Anti-hyperglycemic and anti-hyperlipidemic effects of a methanolic extract of Debregeasia salicifolia in Alloxan-induced diabetic albino mice

Abstract Diabetes mellitus (DM), an endocrine syndrome characterized by high blood glucose levels due to abrogated insulin activity. The existing treatments for DM have side effects and varying degrees of efficacy. Therefore, it is paramount that novel approaches be developed to enhance the management of DM. Therapeutic plants have been accredited as having comparatively high efficacy with fewer adverse effects. The current study aims to elucidate the phytochemical profile, anti-hyperlipidemic, and anti-diabetic effects of methanolic extract D. salicifolia (leaves) in Alloxan-induced diabetic mice. Alloxan was injected intraperitoneally (150 mg kg-1, b.w), to induced diabetes in mice. The mice were divided into three groups (n=10). Group 1 (normal control) received normal food and purified water, Group II (diabetic control) received regular feed and clean water and group III (diabetic treated) received a methanolic extract of the plant (300 mg kg-1) for 28 days with a typical diet and clean water throughout the experiment. Blood samples were collected to checked serum glucose and concentration of LDL, TC, TG. The extract demonstrated significant antihyperglycemic activity (P 0.05), whereas improvements in mice's body weight and lipid profiles were observed after treatment with the extract. This study establishes that the extract has high efficacy with comparatively less toxicity that can be used for DM management.

Resumo Diabetes mellitus (DM) é uma síndrome endócrina caracterizada por níveis elevados de glicose no sangue devido à atividade anulada da insulina. Os tratamentos existentes para o DM têm efeitos colaterais e vários graus de eficácia. Portanto, é fundamental que novas abordagens sejam desenvolvidas para aprimorar o manejo do DM. As plantas terapêuticas foram acreditadas como tendo eficácia comparativamente alta com menos efeitos adversos. O presente estudo visa elucidar o perfil fitoquímico, efeitos anti-hiperlipidêmicos e antidiabéticos do extrato metanólico de D. salicifolia (folhas) em camundongos diabéticos induzidos por aloxana. Alloxan foi injetado por via intraperitoneal (150 mg kg-1, b.w), para induzir diabetes em camundongos. Os camundongos foram divididos em três grupos (n = 10). Grupo 1 (controle normal) recebeu ração normal e água purificada, Grupo II (controle diabético) recebeu ração regular e água limpa, e o grupo III (tratamento diabético) recebeu extrato metanólico da planta (300 mg kg-1) por 28 dias com uma dieta típica e água limpa durante todo o experimento. Amostras de sangue foram coletadas para verificar a glicose sérica e a concentração de LDL, TC, TG. O extrato demonstrou atividade anti-hiperglicêmica significativa (P 0,05), enquanto melhorias no peso corporal e no perfil lipídico dos camundongos foram observadas após o tratamento com o extrato. Este estudo estabelece que o extrato tem alta eficácia com comparativamente menos toxicidade e pode ser usado para o controle do DM.

Cost variation analysis of oral anti-diabetic drugs available in Indian market

Background: Diabetes mellitus (DM) is a chronic progressive metabolic disorder associated with microvascular and macrovascular complications in type 2 DM. Oral anti-diabetic drugs (OADs) play an important role in regulating raised blood glucose levels and compliance to treatment. Aims and Objectives: The aims of this study were to evaluate cost variations of different brands of drug formulations in the management of DM. Materials and Methods: This study was an analytical study. Costs of various OADs were obtained from January to March 2022 edition of current index of medical specialties India. The cost ratio and percentage of variation among different drugs in the treatment of DM available in Indian Market and Manufactured by different pharmaceutical companies were analyzed. Results: The percentage variation in cost among commonly prescribed single OADs was found to be highest for sulfonylurea group of dugs Glimepiride 1 mg tablet (1.366%), followed by Biguanides, Metformin 500 mg tablet (809%), ?-Glucosidase inhibitors, and Voglibose 0.3 mg tablet (571%), while it was lowest for Glibenclamide 5 mg tablet (36%) and Acarbose 25 mg tablet (36%) of sulfonylurea drugs and ?-Glucosidase inhibitors group of drugs, respectively. In combination drug therapy, Glibenclamide and Metformin combination (1.25 + 250 mg tablet) shows maximum variation (132%). Conclusion: There is a wide difference existing in the cost of various oral anti-diabetics available in Indian Market by different brands. The physicians must be aware of these variations and prescribe medicines accordingly, while considering the financial status of patient and also to promote adherence to treatment.

