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Background and objectives Hemoglobinopathies are monogenic disorders with autosomal recessive inheritance. In Europe, with increased migration flows these conditions are appearing more frequently in non-endemic regions. HbA1c testing is useful for evaluating long-term glycaemic status in diabetes mellitus patients. During HbA1c evaluation, other hemoglobin fractions are detected, such as structural hemoglobinopathies. The principal objective of this work is to study the incidence of structural hemoglobinopathies in our area and their management. Material and methods Total population of 65,000 patients for glycaemic monitoring was evaluated with HPLC equipment (HPLC-ARKRAY® ADAMS, Menarini Diagnostics, Italy). This equipment quantifies different hemoglobin fractions. Results We identified a total of 128 variants, representing an incidence with respect to the study population of 0.19% (1.97‰). Most (69) were identified in the foreign population, and the most frequent variant identified was heterozygous S hemoglobinopathy. In six families, structural hemoglobinopathy was identified. Three patients with HbS/HbS were detected. Primary Health Centers were the origin of an important part of these variants (82). Conclusions Our study describes a low incidence for structural variants compared with the estimated incidence in Spain. These variants can interfere with HbA1c testing. In these cases, glycated protein study is an appropriate alternative to monitor diabetic therapy.

Introduction: The study aims to evaluate the anti-hyperglycaemic effect of turmeric and the histological changes in the pancreas of adult Wistar rats. Materials and Methods: Forty adult Wistar rats were divided into four groups of [A-D] ten rats per group. Group A was normal control, group B was diabetic control, group C was treated with 300mg/kg weight of extract and group D was 500mg/kg body weight. All animals had access to food and water ad libitum. Aqueous extract of turmeric was administered orally, once daily for 14 days. The rats were then anaesthetized with dichloromethane before sacrifice and sample collection. Pancreatic tissues were processed, stained using the hematoxylin and eosin (H&E) method. Blood glucose estimation was determined using the glucose oxidase method. Results: The mean body weights of the rats across groups were not statistically significant. Similarly, blood glucose levels across groups revealed a progressive statistically significant increase from group A to D and from day one to day 17. Pairwise comparison of group A with B, C and D showed a statistically significant increase but a comparison of Group B with C and D were not significant. Discussion: There was progressive body weight increase of the rats from day one to the final day across all groups and reduction in the blood glucose levels of the animals treated with 300mg/kg and 500mg/kg body weights, after seven days of treatment, but these, progressively increased with time even with treatment. The overall pancreas features indicate moderate inflammatory changes. Keywords: turmeric, anti- hyperglycemia, alloxan, Wistar rats

Origanum vulgare, known for its medicinal value, is officially accepted in many countries. The flowers and leaves are used globally in homeopathy. In Brazilian folk medicine, O. vulgare has been used to treat diabetes mellitus. This study evaluated the hypoglycemic activity of an infusion extract (RosCE) of commercially available O. vulgare leaves in alloxan-induced diabetic rats. Oral administration of RosCE resulted in the reduction of blood glucose levels after the first day of treatment, compared to the diabetic control group. These results showed that RosCE displays hypoglycemic activity, which may be due to the combined effect of rosmarinic acid, and other minor compounds. Reversed phase-high performance liquid chromatography-diode array detection was used to identify and quantify the major constituents of RosCE. This study presents evidence that supports the folkloric use of O. vulgare for the treatment of hyperglycemia, confirming the use of its infusion as an antidiabetic herbal medicine.

UK guidelines recommend an HbA1c 0.05). There was no difference in 30-day re-admission rates between groups 2.8%, 2.9% and 3.3% (p = 0.983). At 6 months and 1 year, there was sustained and equal reduction in HbA1c in all groups (p

