SuJok Therapy For The Treatment Of Type 2 Diabetes

Background:Diabetes mellitus is one of the oldest characterized diseases in the world. By today diabetes has become a worldwide epidemic that is associated with the modern lifestyle, increased stress, improper nutrition or eating behaviours and lack of physical activity. Material And Methods:330 patients aged 30-76 years were administered to the study. All the metabolic marker analyses were conducted using an automated clinical chemistry analyzer (Dimension Xpand Plus, Siemens Healthcare, Germany). Random Plasma glucose levels (RPG) was taken 2-4 hours post meal.Sujok treatments were carried out by certified Sujok Therapistsaccording to the Diabetes treatment protocol (ISA R&D center, Nagpur, India).Result:A major decrease in plasma glucose levels was recorded 30 minutes after theinitial Sujoktreatment. Following 5 treatments, 70% of the patients responded in decrease in glucose levels (52.45±10.49 mg/dl) while 24% increase in glucose levels (22.2±7.4 mg/dl), 6% of the patients did not show any change in glucose plasma levels.HbA1c was monitored in the patients that undergone 3 months ofSujoktreatment.Aconsiderable decrease in the percent of HbA1c was observed in the plasma of treated patients (5.53±0.98%), in comparison to the initial level measured prior to the treatment procedure (8.13±1.29%).Conclusion:This study is a pilot study to evaluate possible effect of Sujok therapy for thetreatment of diabetes. Overall, it seems that Sujok therapy may decrease glucose levels and HbA1clevels. These results can support the efforts to de velop improved therapeutic and preventive strategies for diabetes. A following research regarding the treatment of diabetes complications by Sujok therapy is currently running with promising results.

A short review on the features of the non-obese diabetic Goto-Kakizaki rat intestine

The Goto-Kakizaki (GK) rat is a non-obese experimental model of type 2 diabetes mellitus (T2DM) that allows researchers to monitor diabetes-induced changes without jeopardizing the effects of obesity. This rat strain exhibits notable gastrointestinal features associated with T2DM, such as marked alterations in intestinal morphology, reduced intestinal motility, slow transit, and modified microbiota compared to Wistar rats. The primary treatments for diabetic patients include administration of hypoglycemic agents and insulin, and lifestyle changes. Emerging procedures, including alternative therapies, metabolic surgeries, and modulation of the intestinal microbiota composition, have been shown to improve the diabetic state of GK rats. This review describes the morpho-physiological diabetic-associated features of the gastrointestinal tract (GIT) of GK rats. We also describe promising strategies, e.g., metabolic surgery and modulation of gut microbiota composition, used to target the GIT of this animal model to improve the diabetic state.

Progress of intelligent-responsive insulin delivery mediated by glucose oxidase / 中国药科大学学报

@#The delivery of exogenous insulin is very important for the treatment of type 1 and advanced type 2 diabetes.Traditional injectable administration is prone to cause hypoglycemia, while the intelligent insulin system has the advantages of safety, long-term effectiveness, and high responsiveness.Glucose oxidase (GOx) can consume O2 and catalyze glucose to produce gluconic acid and H2O2.Therefore, the O2 level, H2O2 content and pH of GOx system are closely related to the glucose level in the system.This review introduces the application of GOx in closed-loop insulin delivery systems at home and abroad in recent years, which can be divided into single response and multiple response of pH-response, hypoxia-response, and H2O2-response according to the mechanism.It also discusses the opportunities and challenge facing by the application of GOx in the future.

Percepção do idoso diabético sobre o papel da família no tratamento / Perception of elderly patients with diabetes about the role of the family in the treatment / Percepción del anciano diabético sobre el papel de la familia en el tratamiento

O objetivo da pesquisa foi conhecer a percepção dos idosos diabéticos acerca da participação da família em seu tratamento. Participaram seis idosos que responderam a uma entrevista semiestruturada. Constataram-se maiores dificuldades em relação à adesão alimentar e ao exercício físico. Foi observada a importância do envolvimento familiar no alcance do controle glicêmico e na qualidade de vida dos entrevistados, e que a família necessita ser apoiada para que consiga desempenhar o papel de diligente.