A Review on Anti-Diabetic Herbs of Siddha System Based on Their Organoleptic Characteristic

The Siddha system is a primordial system of medicine followed over a long period in the Southern part of India. Siddha system has peculiar methods in treating a disease and also possesses various diagnostic methods and treatment protocols. In the Siddha system, diagnostic methods are purely differing from other systems. The diagnostic tools are Envagaithervu (Eight Fold Assessment Test), Neer Kuri & Nei Kuri (Siddha Urine Test), Nadi (Pulse Test) etc. In the Siddha system treatments are based on Nadi, Suvai. Diabetics are the major non-communicable disease in the world. According to the statistics India is second among the top ten nations in the world, with 69.2 million people suffering from diabetes and another 36.5 million struggling with pre-diabetes. This rising prevalence is mostly due to changes in lifestyle, such as consuming unhealthy foods and being physically sedentary. In the Siddha system, it is compared with Neerizhuvu Noi. In Siddha, diabetes is not an illness. It is possible to keep it under control with the right diet and treatment. The article focus on scientific justification of the relationship of herbs cured Neerizhuvu Noi mentioned in classical text by their organoleptic characters and anti diabetic activity of the herbs. Taste plays a significant part in the selection of medicinal plants for each person in this kind of personalized treatment that is based on their constitution. This article discusses the Siddha approach to the control of diabetes, with a particular focus on the flavour of herbs.

Effects of antidiabetics and exercise therapy on suppressors of cytokine signaling-1, suppressors of cytokine signaling-3, and insulin receptor substrate-1 molecules in diabetes and obesity

SUMMARY OBJECTIVE: Pathological destruction of insulin signaling molecules such as insulin receptor substrate, especially due to the increase in suppressors of cytokine signaling molecules, has been demonstrated in experimental diabetes. The contribution of suppressors of cytokine signaling proteins to the development of insulin resistance and the effects of antidiabetic drugs and exercise on suppressors of cytokine signaling proteins are not clearly known. METHODS: A total of 48 Wistar albino adult male rats were divided into six groups: control group, obese group with diabetes, obese diabetic rats treated with metformin, obese diabetic rats treated with pioglitazone, obese diabetic rats treated with exenatide, and obese diabetic rats with applied exercise program. Immunohistochemical staining was performed in both the liver and adipose tissue. RESULTS: There was a statistically significant decrease in suppressors of cytokine signaling-1, a decrease in suppressors of cytokine signaling-3, an increase in insulin receptor substrate-1, and a decrease in immunohistochemical staining in the obese group treated with metformin and exenatide compared to the obese group without treatment in the liver tissue (p<0.05). A statistically significant decrease in immunohistochemical staining of suppressors of cytokine signaling-1 and suppressors of cytokine signaling-3 was found in the obese group receiving exercise therapy compared to the obese group without treatment in visceral adipose tissue (p<0.05). Likewise, no significant immunohistochemistry staining was seen in diabetic obese groups. CONCLUSION: Metformin or exenatide treatment could prevent the degradation of insulin receptor substrate-1 protein by reducing the effect of suppressors of cytokine signaling-1 and suppressors of cytokine signaling-3 proteins, especially in the liver tissue. In addition, exercise can play a role as a complementary therapy by reducing suppressors of cytokine signaling-1 and suppressors of cytokine signaling-3 proteins in visceral adipose tissue.

Antioxidant, Antidiabetic and Lipid Profiling of Spermadicyton Suaveolens in Streptozotocin (STZ) Induced Diabetic Rats

ABSTRACT Diabetes is a life-threatening disease, and currently available synthetic medicines for treating diabetes are associated with various side effects. Therefore, there is an unmet need to develop herbal remedies against diabetes as an alternative to synthetic medicines. Although local healers use the roots of Spermadicyton suaveolens (SS) to manage diabetes, there is negligible research to validate its antidiabetic properties. The present investigation aims to the assess the antioxidant, antidiabetic, and antihyperlipidemic potential of the ethanolic extract of S. Suaveolen's roots (EESS) on streptozotocin (STZ) induced diabetic rats. The extract was screened for in vitro antioxidant and antidiabetic activity. The in vivo antidiabetic potential of EESS (at 200 and 400 mg/kg) was studied on STZ-induced diabetic rats for 20 days. The EESS displayed significant (p<0.05) antidiabetic and antioxidant properties. The administration of 200 mg/kg and 400 mg/kg EESS in STZ-induced diabetic rats significantly reduced hyperglycemia, and restored antioxidant enzymes and lipid profile-a high density lipoprotein (HDL) increased by the administration of a single dose of streptozotocin. Thus, EESS could be a promising herbal medicine in the treatment of diabetes and hyperlipidemia

