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Diabetes mellitus (DM) is one of the common diseases in the world. Its dramatic increase annually is considered a global issue to the people, in which raising awareness about the disease and its complication is crucial. It has been well documented by the literature that smoking and DM are two major risk factors for periodontal disease. Knowledge of oral health is vital for type II DM patients and is a key factor in the treatment and prevention of periodontal disease. A cross-sectional study was conducted among three hundred diabetic patients in a Benghazi diabetic treatment center. The participants were 40.3% (n = 121) male and 59.7% (n = 179) female adults whose ages ranged from 16 to 80 years. Inclusion criteria included Libyan citizens diagnosed with type II DM. The participants were questioned through a structured questionnaire and followed by the examination of their oral status. Periodontal examination was performed by two periodontists using the following indices: plaque index (PI) and periodontal disease index (PDI). Knowledge about oral health and periodontal status for Libyan patients with type II DM was tested through eight core questions using a structured questionnaire. The results showed about half of the sample had poor knowledge regarding the condition and its detrimental effect on oral and general health. Only 31% of participants provided good knowledge about type II DM and its relationship to oral health and periodontal status. The P-value showed a significant relationship between the knowledge and PI and PDI indices. Participants with poor knowledge showed higher scores in both indices. A significant relation was found between PI, PDI and knowledge. As knowledge was fair, the lower the PI and PDI scores. To lessen diabetic complications and their deleterious effects on oral and general health, raising knowledge and awareness could be a solution. Multidisciplinary cooperation between the medical and dental staff could be implemented to increase public knowledge. Key words: Oral health, Periodontal, Patients, Diabetes mellitus, Libya, Health awareness, Dentistry, INTRODUCTION Diabetes mellitus is a group of chronic metabolic cellular disorders defined by hyperglycemia resulting from decreased insulin secretion, resistance of cells to the peripheral effects of insulin function, or [...]

Gentamicin is an effective antibiotic against severe infections, but a major downside is its nephrotoxic effects. Virgin coconut oil has potential antidiabetic effects, but there has been no study on its potential role in gentamicin-induced nephrotoxicity in streptozotocin-induced diabetic rats. Thus, the aim of the current study is to explore the anti-inflammatory and nephroprotective effects of virgin coconut oil on non-diabetic and streptozotocin-induced diabetic rats. A total of 48 adult male Sprague-Dawley rats were randomly divided into eight groups (n=6), including non-diabetic groups (groups 1-4) and streptozotocin-induced diabetic groups (groups 5-8). Groups 1 and 5 received a normal diet, groups 2 and 6 were fed a normal diet + gentamicin at 100 mg/kg/day for the last 10 days of the study period, groups 3 and 7 were treated with 10 ml/kg/day of virgin coconut oil for four weeks, and groups 4 and 8 were given gentamicin for the last 10 days of the study period plus virgin coconut oil for four weeks at the same doses mentioned. Gentamicin adminstaration caused oxidative stress, and led to antioxidant defense depression which was confirmed by elevated kidney Malondialdehyde (MDA) (4.53, 5.62) and reduced renal antioxidant enzymes including renal superoxide dismutase (59.82, 45.58), catalase (53.11, 37.3) and glutathione peroxidase (51.41.36.34) in non-diabetic (ND) and diabetic (D) rats, respectively. It also resulted in a significant increase of serum urea (31.72, 50.78), creatinine (2.88, 4.16), cystatin-C (13.75, 17.69), and inflammatory biomarkers interleukin-6 (IL-6) (84.01, 102.73) and tumor necrosis factor-[alpha] (TNF-[alpha]) (667.05, 853.05) in ND and D rats, respectively. Virgin coconut oil showed protective effects and significantly improved renal function parameters, including serum urea (17.35, 38.9), creatinine (1.69, 2.96) and cystatin-C (14.26, 15.94) for ND and D groups, respectively. Pre-and co-administration of virgin coconut oil exerted a remarkable protective effect against oxidative stress induced by gentamicin in normal and diabetic rats. Pro-inflammatory biomarkers were also improved in groups treated with virgin coconut oil. The results are promising in terms of the use of virgin coconut oil as a dietary agent in attenuating the progression of chronic renal disease, especially in the context of diabetes. Key words: anti-inflammatory, nephroprotective, virgin coconut oil, gentamicin, streptozotocin, flavonoid, phenol, oxidative stress, INTRODUCTION Antibiotics, especially aminoglycosides, have been significantly associated with the development of nephrotoxicity. Gentamicin is one of the most efficacious antibiotics against serious infections, including Gram-negative infections. However, its application [...]

