Review of Diabetic Studies最新文献

Objective: Type 2 diabetes mellitus (T2D) is characterized by the dysregulation of innate immunity leading to higher rates of Staphylococcus aureus nasal carriage, an important risk factor for severe infections. 25-hydroxy vitamin D (25(OH)D) may contribute, via the production of the antimicrobial peptide cathelicidin (LL-37), to epithelial host defense against S. aureus. This study evaluated whether 25(OH)D and LL-37 levels determine S. aureus nasal carriage.

Methods: Two consecutive nasal swabs were obtained from 118 T2D patients to determine S. aureus nasal carriage status. Serum levels of 25(OH)D and LL-37 were measured using chemiluminescence immunoassay and enzyme-linked immunosorbent assay, respectively. Supplementation of vitamin D by a number of participants was taken into account and evaluated.

Results: Forty-two T2D patients (35.6%) were found to be colonized by S. aureus. Vitamin D deficiency was detected in sixty-nine patients (65.7%). Median value for LL-37 in T2D patients was 0.89 ng/ml (range 0.05-8.62 ng/ml). Circulating levels of LL-37 were higher in nasal carriers compared to non-carriers (1.25 ng/ml vs 0.72 ng/ml; p < 0.001). No difference was found in serum 25(OH)D levels between carriers and non-carriers. 25(OH)D and LL-37 serum levels correlated positively in non-carriers, while the relationship was inversed in the carrier group. Vitamin D supplementation was not associated with lower incidence of S. aureus nasal carriage (p = 0.706).

Conclusions: T2D patients presented decreased serum levels of 25(OH)D and LL-37, indicating a potential impairment of innate immunity. Expression of LL-37 may be induced by S. aureus nasal carriage among people with diabetes. Vitamin D supplementation did not influence S. aureus nasal colonization in T2D patients.

Diabetic wounds have a large and increasing burden on the healthcare of the UK. Currently, none of the standard treatment options for the treatment of diabetic wounds specifically target the physiological processes behind their enhanced severity. This review evaluated recent studies in the field of nanotechnology concerned with treating diabetic wounds. The studies had each developed novel therapeutics involving nanomedicines that sought to either enhance angiogenesis, the construction of new blood vessels, or increase collagen production, as well as limit the augmented inflammation, in wounds in diabetic rat or mice models. The investigations tended to either target specific antiinflammatory or pro-proliferative receptors on endogenous cells, or transport growth factors to the wound. Previous studies have shown the beneficial effects of growth factors on healing, but they are easily broken down. By transporting them in nanoscaffolds and liposomes, it has been shown that the longevity of growth factors can be enhanced. Gold nanoparticle matrices have also been shown to have a beneficial effect on healing, by both conveying proliferative factors and independently triggering angiogenesis and collagen production. The most impressive results in the review were achieved by nanomedicines involving multiple growth factors, hence, the review will highlight the beneficial factors to wound healing and suggest a composite therapy to be trialled in the future. The review will evaluate each set of papers using similar nanomedicines and highlight the challenges of transferring this therapy to the clinic.

Background: Diabetes is a chronic, metabolic disease, which is commonly associated with increased blood glucose levels caused by impaired secretion or function of insulin. Therefore, daily blood glucose control, adherence to a dietary and pharmaceutical regimen, regular physical activity, and foot care are fundamental components of disease management. In order to optimize effective self-management, patients need to be trained. Teach-back is a method which aims to improve patients' understanding and perception of treatment regimens based on the interaction between patient and caregiver.

Aim: This study was conducted to investigate the impact of the teach-back method on the effectiveness of self-management in patients with type 2 diabetes (T2D).

Methods: A total of 74 patients with T2D were included in the study by convenience sampling at the Endocrine and Metabolism Clinic. The subjects were assigned to control or intervention group. Data collection was performed by using a demographic data form and a self-efficacy questionnaire that were provided to the patients before and 1 month after training. The patients in the intervention group received a 5-session training program using the teach-back method. The control group received only routine programs. One month after completion of the training sessions, the questionnaires were completed by the subjects in the 2 groups, and the data obtained were analyzed.

