International Journal of Diabetes in Developing Countries最新文献

Background

Oxidative stress is suggested as a potential contributary factor for feto-maternal complications in gestational diabetes mellitus (GDM) and the understanding of oxidative stress and antioxidant levels in GDM still remains obscure.

Objective

This study aimed to investigate the serum levels of oxidants and antioxidants in women with GDM in a Sri Lankan context, and a potential diagnostic marker panel for GDM.

Methods

This pilot case–control study included 30 untreated GDM patients, and 30 age-matched healthy pregnant women (controls) in their second or third trimesters. After collection of demographic and anthropometric data from all study participants, their serum levels of nitric oxide derivative (NOx) concentration, lipid peroxidation (LPO) level, total antioxidant capacity (TAC), and catalase enzyme (CAT) activity were measured. The CombiROC web tool assessed the diagnosis accuracy of potential biomarkers of GDM.

Results

Significantly higher levels of serum NOx (p < 0.001), LPO levels (p < 0.01), and significantly lower TAC (p < 0.001) and CAT activity (p < 0.05) were observed in GDM-afflicted women compared to controls. LPO level:TAC and LPO level:CAT activity ratios were significantly increased in GDM patients (p < 0.001). CombiROC analysis identified five potential diagnostic marker panels with the highest discriminatory power: (NOx-TAC-LPO), (BMI-NOx-TAC-LPO), (BMI-NOx-LPO-CAT), (NOx-TAC-LPO-CAT), and (BMI-NOx-TAC-LPO-CAT). Body mass index (BMI) was identified as an important noninvasive marker of GDM with the cut off of 22.4 kg/m².

Conclusion

This pilot study demonstrated increased oxidative stress and weaker antioxidant defenses in Sri Lankan women with GDM. The identification of potential diagnostic markers, including BMI, may improve GDM diagnosis in the future.

Background

Diabetes type 1 is an autoimmune metabolic disorder in which auto antibodies attack pancreatic β cells, results in hyperglycemia. Diabetes retinopathy linked to diabetes mellitus that affects blood vessels in the retina results in blindness and visual disability in hyperglycemic people. The angiotensin-I converting has a role in diabetes retinopathy.

Objective

We investigate the relationship between angiotensin-converting enzyme gene insertion/deletion (I/D) polymorphism, diabetes retinopathy patients, and diabetes type 1.

Methods

A total of 250 individuals, including retinopathy patients (100), diabetes type 1 patient (100), and controls (50), were studied. Genomic DNA was extract from blood samples and PCR was used to detect the ACE polymorphism by using primers. The obtained data was statistically analyzed through SPSS.

Results

The prevalence of D and I alleles in diabetes retinopathy patients was 57.5% and 42.5%, respectively; in diabetes type 1, it was 66% and 34%, respectively; and in control subjects, it was 69% and 31%, respectively. This study showed the prevalence of the DD genotype and D allele in all groups under study. However, ACE gene polymorphisms may not have much influence on the progression of diabetes retinopathy.

Conclusion

It was established that those with diabetes retinopathy frequently have the angiotensin-converting enzyme gene I/D polymorphism.

Gestational diabetes mellitus (GDM) has conventionally been defined as any degree of glucose intolerance with onset or first recognition during pregnancy (Hinkle et al. in Sci Rep 8:12249, 2018). GDM has both short-term as well as long-term adverse materno-fetal consequences and increases the risk of future non-communicable diseases (NCDs), including type-2 diabetes. Probable epigenetic changes in children exposed to hyperglycemia in-utero predispose them to an increased risk for developing insulin resistance, obesity, type-2 diabetes, and associated NCDs in later life. Therefore, early detection and optimum management of GDM can go a long way in combating this rising epidemic of NCDs. It is pertinent to screen all pregnant women for glucose intolerance in pregnancy with the simple, economical and reliable single step test recommended by DIPSI and approved by the Ministry of Health & Family Welfare Government of India. An optimized strategy to achieve euglycemia can prevent the epidemic of NCD. Gestational programming is a distinctive process. The adverse stimuli (like hyperglycemia) or stresses that occur at critical or sensitive periods of fetal development ultimately lead to permanent changes in the structure, physiology, and metabolism of the growing fetus. This, in turn, predisposes these babies to increased NCD risk in their adult life — the famous J Endocrinol 2004;181:11–23 (Piper et al., 2004).

