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The management of obesity is changing dramatically with the emergence of new drug treatments. Glucagon-like peptide-1 (GLP-1) receptor agonists are approved for this indication in Switzerland, and approval is currently being sought for a GLP-1 and glucose-dependent insulinotropic polypetide (GIP) co-agonist. Reimbursement conditions are restrictive, and patients are given only one opportunity to achieve the weight loss required for continued reimbursement. The popularity of these treatments has led to worldwide stock-outs for several months now, and it is essential that prescribers respect the indications so as not to prejudice obese patients. This article provides a review of the treatments available and the conditions under which they are reimbursed, as well as those that should be reimbursed soon., Competing Interests: L’auteure ne déclare aucun conflit d’intérêts en relation avec cet article.

Neurons have a high energy need, requiring a continuous supply of glucose from the blood. Tight regulation of glucose metabolism in response to stimuli is essential for brain physiology. Glucose metabolism and cerebral blood flow are closely coordinated during neuronal activity to maintain proper brain function. Glucose uptake across the blood-brain barrier is facilitated by a carrier protein: the GLUT-1 transporter. The first way the body meets urgent demand for glucose is to increase the blood flow through vasodilatory responses generated by nitric oxide. If that is insufficient, the second way is to increase the density of GLUT-1 through the translocation of this transporter from intracellular stores. The third pathway is to increase GLUT-1 synthesis by stimulating SLC2A1 (GLUT-1 gene) transcription. A tandem of two key molecules, free estradiol and DHA, is involved in this critical regulation. Their relationship is synergistic and reciprocal: free estradiol with genomic and non-genomic actions via ERα, and DHA via the PPARα-RXRα and PPARɣ-RXRα heterodimers. We highlight several original mechanisms linking two main principles (neuronal stimulation and brain energy metabolism) with the fundamental roles played by DHA and free estradiol. In particular, it has been shown that from a certain level of chronic DHA deficiency, a permanent imbalance sets in with disturbances in glucose intake and brain metabolism. This DHA deficiency is an aggravating factor in some neuropathologies.

Type 1 diabetes mellitus (T1DM) is a disease characterized by the insufficient insulin in a genetically prepared people, and mostly appeared at young ages. Therefore, T1DM is a chronic metabolic disease, and like other metabolic diseases, it associates with elevated oxidative state. Reactive oxygen species (ROS) are metabolites with high reactivity that can cause a diverse destruction to the cellular compartments. Proteins are clear targets for ROS, in which yields oxidized proteins, including protein carbonyls. In the present study, our goal was to determine the oxidative status of T1DM patients by using protein carbonyls as a biomarker. The relationship of protein carbonyl with serum electrolytes (Na+, and K+) were investigated as well. The study was included 60 adolescent with T1DM disease, and 30 healthy adolescent as control. The level of protein carbonyl was elevated significantly in the serum of T1DM patients (24.17±5.93 ng/mL) compared to the control adolescent (12.77±3.11 ng/mL). On the other hand, the levels of both Na and K were reduced in the serum of T1DM patients. The level of oxidative stress was reached the oxidative damage of proteins systemically in these patients. This may results in increasing the health risks of diabetes and may influence the proper growth of these adolescents. No association was observed between protein carbonyl and electrolytes in T1DM patients, but a significant association was obtained between glucose levels and Na levels. We suggest the administration of antioxidants with glycemic control in T1DM patients.

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The aim of this study was to investigate the ability of the filamentous fungus Trichoderma harzianum to secrete lipolytic activity and examined the influence of carbon on lipase production. A quantitative analysis of lipase activity was performed by the titration method using olive oil as a substrate. The isolated strain was cultivated in shaking flasks containing basal media and supplemented with olive oil 1 % (v / v) as lipid source. The effect of other carbon sources added to basal medium as lauric acid ester (Tween 80) and glucose was tested to improve enzyme production. Maximum biomass was produced at a concentration of (1906 mg∙mL-1 ± 4.58) and (622.5 mg∙mL-1 ± 9.19) in mineral medium supplemented with glucose (2 %) and Tween 80 respectively. However, the lipase activity was maximal for olive oil (1.58 IU∙mL-1 min-1 ± 0.11). The result obtained in this study indicated that olive oil proved to be the best inducer and stimulated lipase production. Glucose and Tween 80 supplied as additional carbon sources have not enhanced the lipase production, whereas they only increased the biomass of T. harzianum.

Glucose and fructose (2.0% (w/v)) were used as the carbon sources and peptone was used as nitrogen source (1.5% (w/v)) in order to determine the kinetics study and yield of bacterial cellulose production. Coconut water was prepared as the fermentation medium. Data of the fermentation rate was observed at 19 points of certain time during 7 days of fermentation process. The number of cell biomass was calculated using cell dried weight method, total plate count method and optical density method which was observed at 660 nm. The remaining media substrate was analyzed using the DNS method, while the BC yield was determined by the gravimetric method. The results showed that the best values of μ, Td, Rx, Rs, Rp, Yp/s, Yp/x were achieved by fructose, while the best n and Yx/s value were achieved by glucose. The corresponding values were 0,1141/h, 6,0737 h, 0,1141 g/L/h, 0,0635 g/L/h, 0,3015 g/L/h, 0,317 g/g, 0,5927 g/g 1,3631 times and 0,0983 g/g respectively. The highest BC yield at the end of fermentation process was achieved by glucose carbon at 5.83 g/L, followed by fructose at 4.91 g/L.

