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Fulltext Psidium guajava fruit peel extract reduces oxidative stress of pancreas in streptozotocin-induced diabetic rats

Siti Balkis Budin, Hawa Ismail, Pek LC

Sains Malaysiana, 2013;42:707-713.

Abundant natural products with medicinal properties have been used as food and traditional medicine for diabetes mellitus all over the world. Psidium guajava fruit from the family of Myrtaceae has gained attention for its antioxidant potential. This study was conducted to determine the effects of P. guajava fruit peel aqueous extract on oxidative stress of pancreas in streptozotocin-induced (45 mg/kg) diabetic rats. Diabetic rats were administered with 400 mg/kg of aqueous extract of P. guajava fruit peel daily for 28 days duration. The results showed that diabetic rats supplemented with P. guajava extract did not cause significant difference in blood glucose level (p>0.05) as compared with diabetic rats alone. For oxidative stress evaluation, malondialdehyde (MDA) and protein carbonyl level were significantly lower and the activity of superoxide dismutase (SOD) and glutathione (GSH) level were significantly higher (p<0.05) in P. guajava supplemented rats compared with non-supplemented diabetic rats. However, histological observation showed that supplementation of P. guajava extract did not give protective effects towards alterations in pancreas histology in diabetic rats. The findings suggested that aqueous extract of P. guajava fruit peel supplementation has the ability to reduce oxidative stress in pancreas of diabetic rats and may play a role in reducing the development of diabetic complications.

Matched MeSH terms: Diabetes Complications
Fulltext Prevalence and management of anemia in pre-dialysis Malaysian patients: A hospital-based study

Salman M, Khan AH, Adnan AS, Sulaiman SA, Hussain K, Shehzadi N, et al.

Rev Assoc Med Bras (1992), 2016 Nov;62(8):742-747.
PMID: 27992014 DOI: 10.1590/1806-9282.62.08.742

Objective:: Anemia, a common complication of chronic kidney diseases (CKD), is involved in significant cardiovascular morbidity. Therefore, the objective of our study was to investigate the prevalence and severity of anemia in pre-dialysis patients, as well as to determine the predictors of anti-anemic therapy.
Method:: A retrospective, observational study was conducted on adult pre-dialysis patients receiving treatment at the Hospital Universiti Sains Malaysia from January 2009 to December 2013.
Results:: A total of 615 eligible cases were included. The mean age of patients was 64.1±12.0 years. The prevalence of anemia was 75.8%, and the severity of anemia was mild in 47.7% of the patients, moderate in 32.2%, and severe in 20%. Based on morphological classification of anemia, 76.9% of our patients had normochromic-normocytic anemia whereas 21.8 and 1.3% had hypochromic-microcytic anemia and macrocytic anemia, respectively. Oral iron supplements were prescribed to 38.0% of the patients and none of the patients was given erythropoietin stabilizing agents (ESA) or intravenous iron preparations. In logistic regression, significant predictors of anti-anemic preparation use were decreased hemoglobin and hematocrit, and advanced stages of CKD.
Conclusion:: The results of the present study suggest that the prevalence of anemia in pre-dialysis patients is higher than currently accepted and it is found to be correlated with renal function; prevalence increases with declined renal function. An earlier identification as well as appropriate management of anemia will not only have a positive impact on quality of life but also reduce hospitalizations of CKD patients due to cardiovascular events.

Matched MeSH terms: Diabetes Complications
Safety profiling of pioglitazone and telmisartan combination by sub-chronic toxicity study in rat

Sengupta P, Das A, Ibrahim F, Mandal UK, Chatterjee B, Mahmood S, et al.