Background

The prevalence and incidence of diabetes mellitus (DM) are rapidly increasing worldwide. Diabetic kidney disease (DKD) is a chronic complication of DM and major cause of end-stage renal disease. The pathogenesis of DKD is complex, with various clinical features, pathological phenotypes, and poor therapeutic outcomes. DKD rarely occurs in patients without a history or evidence of DM. We herein report a case of diabetic nephropathy (DN) diagnosed using a renal biopsy in a patient with impaired glucose tolerance (IGT). Initially, DKD was considered to start with proteinuria preceding renal dysfunction, although in recent decades, many patients with DM without proteinuria develop renal insufficiency. Here, we also present a case of DN with normoalbuminuric renal insufficiency.

Case presentation

We report a case of a 73-year-old man with no history of DM who presented with proteinuria, and a renal biopsy revealed mesangial proliferative glomerulopathy with mild acute tubular injury. Glucose metabolism was examined, and a 75 g oral glucose tolerance test showed IGT. Fundus examination revealed diabetic retinopathy. We also report a case of a 57-year-old man with DM with normoalbuminuric renal insufficiency, whose renal biopsy revealed renal tubulointerstitial damage but only mild glomerular injury.

Conclusion

This study represents two cases of DKD with unusual presentations and highlights the role of renal tubular injury in the development of DKD. In patients without a history of clinically overt DM or proteinuria, DKD may still be considered. Thus, these cases may help clinicians to better understand DKD.

Background

Gestational diabetes mellitus (GDM), characterized by hyperglycemia during pregnancy, is influenced by various factors, including genetic predisposition. The potassium inwardly rectifying channel gene (KCNJ11) and its polymorphisms, such as rs5219, have been implicated in diabetes. This study intends to assess the efficiency of meta-analysis to assess the link between KCNJ11 rs5219 polymorphism and GDM risk.

Objective

The primary objective is to examine the probable link between the KCNJ11 rs5219 polymorphism and the risk of resulting GDM through a comprehensive meta-analysis. The study aims to contribute insights into the genetic factors influencing GDM susceptibility, specifically focusing on the KCNJ11 rs5219 polymorphic site.

Methods

A thorough literature search was conducted on Embase, PubMed, and Google Scholar, focusing on studies examining the association between KCNJ11 gene polymorphism and GDM. Inclusion criteria encompassed case–control studies providing genotypic and allele frequency data. The Newcastle–Ottawa Scale assessed study quality. Statistical analyses, utilizing Review Manager 5.4, included heterogeneity assessment, odds ratio calculation, and exploration of publication bias.

Results

These findings indicate that KCNJ11 rs5219 is a significant risk factor for GDM, especially in recessive genetic models. Further research is essential to verify these conclusions and to identify the processes behind them. The Begg and Egger tests show no indication of publication bias in our study.

Conclusion

This meta-analysis indicates a slightly significant association between KCNJ11 rs5219 polymorphism, specifically in the recessive model, and an amplified risk of GDM. The results highlight the intricate interplay of genetic factors in GDM and advocate for further research to unravel underlying mechanisms. Insights gained from this study may contribute to enhanced diagnostics and tailored treatments for individuals affected by gestational diabetes mellitus.

Background

Type 2 diabetes mellitus (T2DM) is a multifactorial disease caused by the combination of two basic factors: insufficient insulin secretion by pancreatic β-cells or a failure of insulin-sensitive tissues to respond adequately to insulin.

Objective

In the presented study we aimed to investigate the serum levels of Vitamin D binding protein (VDBP), C-peptide, Heat shock protein 70 (HSP-70), and biochemical markers in obese women with type 2 diabetes and their possible correlation with the pathogenesis of T2DM.

Methods

A case-control study was performed on 50 T2DM patients and 50 control individuals. The ELISA kits were used to measure serum levels of VDBP, HSP-70, and C-peptide. Furthermore, random serum glucose was measured by the enzymatic colorimetric method, and HbA1c% was assessed using the HPLC method. Finally, the sensitivity and specificity of the studied biomarker were evaluated by the ROC analysis.

Results

The serum levels of HSP-70 and VDBP in age groups ranging between 30–42 and 41–53 years showed no significant differences. In addition, C-peptide was significantly decreased and HBA1c% was significantly increased in T2DM. In contrast, in the age group ranging between 55–76 years, the serum levels of HSP-70, VDBP, and HbA1c% were increased significantly and the C-peptide level was decreased significantly in T2DM patients. Analysis of the optimal diagnostic points in cases of T2DM indicated that C-peptide is the most interesting significant prediction of T2DM in obese cases.

