Diabesity and the related complications are challenging problems in the current era. Conventionally, glucagon was known for its benefit in the management of hypoglycemia due to its involvement in the counter-regulatory mechanism. The studies in the last decade have brought a tremendous change in the therapeutic benefits of glucagon, due to the identification of multiple pleiotropic effects of it. This has resulted in the development of newer therapies for diabetes and obesity by the incorporation of glucagon agonism into incretin-based therapies. These novel dual/triple agonists containing glucagon and incretins give promising and synergistic advantages in the management of metabolic complications of diabesity. The metabolic effects of glucagon receptor antagonists have been disappointing. In addition, novel stable formulations have been developed for the management of hypoglycemia. Dual-hormone automated delivery systems containing insulin and glucagon are another attractive advancement on the process of development to minimize hypoglycemia in long-standing diabetes parallelly with improvement in glycemic control. We summarize the novel mechanisms of glucagon identified and the glucagon-based advancements in the management of diabetes mellitus.
{"title":"Emerging glucagon-based therapies in diabetes mellitus: Toward a better future in diabetes care","authors":"Shahini Winson Gnanathayalan, M. Sumanatilleke","doi":"10.4103/jod.jod_110_23","DOIUrl":"https://doi.org/10.4103/jod.jod_110_23","url":null,"abstract":"\u0000 Diabesity and the related complications are challenging problems in the current era. Conventionally, glucagon was known for its benefit in the management of hypoglycemia due to its involvement in the counter-regulatory mechanism. The studies in the last decade have brought a tremendous change in the therapeutic benefits of glucagon, due to the identification of multiple pleiotropic effects of it. This has resulted in the development of newer therapies for diabetes and obesity by the incorporation of glucagon agonism into incretin-based therapies. These novel dual/triple agonists containing glucagon and incretins give promising and synergistic advantages in the management of metabolic complications of diabesity. The metabolic effects of glucagon receptor antagonists have been disappointing. In addition, novel stable formulations have been developed for the management of hypoglycemia. Dual-hormone automated delivery systems containing insulin and glucagon are another attractive advancement on the process of development to minimize hypoglycemia in long-standing diabetes parallelly with improvement in glycemic control. We summarize the novel mechanisms of glucagon identified and the glucagon-based advancements in the management of diabetes mellitus.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"10 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139380254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dear Sir, People with type 1 diabetes, especially young women, are much more likely to have eating disorders than those without.[1] These disorders most often take the form of food restriction, binging and vomiting, excessive exercise, and the use of laxatives. One of the forms of eating disorders in patients with type 1 diabetes is “Diabulimia,” affecting as many as 60% of patients.[2] Diabulimia is a deliberate reduction of insulin, resulting in weight loss.[3] This term is not currently recognized as a formal diagnosis, but due to the specificity of the problem, numerous studies in this area are underway and guidelines for the best treatment of people deliberately limiting insulin are being developed.