Diabetes mellitus (DM) increases risk of coronary artery disease (CAD). Endothelin-1 (ET-1) is a potential biomarker of endothelial dysfunction. This study aimed to evaluate ET-1 level in CAD patients and its relationship with DM. The cross-sectional design included subjects with angiographically proven CAD and controls among Indonesian. DM was defined by medical history and anti-diabetics use. Serum ET-1 level was measured in both subject groups. We recruited 305 subjects, 183 CAD patients and 122 controls. CAD subjects had higher percentage of males, DM, hypertension, dyslipidemia, smoking, family history of cardiovascular disease, and obesity. ET-1 level was significantly higher in CAD than in controls (2.44 [+ or -] 1.49 pg/mL vs. 1.76 [+ or -] 0.83 pg/mL; p < 0.001). Increased ET-1 level was significantly associated with DM and dyslipidemia. The highest ET-1 level was observed in CAD with DM, followed by CAD non-DM (2.79 [+ or -] 1.63 pg/mL vs. 2.29 [+ or -] 1.40 pg/mL; p = 0.023). Among controls, ET-1 level was the lowest in non-DM subjects. Female CAD had higher proportion of DM; however, ET-1 level was similar to male CAD with DM. In conclusion, an increased ET-1 level was significantly associated with DM in patients with CAD. Further research should investigate the potential role of ET-1 receptor antagonists in the secondary prevention of CAD with DM. Key words: coronary artery disease, endothelin-1, diabetes mellitus, cardiovascular risk factor, Indonesian population Le diabete sucre (DS) entraine un risque accru de coronaropathie. L'endotheline 1 (ET-1) est un biomarqueur potentiel du dysfonctionnement endothelial. Cette etude croisee visait a evaluer les taux d'ET-1 chez les patients atteints de coronaropathie et le lien avec le DS. L'etude comprenait des sujets indonesiens avec coronaropathie confirmee par angiographie et des temoins de la meme origine. Le DS etait caracterise par les antecedents medicaux et l'utilisation de medicaments antidiabetiques. Nous avons mesure les taux d'ET-1 dans les deux groupes de sujets. Nous avons inscrit a l'etude 305 sujets, dont 183 patients atteints de coronaropathie et 122 temoins. Le groupe de sujets atteints de coronaropathie comprenait un pourcentage plus eleve d'hommes, de DS, d'hypertension, de dyslipidemie, de tabagisme, d'antecedents familiaux de maladies cardiovasculaires et d'obesite. Les taux d'ET-1 etaient nettement plus eleves chez les patients atteints de coronaropathie que chez les temoins (2,44 [+ or -] 1,49 pg/ml p/r a 1,76 [+ or -] 0,83 pg/ml, p < 0,001). L'augmentation des taux d'ET-1 etait associee de facon appreciable au DS et a la dyslipidemie. Nous avons observe les taux d'ET-1 les plus eleves chez les patients atteints a la fois de coronaropathie et de DS, suivis de la coronaropathie sans DS (2,79 [+ or -] 1,63 pg/ml p/r a 2,29 [+ or -] 1,40 pg/ml, p = 0,023). Chez les temoins, nous avons observe les taux d'ET-1 les moins eleves chez les patients qui n'etaient pas atteints de DS. Chez les femmes atteintes de coronaropathie, le DS etait plus frequent, mais les taux d'ET-1 etaient similaires a chez les hommes atteints a la fois de coronaropathie et de DS. En conclusion, nous avons observe des taux d'ET-1 nettement plus eleves chez les patients atteints a la fois de coronaropathie et de DS. Plus de recherches devraient porter sur le role eventuel des antagonistes des recepteurs de l'ET-1 dans la prevention secondaire de la coronaropathie avec DS. Mots-cles : coronaropathie, endotheline 1, diabete sucre, facteurs de risque cardiovasculaire, population indonesienne, Introduction Coronary artery disease (CAD) contributes to high mortality and disability-adjusted life-years worldwide (Hay et al. 2017). The burden of this disease is increasingly apparent worldwide, including in Indonesia, by [...]