Regul Toxicol Pharmacol, 2016 Aug 26;81:155-161.
PMID: 27569202 DOI: 10.1016/j.yrtph.2016.08.009

It has been reported that the major cause of mortality in diabetes is cardiovascular diseases and contribution of hypertension is significant in this context. Pioglitazone, a thiazolidinedione class of therapeutic agent is used to treat type 2 diabetes mellitus. Telmisartan, an angiotensin receptor blocker antihypertensive has been reported to have beneficial effect if co-administered with pioglitazone for the management of diabetes complications. The present research work aims to evaluate the safety/toxicity profile of this combination in rat model. The investigation was carried out after co-administering the drugs to the rats for 28 days at three dose levels of 50, 100 and 150 mg/kg covering low to high dose ranges. Various hematological and biochemical parameters were studied in addition to the histopathology of the major organs in order to evaluate the toxicity profile of the combination. Absence of mortality and histopathological changes as well as unaltered hematological and biochemical parameters was observed. This preliminary investigation concludes that the combination of pioglitazone and telmisartan can primarily be stated as safe in animals, even at the dose level which is several folds higher than the intended human dose. Thus, this combination can be explored in future to develop a rational therapy regimen to treat hypertensive diabetic patients.

Matched MeSH terms: Diabetes Complications
Fulltext The statin studies: from targeting hypercholesterolaemia to targeting the high-risk patient

Ong HT

QJM, 2005 Aug;98(8):599-614.
PMID: 16006501

The landmark HMG-CoA reductase inhibitor (statin) studies have practical lessons for clinicans. The 4S trial established the importance of treating the hypercholesterolaemic patient with cardiovascular heart disease. Next, WOSCOPS showed the benefit of treating healthy, high-risk hypercholesterolaemic men. CARE, a secondary prevention trial, showed the benefit of treating patients with cholesterol levels within normal limits. This was confirmed by the LIPID trial, another secondary prevention study, which enrolled patients with cholesterol levels 155-271 mg/dl (4-7 mmol/l). The importance of treating patients with established ischaemic heart disease, and those at high risk of developing heart disease, regardless of cholesterol level, was being realized. In the MIRACL trial, hypocholesterolaemic therapy was useful in the setting of an acute coronary syndrome, while the AVERT study showed that aggressive statin therapy is as good as angioplasty in reducing ischaemic events in patients with stable angina. By showing the value of fluvastatin after percutaneous intervention, LIPS confirmed that benefit is a class action of the statins. The HPS randomized over 20 000 patients, and showed beyond doubt the value of statins in reducing cardiovascular events in the high-risk patient. Although PROSPER showed benefit in treating the elderly patients above 70 years, statin therapy in this trial was associated with an increase in cancer incidence. The comparative statin trials, PROVE-IT, REVERSAL, Phase Z of the A to Z, ALLIANCE and TNT, all showed that high-dose statins will better reduce cardiovascular events in the high-risk patient, although the adverse effects of therapy will also be increased. ALLHAT-LLT, ASCOT-LLA and CARDS showed that for statin therapy to demonstrate a significant benefit, hypertensive or diabetic patients must be at sufficiently high risk of cardiovascular events. The emphasis is now on the risk level for developing cardiovascular events, and treatment should target the high-risk group and not the lipid level of the patient. No therapy is free of adverse effect. Treatment of those most at risk will bring the most benefit; treatment of those not at high risk of cardiovascular disease may expose patients who would not benefit much from therapy to its adverse effects.

Matched MeSH terms: Diabetes Complications/drug therapy
Pulmonary tuberculosis in a hospital setting: gender differences

Nissapatorn V, Kuppusamy I, Sim BL, Fatt QK, Anuar AK

Public Health, 2006 May;120(5):441-3.
PMID: 16545406 DOI: 10.1016/j.puhe.2005.11.005
Matched MeSH terms: Diabetes Complications
Fulltext Sex-related differences in smear-positive pulmonary tuberculosis patients in Kuala Lumpur, Malaysia: Prevalence and associated factors

