Estrés psicológico y angustia por diabetes en adultos con diabetes mellitus tipo 2: una revisión sistemática / Psychological Stress and Diabetes Distress in Adults with Type 2 Diabetes Mellitus: A Systematic Review / Estresse psicológico e angústia causada por diabetes em adultos com diabetes mellitus tipo 2: uma revisão sistemática

Introducción: la diabetes mellitus tipo 2 es una enfermedad crónica que puede causar estrés psicológico en el desarrollo de la enfermedad y como suceso estresante, mientras que la angustia por la diabetes se asocia con estresores como el descontrol de las concentraciones de glucosa, presencia de complicaciones agudas o crónicas, disciplina y apego en el tratamiento integral. El objetivo del estudio fue analizar la literatura científica disponible sobre el estrés psicológico y angustia por diabetes en relación con el con- trol glucémico en adultos con diabetes mellitus tipo 2. Materiales y métodos: para la búsqueda de literatura se utilizaron las bases de datos Pubmed, Medline, Biblioteca Virtual en Salud, CINAHL, EBSCO, Wiley y Google Académico. Se incluyeron artículos indexados en bases de datos con idioma inglés, español y portugués, de diseños descriptivos, correlacionales y experimentales publicados en el periodo 2010-2020. Los artículos se evaluaron a través de la lista de revisión del Joanna Briggs Institute. Resultados: se encontró que el estrés psicológico ocurre mayormente en mujeres y que la angustia por diabetes es predictora del control glucémico pobre, provoca un manejo inadecuado de la glucosa, aumenta la hemoglobina glucosilada y también es una de las causas de mortalidad en hombres. Conclusiones: los hallazgos muestran que existe mayor relación entre la angustia por diabetes y el control glucémico en estos pacientes

Introduction: type 2 diabetes mellitus is a chronic disease that can cause psychological stress in the development of the disease and as a stressful event, while diabetes distress is associated to stressors such as uncontrolled diabetes, presence of acute or chronic complications, discipline and adherence in comprehensive treatment. The aim of the study is to analyze the available scientific literature on psychological stress and diabetes distress in relation to glycemic control in adults with type 2 diabetes mellitus. Materials and methods: For the literature search, Pubmed, Medline, Virtual Health Library, CINAHL, EBSCO, Wiley and Google databases were used. Articles indexed with English, Spanish and Portuguese languages, with descriptive, correlational and experimental designs published in the period 2010 to 2020. The articles were evaluated through the Joanna Briggs Institute Check list. Results: 10 articles that met the inclusion criteria were analyzed, some studies showed an associated of psychological stress and diabetes distress with glycated hemoglobin, in addition, it was found that psychological stress is mostly in women and diabetes distress is a predictor of poor glycemic control, it causes inadequate glucose management, increases glycated hemoglobin and is also one of the causes of mortality in men. Conclusions: The findings show that there is a relationship mainly between diabetes distress and glycemic control in these patients.

Introdução: A diabetes mellitus tipo 2 é uma doença crônica que pode causar estresse psicológico no surgimento da doença e ser um evento estressante, enquanto que a angústia por diabetes está associada a estressores como os níveis glicose descontrolados, presença de complicações agudas ou crônicas, disciplina e aderência a um tratamento integral. O objetivo do estudo foi analisar a literatura científica disponível sobre o estresse psicológico e a angústia por diabetes em relação ao controle glicêmico em adultos com diabetes mellitus tipo 2. Materiais e métodos: As bases de dados Pubmed, Medline, Biblioteca Virtual en Salud, CINAHL, EBSCO, Wiley e Google foram utilizadas para a pesquisa bibliográfica. Foram incluídos artigos indexados em bases de dados em inglês, espanhol e português, com desenhos descritivos, correlacionais e experimentais publicados no período de 2010 a 2020. Os artigos foram avaliados através do Check List do Instituto Joanna Briggs. Resultados: Foram analisados 10 artigos que cumpriram com os critérios de inclusão, alguns estudos mostraram associação do estresse psicológico e angústia por diabetes com a hemoglobina glicosilada, além disso, descobriu-se que o estresse psicológico apresenta principalmente nas mulheres e a angústia por diabetes é um preditor de controle glicêmico deficiente, provocando manejo inadequado da glicose, aumentando a hemoglobina glicosilada e também, é uma das causas de mortalidade nos homens. Conclusões: Os resultados mostraram que existe uma maior relação entre a angustia por diabetes e o controle glicêmico nestes pacientes

