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Spinal fusion procedures are used to treat a wide variety of spinal pathologies. Diabetes mellitus (DM) has been shown to be a significant risk factor for several complications following these procedures in previous studies. To the authors' knowledge, this is the first systematic review and meta-analysis elucidating the relationship between DM and complications occurring after spinal fusion procedures. Systematic literature searches of PubMed and EMBASE were performed from their inception to October 1, 2022, to identify studies that directly compared postfusion complications in patients with and without DM. Studies met the prespecified inclusion criteria if they reported the following data for patients with and without DM: (1) demographics; (2) postspinal fusion complication rates; and (3) postoperative clinical outcomes. The included studies were then pooled and analyzed. Twenty-eight studies, with a cumulative total of 18,853 patients (2695 diabetic patients), were identified that met the inclusion criteria. Analysis showed that diabetic patients had significantly higher rates of total number of postoperative complications (odds ratio [OR] = 1.33; 95% confidence interval [CI] = 1.12–1.58; P = 0.001), postoperative pulmonary complications (OR = 2.01; 95%CI = 1.31–3.08; P = 0.001), postoperative renal complications (OR = 2.20; 95%CI = 1.27–3.80; P = 0.005), surgical site infection (OR = 2.65; 95%CI = 2.19–3.20; P < 0.001), and prolonged hospital stay (OR = 1.67; 95%CI = 1.47–1.90; P < 0.001). Patients with DM had a significantly higher risk of developing complications after spinal fusion, particularly pulmonary and renal complications, in addition to surgical site infections and had a longer length of stay. These findings are important for informed discussions of surgical risks with patients and families before surgery. [ABSTRACT FROM AUTHOR]

Increased atrial elasticity is a marker of cardiovascular events. This study aimed to compare the parameters of elasticity and lipids in children with type 1 diabetes mellitus (TIDM) compared with controls and the effect of lipids on elasticity in children with diabetes.

Objective: The visual system often is affected in patients with preeclampsia and even more in cases of eclampsia, a life-threatening pregnancy complication. Symptoms include blurred vision and deterioration of visual acuity. Pregnancy can also affect pre-existing conditions, such as diabetic retinopathy. In this case series, we describe three patients with the same underlying condition, i.e. (pre)eclampsia who experienced acute visual disturbance whereas the final diagnosis was different: disseminated intravascular coagulopathy (DIC), posterior reversible encephalopathy syndrome (PRES), and diabetic retinopathy.Methods and results: All patients underwent a thorough slit lamp examination and ocular coherence tomography (OCT). All patients presented with acute impaired vision and subretinal fluid and-/or fibrin. Conclusions: These cases highlight the importance of early involvement of ophthalmologists when pregnant women complain about visual disorders.

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Microencapsulating pancreatic islets in immunoprotective alginate hydrogels is a promising strategy for treatment of type 1 diabetes. However, this strategy is limited by inflammation and hypoxia mediated oxidative stress, due to encapsulation and the hydrogel itself, leading to impaired insulin secretion and limited short and long term cell survival. Herein, the antioxidant effect of fucoidan, an algae derived polysaccharide, on beta cells, and its positive effects on encapsulated beta cell viability and function is presented. Fucoidan from Fucus vesiculosus (FF) exhibits a high total antioxidant capacity, and free radical scavenging activity, and is able to significantly alleviate intracellular oxidative stress in rat insolinoma beta cells (INS1E). In addition, FF significantly increases insulin secretion in a dose‐ and time‐dependent manner. When FF is incorporated in ultrapure alginate used for microencapsulation of primary rat islets, both viability and glucose responsiveness of rat islets in these socalled Fucogel microcapsules (Fucocaps) are found to be significantly higher compared to islets encapsulated in alginate alone. Similar results are obtained with INS1E pseudoislets and neonatal pig islets. Fucocaps can provide a redox‐modulatory niche and an immune barrier for islets and beta cells in the same time leading to significantly improved survival and endocrine function by mitigating oxidative stress. [ABSTRACT FROM AUTHOR]