Beta-caryophyllene (BCP), a cannabinoid 2 ([CB.sub.2]) receptor agonist has recently been found to have cardioprotective activity as an anti-inflammatory and antioxidant molecule. L-arginine (LA), a nitric oxide (NO) donor, is a potential regulator of cardiovascular function. Considering the role of [CB.sub.2] receptor activation and NO regulation in cardiovascular diseases, the combination of BCP with LA may be a possible treatment of diabetic cardiomyopathy (DCM). Hence, we investigated the efficacy of the novel combination of BCP with LA on cardiovascular inflammation and oxidative stress in diabetic rats. DCM was induced by streptozotocin (55 mg/kg) in Sprague-Dawley rats intraperitoneally. BCP, LA, and BCP with LA were administered to diabetic rats for 4 weeks. After completion of the study, hemodynamic parameters, biochemical parameters, and inflammatory cytokine levels were analyzed. Also, oxidative stress parameters, nuclear factor kappa beta (NF-[kappa][beta]) expression, and histopathology in cardiac tissues were estimated. The combination of BCP (200 mg/kg) with LA (200 mg/kg) significantly normalized the hemodynamic parameters and decreased the glucose, cardiac markers, interleukin-6, and tumor necrosis factor-alpha levels. Treatment of BCP and LA showed a significant decrease in oxidative stress and down-regulated the cardiac expression of NF- [kappa][beta]. Thus, the combination of BCP with LA improves cardiac functions by attenuating inflammation through NF- [kappa][beta] inhibition in DCM. Key words: beta-caryophyllene, L-arginine, diabetic cardiomyopathy, NF-[kappa][beta] inhibition, streptozotocin. Recemment, on a montre que le beta caryophyllene (BCP), un agoniste des recepteurs cannabinoides de type 2 ([CB.sub.2]), dispose d'une activite cardioprotectrice comme molecule anti-inflammatoire et anti-oxydante. La L- arginine (LA), un donneur d'oxyde nitrique (NO), est un agent de regulation potentiel du fonctionnement cardiovasculaire. Etant donne le role de l'activation des recepteurs [CB.sub.2] et de la regulation du NO dans les maladies cardiovasculaires, l'association de BCP avec de la LA pourrait constituer un traitement eventuel contre la cardiomyopathie diabetique (CMD). Par consequent, nous avons etudie l'efficacite de la nouvelle association du BCP avec la LA sur l'inflammation et le stress oxydatif cardiovasculaires chez des rats diabetiques. Nous avons provoque la CMD a l'aide de streptozotocine (55 mg/kg) administree par voie intraperitoneale chez des rats SD. Nous avons administre le BCP, la LA et le BCP avec la LA pendant 4 semaines chez des rats diabetiques. Une fois l'etude terminee, nous avons analyse les parametres hemodynamiques et biochimiques, de meme que les taux de cytokines inflammatoires. Nous avons aussi estime les parametres du stress oxydatif, l'expression du NF-[kappa][beta] et l'histopathologie des tissus cardiaques. L'association du BCP (200 mg/kg) avec la LA (200 mg/kg) entrainait une stabilisation des parametres hemodynamiques et la diminution des taux de glucose, de marqueurs cardiaques, d'IL-6 et de TNF-[alpha] de facon notable. L'administration de BCP et de LA a entraine une diminution marquee du stress oxydatif, avec une regulation a la baisse de l'expression du NF-[kappa][beta] dans le coeur. Par consequent, l'association du BCP avec la LA permet d'ameliorer certains aspects du fonctionnement du coeur en attenuant l'inflammation par l'intermediaire de l'inhibition du NF-[kappa][beta] dans la CMD. Mots-cles: beta caryophyllene, L-arginine, cardiomyopathie diabetique, inhibition du NF-[kappa][beta], streptozotocine., 1. Introduction According to the International Diabetes Federation, approximately 12%-32% of patients with diabetes have suffered from diabetic cardiomyopathy (DCM), a major cause of mortality, and these patients have a [...]