USE OF GLYCATED HEMOGLOBIN (HBA1C) TESTING IN THE DIAGNOSIS OF DIABETES: A SYSTEMATIC REVIEW

Early detection of diabetes is of great clinical importance in order to prevent or delay its micro- and macrovascular complications. That is why, the largest diabetes associations continue their search for the most accurate, sensitive and speci?c, reliable and reproducible diagnostic assay.ADA, the International Diabetes Federation (IDF), and the European Association for the Study of Diabetes have recommended to consider the use of glycated hemoglobin (HbA1c) testing in the diagnosis of diabetes

Retrospective analysis of OGTT results of 26 558 pregnant women / 公共卫生与预防医学

Objective To investigate the prevalence of gestational diabetes mellitus (GDM) among pregnant women in Wuhan, and to explore the application value of oral glucose tolerance test (OGTT) results in the screening, diagnosis and treatment of GDM. Methods A retrospective analysis was carried out on the OGTT results of 26 558 pregnant women from Hubei Maternal and Child Health Hospital from January 2018 to December 2018. Results (1) A total of 1 754 cases were diagnosed with GDM, with a positive rate of 6.60%. Among them of 776 had fasting blood glucose ≥5.1mmol/L, 880 had 1-hour blood glucose ≥10.0mmol/L, and 798 had 2-hour blood glucose ≥8.5mmol/L. (2) The positive rates of fasting blood glucose, 1-hour blood glucose, and 2-hour blood glucose in the ≥35-year-old age group were all over two times higher than those in the <35-year-old age group (all P<0.01). (3) The ratio of people with single-point positive, two-point positive and three-point positive was 7:2:1. (4) FBG, 1-hour blood glucose and 2-hour blood glucose concentrations were all positively correlated with each other (all P＜0.01). Among these, the positive correlation between 1-hour blood glucose and 2-hour blood glucose was the most significant (r=0.618, P＜0.01). Conclusions The incidence rate of GDM among pregnant women in Wuhan reached 6.60%, and the prevalence in pregnant women over 35 years old was significantly higher. Blood glucose level during pregnancy should be monitored for early detection and intervention to prevent the development of GDM. The relationship between blood glucose concentrations at different time points in the OGTT test had reference value for clinical diagnosis and treatment.

Effect of Shenqi Maiwei Dihuangtang Combined with Acarbose on Blood Glucose Level，Body Mass Index and Abdominal Fat Thickness in Patients with Impaired Glucose Tolerance / 中国实验方剂学杂志

Objective:To explore the effect of Shenqi Maiwei Dihuangtang （SQMWDH） combined with acarbose on the level of 2-hour oral glucose tolerance test （2 h OGTT），body mass index （BMI）， and abdominal fat thickness in patients with impaired glucose tolerance （IGT）. Method:A total of 130 patients with IGT admitted to the First People's Hospital of Shuangliu District from February 2017 to January 2019 were divided into a control group and a treatment group by a random number table. All patients received conventional treatment， such as diet regulation and exercise. The patients in the control group received additional oral administration of acarbose，while those in the treatment group were treated with SQMWDH based on the control group. Fasting blood glucose （FBG），2 h OGTT， and glycated hemoglobin A1c（HbA1c）levels were measured by the blood glucose meter. Abdominal fat thickness was measured by ultrasound tomography，and serum total cholesterol （TC），triglyceride （TG），adiponectin， and leptin levels in fasting venous blood were measured. Result:After treatment，the total response rate of the treatment group was higher than that of the control group （95.00% vs. 81.67%， <italic>χ</italic>²=5.175，<italic>P</italic><0.05）. Before treatment，there was no significant difference in FBG，2 h OGTT，HbA1c， BMI，waist circumference，abdominal fat thickness，TC，TG，adiponectin， and leptin of IGT patients between the two groups. After treatment，the levels of FBG，2 h OGTT，HbA1c， BMI，waist circumference，abdominal fat thickness，TC，TG，and leptin of IGT patients were lower than those before treatment in both groups （<italic>P</italic><0.05）， and the treatment group was inferior to the control group（<italic>P</italic><0.05，<italic>P</italic><0.01）. The level of adiponectin after treatment was higher than that before treatment in both groups （<italic>P</italic><0.05），and the treatment group was superior to the control group （<italic>P</italic><0.05）. Conclusion:SQMWDH combined with acarbose is effective in treating IGT patients by effectively reducing 2 h OGTT and abdominal fat thickness to alleviate obesity and improve the constitution of patients.

