Study of lipid peroxide and lipid profile in diabetes mellitus

The study was designed to find out the correlation between lipid peroxidation, lipoprotein levels to severity and complication of diabetes mellitus. Degree of lipid peroxidation was measured in terms of malondialdehyde (MDA) along with lipid profile and blood glucose in diabetes mellitus. It is categorised into insulin dependent diabetes mellitus (IDDM), non insulin dependent diabetes mellitus (NIDDM) and diabetes mellitus(DM) with complication. Total 112 known diabetic patients and 52 non-diabetic controls were studied. These patients were grouped as per the concentration of fasting blood glucose level i.e. controlled, poorly controlled, and uncontrolled group. There are significant increase in the lipid peroxide (MDA) and lipid profile except HDL cholesterol which is decreased, has been found in all groups as compared to controls In NIDDM group lipid peroxidation was markedly increased than IDDM group and it was higher in DM with complications. Other finding observed was that the level of lipid peroxide increased as per the increase in concentration of blood glucose. The increase lipid peroxidation in the hyperglycemic condition may be explained, as the superoxide dismutase enzyme which is antioxidant becomes inactive due the formation of superoxide radical within the cell. Maximum lipid peroxidation leads to the damage of the tissue and organs which results into complication in diabetic patients. High levels of total cholesterol appear due to increased cholesterol synthesis. The triglyceride levels changes according to the glycemic, control. The increase may be due to overproduction of VLDL-TG. It is concluded that good metabolic control of hyperglycemia will prevent in alteration in peroxidation and the lipid metabolism, which may help in good prognosis and preventing manifestation of vascular and secondary complication in diabetes mellitus.     

Impaired hypothalamic-pituitary-gonadal axis function in men with diabetes mellitus

In view of association of diabetes mellitus and male infertility, present study was designed to investigate the functional status of hypothalamic pituitary gonadal (HPG) axis in diabetic men. Thirty-five diabetic men (BMI 22.24±0.21) in the age group 20–40 (30.6±4.7) years were selected. Twenty-five healthy men (BMI 23.85±0.25), in the same age group (29.5±4.8) served as control. Blood samples were collected for hormonal and biochemical estimations. Diabetic men had significantly low serum testosterone with low LH and FSH, hypercholesterolemia, hypertriglyceridemia, hypoalbuminemia and increased oxidative stress. Low serum testosterone in diabetic men was accompanied by low LH and FSH; the inability of the pituitary gland to respond appropriately to a decline in testosterone implying central effect of high serum glucose on the interaction between the nervous and endocrine system. Nutritional deficiency, increased oxidative stress and increased aromatase activity due to excessive body fat might have also contributed to low serum testosterone.     

Adenosine deaminase and protein tyrosine phosphatase activities in liver and peritoneal macrophages of streptozotocin induced diabetic mice

Adenosine deaminase and protein tyrosine phosphatase activities in liver and peritoneal macrophages were estimated in control, streptozotocin induced diabetes and insulin treated diabetic groups of Swiss albino mice. Both the enzyme levels were elevated while glycogen content decreased in the liver of diabetic group of animals as compared to controls, while in insulin treated group, they were comparable to control levels. In macrophages also, both adenosine deaminase which plays an important role in their maturation and protein tyrosine phosphatase enzyme involved in their activation were high in diabetic group, whereas in insulin treated diabetic group, the values were comparable to control levels. *** DIRECT SUPPORT *** A00FN011 00003     

Cancer in south Karnataka and its paradoxical relation to diabetes mellitus

The present work identifies a high incidence of oral cancer in south Karnataka. The primary reason for this could be due to extensive addiction to tobacco alone or tobacco and alcohol in most of these patients. The next in intensity was cancer of the breast and cervix among the cancer patients surveyed in south Karnataka. Majority of these patients had no specific addiction and the exact reason for this high incidence remains unclear. Only a small percentage of patients exhibited other types of organ related cancer. It has been reported that the incidence percentage of diabetes mellitus and cancer in India, parallel each other. However, we observed a low incidence of diabetes mellitus patients also having cancer in south Karnataka. Though the exact reason for this remains unclear an attempt has been made here to explain this phenomenon, hypothetically using information in literature, which suggests a suppression of cellular regenerative activity by sugar and sugar phosphates. Cellular regenerative activity is well known to be a prerequisite for cancer.     