Desempenho das Unidades Básicas de Saúde e uso do Programa Farmácia Popular / Performance of Basic Health Unitsand use ofthe Popular PharmacyProgram

Resumo Introdução O Brasil conta com dois programas de financiamento governamental para a provisão de medicamentos, o Programa Farmácia Popular do Brasil (PFPB) e a provisão em Unidades do Sistema Único de Saúde, ambos possuindo itens em comum. Objetivo Explorar a relação entre o uso do PFPB por hipertensos e diabéticos com fatores relacionados ao atendimento nas Unidades Básicas de Saúde, à estrutura da farmácia destas Unidades e à disponibilidade dos anti-hipertensivos e antidiabéticos comuns ao PFPB e ao SUS em municípios brasileiros de médio e grande porte populacional. Método Delineamento ecológico transversal utilizando dados secundários do PFPB e do Programa Nacional de Melhoria do Acesso e Qualidade na Atenção Básica (PMAQ-AB), com dados referentes ao ano de 2012. Resultados Municípios de médio porte apresentaram uma proporção de Unidades de Saúde com disponibilidade de anti-hipertensivos e antidiabéticos superior aos de grande porte. A maioria dos respondentes do PMAQ-AB relataram disponibilidade dos anti-hipertensivos e antidiabéticos nos serviços públicos. A análise multivariada mostrou que o uso da Farmácia Popular pela população está mais relacionado às situações emergenciais e ocasionais. Conclusão Na ausência do SUS, o PFPB supre a necessidade da população para obter medicamentos, evidenciando o seu importante papel para a continuidade do tratamento de muitos indivíduos com hipertensão e diabetes.

Abstract Background Brazil has two government-funded drug supply programs, the Popular Pharmacy Program of Brazil (PFPB), and the provision in Unified Health System (SUS) units, which have items in common. Objective To explore the relationship between the use of PFPB by hypertensive and diabetic patients and factors related to care in basic health units, the pharmacy structure of units, and the availability of antihypertensive and antidiabetic agents common to PFPB and SUS in Brazilian municipalities of medium and large population sizes. Method A cross-sectional ecological study was carried out using secondary data from PFPB and the National Program for Improving Access and Quality in Primary Care (PMAQ-AB) for 2012. Results Municipalities of medium population showed a greater proportion of health units with antihypertensive and antidiabetic availability than those of large size. Most respondents at PMAQ-AB affirmed that hypertension and diabetes medications are available in public health services. The multivariate analysis showed that the use of Popular Pharmacy by the population is more related to emergency and occasional situations. Conclusion PFPB supplies the need for the population to obtain medications in the absence of SUS, evidencing an important role in the continuity of drug treatment for many individuals suffering from hypertension and diabetes.

Uso de inhibidores de sglt 2 en pacientes con nefropatía diabética / Use of SGLT-2 inhibitors in patients with diabetic nephropathy

El tratamiento antidiabético oral ha sido un reto en el manejo de la diabetes mellitus. Los pacientes con algún grado de enfermedad renal crónica corren serios riesgos de hipoglucemia, sin embargo, los inhibidores del transportador de glucosa SGLT2 suponen un nuevo abordaje terapéutico de la diabetes mellitus tipo 2. Estudios en modelos experimentales de diabetes han demostrado que la inducción de glucosuria revierte la glucotoxicidad, restaura la normoglucemia, y mejora el funcionamiento de la célula beta y la sensibilidad a la insulina. Por lo tanto, se constituyen en una alternativa segura en estos pacientes.

Oral antidiabetic treatment has been a challenge in the management of diabetes mellitus in patients with some degree of chronic kidney disease due to the constant risks of hypoglycemia; however, glucose transporter SGLT2 inhibitors represent a new therapeutic approach to diabetes mellitus. Type 2, studies in experimental models of diabetes have shown thatthe induction of glycosuria reverses glucotoxicity, restores normoglycemia, and improves beta cell function and insulin sensitivity.

Study of antidiabetic activity of two novel Schiff base derived dibromo and dichloro substituted compounds in streptozotocin-nicotinamide-induced diabetic rats: pilot study