Background: Medical devices (MD) in close skin‐contact for a prolonged time, such as glucose monitoring (CGM) systems, are a risk factor for contact allergy, and there has been an increase in patients using these. Correct diagnosis demands targetted testing. Objectives: We report a new allergen in a continuous CGM system in which the adhesive was changed. The allergy pattern of the patients diagnosed is reported. Methods: The three patients reported were patch tested with an MD series, own material, and possible allergens found through analysis with gas chromatography‐mass spectrometry, comparing analysis from the CGM system before and after change. Results: The patients were sensitized to isobornyl acrylate (IBOA), found in previously used devices and the present CGM. Apart from IBOA, the culprit allergen was found to be 2,2′‐methylenebis(6‐tert‐butyl‐4‐methylphenol) monoacrylate. Conclusion: Allergic contact dermatitis due to CGM systems and insulin pumps are difficult to investigate and require chemical analysis. Because of the lack of information on substances used in the production, and when changes with MDs are initiated, it is difficult to advise patients, especially since they risk sensitization to several allergens. The use of MDs has increased and, thus, the need for collaboration between manufacturers, clinicians, and patient organizations. [ABSTRACT FROM AUTHOR]

Diabetes mellitus type I is a chronic disease, often diagnosed in childhood and associated with an increased risk of diabetes-related emotional and behavioral problems. This cross-sectional study investigated whether the quantity of parent-child time spent together is associated with fewer emotional and behavioral problems of the child. We hypothesized that parent-child time is a protective factor if the time spent together is experienced as satisfactory and without diabetes-related conflicts. A group of 83 families participated in the study. Parents and children independently completed questionnaires about child emotional and behavioral problems, parent-child time, and diabetes-related conflicts. More parent-child time was correlated with fewer child behavioral problems from the parents' perspective. Structural equation models showed that child-reported diabetes-related conflicts moderated the link between parent-child time and child-reported emotional problems as well as between parent-child time and parent-reported child behavioral problems. In addition, we found a moderation effect for parental satisfaction for the link between parent-child time and behavioral problems from the parents' perspective. The results suggest that children benefit most from parent-child time in families where fewer diabetes-related conflicts occur. Practical implications for parent counselling and systemic family therapy are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Conversion in the metabolism of drugs occurs in diabetes mellitus. Considering the importance of metabolic enzymes' activities on the efficacy and safety of medicines, the changes in liver enzymatic activity of CYP2D1 and its related hepatic clearance, by using Dextromethorphan as probe in the animal model of type I and type II diabetes, before and after treatment, was assessed in this study. Methods: Male Wistar rats were randomly divided into 6 groups. Seven days after induction of diabetes type I and type II, treatment groups were received insulin and metformin daily for 14 days, respectively. In day 21, rats were subjected to liver perfusion by Krebs-Henseleit buffer containing Dextromethorphan as CYP2D1 probe. Perfusate samples were analyzed by HPLC fluorescence method in order to evaluate any changes in CYP2D1 activity. Results: The average metabolic ratio of dextromethorphan and hepatic clearance were changed from 0.012 ± 0.004 and 6.3 ± 0.1 in the control group to 0.006 ± 0.0008 and 5.2 ± 0.2 in the untreated type I diabetic group, and 0.008 ± 0.003 and 5.0 ± 0.6 in the untreated type II diabetic rats. Finally, the mean metabolic ratio and hepatic clearance were changed to 0.008 ± 0.001 and 5.4 ± 0.1, and 0.013 ± 0.003 and 6.1 ± 0.4 in the treated groups with insulin and metformin, respectively. Conclusion: In type I diabetic rats, corresponding treatment could slightly improve enzyme activity, whereas the hepatic clearance and enzyme activity reached to the normal level in type II group. [ABSTRACT FROM AUTHOR]

Good management of diabetes requires at the same time self-regulation behaviour and a balanced involvement of family components. This cross-sectional study’s aims were: understanding fear of injections and perceptions of family conflicts in preadolescents and adolescents with type 1 diabetes mellitus and their mothers, comparing their perceptions, and identifying the risk factors impacting patients’ quality of life. Eligibility criteria were: treatment for diabetes mellitus type I, currently aged 10–18 years, attending the hospital for annual hospital follow-ups. Exclusion criteria were: intellectual disabilities, inability to complete questionnaires alone and neuropsychiatric illness with active pharmacotherapy. The study design was cross-sectional. Participants were one hundred and two patients (Mean age = 14.6, SD = 2.4; age range = 10–19 years; Females = 52 and Males = 50) and their mothers (Mean age = 46.9, SD = 6.2, age range = 27–63 years), who filled in self and proxy-report questionnaires (N total= 204). The results showed that 20% of patients and 14.7% of their mothers reported clinical scores for fear of self-injection and blood testing. The mothers reported lower fear of injecting and higher family conflicts compared with the patients. Age, fear of injecting and family conflicts were significantly associated with patients’ quality of life perceptions. Clinical considerations and recommendations are given based on the empirical results.

