This document summarizes a study comparing antioxidant status and inflammatory markers in type 2 diabetic male and female subjects with nephropathy. The study found that inflammatory markers IL-6 and TNF-α were higher in type 2 diabetic female subjects with nephropathy compared to males. It also found that the antioxidant enzyme glutathione peroxidase was lower in both male and female diabetic nephropathy subjects compared to controls, but was lower in females. The study concludes that oxidative stress and inflammation may play a greater role in the pathogenesis of nephropathy in type 2 diabetic females compared to males.
Diabetic nephropathy is a major complication of diabetes that can progress to kidney failure. The document discusses the pathophysiology, risk factors, stages of progression, biomarkers and pathology of diabetic nephropathy. Key factors that contribute to its development include genetic susceptibility, hypertension, activation of the renin-angiotensin-aldosterone system, increased levels of growth factors like TGF-β, and chronic high blood glucose levels which can activate biochemical pathways like protein kinase C. Left untreated, diabetic nephropathy can progress through five stages and ultimately lead to end-stage renal disease.
ABSTRACT- This review is based on the recent diagnostic and prognostic biomarkers for Diabetes and Diabetic complications. Diabetes mellitus
(DM) is known to stimulate oxidative stress along with deranging different metabolisms; one of the Long term complications of diabetes mellitus is
diabetic retinopathy, which is a leading cause of acquired blindness. Diabetic Retinopathy is a progressive disorder disease. It is the mainly frequently
cause of blindness in people aged 35-75 years. Poor glycemic control and oxidative stress have been credited to the development of complications
like diabetic retinopathy. The retina has high content of polyunsaturated fatty acid (PUFA) and glucose oxidation relative to any other tissue. Hyperglycemia
and dyslipidemia in diabetes mellitus stimulate increased lipid peroxidation and reactive oxygen species formation, an important mechanism
in the pathogenesis of diabetic retinopathy. The oxidative stress is altered between excess oxidative species formation and impaired exclusion of
the reactive oxygen species via antioxidant defence system like superoxide dismutase. Hence the study over a period of 6 month from 1st Jan to 30
June 2015 with 54 diabetic retinopathy cases and 54 control cases without retinopathy was undertaken to evaluate the oxidative status and simultaneously
decrease serum vitamin antioxidants levels in diabetic retinopathy cases and increase level of HbA1c. The aim of this study was to analyze
and correlate oxidative stress marker, Malondialdehyde and superoxide dismutase along with glycosylated hemoglobin (HbA1c) in diabetic patients
with and without retinopathy.
Key words- Diabetic retinopathy, Diabetes mellitus, Glycosylated hemoglobin, MDA and SOD
Study of Ischemia Modified Albumin in Type 2 Diabetes as a Marker of Severityiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Type 2 Diabetes Mellitus: The Concerned Complications and Target OrgansApollo Hospitals
Diabetes has been considered as the most dreaded non-communicable disease consuming the mankind rapidly. WHO has predicted the number of diabetics to be approximately 366 millions by 2030. The disease is characterized by hyperglycemia and the basic symptoms are polyphagia, polydipsia and polyuria. The autoimmune type 1 diabetes represent almost 1% of the total diabetic population, the rest being that of type 2 diabetes (T2D). Type 2 diabetes has been linked to a variety of factors such as heredity, environmental factors, unhealthy eating habits, sedentary lifestyle, stress etc. The uncontrolled hyperglycemia has profound deleterious effects on almost all the organs and results in various cardiovascular disorders, retinopathy, neuropathy, and nephropathy. Recent studies have revealed an array of pulmonary dysfunctions related with T2D ranging from respiratory defects to tuberculosis. Diabetes also predisposes the person to hepatic dysfunctions like NAFLD and HCC and a range of infections at various sites which are difficult to manage. Post-surgical infections are of special interest for subjects with uncontrolled hyperglycemia prior to surgery. Scientists all over the world are revealing different pathways and associated therapies for type 2 diabetes in order to control the pathological effects covering almost whole body physiology.
Diabetic kidney disease remains a major global health problem. Recent research has provided insights into the pathophysiology and has identified new diagnostic and therapeutic approaches. Several large clinical trials have shown that sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, mineralocorticoid receptor antagonists, and endothelin receptor antagonists can reduce kidney disease progression and cardiovascular events in patients with diabetes and kidney disease. Ongoing trials are further evaluating combination therapies and the benefits of these agents in non-diabetic kidney disease and heart failure.
Diabetic nephropathy is a chronic kidney disease characterized by gradually increasing urinary albumin excretion, high blood pressure, declining kidney function, and presence of diabetic retinopathy. It develops in 20-40% of people with diabetes and is the leading cause of end-stage renal disease. The pathophysiology involves metabolic and hemodynamic pathways as well as genetic factors. Hyperglycemia causes kidney damage through increased polyol pathway flux, formation of advanced glycation end products, activation of protein kinase C, and other mechanisms. Hemodynamic changes from hypertension increase glomerular pressure and permeability. Genetic factors like ACE polymorphisms also influence risk. Progression is associated with proteinuria, anemia
The document discusses the role of peroxisome proliferator activated receptor gamma (PPARγ) agonists in treating type 2 diabetes and reducing cardiovascular risk. PPARγ agonists like thiazolidinediones improve insulin sensitivity and have beneficial effects on lipids, inflammation, and vascular cell proliferation. They may reduce cardiovascular events in type 2 diabetes through these metabolic and anti-inflammatory mechanisms. However, PPARγ agonists can also cause side effects like fluid retention, weight gain, and congestive heart failure, so their risks and benefits must be carefully weighed.