The objective was to know the perception of elderly diabetics about family participation in treatment. Participants were six elderly who answered a semi-structured interview. It found major difficulties in relation to food and exercise adherence. It was observed the importance of family involvement in achieving glycemic control and quality of life of respondents and that the family needs to be supported so you can play the role of diligent.

El objetivo de la investigación fue conocer la percepción de los ancianos diabéticos acerca de la participación de la familia en su tratamiento. Participaron seis ancianos que respondieron a una entrevista semiestructurada. Se constataron mayores dificultades en relación a la adhesión alimenticia y al ejercicio físico. Se observó la importancia de la participación familiar en el alcance del control glucémico y en la calidad de vida de los entrevistados y que la familia necesita ser apoyada para que pueda desempeñar el papel de diligente.

Management of diabetes mellitus in individuals with chronic kidney disease: therapeutic perspectives and glycemic control

The purpose of this study was to evaluate the therapeutic options for diabetes treatment and their potential side effects, in addition to analyzing the risks and benefits of tight glycemic control in patients with diabetic kidney disease. For this review, a search was performed using several pre-defined keyword combinations and their equivalents: “diabetes kidney disease” and “renal failure” in combination with “diabetes treatment” and “oral antidiabetic drugs” or “oral hypoglycemic agents.” The search was performed in PubMed, Endocrine Abstracts and the Cochrane Library from January 1980 up to January 2015. Diabetes treatment in patients with diabetic kidney disease is challenging, in part because of progression of renal failure-related changes in insulin signaling, glucose transport and metabolism, favoring both hyperglycemic peaks and hypoglycemia. Additionally, the decline in renal function impairs the clearance and metabolism of antidiabetic agents and insulin, frequently requiring reassessment of prescriptions. The management of hyperglycemia in patients with diabetic kidney disease is even more difficult, requiring adjustment of antidiabetic agents and insulin doses. The health team responsible for the follow-up of these patients should be vigilant and prepared to make such changes; however, unfortunately, there are few guidelines addressing the nuances of the management of this specific population.

The Well-Being and Treatment Satisfaction of Diabetic Patients in an Outpatient Setting at a General Hospital in Korea / 임상당뇨병

BACKGROUND: The aim of this study was to assess the psychological well-being and treatment satisfaction in patients with type 2 diabetes mellitus in a general hospital in Korea. METHODS: This study included 440 type 2 diabetes patients above 20 years of age. Well-Being Questionnaire-12 (WBQ-12) and Diabetes Treatment Satisfaction Questionnaire were used to survey well-being and treatment satisfaction, respectively. WBQ-12 consists of 4 categories: negative well-being (NWB), energy (ENE), positive well-being (PWB), and general well-being (GWB). RESULTS: There were significant associations between NWB scores and women, low education, low-income, and number of hospital admissions. Significant associations were also identified between ENE scores and men, higher education, insulin nonusers, high-income, compliance with recommended exercise, number of medications, satisfaction with treatment time, and poor glycemic control. PWB scores were significantly associated with high-income, satisfaction with waiting and treatment times, compliance with recommended diet and exercise, and number of medications. GWB scores were significantly associated with men, higher education, high-income, satisfaction with waiting and treatment times, compliance with recommended exercise, and number of medications. Treatment satisfaction was significantly associated with age, satisfaction with waiting and treatment times, compliance with recommended diet and exercise, and duration of diabetes. CONCLUSION: Diabetes care requires psychosocial support in addition to medical care. Unlike Western studies, our study found that satisfaction with waiting and treatment times had a strong correlation with well-being and treatment satisfaction in diabetes patients.