Wounds of diabetic patients often require weeks of adequate and appropriate care for full recovery. The use of systemic insulin in diabetic patients was reported to enhance wound healing. Thus, the present study was conducted to evaluate the effect of topical insulin on diabetic wounds. Our objective was to compare the effectiveness of topical short and long acting insulin combined with standard wound dressings in healing of wounds in diabetic patients. Thirty adult patients of both sexes from the outpatient settings of the General and Plastic surgery wards at Minia University Hospital were included in the study. Patients were assigned into three groups; control, patients applying short acting insulin and those applying long-acting insulin. The wounds were compared for healing time, inflammation and pain at days 0, 14, and 21. The mean age of patients included in the study was 58.9±5.3 years. The unit healing time for diabetic control group was 25.1±22.9 which was significantly higher than the two other groups (10.02±5.4 and 5.1±2.4, respectively) with no significant difference between topical short and long-acting insulin applying groups. Upon scoring of wounds, the long acting score of the short acting insulin was significantly lower than the control group at day 14 (p=0.001) while both topical insulin groups showed significantly reduced scores at day 21 compared to the control group (p=0.001 and p=0.009 for short and long-acting insulin, respectively). Both topical insulin treatments resulted in an acceleration of the wound healing process with no significant difference between short and long-acting insulin.

Introduction: Salacia lehmbachii is used traditionally for the treatment of diabetes mellitus. This study investigated the hypoglycaemic potentials of ethanol leaf extract of S. lehmbachii and its effects on alloxan-induced diabetic rats’ haematological parameters. Methods: A total of 36 male Wistar rats including normal, diabetic untreated, and diabetic treated ones were used in this study. Diabetes was induced by a single intraperitoneal injection of 150 mg/kg of alloxan. When confirmed diabetes, the rats were orally administered 100 mg/kg, 200 mg/kg, and 400 mg/kg daily of the leaf extract for 21 days. The blood glucose levels and haematological parameters were determined in diabetic treated rats compared with the controls. Results: The ethanol leaf extract of S. lehmbachii significantly reduced the blood glucose levels of alloxan-induced diabetic rats when compared with the diabetic control (P < 0.01). The extract also significantly (P < 0.01) improved the haematological parameters of treated rats at three doses employed. Conclusion: It can be concluded that the ethanol leaf extract of S. lehmbachii possesses antihyperglycaemic properties and could be considered a potential candidate for the development of new drugs in the treatment of anaemic conditions.

We assessed the ameliorative effect of Virgin Coconut Oil following atrazine-induced metabolic derangement in rats. Adult male wistar rats weighing 180-200g were used; randomly separated into two major groups. Thirty-five rats in the test group were randomly divided into five sub-groups of 7 rats per sub-group and treated thus: Sub-group (SG) 1, 2 and 3 received 10ml/kg of distilled water, 10ml/kg VCO, 123mg/kg of Atrazine respectively, SG4 was diabetic control; SG 5 was the diabetic group treated with 10ml/kg of VCO for 2 weeks, after which the animals were sacrificed and blood collected for analysis. 35 rats for the recovery group were also divided into 5 sub-groups of 7 rats per sub-group and were treated; SG 1, 2, 3, 4 and 5 received 10ml/kg distilled water, 10ml/kg VCO, 123mg/kg of ATZ respectively. After 2 weeks, the animals were re-treated thus: SG 1,2,3,4 and 5 received 10ml/kg of distilled water, 10ml/kg of VCO, 123mg/kg of ATZ, 10ml/kg VCO and 10ml/kg distilled water respectively. After 2 weeks, the animals were also sacrificed and blood collected for analysis. ATZ reduced serum insulin and a reduced expression of GLUT4. VCO restored GLUT4 levels but did not significantly restore the insulin to the normal levels

The case was 71-year-old male patient with type 2 diabetes mellitus (T2DM). He was diagnosed T2DM at the age of 61 associated with thirsty, polydipsia and fatigue. HbA1c value was 12.5% and blood glucose profile was 150-300 mg/dL. Just after starting low carbohydrate diet (LCD), his blood glucose kept under 150 mg/dL all day long. He continued good diabetic control as HbA1c 5.8-6.8% for 10 years. Some beneficial points are found: i) keeping LCD with the feeling not stressful but pleasant for observing the normal glucose level, ii) walking daily for 2 hours, iii) continuing educational activity in the walking association for DM and health care. iv) writing the diary for years every day, including exercise, meal, medicine, activities and so on, v) checking post-prandial hyperglycemia by meal tolerance test (MTT). For details of v), HbA1c was 6.5% in May 2021 and fasting glucose was 107mg/dL. Glucose values 45-min and 60-min after 3 meals showed 210-201-177mg/dL and 195-213-172mg/dL, respectively. His various continuing behaviors contributed satisfactory glycemic control. This article becomes reference in the diabetic practice and research.

