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Diabetes mellitus has become a serious and chronic metabolic disorder that results from a complex interaction of genetic and environmental factors, principally characterized by hyperglycemia, polyuria, and polyphagia. Uncontrolled high blood sugar can result in a host of diabetic complications. Prolonged diabetes leads to serious complications some of which are life-threatening. The prevalence of diabetes patients is rising at epidemic proportions throughout the world. Every year, a major portion of the annual health budget is spent on diabetes and related illnesses. Multiple risk factors are involved in the etiopathogenesis of the disease and turning the disease into an epidemic. Diabetes, for which there is no cure, apparently can be kept under control by maintaining self-care in daily living, effective diabetes education, with comprehensive improvements in knowledge, attitudes, skills, and management. In this review, we focused on the biochemical aspects of diabetes, risk factors including both environmental and genetic, disease complications, diagnosis, management, and currently available medications for the treatment of diabetes.

Diabetes mellitus is a syndrome characterized by chronic hyperglycemia with disturbances of metabolism of carbohydrates, fats and proteins and relative insulin deficiency, resistance or both. This case represents a case of Diabetes mellitus treated with homoeopathic remedy Lycopodium. A 48 year old male patient visited OPD on 15/02/2019. He was complaining of polyuria, polyphagia and polydipsia along with weight loss and generalized weakness. There was burning and dryness in the whole body along with itching. This patient improved with Lycopodium 1M, single dose.

Polysaccharides have hypoglycemic activity and pea protein has high nutritional value. The purified pea glycoprotein PGP2 has been shown to inhibit the activity of α-glucosidase and α-amylase in previous studies. To study the mechanism of PGP2-induced blood glucose lowering in vivo, this paper established a diabetic mouse model by intraperitoneal injection of STZ and high-fat diet, and evaluated the blood-glucose-lowering activity of the pea component PGP2 at different doses. The results showed that intragastric administration of PGP2 could effectively reduce diabetic weight loss and polyphagia symptoms, reduce fasting blood glucose levels in mice, and improve oral glucose tolerance levels in mice. PGP2 could promote insulin secretion and had a protective effect on mouse organs. After intragastric administration of PGP2 in mice, the serum levels of total cholesterol, triglycerides and low-density lipoprotein decreased. PGP2 up-regulated the gene expression of insulin receptor substrates IRS-1 and IRS-2 in liver tissues, thereby reducing insulin resistance. Based on the above experimental results, PGP2 had good hypoglycemic activity and was expected to be developed as a natural medicine for the treatment of type II diabetes.

A 6-year-old, vaccinated, male neutered domestic shorthair cat was presented due to polyphagia and hypersexuality manifested since he had been adopted one year prior. Clinical and neurological examination was unremarkable, including absence of scrotal testicles and penile spines, indicative of testosterone absence. Differential diagnoses included inadequate neutering and residual testicular tissue, cryptorchidism, adrenal hyperplasia/neoplasia (sex steroid–producing), urinary bladder neoplasia, infectious myelopathy/neuropathy (e.g., feline infectious peritonitis [FIP]), temporal lobe epilepsy, or primary behavioral disorder. Hematology, biochemistry, and thyroid profile were almost unremarkable. Serology for Feline Immunodeficiency Virus, Feline Leukemia Virus, and Feline Coronavirus was negative. Serum pre- and post-human chorionic gonadotropin hormone stimulation Serum pre- and post-human chorionic gonadotropin hormone (hCG) stimulation testosterone ruled out cryptorchidism. Abdominal ultrasound revealed mildly enlarged colonic lymph nodes, the cytology of which revealed mild reactive hyperplasia. Urinalysis and culture were positive to Enterococcus spp. Magnetic resonance imaging of the brain and spinal cord and cerebrospinal fluid analysis was unremarkable. polymerase chain reaction in the cerebrospinal fluid for Toxoplasma gondii, FPV, FCoV, and bornavirus was negative. Attempts to treat hypersexuality as a behavioral disorder, urinary tract infection (amoxicillin clavulanic acid), pain (meloxicam and diazepam), and anxiety (diazepam) were unsuccessful. Thus, phenobarbital was prescribed in a low dose (1 mg/kg PO q 12h) which eliminated the episodes of polyphagia and hypersexuality without sedating the cat. Phenobarbital withdrawal resulted in hypersexuality re-establishment. Two years later, the cat remained episode-free on phenobarbital. Hypersexuality in male cats is characterized mainly by biting the nape, mounting, pelvic thrusting, penile erection, coital intermission, ejaculation, and/or masturbation. Temporal limbic structures play a significant role in the regulation of sexual arousal independently of testosterone. Hypersexuality has been associated with temporal lobe epilepsy in cats experimentally, while along with other clinical signs such as polyphagia, it is an established condition in humans called Kluver-Bucy syndrome. This is the first report to describe phenobarbital as a successful treatment of hypersexuality and polyphagia in a male neutered cat, raising a suspicion of feline Kluver-Bucy syndrome and temporal lobe epilepsy origin of these signs.

