Mechanism Exploration of TG Regulating PI3K/Akt to Improve Insulin Resistance in Liver of T2DM Rats Based on Transcriptomics / 中国实验方剂学杂志

ObjectiveTo investigate the effect of Tangzhi pills on the improvement of insulin resistance （IR） in the liver with type 2 diabetes （T2DM） by regulating phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway based on differential genes and its possible molecular mechanism. MethodT2DM rat models were prepared by high fat （HFD） diet combined with streptozotocin （STZ） intraperitoneal injection. The experiment was divided into blank group， model group， metformin hydrochloride group （0.18 g·kg-1）， Tangzhi pills high （1.08 g·kg-1）， medium （0.54 g·kg-1） and low （0.27 g·kg-1） dose groups. Rat serum， liver， and pancreatic tissue were collected， and the pathological tissue of the liver and pancreas was observed using hematoxylin-eosin （HE） staining. The fasting blood glucose level （FBG） was detected， and oral glucose tolerance （OGTT） tests were conducted. Enzyme-linked immunosorbent assay （ELISA） was used to detect fasting serum insulin （FINS） and glycated hemoglobin （GHb） levels in rats. IR homeostasis model index （HOMA-IR）， β cellular homeostasis index （HOMA-β）， and insulin sensitivity index （ISI） were calculated. Biochemical methods were used to determine the levels of triglyceride （TG）， total cholesterol （TC）， low-density lipoprotein （LDL-C）， and high-density lipoprotein （HDL-C） in rat serum. Transcriptomics obtained differentially expressed mRNA from liver tissue and enriched differentially expressed pathways. Real-time reverse transcriptase polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of cyclic adenylate responsive element binding protein 3-like protein 2 antibody （CREB3l2）， B-lymphocyte tumor 2 （Bcl-2）， Toll-like receptor 2 （TLR2）， cyclin-dependent kinase inhibitor 1A （CDNK1A）， and DNA damage induced transcription factor 4-like protein （DDIT4） in liver tissue. Western blot was used to detect the protein expression of phosphorylated phosphatidylinositol 3-kinase （p-PI3K）， phosphorylated protein kinase B （p-Akt）， glucose transporter 4 （GLUT4）， insulin receptor （INSR）， and insulin receptor substrate 2 （IRS2）. ResultThe pharmacodynamic experiment results showed that compared with model group， Tangzhi pills groups repaired liver and pancreatic tissue to varying degrees， reduced blood sugar （P<0.01）， and promoted a decrease in serum FINS， GHb， and HOMA-IR （P<0.05， P<0.01）. In addition， HOMA-β and ISI increased （P<0.05， P<0.01）. The levels of TC， TG， and LDL-C decreased （P<0.05， P<0.01）， while the levels of HDL-C increased （P<0.05， P<0.01）. The transcriptomics experimental results confirmed that the PI3K/Akt signaling pathway was significantly expressed in both the blank group and model group， as well as in the high-dose Tangzhi pills group and model group. CDNK1A， DDIT4， CREB3l2， Bcl-2， and TLR2 were significantly differentially expressed mRNA during TG intervention in T2DM. Compared with the model group， the protein expression of p-PI3K， p-Akt， GLUT4， INSR， and IRS2 increased in all Tangzhi pills groups （P<0.01）. The mRNA expression of CREB3l2， Bcl-2， and TLR2 increased （P<0.01）， while that of CDNK1A and DDIT4 decreased （P<0.01）. ConclusionTangzhi pills may regulate the PI3K/Akt signaling pathway based on the differential mRNA expression of CREB3l2， Bcl-2， TLR2， CDNK1A， and DDIT4， thereby improving IR in the liver with T2DM.

Exploring the role of CBT in the self-management of type 2 diabetes: A rapid review

Background: Type 2 diabetes has been recognised as a global health concern: one that requires intervention to lessen the incumbrance caused by the chronic illness. This rapid review was conducted to determine the scientific evidence available on how Cognitive Behaviour Therapy (CBT) interventions improved the self-management of individuals with type 2 diabetes. Aim: The aim of the review was to synthesise current scientific evidence regarding CBT-based interventions and self-management practices. Method: The rapid review served as a framework to appraise current national and international literature. The researchers used Google Scholar, Journal Storage (JSTOR), PsycINFO, APA PsycArticles, SAGE journals and EBSCO Discovery Services to search for relevant studies. This was performed by employing keywords. Nine relevant studies were identified. The studies were heterogenous in methodology. Seven of the nine studies were conducted in developing countries. Results: The study found that the context of developmental countries plays a significant role in the development of type 2 diabetes and requires tailored intervention because of socio-economic variabilities. The main themes identified in relation to improving self-management included: the characteristics of the CBT-based interventions, namely the format, duration, and outcomes, and identifying the techniques and components used in the CBT-based interventions. Conclusion: The review emphasised the need to further investigate the role of CBT in improving self-management of type 2 diabetes, especially in a South African context.

Discussion on Pathogenesis and Treatment of Type 2 Diabetes from Perspective of Intestinal Microecology / 中国实验方剂学杂志

Diabetes is a kind of disease which poses a great threat to human health. Its occurrence and development are often related to many factors such as heredity and environment. According to the eighth edition of Diabetes Federation's diabetes map in 2017， there are about 425 million diabetics in the world. It is estimated that by 2045， the number of diabetics will increase to 700 million， becoming a health problem that has attracted increasing attention all over the world， among which the number of type 2 diabetics （T2DM）accounts for more than 90% of the total. Therefore， it is of great significance to study the pathological mechanism for the effective prevention and treatment of diabetes. Intestinal microflora coexists with human beings and forms an important micro ecosystem， which is involved in the metabolism of substance and energy. In recent years， with the development of high-throughput sequencing technology， a large number of studies have shown that in addition to obesity， genetic and insulin dysfunction， intestinal flora disorder may also lead to diabetes. The unbalanced diet structure of T2DM patients destroys the balance of intestinal flora. It is generally believed that the occurrence and development of T2DM may be one of the results of the intestinal microbial disorder caused by over nutrition. However， there is no clear mechanism of how intestinal flora participates in the development of T2DM. At present， it is generally believed that the intestinal flora may affect the metabolism of the body through the participation in bile acid metabolism， short chain fatty acid metabolism， low-level inflammatory response and other ways. At present， the prevention and treatment of T2DM is mainly based on drug control. Through surgical operation， increasing the number of probiotics， fecal transplantation and other methods to intervene the intestinal microflora to adjust the intestinal microflora， it provides a new means for the prevention and treatment of T2DM. This paper discusses the interaction between T2DM and intestinal microflora in recent years and the possible treatment measures in the future.