Ahmad N, Baharom M, Aizuddin AN, Ramli R

PLoS One, 2021;16(1):e0245304.
PMID: 33417609 DOI: 10.1371/journal.pone.0245304

Smear-positive pulmonary tuberculosis (PTB) is more infectious compared to smear-negative PTB and have great significance for epidemiology and infection control. The prevalence of smear-positive PTB rarely affects males and females equally. Hence, we aimed to identify the sex-related differences in the prevalence of smear-positive PTB and its associated factors in Kuala Lumpur, Malaysia. A cross-sectional study was conducted using data from the National Tuberculosis Information System (TBIS) from 1 January, 2015, to 31 December, 2019. The study population was selected using simple random sampling from the list of registered PTB patients in TBIS. The criteria for inclusion were all Malaysian adults aged ≥18 years residing in Kuala Lumpur and registered as PTB in TBIS. Factors associated with smear-positive PTB in male and female patients were determined using multiple logistic regression analysis. Overall prevalence of smear-positive PTB was 68.6%, and male patients predominated (71%). The male:female prevalence ratio of smear-positive PTB was 2.4:1. Male patients who worked as machine operators and elementary workers (adjusted odds ratio (aOR) 2.23, 95% confidence interval (CI) 1.24-4.02, p = 0.007), were self-employed (aOR 2.58, 95% CI 1.46-4.56, p = 0.001), lived in a residence categorized as 'other' (aOR 2.49, 95% CI 1.28-4.86, p = 0.007) and were smokers (aOR 1.37, 95% CI 1.01-1.87, p = 0.045) had higher odds for smear-positive PTB. Meanwhile, female patients with diabetes mellitus had higher odds for smear-positive PTB (aOR 1.92, 95% CI 1.05-3.54, p = 0.035), while female patients who were healthcare workers had lower odds (aOR 0.33, 95% CI 0.12, 0.94, p = 0.039). The prevalence of smear-positive PTB is higher in males compared to females. The factors associated with smear-positive PTB differed based on sex. The current TB control program, especially on smear-positive PTB, should likely be strategized and stratified by sex.

Matched MeSH terms: Diabetes Complications/pathology
Fulltext Prevalence and factors associated with prediabetes and diabetes in fishing communities in Penang, Malaysia: A cross-sectional study

Rahim FF, Abdulrahman SA, Kader Maideen SF, Rashid A

PLoS One, 2020;15(2):e0228570.
PMID: 32040497 DOI: 10.1371/journal.pone.0228570

BACKGROUND: Diabetes is a metabolic disorder, characterized by hyperglycemic state of the body. A silent killer, which can take the lives of victims if undiagnosed at the earliest stage. Prediabetes has become an important health concern across countries due to its huge potential for the development of diabetes and other complications. The objectives of this study were to determine the prevalence of prediabetes and diabetes and its associated factors among rural fishing communities in Penang, Malaysia.

METHODS: A cross-sectional study was conducted among fishing communities in Southwest District of Penang, Malaysia from August to November 2017. Blood sample (finger prick test) and physical examination were performed on sample of 168 participants consented in this study. Pre-validated Malay versions of International Physical Activity 7 (IPAQ-7) and Perceived Stress Scale (PSS) questionnaires were used to assess the level of physical activity and stress levels of the participants. Multinomial logistic regression models were fitted to identify factors associated with prediabetes and diabetes.

RESULTS: The prevalence of diabetes and prediabetes were 19.6% (95% CI: 14.3, 26.4) and 10.12% (95% CI: 6.4, 15.7) respectively. The median physical activity (interquartile range) in MET-minutes per week for those with diabetes (1071.0 (2120.0)) and prediabetes (1314.0 (1710.0)) was generally lower as compared to non-diabetes. Majority reported moderate stress (57.3%) from PSS system. Abdominal obesity, family history of diabetes and being hypertensive were significant factors associated with diabetes; while older age, bigger waist circumference and self-perceived poor routine diet were factors associated with prediabetes.

CONCLUSIONS: The screening for prediabetes in this population gives the opportunity to implement lifestyle interventions at the earliest possible, which could prevent the development of diabetes. The identification of diabetic individuals provides an opportunity to conduct health promotion and education to ensure good metabolic control and hence reduce the risks of complications.