Influence of pranayamas and yoga-asanas on serum insulin,blood glucose and lipid profile in type 2 diabetes

A distinguishable feature of type 2 diabetes besides hyperglycemia and deranged lipid profile is an impaired insulin secretion, peripheral insulin resistance and obesity which has become a major health concern worldwide. India with an estimated 31million diabetics in 2000 and 79mllions by the yr 2030 has the highest number of type 2 diabetics in the world. In this study, we aimed to see if yoga-asanas and pranayamas have any influence in modifying certain biochemical parameters. Sixty patients of uncomplicated type 2 diabetes (age 35–60 yrs of 1–10 yrs duration) were divided into two groups: Group 1 (n=30): performed yoga along with the conventional hypoglycemic medicines and group 2 (n=30): patients who only received conventional medicines. Duration of the study was 45 days. Basal recordings of blood glucose (fasting and post-prandial), lipid profile and serum insulin were taken at the time of recruitment and the second reading after forty five days. Results showed a significant improvement in all the biochemical parameters in group 1 while group 2 showed significant improvement in only few parameters, thus suggesting a beneficial effect of yoga regimen on these parameters in diabetic patients.     

Antihyperglycemic effect of water extract of dry fruits of<Emphasis Type="Italic">Terminalia chebula</Emphasis> in experimental diabetes mellitus

Water extract of dry fruits ofTerminalia chebula (Hindi-Harda, Telugu-Karakkaya) at a dose of 200 mg/kg body weight improved the glucose tolerance as indicated by 44% of reduction in the peak blood glucose at 2^nd hour in glucose tolerance test in diabetic (streptozotocin induced) rats. Treatment of diabetic rats with an initial fasting blood glucose of 253±9.4 mg/dl daily once with the water extract (200 mg/kg) for two weeks brought down the fasting blood glucose to 123±8.4 mg/dl which is only slightly above the normal value. These results indicate that water extract of Terminalia chebula improves glucose tolerance and brings down fasting blood glucose in diabetic rats.     

RBC membrane composition in insulin dependent diabetes mellitus in context of oxidative stress

Glyco-oxidation is considered as a source of permanent, cumulative, oxidative damage to long lived proteins in ageing and in diabetes. Although RBC depends solely on glucose for energy purpose, hyperglycemic state glycosylates hemoglobin, creates oxidative stress and puts the cellular components at risk. In view of this, RBC membrane composition was analyzed in diabetic patients. The results were compared with healthy age and sex matched control groups. When RBC membrane components such as protein, sialic acid, phospholipids and cholesterol were determined in insulin dependent diabetes mellitus, a significant rise in phospholipids and cholesterol and significant fall in sialic acid and protein content was noted. RBC membrane composition showed pronounced alterations in insulin dependent diabetes mellitus. These changes were accompanied by higher levels of lipid peroxidation products like Malondialdehyde.     

Influence of aerobic treadmill exercise on blood glucose homeostasis in noninsulin dependent diabetes mellitus patients

The role of treadmill exercise on blood glucose homeostasis in noninsulin dependent diabetes mellitus (NIDDM) were studied using males between age of 45 and 60 years (X-52), who were clinically and biochemically-confirmed cases of NIDDM were taken into study group. Control group comprised of 10 males between age group of 45 to 60 (X-53) years. All the subjects were assessed by physician and were investigated to confirm diabetic status. The whole study period was extended for 6 weeks. The significant decrease in postprandial blood sugar (44.4 mg% for the study group and 32.2mg% for the control group) with a significant inter group difference (P<0.05) was observed. The mean decrease in fasting blood sugar (39.4mg% for the study group and 27.4mg% for the control group), with a marginal inter group difference (P<0.05) was observed. The treadmill exercise was found to be a definite tool in addition to drug and diet in glycemic control.     