Analysis of risk factors and establishment of prediction model for post transplantation diabetes mellitus in renal transplant recipients / 器官移植

Objective To analyze the risk factors for the occurrence of post transplantation diabetes mellitus (PTDM) in renal transplant recipients, establish a prediction model for PTDM and evaluate its prediction value. Methods Clinical data of 915 renal transplant recipients were retrospectively analyzed. According to the occurrence of PTDM, all recipients were divided into the PTDM group (n=78) and non-PTDM group (n=837). The main indexes of recipients were collected. The risk factors for the occurrence of PTDM in renal transplant recipients were analyzed by univariate and multivariate analysis. The prediction model for PTDM was established and its prediction value was evaluated. Results Family history of diabetes mellitus, body mass index (BMI), preoperative 2 h postprandial blood glucose and preoperative glycosylated hemoglobin were the independent risk factors for the occurrence of PTDM in renal transplant recipients. The prediction model for PTDM was logit (P)=2.199×family history of diabetes (yes=1, no=0)+0.109×BMI+0.151×2 h postprandial blood glucose (mmol/L)+0.508×glycosylated hemoglobin (%)-9.123. The results of receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of these 4 predictors combined for predicting PTDM in renal transplant recipients was 0.830 [95% confidence interval (CI) 0.786-0.873], the cut-off value was 0.0608, the sensitivity was 0.821, the specificity was 0.700, and the Youden index was 0.521 (P < 0.05). Conclusions Family history of diabetes mellitus, BMI, preoperative 2 h postprandial blood glucose and preoperative glycosylated hemoglobin are the independent risk factors for the occurrence of PTDM in renal transplant recipients. The prediction model for PTDM combined with4 predictors yield relatively high prediction value for PTDM.

Tres versiones del "Ogtt Squeezer", un programa para evaluar de un vistazo la información metabólica de la curva de tolerancia a la glucosa / Three versions of the "Ogtt Squeezer", a program to evaluate ataglance the metabolic information of the oral glucose tolerance test

El diagnóstico clínico de resistencia insulínica (RI) es difícil, ya que el Clamp no es aplicable a la clínica. El así llamado "síndrome metabólico", un predictor clínico de la RI, no identifica alrededor de la mitad de los sujetos afectados. Previamente, definimos adecuadamente (Análisis ROC) los niveles de corte diagnóstico de los siguientes predictores bioquímicos: HOMA1, HOMA2, QUICKI e ISI-Composite, a través de analizar datos de 90 sujetos (53 no resistentes y 37 resistentes) que tenían una medición directa de su resistencia insulínica (Test de supresión pancreática, TSP, Test de Reaven) y también, una curva de tolerancia a la glucosa oral (CTG). Los puntos de corte obtenidos exhibieron un mucho mejor desempeño diagnóstico comparados con los puntos de corte convencionales. También encontramos un predictor nuevo, simple, económico y eficiente, el I0*G60. Definimos la "normalidad metabólica" de la CTG usando las medianas de los valores de varios parámetros en 312 sujetos con un G120 dentro de los 2 primeros terciles del grupo de normo-tolerantes a la glucosa (NGT, n=468; G120: 51-110 mg/dL, los con mejor función beta insular). A las medianas de la función beta insular y de la sensibilidad insulínica se les asignó un valor de un 100%. Se calculó el % relativo de función beta insular (%RFBI) y el % relativo de sensibilidad insulínica (%RSI) del resto de la cohorte (n=573) contra estos valores de referencia. El "OGTT Squeezer" se escribió en Excel. Las glicemias y las insulinemias de la CTG fueron las entradas del programa. Las salidas fueron: I0*G60, ISI-OL, QUICKI, and HOMA1 (predictores) y el índice insulinogénico, el índice de disposición, %RFBI y %RSI (parámetros). El programa también caracterizó la tolerancia glucídica de acuerdo a los criterios de la ADA 2003. El formato final del programa, HTML 5, facilita su uso. Desarrollamos tres versiones del programa: completa, abreviada y mínima.