Aim. To study the specific activity of the microemulsion form of the matrix insulin transdermal delivery system in vivo on the experimental streptozotocin model of type I diabetes.Materials and methods. Male rats (n = 25) were randomized to the experimental and control groups. TDS insulin with a microemulsion composition was applicated to the animals of the experimental group (n = 15) for 4 days with daily replacement of TDS and control of the glycemia level. The glycemia level of the control group rats (n = 10) was determined throughout the experiment. The blood glucose concentration was measured using glucometer One Touch Select (USA). Results. The average blood glucose level in experimental group was 28.4 ± 2.3 mmol/l before application of TDS insulin. The average glycemic index was 21.2 ± 3.1 mmol/l (p < 0.001) during of TDS application. The blood glucose decrease was 26 ± 8% relative to baseline values. The glycemia was 28.4 ± 1.4 mmol/l in the control group rats throughout the experiment.Conclusion. A significant decrease of blood glucose level with TDS insulin application in rats with experimental type 1 diabetes demonstrates the existence of the specific activity of the microemulsion matrix transdermal delivery system of insulin.

Introduction: Diabetes stigma puts patients under the pressure and affects their lives. Considering the importance of stigma in the life and its effect on behavior and social interaction of patients with diabetes, the present study was conducted to determine the stigma in female adults with type I diabetes. Materials and Methods: This cross-sectional study was conducted on 110 adult girls with type 1 diabetes referred to the Iranian Diabetes Association. The participants were within the age range of 14-18 years, who were selected through convenience sampling technique. The data collection tools included the demographic information questionnaire, stigma perception questionnaire associated with type I diabetes, and Rosenberg's Self-Esteem Scale. Data were analyzed by SPSS software (version 22) using one way-ANOVA, independed t-test, and Pearson correlation. Results: The findings of the study showed that the mean score of stigma perception in the subjects was 92.41(41). The mean score of self-steems in the subjects was 22.98(7.9). There was a negative correlation between the stigma and self-esteem (P=0.012, r=-0.754). Conclusion: Based on the obtained results of the current study and the effect of diabetes mellitus type I on the lives of patients, health care providers should plan to reduce the stigma realted to the patients with diabetes mellitus. [ABSTRACT FROM AUTHOR]

Salivary glands are highly responsible for maintaining oral tissue homeostasis by secreting saliva. This study was designed to investigate aquaporin 1 and 4, oxidative stress, and autophagy in submandibular and parotid salivary glands of diabetic rats and the possible ameliorative effect of intermittent fasting on these changes. Fifty adult male rats were divided into control and experimental groups. Experimental diabetes was induced by a single intraperitoneal injection of streptozotocin. After induction of diabetics, the experimental group was divided into two groups (diabetic without intermittent fasting and diabetic with intermittent fasting). The animals were sacrificed two and four weeks after induction of diabetes. Intermittent fasting significantly decreased malondialdehyde and significantly elevated reduced glutathione (GSH) in the submandibular and parotid glands compared to those of diabetic rats. The salivary secretions were also significantly histologically spared in diabetics with intermittent fasting groups. Furthermore, intermittent fasting increased aquaporin 1 in both glands, while aquaporin 4 was only elevated in the submandibular gland. The immunolocalization and gene expression of Lc3-II was higher in the diabetic salivary glands than in the fasting glands. In conclusion, these findings highlight the pathological role of autophagy in diabetic submandibular and parotid glands and provide potential target for the therapeutic role of intermittent fasting to ameliorate the dysfunction of the submandibular and parotid glands in type I diabetes mellitus. • Intermittent fasting upregulated aquaporin 1 in both submandibular and parotid glands. • Intermittent fasting upregulated aquaporin 4 in submandibular gland. • Intermittent fasting improved the oxidative stress induced by diabetes. • The immunolocalization and gene expression of Lc3-II was higher in the diabetic salivary glands than in the fasting gland. [ABSTRACT FROM AUTHOR]