Matched MeSH terms: Diabetes Complications/epidemiology
Fulltext Gycaemic control and treatment profile amongst 20646 adult type 2 diabetes mellitus: a descriptive report

Chew BH, Lee PY, Mastura I, Cheong AT, Sri Wahyu T, Zaiton A

Pertanika Journal of Science & Technology, 2014;22(1):95-103.
MyJurnal

An audit of Diabetes Control and Management-Diabetes Registry Malaysia (ADCM-DRM) was started to monitor the provision of diabetes care in the country. A total of 20,646 patients were registered in the registry until 31st December 2008. This report set out to determine the Type 2 diabetes controls and treatment profiles of these cohorts of patients. This was a registry-based observational study conducted from May to December, 2008. An online standard case record form was available for site data providers to register their diabetic patients aged 18 years old and above annually. Demographic data, diabetes duration, treatment modalities, as well as various risk factors and diabetes complications were reported. Data were analyzed using Data Analysis and Statistical Software (Stata) version 9. A total of 81 centres, 6 of which were hospitals, participated in this registry until 31st December 2008, contributing a total of 20646 patients. A majority of them (99.2%) had Type 2 diabetes mellitus. The mean HbA1c was 8.0% (SD 2.10), with 30.1% and 17.9% of the patients who attained HbA1c < 7% and HbA1c < 6.5%, respectively. Metformin was prescribed more than sulfonylurea while only 11% had insulin. A review of the diabetic care policy and strategies in the primary health care clinics is needed to implement a more effective treatment of diabetes in this country.

Matched MeSH terms: Diabetes Complications
Fulltext Association of the receptor for advanced glycation end-products (RAGE) gene polymorphisms in Malaysian patients with chronic kidney disease

Wong FN, Chua KH, Kuppusamy UR, Wong CM, Lim SK, Tan JA

PeerJ, 2016;4:e1908.
PMID: 27114872 DOI: 10.7717/peerj.1908

Chronic kidney disease (CKD) is a condition associated with progressive loss of kidney function and kidney damage. The two common causes of CKD are diabetes mellitus and hypertension. Other causes of CKD also include polycystic kidney disease, obstructive uropathy and primary glomerulonephritis. The receptor for advanced glycation end-products (RAGE) is a multi-ligand cell surface receptor of the immunoglobulin superfamily and it has been associated with kidney disease in both non-diabetic and diabetic patients. Presently, data on the association between RAGE polymorphisms and CKD in the Malaysian population is limited, while numerous studies have reported associations of RAGE polymorphisms with diabetic complications in other populations. The present study aims to explore the possibility of using RAGE polymorphisms as candidate markers of CKD in Malaysian population by using association analysis.

Matched MeSH terms: Diabetes Complications
Fulltext Determinants of medication adherence among adults with type 2 diabetes mellitus in three Malaysian public health clinics: a cross-sectional study

Chew BH, Hassan NH, Mohd Sidik S

Patient Prefer Adherence, 2015;9:639-48.
PMID: 25999699 DOI: 10.2147/PPA.S81612

Medication adherence (MA) in adults with type 2 diabetes mellitus (T2D) is associated with improved disease control (glycated hemoglobin, blood pressure, and lipid profile), lower rates of death and diabetes-related complications, increased quality of life, and decreased health care resource utilization. However, there is a paucity of data on the effect of diabetes-related distress, depression, and health-related quality of life on MA. This study examined factors associated with MA in adults with T2D at the primary care level. This was a cross-sectional study conducted in three Malaysian public health clinics, where adults with T2D were recruited consecutively in 2013. We used the 8-item Morisky Medication Adherence Scale (MMAS-8) to assess MA as the main dependent variable. In addition to sociodemographic data, we included diabetes-related distress, depressive symptoms, and health-related quality of life as independent variables. Independent association between the MMAS-8 score and its determinants was done using generalized linear models with a gamma distribution and log link function. The participant response rate was 93.1% (700/752). The majority were female (52.8%), Malay (52.9%), and married (79.1%). About 43% of patients were classified as showing low MA (MMAS-8 score <6). Higher income (adjusted odds ratio 0.90) and depressive symptoms (adjusted odds ratio 0.99) were significant independent determinants of medication non-adherence in young adults with T2D. Low MA in adults with T2D is a prevalent problem. Thus, primary health care providers in public health clinics should focus on MA counselling for adult T2D patients who are younger, have a higher income, and symptoms of depression.

