigation of the organic matrix. The aims of the present study were to (i) develop a new approach, based on the demineralization of thin bone tissue section to allow a better characterization of the bone organic component by FTIRM, (ii) to validate collagen glycation and collagen integrity in bone tissue and (iii) to better understand what alterations of tissue material properties in newly forming bone occur in T1DM. The streptozotocin-injected mouse (150 mg/kg body weight, injected at 8 weeks old) was used as T1DM model. Animals were randomly allocated to control (n = 8) or diabetic (n = 10) groups and were sacrificed 4 weeks post-STZ injection. Bones were collected at necropsy, embedded in polymethylmethacrylate and sectioned prior to examination by FTIRM. FTIRM collagen parameters were collagen maturity (area ratio between 1660 and 1690 cm(-1) subbands), collagen glycation (area ratio between the 1032 cm(-1) subband and amide I) and collagen integrity (area ratio between the 1338 cm(-1) subband and amide II). No significant differences in the mineral compartment of the bone matrix could be observed between controls and STZ-injected animals. On the other hand, as compared with controls, STZ-injected animals presented with significant higher value for collagen maturity (17%, p = 0.0048) and collagen glycation (99%, p = 0.0121), while collagen integrity was significantly lower by 170% (p = 0.0121). This study demonstrated the profound effect of early T1DM on the organic compartment of the bone matrix in newly forming bone. Further studies in humans are required to ascertain whether T1DM also lead to similar effect on the quality of the bone matrix.
    Matched MeSH terms: Diabetes Mellitus, Type 1/pathology*
  11. Wan Nazaimoon WM, Khaid BAK
    Malays J Pathol, 1998 Dec;20(2):83-9.
    PMID: 10879267
    We successfully developed an in-house, competitive enzyme immunoassay to measure advanced glycosylation end-products (AGE) in serum. The assay involved coating microtitre wells with AGE-BSA at 8 micrograms/ml for 4 hours, followed by overnight incubation of 20 microliters sample (prediluted at 1:6) with 80 microliters antiserum (1:8000). HRP-labelled goat anti-rabbit was used as the second antibody and 3,5',5,5'-tetramethylbenzidine dihydrochloride as the substrate. Incubation was carried out at 4 degrees C. As suggested in an earlier study, we standardised the AGE units against normal human serum (NHS). Thus, one AGE unit was defined as the inhibition that resulted when the 1:6 diluted NHS was assayed. Mean (+/- SD) AGE level in normal subjects (n = 37) was significantly lower than in diabetes subjects with microalbuminuria (n = 57) (6.0 +/- 0.7 versus 10.2 +/- 4.7 units/ml, p = 0.0001). With the availability of in-house assay and by standardising the AGE unit with the other laboratories, more studies could be undertaken and results compared, and possibly, further elucidate the roles of AGE in the pathogenesis of diabetic complications.
    Matched MeSH terms: Diabetes Mellitus, Type 1/blood; Diabetes Mellitus, Type 1/urine
  12. Ray S, Sarkar D, Ganguly S, Maiti A
    Med J Malaysia, 2012 Feb;67(1):116-7.
    PMID: 22582562
    Latent Autoimmune Diabetes in Adults (LADA) is an autoimmune form of type 1 diabetes mellitus presenting in adulthood. It is often confused with other types of diabetes and therefore the management is frequently inadequate. Acute hyperglycemic crisis in the form of diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar state (HHS) are unusual findings. We report a clinical case of a 66-year-old female who presented for the first time with DKA and was subsequently diagnosed as a case of LADA. Presumptive diagnosis of LADA was confirmed with the presence of autoantibody to glutamic acid decarboxylase 65 (Anti-GAD65 antibody).
    Matched MeSH terms: Diabetes Mellitus, Type 1/diagnosis*
  13. Homayoun Hani, Mohd-Azmi Mohd-Lila, Rasedee Abdullah, Zeenathul Nazariah Allaudin, Kazhal Sarsaifi, Faez Firdaus Jesse Abdullah
    MyJurnal
    Diabetes is one of the major life-threatening health problems worldwide today. It is one of the most fastgrowing diseases that cause many health complications and a leading cause of decreasing life expectancy and high mortality rate. Many studies have suggested several different types of intervention to treat Type 1 diabetes such as insulin therapy, islet transplantation, islet xenotransplantation and stem cell therapy. However, issues regarding the efficacy, cost and safety of these treatments are not always well addressed. For decades, diabetes treatments with few side effects and long-lasting insulin independence has remained one of the most challenging tasks facing scientists. Among the treatments mentioned above, application of human islet transplantation in patients with type 1 diabetes has progressed rapidly with significant achievement. Again, the lack of appropriate donors for islet transplantation and its high cost have led researchers to look for other alternatives. In this review, we discuss very pertinent issues that are related to diabetes treatments, their availability, advantages, disadvantages and also cost,
    Matched MeSH terms: Diabetes Mellitus, Type 1
  14. Md Zain F, Hong JYH, Wu LL, Harun F, Rasat R, Jalaludin MY, et al.
    Citation: Annual Report of the Diabetes in Children & Adolescent Registry (DiCARE) 2006-2007. Kuala Lumpur: Clinical Research Centre; 2008