Haptoglobin Polymorphism and Association with Complications in Ghanaian Type 2 Diabetic Patients

There is scanty information on the role of genetic factors, especially those relating to haptoglobin (Hp) phenotypes in the expression of complications among diabetes mellitus patients in Ghana. In this study, we investigated whether there is any association between Hp phenotypes and diabetic complications and to determine if association of the Hp phenotypes with diabetic complications in Ghanaian diabetics differ from those in Caucasians. A total of 398 participants were randomly recruited into the study. These comprised diabetic patients numbering 290 attending a diabetes Clinic in Ghana and 108 non-diabetic controls from the same community. Analyses of the results indicate that most of the diabetics with complications were of the Hp 2–2 (35%) and Hp 2–1 (23.9%) phenotypes. Fewer diabetics were found to be of the Hp 2–1 M phenotype. The controls were mostly of Hp 1–1 and Hp 2–1 M phenotypes. The odds ratio of having complications in a diabetic with an Hp 2–2 phenotype was 18.27 times greater than that for Hp 0–0. Hp 2–2 phenotype with its poor antioxidant activity may therefore be a useful predictor for the propensity of an individual to develop diabetes complications.     

Acetylation Pharmacogenetics and Renal Function in Diabetes Mellitus Patients

Activities of human hepatic drug metabolizing enzymes N-acetyl transferase (NATS) had earlier been recognized as a cause of inter-individual variation in the metabolism of drugs. Therefore acetylation of many drugs in human exhibit genetic polymorphism. The aim of the study was to investigate if acetylator status predispose diabetic mellitus patients more to the complications of renal disease, One hundred and twenty (120) diabetics consisting of (50) Type 1 (T₁) and 70 Type 2 (T₂) diabetes mellitus patients and 100 healthy individuals as controls were classified as slow or rapid acetylator using sulphamethazine (SMZ) as an in vivo probe. The percentage acetylation, recovery of SMZ, creatinine clearance and presence of urinary albumin were determined. A significant difference (P < 0.05) was observed in the percentage of SMZ acetylated between slow and rapid acetylators in control, T₁ and T₂ subjects. The ratios of slow to rapid acetylators for T₁, T₂ and control subjects were 1:4, 3:2 and 2:3 respectively. No significant differences were observed in the percentage of SMZ recovered in the urine of slow and rapid acetylators that are diabetics. The difference in creatinine clearance of slow and rapid acetylators in T₁ and T₂ were significant (P < 0.05). 29% out of 120 (24.2%) diabetics (T₁ and T₂) exhibited albuminuria out of which 25 (86.2%) had slow acetylator status. These findings suggest that slow acetylator status in diabetes mellitus could be a predisposing factor in the development of renal complications. This underscores the need for a rapid pharmacogenetic testing and therapeutic drug monitoring in such patients. However this inference could be further validated with a larger sample size.     

Paired values of serum fructosamine and blood glucose for the screening of gestational diabetes mellitus: A retrospective study of 165 Saudi pregnant women

This study reports the utilization of serum fructosamine and blood glucose for the screening of gestational diabetes mellitus (GDM). Blood samples from 165 pregnant women were analyzed for fasting blood glucose (FBG), random blood glucose (RBG) and serum fructosamine. The actual fructosamine levels were corrected for serum protein (c-Fruct) for more precise presentation. Two cut-off values of FBG (>5.3 mmol/L and >7.0 mmol/L) and RBG (>7.8 mmol/L and >11.0 mmol/L) were used to classify hyperglycemic subjects for subsequent evaluation. The average values±standard deviations for FBG, RBG and cFruct were 5.865±1.95, 7.767±3.21 and 2.387±0.47 mmol/L, respectively. FBG levels were significantly correlated with RBG (Pearson correlation=0.597, P<0.001). Significant correlations were also observed between cFruct and FBG (Pearson correlation=0.673, P<0.001) or RBG (Pearson correlation=0.641, P<0.001). Out of 165 subjects, 24 (14.5%) cases were classified as hyperglycemic on the basis of FBG>7.0 mmol/L or RBG>11.0 mmol/L; use of lower cut-off values resulted higher frequencies of hyperglycemia. Whereas, a combined criteria of FBG>5.3 mmol/L and cFruct >2.5 mmol/L predicted 35 patients as the most probable hyperglycemic as compared to 32 patients identified using the criteria of RBG >7.8 mmol/L and cFruct >2.5 mmol/L. These criteria were associated with 4.8% and 3.6% false-positivity at the expense of 3.6% and 3.0% false-negative outcomes, respectively. The levels of FBG, RBG and cFruct were significantly higher in hyperglycemic groups (irrespective of grouping criteria) as compared to the respective normal groups. In conclusion, these findings clearly indicate that the paired values of cFruct with FBG or RBG could help in filtering high-risk individuals for OGTT and therefore avoiding a unnecessary OGTT.     