This pilot study investigated reported fruit and vegetable consumption and diabetic control for older patients with a diagnoses of diabetes and food insecurity at a rural Midwestern Federally Qualified Health Center. Vouchers ($40 per month for 3 months) were provided for fruits and vegetables at a local farmers’ market during a 12-week program (June 2020-August 2020). Data revealed a statistically significant increase in reported green vegetable consumption and farmers’ market visits postintervention. There was not a significant change in hemoglobin A1c, body mass index, or other reported produce consumption.

Biological features of silver nanoparticles in rising the insulin level of diabetic animal models were considered in recent years, which resulted in decreasing hyperglycemia condition. We reviewed the published literature to investigate the possible role of silver nanoparticles (Ag-NPs) throughout the treatment of diabetes mellitus in animal studies. In this systematic review and meta-analysis, we performed a search throughout the English literature of electronic databases, including Scopus, PubMed, and ISI Web of Science, up to the date of May 22, 2020. Primary outcomes and data regarding fast blood sugar (FBS), lipid profile, and liver enzyme were collected from the available articles, while the studies that did not provide sufficient information on the effects of silver nanoparticles through the course of diabetes mellitus were excluded. Our search yielded 1283 results that included five animal studies in the meta-analysis. The comparison between the plasma insulin level of the diabetic group treated by Ag-NPs with the diabetic control group displayed no significant differences with the P values = 0.299. In addition, significant differences were revealed by comparing the FBS level of the diabetic group treated by Ag-NPs with the diabetic control group (P value

This study is aimed at investigating the relationship between treatment modality, glycemic control and blood homeostasis as represented by prothrombin time (PT) and activated thromboplastin time (APTT) in T2DM patients. Sixty-four type 2 diabetic patients (40 males and 24 females) on metformin or insulin or both for not less than six months of ages between 20 and 75 years were selected during their visit to Diabetes Endocrine and Metabolism Centers in two General Hospitals in Basra. Socioeconomic characteristics and treatment plans were recorded. Glycated haemoglobin (HbA1c), lipid profiles and hematological parameters measured in blood samples were taken. Lower mean HbA1c (p = 0.0383) was found in patients on metformin alone, higher percentage of hemoglobin was found in patients on insulin treatment, and higher levels of LDL (P = 0.0018) and HDL (P = 0.0241) in patients on metformin and insulin. Treatment manner had no effect on mean PT or APTT, however, there was a significant inverse correlation of PT with LDL (P = 0.0042), and a direct correlation of APTT with HbA1c (p = 0.0209) and an inverse correlation of APTT with platelets count (P = 0.0324) in patients on insulin treatment. In addition, there was a significant direct correlation of APTT with triglycerides (TG) (P = 0.0069) in patients on metformin treatment. In conclusion, lower mean of HbA1c was found only in patients receiving metformin drug alone, higher Hb percentage were found in patients treated with insulin alone, higher LDL and higher HDL levels were found in patients treated with both metformin and insulin for at least six months. Treatment manner had no effect on mean PT or APTT and further studies are needed to bring about understanding of diabetic control and blood homeostasis.

The patient is a 56-year old (yo) female with type 2 diabetes mellitus (T2DM). Medical histories include persisting T2DM from 35yo, renal stone at 43yo, hypertension from 45yo, photocoagulation for retinopathy on 54yo. An incidentaloma was found in the left adrenal gland, where endocrinological exams were negative for functional tumor. Her diabetic control situation became worse with HbA1c > 10%, then the treatment has been changed from multiple daily injection (MDI), Dulaglutide to Xultophy which is combined agents of degludec and liraglutide (IDegLira). It was provided 10-18 doses daily, and then glucose variability profile was improved satisfactory, suggesting the dual synergistic effects.

Obesity is a global problem and numbers are rising at a fast pace in developing countries and it becomes a major public health concern. Economic costs associated with obesity are high and increasing with the rate of obesity. Obesity is a state of body fat being accumulated in excess, and it is well known that many diseases including metabolic disorders, such as diabetes and hyperlipemia and diseases in circulatory organs Such as hypertension and ischemic cardiac diseases tend to follow obesity. The fat contained in meals is one of the nutrients most profoundly related to the accumulation of body fat, but the excessive ingestion of fat may result in obesity. However, fat has intrinsic taste, and meals of extremely reduced-fat are often insufficient to give Satisfaction. Further, when deep-fried food or fried food is made, edible oil is indispensable as a heating medium. The so-called fat substitutes were developed in the early 2000s for resolving such a situation. However, none of them are fully satisfactory in Safety, physical properties, cooking properties and flavor. This review will discuss the dietary fats that were developed for different food applications which are claimed as healthy oils with lower calorie intake than classical triglycerides oils which have a caloric content of average of 9 cal/gm and recommendations for optimum healthier and dietary for obesity and diabetic control and lower calories food.