Objective: Type I diabetes is an immunologically-mediated devastation of insulin producing cells (IPCs) in the pancreatic islet. Stem cells that produce β-cells are a new promising tool. Adult stem cells such as mesenchymal stem cells (MSCs) are self renewing multi potent cells showing capabilities to differentiate into ectodermal, mesodermal and endodermal tissues. Pancreatic and duodenal homeobox factor 1 (PDX1) is a master regulator gene required for embryonic development of the pancreas and is crucial for normal pancreatic islets activities in adults. Materials and Methods: We induced the over-expression of the PDX1 gene in human bone marrow MSCs (BM-MSCs) by Lenti-PDX1 in order to generate IPCs. Next, we examine the ability of the cells by measuring insulin/c-peptide production and INSULIN and PDX1 gene expressions. Results: After transduction, MSCs changed their morphology at day 5 and gradually differentiated into IPCs. INSULIN and PDX1 expressions were confirmed by real time polymerase chain reaction (RT-PCR) and immunostaining. IPC secreted insulin and C-peptide in the media that contained different glucose concentrations. Conclusion: MSCs differentiated into IPCs by genetic manipulation. Our result showed that lentiviral vectors could deliver PDX1 gene to MSCs and induce pancreatic differentiation.

Lactobacillus johnsonii N6.2 mitigates the onset of type 1 diabetes (T1D) in biobreeding diabetes-prone rats, in part, through changes in kynurenine:tryptophan (K:T) ratios. The goal of this pilot study was to determine the safety, tolerance, and general immunological response of L. johnsonii N6.2 in healthy subjects. A double-blind, randomized clinical trial in 42 healthy individuals with no known risk factors for T1D was undertaken to evaluate subject responses to the consumption of L. johnsonii N6.2. Participants received 1 capsule/day containing 108 colony-forming units of L. johnsonii N6.2 or placebo for 8 weeks. Comprehensive metabolic panel (CMP), leukocyte subpopulations by complete blood count (CBC) and flow cytometry, serum cytokines, and relevant metabolites in the indoleamine-2,3-dioxygenase pathway were assessed. L. johnsonii N6.2 survival and intestinal microbiota was analyzed. Daily and weekly questionnaires were assessed for potential effects of probiotic treatment on general wellness. The administration of L. johnsonii N6.2 did not modify the CMP or CBC of participants suggesting general safety. In fact, L. johnsonii N6.2 administration significantly decreased the occurrence of abdominal pain, indigestion, and cephalic syndromes. As predicted, increased serum tryptophan levels increased resulting in a decreased K:T ratio was observed in the L. johnsonii N6.2 group. Interestingly, immunophenotyping assays revealed that monocytes and natural killer cell numbers were increased significantly after washout (12 weeks). Moreover, an increase of circulating effector Th1 cells (CD45RO+CD183+CD196−) and cytotoxic CD8+ T cells subset was observed in the L. johnsonii N6.2 group. Consumption of L. johnsonii N6.2 is well tolerated in adult control subjects, demonstrates systemic impacts on innate and adaptive immune populations, and results in a decreased K:T ratio. These data provide support for the safety and feasibility of using L. johnsonii N6.2 in prevention trials in subjects at risk for T1D.Trial registration: This trial was registered at http://clinicaltrials.gov as NCT02349360.

Abstract. Islet cells antibodies of a pancreas (ICA) are the sensitive and high–specific serological marker of diabetes type I (IDDM). Serum of 50 children (less than 16 yr.old) and 46 adult patients with IDDM was tested for ICA with indirect immunofluorescence. The control group consisted of 10 children and 40 adults without endocrinologic disorders.Serial cryosections of human pancreas 5 mkm thick were incubated with patients serum for 30 min. After the unbound serum proteins were washed away with phosphate buffered saline (0.01M, pH 7.2) the section was incubated with FITC labeled antiserum against human immunoglobulins. Specific cytoplasmic fluorescence of islet cells was scored as positive test result.No specific staining was found in serum of the control group and specificity of the method was 100%. In adults and children at onset of IDDM ICA were found statistically more frequently than in patients with longstanding disease: 75,6 % v.s. 21,8 % (p