Diabetic nephropathy is a major complication of diabetes that can progress to kidney failure. The document discusses the pathophysiology, risk factors, stages of progression, biomarkers and pathology of diabetic nephropathy. Key factors that contribute to its development include genetic susceptibility, hypertension, activation of the renin-angiotensin-aldosterone system, increased levels of growth factors like TGF-β, and chronic high blood glucose levels which can activate biochemical pathways like protein kinase C. Left untreated, diabetic nephropathy can progress through five stages and ultimately lead to end-stage renal disease.
ABSTRACT- This review is based on the recent diagnostic and prognostic biomarkers for Diabetes and Diabetic complications. Diabetes mellitus
(DM) is known to stimulate oxidative stress along with deranging different metabolisms; one of the Long term complications of diabetes mellitus is
diabetic retinopathy, which is a leading cause of acquired blindness. Diabetic Retinopathy is a progressive disorder disease. It is the mainly frequently
cause of blindness in people aged 35-75 years. Poor glycemic control and oxidative stress have been credited to the development of complications
like diabetic retinopathy. The retina has high content of polyunsaturated fatty acid (PUFA) and glucose oxidation relative to any other tissue. Hyperglycemia
and dyslipidemia in diabetes mellitus stimulate increased lipid peroxidation and reactive oxygen species formation, an important mechanism
in the pathogenesis of diabetic retinopathy. The oxidative stress is altered between excess oxidative species formation and impaired exclusion of
the reactive oxygen species via antioxidant defence system like superoxide dismutase. Hence the study over a period of 6 month from 1st Jan to 30
June 2015 with 54 diabetic retinopathy cases and 54 control cases without retinopathy was undertaken to evaluate the oxidative status and simultaneously
decrease serum vitamin antioxidants levels in diabetic retinopathy cases and increase level of HbA1c. The aim of this study was to analyze
and correlate oxidative stress marker, Malondialdehyde and superoxide dismutase along with glycosylated hemoglobin (HbA1c) in diabetic patients
with and without retinopathy.
Key words- Diabetic retinopathy, Diabetes mellitus, Glycosylated hemoglobin, MDA and SOD
Study of Ischemia Modified Albumin in Type 2 Diabetes as a Marker of Severityiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Type 2 Diabetes Mellitus: The Concerned Complications and Target OrgansApollo Hospitals
Diabetes has been considered as the most dreaded non-communicable disease consuming the mankind rapidly. WHO has predicted the number of diabetics to be approximately 366 millions by 2030. The disease is characterized by hyperglycemia and the basic symptoms are polyphagia, polydipsia and polyuria. The autoimmune type 1 diabetes represent almost 1% of the total diabetic population, the rest being that of type 2 diabetes (T2D). Type 2 diabetes has been linked to a variety of factors such as heredity, environmental factors, unhealthy eating habits, sedentary lifestyle, stress etc. The uncontrolled hyperglycemia has profound deleterious effects on almost all the organs and results in various cardiovascular disorders, retinopathy, neuropathy, and nephropathy. Recent studies have revealed an array of pulmonary dysfunctions related with T2D ranging from respiratory defects to tuberculosis. Diabetes also predisposes the person to hepatic dysfunctions like NAFLD and HCC and a range of infections at various sites which are difficult to manage. Post-surgical infections are of special interest for subjects with uncontrolled hyperglycemia prior to surgery. Scientists all over the world are revealing different pathways and associated therapies for type 2 diabetes in order to control the pathological effects covering almost whole body physiology.
Diabetic kidney disease remains a major global health problem. Recent research has provided insights into the pathophysiology and has identified new diagnostic and therapeutic approaches. Several large clinical trials have shown that sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, mineralocorticoid receptor antagonists, and endothelin receptor antagonists can reduce kidney disease progression and cardiovascular events in patients with diabetes and kidney disease. Ongoing trials are further evaluating combination therapies and the benefits of these agents in non-diabetic kidney disease and heart failure.
Diabetic nephropathy is a chronic kidney disease characterized by gradually increasing urinary albumin excretion, high blood pressure, declining kidney function, and presence of diabetic retinopathy. It develops in 20-40% of people with diabetes and is the leading cause of end-stage renal disease. The pathophysiology involves metabolic and hemodynamic pathways as well as genetic factors. Hyperglycemia causes kidney damage through increased polyol pathway flux, formation of advanced glycation end products, activation of protein kinase C, and other mechanisms. Hemodynamic changes from hypertension increase glomerular pressure and permeability. Genetic factors like ACE polymorphisms also influence risk. Progression is associated with proteinuria, anemia
The document discusses the role of peroxisome proliferator activated receptor gamma (PPARγ) agonists in treating type 2 diabetes and reducing cardiovascular risk. PPARγ agonists like thiazolidinediones improve insulin sensitivity and have beneficial effects on lipids, inflammation, and vascular cell proliferation. They may reduce cardiovascular events in type 2 diabetes through these metabolic and anti-inflammatory mechanisms. However, PPARγ agonists can also cause side effects like fluid retention, weight gain, and congestive heart failure, so their risks and benefits must be carefully weighed.
Diabetic Retinopathy: Role of Traditional Medicinal Plants in its management ...inventionjournals
The objective of this review is Diabetic Retinopathy (DR) and Role of herbal medicines for the treatment of DR. Eye is unique structure of the body and its anatomical and physiological framework is said to be unique. Every organism has adaptive capacity to lead life on earth. Due to modern life style, the number of diseases increasing day by day. Diabetic Retinopathy is an ocular manifestation of the systemic disease and sight-threatening disease. The treatment of modern system of medicine, focal laser therapy, anti-vascular growth factor drugs. These treatment modalities have side effects. Various medicinal plants have been studied and shown to be effective in the management of DR.based on a various biomarkers present in them.