Ethanolic extract of Passiflora edulis Sims leaves inhibits protein glycation and restores the oxidative burst in diabetic rat macrophages after Candida albicans exposure

abstract This study was conducted to evaluate the effects of the ethanolic extract of Passiflora edulis leaves on blood glucose, protein glycation, NADPH oxidase activity and macrophage phagocytic capacity after Candida albicans exposure in diabetic rats. The Passiflora edulis Sims leaves were dried to 40°C, powdered, extracted by maceration in 70% ethanol, evaporated under reduced pressure and lyophilised. The biochemical tests performed were total phenolic content (TP) as determined by the Folin-Ciocalteu assay, trapping potential DPPH assay and total iron-reducing potential. Diabetes was induced by alloxan injection. Protein glycation was determined by AGE and fructosamine serum concentrations. Extract-treated diabetic animals demonstrated lower fructosamine concentrations compared with the diabetic group. Our results suggest that ethanolic Passiflora edulis Sims leaf extraction may have beneficial effects on diabetes and may improve glycaemic control in diabetic rats.

resumo O objetivo deste estudo foi avaliar os efeitos do extrato etanólico de folhas de Passiflora edulis sobre os níveis de glicose sanguínea, glicação protéica, produção de espécies reativas de oxigênio (ERO) e capacidade fagocítica de macrófagos de ratos diabéticos. As folhas de Passiflora edulis Sims foram secas a 40 °C, trituradas e o extrato preparado por maceração em solução hidroetanólica 70% (v/v) etanol foi evaporado sob pressão reduzida e liofilizado. Os testes químicos realizados demonstraram que além da presença de compostos fenólicos, determinada pelo método de Folin-Ciocalteu, o extrato apresentou potencial sequestrante de radicais DPPH e redutor de ferro. Nos animais diabéticos foi observado aumento na glicação protéica, avaliada pela concentração de frutosaminas e de produtos de glicação avançada (AGE), e redução na produção de ERO por macrófagos frente à Candida albicans, quando comparados ao grupo controle. O tratamento dos animais diabéticos com o extrato reduziu as concentrações de frutosaminas e manteve a produção de ERO em níveis semelhantes aos observados no grupo controle. Nossos resultados sugerem que o extrato etanólico de folhas de Passiflora edulis Sims pode apresentar efeitos benéficos sobre o diabetes e melhorar o controle glicêmico em ratos diabéticos.

Molecular structure and pharmacological characteristics of DPP4 inhibitors / 中国药学杂志

OBJECTIVE: To review the molecular structure and pharmacological characteristics of DPP-4 inhibitors. METHODS: based on the research literatures in recent years, reviewed the history and development of incretin in diabetes management, especially the R & D process and the molecular structure, pharmacodynamic / pharmacokinetic (PK/PD) and clinical efficacy of DPP-4 inhibitors. RESULTS and CONCLUSION: DPP-4 inhibitors have many advantages and good future in diabetes care.

Evaluación económica del tratamiento de diabetes tipo 2 con saxagliptina en Colombia / Economic evaluation of type 2 diabetes treatment with saxagliptin in Colombia

Objetivo: Determinar la relación costo efectividad incremental del agregado de saxagliptina o sulfonilureas en Colombia a personas con DMT2 que no logran alcanzar metas glucémicas con metformina, durante un período máximo de 20 años. Metodología: Se realizó un estudio de costo efectividad, utilizando un modelo de simulación de eventos discretos con incremento de tiempo fijo (Diabetes Cardiff Model). Las características de la cohorte de pacientes y el perfil de eficacia para cada tratamiento se obtuvieron de la literatura. El costo de los medicamentos se obtuvo de SISMED y Farmaprecios. Los costos de los eventos macro y microvasculares se basaron en el POS, Manual Tarifario SOAT y consulta con experto local. La tasa de descuento en costos y beneficios fue 3,5 por ciento. Resultados: En el grupo tratado con saxagliptina registramos menos eventos fatales y no fatales y menos episodios de hipoglucemia. En ambas estrategias los mayores costos correspondieron a los medicamentos, seguidos por los asociados al tratamiento del infarto de miocardio. El costo incremental de la terapia con saxagliptina fue de US$ 555.552 a 20 años. El tratamiento con saxagliptina redundó en un mayor número de Años de Vida Ajustados por Calidad (AVAC) y Años de Vida Ganados (AVG), respecto al obtenido con sulfonilureas. El costo por AVAC fue de US$ 2.190. Los resultados de costo efectividad fueron robustos al análisis de sensibilidad. Conclusión: El agregado de saxagliptina a pacientes que no logran un control glucémico adecuado con metformina, es muy costo efectiva comparada con el agregado de sulfonilureas.