Background. To compare the demographic and clinical characteristics of children with newly clinically diagnosed type 1 diabetes (T1DM) who presented with diabetic ketoacidosis (DKA) versus non DKA presentation and to identify the precipitating factor(s) related to progression to DKA. Methods. Over a 3 month period, 99 patients newly diagnosed with T1DM were recruited from Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU), Cairo University, with 53 patients presented with DKA and 46 were non DKA. Results. Polyuria, polydipsia, weight loss, polyphagia and nocturia were the most common symptoms preceding the diagnosis among the whole study group (93.8%, 92% and 80.8%, 76.8%, 46.5 % respectively) with no difference between DKA and non DKA groups. Delayed diagnosis occurred in 98.1% and 58.7% of DKA and non DKA groups respectively. In the DKA group the diagnosis of diabetes was missed in 69.8% and in 28.3% the initiation of insulin therapy was delayed despite diagnosis. Multivariate analysis performed to identify the most significant precipitating factor(s) associated with the development of DKA at diabetes diagnosis showed that delayed start of insulin therapy was the most significant factor (OR = 1.267, P value = 0.023). Conclusion. The prevalence of DKA is high among Egyptianchildren at diagnosis of type 1 diabetes. It is not only caused by misdiagnosis and mismanagement of diabetes, but also delayed initiation of insulin therapy in those diagnosed. This highlights the importance of increasing awareness concerning clinical features of diabetes in children and the urgency of insulin therapy among primary health care professionals and the community.

Diabetes Mellitus (DM) is a group of metabolic disorders characterised by hyperglycaemia due to absolute or relative deficiency of insulin. It is characterised by polyuria, polydipsia, polyphagia, rapid weight loss, fatigue etc. Based on similarities in signs and symptoms DM can be correlated with Prameha/Madhumeha in Ayurveda. Rasausadhies (metallic formulations) have been used in the treatment of Diabetes mellitus with its excellence for centuries but their scientific evaluation has not systematically established with modern tools. Rasausadhies have been popularly used since the period of great alchemist Nagarjuna, i.e. 8th century AD. In this time, invention of special processing techniques as Sodhana (purification), Marana (incineration), Sanskara (which increases the potency), Murchhana (triturating up to fine disintrigation) etc, have been established which are being used to convert the minerals and metals into easily consumable form and immediate showing the desirable effect. The present study deals with review of Rasausadhies from all the classics of Ayurveda which are mentioned in the treatment of Prameha.

Patients of Diabetes Mellitus-type 2 (DM-2) is not only characterized by an increase of blood glucose levels, but also it is characterized by polyphagia and weight loss. This research aimed to discover the potential of 80% ethanol extract of Indonesia Nigella sativa L. (black cumin) seeds to the feed consumption level and changes in body weight of DM-2 rats model due to the administration of High Fat Diet (HFD) followed by the induction of streptozotocin (STZ) in a dose of 30 mg/kg Body Weight (BW). The DM-2 rats as the induction results divided into five groups, it was given a treatment using N. sativa extract with different doses, i.e. 0, 24, 48 and 72 mg/kg BW (DM-0, DM-24, DM-48, DM-72), positive control used metformin 45 mg/kg BW (DM-Metf). Non-DM rats (Normal) used as reasonable control. HFD induction carried out for 14 weeks, and N. sativa therapy conducted for four weeks after the oral glucose tolerance test. During the treatment, an observation of the feed consumption level and weekly weight gain were carried out. The data obtained were tested using one-way ANOVA, and it continued by Duncan Multiple Rank Test (DMRT), α= 5%. The research results indicated that the administration of 80% ethanol extract Indonesia N. sativa using the doses of 24 mg/kg BW and 48 mg/kg BW can control the feed consumption levels and prevent significant weight loss (p0.05)

Background and objectives Diabetes is a serious threat to global health that respects neither socioeconomic status nor national boundaries. Globally, diabetes is among the top 10 causes of death. Unani system argued the effectiveness of several anti-hyperglycemic drugs, and all such drugs looked-for to be validated on scientifically. Hence a clinical trial was contemplated to evaluate the clinical efficacy of Qurs-e-Gulnar in the management of Diabetes Mellitus. Methods This study was conducted as single blind randomized control, on 40 patients of type 2 diabetes with the test (n=20) and control (n=20) groups for 45 days. Test group received Qurs-e-Gulnar at the dose of three Qurs twice a day, and control group received two capsules Diabeat® twice a day before meal. Subjective (at 0, 15th, 30th, and 45th) and objective parameters were assessed as pre-post treatment respectively. Results After treatment with test compound significant reduction was observed in all the subjective parameters viz. polyuria, polydipsia, polyphagia and tiredness in comparison of control group. The objective parameters FBS and PPBS was found to be significantly reduced (pt-test, and Fischer exact test. Conclusion On the basis of above observation it is concluded that the test compound Qurs-e-Gulnar has significant anti-diabetic effect which is evidentially observed both in subjective and objective parameters in test group in comparison of control group (CTRI/2017/07/009060).