[1,4] Factors that may increase the risk of eating disorders in people with type 1 diabetes, in addition to concerns about body shape and weight, include the need to cope with a chronic disease and constant control of food intake along with insulin dosing. In this letter, we would like to draw your attention to the particular danger of coexistence of both of these diseases. Reducing the supply of insulin in people with type 1 diabetes results in an increase in blood glucose concentration, followed by catabolic changes and glucosuria resulting in a rapid loss of calories. Such manipulation of insulin doses allows patients to lose weight quickly but has serious health consequences. Among the effects of insulin restriction, ketoacidosis can be distinguished as an acute complication of diabetes. Long-term complications associated with diabulimia include retinopathy and nephropathy.[5] Patients with type 1 diabetes, limiting the supply of insulin to lose weight quickly and easily, often underestimate the health consequences of such decisions. The vast majority of patients are aware of the serious complications that result from such management, but they still decide to further reduce insulin doses.[1] Due to the commonness of the problem of diabulimia, special vigilance should be maintained in the care of patients with type 1 diabetes. Alarming symptoms suggesting the possibility of co-occurrence of eating disorders are sudden and significant weight loss, large changes in the daily dose of insulin, and significant fluctuations in blood glucose levels (both hyper- and hypoglycemia). In the treatment of eating disorders, apart from diabetes education, psychological care of the patient is very important, which is why cooperation between specialists is essential. Interdisciplinary care for a patient with type 1 diabetes is, therefore, needed both in the treatment and prevention of eating disorders.[4] Due to the increasing scale of the problem described, we hope that this letter will contribute to increasing vigilance for the appropriate diagnosis and multidirectional treatment of patients with type 1 diabetes and comorbid eating disorders. Authors’ contribution KM and AB contributed equally to this article. Financial support and sponsorship Nil. Conflicts
{"title":"Eating disorders and type 1 diabetes as a significant problem","authors":"Karolina Matuszewska, Adrian Bystroń","doi":"10.4103/jod.jod_79_23","DOIUrl":"https://doi.org/10.4103/jod.jod_79_23","url":null,"abstract":"Dear Sir, People with type 1 diabetes, especially young women, are much more likely to have eating disorders than those without.[1] These disorders most often take the form of food restriction, binging and vomiting, excessive exercise, and the use of laxatives. One of the forms of eating disorders in patients with type 1 diabetes is “Diabulimia,” affecting as many as 60% of patients.[2] Diabulimia is a deliberate reduction of insulin, resulting in weight loss.[3] This term is not currently recognized as a formal diagnosis, but due to the specificity of the problem, numerous studies in this area are underway and guidelines for the best treatment of people deliberately limiting insulin are being developed.[1,4] Factors that may increase the risk of eating disorders in people with type 1 diabetes, in addition to concerns about body shape and weight, include the need to cope with a chronic disease and constant control of food intake along with insulin dosing. In this letter, we would like to draw your attention to the particular danger of coexistence of both of these diseases. Reducing the supply of insulin in people with type 1 diabetes results in an increase in blood glucose concentration, followed by catabolic changes and glucosuria resulting in a rapid loss of calories. Such manipulation of insulin doses allows patients to lose weight quickly but has serious health consequences. Among the effects of insulin restriction, ketoacidosis can be distinguished as an acute complication of diabetes. Long-term complications associated with diabulimia include retinopathy and nephropathy.