This document summarizes recent developments in anti-diabetic therapies that target incretin hormones like GLP-1. DPP-4 inhibitors and GLP-1 agonists help address multiple defects in type 2 diabetes pathophysiology by increasing insulin secretion, reducing glucagon levels, and promoting satiety. While some DPP-4 inhibitors were found to increase heart failure risk, the GLP-1 agonists liraglutide and lixisenatide showed neutral cardiovascular outcomes. GLP-1 therapies may also help preserve pancreatic beta cell function and reduce weight. However, they have been linked to rare cases of thyroid cancer in rodents and should not be used in patients with personal or family history of medull
Diabetes and hematology is there a link.pptxMarwa Khalifa
This document discusses anemia in diabetes mellitus patients. It notes that anemia is more common in poorly controlled diabetes compared to well controlled diabetes. It also discusses the etiology and complications of anemia in diabetes patients, including it being a risk factor for cardiovascular disease and kidney disease. The document outlines how certain medications and conditions can impact HbA1c levels and provides information on changes in white blood cells, platelets, and coagulation factors associated with diabetes.
Unlocking Diabetic Nephropathy (DN) through its key pathological mechanisms - Oxidative Stress and Fibrosis
https://coboscientific.com/biomarkers/diabetic-nephropathy/
This document discusses various potential biomarkers for predicting and monitoring prediabetes and diabetes. It notes that glucose and HbA1c are commonly used but have limitations. Several other biomarkers are proposed that may provide earlier or more accurate detection of prediabetes when beta cell function is still intact, including various proteins, lipids, amino acids, iron levels and microRNAs. Combining biomarkers could improve sensitivity and specificity over any single marker. Further research is still needed to validate clinical utility.
1) This document reviews the impact of glucose-lowering drugs on cardiovascular disease in type 2 diabetes patients.
2) It discusses the natural history and pathophysiology of type 2 diabetes, including the increased risk of cardiovascular complications.
3) The review examines the effects of various oral and injectable glucose-lowering drugs on established cardiovascular risk factors and long-term cardiovascular outcomes based on evidence from epidemiological studies and clinical trials.
Diabetes y su asociación con la inflamaciónapedreanez
This document summarizes recent evidence that implicates the involvement of the immune system in type 2 diabetes (T2D). It finds that components of the immune system are altered in obesity and T2D, with changes occurring in tissues like adipose tissue, the liver, pancreatic islets and blood vessels. Circulating markers of inflammation are elevated in obesity and T2D. The document also finds evidence that inflammation is present in insulin sensitive tissues and pancreatic islets. Preliminary clinical trials using anti-inflammatory drugs have shown promise in lowering blood glucose in T2D patients, supporting the idea that T2D can be viewed as an autoinflammatory disease.
This document discusses the potential benefits of combining a SGLT-2 inhibitor (SGLT2i) and DPP-4 inhibitor (DPP4i) for treatment of type 2 diabetes. It notes that SGLT2is increase glucagon levels while DPP4is inhibit glucagon release, providing a counteracting effect. The combination addresses multiple metabolic abnormalities and has synergistic effects on glycemic control, cardiovascular risk reduction, renal protection, and other benefits. Clinical evidence suggests this combination may be preferred over other therapies for patients with diabetes and cardiovascular or renal complications.
This document summarizes diabetic retinopathy, including its types, pathogenesis, risk factors, diagnosis, management, and biomarkers. Diabetic retinopathy occurs when diabetes damages the tiny blood vessels inside the retina. It is classified into non-proliferative and proliferative stages. Risk factors include duration of diabetes, poor control, hypertension, and nephropathy. Diagnosis involves eye exams and tests like fluorescein angiography. Management includes laser surgery, injections, and vitrectomy. Novel biomarkers being studied to predict diabetic retinopathy include fibrinogen, apolipoproteins, retinal arteriolar tortuosity, and inflammatory markers like interleukin-6 and C-reactive protein.
This document summarizes different types of diabetes and diabetic neuropathy. It discusses the pathogenesis of diabetic neuropathy including various metabolic pathways involved like the polyol pathway, hexosamine pathway, protein kinase C pathway, and advanced glycation end products. It also discusses the role of oxidative stress, inflammation, and neuroinflammation in causing nerve damage. The document outlines different types of diabetic neuropathy and recent approaches to treat it, including gene therapy targeting the underlying causes. It provides references for the information presented.
Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia.
Several distinct types of DM are caused by a complex interaction of genetics and environmental factors.
Depending on the etiology of the DM, factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization, and increased glucose production.
The metabolic dysregulation associated with DM causes secondary pathophysiologic changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system.
This document discusses diabetes and cardiovascular disease. It defines diabetes and describes its increasing worldwide prevalence. It notes that diabetes significantly increases the risk of cardiovascular diseases like coronary artery disease and stroke. The pathophysiology of diabetic vascular disease is described, including how hyperglycemia, dyslipidemia, inflammation, and oxidative stress damage blood vessels and promote atherosclerosis. The document also outlines criteria for diagnosing diabetes and the role diabetes plays in various cardiovascular conditions.
This document summarizes a journal club discussion on the role of peroxisome proliferator-activated receptor gamma (PPARγ) agonists in treating diabetes and cardiovascular disease. PPARγ agonists like thiazolidinediones improve insulin resistance and reduce inflammation. They may protect blood vessels by inhibiting smooth muscle cell proliferation and migration involved in atherosclerosis and restenosis. While clinical trials show PPARγ agonists reduce cardiovascular risk factors, their side effects like fluid retention require monitoring, and further outcomes research is still needed to establish their long-term cardiovascular benefits and safety.