Resumen Introducción. El gusano cogollero, Spodoptera frugiperda, es una de las plagas más devastadoras a nivel mundial. Aunque de origen americano, este insecto amenaza la seguridad alimentaria de todo el orbe. La razón es que su polifagia y adaptabilidad se combinan con los efectos del cambio climático. En Costa Rica las especies del orden Spodoptera son consideradas plagas menores en el cultivo de la caña de azúcar; no obstante, existe un desconocimiento sobre la dinámica poblacional de polillas de este género. Objetivo. Monitorear las poblaciones de las especies S. frugiperda, S. sunia y S. exigua en una plantación de caña de azúcar. Materiales y métodos. El estudio se efectuó en una plantación de caña de azúcar variedad CC 01-1940, ubicada en Guanacaste, Costa Rica, entre febrero de 2018 y mayo de 2019. Se emplearon trampas con feromonas sexuales formuladas para S. frugiperda, S. sunia y S. exigua, cada feromona correspondió a un tratamiento y se colocaron diez repeticiones de cada uno. Se comparó la abundacia de cada especie y se correlacionó con distintas variables climatológicas. Resultados. El mayor porcentaje de capturas correspondió a S. frugiperda, seguido por S. sunia, mientras que las capturas de S. exigua fueron marginales. Tanto para S. frugiperda como para S. sunia, los meses de la estación seca favorecieron mayores poblaciones, por lo que factores como mayor temperatura promedio, amplitud térmica y menor humedad relativa se asociaron con mayores capturas en las trampas. Conclusiones. Aumentos en la temperatura promedio y disminución de periodos de lluvia, podrían incrementar la incidencia del género Spodoptera como plagas en la producción cañera. Abstract Introduction. The fall armyworm, Spodoptera frugiperda, is one of the world’s most devastating pests. Although originally from the Americas, this insect has become a global food security threat. The reason is that its polyphagia and adaptability combine with the effects of climate change. In Costa Rica, the species of the Spodoptera order, are considered minor pests in sugarcane production. Nevertheless, there is a knowledge gap in population dynamics of the moths of this genus. Objective. Monitor the populations of S. frugiperda, S. sunia, and S. exigua species in a sugarcane field. Materials and methods. The study was conducted in a sugarcane plantation of the variety CC 01-1940, located in Guanacaste, Costa Rica between February 2018 and May 2019. Sexual pheromone-baited traps formulated for S. frugiperda, S. sunia, and S. exigua were used, each pheromone corresponded to a treatment and ten replicates of each one were established. The abundance of each species was compared and correlated with several climatological variables. Results. The highest percentage of catches corresponded to S. frugiperda, followed by S. sunia, while the captures of S. exigua were marginal. For both S. frugiperda and S. sunia, the dry season months favored larger populations, so factors such as higher average temperature, thermal amplitude, and lower relative humidity were associated with higher captures in the traps. Conclusions. Increases in the average temperature and decrease in rainfall periods could increase the incidence of Spodoptera genus as pests in sugarcane production.

Calcium (Ca) is an essential macronutrient for plant growth. It can confer plants with resistance to abiotic stresses. However, little is understood about its role on biotic stresses. Frankliniella occidentalis (Thysanoptera: Thripidae) is one of the world’s most important invasive pests and poses a great threat to crops; meanwhile, it is hard to control due to its polyphagia and rapid reproduction. In order to clarify the effects of Ca on the induced defense of kidney bean plants against F. occidentalis by different application methods, we treated plants with different concentrations of CaCl2 solution using three methods, including spraying on leaf, root-irrigation, and seed soaking. The activities of defensive enzymes in leaves of kidney bean plants in response to F. occidentalis feeding as well as the developmental time of F. occidentalis were examined. The results showed that all the three treatment methods with different concentrations of CaCl2 solution could obviously induce activities of lipoxygenase (LOX), phenylalanine ammonia lyase (PAL), and β-1, 3-glucanase in leaves of kidney bean plants against F. occidentalis, while inductive effects of spraying the 10 mM CaCl2 on leaves were the best among all the treatments. Furthermore, we found that the developmental time of the whole immature stage of F. occidentalis feeding on plants sprayed with 10 mM CaCl2 was longer than those on control plants. Overall, our results indicated that the exogenous CaCl2 could enhance enzymatic activities in plants by thrips-induced effects, and spraying 10 mM CaCl2 on leaves of kidney bean plants showed the highest resistance against F. occidentalis.

Diabetes mellitus is a chronic metabolic disease that still remains a significant health problem in the world. In Indonesia, 7 percent of people age more than 15 have diabetes, and it caused 99.400 deaths in 2014. There are typical symptoms such as polyuria, polyphagia, polydipsia, and weight loss, and other symptoms. Diabetes mellitus is a multifactorial disease that affected by genetic component, environment, social, and culture. One of the risk factors that effect is exposure to chemical compound for example pesticides. Pesticides are chemical compounds that are used to kill pests in various sectors of life. Agricultural culture is related to pesticides. Pesticides are potentially toxic to a human when humans are exposed to pesticides through oral, transdermal, or inhalation. The pesticides that enter the human digestive system will be converted into glucose by gluconeogenesis in the intestine and liver. Moreover, there is a relationship between work period, pesticide spraying frequency, use of personal protective equipment, and pesticide dosage with the incidence of diabetes mellitus type 2. Farmers are a higher risk of diabetes mellitus type 2.