Objectives: Diabetes Mellitus being a major issue faced by developing countries like Pakistan. Non-adherence is a major issue in achieving a desired therapeutic goal. This study aims at determining relation with the drug non-adherence associated with the treatment regime, treatment satisfaction and educational status of the person. Study Design: This was a cross sectional study. Place and Duration: This study was done at the Diabetes clinic, Nishtar hospital, Multan. Total 242 diabetic patients were studied over a period of 10 months. Methodology: The inclusion criteria was set as patients who have been diagnosed with Diabetes Type II and had been on oral hypoglycemic medications for about last 5 months or more. Those patients who were diagnosed with Type I diabetes and Type II diabetes less than 5 months were not included in the study. Also those patients who were on Insulin therapy were also excluded. Socio-demographic data was obtained along with therapy type and educational status. Drug adherence level was studied with the 8-item Morisky (MMAS-8). Treatment satisfaction was studied with the help of treatment satisfaction questionnaire for medication. The data was analyzed on the SPSS version 23 with significant p-value <0.05. Results: Among 242 patients 152(62.81%) were females and 90(37.19%) were males. Mean age of the patients were 47.68±15.13 years. Patients on combination therapy were (n=134, 55.3%) and on monotherapy were (n=108, 44.6%). Mean adherence score was 5.4±1.1.The mean for four domains of Treatment Satisfaction Questionnaire for Medication(TSQM) were: effectiveness= 66.93±15.27, side effects=32.09±26.91, convenience =62.59±14.49 and satisfaction= 65.49±16.13.Non-adherence was found to be associated with age, illiteracy, side-effects, satisfaction and convenience (p<0.05). Conclusion: Non-adherence must be overcome in patients to achieve appropriate glucose levels. Significant factors affecting the adherence levels were Illiteracy, Side effects, convenience and satisfaction of the patient. Public awareness campaigns and regular clinic visits should be encouraged. Drugs having lower side-effects, higher satisfaction levels and combined generics for once daily dosing having greater convenience should be used. [ABSTRACT FROM AUTHOR]

Lactobacillus johnsonii N6.2 mitigates the onset of type 1 diabetes (T1D) in biobreeding diabetes-prone rats, in part, through changes in kynurenine:tryptophan (K:T) ratios. The goal of this pilot study was to determine the safety, tolerance, and general immunological response of L. johnsonii N6.2 in healthy subjects. A double-blind, randomized clinical trial in 42 healthy individuals with no known risk factors for T1D was undertaken to evaluate subject responses to the consumption of L. johnsonii N6.2. Participants received 1 capsule/day containing 108 colony-forming units of L. johnsonii N6.2 or placebo for 8 weeks. Comprehensive metabolic panel (CMP), leukocyte subpopulations by complete blood count (CBC) and flow cytometry, serum cytokines, and relevant metabolites in the indoleamine-2,3-dioxygenase pathway were assessed. L. johnsonii N6.2 survival and intestinal microbiota was analyzed. Daily and weekly questionnaires were assessed for potential effects of probiotic treatment on general wellness. The administration of L. johnsonii N6.2 did not modify the CMP or CBC of participants suggesting general safety. In fact, L. johnsonii N6.2 administration significantly decreased the occurrence of abdominal pain, indigestion, and cephalic syndromes. As predicted, increased serum tryptophan levels increased resulting in a decreased K:T ratio was observed in the L. johnsonii N6.2 group. Interestingly, immunophenotyping assays revealed that monocytes and natural killer cell numbers were increased significantly after washout (12 weeks). Moreover, an increase of circulating effector Th1 cells (CD45RO+CD183+CD196-) and cytotoxic CD8+ T cells subset was observed in the L. johnsonii N6.2 group. Consumption of L. johnsonii N6.2 is well tolerated in adult control subjects, demonstrates systemic impacts on innate and adaptive immune populations, and results in a decreased K:T ratio. These data provide support for the safety and feasibility of using L. johnsonii N6.2 in prevention trials in subjects at risk for T1D. [ABSTRACT FROM AUTHOR]