Matched MeSH terms: Diabetes Complications
Fulltext A clinical update on metformin and lung cancer in diabetic patients

Gupta G, de Jesus Andreoli Pinto T, Chellappan DK, Mishra A, Malipeddi H, Dua K

Panminerva Med, 2018 Jun;60(2):70-75.
PMID: 29370676 DOI: 10.23736/S0031-0808.18.03394-3

Diabetes mellitus (DM) is frequently increased in many countries and become a serious health problem worldwide. Diabetes is associated with dysfunction of different organs such as heart, eyes, blood vessels, nerves, and kidneys. There is a strong connection between diabetes and cancer. Metformin is one of the most commonly prescribed oral antidiabetic medicines and it is suggested as the first-line therapy due to its comparatively safe, inexpensive, effective and well-tolerated. Some of the in vitro and in vivo investigations proved that metformin may have a direct anticancer action by preventing the proliferation of malignant cells and formations of the colony, inducing arrest of cell cycle and apoptosis and suppressing tumor growth. The antiproliferative mechanism of metformin alone or in combination with various chemotherapeutic agents is complex and involves several beneficial roles. In this regard, clinical studies are required to explain these roles. In the coming future, the use of metformin, alone or in combination with current chemotherapy, might be a conventional approach to effectually manage lung cancer. This mini-review provides a critical overview of currently available clinical trials investigating the effects of metformin in lung cancer.

Matched MeSH terms: Diabetes Complications/drug therapy*
Fulltext Antimicrobial activity of Nigella sativa L. seed oil against multi-drug resistant Staphylococcus aureus isolated from diabetic wounds

Emeka LB, Emeka PM, Khan TM

Pak J Pharm Sci, 2015 Nov;28(6):1985-90.
PMID: 26639493

Microbial resistance to existing antibiotics has led to an increase in the use of medicinal plants that show beneficial effects for various infectious diseases. The study evaluates the susceptibility of multidrug resistant Staphylococcus aureus to Nigella sativa oil. Staphylococcus aureus was isolated from 34 diabetic patient's wounds attending the Renaissance hospital, Nsukka, Southeast Nigeria. The isolates were characterized and identified using standard microbiological techniques. Isolates were cultured and a comparative In vitro antibiotic susceptibility test was carried out using the disk diffusion method. Of the 34 samples collected, 19(56%) showed multidrug resistance to the commonly used antibiotics. Nigella sativa oil was then studied for antibacterial activity against these multidrug resistant isolates of Staphylococcus aureus in varying concentration by well diffusion method. The oil showed pronounced dose dependent antibacterial activity against the isolates. Out of 19 isolates, 8(42%) were sensitive to undiluted oil sample; 4(21%) of these showed sensitivity at 200 mg/ml, 400 mg/ml and 800 mg/ml respectively. Eleven (58%) of the isolates were completely resistant to all the oil concentrations. The present study, reports the isolation of multi-drug resistant S. aureus from diabetic wounds and that more than half of isolates were susceptible to different concentrations N. sativa oil.