Abstract Schiff bases are aldehyde-or ketone-like chemical compounds in which an imine or azomethine group replaces the carbonyl group. Such compounds show various beneficial biological activities, such as anti-inflammation and antioxidants. The present study addresses comprehensiveevaluation of antidiabetic effect of two novel dibromides and dichlorides substituted Schiff bases substituted Schiff bases (2,2'-[1,2-cyclohexanediylbis (nitriloethylidyne)]bis[4-chlorophenol] (CNCP) and 2, 2'-[1,2-cyclohexanediylbis(nitriloethylidyne)]bis[4-bromophenol] (CNBP) with two different doses, high (LD) and low (LD) in streptozotocin and nicotinamide induced diabetic rats. The rats were separated into normal, untreated, treated and reference groups. Except for the normal group, diabetes traits were induced in the rest animals. Insulin level was measured, and the effect of the compounds on biochemical parameters of liver function and lipid profile were evaluated. High glucose and decreased insulin level are observed in the groups. The histological evaluation confirms that the hepatic architecture in the treated animals with a low dose of CNCP is quite similar to that of the normal hepatic structure and characterized by normal central vein, hepatocytes without any fatty alterations and mild red blood cell infiltration. CNCP (LD) and CNBP (HD) are more successful in enhancing cell survival in the diabetic rat's liver and can be responsible for causing much healthier structure and notable morphology improvement.

Design, synthesis and antidiabetic activity studies of purine derivatives / 药学学报

Based our previous work, twelve purine derivatives were designed and synthesized as dual modulators of GPR119 and DPP-4by conjugating the GPR119 activating and DPP-4 inhibiting fragments with the position 6 and 9 of purine core via an approach of merged pharmacophores. Compound 11, bearing 2-fluoro-4-methylsulphonyl anilide and cyanopyrrolidine moieties, exhibited the most potent GPR119 agonistic activities (EC50 = 0.33 μmol·L-1, IA = 71.1%) and DPP-4 inhibitory (58.4% inhibition at 10 μmol·L-1, 21.2% inhibition at 1 μmol·L-1) activities in the in vitro antidiabetic study. Subsequently, we performed studies on structure activity relationships and molecular docking to guide the further drug design.

In Vitro Investigation of Antioxidant and Antidiabetic Properties of Phenolic-Rich Extract from Stingless Bee Honey (Heterotrigona itama)

@#Introduction: The increase of Type 2 diabetes mellitus has prompted numerous research toward finding an alternative to manage the disease through the oxidant-antioxidant balance, mainly through bioactive compounds in natural products. This study explored the antioxidant and antidiabetic properties of phenolic-rich extract (PRE) from Stingless bee honey (SBH) (Heterotrigona itama) as therapeutic agent to restore the redox balance. Methods: The total phenolic content (TPC), total flavonoid content (TFC) and antioxidant assays of PRE and SBH, were determined to provide preliminary insight into the sample’s antioxidant properties, followed by high-performance liquid chromatography analysis of PRE. The antidiabetic potential of PRE and SBH were determined based on their inhibition against α-amylase and α-glucosidase enzymes. The cytotoxicity analysis of PRE was conducted on 3T3-L1 adipocytes and L6 muscle cells before the glucose uptake and cellular antioxidant analyses were performed on both cell lines, respectively. Results: PRE yielded higher TPC, TFC and antioxidant activities than SBH. The phytochemical profile of PRE comprises gallic acid, myricetin, kaempferol, epicatechin, chlorogenic acid, quercetin, syringic acid, and cinnamic acid. The results from carbohydrate enzymatic inhibitory assays collectively suggested that PRE exhibited more robust antidiabetic activities than SBH. PRE showed good glucose uptake stimulating and reactive oxygen species scavenging effects in those cell lines. Conclusion: Overall, PRE from SBH showed higher carbohydrate enzymatic inhibition, glucose uptake, and protection against intracellular oxidative stress, primarily due to its high antioxidant content and may serve as an alternative therapeutic agent for managing T2DM.

PROSTATE CANCER AND DIABETES BIOLOGY OR DETECTION BIAS

Prostate cancer and diabetes are the two highly prevalent health problems in men worldwide and have a high mortality rates but their association is quite complex and contradictory. This review reported several population based studies which tried to establish a possible association and explains the mechanism by which diabetes exhibits its effect on prostate cancer progression. It also explores the literature around the expression of various receptors and genes which enlightens the possible molecular basis of association and the effect of current antidiabetic drugs like metformin and insulin on the growth and advancement of prostate cancer in diabetic men. Masking of early tumor detection by diabetes might be the possible explanation for the reported inverse association with worse prognosis and shorter survival rate in diabetic prostate cancer patients.