Objective: To determine in Colombia, the cost effectiveness ratio of the saxagliptin or sulphonylureas addition to patients with T2DM who fail to achieve glycemic goals with metformin, for a maximum period of 20 years. Methods: We performed a cost effectiveness analysis, using a discrete event simulation model with fixed time step (Cardiff Diabetes Model). The characteristics of the cohort of patients and efficacy profile for each treatment were obtained from the literature. The cost of medication was obtained from SISMED and Farmaprecios. The costs of macro and microvascular events were based on POS tariffs, SOAT Manual and consultation with local expert. The discount rate on costs and benefits was 3.5 percent. Results: The group treated with saxagliptin had fewer fatal and nonfatal events and fewer episodes of hypoglycemia than the one with sulfonylureas. In both strategies the higher cost corresponds to the drugs, followed by those associated with the treatment of myocardial infarction. The incremental cost of saxagliptin therapy was US$ 555.552 to 20 years. Saxagliptin treatment resulted in a greater number of quality-adjusted life year (QALYs) and life-years gained (LYG) than that obtained with sulfonylureas. The cost per QALY was US$ 2,190. Cost-effectiveness results were robust to sensitivity analysis. Conclusion: Addition of saxagliptin to patients who do not achieve adequate glycemic control with metformin, is highly cost-effective compared with the addition of sulphonylureas.

Enfoques del trasplante pancreático y de Islotes de Lanngerhans en el tratamiento de la Diabetes / Pancreatic Transplantation and Lanngerhans Islets Approaches in the Treatment of Diabetes

La diabetes es una enfermedad con gran repercusión a nivel mundial, los objetivos de una terapia prolongada, en pacientes con cierta limitación en la terapia exógena convencional son mejorar la calidad de vida con niveles normoglicemicos sustentables. Los trasplantes de órgano o de islotes son alternativas promisorias para este fin. Por lo que el enfoque de las técnicas, historia y perspectivas a futuro es de gran interés dentro de múltiples campos como la cirugía, la endocrinología, la medicina interna, finalmente y más importante la vida del paciente.

Diabetes is a disease with a huge world-wide mean, the objective of a long time therapy, in patients with some limitation with the conventional exogenous therapy are to improve life quality with a sure lasting normoglicemia. Pancreas transplant or pancreatic islets which are promissory on this go. That's why we focus on techniques, history and future perspectives are of a huge interest on many areas, as the surgery, endocrinology, internal medicine and finally and more important patients life, various cardiovascular, metabolic and ophthalmological diseases among others.

Diabetes control- the legacy of a memory

Achieving and maintaining good glycaemic control remains an important goal in the management of this common and prevalent disorder. Recent evidence from important megatrials, ACCORD, ADVANCE, VADT, UKPDS-10 year follow-up as well as the STENO-2 follow-up study, have cleared doubts concerning the benefits of targeting good glycaemic control. For the first time, we have the reassurance that macrovascular benefits can be realised from good glycaemic control. The legacy effect of prior good glucose control from the UKPDS-10 year follow-up, reinforces the results seen from the DCCT-EDIC (for Type 1 diabetes). The Intervention Phase of the UKPDS revealed benefits for reduction of microvascular complications, while it was only at the end of the Post-Trial Monitoring Phase where significant improvements in both micro and macrovascular outcomes were seen. The other three Trials assessing the effect of glycaemic control on cardiovascular outcomes, although largely negative for CV benefit, give valuable insight towards appropriate patient characteristics for which aggressive glucose control can and should be instituted. Individualising glycaemic targets, which has been the approach that many clinicians have been practising, has received new impetus albeit with clearer details. Getting to glycaemic goal early in the course of T2DM and Doing to Safely (Avoiding hypoglycaemia) are the key ingredients to successful management. The legacy of the memory of initial good metabolic/glycaemic control is investment in good health with benefits of reductions in both micro and more importantly, macrovascular disease, years later. Multifactorial interventions that include blood pressure, lipid lowering in addition to glucose control in these individuals with the Metabolic Syndrome result in more immediate beneficial additive effects on cardiovascular outcomes.