Matched MeSH terms: Diabetes Complications/diagnosis; Diabetes Complications/drug therapy*; Diabetes Complications/microbiology
Fulltext COVID-19-associated mucormycosis: Evidence-based critical review of an emerging infection burden during the pandemic's second wave in India

Aranjani JM, Manuel A, Abdul Razack HI, Mathew ST

PLoS Negl Trop Dis, 2021 Nov;15(11):e0009921.
PMID: 34793455 DOI: 10.1371/journal.pntd.0009921

Coronavirus Disease 2019 (COVID-19), during the second wave in early 2021, has caused devastating chaos in India. As daily infection rates rise alarmingly, the number of severe cases has increased dramatically. The country has encountered health infrastructure inadequacy and excessive demand for hospital beds, drugs, vaccines, and oxygen. Adding more burden to such a challenging situation, mucormycosis, an invasive fungal infection, has seen a sudden surge in patients with COVID-19. The rhino-orbital-cerebral form is the most common type observed. In particular, approximately three-fourths of them had diabetes as predisposing comorbidity and received corticosteroids to treat COVID-19. Possible mechanisms may involve immune and inflammatory processes. Diabetes, when coupled with COVID-19-induced systemic immune change, tends to cause decreased immunity and an increased risk of secondary infections. Since comprehensive data on this fatal opportunistic infection are evolving against the backdrop of a major pandemic, prevention strategies primarily involve managing comorbid conditions in high-risk groups. The recommended treatment strategies primarily included surgical debridement and antifungal therapy using Amphotericin B and selected azoles. Several India-centric clinical guidelines have emerged to rightly diagnose the infection, characterise the clinical presentation, understand the pathogenesis involved, and track the disease course. Code Mucor is the most comprehensive one, which proposes a simple but reliable staging system for the rhino-orbital-cerebral form. A staging system has recently been proposed, and a dedicated registry has been started. In this critical review, we extensively analyse recent evidence and guidance on COVID-19-associated mucormycosis in India.

Matched MeSH terms: Diabetes Complications/microbiology
Fulltext Multimorbidity in patients with heart failure from 11 Asian regions: A prospective cohort study using the ASIAN-HF registry

Tromp J, Tay WT, Ouwerkerk W, Teng TK, Yap J, MacDonald MR, et al.

PLoS Med, 2018 03;15(3):e1002541.
PMID: 29584721 DOI: 10.1371/journal.pmed.1002541

BACKGROUND: Comorbidities are common in patients with heart failure (HF) and complicate treatment and outcomes. We identified patterns of multimorbidity in Asian patients with HF and their association with patients' quality of life (QoL) and health outcomes.

METHODS AND FINDINGS: We used data on 6,480 patients with chronic HF (1,204 with preserved ejection fraction) enrolled between 1 October 2012 and 6 October 2016 in the Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) registry. The ASIAN-HF registry is a prospective cohort study, with patients prospectively enrolled from in- and outpatient clinics from 11 Asian regions (Hong Kong, Taiwan, China, Japan, Korea, India, Malaysia, Thailand, Singapore, Indonesia, and Philippines). Latent class analysis was used to identify patterns of multimorbidity. The primary outcome was defined as a composite of all-cause mortality or HF hospitalization within 1 year. To assess differences in QoL, we used the Kansas City Cardiomyopathy Questionnaire. We identified 5 distinct multimorbidity groups: elderly/atrial fibrillation (AF) (N = 1,048; oldest, more AF), metabolic (N = 1,129; obesity, diabetes, hypertension), young (N = 1,759; youngest, low comorbidity rates, non-ischemic etiology), ischemic (N = 1,261; ischemic etiology), and lean diabetic (N = 1,283; diabetic, hypertensive, low prevalence of obesity, high prevalence of chronic kidney disease). Patients in the lean diabetic group had the worst QoL, more severe signs and symptoms of HF, and the highest rate of the primary combined outcome within 1 year (29% versus 11% in the young group) (p for all <0.001). Adjusting for confounders (demographics, New York Heart Association class, and medication) the lean diabetic (hazard ratio [HR] 1.79, 95% CI 1.46-2.22), elderly/AF (HR 1.57, 95% CI 1.26-1.96), ischemic (HR 1.51, 95% CI 1.22-1.88), and metabolic (HR 1.28, 95% CI 1.02-1.60) groups had higher rates of the primary combined outcome compared to the young group. Potential limitations include site selection and participation bias.