Trends in antidiabetic drug utilization in Type 2 diabetes patients in a diabetes clinic of a tertiary care teaching hospital in India

Background: The treatment of Type 2 diabetes mellitus (T2DM) requires many classes of drugs, combination of old and new drugs is usually recommended for intensification of therapies. Antidiabetic drug (ADD) utilization study promotes rational use of ADDs and reveals the recent trends in use. Aims and Objectives: The objective of the study was to analyze drug utilization pattern with particular attention to initiation and intensification of the treatment options in T2DM patients of a diabetes clinic run by endocrinology department of a tertiary care teaching hospital in Eastern India. Materials and Methods: This was a cross-sectional and observational study conducted at the diabetes clinic of a tertiary care Medical College and Hospital of West Bengal over a period of 12 months. After obtaining informed consent, diagnosed adult Type 2 diabetes patients receiving any ADD were included in the study. Demographic, clinical, and laboratory data, proportion of each class of ADDs, and WHO core drug use indicators were analyzed. Results: A total of 298 patients ([167, 56%] males and [131, 44%] females) were enrolled. The mean age of the patients was 52.33 ± 9.91. Metformin (287/298, 96%) was the most commonly prescribed drug, followed by glimepiride (168/298, 56.38%), insulins (116/298, 38.93%), DPP4 inhibitors (108/298, 36.24%), and pioglitazone (99/298, 33.22%). Metformin, glimepiride (53/109, 48.62%) and metformin, glimepiride, and pioglitazone (36/113, 31.86%) were the common dual and triple drug combinations. Conclusion: In Type 2 diabetes, metformin was the preferred agent for initiation of the treatment; glimepiride, insulin, DPP-4is, and pioglitazone were used in combination of metformin for intensification of therapy, consistent with current clinical practice guidelines.

Bioassay-guided isolation of α-glucosidase inhibitors from Byrsonima garcibarrigae Cuatrec

SUMMARY Introduction: Byrsonima garcibarrigae is an endemic tree of Amazonas state, Brazil, with pharmacological and chemical knowledge poorly understood. Aim: To investigate the antidiabetic potential of the B. garcibarrigae stem bark. Methods: The stem bark was sequentially extracted by maceration with hexane (EHBG), ethyl acetate (EABG), and methanol (EMBG). The antioxidant capacity, α-glucosidase inhibitory potentials and anti-glycation capacities were evaluated. A bio-guided fractionation gave compounds that were characterized by MS and NMR. Results: 8 compounds were identified by HPLC-MS. EMBG showed the highest α-glucosidase inhibitory activity (1.09±0.32 µg/mL), antioxidant activity (9.2±0.23 µg/mL) and phenolic compounds content (61.43±0.50%), thus was fractionated producing hexane (FHX), chloroform (FCL) and hydromethanolic (FHM) fractions. After additional anti- α-glucosidase assays, FHM (1.02±0.49 µg/mL) was fractionated giving quercitrin and epicatechin. The anti-glycation assay showed that EMBG, FHM and quercitrin presented higher activities in comparison to the positive control, amino-guanidine. Conclusions: B. garcibarrigae displayed antidiabetic potential since inhibited α-glucosidase, as well as presented expressive antioxidant and anti-glycation activities were recorded.

Introducción: Byrsonima garcibarrigae es un árbol endémico del estado de Amazonas, Brasil, con poco conocimiento farmacológico y químico. Objetivo: investigar el potencial antidiabético de la corteza del tallo de B. garcibarrigae. Métodos: la corteza del tallo se extrajo secuencialmente mediante maceración con hexano (EHBG), acetato de etilo (EABG) y metanol (EMBG). Se evaluó la capacidad antioxidante, los potenciales inhibidores de la α-glucosidasa y las capacidades anti-glicación. Un fraccionamiento bioguiado dio compuestos que se caracterizaron por MS y NMR. Resultados: se identificaron 8 compuestos mediante HPLC-MS. EMBG mostró la mayor actividad inhibidora de α-glucosidasa (1,09 ± 0,32 µg/mL), actividad antioxidante (9,2±0.23 µg/mL) y contenido de compuestos fenólicos (61,43 ± 0.50%), por lo que se fraccionó produciendo hexano (FHX), cloroformo (FCL) e hidrometanólicas (FHM). Después de ensayos adicionales de anti- α-glucosidasa, se fraccionó FHM (1,02 ± 0,49 µg/mL) dando quercitrina y epicatequina. El ensayo antiglicación mostró que EMBG, FHM y quercitrina presentaron actividades más altas en comparación con el control positivo, aminoguanidina. Conclusiones: B. garcibarrigae mostró potencial antidiabético ya que se registró una inhibición de la α-glucosidasa, así como también presentó actividades expresivas antioxidantes y antiglicación.