[5] Patients with type 1 diabetes, limiting the supply of insulin to lose weight quickly and easily, often underestimate the health consequences of such decisions. The vast majority of patients are aware of the serious complications that result from such management, but they still decide to further reduce insulin doses.[1] Due to the commonness of the problem of diabulimia, special vigilance should be maintained in the care of patients with type 1 diabetes. Alarming symptoms suggesting the possibility of co-occurrence of eating disorders are sudden and significant weight loss, large changes in the daily dose of insulin, and significant fluctuations in blood glucose levels (both hyper- and hypoglycemia). In the treatment of eating disorders, apart from diabetes education, psychological care of the patient is very important, which is why cooperation between specialists is essential. Interdisciplinary care for a patient with type 1 diabetes is, therefore, needed both in the treatment and prevention of eating disorders.[4] Due to the increasing scale of the problem described, we hope that this letter will contribute to increasing vigilance for the appropriate diagnosis and multidirectional treatment of patients with type 1 diabetes and comorbid eating disorders. Authors’ contribution KM and AB contributed equally to this article. Financial support and sponsorship Nil. Conflicts ","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135815998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Gautam, Shoorvir V. Singh, Ankit Gupta, Anupam Sharma, Saurabh Gupta, N. Pursnani, P. Agrawal
Background: Despite of several guidelines metformin and glimepiride remains the first prescribed drug in most people with diabetes. Very often canagliflozin and teneligliptin remain the third prescribed OHA. Efficacy of teneligliptin and canagliflozin as solo drug or in combination with other single OHA’s on glycaemic parameters, lipid profiles & blood pressure is already established. But their efficacy on above parameters when used as third drug next to metformin and sulfonylurea is still not investigated. Aims and objectives: Aim of this study is to compare glycaemic and non-glycemic effects of canagliflozin and teneligliptin as third line drug. Objective is to establish their multiple pleotropic effects at this position. Methods: Subjects with uncontrolled glycaemic parameters with hypertension and diabetic dyslipidaemia already on half maximal doses of metformin and glimepiride were enrolled in the study. Out of 87 selections, 45 were prescribed canagliflozin 100 mg/d and to 42 subjects, teneligliptin 20mg/d, each for 24 weeks. Effects over HbA1c, fasting and post prandial plasma glucose, systolic and diastolic blood pressures, HDL’c and triglycerides were observed pre and post intervention. Results: As a third drug both canagliflozin and teneligliptin show significant reduction in HbA1c (1.5 versus 1.6%), fasting (-20.2 versus -28.8 mg %), and post prandial (-39.9 versus – 58.5mg %). Effects over systolic (4 mmHg versus 1.1 mmHg) and diastolic BP (3.1 mmHg versus 0.2 mmHg) was clinically and statistically significant (p = 0.3 and 0.1) respectively in both groups. A statistically insignificant (9.6 versus 4.1 mg%; p =) reduction in Triglycerides but significant (7.6 versus 1.2; p <0.0001) increase in HDL’c was observed. Conclusion: Canagliflozin and teneligliptin, both retains their glycaemic and non-glycaemic benefits even when used as third OHA for diabetes management. Canagliflozin scores better for comorbid hypertension and diabetic dyslipidaemia.
背景:尽管有一些指南，二甲双胍和格列美脲仍然是大多数糖尿病患者的首选处方药。通常，卡格列净和替尼格列汀仍然是OHA的第三处方。替尼格列汀和卡格列净单独用药或与其他单一OHA联合用药对血糖参数、血脂和血压的影响已经确定。但作为二甲双胍、磺脲类药物后的第三种用药，其在上述指标上的疗效尚不明确。目的和目的:本研究的目的是比较卡格列净和替尼格列汀作为三线药物的降糖和非降糖作用。目的是确定其在该部位的多重多效性。方法:血糖参数不受控制并伴有高血压和糖尿病性血脂异常的受试者已服用最大剂量的一半二甲双胍和格列美脲纳入研究。在87个选择中，45个受试者服用卡格列净100mg /d, 42个受试者服用替尼格列汀20mg/d，每个疗程24周。观察干预前后对HbA1c、空腹和餐后血糖、收缩压和舒张压、HDL 'c和甘油三酯的影响。结果:作为第三种药物，canagliflozin和teneligliptin在空腹(-20.2 mg %对-28.8 mg %)和餐后(-39.9 mg %对- 58.5mg %)均显示出显著的HbA1c降低(1.5%对1.6%)。两组对收缩压(4mmhg vs 1.1 mmHg)和舒张压(3.1 mmHg vs 0.2 mmHg)的影响分别具有临床和统计学意义(p = 0.3和0.1)。统计学上不显著(9.6 vs 4.1 mg%;p =)降低甘油三酯，但显著(7.6对1.2;p <0.0001)， HDL 'c升高。结论:加格列净和替尼格列汀即使作为糖尿病治疗的第三种OHA，也能保持它们的降糖和非降糖益处。卡格列净对合并症高血压和糖尿病性血脂异常评分更高。