The present study was to estimate the anti-diabetic and antihyperlipidemic activity of aqueous extract of leaves of plant Aloe barbadensis.In alloxan-induced diabetes in rats, the research examined six groups of six male wister rats every to value the hypoglycaemic effect of the barbadensis (ALEC) exposed to hostile to diabetic action in rodents where alloxan monohydrates were utilized as a portion of 120.00 mg/kg in intraperitoneal portion as a diabetogenic specialist to an acquainted diabetic with test rodents. In sub intense, treatment, bunch blood glucose levels are seen on 14.00th, 21.00th and 30.00th-day present treatment compare on typical control in diabetic control checked expanded blood glucose level was watched, with dosages of 100.00, 250.00 and 500.00 mg/kg b.w. A portion of 500.00 mg/kg b.w/day was seen as having the most significant activity. Glibenclamide was applied as a standard drug, and the outcome was compared about it. In the antihyperlipidemic activity, serum cholesterol levels were recorded at aqueous extracts of 100.00, 250.00 and 500.00 mg/kg, on 30.00th-day post-treatment. Serum cholesterol levels were ordinary benchmark groups was 107.70±01.21 mg/dl diabetic control 178.50±01.04 mg/dl and standard medications treatment bunches was 111.30±02.40 mg/dl and ALEC treatment bunches were 171.20±01.03 mg/dl, 145.80±02.92 mg/dl and 118.80±03.86 mg/dl for 100.00, 250.00 and 500.00 mg/kg separately. The results show that the aqueous extract of Aloe barbadensis has significant and continuous oral hypoglycaemic activity, equivalent to the hypoglycaemic result of glibenclamide, a sulfonylurea derivative and hyperlipidemic activity. Extracts also confirmed antihyperlipidaemic possible of the plant extract is establish to be comparable with that of the standard.

Diabetes is a typical and pervasive sickness and a significant medical issue around the world. It has been accounted for to be the significant reason for visual impairment, kidney disappointment, lower-furthest point removal, cardiovascular maladies and untimely mortality. Diabetes has to expand cases in rustic and helpless populaces all through the world. Diabetes has expanding suitcases in rustic and helpless populaces all through the world, regardless of significant examination concerning sympathetic the pathophysiology and action of diabetes mellitus. It has kept on being a significant medical issue around the world. The chance of its administration by the uttered organization of hypoglycemic specialists has animated incredible examination enthusiasm for throughout the long term. Taking into account the issue with different reasons, the mix of restorative specialists focused on explicit path-organic trails of diabetes and its intricacies bring about a special and additional powerful administration issue. From cell, reinforcement considers, it was discovered that STZ instigated diabetic control creatures indicated a critical diminishing in the degrees of SOD and CAT when contrasted with typical switch. Standard gathering preserved with Glibenclamide and test bunch preserved with Glibenclamide + ginger blend indicated huge increment in CAT and SOD when contrasted with diabetic control insulin lack prompts different metabolic deviations in the rodents; the ascent in blood glucose level is joined by an increment in SGOT and SGPT level. The current investigation was led to assess the counter diabetic action of blend with Ginger. The organization of boundaries actuated diabetes were assessed in the examination. When utilized in mix with Ginger, even at sub remedial degree of Glibenclamide demonstrated comparative impacts as that of a restorative portion of Glibenclamide.

Chronic hyperglycemia is associated with poor cardiovascular surgical outcomes due to microvascular and macrovascular complications. This is a major concern as over one third of cardiovascular surgical patients have diabetes mellitus which greatly increases their risk of experiencing adverse cardiovascular events. A literature review was performed to identify articles discussing the effects of anti-diabetic medications (ADMs) on cardiovascular outcomes and surgical mortality and morbidity rates. Optimizing perioperative glucose levels remains a key factor in producing good surgical outcomes. In addition, recognizing gender differences, increasing patient satisfaction, and implementing dedicated diabetic teams all improve surgical mortality and morbidity rates in the diabetic population.