Influence of Physician Specialty on Treatment Goals for Diabetic Patients: Results of a Survey given to the Members of the Ishikawa Medical Association / General Medicine

<b>BACKGROUND</b> : This survey examined how a physician's specialty may influence attitudes towards blood glucose control in diabetic patients.<br><b>METHODS</b> : A questionnaire was mailed to all members of the Ishikawa Medical Association (n=1,610) as well as diabetic specialists (n=36) querying their specialties, confidence in offering diabetic treatment, and treatment goals/change levels of plasma glucose levels for 5 theoretical cases.<br><b>RESULTS</b> : 301 physicians responded. The percentage answering treatment goal/change levels was 93% of internal medicine physicians (n=145), 72% of surgeons (n=29), 52% of pediatricians (n=23) and 20% in other specialties (n=99). The percentage answering “I am confident in offering diabetic treatment” was 57% of internal medicine physicians, 14% of surgeons, 13% of pediatricians and 3% in other specialties. There were significant differences among specialties in the fasting plasma glucose levels in the treatment goal, and the postprandial plasma glucose change levels. Internal medicine specialists tended to give higher glucose levels than other specialties.<br><b>CONCLUSIONS</b> : The majority of physicians interested in diabetes care appear to be internal medicine specialists. Physician's specialty may influence their attitude toward glucose control in diabetic patients.

Traditionally used plants in diabetes therapy: phytotherapeutics as inhibitors of alpha-amylase activity / Plantas tradicionalmente utilizadas na terapia da diabetes: fitomedicamentos como inibidores da atividade alfa-amilase

Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycaemia. There are many and diverse therapeutic strategies in the management of Type 2 diabetes. The inhibition of alpha-amylase activity is only one possibility to lower postprandial blood glucose levels. In our in-vitro studies we could demonstrate that different plants, mostly traditionally used in common diabetic therapy in Africa or Europe, are able to inhibit alpha-amylase, which is responsible for the breakdown of oligosaccharides into monosaccharides which are absorbed. An inhibition of alpha-amylase activity of 90 percent was seen with the extract of the leaves of Tamarindus indica. To quantify inhibtion rates, acarbose was used (IC50: 23.2 µM). Highest inhibition level of acarbose in our testmodel was about 85 percent. Additionally tests with pure polyphenolic compounds might explain the biological activity of the selected plants.

Diabetes mellitus é uma desordem metabólica caracterizada pela hiperglicemia crônica. Existem diversas estratégias terapêuticas no tratamento da diabetes Tipo 2. A inibição da atividade da a-amilase é apenas uma possibilidade de reduzir os níveis de glicose posprandiais. Nos nossos estudos in vitro pudemos demonstrar que diferentes plantas, especialmente as tradicionalmente usadas em terapia comum de diabetes na África ou Europa, são capazes de inibir a a-amilase, a qual é responsável pela quebra dos oligossacarídeos em monossacarídeos, os quais são absorvidos. Uma inibição da atividade da a-amilase da ordem de 90 por cento foi observada com o extrato das folhas de Tamarindus indica. Para quantificar os graus de inibição, acarbose foi usada (IC50: 23,2 mM). O maior grau de inibição de acarbose no nosso modelo de teste foi de cerca de 85 por cento. Adicionalmente testes com compostos polifenólicos puros poderão explicar a atividade biológica das plantas selecionadas.