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High prevalence of fragmented QRS on electrocardiography in Japanese patients with diabetes irrespective of metabolic syndrome.
Yagi, K, Nagata, Y, Yamagami, T, Chujo, D, Kamigishi, M, Yokoyama-Nakagawa, M, Shikata, M, Enkaku, A, Takikawa-Nishida, A, Honoki, H, et al
Journal of diabetes investigation. 2021;(9):1680-1688
Abstract
AIMS/INTRODUCTION Fragmented QRS (fQRS) on electrocardiography is a marker of myocardial fibrosis and myocardial scar formation. This study aimed to clarify the relationship of fQRS with diabetes mellitus and metabolic syndrome (MetS) in Japanese patients. MATERIALS AND METHODS Approximately 702 individuals who had a routine health checkup at the Hokuriku Health Service Association (Toyama, Japan) in October 2014 were enrolled and categorized into one of the following four groups based on MetS and diabetes mellitus status: with diabetes mellitus (+) MetS+ (164 participants); diabetes mellitus+ without MetS (Mets-; 103 participants); diabetes mellitus- MetS+ (133 participants); and diabetes mellitus- MetS- (302 participants). fQRS was assessed using the results of electrocardiography. RESULTS The prevalence of fQRS was statistically higher in patients with diabetes mellitus+ MetS+ (37%) and diabetes mellitus+ MetS- (35%), than those with diabetes mellitus- MetS+ (14%) or diabetes mellitus- MetS- (10%; P < 0.0001). Significant differences were observed between the fQRS(+) and fQRS(-) groups for age, sex, waist circumference, heart rate, hypertension, hemoglobin A1c, total cholesterol, MetS and diabetes mellitus. The area under the receiver operating characteristic curve for traditional risk factors and diabetes mellitus was 0.72 (P = 0.0007, 95% confidence interval 0.67-0.76), and for traditional risk factors and MetS it was 0.67 (P = 0.28, 95% confidence interval 0.62-0.72). Patients with diabetes mellitus had more than threefold higher likelihood of showing fQRS (odds ratio 3.41; 95% confidence interval 2.25-5.22; P < 0.0001) compared with the reference group without diabetes mellitus, after adjusting for age, sex, dyslipidemia, hypertension and waist circumference. CONCLUSIONS fQRS was observed more frequently in diabetes mellitus patients than in MetS and control individuals. Diabetes mellitus was the most significant determinant for fQRS among MetS and other traditional metabolic risk factors.
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Berberine and lycopene as alternative or add-on therapy to metformin and statins, a review.
Hedayati, N, Oskouei, Z, Tabeshpour, J, Naeini, MB
European journal of pharmacology. 2021;:174590
Abstract
Nutraceuticals are principally extracted from natural products that are frequently safe and well-tolerated. Lycopene and berberine are natural plants with a wide range of beneficial effects including protective activities against metabolic disorders such as diabetes and cardiovascular diseases. These compounds might be considered technically more as a drug than a nutraceutical and could be prescribed as a product. However, further studies are needed to understand if these supplements could affect metabolic syndrome outcomes. Even if nutraceuticals exert a prophylactic activity within the body, their bioactivity and bioavailability have high interindividual variation, and precise assessment of biological function of these bioactive compounds in randomized clinical trials is critical. However, these reports must be interpreted with more considerations due to the low quality of the trials. The aim of this paper is to bring evidence about the management of cardiovascular diseases and diabetes through the use of nutraceuticals with particular attention to lycopene and berberine effectiveness.
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Research gaps in Ramadan fasting studies in health and disease.
Bandarian, F, Namazi, N, Atlasi, R, Nasli-Esfahani, E, Larijani, B
Diabetes & metabolic syndrome. 2021;(3):831-835
Abstract
BACKGROUND AND AIM Ramadan fasting is a religious fasting of Muslims and has many effects on health and disease. This study aim was to analyze Ramadan fasting research output during the past five years and identify research gaps in this field. MATERIALS AND METHODS A systematic search was performed in Web of Science, pubmed, Scopus, EMBASE and Cochrane databases by appropriate keywords. Documents published between January 2015 and January 2020 with English language were included. After removing duplicates, remained documents were screened and classified. RESULTS Finally, after screening, 393 documents remained and were classified. Of these documents, 53 were review article and 338 original articles. More than 96% of studies were clinical study while basic science studies were too limited. Among the study topics, diabetes mellitus with 31% was the most common topic followed by metabolic disorders and nutrition, respectively. CONCLUSION Ramadan fasting is an important religious issue that needs more attention. Research should be directed to clinical and basic studies in different health and disease conditions other than nutrition and metabolic disorders.
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Trace element nanoparticles improved diabetes mellitus; a brief report.
Ashrafizadeh, H, Abtahi, SR, Oroojan, AA
Diabetes & metabolic syndrome. 2020;(4):443-445
Abstract
BACKGROUND Diabetes mellitus is a chronic metabolic disease that induces several complications in various organs such as the liver, kidney, and reproductive system. Trace elements such as copper, zinc, selenium, and magnesium play an essential role in the management or treatment of diabetes mellitus. AIM: the aim of the present study was conducted to investigate the effect of these trace elements nanoparticles and their probable mechanism of action on diabetes and its complications. METHODS The present brief report was conducted with a search of articles published in several databases including PubMed, ScienceDirect, Google Scholar, and Scopus. The articles were selected from 2011 to 2018 using the keywords "zinc," "copper," "selenium," "magnesium," and "diabetes." Following the eligibility criteria were selected 16 articles and 1 book. RESULTS The scientific results of the presented brief report show that zinc, copper, selenium, and magnesium have antidiabetic effects. Also, they improved the diabetes-induced complications through increase antioxidant enzyme level, glucose utilization, and insulin sensitivity. CONCLUSION While zinc, copper, selenium, and magnesium revealed antidiabetic effects, but their nanoparticles were more potent for the treatment of this disease.