BACKGROUND AND OBJECTIVE Hedera helix L. (Ivy) has been utilized as an alternative medicine for cough however, through extensive literature search; we found no reported activity of ivy on α-glucosidase inhibition, HbA1c levels and its protective effect on vital organs. Therefore, the present study aimed to evaluate the antidiabetic and protective effect of ivy in alloxan induced rat model. MATERIALS AND METHODS The hypoglycemic activity of ivy was examined in normoglycemic, glucose overloaded and alloxan-induced rats. The antidiabetic potential was also confirmed by estimation of HbA1c and α-glucosidase inhibitory activity. RESULTS Results of acute and chronic study revealed that ivy produced highly significant decline (p

We aimed to screen for depression among a sample of adolescents with type 1 Diabetes Mellitus (T1DM) and to determine the impact of obesity and poor diabetic control as potential risk factors. One ...

Background While not studied for distal radius fractures, the effect of surgical timing on complication rate has been extensively analyzed in the treatment of pilon fractures. The primary aim of this study was to identify any effect surgical timing has on postoperative complication rates after surgical fixation of distal radius fractures in diabetic patients. Methods All patients who underwent surgical fixation of distal radius fractures at a single suburban academic hospital between 2012 and 2019 were reviewed. For each patient, demographics, comorbidities, injury details, fixation method, and postoperative complications were noted. The effect surgical delay, among other factors, had on complication rate in diabetic and nondiabetic patients was explored. Results Overall, 124 diabetic and 371 nondiabetic distal radius fractures were included. While diabetics had a statistically higher rate of total complications (21.0 vs. 13.5%, P = .045) but similar major complications requiring surgery ( P = .12), there was no difference in surgical delay between groups among patients who had total ( P = .31) or major ( P = .69) complications. Surgical timing was not a risk factor for total ( P = .50) or major complications ( P = .32) in diabetic fracture bivariate or multivariate analysis. Only younger age and higher energy injuries were significant risk factors for total complications in bivariate ( P = .02, P = .03) and multivariate ( P = .04, P < .05) analysis. Conclusion Complication rates after surgically stabilized distal radius fractures in diabetic patients are higher than in nondiabetic patients. However, this rate is not affected by surgical timing. Instead, surgeons should consider factors such as diabetic control in an effort to maximize outcomes and decrease complications. Level of Evidence Prognostic Level III

We investigated the protective effect of green tea on diabetic hepato-renal complications. Thirty male Wistar rats were randomly divided into five equal groups: normal control, diabetic control, glibenclamide-treated, green tea-treated, and combined therapy-treated groups; ethical approval number "BERC-014-01-20." After eight weeks, animals were sacrificed by CO

Introduction: Diabetes mellitus has harmful effects on body functions, such as learning and memory. According to the role of exercise and medicinal plants on body health, the purpose of this study was to survey the effect of combined aerobic training and the use of Ripe Pistachio Hulls (RPH) hydro-alcoholic extract on learning and memory in streptozotocin-induced diabetic male rats. Methods: In this experimental study, 42 male Wistar rats weighing 250-280 g were used in 6 groups with an equal number of 7 rats in each one. Streptozotocin (STZ) (50 mg / kg)was used to induce diabetes , and the test protocol was applied for 8 weeks. Passive avoidance memory was assessed using a step-through passive avoidance apparatus (shuttle box). SPSS software was used to analyze the data and P