{"title":"Comparison of efficacy between canagliflozin and teneligliptin as add-on therapy to metformin and glimepiride on plasma glucose levels along with blood pressure and lipid levels in patients with type 2 diabetes mellitus","authors":"A. Gautam, Shoorvir V. Singh, Ankit Gupta, Anupam Sharma, Saurabh Gupta, N. Pursnani, P. Agrawal","doi":"10.4103/jod.jod_31_23","DOIUrl":"https://doi.org/10.4103/jod.jod_31_23","url":null,"abstract":"Background: Despite of several guidelines metformin and glimepiride remains the first prescribed drug in most people with diabetes. Very often canagliflozin and teneligliptin remain the third prescribed OHA. Efficacy of teneligliptin and canagliflozin as solo drug or in combination with other single OHA’s on glycaemic parameters, lipid profiles & blood pressure is already established. But their efficacy on above parameters when used as third drug next to metformin and sulfonylurea is still not investigated. Aims and objectives: Aim of this study is to compare glycaemic and non-glycemic effects of canagliflozin and teneligliptin as third line drug. Objective is to establish their multiple pleotropic effects at this position. Methods: Subjects with uncontrolled glycaemic parameters with hypertension and diabetic dyslipidaemia already on half maximal doses of metformin and glimepiride were enrolled in the study. Out of 87 selections, 45 were prescribed canagliflozin 100 mg/d and to 42 subjects, teneligliptin 20mg/d, each for 24 weeks. Effects over HbA1c, fasting and post prandial plasma glucose, systolic and diastolic blood pressures, HDL’c and triglycerides were observed pre and post intervention. Results: As a third drug both canagliflozin and teneligliptin show significant reduction in HbA1c (1.5 versus 1.6%), fasting (-20.2 versus -28.8 mg %), and post prandial (-39.9 versus – 58.5mg %). Effects over systolic (4 mmHg versus 1.1 mmHg) and diastolic BP (3.1 mmHg versus 0.2 mmHg) was clinically and statistically significant (p = 0.3 and 0.1) respectively in both groups. A statistically insignificant (9.6 versus 4.1 mg%; p =) reduction in Triglycerides but significant (7.6 versus 1.2; p <0.0001) increase in HDL’c was observed. Conclusion: Canagliflozin and teneligliptin, both retains their glycaemic and non-glycaemic benefits even when used as third OHA for diabetes management. Canagliflozin scores better for comorbid hypertension and diabetic dyslipidaemia.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"61 1","pages":"157 - 160"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77966777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Agrawal, N. Pursnani, A. Gautam, Akhilesh K Singh, Awadhesh Singh
Maternally inherited diabetes and deafness (MIDD) is a rare subtype of diabetes with a prevalence of up to 1% globally but often missed if not suspected. We present a case of MIDD and a thorough review of the literature related to it. The phenotypic presentation of diabetes depends on heteroplasmy levels of m.3243A>G mutation of the individual patient. Patients with MIDD may have involvement of other organs such as eye, muscles, kidney, and heart. In our patient, along with diabetes and deafness, there was also an associated vision loss with a strong maternal inheritance of diabetes. A young male who presented with diabetic ketoacidosis (DKA) and hearing and vision impairment and on further diagnostic work up turned out to be a case of genetically confirmed (m.3243A>G mutation) MIDD. To the best of our knowledge, this should be the first case of MIDD presenting as DKA being reported from India.