Introdução: Byrsonima garcibarrigae é uma árvore endêmica do estado do Amazonas, Brasil, com pouco conhecimento farmacológico e químico. Objetivo: investigar o potencial antidiabético da casca do caule de B. garcibarrigae. Métodos: a casca do caule foi extraída sequencialmente por maceração com hexano (EHBG), acetato de etila (EABG) e metanol (EMBG). A capacidade antioxidante, potencial inibibitório de α-glicosidase e capacidade antiglicação foram avaliadas. Um fracionamento bioguiado isolou compostos que foram caracterizados por MS e RMN. Resultados: 8 compostos foram identificados por HPLC-MS. O EMBG apresentou a maior atividade inibitória de α-glicosidase (1,09 ± 0,32 µg/mL), atividade antioxidante (9,2±0,23 µg/mL) e teor de compostos fenólicos (61,43 ± 0,50%), por isso foi fracionado produzindo hexano (FHX), clorofórmio (FCL) e hidrometanólico (FHM). Após ensaios anti- α-glicosidase adicionais, FHM (1,02 ± 0,49 µg/mL) foi fracionado, originando a quercitrina e epicatequina. O ensaio de antiglicação mostrou que EMBG, FHM e quercitrina exibiram atividades mais altas em comparação com o controle positivo, aminoguanidina. Conclusões: B. garci-barrigae apresentou potencial antidiabético, uma vez que foi registrada inibição da α-glicosidase, bem como expressiva atividade antioxidante e antiglicação.

Interacciones en el tratamiento antitrombótico e hipoglucemiante / Interactions in antithrombotic and hypoglycemic therapy

Resumen Esta revisión consiste en una puesta al día del tratamiento antiplaquetario y la interacción que presenta con los hipoglucemiantes orales en pacientes diabéticos con cardiopatía isquémica. Re sumimos los principales mecanismos fisiopatológicos que intervienen en el aumento del riesgo cardiovascular en este grupo, los efectos de la combinación entre los hipoglucemiantes orales, sus efectos antitrombóticos y su interacción con los antiplaquetarios y, por último, los trabajos que estudiaron los beneficios de los antiplaque tarios en pacientes diabéticos en diferentes escenarios de la cardiopatía isquémica. Los variados mecanismos de acción implican una mejora del control de la glucemia, del aumento de la biodisponibilidad del óxido nítrico, reducción del estrés oxidativo y, para ciertas moléculas, una inhibición directa de la activación y de la agregación plaquetaria.

Abstract This review is an update on antiplatelet therapy and its interaction with oral hypoglycemic agents in diabetic patients with ischemic heart disease. We summarize the main pathophysiological mechanisms that intervene in diabetic patients and that increase the ischemic risk, the effects of the combination of oral hypoglycemic agents, their antithrombotic ef fects and their interaction with antiplatelet, and finally the studies that demonstrated the benefits of antiplatelet in diabetic patients in different scenarios of ischemic heart disease. The different mechanisms of action involve improved glycemic control, increased bioavailability of nitric oxide, reduced oxidative stress and, for certain mol ecules, direct inhibition of platelet activation and aggregation.

Evaluation of adverse drug reactions in patients with Type II diabetes mellitus in tertiary care hospitals, Bhopal

Background: Pharmacovigilance is the science which deals with adverse drug reactions (ADRs) appear after long and short drug treatment. ADRs monitoring is essential to gain knowledge of drugs reaction for betterment of mankind. In the present study, observation of ADRs in Type II diabetic patients was conducted in tertiary care hospitals, Bhopal. ADRs reported in the present study were diarrhea, myalgia, flatulence, palpitations, rash, itching, etc., in patients receiving oral hypoglycemic agents. So through this observation, we want to acknowledge the various adverse effects occurred by oral hypoglycemic agents for reduction of morbidity and mortality in Type II Diabetic patients. Aims and Objectives: (1) The objectives of the study were to ADRs monitoring in Type II Diabetic patients receiving oral anti-diabetic agents and (2) to compare ADRs in conventional versus newer anti-diabetic agents therapies in Type II Diabetic patients. Materials and Methods: 150 patients were enrolled for evaluating adverse effects with oral antidiabetic agents. All patients were followed up by medical history, history of drugs, and any severity of ADR. Causality was graded by Naranjo scale. Results: 45 patients (30%) with mean age of 64.6 year (SD = 2.41) complained adverse effects and out of which 17 (11.3%) patients were reported to the physician. The most common adverse effect was found with sulfonylureas, biguanides, and thiazolidinediones such as hypoglycemia, weight gain, gastrointestinal (GI) disturbances allergic reactions, and dizziness probability of adverse effects more common in females (64.17%) in comparison to male (35.29%) patients. Conclusion: In Type II Diabetic patients receiving oral antidiabetic agents provides a fruitful information about a ADRs and enhance knowledge about pharmacovigilance to health-care providers. However, predominance of adverse effects in female diabetic patients was reported. Hypoglycemia, weight gain, and GI tract disturbances were observed frequently with oral antidiabetic agent in middle age diabetic patients. By this information, we can prevent drug related complications and improve quality of life of a person

Enhancement of mangiferin by fungal endophytes isolated from Salacia chinensis L. and Salacia oblonga Wall.