Case summary A 7-year-old male neutered domestic longhair cat was presented with chronic progressive gynaecomastia, polydipsia, polyphagia, weight loss and poor fur regrowth. Sexualised behavioural changes were not reported and virilisation was not present on physical examination. Pertinent haematology, biochemistry and urinalysis findings at the time of referral included mild hypokalaemia. Left adrenomegaly and mild prostatomegaly were identified on a CT scan. Evaluation of adrenal hormones with a low-dose dexamethasone suppression test, serum progesterone, testosterone, oestradiol, plasma aldosterone, renin, plasma metanephrine and normetanephrine measurement supported a diagnosis of hyperprogesteronism, hyperaldosteronism and hypercortisolism. Adrenalectomy was performed and histopathology was consistent with an adrenocortical tumour. Clinical signs and hormone elevations resolved postoperatively. Relevance and novel information To our knowledge, this is the second report of gynaecomastia secondary to an adrenal tumour in a male neutered cat and the first associated with hyperprogesteronism.

Diabetes mellitus (DM) as a common chronic disease, is one of the most serious and critical health problems in the world in the 21st century. Due to long-term asymptomatic, about 50% of DM patients are undiagnosed. With the development of machine learning (ML), early diagnosis of DM becomes possible. This study collected 575 sample instances, including 20 risk factors, including 10 symptom factors and 10 disease factors. ML was used to construct an early risk prediction model for DM. In this study, 16 classifiers were compared for the data. And the classification effect of XGboost is found to be the best. Precision, Recall and F-measure are 98.80%, 99% and 98.90% respectively. The classifier is used to analyze the risk factors that are highly correlated with DM. For the early prediction of DM, the top ten risk factors of attribute importance, from high to low are: polydipsia, polyuria, age, pregnancies, DM history, weight loss, polyphagia, obesity, living habits, visual blurring. This study can not only complete the classification and detection of DM, but also plays an important role in control and prevention of DM. Besides, this study shows that ML has great potential in the clinical application of non-invasive assessment of early risk of DM.

Experimental results for the new nerve growth factor (NGF) mimetic GK-2 [bis-(N-monosuccinyl-L-glutamyl-L-lysine)hexamethylenediamide] administered perorally toWistar rats in a streptozotocin-induced type 2 diabetes mellitus model are reported. The antihyperglycemic activity of GK-2 was determined in a dose range from 1 to 10 mg/kg. The most pronounced effect was observed at doses of 2.5 and 5 mg/kg. GK-2 was also found to reduce the severity of polydipsia and polyphagia and to produce a positive effect on the body-weight dynamics of diabetic animals. The dose dependence of GK-2 effects was described by a bell-shaped curve typical of regulatory peptides with various chemical structures. The ten-fold greater width of the dose–activity curve of the drug observed in this work combined with its high safety suggests that a satisfactory therapeutic index for GK-2 as a potential antidiabetic drug for peroral administration can be expected.

Simple Summary This is the first case report of two guinea pigs with insulin-dependent diabetes mellitus (DM) successfully treated with long-acting basal insulin glargine. Both animals presented with typical symptoms and laboratory changes like polyphagia, glucosuria and highly elevated blood glucose levels that suggested the presence of a diabetes mellitus. One of the guinea pigs had asymmetric bilateral cataracts. Mostly, a disorder resembling type II-DM in humans seems to be prevalent in guinea pigs. In this case, the animals did not respond to the standard treatment of a dietary change but responded promptly to insulin treatment. The diabetes has remained controlled for over 1.5 years now. Thus far, there is only sparse scientific information on spontaneous type I diabetes mellitus and treatment modalities in pet guinea pigs. We discuss the current literature including up to date diagnosis, treatment, monitoring with the evaluation of different glucometers and long-time follow-up. Moreover, individual ophthalmic abnormalities and management regarding suspected diabetic cataracts are described in detail. Abstract Scientific information on spontaneous type I diabetes mellitus (DM) and treatment modalities in guinea pigs is scarce. As most diabetic guinea pigs are overweight and respond to dietary changes, a disorder resembling type II-DM in humans seems to be most prevalent in this species. In the present report, a nine-month-old female intact guinea pig (GP1) was presented because of a cataract and polyphagia. The physical examinations in GP1 and its littermate, GP2, were unremarkable. Laboratory tests revealed hyperglycemia, hyperlipidemia, elevated fructosamine concentrations, and glucosuria in GP1 and GP2. Not responding to dietary changes, an insulin-dependent diabetes mellitus was suspected in both animals. Treatment with 0.5 IU of glargine insulin (Lantus®) per guinea pig subcutaneously (s.c.) once daily was initiated in both animals. Monitoring included repeated clinical evaluations and the measurement of plasma glucose and fructosamine concentrations. Capillary glucose concentration was measured using a glucometer, and glucosuria was monitored by dipstick. Blood glucose concentrations decreased quickly in both GPs, and glucosuria resolved. Including several dose adjustments, DM remained controlled for over 1.5 years. Bilateral cataracts and lens-induced uveitis in GP1 were medically managed with only slight progression. This is the first report of guinea pigs with insulin-dependent diabetes mellitus that were successfully treated with long-acting basal insulin glargine.