    The objective of Diabetes in Children and Adolescents Registry (DiCARE) under the Ministry of Health (MOH) is to collect information about diabetes mellitus in children and adolescents in Malaysia. This is important in estimating the incidence of diabetes mellitus among children and adolescents and at the same time evaluating the risk factors and the management. The registry aims to evaluate the efficiency and effectiveness of health care among the young diabetics and the health economics of diabetes. The issues related to diabetes care can be looked into and solved when the patients are still young, with the hope that they will become knowledgeable adults who can reasonably handle their diabetes well and thus decrease the long term complications. This information is deemed important in assisting the MOH, Non-Governmental Organizations, healthcare providers and industries in the planning and evaluation of diabetes mellitus prevention and control.
    Matched MeSH terms: Diabetes Mellitus, Type 1
  15. Chaudhry SRY, Akram A, Aslam N, Wajid M, Iqbal Z, Nazir I, et al.
    Pak J Pharm Sci, 2019 Mar;32(2):505-514.
    PMID: 31081759
    Echinops echinatus is traditionally an important plant that finds its extensive use as a diuretic, anti-inflammatory, anti-pyretic, nerve tonic, abortifacient, aphrodisiac, antiasthmatic, and antidiabetic agent. The current study investigates protection against the hyperglycemia and dyslipidemia in alloxan-induced (type I diabetes) and fructose-fed insulin resistance (type II diabetes) models of diabetes treated with aqueous methanolic root extract of E. echinatus (Ee.Cr). Albino rats were treated orally with Ee.Cr at doses 100, 300 and 500mg/kg. The fasting blood glucose was measured by glucometer, while standard kits were used to determine the levels of serum total cholesterol, triglycerides and HDL. The administration of Ee.Cr significantly (P<0.001) reduced the FBG concentration in a dose-dependent pattern in alloxan-induced and fructose-fed diabetic rats. The Ee.Cr also corrected the dyslipidemia associated with fructose and alloxan-induced diabetes by significantly (P<0.001) decreasing the concentration of serum total cholesterol, triglycerides, and LDL and by increasing HDL concentration. Ee.Cr also significantly (P<0.001) improved the glucose tolerance in fructose-fed rats. We conclude that Ee.Cr has antidiabetic and antidyslipidemic effects in both insulin-dependent alloxan-induced diabetes and fructose-induced insulin resistance diabetes rat models.
    Matched MeSH terms: Diabetes Mellitus, Type 1/drug therapy*; Diabetes Mellitus, Type 1/metabolism
  16. Nazratun Nafizah AH, Budin SB, Zaryantey AH, Mariati AR, Santhana RL, Osman M, et al.
    Arab J Gastroenterol, 2017 Mar;18(1):13-20.
    PMID: 28336227 DOI: 10.1016/j.ajg.2017.02.001
    BACKGROUND AND STUDY AIMS: The complex series of deleterious events among diabetes patients leads to multiple organ failure. Therefore, a holistic approach of treatment is urgently required to prevent worsening of complications. The present investigation was carried out to study the possible protective effects of Roselle or Hibiscus sabdariffa Linn (HSL) calyxes aqueous extract, as an antidiabetic and antioxidant agent against oxidative liver injury in streptozotocin-induced diabetic rats.

    MATERIAL AND METHODS: A single dose of streptozotocin (45mg/kg body weight, iv) was used to induced diabetes in male Sprague Dawley rats which were then divided into two groups: Diabetic control (DC) and HSL-treated diabetic (DR) group. Normal rats were divided into normal control (NC), HSL-treated control (NR). Aqueous calyxes extract of HSL (100mg/kg/day, orally) was given for 28 consecutive days in the treated group. Weight, biochemical and histopathological (light and electron microscopic) parameters were compared in all groups.