Background: Diabetes Mellitus (D.M.) is a major health problem affecting more than 200 million worldwide. The ideal treatment for autoimmune type I diabetes is regeneration of endogenous β-cells which could be achieved by mesenchymal stem cells transplantation. Aim of the work: This work aimed to compare the effect of intravenous bone marrow derived mesenchymal stem cells (BMSCs) and adipose tissue derived mesenchymal stem cells (AMSCs) on Streptozotocin (STZ)-induced type I diabetes in albino rats. Material and Methods: Fifty albino male rats were divided into 4 groups; control, diabetic, BMSCs treated and AMSCs treated. Treated groups were intravenously given 1 ml PKH26 labeled allogenic BMSCs or AMSCs suspended in phosphate buffered saline, respectively. Animals of all groups were sacrificed 2 weeks after stem cells administration. Sections from control and treated groups were examined by fluorescence microscope. Sections from all groups were immunohistochemically stained to detect insulin and proliferating cell nuclear antigen (PCNA). Mean area percent of insulin and number of PCNA positive reactions were measured and statistically analyzed. Results: Diabetic rats showed cell death and congested blood vessels in both exocrine and endocrine pancreas. Treated groups revealed homing of stem cells in pancreas after their transplantation. Moreover, nearly normal histological features were seen in AMSCs treated group. Studying the treated groups immunohistochemically, revealed increase in insulin and PCNA positive reactions when compared to diabetic group with more increase in AMSCs treated group than BMSCs treated group. Conclusion: Intravenous AMSCs could be more effective than BMSCs in treatment of STZ-induced type I diabetes. [ABSTRACT FROM AUTHOR]

"nBackground: Type I diabetes is an autoimmune disease characterized by T-cell Mediated destruction of pancreatic β-cells. A variety of environmental, genetic and Immunologic factors are involved in the development of the disease. IL18 is a cytokine secreted by macrophage and monocytes and play an important role in the pathogenesis of diabetes Type I through inducing IFN-γ production. It is shown to be strongly associated with the development of diabetes in NOD mice. It is also shown to have increased level in the subclinical stage of diabetes mellitus (type 1). Genetic polymorphisms in the IL-18 gene influence production and secretion of cytokine and are considered as a risk factor in auto-Immune diseases. "nMethods: In this case control study, 75 type I diabetic patients and 88 healthy controls studied for polymorphism at positions -137 and -607. DNA extraction from the whole blood was performed according to the standardized method and polymorphism was determines by SSP-PCR. Data were analyzed by SPSS-12 using Chi-Square Test with 95% Confidence interval. "nResults: A statistical significant difference in GG genotype (53%) and CC genotype (16%) at the -137 position of IL18 gene was found, as compared to the control subjects (p=0.000) whereas we have not shown any statistical significance at the position -607. "nConclusion: IL18 is a key cytokine secreted by macrophages and monocytes and stimulate the Th1 lymphocyte. This cytokine can activate cytotoxic T lymphocytes (CTL) and destroy the pancreatic β cell. Our results show that the frequency of GG and CC genotypes at the position -137 may be associated with susceptibility to diabetes.

Diabetes-related distress has an adverse impact on health outcomes, including haemoglobin, dietary and exercise behaviours. Purpose of the present study was to determine the relationship between self-care, coping strategies and quality of life of individuals with diabetes. It was hypothesized that there is likely to be a relationship between self-care, coping strategies and quality of life of individuals with diabetes; coping strategies are likely to mediate the relationship between self care and quality of life. The sample comprised of 250 individuals with equal number of type I and type II diabetes and it was recruited from different hospitals in Lahore. We used Diabetes Self-care Activities Scale (DSAS), Coping Strategies Questionnaire (CSQ) and Quality of Life Scale (QoL) for assessment. Results showed that good self-care improves quality of life with the mediation of coping strategies in individuals with diabetes. Present findings might prove helpful for individuals, healthcare professionals and caregivers of individuals with diabetes in improving their quality of life. [ABSTRACT FROM AUTHOR]

Gum Arabic (GA) from Acacia seyal and Acacia senegal is a branched-chain polysaccharide which has strong antioxidant properties, and has been used to reduce the experimental toxicity. Yet, the effects of GA on oxidative stress in type I diabetic rats have not been reported. The aim of the study was to investigate the effects of GA on oxidative stress in Alloxan induced diabetes in rats. The rats were divided into 3 groups ( n = 20 of each): control group, diabetic group injected with allaoxan, and diabetic group given 15% GA in drinking water for 8 weeks. Oxidative damage to liver tissue was evaluated by measurement of key hepatic enzymes, lipid peroxidation, antioxidant enzymes and expression of oxidative stress genes. Activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GP x ) were significantly ( P < 0.05) increased in GA group compared to diabetic and control groups. Treatment of GA decreased liver malondialdehyde (MDA), and increased glutathione (GSH). In addition, GA was significantly ( P < 0.05) reduced the activities of key liver enzymes, including alanine transaminase (ALT) and aspartate transaminase (AST). SOD, GP x and heat shock protein 70 (HSP70) mRNA were significantly increased in GA group compared to control and diabetic groups. Liver of all diabetic rats showed marked degeneration whereas slight degeneration was observed in GA treated rats compared to control. The results suggest that GA may protect liver by modulating the expression of oxidative stress genes, and thus can improve antioxidant status. [ABSTRACT FROM AUTHOR]

