Pub Date : 2023-09-13DOI: 10.1186/s43162-023-00238-9
Hayder M. Al-kuraishy, Ali I. Al-Gareeb, Majid S. Jabir, Salim Albukhaty
Abstract Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance (IR) and hyperglycemia. The development of inflammatory disorders in T2DM triggers the activation of different growth factors as a compensatory mechanism to reduce IR and adipose tissue dysfunction in T2DM. Fibroblast growth factor 21 (FGF21) which is involved in the regulation of glucose homeostasis is attractive to be a novel therapeutic target in the management of T2DM. FGF21 has poor pharmacokinetic profile as it rapidly degraded; therefore, FGF21 analogs which are more stable can be used in T2DM patients. However, FGF21 analogs are tested pre-clinically but not approved in clinical settings. Therefore, searching for anti-diabetic agents who enhance FGF21 expression is mandatory. It has been shown that metformin which used as a first-line in the management of T2DM can positively affect the expression of FGF21, though the underlying mechanisms for metformin-induced FGF21 expression are not fully elucidated. Therefore, this review from published studies aimed to find how metformin improves insulin sensitivity through FGF21-dependent pathway in T2DM. In conclusion, metformin improves FGF21 signaling in T2DM, and this could be a novel mechanism for metformin in the amelioration of glucose homeostasis and metabolic disorders in T2DM patients.
{"title":"Effects of metformin on fibroblast growth factor 21 in patients with type 2 diabetes mellitus: faraway but so close","authors":"Hayder M. Al-kuraishy, Ali I. Al-Gareeb, Majid S. Jabir, Salim Albukhaty","doi":"10.1186/s43162-023-00238-9","DOIUrl":"https://doi.org/10.1186/s43162-023-00238-9","url":null,"abstract":"Abstract Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance (IR) and hyperglycemia. The development of inflammatory disorders in T2DM triggers the activation of different growth factors as a compensatory mechanism to reduce IR and adipose tissue dysfunction in T2DM. Fibroblast growth factor 21 (FGF21) which is involved in the regulation of glucose homeostasis is attractive to be a novel therapeutic target in the management of T2DM. FGF21 has poor pharmacokinetic profile as it rapidly degraded; therefore, FGF21 analogs which are more stable can be used in T2DM patients. However, FGF21 analogs are tested pre-clinically but not approved in clinical settings. Therefore, searching for anti-diabetic agents who enhance FGF21 expression is mandatory. It has been shown that metformin which used as a first-line in the management of T2DM can positively affect the expression of FGF21, though the underlying mechanisms for metformin-induced FGF21 expression are not fully elucidated. Therefore, this review from published studies aimed to find how metformin improves insulin sensitivity through FGF21-dependent pathway in T2DM. In conclusion, metformin improves FGF21 signaling in T2DM, and this could be a novel mechanism for metformin in the amelioration of glucose homeostasis and metabolic disorders in T2DM patients.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135735859","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}
Pub Date : 2023-09-11DOI: 10.1186/s43162-023-00243-y
Ahmed E. Mansour, Rasha O. Abdelmoniem, Ayman M. Elbadawy, Walaa M. Ibrahim
Abstract Background Diabetic kidney disease is a major microvascular complication of diabetes mellitus and is the leading cause of end-stage renal disease all over the world. The general recommendation for the subjects with DM is to perform kidney function as screening: in T1DM, 5 years after diagnosis, and in type 2, at the time of diagnosis. The early diagnosis of diabetic kidney disease depends on the albumin excretion ratio; however, the albumin excretion ratio (AER) does not correlate with the severity and progression of the disease. Methods The subjects in this study included thirty patients with type 1 diabetes mellitus and thirty patients with type 2 diabetes mellitus who were recruited from the outpatient clinic and inpatient in the Internal Medicine Department at Benha University Hospitals in the endocrinology unit from January 2022 to January 2023 as cases who were subground according to albuminuria into two groups (normoalbuminuria less than 30 mg/24 h urinary collection) and albuminuric group more than 30 mg/24 h urinary collection; all patients were subjected to thorough history including baseline characteristics, examination, and related laboratory investigations. Results Serum cystatin C level at a cutoff value of 82 was associated with sensitivity (81.4) and specificity (82.4), and it was negatively significantly correlated with BMI, duration of diabetes mellitus, albuminuria, blood urea, and serum creatinine, and it was positively significantly correlated with e-GFR creatinine. Conclusion Serum cystatin C can be used as an early marker of diabetic kidney disease in both type I and type II diabetic patients better than AER and serum creatinine.