    RESULTS: Supplementation of HSL significantly lowered the level of fasting blood glucose and increased plasma insulin level in DR group compared to DC group (p<0.05). Alanine aminotransaminases and aspartate aminotransferase enzymes level were found to be significantly reduced in DR compared to DC. Microscopic examination demonstrated destruction of the liver architecture, cytoplasmic vacuolation of the hepatocytes and signs of necrosis in diabetic rats. Moreover, dilatation and congestion of blood vessels with leucocytes adherence were detected. Ultrastructural study using electron microscope showed homogeneous substance accumulation in nuclear chromatin, a decrease of organelles and mitochondrial degeneration in the diabetic rats.

    CONCLUSION: Administration of HSL in diabetic rats causes significant decrease in hepatocyte destruction and prevented the changes associated with the diabetic condition. Thus, our findings provide a scientific rationale for the use of HSL as promising agent in preventing liver injury in diabetes.

    Matched MeSH terms: Diabetes Mellitus, Type 1/complications; Diabetes Mellitus, Type 1/drug therapy*; Diabetes Mellitus, Type 1/metabolism
  17. Huri HZ, Ling DY, Ahmad WA
    Drug Des Devel Ther, 2015;9:4735-49.
    PMID: 26316711 DOI: 10.2147/DDDT.S87294
    PURPOSE: Cardiovascular disease (CVD) is a macrovascular complication in patients with type 2 diabetes mellitus (T2DM). To date, glycemic control profiles of antidiabetic drugs in cardiovascular (CV) complications have not been clearly elucidated. Therefore, this study was conducted retrospectively to assess the association of antidiabetic drugs and glycemic control with CV profiles in T2DM patients. The association of concurrent medications and comorbidities with glycemic control was also investigated.

    METHODS: A total of 220 T2DM patients from the University of Malaya Medical Centre, Malaysia, who had at least one CV complication and who had been taking at least one antidiabetic drug for at least 3 months, were included. The associations of antidiabetics, cardiovascular diseases, laboratory parameters, concurrent medications, comorbidities, demographics, and clinical characteristics with glycemic control were investigated.

    RESULTS: Sulfonylureas in combination (P=0.002) and sulfonylurea monotherapy (P<0.001) were found to be associated with good glycemic control, whereas insulin in combination (P=0.051), and combination biguanides and insulin therapy (P=0.012) were found to be associated with poor glycemic control. Stroke (P=0.044) was the only type of CVD that seemed to be significantly associated with good glycemic control. Other factors such as benign prostatic hyperplasia (P=0.026), elderly patients (P=0.018), low-density lipoprotein cholesterol levels (P=0.021), and fasting plasma glucose (P<0.001) were found to be significantly correlated with good glycemic control.

    CONCLUSION: Individualized treatment in T2DM patients with CVDs can be supported through a better understanding of the association between glycemic control and CV profiles in T2DM patients.