Background Occult (or atypical) hyperadrenocorticism (HAC) shows clinical signs and laboratory abnormalities similar to classic hyperadrenocorticism, but normal signs in routine screening tests such as the corticotropin (ACTH) stimulation test and low‐dose dexamethasone suppression test (LDDST). Here, we describe a case of occult HAC in a Yorkshire terrier treated with mitotane. Case An 11‐year‐old spayed female presented to the Veterinary Teaching Hospital of Seoul National University because of respiratory distress symptoms, polyphagia, and polydipsia, suggestive of HAC. In abdominal sonography, enlargement of the caudal pole of the left adrenal gland was found, but the cortisol level of post‐ACTH stimulation test was below the cut‐off value, and LDDST was negative. To finalise the diagnosis of occult HAC, 17‐hydroxyprogesterone (17‐OHP) was examined. The concentrations of 17‐OHP (pre‐ and post‐ACTH stimulation) were found to be elevated. As occult HAC was highly suspected, we prescribed trilostane for trial therapy. At first, the clinical signs improved, but they later worsened. We changed medication as trilostane to mitotane, and the symptoms were relieved after mitotane administration. Conclusion This is a unique case of occult HAC in which the response to mitotane was better than trilostane., This is a unique case of occult HAC in which the response was to mitotane but not trilostane. In abdominal sonography, enlargement of the caudal pole of the left adrenal gland was found, but in the ACTH stimulation test and LDDST, the cortisol level was below the cut‐off values. Basal and post‐ACTH stimulation serum concentrations of 17‐OHP were found to be elevated.

Introduction Diabetic ketoacidosis (DKA) is a life-threatening illness which classically presents with polyuria, polydipsia, and polyphagia that can rapidly progress to severe dehydration and altered mental status from cerebral edema. Younger patients may present with subtle or atypical symptoms that are critical to recognize and emergently act upon. Such patients are often cared for by teams in the emergency department (ED) requiring multidisciplinary collaboration. Methods This simulation case was designed for pediatric emergency medicine fellows and residents. The case was a 14-month-old male who presented to the ED with respiratory distress and dehydration. The team was required to perform an assessment, manage airway, breathing and circulation, and recognize and initiate treatment for DKA including judicious fluid administration and an insulin infusion. The patient developed altered mental status with signs of cerebral edema requiring the initiation of cerebral protection strategies. We created a debriefing guide and a participant evaluation form. Results Forty-two participants completed this simulation across seven institutions including attendings, residents, fellows, and nurses. The scenario was rated by participants on a 5-point Likert scale and was generally well received (M = 5.0). Participants rated the simulation case as effective in teaching how to recognize (M = 4.8) and manage (M = 4.5) DKA with cerebral edema in a pediatric patient. Discussion This simulation represents a resource for learners in the pediatric ED in the recognition and management of a toddler with DKA and can be adapted to learners at all levels and tailored to various learning environments.

Prader–Willi syndrome (PWS) is a genetic disorder characterized by a uniquely recognizable tetrad of phenotypic features that underlie the impact of the abnormalities residing in chromosome 15q11-q13. Among these, alterations in sleep are inordinately prevalent and can manifest as sleep-disordered breathing, hypersomnia syndromes, and sleep maintenance insomnia. The complex multisystem features of the condition, and the potential risk for sudden death, particularly during initiation of growth hormone therapy, require multidisciplinary coordination and careful monitoring for optimal outcomes.

Objective. To establish the diagnosis model for syndromes of type 2 diabetes mellitus (T2-DM) and explore symptoms, the pulse and tongue signs, and laboratory indexes related to syndromes of T2-DM. Methods. A syndromatologic and laboratory investigation was conducted in 554 T2-DM patients with 58 symptoms, 14 tongue signs, 6 pulse signs, and 12 laboratory indexes. The clinical data on the syndrome were collected and analyzed by using logistic regression analysis, decision tree, and K-nearest neighbor to establish a diagnostic model for effectively distinguishing the typical syndromes in T2-DM patients. Results. The most typical syndromes revealed in T2-DM were stomach heat flourishing (SHF) syndrome (261 patients, accounting for 47.1%) and Qi-Yin deficiency (QYD) syndrome (293 patients, 52.9%). According to the clinical data of the patients with these two syndromes, variables including 6 symptoms and signs, 2 pulse signs, 1 tongue sign, and 2 laboratory indicators were introduced into the logistic regression model. All of them were statistically significant. Then, a diagnostic model constructed by QUEST and CHAID algorithms of the decision tree for identifying the two syndromes was proved to have an accurate diagnostic rate of 85.2%. It was found that the following sign and symptoms were effective to differentiate these two syndromes: odor in the mouth, polyphagia, vulnerability to starvation, burning sensation in the stomach, fatigue, limb weakness, slippery and replete pulse, weak pulse, pink tongue, oral glucose tolerance test, and hemoglobin A1C. A classification model constructed by the K-nearest neighbor method to identify the two syndromes showed an accurate diagnostic rate of 88.3%. Three major statistically significant predictors included in the model were slippery and replete pulse, polyphagia, and weak pulse ( P < 0.05 ). Conclusion. A model for distinguishing the two typical syndromes (SHF syndrome and QYD syndrome) in T2-DM patients was effectively established. This model could help to provide methodological support for the standardization of traditional Chinese medicine (TCM) syndrome differentiation methods.