Systemic diseases, or conditions themselves do not cause periodontitis but alter host tissues to increase the progression of periodontal disease. Systemic diseases and conditions can influence the course of periodontitis or affect the periodontal supporting tissues independent of the presence of dental plaque. Most commonly affecting diseases are diabetes, neoplasms.
1) Diabetic nephropathy is a kidney disease caused by damage from uncontrolled diabetes, often accompanied by high blood pressure. It involves thickening and scarring of the kidney's filtering units called glomeruli.
2) The trial drug formula, containing herbs like Berberis vulgaris and Solanum nigrum, improved creatinine clearance in 65.71% of patients with mild to moderate renal impairment after 120 days. For patients with severe impairment, a slower response was seen.
3) The formulation acts as a renal function modulator through vasodilation and improved blood flow. It is recommended for early stages of diabetic nephropathy and was found to be an effective and affordable
1) Diabetic nephropathy is a kidney disease caused by damage from uncontrolled diabetes, often accompanied by high blood pressure. It involves thickening and scarring of the kidney's filtering units called glomeruli.
2) The trial drug formula, containing herbs like Berberis vulgaris and Solanum nigrum, improved creatinine clearance in 65.71% of patients with mild to moderate renal impairment after 120 days. For patients with severe impairment, a slower response was seen.
3) The formulation acts as a renal function modulator through vasodilation and improved blood flow. It is recommended for early stages of diabetic nephropathy and was found to be an effective and affordable
Diabetes is a group of metabolic disorders characterized by hyperglycemia. The prevalence of diabetes has risen dramatically worldwide over the past few decades. Diabetes greatly increases the risk of cardiovascular disease like coronary artery disease. Patients with diabetes have a 2-4 times higher risk of cardiovascular disease and it often develops decades earlier than in non-diabetic patients. Diabetes contributes to both microvascular complications like nephropathy and retinopathy as well as macrovascular complications from atherosclerosis.
Blood sugar- how much low is safe in coronary artery disease- copyRamachandra Barik
This document discusses the relationship between diabetes, blood sugar control, and cardiovascular disease risk. It reviews observational studies and clinical trials that have examined the effects of intensive glucose control on cardiovascular outcomes. The studies show mixed results, with some finding benefits of tight control for reducing heart attacks and others finding no benefits or even potential harms of very tight control, especially in older patients or those with existing heart disease. The document concludes that an A1C target of less than 7% is generally appropriate for most patients, but that goals need to be individualized based on age, comorbidities, and other factors. Very tight control to A1C levels below 6.5% may not be safe and could potentially increase risks in some high
Diabetic Retinopathy: Role of Traditional Medicinal Plants in its management ...inventionjournals
The objective of this review is Diabetic Retinopathy (DR) and Role of herbal medicines for the treatment of DR. Eye is unique structure of the body and its anatomical and physiological framework is said to be unique. Every organism has adaptive capacity to lead life on earth. Due to modern life style, the number of diseases increasing day by day. Diabetic Retinopathy is an ocular manifestation of the systemic disease and sight-threatening disease. The treatment of modern system of medicine, focal laser therapy, anti-vascular growth factor drugs. These treatment modalities have side effects. Various medicinal plants have been studied and shown to be effective in the management of DR.based on a various biomarkers present in them.
This document summarizes recent developments in anti-diabetic therapies that target incretin hormones like GLP-1. DPP-4 inhibitors and GLP-1 agonists help address multiple defects in type 2 diabetes pathophysiology by increasing insulin secretion, reducing glucagon levels, and promoting satiety. While some DPP-4 inhibitors were found to increase heart failure risk, the GLP-1 agonists liraglutide and lixisenatide showed neutral cardiovascular outcomes. GLP-1 therapies may also help preserve pancreatic beta cell function and reduce weight. However, they have been linked to rare cases of thyroid cancer in rodents and should not be used in patients with personal or family history of medull
Diabetes and hematology is there a link.pptxMarwa Khalifa
This document discusses anemia in diabetes mellitus patients. It notes that anemia is more common in poorly controlled diabetes compared to well controlled diabetes. It also discusses the etiology and complications of anemia in diabetes patients, including it being a risk factor for cardiovascular disease and kidney disease. The document outlines how certain medications and conditions can impact HbA1c levels and provides information on changes in white blood cells, platelets, and coagulation factors associated with diabetes.
Unlocking Diabetic Nephropathy (DN) through its key pathological mechanisms - Oxidative Stress and Fibrosis
https://coboscientific.com/biomarkers/diabetic-nephropathy/
This document discusses various potential biomarkers for predicting and monitoring prediabetes and diabetes. It notes that glucose and HbA1c are commonly used but have limitations. Several other biomarkers are proposed that may provide earlier or more accurate detection of prediabetes when beta cell function is still intact, including various proteins, lipids, amino acids, iron levels and microRNAs. Combining biomarkers could improve sensitivity and specificity over any single marker. Further research is still needed to validate clinical utility.
1) This document reviews the impact of glucose-lowering drugs on cardiovascular disease in type 2 diabetes patients.
2) It discusses the natural history and pathophysiology of type 2 diabetes, including the increased risk of cardiovascular complications.
3) The review examines the effects of various oral and injectable glucose-lowering drugs on established cardiovascular risk factors and long-term cardiovascular outcomes based on evidence from epidemiological studies and clinical trials.