Microbes residing in the internal tissues of a plant are called endophytes, and are known for producing phytochemicals such as taxol, podophyllotoxin, azadirachtin and vinca alkaloids. In this study, out of five isolates from Salacia species, two fungi Penicillium capsulatum and Aspergillus fumigatus have been evaluated and confirmed by polymerase chain reaction (PCR) amplification for their endophytic action to produce mangiferin. Mangiferin has been reported to possess protective properties, including antioxidant, antidiabetic and immunomodulatory. It has been reported that the content of mangiferin is 7-9% in Mangifera indica, and is also present in other plants like Swertia chirata, Salacia chinensis, and Hypericum aucheri. Therefore, an attempt was made to explore the biotechnological approach and regulation studies to increase the production of mangiferin in S. chinensis and S. oblonga. Endophytes were isolated, screened, and analyzed, to evaluate the mangiferin in fungal extracts in comparison with crude plant extracts. An HPLC analysis was used to determine the mangiferin content present in the fungal extract of S. chinensis stem (74.74 g/mL), followed by fungi extracts of S. oblonga root (33.75 g/mL) and S. chinensis root (30.50 g/mL), compared with the plant extracts. These results were confirmed by FTIR analyses

Insulin Initiation with Insulin Degludec/Insulin Aspart versus Insulin Glargine in Oral Antidiabetic Drugs Failure Patients with Type 2 Diabetes Mellitus: A Real-World Study from India

Context: Oral antidiabetic drug (OAD) failure is an indication for starting insulin therapy, but there is still a dilemma as to whether basal insulin or a premixed/co-formulation analog should be the choice. Aim: To compare the safety and efficacy of once daily (OD) insulin degludec/insulin aspart (IDegAsp) to OD insulin glargine (IGlar U100) in insulin-naïve Indian subjects with type 2 diabetes mellitus (T2DM), inadequately controlled with OADs alone. Setting and design: Retrospective study. Methods and material: Data was retrieved from the author’s clinic database of OAD failure patients (18-80 years), who were started either with (IGlar U100, n = 120) or IDegAsp (n = 89) OD over and above the standard of care. Data of fasting plasma glucose (FPG), postprandial plasma glucose (PPG) and glycated hemoglobin (HbA1c) from baseline and at last follow-up visits were collected. Statistical analysis used: Baseline characteristics and change in study parameters during the follow-up period were computed between two groups (IGlar U100 vs. IDegAsp) by unpaired t-test and paired t-test, respectively. ANCOVA test was used to compute percentage reduction in body weight, body mass index (BMI), FPG, PPG and HbA1c in between two groups (IGlar U100 vs. IDegAsp). Results: IDegAsp caused a significantly greater reduction in FPG, PPG and HbA1c as compared to the IGlar U100 arm. There was no significant difference in the proportion of patients with hypoglycemia between IDegAsp and IGlar U100 groups (p = 0.208). No episodes of severe hypoglycemia were reported. Conclusion: Comparison of IDegAsp and IGlar U100 OD in T2DM patients indicated that both were relatively safe but the former controlled FPG and PPG levels more effectively.

Factors Influencing Oral Anti-diabetic Medication Adherence among Type 2 Diabetes Mellitus in Urban Health Training Centre, Bengaluru.

Background: Medication adherence is a major challenge in treatment of type 2 diabetes. Hence the pre-sent study was undertaken to assess the factors influencing drug adherence in Type 2 diabetes Benga-luru. Methods: A descriptive study was conducted in urban health training centre Bengaluru for a period of 9 months. A total of 70 type 2 Diabetes patients only on oral drugs willing to give informed consent were included. Institutional Ethical Committee clearance was obtained and pre-tested semi structured proforma was administered and the probable factors that affect adherence was included. Data was en-tered in Microsoft excel and analyzed in SPSS-21. Descriptive statistics and inferential statistics like Bi-nary logistic regression was used to assess the factors influencing drugs. Results: Around 92.8% consumed ?2 drugs and consumed single or combination of drugs. Most com-mon anti-diabetic drug consumed was Biguanides in 64(91.4%). Good adherence (0-2 score) to oral anti-diabetic drugs was observed in 43 (61%) study subjects the factor significantly associated with poor ad-herence in Binary Logistic Regression Model is sometimes forgetting to consume the medication. Conclusion: The factors that influenced oral anti-diabetic drugs good adherence is consuming the medi-cations without forgetting. Efforts are needed to improve adherence and self-management techniques to prevent complications.