Results: In contrast to the control group, mean and standard deviation of self-efficacy were significantly higher in the intervention group one month after training by the teach-back method than before training. The two groups did not significantly differ regarding mean score of self-efficacy before training, but there was a significant difference one month after training: the mean score of self-efficacy in the intervention group was significantly higher than in the control group (p < 0.001).

Conclusions: Teach-back is a training procedure aimed at improving patients' understanding of treatment regimens. This study showed that teach-back significantly improved patients' self-efficacy even over as short a period as one month. It may be interesting to study the long-term effects of this simple but effective training method.

Aim: The study aimed to investigate the possible relationship between diabetic peripheral neuropathy (DPN) and the development of depressive symptoms in patients with type 2 diabetes mellitus (T2D).

Methods: A comparative non-experimental study was conducted. Ninety-five T2D individuals aged 65 years and more were recruited. The sample was divided into two groups: 50 participants with T2D and without DPN and 45 participants with T2D and DPN. The Patient Health Questionnaire 9 (PHQ-9) was used to collect information about low mood and depression symptoms in the subjects recruited.

Results: Participants with DPN recorded higher scores on PHQ-9 than those with T2D only. The mean PHQ-9 score for the DPN group (6.09) was significantly higher than that for the T2D only group (2.24) (p < 0.001). Participants with DPN were more likely to have mild to moderate or moderately severe low mood and depression symptoms than T2D only participants who exhibited minimal to no low mood and depressive symptoms.

Conclusions: The association between DPN and depression is confirmed by this study, with significant depressive symptoms found in patients with neuropathy when compared to diabetes patients with no neurological complications. It is therefore important that discomfort and emotional problems caused by DPN should be taken seriously and addressed closely in the management of DPN in order to prevent depression. Also, a change in screening practices to identify patients with diabetes and depressive symptoms is required.

Background: Diabetes is a global health problem that has affected more than 400 million people worldwide. Adherence to treatment is considered to be one of the most important and deterministic factors in the treatment of diabetes. This study investigates medication adherence and factors affecting it in patients with type 2 diabetes.

Methods: This cross-sectional study investigated 136 patients with type 2 diabetes in 2018-2019. Data collection was done using a checklist that included information on personal characteristics, medication, and healthcare. The collected data were analyzed by statistical tests in SPSS 25 software.

Results: 79.4% of the patients adhered to prescribed medication. Medication adherence had no significant relationship with taking other drugs, fasting blood sugar (FBS), and the daily number of hypoglycemic tablets (p ˃ 0.05). However, adherence to medication was significantly associated with age, gender, income, hemoglobin A1c, medication period, and hypoglycemia (p ˂ 0.05).

Conclusions: Higher levels of adherence were observed among females aged below 60 years, with higher income, a hemoglobin A1c level below 7%, a medication period of less than 10 years, and among patients without hypoglycemia. Regarding drug type, adherence levels were lower in people taking glibenclamide.

Background: The insulin-like growth factor (IGF) system is an important system in normal physiological functioning of the body. In diabetes mellitus, alterations of IGF-binding protein (IGFBP) levels have been described, mainly in vascular complications.

Aim: The aim of this review was to explore the role of the IGF system in reducing diabetes complications and its role as potential therapeutic target.

Results: IGF-1 plays a role in neuronal growth and developmental processes. Low concentrations of IGF-1 have been associated with neuropathy and other diabetes complications. Moreover, impaired IGF synthesis and function may result in cellular senescence and impaired vascular endothelial proliferation, adhesion, and integration. Of note, high IGF-1 bioavailability may prevent or delay the inception of diabetes-associated complications in diabetes patients. The mechanism of normal functioning IGF-1 is induced by increasing nitric oxide synthesis and potassium ion channel opening in cardiovascular physiology, which improves impaired small blood vessel function and reduces the occurrence of diabetes complications associated with reduced concentrations of IGF-1.