Diabetes y su asociación con la inflamaciónapedreanez
This document summarizes recent evidence that implicates the involvement of the immune system in type 2 diabetes (T2D). It finds that components of the immune system are altered in obesity and T2D, with changes occurring in tissues like adipose tissue, the liver, pancreatic islets and blood vessels. Circulating markers of inflammation are elevated in obesity and T2D. The document also finds evidence that inflammation is present in insulin sensitive tissues and pancreatic islets. Preliminary clinical trials using anti-inflammatory drugs have shown promise in lowering blood glucose in T2D patients, supporting the idea that T2D can be viewed as an autoinflammatory disease.
This document discusses the potential benefits of combining a SGLT-2 inhibitor (SGLT2i) and DPP-4 inhibitor (DPP4i) for treatment of type 2 diabetes. It notes that SGLT2is increase glucagon levels while DPP4is inhibit glucagon release, providing a counteracting effect. The combination addresses multiple metabolic abnormalities and has synergistic effects on glycemic control, cardiovascular risk reduction, renal protection, and other benefits. Clinical evidence suggests this combination may be preferred over other therapies for patients with diabetes and cardiovascular or renal complications.
This document summarizes diabetic retinopathy, including its types, pathogenesis, risk factors, diagnosis, management, and biomarkers. Diabetic retinopathy occurs when diabetes damages the tiny blood vessels inside the retina. It is classified into non-proliferative and proliferative stages. Risk factors include duration of diabetes, poor control, hypertension, and nephropathy. Diagnosis involves eye exams and tests like fluorescein angiography. Management includes laser surgery, injections, and vitrectomy. Novel biomarkers being studied to predict diabetic retinopathy include fibrinogen, apolipoproteins, retinal arteriolar tortuosity, and inflammatory markers like interleukin-6 and C-reactive protein.
This document summarizes different types of diabetes and diabetic neuropathy. It discusses the pathogenesis of diabetic neuropathy including various metabolic pathways involved like the polyol pathway, hexosamine pathway, protein kinase C pathway, and advanced glycation end products. It also discusses the role of oxidative stress, inflammation, and neuroinflammation in causing nerve damage. The document outlines different types of diabetic neuropathy and recent approaches to treat it, including gene therapy targeting the underlying causes. It provides references for the information presented.
Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia.
Several distinct types of DM are caused by a complex interaction of genetics and environmental factors.
Depending on the etiology of the DM, factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization, and increased glucose production.
The metabolic dysregulation associated with DM causes secondary pathophysiologic changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system.
This document discusses diabetes and cardiovascular disease. It defines diabetes and describes its increasing worldwide prevalence. It notes that diabetes significantly increases the risk of cardiovascular diseases like coronary artery disease and stroke. The pathophysiology of diabetic vascular disease is described, including how hyperglycemia, dyslipidemia, inflammation, and oxidative stress damage blood vessels and promote atherosclerosis. The document also outlines criteria for diagnosing diabetes and the role diabetes plays in various cardiovascular conditions.
This document summarizes a journal club discussion on the role of peroxisome proliferator-activated receptor gamma (PPARγ) agonists in treating diabetes and cardiovascular disease. PPARγ agonists like thiazolidinediones improve insulin resistance and reduce inflammation. They may protect blood vessels by inhibiting smooth muscle cell proliferation and migration involved in atherosclerosis and restenosis. While clinical trials show PPARγ agonists reduce cardiovascular risk factors, their side effects like fluid retention require monitoring, and further outcomes research is still needed to establish their long-term cardiovascular benefits and safety.
Systemic diseases, or conditions themselves do not cause periodontitis but alter host tissues to increase the progression of periodontal disease. Systemic diseases and conditions can influence the course of periodontitis or affect the periodontal supporting tissues independent of the presence of dental plaque. Most commonly affecting diseases are diabetes, neoplasms.
1) Diabetic nephropathy is a kidney disease caused by damage from uncontrolled diabetes, often accompanied by high blood pressure. It involves thickening and scarring of the kidney's filtering units called glomeruli.
2) The trial drug formula, containing herbs like Berberis vulgaris and Solanum nigrum, improved creatinine clearance in 65.71% of patients with mild to moderate renal impairment after 120 days. For patients with severe impairment, a slower response was seen.
3) The formulation acts as a renal function modulator through vasodilation and improved blood flow. It is recommended for early stages of diabetic nephropathy and was found to be an effective and affordable
1) Diabetic nephropathy is a kidney disease caused by damage from uncontrolled diabetes, often accompanied by high blood pressure. It involves thickening and scarring of the kidney's filtering units called glomeruli.
2) The trial drug formula, containing herbs like Berberis vulgaris and Solanum nigrum, improved creatinine clearance in 65.71% of patients with mild to moderate renal impairment after 120 days. For patients with severe impairment, a slower response was seen.
3) The formulation acts as a renal function modulator through vasodilation and improved blood flow. It is recommended for early stages of diabetic nephropathy and was found to be an effective and affordable
Diabetes is a group of metabolic disorders characterized by hyperglycemia. The prevalence of diabetes has risen dramatically worldwide over the past few decades. Diabetes greatly increases the risk of cardiovascular disease like coronary artery disease. Patients with diabetes have a 2-4 times higher risk of cardiovascular disease and it often develops decades earlier than in non-diabetic patients. Diabetes contributes to both microvascular complications like nephropathy and retinopathy as well as macrovascular complications from atherosclerosis.