Use of glycated hemoglobin (HbA<Subscript>1C</Subscript>) and impaired glucose tolerance in the screening of undiagnosed diabetes in the Malaysian population

Although HbA_1C is widely accepted as a useful index of mean blood glucose in type 2 diabetic patients its usefulness as screening test for diabetes has been controversial. The present study was undertaken to determine whether the level of HbA_1C predicted diabetes in a prediabetic group of subjects. Plasma lipids, oral glucose tolerance, HbA_1C was determined in 90 normal control subjects, 57 offspring of one type 2 diabetes mellitus parent and 11 diagnosed type 2 diabetes mellitus individuals. The mean age of participants was 44.5 yrs (not significantly different amongst the three groups) and the mean body mass index was 26.8 (not significantly different amongst the three groups). Two hours after a 75 g glucose challenge, the offspring had a significantly higher plasma glucose level (mean = 7.1 mmol/L, p value = 0.002) than the normals. Similarly the HbA_1C values were higher in the offspring than in the normals (mean = 5.78%, p value = 0.016). Besides the significantly higher values for oral glucose tolerance test and HbA_1C, the diabetics also were significantly higher for triglycerides (mean = 2.25mmol/L), total cholesterol (mean = 6.24mmol/L) and systolic blood pressure (mean = 138.45mm Hg) than the offspring (P value = 0.031, 0.006, 0.010) and the normals (P value = 0.026, 0.018, 0.002) respectively. The mean values of diastolic blood pressure, LDL cholesterol and HDL cholesterol were not significantly different amongst the three groups.     

Assessment of Endothelial Dysfunction in Health and Disease; Using Various Parameters

Conditions like hypertension, atherosclerosis and diabetes are known to be the result of endothelial dysfunction which could begin early in the life of an individual. The markers of endothelial dysfunction studied in the present work are plasma hemoglobin, serum high sensitivity C-reactive protein (hsCRP) and plasma nitrite and nitrate. We studied the onset of endothelial dysfunction with increase in age as well as in disease condition like newly detected hypertensives and of hypertensive diabetic patients. The mean plasma hemoglobin and hsCRP values were found to increase with age. hsCRP and plasma hemoglobin levels were significantly higher in patient groups as compared to aged-matched controls. On the other hand nitrate and nitrite was significantly higher in patients who suffered from both diabetes and hypertension together and nitrate values were significantly lower in patients who suffered from hypertensive alone. Plasma hemoglobin and hsCRP are associated with endothelial dysfunction and increases both with age as well as in disease condition.     

Evaluation of Flow Rate,pH, Buffering Capacity,Calcium, Total Proteins and Total Antioxidant Capacity Levels of Saliva in Caries Free and Caries Active Children: An In Vivo Study

The purpose of this study was to evaluate the relationship between the physicochemical properties of saliva such as flow rate, pH, buffering capacity, calcium level, total protein and total antioxidant levels in caries free and caries active children. The present study included one hundred and twenty healthy children who were divided into two groups; group I and group II comprising of age groups 7–10 and 11–14 years, respectively. Both the groups were then sub-divided equally according to gender. They were further divided into caries free and caries active with 15 children in each group. Unstimulated saliva was collected by suction method and flow rates were determined. The samples were then analyzed for pH, buffering capacity, total protein, calcium and total antioxidant capacity. The data was statistically analyzed using student t test (unpaired). The results revealed that when all these parameters were compared among the caries free and caries active children, flow rate, pH, buffering capacity were slightly reduced in caries active children, but total protein and total antioxidant capacity of saliva increased significantly in caries active children and the total calcium decreased significantly in caries active children. Within the limitation of this study, we conclude that, the physicochemical properties of saliva play a major role in the development of caries.     