Diabetes mellitus (DM) is a common endocrinopathy in petanimals with variable pathophysiological metabolic pathwaysin dogs. Consequently, various hematological and biochemicalparameters tend to have high variability. Therefore, the aimof this study was to assess the most reliable and practicalhematological and/or biochemical parameter for monitoringDM during the insulin treatment in dogs and cats. This researchincluded 11 pet animals (8 dogs and 3 cats) with high resolutionof DM clinical symptoms. Red blood cell (RBC) and white bloodcell count (WBC) were measured on whole blood samples byusing hematological analyzer. Alanine aminotransferase (ALT),alkaline phosphatase (ALKP), glucose, urea, and creatininewere obtained from plasma samples analyzed with automaticcolorimetric analyzer. The variability of the parameters wasassessed by the coefficient of variation (CV, %). Parameterswith CV >34% were considered with non-normal distribution.RBC and glucose had CV of 24% and 25%, respectively.The other parameters had CV ranging between 39% and162%. Polyuria and polydipsia were present in 7 dogs and 1cat. Polyphagia was present in 4 dogs and 1 cat. Intermittentpolyphagia was found in 3 dogs. The clinical manifestationshad variable underlying conditions which resulted in variableconcomitant organopathies. In conclusion, the blood glucoseindicated normal distribution and can be used as a reliableindicator for monitoring DM in diabetic dogs and cats. By usingtelemetric blood glucose monitoring devices, the veterinarydoctors will have continuous and reliable data for the status andthe effectiveness of the therapy for their patients.

Case summary A 9-year-old male neutered Maine Coon cat presented with a 6-month history of polyphagia and one recent episode of tremors and weakness. Blood work revealed profound hypoglycemia and results of a paired insulin glucose test were consistent with an insulinoma. Abdominal ultrasound revealed a solitary pancreatic mass, and results of a fine-needle aspirate (FNA) gave further support for the location of the neuroendocrine tumor. After unsuccessful medical management of the hypoglycemia, the mass was surgically removed. Immunohistochemistry confirmed that it was an insulinoma. At the time of writing, the patient had been in clinical remission for 9 months. Relevance and novel information Feline insulinomas are rare and there is very little information on their behavior, clinical course and histologic characteristics. This is the first reported case of an insulinoma in a Maine Coon cat and the first to describe results of an ultrasound-guided FNA of the mass. In addition, the progression of disease, histopathology and immunohistochemistry results add to the currently minimal database for feline insulinomas.

Depression is the most common psychiatric disorder in diabetic patients, showing higher rates in women than in men. This comorbidity has been studied in rodents using the streptozotocin (STZ)-induced diabetes (DM) model, consistently reporting a depressive-like profile in males. Few articles have examined these disturbances in females (ovariectomized or combined with male rats) yielding controversial results. This work was aimed to study whether there are sex differences in the depressive-like profile of STZ-treated male and naturally cycling female Wistar rats. We also analyzed the possible influence of the estrous cycle in females. DM was induced by injecting STZ (50 mg/kg, i.p.) in 2 consecutive days. Ten days later, the depressive-like profile was assessed in the Forced-Swim Test (FST). Locomotion and motor coordination were also evaluated. Body weight and blood glucose levels were registered at the beginning and at the end of the experiment; the estrous cycle, food and water intake were daily monitored. All diabetic subjects showed increased blood glucose levels, polyphagia, polydipsia and decreased body weight as compared to controls, but males were more susceptible to STZ-treatment than females pooled in all phases of the estrous cycle. After treatment with STZ, males and females in proestrus/estrus (P/E) exhibited a depressive-like profile in the FST (increased immobility and reduced swimming); females in metestrus/diestrus were unaffected. The only sex difference observed was a more pronounced reduced swimming in STZ-treated P/E females compared with hyperglycemic males. No changes in locomotion or motor coordination were found. This work emphasizes estrous cycle differences in STZ-treated rats, and in the resultant depressive-like profile. It also supports clinical evidences made in women with DM and stresses the importance of studying STZ-treated naturally cycling females and their estrous cycle phases.

