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Vascular dementia (VaD), being strongly associated with metabolic conditions is a major health concern around the world. Diabetes is a major risk factor for the development of VaD. This study investigates the efficacy of quercetin and folacin in diabetes induced vascular endothelium dysfunction and related dementia. Single dose streptozotocin (STZ) (50 mg/kg i.p) was administered to albino Wistar rats (male, 200–250 g) by dissolving in citrate buffer. Morris water maze (MWM) and attentional set shifting tests were used to assess the spatial learning, memory, reversal learning, and executive functioning in animals. Body weight, serum glucose, serum nitrite/nitrate, vascular endothelial function, aortic superoxide anion, brains' oxidative markers (thiobarbituric acid reactive species-TBARS, reduced glutathione-GSH, superoxide dismutase-SOD, and catalase-CAT), mitochondrial enzyme complex (I, II, and IV), inflammatory markers (interleukin-IL-6, IL-10, tumor necrosis factor-TNF-α, and myeloperoxidase-MPO), and acetylcholinesterase activity-AChE were also assessed. Quercetin (30 mg kg−1/60 mg kg−1) and folacin (30 mg kg−1/60 mg kg−1) were used as the treatment drugs. Donepezil (0.5 mg kg−1) was used as a positive control. STZ administered rats showed reduction in learning, memory, reversal learning, executive functioning, impairment in endothelial function, increase in brains' oxidative stress; inflammation; AChE activity, and decrease in mitochondrial complex (I, II, and IV) activity. Administration of quercetin and folacin in two different doses, significantly attenuated the STZ induced diabetes induced impairments in the behavioral, endothelial, and biochemical parameters. STZ administration caused diabetes and VaD which was attenuated by the administration of quercetin and folacin. Therefore, these agents may be studied further for the assessment of their full potential in diabetes induced VaD conditions. [ABSTRACT FROM AUTHOR]

Introduction: Patients with diabetes have easy access to a wide range of digital applications that may help with self-management and lower barriers; however, robust evidence of their effectiveness remains somewhat elusive. Zyla is a medical artificial intelligence (AI)-based personalized care management app that assists the treating physician in improving the standard of patient care by offering the patients comprehensive and individualized care. This preliminary evaluation of data collected through the Zyla app aims to understand the impact of diabetes disease outcomes among patients subscribed to this app., Methods: This was a retrospective, observational program conducted through the Zyla app in the calendar year 2020. The Zyla app's objective is to assist the treating physician in improving the standard of patient care by giving them the choice of assembling a personalized team (consisting of clinical nutritionists, physiotherapists, and counselors over a virtual platform) that can offer patients comprehensive and individualized care. Data on parameters like glycated hemoglobin (HbA1c), fasting blood sugar (FBS), post-prandial glucose (PPG), serum creatinine (SC), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were collected through the Zyla app. Clinical outcomes assessed were the change from baseline to last reported levels of the mentioned parameters and are reported using descriptive analysis., Results: The glycemic control parameters, HbA1c (change from baseline (CFB): -1.08), FBS (CFB: -15.93), and PPG levels (-18.42), were significantly lower ( P <0.0001) at the last assessment compared with baseline. For the lipid profile, levels of TGs ( P <0.0001) and TC ( P = 0.0037) were significantly lower compared with baseline, while HDL-C levels were comparatively higher (CFB: 0.68) and LDL-C levels were lower (CFB:11.60), however non-significant. Serum creatinine was also lower compared to baseline (CFB: -0.25); however, the difference was not statistically significant., Conclusions: A significant improvement in all glycemic parameters was seen with the use of the Zyla app along with numerical improvements in kidney function parameters and cholesterol status among patients. These preliminary findings warrant further rigorous studies to validate the impact of medical apps in the management of diabetics in India., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Nil declare(s) personal fees from AstraZeneca Pharma India Ltd. Manuscript writing and the program presented in this report were supported by AstraZeneca Pharma India Ltd. Krishna Seshadri declare(s) employment from EMR Company. Bharath HS and Prashant Sada declare(s) employment from AstraZeneca Pharma India Limited. Khushboo Agarwal declare(s) employment from Zyla Health. Other relationships: Khushboo Agarwal is the Founder and CEO of Zyla Health. Also, authors located in different parts of the country collaborated on the following original program., (Copyright © 2024, Sethi et al.)