Regulation of metabolic pathways in liver and kidney during experimental diabetes: Effects of antidiabetic compounds

Diabetes has been classified as a disease of glucose overproduction by tissues, mainly liver and glucose underutilization by insulin requiring tissues like liver, adipose and muscle due to lack of insulin. There is, however, glucose over utilization in tissues not dependent on insulin for glucose transport like kidney, nerve and brain. There are serious complications due to this excess glucose in these tissues and their reversal is important for a good metabolic control and normalisation of other parameters. Insulin, trace metals and some plant extracts have been used to see the reversal effects of the complications of diabetes in liver and kidney in experimental diabetes. Almost complete reversal of the metabolic changes has been achieved in the activities of key enzymes of metabolic pathways in liver and kidney and an effective glucose control has been achieved suggesting a combination of therapies in the treatment of metabolic disturbance of the diabetic state.     

Dyslipidemia Associated with Poor Glycemic Control in Type 2 Diabetes Mellitus and the Protective Effect of Metformin Supplementation

The nature of the dyslipidemia associated with diabetes mellitus is complex and is the major risk factor for atherosclerosis and coronary artery disease. Aim of this study was to assess the effect of glycemic control, achieved by metformin, glibenclamide and insulin, on lipid profile in type 2 diabetic patients. One hundred and sixty-five type 2 diabetes mellitus patients were classified into good glycemic control (Group I) and poor glycemic control (Group II) on the basis of their blood HbA1c values. The Group II was characterized with high serum triglyceride (190.46 ± 15.20 mg/dl), total cholesterol (175.3 ± 6.31 mg/dl) as well as high LDL-cholesterol (109.0 ± 5.88 mg/dl). Significant correlations were evident between HbA1c and dyslipidemia, particularly serum TG (r = 0.28, P < 0.05), and between HbA1c and total cholesterol (r = 0.310, P < 0.05). Better glycemic control and improved dyslipidemia were observed in patients on combination therapy of metformin plus glibenclamide.     

Hypoglycaemic, hypolipidemic and antioxidant properties of tulsi (Ocimum sanctum linn) on streptozotocin induced diabetes in rats

Effect of oral administration of 200 mg/Kg body weight of the aqueous extract ofOcimum sanctum (Tulsi) mixed with diet for eight weeks to diabetic (streptozotocin induced) rats was studied. There was significant reduction in fasting blood glucose, serum lipid profile, lipid peroxidation products, (LPO) and improvement in glucose tolerance. The aqueous extract also decreased LPO formation (thiobarbituric acid reactive substances TBARS) and increased antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), glutathione transferase (GT) and one antioxidant reduced glutathione (GSH) in plasma and rat liver, lung, kidney and brain. The decrease in TBARS and increase in GSH, SOD, CAT, GPX, and GT clearly shows the antioxidant property ofOcimum sanctum.     

Comparison between erythrocyte hemoglobin and spectrin glycosylation and role of oxidative stress in type-2 diabetes mellitus

New findings on organization of blood cell cytoskeleton represent an exciting aspect of modem cell biology and hematology, which is an interesting investigation to study diabetes. The present study was undertaken in 150 subjects. Out of these, 30 subjects were controls (Group I) and 30 were type-2 diabetics without any complication (Group II), while remaining 90 subjects were type-2 diabetics with complication (Group III). We determined erythrocyte spectrin and hemoglobin glycosylation and also estimated plasma lipid peroxide, nitric oxide and erythrocyte glutathione peroxidase activity to assess the status of oxidative stress. There was a significant increase in spectrin (P<0.001) and hemoglobin (P<0.001) glycosylation in Group II and III as compared to Group I and spectrin glycosylation was nearly three times more as compared to hemoglobin, whereas plasma levels of lipid peroxide (P<0.001) as well as nitric oxide (P<0.001) were found to be significantly increased and GPx activity (P<0.001) was significantly decreased in Group II and III as compared to Group I. However, it was also observed that spectrin (P>0.05) and hemoglobin (P>0.05) glycosylation was not significantly different in Group II and III. In contrast, there was significant rise in lipid peroxide (P<0.001), nitric oxide (P<0.001) and fall in GPx activity (P<0.001) in Group III when compared to Group II. Increased erythrocyte protein glycosylation and oxidative stress is clearly evident from our study. However, to understand the exact interplay between these two mechanisms, further studies are required.