Diseases’ clinical-epidemiological characterization assists in directing the diagnosis. The objective of this study was to describe epidemiological, clinical and laboratorial aspects of a case series of canine hyperadrenocorticism (HAC). One-hundred fifteen records of dogs diagnosed by the low dose dexamethasone suppression test and/or ACTH stimulation test were evaluated. Of the cases, 81.3% were HAC ACTH-dependent and 18.7% HAC ACTH-independent. Females were more affected, representing 69.3% of the cases. The mean age was 10.3±2.5 years and 64.9% were gonadectomized. Most of the patients were small size dogs, weighting less than 10kg (73.9%). The most frequent breeds were: Poodle (27%), Dachshund (17.4%), and Yorkshire Terrier (10.4%). The most frequent clinical manifestations were polyphagia (86%), polydipsia (82.6%), polyuria (80%), abdominal enlargement (82.6%), thin skin (79.1%), muscular weakness (78.3%) and panting (74.8%). However, eventually unusual HAC-associated signs would be present in some dogs in a more important way compared with the classic disease´s clinical signs. The CBC showed neutrophilia (66%), eosinopenia (58.3%) and lymphopenia (42.6%) as main hematological abnormalities. The most common findings in serum biochemistry were increased alkaline phosphatase activity (81.74%), increased ALT activity (62.6%), hypercholesterolemia (66%) and hypertriglyceridemia (54.7%). Urinalysis revealed hyposthenuria in 14.9% and isostenuria in 13.5%; besides proteinuria in 50% of the cases. Abdominal ultrasound showed bilateral adrenal hyperplasia (92.2%) with adrenal asymmetry in 20.8% of the cases, in addition to hepatomegaly (80.9%), biliary sludge (67.8%) and hepatic hyperechogenicity (47.8%). It was concluded that small size gonadectomized female dogs, mainly Poodles and Dachshunds, presented higher frequency in the population studied, and that the main changes observed in clinical and complementary tests were polyphagia, polyuria, polydipsia, abdominal enlargement, adrenal hyperplasia, increased phosphatase alkaline and hyperlipidemia. These results corroborated to a better disease characterization at Brazil. This work concluded that the population studied resembles the profile describe in European and North American epidemiologic studies, and that the HAC dog´s clinical picture looks similar worldwide. RESUMO: A caracterização clínica-epidemiológica de doenças auxilia no direcionamento do diagnóstico. O objetivo deste trabalho foi descrever aspectos epidemiológicos, clínicos e laboratoriais de uma série de casos de hiperadrenocorticismo (HAC) canino. Foram avaliados 115 prontuários de cães diagnosticados pelo teste de supressão por baixa dose de dexametasona e/ou teste de estimulação com ACTH. Os casos de HAC ACTH-dependentes representaram 81,3% da população, e 18,7% foram ACTH-independentes. As fêmeas foram mais acometidas, representando 69,3% dos casos. A média de idade foi 10,3 ± 2,5 anos e 64,9% eram gonadectomizados. A maioria dos cães foi de porte pequeno, de até 10 kg (73,9%). As raças mais frequentes foram Poodle (27%), Dachshund (17,4%) e Yorkshire (10,4%). As manifestações clínicas mais relatadas foram polifagia (86%), polidipsia (82,6%), poliúria (80%), abdome pendular (82,6%), atrofia cutânea (79,1%), fraqueza muscular (78,3%) e dispneia (74,8%). Entretanto, eventualmente sinais clínicos pouco associados ao HAC se manifestaram de forma mais importante que os sinais clássicos da doença. O hemograma revelou neutrofilia (66%), eosinopenia (58,3%) e linfopenia (42,6%) como principais alterações hematológicas. Na bioquímica sérica foi observado aumento de fosfatase alcalina (81,74% dos casos), aumento da atividade da ALT (62,6%), hipercolesterolemia (66%) e hipertrigliceridemia (54,7%). A urinálise revelou hipostenúria em 14,9% e isostenúria em 13,5%; além de proteinúria em 50% dos casos. A ecografia abdominal evidenciou hiperplasia bilateral de adrenal (92,2%) com assimetria de adrenais em 20,8% dos casos, além de hepatomegalia (80,9%), lama biliar (67,8%) e hiperecogenicidade hepática (47,8%). Concluiu-se que fêmeas castradas de pequeno porte, principalmente das raças Poodles e Dachshunds, apresentaram maior frequência na população estudada e que as principais alterações observadas clínicas e nos exames complementares foram polifagia, poliúria, polidipsia, aumento abdominal, hiperplasia da adrenal, aumento de fosfatase alcalina e hiperlipidemia. Estes resultados corroboram para melhor caracterização da doença no Brasil. Este estudo concluiu que a população estudada se assemelha ao perfil populacional de cães com HAC descrito em estudos Europeus e Norte Americanos de forma que o perfil dos casos ao redor do globo parece similar.