CONCLUSIONS: Among Asian patients with HF, comorbidities naturally clustered in 5 distinct patterns, each differentially impacting patients' QoL and health outcomes. These data underscore the importance of studying multimorbidity in HF and the need for more comprehensive approaches in phenotyping patients with HF and multimorbidity.

TRIAL REGISTRATION: ClinicalTrials.gov NCT01633398.

Matched MeSH terms: Diabetes Complications/epidemiology
Health burden associated with visual impairment in Singapore: the Singapore epidemiology of eye disease study

Wang X, Lamoureux E, Zheng Y, Ang M, Wong TY, Luo N

Ophthalmology, 2014 Sep;121(9):1837-42.
PMID: 24768238 DOI: 10.1016/j.ophtha.2014.03.017

To assess the impact of visual impairment (VI) on health-related quality of life and to compare the health burden of VI and other health conditions in Singapore.

Matched MeSH terms: Diabetes Complications
Fulltext Natural Phyto-Bioactive Compounds for the Treatment of Type 2 Diabetes: Inflammation as a Target

Gothai S, Ganesan P, Park SY, Fakurazi S, Choi DK, Arulselvan P

Nutrients, 2016 Aug 04;8(8).
PMID: 27527213 DOI: 10.3390/nu8080461

Diabetes is a metabolic, endocrine disorder which is characterized by hyperglycemia and glucose intolerance due to insulin resistance. Extensive research has confirmed that inflammation is closely involved in the pathogenesis of diabetes and its complications. Patients with diabetes display typical features of an inflammatory process characterized by the presence of cytokines, immune cell infiltration, impaired function and tissue destruction. Numerous anti-diabetic drugs are often prescribed to diabetic patients, to reduce the risk of diabetes through modulation of inflammation. However, those anti-diabetic drugs are often not successful as a result of side effects; therefore, researchers are searching for efficient natural therapeutic targets with less or no side effects. Natural products' derived bioactive molecules have been proven to improve insulin resistance and associated complications through suppression of inflammatory signaling pathways. In this review article, we described the extraction, isolation and identification of bioactive compounds and its molecular mechanisms in the prevention of diabetes associated complications.

Matched MeSH terms: Diabetes Complications/prevention & control*
International comparison of UK registry data (chapter 17)

Caskey F, Steenkamp R, Ansell D

Nephrol Dial Transplant, 2007 Aug;22 Suppl 7:vii185-93.
PMID: 17724048

In 2005, the incidence of renal replacement therapy (RRT) in the United Kingdom was 110 per million of the population (pmp) using the day 0 definition and 103 pmp using the day 90 definition. Relative to the 42 countries reporting data to the USRDS, the day 0 and day 90 rates for RRT incidence in the UK are the 32nd and 35th lowest, respectively. However, the overall incidence for the UK masks higher rates in Scotland, Wales and Northern Ireland (123, 129 and 140 pmp, respectively). Of the six countries with RRT incidence rates comparable with those in the UK (Australia, Finland, Malaysia, New Zealand, Norway and the Netherlands) three had relatively high rates for the age band 20-44, and two had relatively high rates for the age band 45-60. The proportion of incident patients with diabetes as the cause of established renal failure also varied considerably among these six comparator countries from 16% to 40% but rates of peritoneal dialysis utilization were comparable with that in the UK and generally higher than in countries with higher rates of RRT incidence. When transplantation rates were considered alongside prevalence rates for RRT, the UK position appeared relatively high at 46% (11th out of 37 countries), although still considerably lower than in Norway and the Netherlands (72 and 54%, respectively). Although variation in RRT incidence rate exists within the four countries of the UK, the overall RRT incidence, reported for the first time this year, appears similar to that observed in a number of demographically similar countries around the world. Examining the UK alongside the six comparator countries, different patterns of RRT incidence were observed across the age bands and variation in the RRT incidence secondary to diabetes mellitus raised interesting questions. The higher rates of renal transplantation achieved in several of the comparator countries also justifies further analysis.