Blood sugar- how much low is safe in coronary artery disease- copyRamachandra Barik
This document discusses the relationship between diabetes, blood sugar control, and cardiovascular disease risk. It reviews observational studies and clinical trials that have examined the effects of intensive glucose control on cardiovascular outcomes. The studies show mixed results, with some finding benefits of tight control for reducing heart attacks and others finding no benefits or even potential harms of very tight control, especially in older patients or those with existing heart disease. The document concludes that an A1C target of less than 7% is generally appropriate for most patients, but that goals need to be individualized based on age, comorbidities, and other factors. Very tight control to A1C levels below 6.5% may not be safe and could potentially increase risks in some high
ALPHA LOGARITHM TRANSFORMED SEMI LOGISTIC DISTRIBUTION USING MAXIMUM LIKELIH...BRNSS Publication Hub
The document discusses the alpha logarithm transformed semi-logistic distribution and its maximum likelihood estimation method. It introduces the distribution, provides its probability density function and cumulative distribution function. It then describes generating random numbers from the distribution and outlines the maximum likelihood estimation method to estimate the distribution's unknown parameters. This involves deriving the likelihood function and taking its partial derivatives to obtain equations that are set to zero and solved to find maximum likelihood estimates of the location, scale, and shape parameters.
AN ASSESSMENT ON THE SPLIT AND NON-SPLIT DOMINATION NUMBER OF TENEMENT GRAPHSBRNSS Publication Hub
This document summarizes research on the split and non-split domination numbers of tenement graphs. It defines tenement graphs and provides basic definitions of domination, split domination, and non-split domination. Formulas for the split and non-split domination numbers of tenement graphs are presented based on the number of vertices. Theorems are presented stating that the mid vertex set of a tenement graph is always a split dominating set, but its size is not always equal to the split domination number.
This document summarizes research on generalized Cantor sets and functions where the standard construction is modified. It introduces Cantor sets defined by an arbitrary base where the intervals removed at each stage are not all the same length. It also defines irregular or transcendental Cantor sets generated by transcendental numbers like e. The key findings are:
1) There exists a unique probability measure for generalized Cantor sets that generates the cumulative distribution function.
2) The Holder exponent of generalized Cantor sets is shown to be logn/s where n is the base and s is the number of subintervals.
3) Lower and upper densities are defined for the measure on generalized Cantor functions and their properties are
SYMMETRIC BILINEAR CRYPTOGRAPHY ON ELLIPTIC CURVE AND LIE ALGEBRABRNSS Publication Hub
1) The document discusses symmetric bilinear pairings on elliptic curves and Lie algebras in the context of cryptography. It provides an overview of the theoretical foundations and applications of combining these areas.
2) Key concepts covered include the Weil pairing as a symmetric bilinear pairing on elliptic curves, its properties of bilinearity and non-degeneracy, and efficient computation. Applications of elliptic curves in cryptography like ECDH and ECDSA are also summarized.
3) The security of protocols like ECDH and ECDSA relies on the assumed difficulty of solving the elliptic curve discrete logarithm problem (ECDLP). The document proves various mathematical aspects behind symmetric bilinear pairings and their use in elliptic curve cryptography.
SUITABILITY OF COINTEGRATION TESTS ON DATA STRUCTURE OF DIFFERENT ORDERSBRNSS Publication Hub
This document summarizes research investigating the suitability of cointegration tests on time series data of different orders. The researchers used simulated time series data from normal and gamma distributions at sample sizes of 30, 60, and 90. Three cointegration tests (Engle-Granger, Johansen, and Phillips-Ouliaris) were applied to the data. The tests were assessed based on type 1 error rates and power to determine which test was most robust for different distributions and sample sizes. The results indicated the Phillips-Ouliaris test was generally the most effective at determining cointegration across different sample sizes and distributions.
Artificial Intelligence: A Manifested Leap in Psychiatric RehabilitationBRNSS Publication Hub
Artificial intelligence shows promise in improving psychiatric rehabilitation in 3 key ways:
1) AI can help diagnose and treat mental health issues through virtual therapists and chatbots, improving access and reducing stigma.
2) Technologies like machine learning and big data allow personalized interventions and more accurate diagnoses.
3) The COVID-19 pandemic has increased need for mental health support, and AI may help address gaps by providing remote services.
A Review on Polyherbal Formulations and Herbal Medicine for Management of Ul...BRNSS Publication Hub
This document provides a review of polyherbal formulations and herbal medicines for treating peptic ulcers. It discusses how peptic ulcers occur due to an imbalance between aggressive and protective factors in the gastrointestinal tract. Common causes include H. pylori infection and NSAID use. While synthetic medications are available, herbal supplements are more affordable and have fewer side effects. The review examines various herbs that have traditionally been used to treat ulcers, including their active chemical constituents. It defines polyherbal formulations as combinations of two or more herbs, which can enhance therapeutic effects while reducing toxicity. The document aims to summarize recent research on herb and polyherbal formulation treatments for peptic ulcers.
Current Trends in Treatments and Targets of Neglected Tropical DiseaseBRNSS Publication Hub
This document summarizes current trends in treatments and targets of neglected tropical diseases. It begins by stating that neglected tropical diseases affect over 1.7 billion people globally each year and are caused by a variety of microbes. The World Health Organization is working to eliminate 30 neglected tropical diseases by 2030. The document then discusses several specific neglected tropical diseases in more detail, including human African trypanosomiasis, Chagas disease, leishmaniasis, soil-transmitted helminths, and schistosomiasis. It describes the causative agents, transmission methods, symptoms, affected populations, and current treatment options for each of these diseases. Overall, the document aims to briefly discuss neglected infectious diseases and treatment
Evaluation of Cordia Dichotoma gum as A Potent Excipient for the Formulation ...BRNSS Publication Hub
This document summarizes a study that evaluated Cordia dichotoma gum as an excipient for oral thin film drug delivery. Films were prepared with varying ratios of the gum, plasticizers (methyl paraben and glycerine), and the model drug diclofenac sodium. The films were evaluated for properties like thickness, folding endurance, tensile strength, water uptake, and drug release kinetics. The results found that a film with 10% gum, 0.2% methyl paraben and 2.5% glycerine (CDF3) exhibited the best results among the formulations tested. Stability studies showed the films were stable for 30 days at different temperatures. Overall, the study demonstrated that C.