Conclusions: IGF may be considered an alternative therapy for diabetes and diabetes-associated complications. Therefore, future studies should focus on the mechanism of action and therapeutic potential of IGFs in reducing the risk of development and progression of the disease in different clinical settings.

Background: A higher rate of attenuation of molecules in drug discovery has enabled pharmaceutical companies to enhance the efficiency of their hit identification and lead optimization. Selection and development of appropriate in-vitro and in-vivo strategies may improve this process as primary and secondary screening utilize both strategies. In-vivo approaches are too relentless and expensive for assessing hits. Therefore, it has become indispensable to develop and implement suitable in-vitro screening methods to execute the required activities and meet the respective targets. However, the selection of an appropriate in-vitro assay for specific evaluation of cellular activity is no trivial task. It requires thorough investigation of the various parameters involved.

Aim: In this review, we aim to discuss in-vitro assays for type 2 diabetes (T2D), which have been utilized extensively by researchers over the last five years, including target-based, non-target based, low-throughput, and high-throughput screening assays.

Methods: The literature search was conducted using databases including Scifinder, PubMed, ScienceDirect, and Google Scholar to find the significant published articles.

Discussion and conclusion: The accuracy and relevance of in-vitro assays have a significant impact on the drug discovery process for T2D, especially in assessing the antidiabetic activity of compounds and identifying the site of effect in high-throughput screening. The report reviews the advantages, limitations, quality parameters, and applications of the probed in-vitro assays, and compares them with one another to enable the selection of the optimal method for any purpose. The information on these assays will accelerate numerous procedures in the drug development process with consistent quality and accuracy.

Background: Diabetes mellitus is a systemic disorder associated with inflammation and oxidative stress which may target many organs such as the kidney, retina, and the vascular system. The pathophysiology, mechanisms, and consequences of diabetes on these organs have been studied widely. However, no work has been done on the concept of the lung as a target organ for diabetes and its implications for lung diseases.

Aim: In this review, we aimed to investigate the effects of diabetes and hypoglycemic agent on lung diseases, including asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis, pulmonary hypertension, and lung cancer. We also reviewed the potential mechanisms by which these effects may affect lung disease patients.

Results: Our results suggest that diabetes can affect the severity and clinical course of several lung diseases.

Conclusions: Although the diabetes-lung association is epidemiologically and clinically well-established, especially in asthma, the underlying mechanism and pathophysiology are not been fully understood. Several mechanisms have been suggested, mainly associated with the pro-inflammatory and proliferative properties of diabetes, but also in relation to micro- and macrovascular effects of diabetes on the pulmonary vasculature. Also, hypoglycemic drugs may influence lung diseases in different ways. For example, metformin was considered a potential therapeutic agent in lung diseases, while insulin was shown to exacerbate lung diseases; this suggests that their effects extend beyond their hypoglycemic properties.

Background: Individuals with diabetes may develop diabetic foot ulcers due to diabetic peripheral neuropathy. Multiple factors influence the ulcer healing process; oxygen helps in facilitating the different stages of wound healing.

Objective: The objective of this systematic review was to analyze the different levels of evidence available in the application of topical oxygen therapy, warm oxygen therapy, or other modes of topical oxygen delivery in the healing dynamics of diabetic foot ulcers.

Methods: Databases searched included Pubmed/Medline, Science Direct, Web of Science, Scopus, Cochrane, and CINAHL. The eligibility criteria of studies included participants ≥18 years with chronic non-healing diabetic foot ulcer (duration ≥3 months) receiving warm oxygen or topical oxygen therapy (TOT), and other modes of topical oxygen administration, which were compared with standard care group. Randomized and non-randomized studies were included. The primary outcome measure assessed was the rate of wound healing or wound closure.

Results: The review included 5 studies which used different modes of topical oxygen administration. The healing trajectory of the wounds was completely achieved in low-grade ulcers (grade 1), whereas all high-grade ulcers (grades 2, 3, and above) showed either 100% or 50% healing with a reduction in ulcer size and ulcer tissue depth.

Conclusion: Topical oxygen therapy facilitates wound healing dynamics among individuals with chronic diabetic foot ulcers.