Objective: Type I diabetes is an immunologically-mediated devastation of insulin producing cells (IPCs) in the pancreatic islet. Stem cells that produce β-cells are a new promising tool. Adult stem cells such as mesenchymal stem cells (MSCs) are self renewing multi potent cells showing capabilities to differentiate into ectodermal, mesodermal and endodermal tissues. Pancreatic and duodenal homeobox factor 1 (PDX1) is a master regulator gene required for embryonic development of the pancreas and is crucial for normal pancreatic islets activities in adults. Materials and Methods: We induced the over-expression of the PDX1 gene in human bone marrow MSCs (BM-MSCs) by Lenti-PDX1 in order to generate IPCs. Next, we examine the ability of the cells by measuring insulin/c-peptide production and INSULIN and PDX1 gene expressions. Results: After transduction, MSCs changed their morphology at day 5 and gradually differentiated into IPCs. INSULIN and PDX1 expressions were confirmed by real time polymerase chain reaction (RT-PCR) and immunostaining. IPC secreted insulin and C-peptide in the media that contained different glucose concentrations. Conclusion: MSCs differentiated into IPCs by genetic manipulation. Our result showed that lentiviral vectors could deliver PDX1 gene to MSCs and induce pancreatic differentiation. [ABSTRACT FROM AUTHOR]

Abstract: Background: Research has shown that suicide risk is often present in patients suffering from type 1 diabetes mellitus (DM-1). Objectives: The aim of the present paper was to investigate whether there was a relationship between DM-1 and suicidal behavior and to determine whether or not people affected by DM-1 are at an increased risk of completed suicide, attempted suicide, and suicidal ideation. Data sources: We performed a careful MedLine, ExcerptaMedica, PsycLit, PsycInfo and Index Medicus search to identify all papers on the topic for the period 1970 to 2013 written in English. The following search terms were used: (suicide OR suicide attempt OR ideation) AND (diabetes mellitus). Where a title or abstract seems to describe a study eligible for inclusion, the full article was examined. Eligibility criteria: We included only original articles published in English peer-reviewed journals. We excluded meta-analyses and systematic reviews, studies that were not clear about follow-up times, the method of statistical analysis, diagnostic criteria or the number of patients included, and studies only on patients affected by type 2 diabetes mellitus (DM-2). Results: The research reviewed indicated that patients with DM-1 are at an increased risk for suicide, although no clear consensus exists regarding the level of the increased risk. Limitations: The studies used different measurement techniques and different outcomes, and they assessed patients at different time points. Conclusions and implications: Our findings support the recommendation that a suicide risk assessment of patients with DM-1 should be part of the routine clinical assessment. The assessment of patients at risk should consist of the evaluation of current and previous suicidal behaviors (both suicidal ideation and attempted suicide). [Copyright &y& Elsevier]

Hypertension and diabetes have been related to noradrenergic system impairment, especially to the response mediated by alpha-1 receptors. The aim of this work was to investigate possible changes in the expression of alpha-1 adrenergic receptors in aorta and carotid arteries of Wistar Kyoto and spontaneously hypertensive rats after 4 weeks of the onset of diabetes. Our results suggest that early diabetes modifies the expression of alpha-1 adrenergic receptors in aorta and carotid arteries of both WKY and SHR strains in a different way. [ABSTRACT FROM AUTHOR]

