METHODS: The VISION study was a prospective, non-interventional, observational study of adult patients with Type 2 diabetes mellitus in 6 countries in the Western Pacific, Middle East and North Africa, receiving insulin injection therapy for the first time. In this VISION Ramadan substudy, fasting data was collected during Ramadan 2014 and 2015.
RESULTS: Of 1617 patients in the VISION study, data was collected for 357 patients who chose to fast during Ramadan. At baseline, mean HbA1c was 10.1%, duration of diabetes was 8.8 years, and mean BMI was 30 kg/m2. All patients with non-missing data (n = 169) received advice on fasting during Ramadan. The majority of patients fasted for the full month of Ramadan, and around one-third of patients fasted outside Ramadan.
CONCLUSIONS: Here we provide an update on the characteristics and Ramadan experience of patients with Type 2 diabetes mellitus who initiated insulin therapy and chose to fast during Ramadan. There is still a need to explore patient's experience during fasting, and identify and address methods to better help manage those patients.
AIM OF THE STUDY: Our study focuses on previously unreported anti-depressant activity of E. variegata bark ethanolic extract (EBE) and determination of its mechanism of action possibly through regulation of monoamine oxidase activity in mouse brain homogenates.
MATERIALS AND METHODS: EBE was characterized using standard protocols for phytochemical analysis, followed by liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS) analysis. Anti-depressant activity of EBE (50, 100, 200 and 500 mg/kg) was evaluated in Swiss white albino mice using acute and chronic forced swim test (FST) models. Furthermore, the potential use of the extract as an adjunct to selective serotonin reuptake inhibitor (SSRI), escitalopram, was evaluated using the chronic unpredictable mild stress test model wherein inhibitory effects on monoamine oxidase (MAO) A and B were assessed by spectrophotometric-chemical analysis in mouse whole brain homogenates.
RESULTS: The extract showed significant reduction in immobility time periods in both acute (200 mg/kg) and chronic (100, 200 and 500 mg/kg) FST models. When used as an adjunct with escitalopram (15 mg/kg), the extract (100, 200 and 500 mg/kg) showed significantly greater inhibition of MAO-A and B activities when compared to escitalopram alone (30 mg/kg). Phytochemical analysis of EBE revealed presence of sugars, steroids, glycosides, alkaloids and tannins. LC-MS and GC-MS analysis identified components such as 2-amino-3-methyl-1-butanol, phenylethylamine, eriodictyol, daidzein and pomiferin, N-ethyl arachidonoyl amine, inosine diphosphate, trimipramine, granisetron, 3,4-dihydroxymandelic acid, ethyl ester, tri-TMS and dodecane, previously reported for their anti-depressant activity.
CONCLUSIONS: The study thus demonstrated potential for use of the E. variegata bark ethanolic extract as an adjunct to currently available SSRI treatment. The study also identified components present in E. variegata bark ethanolic extract that may be responsible for its anti-depressant activity. Furthermore, the study thus confirms the traditional use of E. variegata barks in improving CNS function through its anti-depressant like activity.