{"title":"Maternally inherited diabetes mellitus and deafness (MIDD): A case report and review of literature","authors":"P. Agrawal, N. Pursnani, A. Gautam, Akhilesh K Singh, Awadhesh Singh","doi":"10.4103/jod.jod_21_23","DOIUrl":"https://doi.org/10.4103/jod.jod_21_23","url":null,"abstract":"Maternally inherited diabetes and deafness (MIDD) is a rare subtype of diabetes with a prevalence of up to 1% globally but often missed if not suspected. We present a case of MIDD and a thorough review of the literature related to it. The phenotypic presentation of diabetes depends on heteroplasmy levels of m.3243A>G mutation of the individual patient. Patients with MIDD may have involvement of other organs such as eye, muscles, kidney, and heart. In our patient, along with diabetes and deafness, there was also an associated vision loss with a strong maternal inheritance of diabetes. A young male who presented with diabetic ketoacidosis (DKA) and hearing and vision impairment and on further diagnostic work up turned out to be a case of genetically confirmed (m.3243A>G mutation) MIDD. To the best of our knowledge, this should be the first case of MIDD presenting as DKA being reported from India.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"1 1","pages":"173 - 176"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74234079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Suruj Jyoti Dutta, P. Dutta, Anupama Dutta, Sultan Ahmed, Sarojmoni Sonowal, Angshuman Boruah
Background: Diabetic peripheral neuropathy (DPN), being the most common and early complication of diabetes mellitus, results in significant morbidity and debilitating sequelae in the form of foot ulcers, infection, and amputation. Due to the disease’s longevity, young type 2 diabetes constitutes a high risk for developing neuropathy, and screening of patients for DPN becomes crucial. Objectives: This study aimed to estimate the prevalence and identify the associated risk factors of peripheral neuropathy among young type 2 diabetes mellitus patients attending a tertiary care hospital in upper Assam. Materials and Methods: This cross-sectional study was conducted from July 1, 2022 to September 30, 2022 in the Department of Medicine. A total of 165 participants attending the outpatient Department and the Diabetic clinic, diagnosed with type 2 diabetes below the age of 45 years were recruited using non-random consecutive sampling. Patients were then interviewed using a pre-designed, pre-tested schedule. DPN was assessed by detection of vibration perception threshold (VPT) using a biothesiometer, the cutoff value for which was taken as 15 V. Results: The prevalence of DPN as assessed by VPT using biothesiometer was 13.9%. The prevalence of mild, moderate, and severe neuropathies was 9.1%, 3.6%, and 1.2%, respectively. DPN was found to have a significant association with the duration of diabetes and hypertension. Socio-demographic characteristics, smoking, alcohol intake, physical activity, anti-diabetic medication, and dyslipidemia were not found to have a significant association with DPN. Conclusion: This study has stressed the importance of screening for hypertension even in the younger age groups as well as the need for early detection of DPN, which can aid in taking necessary actions to impede the disease’s progression.
{"title":"Prevalence and risk factors of peripheral neuropathy among young type 2 diabetes mellitus patients attending a tertiary care hospital in upper Assam: A cross-sectional study","authors":"Suruj Jyoti Dutta, P. Dutta, Anupama Dutta, Sultan Ahmed, Sarojmoni Sonowal, Angshuman Boruah","doi":"10.4103/jod.jod_22_23","DOIUrl":"https://doi.org/10.4103/jod.jod_22_23","url":null,"abstract":"Background: Diabetic peripheral neuropathy (DPN), being the most common and early complication of diabetes mellitus, results in significant morbidity and debilitating sequelae in the form of foot ulcers, infection, and amputation. Due to the disease’s longevity, young type 2 diabetes constitutes a high risk for developing neuropathy, and screening of patients for DPN becomes crucial. Objectives: This study aimed to estimate the prevalence and identify the associated risk factors of peripheral neuropathy among young type 2 diabetes mellitus patients attending a tertiary care hospital in upper Assam. Materials and Methods: This cross-sectional study was conducted from July 1, 2022 to September 30, 2022 in the Department of Medicine. A total of 165 participants attending the outpatient Department and the Diabetic clinic, diagnosed with type 2 diabetes below the age of 45 years were recruited using non-random consecutive sampling. Patients were then interviewed using a pre-designed, pre-tested schedule. DPN was assessed by detection of vibration perception threshold (VPT) using a biothesiometer, the cutoff value for which was taken as 15 V. Results: The prevalence of DPN as assessed by VPT using biothesiometer was 13.9%. The prevalence of mild, moderate, and severe neuropathies was 9.1%, 3.6%, and 1.2%, respectively. DPN was found to have a significant association with the duration of diabetes and hypertension. Socio-demographic characteristics, smoking, alcohol intake, physical activity, anti-diabetic medication, and dyslipidemia were not found to have a significant association with DPN. Conclusion: This study has stressed the importance of screening for hypertension even in the younger age groups as well as the need for early detection of DPN, which can aid in taking necessary actions to impede the disease’s progression.