Clinically, diagnosing insulin resistance (IR) is difficult since the Clamp is not applicable to clinical work. The so-called "Metabolic Syndrome", a clinical surrogate of IR, fails to identify around 50% of affected subjects. Previously, we properly defined (ROC Analysis) the diagnostic cut-offs of the following biochemical predictors: HOMA1, HOMA2, QUICKI, and ISI-Composite by analyzing data from 90 subjects (53 non-insulin-resistant and 37 insulin-resistant subjects) who had a direct measurement of insulin resistance (Pancreatic Suppression Test, PST, Reaven's Test), and also, an Oral Glucose Tolerance Test (OGTT). The resulting cut-offs exhibited much better performances compared with the conventional cut-offs. We also found a new, simple, inexpensive and efficient predictor, the I0*G60. We chose to define the "metabolic normalcy" of the OGTT by using the median values of several parameters in 312 NGT subjects with a G120 in the first 2 tertiles of the NGT group (n=468; G120: 51-110 mg/dL, those with the best beta-cell function). The median values of both Beta-Cell Function and Insulin Sensitivity of these subjects were assigned a 100% value. Both % Relative Beta-Cell Function (%RBCF) and % Relative Insulin Sensitivity (%RIS) of everyone else in the cohort (n=573) was calculated against these reference values. The "OGTT Squeezer" was written in Excel. The OGTT's glucose and insulin values served as the inputs of the program. The outputs were: I0*G60, ISI-OL, QUICKI, and HOMA1 (predictors), and Insulinogenic Index, Disposition Index, %RBCF, and %RIS (parameters). Moreover, the program characterized the OGTT according to the ADA 2003 criteria. The HTML 5 format of the program facilitates its use. We developed 3 versions of the program: complete, abbreviated, and minimal versions.

Circulating Spexin levels in pregnant women with and without gestational diabetes

Background: Several previous studies suggest that SPX plays a role in appetite control and body weight and blood glucose regulation. The aim of this study to determine SPX levels in healthy pregnancies and in gestational diabetes (GDM) and to investigate the association of SPX levels with weight gain and lipid and glucose metabolism in subjects with and without GDM.Methods: A total of 44 women with GDM and 44 women without GDM were randomly enrolled who applied for GDM screening during the 24-28th week of pregnancy. Demographics, blood glucose and lipid profiles and Spexin levels were compared between groups.Results: The mean age, BMI, and weight gain during pregnancy were higher in the GDM group. The LDL cholesterol, Hba1c, SPX and glucose levels in response to OGTT were higher in the GDM group. The SPX levels were correlated with Hba1c and blood glucose levels after OGTT, and were not correlated with the age, BMI, weight gain during pregnancy, lipid parameters, and fasting blood glucose levels in the whole study population.Conclusions: SPX levels were higher in the GDM group compared with non-GDM group and SPX levels were correlated with HbA1c levels and post-OGTT glucose levels but not with fasting glucose levels.

Retracted: Prevalence of gestational diabetes mellitus and associated risk factors amongst antenatal women attending urban health centre of Rajkot City, Gujarat

The article "Prevalence of gestational diabetes mellitus and associated risk factors amongst antenatal women attending urban health centre of Rajkot City, Gujarat" is retracted by the Editor-in-Chief, due to violation of the policies and practices of International Journal of Community Medicine and Public Health. The article is retracted due to dispute in authorship.

Prevalence of glucose abnormalities in polycystic ovary syndrome women and evaluating the efficacy of fasting blood glucose in detecting these glucose abnormalities compared to glucose tolerance test