Indonesia faces a double burden of communicable and non-communicable diseases, including metabolic and degenerative problems. Delay in the detection of diabetic nephropathy (DN) as one of the chronic microvascular complications is often seen, leading to the need for hemodialysis due to the end-stage renal disease (ESRD). An assessment of diabetes mellitus (DM) control target achievement, based on the guideline from the Indonesian Society of Endocrinology (Perkumpulan Endokrinologi Indonesia, PERKENI), and nephropathy early detection was performed in 54 Type-2 DM patients from 5 private hospitals in Pekanbaru Riau, Indonesia, from November 2018 to September 2019. Results showed poor achievement of DM control with 61.1% had abnormal body mass index, 57.5% had HbA1c>7%, and 77.7% had LDL serum >100 mg/dL. Nevertheless, most patients achieved good blood pressure control (74%). A high percentage of nephropathy-proteinuria was seen (40.7%) with 40.9% of them revealed renal insufficiency classified as chronic kidney disease (CKD) stage 3 and 4. There was a significant correlation between proteinuria and declined GFR (p=0.016), onset of DM (p=0.02), and diastolic blood pressure (p=0.03). No correlation was found between HbA1c and declined GFR, which may be due to the cross-sectional nature of the study. It will be interesting to perform a prospective study on proteinuria modification as a predictor of nephropathy early detection in DM patients since kidney biopsy and urine albumin creatinine ratio assessment are not available in primary health care services in remote areas. Korelasi antara Proteinuria dan Laju Filtrasi Glomerulus pada Diabetes Melitus Tipe 2 Indonesia menghadapi beban ganda penyakit menular dan tidak menular, termasuk masalah metabolisme dan degeneratif. Keterlambatan dalam deteksi nefropati diabetik sebagai salah satu komplikasi mikrovaskular kronis sering terlihat, mengarah pada kebutuhan untuk hemodialisis karena penyakit ginjal stadium akhir (ESRD). Dari 54 pasien diabetes melitus (DM) tipe-2 tanpa keluhan edema, sesak, dan lemas dari 5 rumah sakit swasta di Pekanbaru, Riau, Indonesia, dari November 2018 hingga September 2019, dilakukan penilaian kontrol DM sesuai panduan Perkumpulan Endokrinologi Indonesia (PERKENI). Didapatkan hasil bahwa pencapaian kontrol DM masih buruk dengan 61,1% memiliki indeks massa tubuh abnormal 57,5% memiliki HbA1c >7%, dan 77,7% memiliki serum LDL >100 mg/dL. Namun demikian, sebagian besar pasien mencapai kontrol tekanan darah yang baik (74%). Pasien terdeteksi proteinuria >25 mg/dL mencapai 40,7% dengan 40,9% diantaranya mengalami gangguan filtrasi ginjal yang didefinisikan sebagai GFR

The changes of the linker of nucleoskeleton and cytoskeleton (LINC) complex have been studied in many muscular abnormality conditions; however, the effects of diabetes and physical activities on it have still remained to be defined. Therefore, the purpose of the this study was to evaluate the impacts of a six-week endurance training on the levels of SUN1 and Nesprin-1 proteins in Soleus and EDL muscles from diabetic wistar rats. A total number of 48 male Wistar rats (10 weeks, 200-250 gr) were randomly divided into healthy control (HC, N = 12), healthy trained (HT, N = 12), diabetic control (DC, N = 12), and diabetic trained (DT, N = 12) groups. Diabetes was also induced by a single intraperitoneally injection of streptozocin (45 mg/kg). The training groups ran a treadmill for five consecutive days within six weeks. The levels of the SUN1 and the Nesprin-1 proteins were further determined via ELISA method. The induction of diabetes had significantly decreased the levels of Nesprin-1 protein in the soleus and EDL muscles but it had no effects on the SUN1 in these muscles. As well, the findings revealed that six weeks of endurance training had significantly increased the levels of Nesprin-1 in DT and HT groups in the soleus as well as the EDL muscles; however, it had no impacts on the SUN1 in these muscles. The muscle fiber cross-sectional area (CSA) and myonuclei also decreased in diabetic control rats in both studied muscles. The training further augmented these parameters in both studied muscles in HT and DT groups. The present study provides new evidence that diabetes changes Nesprin-1 protein levels in skeletal muscle and endurance exercise training can modify it.

The case was a 55-year-old female patient with depression for 5 years and type 2 diabetes mellitus (T2DM) for 3 years. She has received anti-depressant and anti-hyperglycemic agents (OHAs). Approximately 1 year ago, her diabetic control became exacerbated without specific triggers. She was started to given Ipragliflozin L-Proline as Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitor. After that, her glucose variability and depression had been improved. According to the previous reports, SGLT-2 inhibitors seem to have anti-depression efficacy for diabetes. The case has been followed up in detail, and this report is expected to be a useful reference for diabetes care.

Continuous Glucose Monitoring (CGM) has been recently applied in the clinical diabetic practice. Authors have continued research of glucose variability. In this study, 51 year-old female patient with Type 1 diabetes mellitus (T1DM) was investigated. She has given multiple daily insulin injection (MDI) for long and her recent daily glucose profile was unstable. After applied with FreeStyle Libre, her blood variability was improved with the average glucose from 222 mg/dL to 135 mg/dL, which was partly from her motivation for better diabetic control. Thus, CGM may become a trigger to give beneficial influence for regular lifestyle of the patients.