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"53 1","pages":"149 - 156"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87141253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A cavernosal abscess is a rare urological condition to occur. It is classified as primary and secondary. The primary is mostly idiopathic, whereas the secondary is associated with some precipitating factors. Most of the cases were diagnosed clinically. In some cases, imaging such as an ultrasound of the local region or magnetic resonance imaging may be required. Cavernosal abscesses can be treated using a minimally invasive procedure such as image-guided drainage or incision and drainage along with systemic antibiotics. A 52-year-old uncircumscribed uncontrolled diabetic patient presented with a complaint of swelling in the penile region for the 1-week duration. He also complains of pain in the penile region for a 5-day duration. He is a known case of type 2 diabetes on oral hypoglycemic drugs for the past 2 years. Clinical examination confirmed the diagnosis of cavernosal abscess. The patient underwent circumcision with incision and drainage of abscess under higher antibiotic coverage (vancomycin and metronidazole). The patient underwent local excision of primary scrotal calcinosis after 1 month. The patient is followed up for more than 2 years without any evidence of recurrence or impotence. The cavernosal abscess is one of the rare urological conditions, which needs immediate surgical intervention to reduce future complications such as erectile dysfunction and recurrent abscess. Uncontrolled diabetes has a high chance of developing cavernosal abscesses even without precipitating factors.
{"title":"Cavernosal abscess and primary scrotal calcinosis in the diabetic patient: A case report and review of literature","authors":"J. Pandiaraja","doi":"10.4103/jod.jod_32_23","DOIUrl":"https://doi.org/10.4103/jod.jod_32_23","url":null,"abstract":"A cavernosal abscess is a rare urological condition to occur. It is classified as primary and secondary. The primary is mostly idiopathic, whereas the secondary is associated with some precipitating factors. Most of the cases were diagnosed clinically. In some cases, imaging such as an ultrasound of the local region or magnetic resonance imaging may be required. Cavernosal abscesses can be treated using a minimally invasive procedure such as image-guided drainage or incision and drainage along with systemic antibiotics. A 52-year-old uncircumscribed uncontrolled diabetic patient presented with a complaint of swelling in the penile region for the 1-week duration. He also complains of pain in the penile region for a 5-day duration. He is a known case of type 2 diabetes on oral hypoglycemic drugs for the past 2 years. Clinical examination confirmed the diagnosis of cavernosal abscess. The patient underwent circumcision with incision and drainage of abscess under higher antibiotic coverage (vancomycin and metronidazole). The patient underwent local excision of primary scrotal calcinosis after 1 month. The patient is followed up for more than 2 years without any evidence of recurrence or impotence. The cavernosal abscess is one of the rare urological conditions, which needs immediate surgical intervention to reduce future complications such as erectile dysfunction and recurrent abscess. Uncontrolled diabetes has a high chance of developing cavernosal abscesses even without precipitating factors.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"44 1","pages":"177 - 179"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82769559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sweeping toward a healthier India: A proposal to address both communicable and noncommunicable diseases through physical activity","authors":"S. Samajdar, Shashank R. Joshi","doi":"10.4103/jod.jod_36_23","DOIUrl":"https://doi.org/10.4103/jod.jod_36_23","url":null,"abstract":"","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"80 1","pages":"180 - 181"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83849312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetes mellitus is a chronic disorder that progresses globally at an alarming rate. The impact of this disorder is severe as it deteriorates the quality of life due to its associated diseases such as kidney disease, cardiovascular disease, obesity, and neurological disorders and also disturbs bone metabolism. One of the major complications of diabetes is osteoporosis, which is frequently brought on by diabetes. Bone abnormalities and a higher risk of fractures are linked to both type type-1 diabetes and type-2 diabetes and hence diabetes is regarded as one of the risk factors for the occurrence of osteoporosis. In view of this, there is a need to assess the therapeutic role of hypoglycemic agents in the treatment of osteoporosis. Glucagon-like peptide-1 (GLP-1) agonist, a hypoglycemic class could be a novel and promising drug target in the management of osteoporosis due to its additional role in the bone remodeling process. It has also been reported that GLP-1 agonists can increase bone mineral density, improve bone quality, and prevent fractures in diabetic patients. This review highlights the recent findings by which antidiabetic medications are used in the treatment of diabetes-induced osteoporosis and also gives an insight into its pathophysiology and possible mechanisms that are involved in the treatment of diabetes-induced osteoporosis. However, more research is required to fully understand the therapeutic role and unique mechanism of GLP-1 agonists in the bone remodeling process.