Background: Polycystic ovarian syndrome (PCOS) is the most commonly prevalent endocrinopathy of reproductive age women. It is a significant public health issue with reproductive, metabolic and psychological features. Because patients with PCOS are at high risk for developing glucose abnormalities, the early identification of affected patients and institution of life style changes or pharmacological treatment may help reduce the long-term risks associated with PCOS. This study was done to assess the prevalence of glucose abnormalities and to evaluate the efficacy of Fasting blood glucose (FBG) in detecting glucose abnormalities when compared to 2 hrs oral glucose tolerance test (OGTT).Methods: Hospital based cross sectional study carried out in 300 women diagnosed as PCOS according to Rotterdam criteria. In patients diagnosed as PCOS, Fasting Blood Glucose and OGTT were done. OGTT taken as an accurate test and FBG values compared with OGTT values to evaluate the efficacy of FBG. Prevalence of glucose abnormalities and association with age, BMI and clinical features was evaluated.Results: Glucose abnormalities were detected in 69 (23%) women with 2 hours OGTT, but with FBG only in 49 (16.33%) women, around one third of women were missed. Sensitivity of FBG was 71.01% (95% CI 58.84% to 81.31%). Mean age of women with abnormal OGTT (27.99) was significantly higher than the women with normal OGTT (24.7). Mean BMI of women with abnormal OGTT (27.42) was significantly higher than the Mean BMI of women with normal OGTT (23.36).Conclusions: Sensitivity of FBG was low in detecting glucose abnormalities. Increasing age, increase in a BMI, menstrual abnormalities, hirsutism/acne and family history of diabetes appear to have positive linear correlation with prevalence of glucose abnormalities.

Can single plasma glucose value 2 hours after 75g glucose (DIPSI criteria) replace the gold standard OGTT for the diagnosis of gestational diabetes mellitus?

Background: Gestational diabetes mellitus is a common medical complication of pregnancy associated with several fetal and maternal complications. There are several screening tools for detecting gestational diabetes mellitus including recent DIPSI criteria of non-fasting single plasma 2-hour value after 75 grams glucose (single step test). The  present study was aimed at calculating  prevalence of GDM, sensitivity and specificity using  non-fasting single plasma 2-hour value after 75 grams glucose for screening and diagnosis of gestational diabetes mellitus and to study the high-risk characteristics for GDM in this study population.Methods: This was a prospective study conducted for a period of one year. 750 antenatal women attending Antenatal outpatient department(OPD) with period of gestation 24-28 weeks were enrolled in the study. All women  were first tested by 75 gm glucose and then by OGTT for confirmation. Prevalence rates, sensitivity, specificity, positive predictive value and negative predictive value were studied. History based questionnaire was used to study the risk characteristics for GDM.Results: Prevalence rate, sensitivity, specificity, positive predictive value and negative predictive value for patients were 14.13%, 73.58%, 95.03%, 70.90% and 95.67%. Among the risk factors 7.2% patients were more than 30 years in age. 0.93% had GDM in previous pregnancy.4.21% had GCA in previous pregnancy, 12.4% had SB/IUD/NND in previous pregnancy. 1.17% had previous pregnancy with birth weight more than 3.5 kg and 9.73% had family history of diabetes mellitus. Past history of GDM (50%) was the most common risk factor in GDM group followed by age > 30 years (29.6%), and family history (24.6%).Conclusions: Screening using DIPSI criteria has good sensitivity and negative predictive values. It can serve as both screening and diagnostic test besides being simple, user friendly, cost effective and evidence-based test in less resource countries like India.

Inhibition of dipeptidyl peptidase IV by fexofenadine: Virtual screening study

Dipeptidyl peptidase IV (DPP IV) is relatively new anti-diabetic target. DPP IV inhibitors lower fasting andpostprandial glucose concentrations by preventing the degradation of the natural hypoglycemic incretin hormones:glucose-dependent insulinotropic peptide and glucagon-like peptide-1. In this work, the high throughput dockingsoftware FRED was used as a virtual screening tool against in house built drug database to discover new DPP IVinhibitors. One of the highest ranking hits, the antihistamine drug fexofenadine, was found to inhibit recombinanthuman DPP IV in vitro with IC50 = 4.6 (±1.0) µM. The anti-diabetic effect of fexofenadine was validated in vivo byoral glucose tolerance test. These results could be helpful in the development of novel DPP IV inhibitors based onfexofenadine scaffold for the treatment of type 2 diabetes.