Graphical abstract, Highlights • Diabetes is both clinically as well as genetically multifaceted group of disorders characterized by high blood glucose level. • Hyperglycemic condition arises due to shortage of insulin secretion or resistance developed by the cells of body against the insulin binding on its membrane receptors, or it may be the combination of both. • Present study was designed to explore therapeutic efficacy of exogenous supplementation of melatonin and insulin against the diabetes induced alterations in hematological variables. • Combined administration of melatonin and insulin significantly restored the altered hematological variables towards the normal range., The aim of the present was to ameliorate the protective effect of exogenous melatonin and insulin against the diabetes induced alterations in the different hematological variables. Albino rats were administrated streptozotocin at the dose of 15 mg/kg for 6 days. Total 54 rats were randomly selected for the experimental purpose and were divided into two major groups. Group-1 consisting twenty four (24) and were further sub-divided into four (4) different groups viz. group-I served as normal control, group-II served as melatonin treated, group-III served as insulin treated and group-IV served as glibenclamide treated. Group-2 consisting thirty (30) rats were given streptozotocin (STZ) injection (15 mg/kg) for 6 days. After confirmation of diabetes by measuring blood glucose level, animals having blood glucose level above 250 mg/dl) confirmed as diabetic. Thirty (30) Diabetic rats were further subdivided into following sub-groups and were given different therapeutic treatments, Viz group-I served as Diabetic control, group-II treated with melatonin, group-III treated with insulin, group-IV given treatment of melatonin and insulin and group-V were given treatment of glibenclamide respectively. Diabetic rats showed modulation in all the studied hematological variables. Diabetic rats displayed significant decline in RBCs count, HB level and its associated indices (HCT, RDW, MCV, MCH, MCHC), WBCs and its related indices (polymorphs and lymphocytes) and platelet distribution width (PDW %) whereas platelet count showed significant increase. Nonetheless alone as well as combined treatment of exogenous melatonin and insulin restored all altered hematological parameters. However, significant recovery was found in the group in which combined dose of melatonin and insulin was administrated. Therefore, it might be concluded that combined administration of melatonin and insulin will be better remedy to normalize the altered blood profile during the diabetic condition.

The present study was undertaken to evaluate the pharmacognostical parameters, formulation, standardization and hypoglycaemic effect of herbal preparation in alloxan induced diabetic rats. The physicochemical properties of polyherbal finished product were: Specific gravity (1.03 at 25°C), pH of 10%v/v solution (4.543), solid content (7% w/v), viscosity (4.59 cp), surface tension (43.37 dynes/cm) and refractive index (1.37). The colour (brown), odour (sweet aromatic), and taste (sweet) of polyherbal formulation was satisfactory in physical appearance. The study was also aimed to evaluate the antidiabetic activity of herbal formulation in alloxan induced diabetic rats model. The results of the body weight and blood glucose level of control, diabetic control group, standard group (Glibenclamide 5mg/kg)-standard drug used and two different doses of trial formulation (600mg and 300mg/kg)-summarised in Table No 1 and Table No 2 respectively. The initial body weight of Herbal formulation low dose and high dose were 123.33±5.78 and 185±8.38 respectively and after 11 days of treatment the bodyweight was decreased to 119.33±8.45 and1 70.33±7.79 respectively. Two different doses of the herbal formulation (low dose and high dose) i,e 123.33±5.78 and 185±8.38 blood glucose level were studied in two different groups of animals. Both groups showed a significant decrease of blood glucose level on alloxan induced diabetic rats when compared to control group. The low dose result shows for respective day 3: 5.01±0.21, day 7: 33.23±1.70 and day11: 63.20±2.46 and for high doses for day 3: 6.59±0.34, day 7: 35.26±1.84 and day 11: 65.63±2.46. Both groups showed a significant decrease of blood glucose level on alloxan induced diabetic rats when compared to control group. The present study showed that the investigation of the polyherbal formulation containing five herbs has a potent anti diabetic effect which could be used in the management of diabetes mellitus effectively.