{"title":"An update on the role of antihyperglycemic agents in diabetoporosis","authors":"Nidhi Sharma, A. Nayak","doi":"10.4103/jod.jod_35_23","DOIUrl":"https://doi.org/10.4103/jod.jod_35_23","url":null,"abstract":"Diabetes mellitus is a chronic disorder that progresses globally at an alarming rate. The impact of this disorder is severe as it deteriorates the quality of life due to its associated diseases such as kidney disease, cardiovascular disease, obesity, and neurological disorders and also disturbs bone metabolism. One of the major complications of diabetes is osteoporosis, which is frequently brought on by diabetes. Bone abnormalities and a higher risk of fractures are linked to both type type-1 diabetes and type-2 diabetes and hence diabetes is regarded as one of the risk factors for the occurrence of osteoporosis. In view of this, there is a need to assess the therapeutic role of hypoglycemic agents in the treatment of osteoporosis. Glucagon-like peptide-1 (GLP-1) agonist, a hypoglycemic class could be a novel and promising drug target in the management of osteoporosis due to its additional role in the bone remodeling process. It has also been reported that GLP-1 agonists can increase bone mineral density, improve bone quality, and prevent fractures in diabetic patients. This review highlights the recent findings by which antidiabetic medications are used in the treatment of diabetes-induced osteoporosis and also gives an insight into its pathophysiology and possible mechanisms that are involved in the treatment of diabetes-induced osteoporosis. However, more research is required to fully understand the therapeutic role and unique mechanism of GLP-1 agonists in the bone remodeling process.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"34 1","pages":"117 - 125"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73061310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"From diabetes care to metabolic care","authors":"K. Seshadri, V. Mohan","doi":"10.4103/jod.jod_69_23","DOIUrl":"https://doi.org/10.4103/jod.jod_69_23","url":null,"abstract":"","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"128 1","pages":"115 - 116"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87085376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Gupte, Kalyani Khade, G. Wagh, C. S. Deshmukh, V. Pandit, S. Bhalerao
Introduction: Polycystic ovarian syndrome (PCOS) is the commonest cause of infertility due to anovulation. The combination of Curcuma longa (CL) and Emblica officinalis (EO) is known to ameliorate diabetes and, thereby, may resurrect PCOS. The present study aimed to evaluate the effect of this combination prepared by two different methods, independently and with metformin (Met), compared with Met in PCOS on glycaemic control, inflammation, adipokines, and anthropometry. Aim: The aim of the study was to evaluate the effect of the combination of CL and EO, prepared by two different methods, independently and with Met, compared with Met in PCOS. Materials and Methods: PCOS women aged 18–35 years were selected through Rotterdam criteria from a tertiary care teaching hospital setting post-Ethics Committee permission. They were randomized to five groups (eight per group); combination of CL and EO prepared by traditional method (TF- Traditional Formulation), standardized extraction method (PNAE- Pharmanza Nisha Amalaki Extract), standard control Metformin (Met) and their combinations, TF + Met and PNAE + Met for 90 days. Fasting glucose, insulin, lipid profile, reproductive hormones (luteinizing hormone [LH], follicle-stimulating hormone [FSH], and free testosterone), inflammatory markers (tumor necrosis factor-alpha [TNF-α], interleukin [IL]-6), and adipokines (leptin and adiponectin) were done at baseline and day 90, whereas anthropometry was done monthly. Results: Of 48 randomized women, 37 completed