Atividades biologicas avaliadas in vitro de especies do genero Erythroxylum: uma revisao de literatura

Introdução: o gênero Erythroxylum é composto por 230 espécies distribuídas em regiões subtropicais da América do Sul, que são utilizadas pela população tradicional para o tratamento de diversos acometimentos, como febre, asma, sinusite, gripe, sangramento, amenorreia, afecções virais, dentre outros. Objetivo: realizar uma revisão sistemática da literatura sobre as atividades biológicas in vitro de espécies do gênero Erythroxylum. Metodologia: para o presente estudo foram utilizadas as bases eletrônicas: LILACS, PubMed, SciELO, ScienceDirect e BIREME. Os descritores consultados foram: Erythroxylum AND in vitro. Resultados e discussão: um total de 64 artigos foram selecionados para compor a revisão após emprego da ferramenta PRISMA e serem avaliados quanto aos critérios de inclusão e exclusão. Esse levantamento demonstrou que diversas espécies do gênero Erythroxylum apresentaram suas propriedades biológicas validadas através de estudos in vitro, com destaque para as atividades antioxidante, antibiótica, anticâncer, anti-hipertensiva, antidiabética e neuroprotetora. Conclusão: mais estudos devem ser realizados a fim de elucidar as propriedades biológicas de Erythroxylum sp., visto que apenas 30 espécies do gênero foram estudadas até o presente momento.

SUMMARY Introduction: The genus Erythroxylum is composed of 230 species distributed in subtropical regions of South America, these are used by the traditional population for the treatment of various disorders, such as fever, asthma, sinusitis, flu, bleeding, amenorrhea, viral disorders, among others. Aim: To carry out a systematic literature review on the in vitro biological activities of species of the genus Erythroxylum. Methodology: For this study, the following electronic databases were used: LILACS, PubMed, SciELO, ScienceDirect and BIREME. The descriptors consulted were: Erythroxylum AND in vitro. Results and discussion: A total of 64 articles were selected to compose the review after using the PRISMA tool and to be evaluated for inclusion and exclusion criteria. This study demonstrated that several species of the genus Erythroxylum presented their biological properties validated through in vitro studies, with emphasis on the antioxidant, antibiotic, anticancer, antihypertensive, anti-diabetic and neuroprotective activities. Conclusion: Further studies should be carried out in order to elucidate the biological properties of Erythroxylum sp., since only 30 species of the genus have been studied so far.

Introducción: el género Erythroxylum está compuesto por 230 especies distribuidas en las regiones subtropicales de América del Sur, estas son utilizadas por la población tradicional para el tratamiento de diversos trastornos, como fiebre, asma, sinusitis, gripe, hemorragias, amenorrea, trastornos virales, entre otros. Objetivo: realizar una revisión sistemática de la literatura sobre las actividades biológicas in vitro de especies del género Erythroxylum. Metodología: para este estudio se utilizaron las siguientes bases de datos electrónicas: LILACS, PubMed, SciELO, ScienceDirect y BIREME. Los descriptores consultados fueron: Erythroxylum AND in vitro. Resultados y discusión: un total de 64 artículos fueron seleccionados para componer la revisión después de utilizar la herramienta PRISMA y para ser evaluados por criterios de inclusión y exclusión. Este estudio demostró que varias especies del género Erythroxylum presentaron sus propiedades biológicas validadas a través de estudios in vitro, con énfasis en las actividades, antioxidante, antibiótica, anticancerígena, antihipertensiva, antidiabética y neuroprotectora. Conclusión: se deben realizar más estudios para dilucidar las propiedades biológicas de Erythroxylum sp., ya que hasta el momento solo se han estudiado 30 especies del género.

Direct Evidence for Intracellular Homeostasis in Mammalian Cells: Insulin-independent Glucose Metabolisms

In our previous study, carbonates, NaHCO3 and Na2CO3, influence glucose metabolism in vitro, using Py-3Y1-S2 rat fibroblast cells, and these compounds accelerate significantly glucose consumption. In the present study, the effects of the carbonates on glucose metabolism were examined to determine whether these effects are universal among different cell lines, VERO green monkey kidney cells, TE-13 human esophageal cancer cells, and HepG2 human cells. Glucose was completely converted to lactate, which disappeared gradually from the culture medium. However, the disappearance of lactate from the medium was independent of carbonates. The present study clarified that NaHCO3 and Na2CO3 directly regulate glucose metabolism among different cell lines via an insulin-independent pathway, that is, intracellular homeostasis.