Matched MeSH terms: Diabetes Complications/complications; Diabetes Complications/epidemiology
Metformin attenuated histopathological ocular deteriorations in a streptozotocin-induced hyperglycemic rat model

Nahar N, Mohamed S, Mustapha NM, Lau S, Ishak NIM, Umran NS

Naunyn Schmiedebergs Arch Pharmacol, 2021 Mar;394(3):457-467.
PMID: 33047165 DOI: 10.1007/s00210-020-01989-w

Diabetes mellitus (DM) often causes ocular disorders leading to vision loss. Metformin is commonly prescribed for type 2 diabetes. This study assessed the effect of metformin on hyperglycemic histopathological eye abnormalities and some possible pathways involved. Male rats were divided into 3 groups (N = 6), namely, healthy control, hyperglycemic non-treated control, and hyperglycemic rats treated with 200 mg/kg metformin. Two weeks after diabetes induction by an intraperitoneal streptozotocin (60 mg streptozotocin (STZ)/kg) injection, the rats develop ocular abnormalities, and metformin (200 mg/kg) treatment was administered daily. Rats underwent dilated retinal digital ophthalmoscope examination and graded for diabetic retinopathy. Rats were sacrificed at 12 weeks, and the cornea, lens, sclera, ciliary body, iris, conjunctiva, retinal, and optic nerve were examined histologically. Rats' fasting blood glucose and body weight were monitored. Serum tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF), claudin-1, and glutathione/malondialdehyde ratios were analyzed. Metformin significantly attenuated diabetes-related histopathological ocular deteriorations in the cornea, lens, sclera, ciliary body, iris, conjunctiva, retina, and optic nerve partly by restoring serum TNF-α, VEGF, claudin-1, and glutathione/malondialdehyde ratios without significantly affecting the fasting blood glucose levels or body weight in these hyperglycemic rats. Metformin attenuated hyperglycemia-associated histopathological eye deteriorations, possibly partly by ameliorating vascular leakage, oxidative stress, inflammation, and neovascularization, without affecting the fasting blood glucose levels or body weights in these STZ-induced diabetic rats.

Matched MeSH terms: Diabetes Complications/blood; Diabetes Complications/drug therapy*; Diabetes Complications/pathology
Earlier onset of motor complications in Parkinson's patients with comorbid diabetes mellitus

Mohamed Ibrahim N, Ramli R, Koya Kutty S, Shah SA

Mov Disord, 2018 12;33(12):1967-1968.
PMID: 30427552 DOI: 10.1002/mds.27526
Matched MeSH terms: Diabetes Complications/drug therapy*
Dynamics of Diabetes and Obesity: An Alarming Situation in the Developing Countries in Asia

Chakraborty C, Das S

Mini Rev Med Chem, 2016;16(15):1258-1268.
PMID: 27145852 DOI: 10.2174/1389557516666160505115512

The incidence of diabetes in developing countries in Asia has increased over the last few years. The economic development is radically changing the lifestyle of the younger generation who prefer to embrace the western lifestyle of eating high calorie fast food with minimal physical exercise. Previously, the rate of diabetes was very low but it is increasing at an alarming rate in the developing countries in Asia. Admittedly, there is paucity of literature on the prevalence of patients with type-1 diabetes in Asian developing countries due to lower field surveys and lack of quantitative data. Few contributing factors such as body mass index (BMI) and its relation with obesity and diabetes, energy dense diet, excessive caloric intake, sedentary behaviors, lifestyle and family history, gene and genomewide association of diabetes, genes and gene polymorphisms are being discussed especially with regard to the Asian population. Dynamics of the diabetes and obesity was depicted for the population of Asian developing countries with special emphasis on China and India. Diabetes has become widespread among the low-income communities. Hence, it is necessary to develop appropriate healthcare policies in order to mitigate this rampant epidemic before it is too late.

Matched MeSH terms: Diabetes Complications/epidemiology; Diabetes Complications/prevention & control

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