Objective: Hypothalamic obesity (HO) is an intractable form of obesity syndrome occurring in patients following hypothalamic insults. It is characterized by significant polyphagia, lack of satiety, and rapid weight gain not usually responsive to caloric restriction or lifestyle modification. There are no established treatment modalities for HO. Liraglutide, a glucagon-like peptide-1 analog, has been approved for long-term treatment of obesity. We present a case of successful treatment with liraglutide of HO following resection of craniopharyngioma. Methods: We present a case report and review of the literature. Results: A 23-year-old female had developed panhypopituitarism and HO immediately following resection of a craniopharyngioma at age 8. She complained of poor quality of life due to weight gain from excessive hunger and lack of satiety. A trial of triiodothyronine at age 9, and dextroamphetamine starting at age 13, in addition to lifestyle modification had had limited efficacy. She began treatment with liraglutide at age 21 with a starting body mass index of 35.3 kg/m2, and noted marked improvement in polyphagia, began to recognize satiety after meals, and was able to lose 20 pounds over 6 months. She felt remarkably well both physically and emotionally, and no adverse effects of the medication were noted. Weight reduction has been maintained over 27 months with liraglutide use. Conclusion: Significant reduction in weight and recognition of satiety without adverse effects is noted in a young woman with HO with extended use of liraglutide. The use of glucagon-like peptide-1 analogs may represent attractive treatment options for treatment of HO.

Diabetes mellitus is a state of chronic hyperglycemia which causes various complications. Traditionally, The Tithonia diversifolia (Hemsley) A Gray leaf has long been used for the treatment of diabetes. The aim of this study is to investigate the effect of the T. diversifolia leaf on blood glucose, polyphagia, and weight loss in a diabetic rat model. Rats were made diabetic with intraperitonial injection of Nicotinamide and Streptozotocin and divided into 5 groups. Group 1 were healthy rats, group 2 were diabetic rats, while groups 3, 4, and 5 were diabetic rats treated with 25, 50, and 100 mg/kg body weight of 70% ethanol extract of Tithonia diversifolia leaf respectively for 28 days. Blood was taken after treatment for measuring glucose. The ethanol extract of T. diversifolia leaf decreased blood glucose in diabetic rats (P

The blue-eyed black lemur (Eulemur flavifrons) is classified by the International Union for Conservation of Nature (IUCN) as critically endangered. A 23-year-old male housed at Mulhouse Zoo presented with lethargy, polyphagia, alopecia, and chronic weight loss. Clinical examination suggested an endocrine pathology such as hyperthyroidism. Secondary examinations included cervical ultrasound, thyroid biopsy, and scintigraphy. The latter revealed elevated thyroid activity. Blood analysis was performed to measure the level of anti-receptor thyroid-stimulating hormone antibodies, which allowed us to test the autoimmune hypothesis. The high level of antibodies together with levels of thyroid-stimulating hormone and the scintigraphy images led to the diagnosis of Grave's disease. Carbimazole treatment followed by thyroidectomy resulted in a quick weight gain and general improvement in health status. The following breeding season, the treated individual sired an offspring. To the authors' knowledge, this is the first report of likely Grave's disease in a non-human primate.

Diabetes mellitus (DM) is a metabolic disorder with symptoms of polydipsi, polyuria, polyphagia, weight loss and tingling. The incidence of DM increased with the number of patients with type 2 DM more than type1 DM. Insulin resistance and deficiency is characteristic of type 2 diabetes. Streptozotocin (STZ) as a DM inducer model is better than alloxan by altering the physiological pancreas. The purpose of this study was to determine the physiological response and blood sugar levels of mice after exposure to STZ. Descriptive research design with the study subjects of 16 white wistar strains (Rattus norvegicus). STZ is given 40mg / kg BW for 3 days. Data collection is done 2 days after STZ last gift. Blood glucose levels are obtained from the end of the tail while the heart rate is measured using a modified stethoscope. Data is presented in the mean ± SD. The results showed heart rate 500 ± 59.32 / min, weight 292,5 ± 65,26 (gr) and blood glucose content 237 ± 102.5 ml /dl. STZ responded to ratts resulting in physiological changes. Histologic observation of pancreatic cells is needed to determine the damage caused by STZ . Needed longer observation to see the response of ratts further.

Trilostane is the recommended medical treatment for dogs with hyperadrenocorticicm (HAC). The objective of this study was to investigate the association between ACTH stimulation test (ACTHST) results, and relevant clinical signs, in dogs treated with trilostane. A disease-specific questionnaire was developed, which included the owner's assessment of polydipsia, polyuria, polyphagia, panting, and satisfaction with the treatment, based on a 5-response category rating scale. Forty-nine dogs with HAC were prospectively enrolled. Dogs were grouped according to their recheck appointment (first recheck, 710 days after commencement of treatment or change of trilostane dose; second recheck, 4 weeks after the first recheck; third recheck, performed at 3-6 months intervals once the dog was well controlled). At the recheck appointment, the owner's questionnaire responses were recorded, and an ACTHST was performed, along with urine specific gravity measurement. Linear mixed effects models were used to assess differences among the three recheck time points and to test possible associations between ACTHST results and clinical signs. Significant differences between rechecks were present for stimulated cortisol (first to third recheck, P < 0.001; second to third recheck, P < 0.01), polydipsia (first to second recheck, P = 0.001), polyuria (first to second recheck, P < 0.001; first to third recheck, P = 0.001), and owner satisfaction (first to second recheck, P < 0.001; first to third recheck, P < 0.001). Backward stepwise variable elimination did not identify any significant associations between ACTHST results and clinical signs. Therefore, clinical signs of HAC were not predicted based on the ACTHST results.