    Matched MeSH terms: Diabetes Mellitus, Type 1/blood; Diabetes Mellitus, Type 1/diagnosis; Diabetes Mellitus, Type 1/drug therapy*; Diabetes Mellitus, Type 1/epidemiology
  18. Nazaimoon WM, Azmi KN, Rasat R, Ismail IS, Singaraveloo M, Wan Mohamad WB, et al.
    Med J Malaysia, 2000 Sep;55(3):318-23.
    PMID: 11200711
    This study determined the prevalence and significance of autoantibodies to GAD65 (GAD Ab), insulin (IAA), tyrosine-like phosphatase (IA2) and islet-cell (ICA) in a group of 213 young Malaysian Type 1 diabetics, diagnosed before the age of 40 years. Venous blood was taken at fasting, and at 6 minutes post-glucagon (1 mg i.v.). IAA was detected in 47.4%, GAD Ab in 33.8%, IA2 in 8.9% and ICA in 1.4% of the subjects. When based on post-glucagon C-peptide level of 600 pmol/L, 172 (80.7%) patients had inadequate pancreatic reserve, while the remainder 41(19.3%) showed normal response. The autoantibodies, either alone or in combination, were detectable in both groups of patients; higher prevalence in those with poor or no beta-cell function (73.3% versus 46.3%, p = 0.0001). Although the prevalence of GAD Ab was highest in newly diagnosed patients (< 5 years), unlike IA2 and ICA, the marker remained detectable in 24-25% of those patients with long-standing disease. Nineteen patients could probably belong to the "latent autoimmune diabetes in adults (LADA)" subset, where pancreatic reserve was adequate but patients had detectable autoantibodies and insulin-requiring. On the other hand, 68 of the 213 patients (32%) were seronegative, but presented with near or total beta-cell destruction. Thus, as has also been suggested by others, there is indeed etiological differences between the Asian and the Caucasian Type 1 diabetics, and, there is also the possibility that other, but unknown autoantigens are involved in causing the pancreatic damage.
    Matched MeSH terms: Diabetes Mellitus, Type 1/immunology*
  19. Abdulrazaq NB, Cho MM, Win NN, Zaman R, Rahman MT
    Br J Nutr, 2012 Oct;108(7):1194-201.
    PMID: 22152092
    Zingiber officinale (ZO), commonly known as ginger, has been traditionally used in the treatment of diabetes mellitus. Several studies have reported the hypoglycaemic properties of ginger in animal models. The present study evaluated the antihyperglycaemic effect of its aqueous extract administered orally (daily) in three different doses (100, 300, 500 mg/kg body weight) for a period of 30 d to streptozotocin (STZ)-induced diabetic rats. A dose-dependent antihyperglycaemic effect revealed a decrease of plasma glucose levels by 38 and 68 % on the 15th and 30th day, respectively, after the rats were given 500 mg/kg. The 500 mg/kg ZO significantly (P<0·05) decreased kidney weight (% body weight) in ZO-treated diabetic rats v. control rats, although the decrease in liver weight (% body weight) was not statistically significant. Kidney glycogen content increased significantly (P<0·05) while liver and skeletal muscle glycogen content decreased significantly (P<0·05) in diabetic controls v. normal controls. ZO (500 mg/kg) also significantly decreased kidney glycogen (P<0·05) and increased liver and skeletal muscle glycogen in STZ-diabetic rats when compared to diabetic controls. Activities of glucokinase, phosphofructokinase and pyruvate kinase in diabetic controls were decreased by 94, 53 and 61 %, respectively, when compared to normal controls; and ZO significantly increased (P<0·05) those enzymes' activities in STZ-diabetic rats. Therefore, the present study showed that ginger is a potential phytomedicine for the treatment of diabetes through its effects on the activities of glycolytic enzymes.
    Matched MeSH terms: Diabetes Mellitus, Type 1/blood; Diabetes Mellitus, Type 1/drug therapy*; Diabetes Mellitus, Type 1/metabolism*; Diabetes Mellitus, Type 1/pathology
  20. Rama Chandran S, Tay WL, Lye WK, Lim LL, Ratnasingam J, Tan ATB, et al.
    Diabetes Technol Ther, 2018 05;20(5):353-362.
    PMID: 29688755 DOI: 10.1089/dia.2017.0388
    BACKGROUND: Hypoglycemia is the major impediment to therapy intensification in diabetes. Although higher individualized HbA1c targets are perceived to reduce the risk of hypoglycemia in those at risk of hypoglycemia, HbA1c itself is a poor predictor of hypoglycemia. We assessed the use of glycemic variability (GV) and glycemic indices as independent predictors of hypoglycemia.

    METHODS: A retrospective observational study of 60 type 1 and 100 type 2 diabetes subjects. All underwent professional continuous glucose monitoring (CGM) for 3-6 days and recorded self-monitored blood glucose (SMBG). Indices were calculated from both CGM and SMBG. Statistical analyses included regression and area under receiver operator curve (AUC) analyses.

    RESULTS: Hypoglycemia frequency (53.3% vs. 24%, P type 1 diabetes compared with type 2 diabetes. HbA1c was, at best, a weak predictor of hypoglycemia. %CVCGM, Low Blood Glucose Index (LBGI)CGM, Glycemic Risk Assessment Diabetes Equation (GRADE)HypoglycemiaCGM, and Hypoglycemia IndexCGM predicted hypoglycemia well. %CVCGM and %CVSMBG consistently remained a robust discriminator of hypoglycemia in type 1 diabetes (AUC 0.88). In type 2 diabetes, a combination of HbA1c and %CVSMBG or LBGISMBG could help discriminate hypoglycemia.

    CONCLUSION: Assessment of glycemia should go beyond HbA1c and incorporate measures of GV and glycemic indices. %CVSMBG in type 1 diabetes and LBGISMBG or a combination of HbA1c and %CVSMBG in type 2 diabetes discriminated hypoglycemia well. In defining hypoglycemia risk using GV and glycemic indices, diabetes subtypes and data source (CGM vs. SMBG) must be considered.

    Matched MeSH terms: Diabetes Mellitus, Type 1/blood*
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