Ross syndrome is a rare disorder of sweating with a triad of segmental anhidrosis, tonic pupil, and hyporeflexia. Survey of available literature shows scarce reporting of such cases globally and countable number of cases from India. Here, we report the case of a 35-year-old male presented with heat intolerance and all three clinical features of Ross syndrome. Further investigations revealed him to be diabetic. Diabetes was treated with insulin and oral hypoglycemics. The patient had increased comfort in hot and humid climate and slight improvement in sweating over anhidrotic areas after strict diabetic control. The association of diabetes mellitus and Ross syndrome in the index case is quite interesting and hitherto not reported.

Fluoroquinolone antibiotics may cause acute disorders in blood glucose levels, this side effect is worthwhile, especially in diabetic patients, this study aimed to investigate the effect of each of two fluoroquinolones, moxifloxacin and levofloxacin, on blood glucose levels in STZ-induced diabetic wistar rats after induction of a type 2-like diabetes, and ensuring the stability of the diabetic condition, as well as waiting for aging (4 months). Experimental animals were divided into four groups: group 1; diabetic animals were treated with moxifloxacin (n=15), group 2; diabetic animals were treated with levofloxacin (n=15), group 3; diabetic control animals (n=15), and group 4; non-diabetic control animals (n=6), insulin levels, body weights, and blood glucose levels were compared at different times for a period of 14 days during the treatment with fluoroquinolones. Fluoroquinolones reduced blood glucose levels, this effect was greater with levofloxacin than moxifloxacin, accompanied with high insulin levels with levofloxacin more than moxifloxacin. There were no statistically significant differences in body weights after treating with fluoroquinolones, in conclusion: there are dissimilarity in the effect of moxifloxacin and levofloxacin on blood glucose and Insulin levels in type-2 diabetes, inspite of the importance of these compounds in the treatment of resistant infections on other antibiotics, it is necessary to exercise caution when using these compounds in diabetic patients through the precautional monitoring of blood glucose levels.

Microfluidic devices have led to novel biological advances through the improvement of micro systems that can mimic and measure. Microsystems easily handle sub-microliter volumes, obviously with guidance presumably through laminated fluid flows. Microfluidic systems have production methods that do not need expert engineering, away from a centralized laboratory, and can implement basic and point of care analysis, and this has attracted attention to their widespread dissemination and adaptation to specific biological issues. The general use of microfluidic tools in clinical settings can be seen in pregnancy tests and diabetic control, but recently microfluidic platforms have become a key novel technology for cancer diagnostics. Cancer is a heterogeneous group of diseases that needs a multimodal paradigm to diagnose, manage, and treat. Using advanced technologies can enable this, providing better diagnosis and treatment for cancer patients. Microfluidic tools have evolved as a promising tool in the field of cancer such as detection of a single cancer cell, liquid biopsy, drug screening modeling angiogenesis, and metastasis detection. This review summarizes the need for the low-abundant blood and serum cancer diagnosis with microfluidic tools and the progress that has been followed to develop integrated microfluidic platforms for this application in the last few years.

IntroductionA triple disaster struck eastern Japan in March 2011. We investigated the psychological distress and post-traumatic stress disorder (PTSD) symptoms caused by the disaster in people without or with diabetes mellitus.Research design and methodsThis cross-sectional analysis examined the 16 097 evacuees (1820 (11.3%) with and 14 277 (88.7%) without diabetes mellitus) included in the Fukushima Health Management Survey. Non-specific mental health distress was assessed using the Kessler-6 Scale, and traumatic symptoms were evaluated using the PTSD Checklist. Logistic regression analyses were used to estimate the OR and 95% CI associated with symptoms, adjusted for diabetes-related and disaster-related factors.ResultsIn the age-adjusted and sex-adjusted logistic models, suboptimal diabetic control (hemoglobin A1c (HbA1c) ≥7%) was associated with both psychological distress and possible PTSD. In the same models, current smoking, evacuation, and sleep dissatisfaction were associated with psychological distress and possible PTSD. In the multivariate-adjusted logistic models, HbA1c ≥7% was associated with psychological distress, independent of job change, evacuation, or sleep dissatisfaction.ConclusionAfter the triple disaster, non-specific mental health distress was associated with suboptimal diabetic control. Thus, patients with diabetes, especially those with suboptimal diabetic control, may be vulnerable to postdisaster psychological burden.