Hypoglycemic effect of okra extract on type 2 diabetic mice and correlation with TNF-α and IDE / 中草药

Objective: To analyze the hypoglycemic effect of okra (Abelmoschus esculentus) extract on the hyperlipidemia and streptozotocin (STZ)-induced type 2 diabetic mice and the correlation between TNF-α and IDE. Methods: The diabetic mice were induced by high fat diet followed by a low dose of streptozotocin (STZ) and randomly divided into control group, diabetic model group, okra alcohol extract high, medium, and low dose (400, 200, and 100 mg/kg) groups, okra aqueous extract high, medium, and low dose (200, 100, and 50 mg/kg) groups. After the exposure to conventional or different treatment groups for 40 d, fasting blood sugar, glucose tolerance, related biochemical indexes in serum and liver tissue, and liver HE staining pathological sections were measured. Results: The okra alcohol extract high dose group and okra aqueous extract middle dose group effectively reduced the mice fasting blood glucose and improved oral glucose tolerance in mice, inhibited of type 2 diabetes mellitus rats serum TC, TG, LDL-C, ALT, AST, and mRNA expression of TNF-α and IDE in the rats liver. Conclusion: The okra alcohol extract with high dose and the okra aqueous extract with middle dose could reduce TC, TG, LDL-C, while increase HDL-C to improve the mouse obesity, and hyperlipidemia symptoms. And hypoglycemic and liver protection and TNF-α and IDE gene expression levels have a certain correlation.

Inhibition of puerarin on sodium-dependent glucose cotransporters 2 to promote urinary glucose excretion / 药物评价研究

Objective To study that puerarin can prevent the renal glucose reabsorbtion process and promote urinary glucose excretion by inhibiting sodium-dependent glucose cotransporters 2 (SGLT2) to reduce plasma glucose in diabetes rats.Methods Molecular docking was carried out on puerarin and the obtained SGLT2 complexes through homology modeling method with dapagliflozin as positive control.Chinese hamster ovary (CHO) cells stably expressing human SGLT2 and [14C]-MethylD-glucopyranoside ([14C]-AMG) as the substrate were used in vitro for the transport assays and IC50 for SGLT2.The antihyperglycemic activity ofpuerarin was operated by oral glucose tolerance test (OGTT) and urinary glucose excretion (UGE) test in rats.Results Puerarin was identified as the substrate of SGLT2 through molecular docking,but the overall effect was not as strong asdapagliflozin.In vitro experiments showed that puerarin can strongly inhibit hSGLT2,the maximum effect was about 84％ with the half inhibitory concentration (IC50) of 0.40 mol/L.OGTT results showed that glucose inhibition rates of puerarin 10,30,60 and 120 mg/kg doses were 5.1％,6.5％,16％,and 22％ respectively,in a dose-dependent manner.In the UGE experiment,the urine sugar increased with the increase of puerarin dose.Compared with model group,the 30,60,and 120 mg/kg dose groups had significant difference (P ＜ 0.05 and 0.01).Conclusion Puerarin exhibited antiglycemic activity through inhibiting SGLT2 and was considered to be a new lead compound of SGLT2 inhibitors.

Maternal 75-g OGTT glucose levels as predictive factors for large-for-gestational age newborns in women with gestational diabetes mellitus

ABSTRACT Objective Our goal was to investigate which glucose measurement from the 75-g oral glucose tolerance test (OGTT) has more capability of predicting large for-gestational-age (LGA) newborns of mothers with gestational diabetes mellitus (GDM). Subjects and methods The study group consisted of 118 consecutively pregnant women with singleton pregnancy, patients of Outpatients Department of the Endocrinology, Diabetes, and Metabolic Disorders Clinic. All were prospectively screened for GDM between 24th and 28th week of pregnancy and followed to delivery. Outcome measures included: patients’ ages, pre-pregnancy BMI, BMI before delivery, FPG, 1 and 2 hour OGTT glucose values, haemoglobin A1c at third trimester, gestational week of delivery, mode of delivery and baby birth weight. Results From 118 pregnancies, 78 (66.1%) women were with GDM, and 40 (33.9%) without GDM. There were statistically significant differences (30.7 versus 5.0%, p < 0.01) between LGA newborns from GDM and control group, respectively. Gestation week of delivery and fasting glucose levels were independent predictors for LGA (Beta = 0.58 and Beta = 0.37 respectively, p < 0.01). Areas under the receiver operator characteristic curve (AUC) were compared for the prediction of LGA (0.782 (0.685-0.861) for fasting, 0.719 (0.607-0.815) for 1-hour and 0.51 (0.392-0.626) for 2-hour OGTT plasma glucose levels). Conclusion Fasting and 1-hour plasma glucose levels from OGTT may predict LGA babies in GDM pregnancies.

Preparation and therapeutic evaluation of rutin-phospholipid complex for antidiabetic activity.