Assessment of Medication Adherence Pattern for Patients with Chronic Diseases...BRNSS Publication Hub
This study assessed medication adherence and knowledge among rural patients with chronic diseases in South Indian hospitals. 1500 hypertensive patients were divided into intervention and control groups. The intervention group received education from pharmacists at various times, while the control group did not. A questionnaire evaluated patients' medication knowledge at baseline and several follow-ups. The intervention group showed improved medication knowledge scores after education compared to the control group. Female gender, lower education, and income were linked to lower knowledge. The study highlights the need to educate rural patients to improve medication understanding and adherence.
This document proposes a system to hide information using four algorithms for image steganography. The system first encrypts data using a modified AES algorithm. It then encrypts the encrypted data using a modified RSA algorithm. Next, it uses a fuzzy stream algorithm to add ambiguity. Finally, it hides the encrypted data in the least significant bits of cover images using LSB steganography. The document evaluates the proposed system using metrics like PSNR, MSE, and SSIM to analyze image quality and the ability to hide data imperceptibly compared to other techniques. It selects four color images as cover files and tests the system on them.
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2. Kafle and Singh: Antioxidant Status and Inflammatory Markers in Type 2 Diabetic Male and Female Nephropathy Subjects
IJPBA/Jan-Mar-2021/Vol 12/Issue 1 28
prominent clinical feature of diabetes, is a major
cause responsible for the increased production
of reactive oxygen species (ROS) and intensified
oxidative stress.[4,5]
There is a strong belief that
renal glomeruli are particularly sensitive to
oxidative stress,[6]
suggesting the involvement and
participation of ROS in the pathogenesis of diabetic
nephropathy. Possible mechanisms for the induction
of inflammation in vascular tissues may include
activationofproteinkinaseCpathwayandoxidative
stress,[7]
upregulation of recent advanced glycation
end products (RAGE),[8]
and activation of innate
immunity.[9]
For instance, carboxymethyllysine-
protein adducts due to malondialdehyde (MDA),
AGEs, can increase the expression of a variety of
pro-inflammatory molecules and nuclear factor-
kappa B through the interaction with RAGE in renal
cells causing diabetic nephropathy in T2DM.[10,11]
MATERIALS AND METHODS
The study was carried out in collaboration with
the Department of Biochemistry, Chitwan Medical
College and Department of Nephrology in G.R
Medical College, Gwalior. The ethical committee
of GRMC has approved this research work.
The diabetic nephropathy patients attending the
department of nephrology were included in this
research work by their consent.
Details of study are as follows:
Experimental designs of study are as follows: (Age
matched).
Total number of subjects (experimental): 200.
• 100 – T2DM subjects
• 100 – T2DM with diabetic nephropathy
• 50 – Male diabetic nephropathy subjects
• 50 – Female diabetic nephropathy subjects.
• 100 –
T2DM subjects without microvascular
complications.
• 50 – Male T2DM subjects
• 50 – Female T2DM subjects.
Ten milliliters of blood sample will be drawn from
the antecubital vein following overnight fasting.
Thebloodsamplewillbecollectedinplain,fluoride,
and ethylenediaminetetraacetic acid Vacutainer.
The blood sample was centrifuged for 10 min at
3000 rpm at room temperature. The whole blood
and serum were stored at 4°C for biochemical and
immunological investigations.
Fasting blood sugar level was estimated by glucose
oxidase-peroxidase method. Urea and creatinine
were estimated by autoanalyzer through kit
methods (diacetyl monoxime and Jaffe’s method).
Glutathione peroxides (Gpx) were estimated by
the method of Hafeman et al. (1974). Glutathione
reductase (GR) was estimated by the method of
Horn HD (1963). Plasma MDA was estimated
by Jean et al. (1983). Hemoglobin was measured
by cyanmethemoglobin method. Inflammatory
markers TNF-α and IL-6 were estimated by
kits available from ImmunoTech company by
sandwich enzyme-linked immunosorbent assay
method.
Statistical analysis was done using Student’s t-test.
A Student’s t-test was used to estimate differences
between the groups. All parameters were given
as mean ± standard deviation. The criterion for
significance was P 0.05.
RESULTS
It was found from the study that both male
and female diabetic nephropathy subjects have
significant increase of fasting blood sugar, serum
urea, creatinine, MDA, and inflammatory markers
(IL-6 and TNF-α) as compared to both male and
female diabetic subjects without microvascular
complication. All the parameters are showing
highly significant at P 0.05.
Antioxidant enzyme Gpx being decreased in both
male and female diabetic nephropathy subjects
as compared to both male and female diabetic
subjects without microvascular complication and it
was highly significant at P 0.05, whereas GR was
found to be normal range (3–13 U/g of Hb) in both
diabetic nephropathy and diabetic subjects without
microvascular complication and was found non-
significant at P 0.05.
In our study, the body mass index (BMI) was found
to be increased in both male and female diabetic
nephropathy subjects as compared to both male
and female diabetic subjects without microvascular
complication and it was found significant at 5%
(P 0.05) [Table 1].