Cardiac fibrosis is one of the major pathological characteristics of diabetic cardiomyopathy (DCM). MicroRNAs (miRNAs, miRs) have been identified as key regulators in the progression of cardiac fibrosis. This study aimed to investigate the role of miR-30a-5p in DCM and the underlying mechanism. The rat model of diabetes mellitus (DM) was established by streptozotocin injection, and the rat primary cardiac fibroblasts (CFs) were isolated from cardiac tissue and then treated with high glucose (HG). MTT assay was performed to assess the viability of CFs. Dual-luciferase reporter gene assay was conducted to verify the interaction between miR-30a-5p and Smad2. The expression of miR- 30a-5p was downregulated in the myocardial tissues of DM rats and HG-stimulated CFs. Overexpression of miR-30a-5p reduced Smad2 levels and inhibited collagen formation in HG-stimulated CFs and DM rats, as well as decreased the proliferation of CFs induced by HG. Smad2 was a target of miR-30a-5p and its expression was inhibited by miR-30a-5p. Furthermore, the simultaneous overexpression of Smad2 and miR-30a-5p reversed the effect of miR-30a-5p overexpression alone in CFs. Our results indicated that miR-30a-5p reduced Smad2 expression and also induced a decrease in proliferation and collagen formation in DCM. Key words: diabetic cardiomyopathy, cardiac fibrosis, high glucose, miR-30a-5p, Smad2. La fibrose cardiaque est l'une des principales caracteristiques pathologiques de la cardiomyopathie diabetique (CMD). On a etabli que les microARN (miARN) sont des regulateurs cles dans l'evolution de la fibrose cardiaque. Cette etude portait sur le role du miR-30a-5p dans la CMD et le mode d'action sous-jacent. Nous avons realise le modele de diabete sucre (DS) chez le rat par l'injection de streptozotocine, et nous avons isole des fibroblastes cardiaques (FC) de rat a partir de tissu cardiaque, puis administre des quantites de glucose elevees (HG). Nous avons evalue la vitalite des FC a l'aide de l'epreuve MTT. Nous avons mene l'epreuve de gene rapporteur par la double luciferase afin de verifier la presence d'une interaction entre le miR30a-5p et Smad2. Les resultats ont montre que l'expression du miR-30a-5p etait regulee a la baisse dans le tissu myocardique de rats atteints de DS et dans des FC stimules par l'HG. La subexpression du miR-30a-5p entrainait une diminution des taux de Smad2 avec une inhibition de la formation de collagene dans les FC stimules par l'HG et chez les rats atteints de DS, de meme qu'une diminution de la proliferation des FC induite par l'HG. Smad2 constituait une cible du miR- 30a-5p et son expression etait inhibee par le miR-30a-5p. En outre, la surexpression simultanee de Smad2 et du miR-30a-5p entrainait une inversion de l'effet de la subexpression du miR-30a-5p seul dans les FC. Nos resultats ont montre que le miR-30a-5p permettait de faire diminuer l'expression de Smad2, de meme que la proliferation des cellules et la formation de collagene dans la CMD. [Traduit par la Redaction] Mots-cles: cardiomyopathie diabetique, fibrose cardiaque, hyperglycemie, miR- 30a-5p, Smad2., Introduction Diabetic cardiomyopathy (DCM) is a cardiac dysfunction that affects about 12% of people with diabetes, leading to significant heart failure and death (Lorenzo-Almoros et al. 2017). It has been [...]