The objective of the present work to prepare Rutin-phospholipid complex (RPC), a phytoformulation and characterization, evaluation for its antidiabetic activity in streptozotocin induced diabetic model. Prepared RPC was characterized and screened for antidiabetic activity by OGTT in normoglycemic and diabetic rats for RT and RPC at different time intervals. Effect of RT and RPC (50 and 100 mg/kg b.w. p.o. respectively) in STZ induced diabetic rats for one day and fifteen days was studied. This is followed by estimation of Estimation of SG, and lipid parameters. Histopathology studies of pancreatic tissue and bioavailability studies of RT & RPC were also carried out. SEM data showed that RPC has irregular size vesicles consisting of phosphatidylcholine. RPC showed a single endothermal peak at 147.68°C in DSC studies. OH group has shifted to lower frequency in phytosome compared to rutin phospholipid in FTIR spectra. Treatment with RPC (50 and 100 mg/kg b.w. p.o.) significantly reduced the blood glucose levels and restored the altered lipid parameters as compared to RT. Histopathological studies revealed that RPC also restored back the size of pancreatic islets and maintained the normal β-cells. A higher serum concentration of RT (13.20 μg/mL) in RPC treated group was observed in bioavailability studies as compared to RT. RPC maintained effective concentration of rutin for a longer period in rat serum.

Effects of Impaired ATP Production and Glucose Sensitivity on Human β-Cell Function: A Simulation Study / Efecto de Alteraciones en la Producción de ATP y la Sensibilidad a la Glucosa en el Funcionamiento de la Célula β Humana: un Estudio de Simulación

In this paper we used a mathematical model to explore the effects of impaired ATP production and glucose sensitivity on the electrical response and insulin secretion of human β-cells. The model was extended by the addition of explicit empirical equations that describe recent experimental observations, namely, the increase of ATP as a function of glucose concentration and the oscillations in ATP at high glucose levels. Simulations were performed at selected glucose concentrations from an oral glucose tolerance test in normal subjects to evaluate the response of the human β-cell in normal and pathological scenarios. Our simulations reproduced experimental observations, such as the impaired insulin secretion as a consequence of β-cell dysfunction and restoration of electrical activity by the use of a sulfonylurea. Our results suggest that both reduced glucose sensitivity and impaired ATP production could be related to the pathogenesis of type 2 diabetes.

En este artículo usamos un modelo matemático para explorar los efectos de alteraciones en la producción de ATP y sensibilidad a la glucosa en la respuesta eléctrica y la secreción de insulina en células β humanas. El modelo fue extendido al añadir ecuaciones empíricas explícitas que describen recientes observaciones experimentales, como el incremento en el ATP como función de la concentración de glucosa y las oscilaciones en el ATP a altos niveles de glucosa. Se realizaron simulaciones a niveles de glucosa alcanzados durante una prueba de tolerancia a la glucosa para evaluar la respuesta de la célula β humana en escenarios normales y patológicos. Nuestras simulaciones reprodujeron varias observaciones experimentales, tales como la secreción de insulina alterada como consecuencia de la disfunción de la célula β y la restauración de la actividad eléctrica al aplicar una sulfonilurea. Nuestros resultados sugieren que tanto una reducción en la sensibilidad a la glucosa como la alteración en la producción de ATP podrían estar relacionadas a la patogénesis de la diabetes tipo 2.

In vitro α-amylase inhibitory activity and in vivo hypoglycemic effect of methanol extract of Citrus macroptera Montr. fruit

Objective: To investigate the therapeutic effects of methanol extract of Citrus macroptera Montr. fruit in α-amylase inhibitory activity (in vitro) and hypoglycemic activity in normal and glucose induced hyperglycemic rats (in vivo). Methods: Fruits of Citrus macroptera without rind was extracted with pure methanol following cold extraction and tested for presence of phytochemical constituents, α-amylase inhibitory activity, and hypoglycemic effect in normal rats and glucose induced hyperglycemic rats. Results: Presence of saponin, steroid and terpenoid were identified in the extract. The results showed that fruit extract had moderate α-amylase inhibitory activity [IC

In vitro α-amylase inhibitory activity and in vivo hypoglycemic effect of methanol extract of Citrus macroptera Montr. fruit