3. Kafle and Singh: Antioxidant Status and Inflammatory Markers in Type 2 Diabetic Male and Female Nephropathy Subjects
IJPBA/Jan-Mar-2021/Vol 12/Issue 1 29
The hemoglobin levels was found to be decreased in
both male and female diabetic nephropathy subjects
as compared to both male and female diabetic
subjects without microvascular complication
and it was found significant at P 0.05 but the
hemoglobin levels were found within the normal
range in both male and female diabetic subjects
without microvascular complication.
DISCUSSION
Our results are consistent with those of other studies
on oxidative stress but for IL-6 and TNF-α till date,
very few researches have been done with regard to
inflammatory markers so that the exact mechanism
for increase in the level of these inflammatory
markers in type-2 female diabetic nephropathy as
compared to type-2 male diabetic nephropathy is still
unknown. It might be hyperglycemia-induced ROS,
advanced glycation end-products, etc., may play an
important role in the generation of cytokines (IL-6
and TNF- α) in renal cells in diabetic nephropathy
subjects. More recent studies in type 2 diabetic
patients demonstrate a significant association
between IL-6 and glomerular basement membrane
thickening, a crucial lesion of diabetic nephropathy,
and a strong predictor of renal progression.[12]
The increase in protein oxidation and lipid
peroxidation as reflected by increase in plasma
levels of MDA in T2DM is due to hyperglycemia
inducing overproduction of oxygen free radicals,
suggesting a feature of oxidative stress in type 2
diabetes. The increased levels of thiobarbituric
acid reactive substances in T2DM diabetic
nephropathy patients may be due to the following
reasons: (1) Oxidative stress in diabetic patients.
(2) Compositional changes in low-density
lipoproteins may lead to conformational changes,
possibly resulting in a different exposure of fatty
acids to oxygen free radicals that enhance a faster
rate of lipid peroxidation.[13]
Antioxidant enzyme Gpx was found decreased
more in T2DM female nephropathy subjects as
compared to T2DM male nephropathy subjects,
suggesting female T2DM nephropathy subjects
in more stressed condition. This might be due to
hyperglycemia induced oxidative stress, due to low
hemoglobin concentration in female subjects of
diabetic nephropathy and due to excess utilization
of NADPH in renal mesangial cells through
polyol pathway in type 2 diabetic nephropathy
subjects. Our study results were also consistent
with Srivastava et al., 2004.[14]
The decrease in
hemoglobin level in diabetic nephropathy subjects
Table 1: Mean±standard deviation between age‑matched T2DM male and female without microvascular complications and
diabetic nephropathy subjects
S. No. Parameters T2DM without
microvascular
complications (males, n=50)
T2DM with diabetic
nephropathy
(males=50)
T2DM without
microvascularcomplications
(females, n=50)
T2DM with diabetic
nephropathy
(females=50)
1 Age 45–60 years 45–60 years 45–60 years 45–60 years
2 Duration 5.5 years 14 years 6.0 years 13 years
3 BMI 28.98±1.70 29.98±4.00* 28.78±1.80 29.29±4.41*NS
4 FBS 146±33.10 193.13±22.62* 156±35.10 210±25.59*NS
5 Urea 30±7.62 109±33.32* 28±6.62 115±34.10*NS
6 Creatinine 1.01±0.35 3.36±1.75* 1.13±0.55 3.42±1.60*NS
7 MDA 5.31±1.10 6.92±1.33* 5.00±1.00 7.03±1.62*NS
8 Gpx 6.46±0.84 4.897±0.895* 5.40±1.02 4.41±0.36*NS
9 GR 6.55±1.02 6.90±0.895NS
6.00±1.32 6.50±0.738NS
10 IL‑6 13.59±1.96 30.40±15. 63* 12.50±1.70 40.28±22.10*+
11 TNF‑α 13.36±1.81 36.88±14.70* 14.00±1.95 56.07±19.72*+
12 Hb 12.36±0.95 7.60±0.95* 12.00±0.90 6.37±1.14*+
*Significant at P0.05 within type 2 male diabetic nephropathy and T2DM without microvascular complications male subjects. *Significant at P0.05 within type 2 female
diabetic nephropathy and T2DM without microvascular complications female subjects. +
Significant at P0.05 within type 2 diabetic nephropathy male and female subjects.
Abbreviations with their units: BMI: Body mass index (Kg/m2
), FBS: Fasting blood glucose (mg/dl), Urea (mg/dl), Creatinine (mg/dl), MDA: Malondialdehyde (µmol/liter
of plasma), Gpx: Glutathione peroxidase (U/mg of Hb), GR: Glutathione reductase (U/g of Hb), IL‑6: Interleukin‑6 (pg/ml), TNF‑α: Tumor necrosis factor‑α (pg/ml), Hb:
Hemoglobin (gm/dl)
4. Kafle and Singh: Antioxidant Status and Inflammatory Markers in Type 2 Diabetic Male and Female Nephropathy Subjects
IJPBA/Jan-Mar-2021/Vol 12/Issue 1 30
as compared to regulated diabetes might be due to
decrease in production of hormone erythropoietin
which is produced from the renal cells of kidney,
which was also reported by Ravanan et al., 2007.[15]
CONCLUSION
Hyperglycemia induces intracellular ROS in
glomerular mesangial and tubular epithelial
cells which induces cytokines, IL-6, and TNF-α
production in diabetic kidney. From our study, it
was concluded that inflammatory markers, IL-6 and
TNF-α, were found to be increased in type 2 female
diabetic nephropathy subjects than male nephropathy
subjects. Antioxidant Gpx enzyme levels are found
to be decreased in the erythrocyte of both female
diabetic nephropathy and male nephropathy subjects,
however, decrease in Gpx level in female subjects
was more than in male nephropathy subjects of type
2 diabetes. The level of GR was found within the
normal range in all the subjects.
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