Competing Interests: Intérêts concurrents: Matthew Lanktree a reçu des honoraires de conférencier d’Otsuka et des honoraires pour sa participation à des comités consultatifs pour Bayer, Otsuka, Reata et Sanofi. Ces honoraires étaient sans lien avec les inhibiteurs du SGLT2. Aucun autre intérêt concurrent n’a été déclaré.

This study aims to evaluate the neoglucogenic capacity in camel and was carried out on six 3 years old male dromedaries (Camelus dromedarius), weighting around 300 kg. Two dynamic tests were performed; intravenously and orally. The infusion concerned some precursors of gluconeogenesis such as propionate and propylene glycol and, to a lesser degree, the acetate. Oral administration interested, glucose, fructose and sucrose. The results of this study show that, during both tests, blood glucose rises and remains at a high value for a longer period compared to other conventional ruminants (cattle, sheep, goat). [ABSTRACT FROM AUTHOR]

The paper using sugarcane pith as a raw material, the feasibility of aluminum hydroxide Lewis acid combined with microwave conditions to be used as a resource was investigated.Under the conditions of the combination of stellate acid and microwave, the 5-hydroxymethyl furfural (5-HMF) in 0.9% of the liquid phase product can be detected, and its low yield of 0.9% is worthy of further improvement. Economic analysis shows that the added value of 5-HMF produced by Lewis acid combined with microwave is as high as about 30,000 yuan per ton, and the prospect of resource utilization is huge. Use oxalic acid to hydrolyze the remaining cellulose and hemicellulose after 5-HMF is prepared from sugarcane pith to glucose, which is used in food and related products. It has very important application value in the industry. In this paper, the hemicellulose in cane pith is converted to 5-HMF under microwave reaction conditions, and then the remaining residue of the reaction is hydrolyzed with oxalic acid to produce glucose, which provides theoretical basis and technical support for further research on the high-value utilization of sugar cane pith in the future.

We present the case of a 69-year old man who was brought to the hospital after being found unconscious; last seen at baseline 9 hours prior. On admission he was found to be severely hypoglycemic and received prompt glucose administration, with no immediate neurological improvement. Stroke was suspected. A brain MRI revealed abnormal hyperintense signal involving the head and tail of the left hippocampus. After close neurological monitoring and supportive care in the ICU, his condition improved over time, leaving no residual focal deficits. This case highlights the presence of MRI changes in patients with severe hypoglycemia as it happens in hypoglycemic coma.

Optimal brain performance is intimately linked to the brain’s Yin and the Yang − the balance between its structure and its energy metabolism. This relationship is clearly exemplified in infant brain development and in Alzheimer’s disease, and probably also applies to human brain evolution. In these examples, redundant pathways help achieve this important balance. For instance, the key structural lipid for the brain, docosahexaenoic acid (DHA), is supplied to the infant brain from at last three overlapping sources: (i) milk; (ii) infant’s own fat stores and (iii) by some endogenous synthesis from α-linolenic acid (ALA) or eicosapentaenoic acid (EPA). On the energy side, glucose is normally the brain’s main fuel but under conditions of prolonged starvation, it can be almost totally replaced by the ketone bodies, acetoacetate and β-hydroxybutyrate. When ketones are present in the blood they spare glucose uptake by the brain because they are actually the brain’s preferred fuel and are essential for normal infant brain development. The redundant sources of ketones are long chain fatty acids (including the relatively ketogenic ALA) in infant stores, and medium chain triglycerides (MCT) in milk. Besides infancy, nowhere is the strain on the brain’s balance between yin and yang more apparent than in Alzheimer’s disease (AD). One of the reasons why attempts to treat AD have largely failed could well be because chronically inadequate glucose supply to some areas of the brain on the order of 10% is present in people at risk of AD long before cognitive decline begins. However, brain ketone uptake is still normal even in moderately advanced AD. Hence, treatments that ignore the brain energy (glucose) deficit in AD would be predicted to fail, but treatments that attempt to rescue brain fuel availability via ketones would be predicted to have a better chance of succeeding. By analogy to ketones sparing glucose for brain energy metabolism, perhaps ALA or EPA entering the brain can help spare (conserve) DHA for its structural role. If so, it would not necessarily be futile to transport ALA and EPA into the brain just to β-oxidize the majority afterwards; DHA sparing as well as ketone production could be important beneficiaries.

Copyright of Archives de l'Institut Pasteur de Tunis is the property of Institut Pasteur de Tunis and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)