the study. TF and Met groups demonstrated higher weight decrease, whereas TF + Met significantly decreased waist circumference. Blood glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) decreased in all groups except glucose in TF + Met and HOMA-IR in the Met group. Only PNAE decreased free testosterone. TNF-α increased while leptin decreased in all groups. Both TF and PNAE, with Met reduced IL 6, significantly only in PNAE + Met group. Similarly, both TF and PNAE, with Met reduced LH/FSH ratio and significantly increased adiponectin. Two females, each, conceived in TF and PNAE, whereas one was in PNAE + Met group. No adverse events were reported. Conclusion: Both botanical formulations, TF and PNAE, were comparable to Met. The standardized extracts formulation PNAE seems more promising due to administration ease, smaller dose, and consistent bioactives.
{"title":"Effect of combination of Curcuma longa with Emblica officinalis in females with polycystic ovarian syndrome: An open-label, randomized active-controlled, exploratory clinical study","authors":"P. Gupte, Kalyani Khade, G. Wagh, C. S. Deshmukh, V. Pandit, S. Bhalerao","doi":"10.4103/jod.jod_17_23","DOIUrl":"https://doi.org/10.4103/jod.jod_17_23","url":null,"abstract":"Introduction: Polycystic ovarian syndrome (PCOS) is the commonest cause of infertility due to anovulation. The combination of Curcuma longa (CL) and Emblica officinalis (EO) is known to ameliorate diabetes and, thereby, may resurrect PCOS. The present study aimed to evaluate the effect of this combination prepared by two different methods, independently and with metformin (Met), compared with Met in PCOS on glycaemic control, inflammation, adipokines, and anthropometry. Aim: The aim of the study was to evaluate the effect of the combination of CL and EO, prepared by two different methods, independently and with Met, compared with Met in PCOS. Materials and Methods: PCOS women aged 18–35 years were selected through Rotterdam criteria from a tertiary care teaching hospital setting post-Ethics Committee permission. They were randomized to five groups (eight per group); combination of CL and EO prepared by traditional method (TF- Traditional Formulation), standardized extraction method (PNAE- Pharmanza Nisha Amalaki Extract), standard control Metformin (Met) and their combinations, TF + Met and PNAE + Met for 90 days. Fasting glucose, insulin, lipid profile, reproductive hormones (luteinizing hormone [LH], follicle-stimulating hormone [FSH], and free testosterone), inflammatory markers (tumor necrosis factor-alpha [TNF-α], interleukin [IL]-6), and adipokines (leptin and adiponectin) were done at baseline and day 90, whereas anthropometry was done monthly. Results: Of 48 randomized women, 37 completed the study. TF and Met groups demonstrated higher weight decrease, whereas TF + Met significantly decreased waist circumference. Blood glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) decreased in all groups except glucose in TF + Met and HOMA-IR in the Met group. Only PNAE decreased free testosterone. TNF-α increased while leptin decreased in all groups. Both TF and PNAE, with Met reduced IL 6, significantly only in PNAE + Met group. Similarly, both TF and PNAE, with Met reduced LH/FSH ratio and significantly increased adiponectin. Two females, each, conceived in TF and PNAE, whereas one was in PNAE + Met group. No adverse events were reported. Conclusion: Both botanical formulations, TF and PNAE, were comparable to Met. The standardized extracts formulation PNAE seems more promising due to administration ease, smaller dose, and consistent bioactives.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"10 1","pages":"126 - 134"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73787142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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