Background: Curcumin exhibits anti-diabetic activities, induces heme-oxygenase-1 (HO-1) and is an inhibitor of transcriptional co-activator p300. A novel water soluble curcumin derivative (NCD) has been developed to overcome low invivo bioavailability of curcumin. We evaluated the effect of the NCD on signaling mechanisms involved in cardiomyocyte hypertrophy and studied whether its action is mediated via inducible HO-1. Materials and methods: Rats were divided into controls, controls receiving NCD, diabetic, diabetic receiving NCD, diabetic receiving pure curcumin, diabetic receiving HO inhibitor, zinc protoporphyrin IX (ZnPP IX) and diabetic receiving NCD and ZnPP IX. NCD and curcumin were given orally. After 45 days, cardiac physiologic parameters, plasma glucose, insulin, glycated hemoglobin (GHb), HO-1 gene expression and HO activity in pancreas and cardiac tissues were assessed. Gene expression of p300, atrial natriuretic peptide (ANP) and myocyte enhancer factor 2 (MEF2A and MEF2C) were studied. Results: NCD and curcumin decreased plasma glucose, GHb and increased insulin levels significantly in diabetic rats. This action may be partially mediated by induction of HO-1 gene. HO-1 gene expression and HO activity were significantly increased in diabetic heart and pancreas. Diabetes upregulated the expression of ANP, MEF2A, MEF2C and p300. NCD and curcumin prevented diabetes-induced upregulation of these parameters and improved left ventricular function. The effect of the NCD was better than the same dose of curcumin. [ABSTRACT FROM AUTHOR]

This study deals with cardiovascular autonomic neuropathy (CAN) in type 1 diabetic patients and its association with other complications. We searched for CAN in 684 patients (age, 47 ± 12 years; diabetes duration, 22 ± 11 years) by cardiovascular responses to deep breathing and standing. Patients considered as positive had laboratory evaluation: “Ewing” tests (deep breathing, Valsalva, stand test, hand grip); heart rate variability (HRV) [low frequency (LF) and high frequency (HF) power] and spontaneous baroreflex slope (SBS). Logistic regression was used to identify the combination of patient characteristics, including other complications, most associated with CAN severity according to Ewing Score (ES 0–5). 66.2% presented no significant abnormality (ES 0–0.5), 21.5 % had mild abnormalities (ES 1–2), and 12.3% had confirmed autonomic failure (ES > 2). Decrease in LF, HF and SBS was highly correlated to CAN severity. In the stepwise regression, age, retinopathy, nephropathy, bladder dysfunction, erectile dysfunction, peripheral neuropathy and hypertension remained correlated with CAN, whereas digestive neuropathy, BMI and HbA1c were excluded. Despite a small number of events, we found a significant association between coronary disorders and CAN severity. Simple bedside tests can detect CAN. HRV and SBS provide additional elements on CAN severity. Diabetes duration did not discriminate sufficiently patients with CAN. The association with retinopathy is in favor of the role of poor glycemic control in CAN development. This study shows the interest of CAN detection and the need to look for extracardiac autonomic neuropathy and silent myocardial ischemia in patients with confirmed CAN. [ABSTRACT FROM AUTHOR]

Early stages of diabetes have been related to arterial impairment in the vasoconstriction to norepinephrine. For that reason, the aim of this work was to investigate possible changes in the reactivity to angiotensin II and 5-HT in pithed rats and to evaluate the responses of aortic rings to acetylcholine and sodium nitroprussiate in streptozotocin-induced diabetes with 4 weeks evolution in both Wistar-Kyoto (WKY) and Spontaneously hypertensive rats (SHR). Our results suggest that hypertension produces a greater decrease in the vasoconstrictor response to angiotensin II and 5-HT in early stages of diabetes, while the NO-GMPc pathway could be involved such effect. [ABSTRACT FROM AUTHOR]

This paper presents a novel blood glucose regulation for type I (insulin-dependent) diabetes mellitus patients using biologically inspired TSK0-FCMAC, a fuzzy cerebellar model articulation controller (CMAC) based on the zero-ordered Takagi—Sugeno—Kang (TSK) fuzzy inference scheme. TSK0-FCMAC is capable of performing localized online training with an effective fuzzy inference scheme that could respond swiftly to changing enviromnent such as human's endocrine system. Without prior knowledge of disturbance (e.g., food intake), the proposed fuzzy CMAC is able to capture the glucose-insulin dynamics of individuals under different dietary profiles. Preliminary simulations show that the blood glucose level is kept within the state of euglycemia. The design of the proposed system follows closely to what is available in real life and is suitable for animal and clinical pilot testing in the near future. [ABSTRACT FROM AUTHOR]