Objective: To investigate the therapeutic effects of methanol extract of Citrus macroptera Montr. fruit in α-amylase inhibitory activity (in vitro) and hypoglycemic activity in normal and glucose induced hyperglycemic rats (in vivo). Methods: Fruits of Citrus macroptera without rind was extracted with pure methanol following cold extraction and tested for presence of phytochemical constituents, α-amylase inhibitory activity, and hypoglycemic effect in normal rats and glucose induced hyperglycemic rats.Results:showed that fruit extract had moderate α-amylase inhibitory activity [IC50 value=(3.638±0.190) mg/mL] as compared to acarbose. Moreover at 500 mg/kg and 1 000 mg/kg doses fruit extract significantly (P<0.05 and P<0.01 respectively) reduced fasting blood glucose level in normal rats as compared to glibenclamide (5 mg/kg). In oral glucose tolerance test, 500 mg/kg dose significantly reduced blood glucose level (P<0.05) at 2 h but 1000 mg/kg dose significantly reduced blood glucose level at 2 h and 3 h (P<0.05 and P<0.01 respectively) whereas glibenclamide (5 mg/kg) significantly reduced glucose level at every hour after administration. Overall time effect is also considered extremely significant with F value=23.83 and P value=0.0001 in oral glucose tolerance test.Conclusion:These findings suggest that the plant may be a potential source for the development Presence of saponin, steroid and terpenoid were identified in the extract. The results of new oral hypoglycemic agent.

Simulation of Oral Glucose Tolerance Tests and the Corresponding Isoglycemic Intravenous Glucose Infusion Studies for Calculation of the Incretin Effect

The incretin effect, which is a unique stimulus of insulin secretion in response to oral ingestion of nutrients, is calculated by the difference in insulin secretory responses from an oral glucose tolerance test (OGTT) and a corresponding isoglycemic intravenous glucose infusion (IIGI) study. The OGTT model of this study, which is individualized by fitting the glucose profiles during an OGTT, was developed to predict the glucose profile during an IIGI study in the same subject. Also, the model predicts the insulin and incretin profiles during both studies. The incretin effect, estimated by simulation, was compared with that measured by physiologic studies from eight human subjects with normal glucose tolerance, and the result exhibited a good correlation (r > 0.8); the incretin effect from the simulation was 56.5% +/- 10.6% while the one from the measured data was 52.5% +/- 19.6%. In conclusion, the parameters of the OGTT model have been successfully estimated to predict the profiles of both OGTTs and IIGI studies. Therefore, with glucose data from the OGTT alone, this model could control and predict the physiologic responses, including insulin secretion during OGTTs and IIGI studies, which could eventually eliminate the need for complex and cumbersome IIGI studies in incretin research.

In vitro α-amylase inhibitory activity and in vivo hypoglycemic effect of methanol extract of Citrus macroptera Montr. fruit

<p><b>OBJECTIVE</b>To investigate the therapeutic effects of methanol extract of Citrus macroptera Montr.fruit in α-amylase inhibitory activity (in vitro) and hypoglycemic activity in normal and glucose induced hyperglycemic rats (in vivo).</p><p><b>METHODS</b>Fruits of Citrus macroptera without rind was extracted with pure methanol following cold extraction and tested for presence of phytochemical constituents, α-amylase inhibitory activity, and hypoglycemic effect in normal rats and glucose induced hyperglycemic rats.</p><p><b>RESULTS</b>Presence of saponin, steroid and terpenoid were identified in the extract. The results showed that fruit extract had moderate α-amylase inhibitory activity [IC50 value=(3.638±0.190) mg/mL] as compared to acarbose. Moreover at 500 mg/kg and 1 000 mg/kg doses fruit extract significantly (P<0.05 and P<0.01 respectively) reduced fasting blood glucose level in normal rats as compared to glibenclamide (5 mg/kg). In oral glucose tolerance test, 500 mg/kg dose significantly reduced blood glucose level (P<0.05) at 2 h but 1 000 mg/kg dose significantly reduced blood glucose level at 2 h and 3 h (P<0.05 and P<0.01 respectively) whereas glibenclamide (5 mg/kg) significantly reduced glucose level at every hour after administration. Overall time effect is also considered extremely significant with F value=23.83 and P value=0.0001 in oral glucose tolerance test.</p><p><b>CONCLUSION</b>These findings suggest that the plant may be a potential source for the development of new oral hypoglycemic agent.</p>