Conclusion

To the best of our knowledge, this is a detailed study about analyzing the optimal diagnostic points for predicting T2DM cases using HSP-70, VDBP, and C-peptide levels.

Background

Type 2 Diabetes (T2D) is catalyzed by enhanced oxidative stress which induces pancreatic beta cell apoptosis. Genetic variations in extrinsic death pathway genes like FAS and FASLG might alter the apoptotic activity and cause individuals susceptible to T2D. 

Objective 

The present study aimed to evaluate the oxidative stress markers, the association of FAS -670 G > A and FASLG -844 T > C polymorphisms and their serum soluble levels in type 2 diabetes.

Methods

Serum nitrates/nitrites and oxidative DNA damage levels were estimated by Griess reagent assay and Comet assay, respectively. Genotyping of FAS -670 G > A and FASLG -844 T > C polymorphisms were determined by PCR–RFLP method. Serum soluble FAS and soluble FASLG levels were estimated by ELISA. Statistical analyses were performed using Open-epi, SNPStats and SPSS software. Gene–gene and gene-epidemiological interactions were performed using MDR software.

Results

Nitrates/nitrites and oxidative DNA damage levels were significantly higher in T2D patients compared to controls. Molecular analysis has revealed the association of FAS -670 GG and FASLG -844 CC genotypes with increased risk of T2D. In addition, it was found that T2D patients had significantly lower serum soluble FAS levels and higher serum soluble FASLG levels. Further, MDR gene–gene interaction analysis has demonstrated strong interaction between the genes, whereas gene-epidemiological interactions have shown additive effects on the disease phenotype.

Conclusion

The higher levels of nitrates/nitrites and oxidative DNA damage in individuals with T2D highlight the role of oxidative stress in T2D development. Additionally, the association between the FAS -670 G > A and FASLG -844 T > C polymorphisms and elevated risk of T2D underscores the plausible impact of genetic variants on T2D susceptibility.

Monogenic diabetes (MD) represents a cluster of different types of diabetes produced by a mutation of a single gene. The commonest type of MD is maturity-onset diabetes of the young (MODY) which has several subtypes, and neonatal diabetes mellitus (NDM). With improved diagnostic facilities, more cases of monogenic diabetes are being described, and pregnancy is being reported in different forms of monogenic diabetes as these patients enter the reproductive age group. The treatment of monogenic diabetes may change once pregnancy sets in. For example, some forms of monogenic diabetes which respond to oral antidiabetic drugs (OHA), particularly the sulfonylurea agents (SUs), may need insulin during pregnancy. However, this depends on the fetal inheritance of mutation from the mother. This review attempts to put together published reports of pregnancy in various types of monogenic diabetes focussing on the most frequently seen forms of MD.

Background

Type 2 diabetes mellitus (T2DM) is a significant health concern and imposes a substantial burden on society. Although leading a healthy lifestyle is an effective means of reducing the risk of T2DM, the complex interplay of diverse lifestyle factors necessitates a comprehensive assessment.

Objective

This study aims to develop and investigate the association between a healthy lifestyle index (HLI) and T2DM among teachers.

Methods

A total of 11412 teachers from schools in Peninsular Malaysia were recruited. The HLI score was constructed using both unweighted and regression-weighted methods. A comparison was conducted and the index with the lowest AIC was considered the best. The final model with an index and other covariates was then optimised, followed by model validations.

Results

All teachers (n = 11412) who completed the baseline survey were included in the analysis. Majority were females, Malays, married, and had at least a bachelor’s degree. Among the developed indexes comprised of waist circumference, physical activity, sleep duration, and mental health status (e.g. stress, anxiety, and depression). The B HLI index is the best proxy for teachers’ lifestyles associated with T2DM. The optimised regression showed that an increase of an HLI score reduced the odds of T2DM by 59%. The model had an adjusted R² of 26.8% and an area under the curve of 0.837. The model was externally validated with the validation dataset by achieving an adequate C-statistic value of 0.798.

Conclusion

A higher HLI score was associated with a reduced odd of T2DM. This finding highlights the importance of integrating multidimensional lifestyle modification rather than singular ones when developing health promotion strategies.