{"title":"The utility of estimation of glomerular filtration rate by serum cystatin C as a predictor of diabetic kidney disease in both type I and type II diabetic patients: a single center study","authors":"Ahmed E. Mansour, Rasha O. Abdelmoniem, Ayman M. Elbadawy, Walaa M. Ibrahim","doi":"10.1186/s43162-023-00243-y","DOIUrl":"https://doi.org/10.1186/s43162-023-00243-y","url":null,"abstract":"Abstract Background Diabetic kidney disease is a major microvascular complication of diabetes mellitus and is the leading cause of end-stage renal disease all over the world. The general recommendation for the subjects with DM is to perform kidney function as screening: in T1DM, 5 years after diagnosis, and in type 2, at the time of diagnosis. The early diagnosis of diabetic kidney disease depends on the albumin excretion ratio; however, the albumin excretion ratio (AER) does not correlate with the severity and progression of the disease. Methods The subjects in this study included thirty patients with type 1 diabetes mellitus and thirty patients with type 2 diabetes mellitus who were recruited from the outpatient clinic and inpatient in the Internal Medicine Department at Benha University Hospitals in the endocrinology unit from January 2022 to January 2023 as cases who were subground according to albuminuria into two groups (normoalbuminuria less than 30 mg/24 h urinary collection) and albuminuric group more than 30 mg/24 h urinary collection; all patients were subjected to thorough history including baseline characteristics, examination, and related laboratory investigations. Results Serum cystatin C level at a cutoff value of 82 was associated with sensitivity (81.4) and specificity (82.4), and it was negatively significantly correlated with BMI, duration of diabetes mellitus, albuminuria, blood urea, and serum creatinine, and it was positively significantly correlated with e-GFR creatinine. Conclusion Serum cystatin C can be used as an early marker of diabetic kidney disease in both type I and type II diabetic patients better than AER and serum creatinine.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135979641","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}
Pub Date : 2023-09-11DOI: 10.1186/s43162-023-00249-6
Hamdy Ibrahim, Safwat Abdel Maksod, Magdy Khorshed, Ahmed Alsisi, Nasser Fouad, Hanan Rady, Alaaa Al Amir, Adel Mohamed, Mohamed Hosny
Abstract Meningococcal meningitis (MM) is a medical emergency that progresses rapidly to cause life-threatening organ failure, and a high level of suspicion is required for early diagnosis and intervention with antibiotics and fluid resuscitation. Herein, we present two cases of meningococcal meningitis in an adolescent boy and a young female child who presented with fever and rash; the purpose is to alert the emergency physicians about this life-threatening condition as early disease recognition and management is highly important for the patient’s survival.