Diabetes mellitus (DM) is associated with increased risk of sudden cardiac death, but its role in arrhythmogenesis is not clear. We evaluated contributions of DM duration and hyperglycemia level to development of proarrhythmic electrophysiological changes in the experimental ischemia/reperfusion model. Ventricular epicardial 64-lead mapping and arrhythmia susceptibility burst-pacing testing were performed in 43 healthy and 55 diabetic (alloxan model) anesthetized rabbits undergoing 15 min left anterior descending coronary artery occlusion, followed by 15 min reperfusion. During ischemia, arrhythmia inducibility did not differ between the groups, but the number of reperfusion ventricular tachycardias and (or) fibrillations (VT/VFs) were higher in the DM group (14 out of 55) as compared with control (3 out of 43, p = 0.017). In the diabetic animals, both DM duration and glucose concentration were associated with reperfusion VT/VF development in univariate logistic regression analysis (odds ratio (OR) 1.058, 95% confidence interval (CI) 1.025-1.092, p < 0.001; and OR 1.119, 95% CI 1.045-1.198, p = 0.001, respectively). Only the DM duration, however, remained an independent predictor of reperfusion VT/VF in multivariate logistic regression analysis (OR 1.060, 95% CI 1.006-1.117, p = 0.029). Among mapping parameters, DM duration was associated with the prolongation of total ventricular activation duration (regression coefficient 0.152, 95% CI 0.049- 0.255, p = 0.005) and activation-repolarization intervals (ARIs) (regression coefficient 0.900, 95% CI 0.315-1.484, p = 0.003). The prolonged ARI was the only mapping characteristic predicting reperfusion VT/VF development (OR 1.028, 95% CI 1.009-1.048, p = 0.004). The DM durationdependent prolongation of ventricular repolarization presents a link between DM development and reperfusion VT/VF inducibility. Key words: diabetes, arrhythmias, activation-recovery interval, reperfusion, repolarization. Le diabete sucre (DS) est associe a un risque accru de mort subite cardiaque, mais son role dans l'arythmogenese demeure a clarifier. Nous avons evalue les contributions de la duree du DS et du degre d'hyperglycemie sur Revolution de changements electrophysiologiques proarythmiques dans le modele experimental d'ischemie-reperfusion. A l'aide de la cartographie de l'epicarde ventriculaire a 64 derivations, nous avons procede a l'etude de stimuli en salves sur la susceptibilite aux arythmies chez 43 lapins anesthesies (modele d'alloxane) en bonne sante et 55 atteints de DS, tous soumis a une occlusion de l'artere interventriculaire anterieure pendant 15 minutes, suivie d'une reperfusion de 15 minutes. Au cours de l'ischemie, l'inductibilite des arythmies n'etait pas differente entre les deux groupes, mais le nombre d'arythmies de reperfusion de type tachycardie ventriculaire et/ou fibrillation ventriculaire (TV-FV) etait plus eleve dans le groupe DS (14 sur 55) que chez les temoins (3 sur 43; p = 0,017). Chez les animaux atteints de diabete, la duree du DS comme la glycemie etaient associees avec l'apparition de TV-FV de reperfusion selon une analyse de regression logistique univariee (rapport de cotes [RC] de 1,058; IC a 95 % de 1,025 a 1,092; p < 0,001; et RC de 1,119; IC a 95 % de 1,045 a 1,198; p = 0,001; respectivement). Cependant, selon une analyse de regression logistique multivariee, seule la duree du DS demeurait un facteur de prediction independant pour les TV-FV de reperfusion (RC de 1,060; IC a 95 % de 1,006 a 1,117; p = 0,029). Parmi les parametres de la cartographie, la duree du DS etait associee avec une prolongation de la duree totale de l'activation ventriculaire (coefficient de regression de 0,152; IC a 95 % de 0,049 a 0,255; p = 0,005) et de la duree des intervalles entre l'activation et la repolarisation (IAR; coefficient de regression de 0,900; IC a 95 % de 0,315 a 1,484; p = 0,003). La prolongation des IAR etait l'unique caracteristique cartographique constituant un facteur de prediction pour l'apparition de TV-FV de reperfusion (RC de 1,028; IC a 95 % de 1,009 a 1,048; p = 0,004). Nous en sommes arrives a la conclusion que la prolongation de la repolarisation des ventricules dependante de la DS represente un lien entre Revolution du DS et l'inductibilite de TV-FV de reperfusion. [Traduit par la Redaction] Mots-cles: diabete, arythmies, intervalle entre l'activation et la recuperation, reperfusion, repolarisation., Introduction Cardiovascular pathologies often complicate diabetes mellitus (DM) (Braunwald 2019). Specifically, DM increases risk of ventricular arrhythmias and sudden cardiac death in patients with coronary artery disease as well as [...]

PURPOSE Although diabetes care guidelines recommend paying attention to oral health, the effect on daily practice has been limited, and patients with diabetes have yet to benefit. We investigated whether implementation of an oral care protocol for general practitioners (GPs [family physicians]) can improve patient-centered outcomes for patients with type 2 diabetes. METHODS Twenty-four GP offices were randomly assigned to the experimental or control group (12 offices each). In the experimental group, GPs and nurse practitioners implemented an oral care protocol. No extra attention was given to oral health in the control group. The primary outcome parameter was oral health-related quality of life (QoL) assessed with the 14-item Oral Health Impact Profile at baseline and 1 year later. Other outcomes were self-reported oral health complaints and general health-related QoL (36-item Short Form Health Survey). RESULTS Of 764 patients with type 2 diabetes, 543 (71.1%) completed the 1-year follow-up. More patients reported improved oral health-related QoL in the experimental group (35.2%) compared to the control group (25.9%) (P = .046; [P.sub.adj] = .049). In a secondary post hoc analysis including GP offices with [greater than or equal to] 60% patient follow-up (n = 18), improvement was 38.3% and 24.9%, respectively (P and [P.sub.adj] = .011). Improvement of self-reported oral health complaints did not differ between groups. The intervention had no effect on general health--related QoL, with the exception of the concept scale score for changes in health over time ([P.sub.adj] = .033). CONCLUSIONS Implementation of an oral care protocol in primary diabetes care improved oral health-related QoL in patients with type 2 diabetes. Key words: type 2 diabetes mellitus; primary care; oral care; oral health; quality of life, INTRODUCTION Diabetes mellitus is a disease of epidemic proportions, currently affecting 451 million individuals worldwide. (1) The most devastating consequence of diabetes mellitus is the development of chronic complications, such [...]

* Context.--Women with diabetes have increased stillbirth risk. Although the underlying pathophysiological processes are poorly understood, stillbirth is frequently related to abnormal placental structure and function. Objective.--To investigate placental morphology and cellular characteristics in the placentas of women with diabetes who had stillbirths and stillbirths of unexplained cause. Design.--Placentas from women with uncomplicated live births, live births in women with diabetes, unexplained stillbirths, and stillbirths related to diabetes (n = 10/group) underwent clinical histopathologic assessment and were also investigated using immunohistochemical staining to quantify syncytial nuclear aggregates, proliferation, trophoblast area, vascularization, T cells, placental macrophages (Hofbauer cells), and the receptor for advanced glycation end products. Results.--[Ki67.sup.+] cells were decreased in unexplained stillbirths compared with live births in women with diabetes. Both stillbirth groups had increased cytokeratin 7+/nuclear area compared with controls. Blood vessels/villi were decreased in unexplained stillbirth compared with live births from women with diabetes. Compared with uncomplicated controls, [CD163.sup.+] macrophages were increased in live births in women with diabetes and unexplained stillbirths, and further increased in stillbirths related to diabetes. There was no change in [CD3.sup.+] T cells or syncytial nuclear aggregates. Receptor for advanced glycation end products-positive cells were decreased in both stillbirth groups compared with diabetes-related live births. Co-localization of receptor for advanced glycation end products in macrophages was increased in both stillbirth groups compared with live birth groups. Conclusions.--Stillbirths related to diabetes exhibit placental phenotypic differences compared with live births. Further investigation of these parameters may provide understanding of the pathologic mechanisms of stillbirth and aid the development of stillbirth prevention strategies. (Arch Pathol Lab Med. 2021;145:82-89; doi: 10.5858/arpa.2019-0524-OA), Stillbirth is defined in the United Kingdom as intrauterine fetal death after 24-weeks gestation and in 2017 the stillbirth rate was 4.2 per 1000 total births. (1) The stillbirth rate [...]