{"title":"Meningococcal meningitis, a life-threatening disease with a dangerous skin rash: two case reports","authors":"Hamdy Ibrahim, Safwat Abdel Maksod, Magdy Khorshed, Ahmed Alsisi, Nasser Fouad, Hanan Rady, Alaaa Al Amir, Adel Mohamed, Mohamed Hosny","doi":"10.1186/s43162-023-00249-6","DOIUrl":"https://doi.org/10.1186/s43162-023-00249-6","url":null,"abstract":"Abstract Meningococcal meningitis (MM) is a medical emergency that progresses rapidly to cause life-threatening organ failure, and a high level of suspicion is required for early diagnosis and intervention with antibiotics and fluid resuscitation. Herein, we present two cases of meningococcal meningitis in an adolescent boy and a young female child who presented with fever and rash; the purpose is to alert the emergency physicians about this life-threatening condition as early disease recognition and management is highly important for the patient’s survival.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135980476","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":"Uncovering the link between celiac disease and hypopituitarism: a case report and review of literature","authors":"Hameed Haidar Khan, Imran Ullah, Javeria Rufaq, Qaiser Wadood, Imad Majeed, Salman Khan","doi":"10.1186/s43162-023-00246-9","DOIUrl":"https://doi.org/10.1186/s43162-023-00246-9","url":null,"abstract":"","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47961150","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}
Pub Date : 2023-08-28DOI: 10.1186/s43162-023-00248-7
W. Pangkanon, N. Leelaviwat, S. Saowapa, En-Dien Liao, J. Payne
{"title":"Paraspinal myositis in a patient with COVID-19 infection: a case report","authors":"W. Pangkanon, N. Leelaviwat, S. Saowapa, En-Dien Liao, J. Payne","doi":"10.1186/s43162-023-00248-7","DOIUrl":"https://doi.org/10.1186/s43162-023-00248-7","url":null,"abstract":"","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41712544","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}
Pub Date : 2023-08-18DOI: 10.1186/s43162-023-00245-w
H. El-Shareif
{"title":"Agranulocytosis: a rare complication of the thionamides","authors":"H. El-Shareif","doi":"10.1186/s43162-023-00245-w","DOIUrl":"https://doi.org/10.1186/s43162-023-00245-w","url":null,"abstract":"","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44058532","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}
Pub Date : 2023-08-18DOI: 10.1186/s43162-023-00241-0
S. Hosny, M. Nasr, Moataz M. W. Abd Elfattah, Samar Helmy Abdel Dayem, R. Ibrahim
{"title":"Evaluating the relation between serum apolipoprotein B (apo B), apolipoprotein A (apo A) and apo B/apo A ratio with diabetic retinopathy in a sample of type 2 Egyptian diabetic patient","authors":"S. Hosny, M. Nasr, Moataz M. W. Abd Elfattah, Samar Helmy Abdel Dayem, R. Ibrahim","doi":"10.1186/s43162-023-00241-0","DOIUrl":"https://doi.org/10.1186/s43162-023-00241-0","url":null,"abstract":"","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44731935","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}
Abstract Diabetes has become a serious health concern for the global population. An estimated 643 million people will have type 2 diabetes mellitus by the year 2030. A sedentary lifestyle is one of the important risk factors along with obesity, hypertension, and diet. Exercise improves blood glucose levels and reduces glycosylated hemoglobin (HbA1c). Physical aerobic exercise utilizes energy stored in the form of ATP and helps to burn stored fat. The process of muscular contraction during a physical workout controls the mechanisms responsible for improving blood glucose levels. These involve complex pathways that ultimately increase the uptake of blood glucose, improve insulin sensitivity and blood flow, and optimize the functioning of the endocrine pancreas. An overall reduction in HbA1C can be achieved through the interplay of all these pathways.
{"title":"A step in the right direction: exploring the effects of aerobic exercise on HbA1c reduction","authors":"Bhupinder Singh, Yogitha Chowdary Koneru, Holden Zimmerman, Sai Gautham Kanagala, Indigo Milne, Anirudh Sethi, Rohit Jain","doi":"10.1186/s43162-023-00247-8","DOIUrl":"https://doi.org/10.1186/s43162-023-00247-8","url":null,"abstract":"Abstract Diabetes has become a serious health concern for the global population. An estimated 643 million people will have type 2 diabetes mellitus by the year 2030. A sedentary lifestyle is one of the important risk factors along with obesity, hypertension, and diet. Exercise improves blood glucose levels and reduces glycosylated hemoglobin (HbA1c). Physical aerobic exercise utilizes energy stored in the form of ATP and helps to burn stored fat. The process of muscular contraction during a physical workout controls the mechanisms responsible for improving blood glucose levels. These involve complex pathways that ultimately increase the uptake of blood glucose, improve insulin sensitivity and blood flow, and optimize the functioning of the endocrine pancreas. An overall reduction in HbA1C can be achieved through the interplay of all these pathways.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136272434","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":"A retrospective cohort study on prognostic factors and anti-thrombotic therapy and its correlation with disease outcome in patients of COVID-19","authors":"Manthan Prajapati, Madhav Oza, Mansi Bhagat, Mrudangsinh Rathod, Mehul R Marwadi","doi":"10.1186/s43162-023-00240-1","DOIUrl":"https://doi.org/10.1186/s43162-023-00240-1","url":null,"abstract":"","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45411504","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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