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Impact of Crocus Sativus L. on Metabolic Profile in Patients with Diabetes Mellitus or Metabolic Syndrome: A Systematic Review.
Giannoulaki, P, Kotzakioulafi, E, Chourdakis, M, Hatzitolios, A, Didangelos, T
Nutrients. 2020;(5)
Abstract
BACKGROUND Experimental studies demonstrated a positive effect of administration of Crocus sativus L. (saffron) and its bioactive ingredients on metabolic profile through their antioxidant capacity. PURPOSE To determine if the use of saffron in humans is beneficial to patients with diabetes mellitus (DM) or metabolic syndrome (MS). METHODS This systematic review includes 14randomized control trials that investigated the impact of saffron administration and its bioactive ingredient crocin on the metabolic profile of patients with DM, MS, prediabetes, and coronary artery disease. We documented the following clinical outcomes: fasting blood glucose (FBG), glycated haemoglobin (HbA1c), total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, systolic, and diastolic blood pressure. RESULTS Eight studies examined the efficacy of saffron in patients with DM, four with the metabolic syndrome, one with prediabetes and one with coronary artery disease. A favorable effect on FBG was observed. The results regarding blood lipids and blood pressure were inconclusive in the current review. CONCLUSIONS According to the available limited evidence, saffron may have a favorable effect on FBG. Many of the studies in the reviewed literature are of poor quality, and more research is needed in this direction to confirm and establish the above findings.
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A 50-year history of the health impacts of Westernization on the lifestyle of Japanese Americans: A focus on the Hawaii-Los Angeles-Hiroshima Study.
Yoneda, M, Kobuke, K
Journal of diabetes investigation. 2020;(6):1382-1387
Abstract
A medical survey of Japanese Americans have been carried out since 1970; in particular, this survey was administered to the Japanese emigrants from Hiroshima (Japan) to Hawaii or Los Angeles (USA) and their offspring. Labeled the Hawaii-Los Angeles-Hiroshima Study, it constituted a long-term epidemiological study of Japanese Americans who are genetically identical to the native Japanese people, but have experienced rapid and intense Westernization in terms of their lifestyles. The authors have compared the medical survey data procured from two Japanese populations, evincing very disparate lifestyles; that is, the native Japanese inhabitants of Hiroshima (Japan) and Japanese Americans living in Hawaii or Los Angeles (USA). The focus was particularly on differences in the intake of nutrients, the frequency of obesity, the prevalence of metabolic syndrome and diabetes mellitus, and the progression of atherosclerosis. The authors believe that the health effects of the lifestyles of Japanese Americans can predict the imminent health prospects of native Japanese people who adopt Westernized lifestyles in Japan. This review thus summarized the major results accumulated from the Hawaii-Los Angeles-Hiroshima Study over the past 50 years.
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Prediction and early detection of cardiovascular disease in South Asians with diabetes mellitus.
Wander, GS, Bansal, M, Kasliwal, RR
Diabetes & metabolic syndrome. 2020;(4):385-393
Abstract
BACKGROUND Although diabetes mellitus (DM) is no longer considered "coronary heart disease risk equivalent", the risk remains sufficiently high, necessitating early recognition and management of cardiovascular disease (CVD) in these patients. Despite this understanding, the optimum strategy for prediction and early detection of CVD in DM remains debatable. METHODS Major societal guidelines for prediction and evaluation of CVD in subjects with or without DM were reviewed. Available evidence about various risk stratification strategies-their advantages, disadvantages and current role in clinical practice-were extensively reviewed. Special emphasis was placed on evidence from South Asian/Indian populations. RESULTS The inconsistency and variability inherent to the clinical risk algorithms, lack of consensus regarding the incremental value of subclinical atherosclerosis imaging and the lack of sufficient data to demonstrate the benefits of recognizing asymptomatic atherosclerotic disease are some of the reasons underlying prevailing uncertainty about the optimum approach for cardiovascular risk assessment in DM. These challenges notwithstanding, an evidence-based cardiovascular risk stratification strategy incorporating clinical risk algorithms, biomarkers, atherosclerosis imaging, and cardiac stress testing is proposed. CONCLUSIONS The proposed algorithm should help clinicians in optimizing cardiovascular evaluation and management of their patients with DM. However, this remains a dynamic field; further research into different risk assessment tools, esp. focusing on their impact on improving clinical outcomes, should help refine the evaluation strategy in future.
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Effect of Treatment of Mild Gestational Diabetes on Long-Term Maternal Outcomes.
Casey, BM, Rice, MM, Landon, MB, Varner, MW, Reddy, UM, Wapner, RJ, Rouse, DJ, Biggio, JR, Thorp, JM, Chien, EK, et al
American journal of perinatology. 2020;(5):475-482
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Abstract
OBJECTIVE The main purpose of this article is to evaluate whether identification and treatment of women with mild gestational diabetes mellitus (GDM) during pregnancy affects subsequent maternal body mass index (BMI), anthropometry, metabolic syndrome, and risk of diabetes. STUDY DESIGN This is a follow-up study of women who participated in a randomized controlled treatment trial for mild GDM. Women were enrolled between 5 and 10 years after their index pregnancy. Participants underwent blood pressure, height, weight, and anthropometric measurements by trained nursing personnel using a standardized approach. A nurse-assisted questionnaire regarding screening and treatment of diabetes or hypercholesterolemia, diet, and physical activity was completed. Laboratory evaluation included fasting serum glucose, fasting insulin, oral glucose tolerance test, and a lipid panel. Subsequent diabetes, metabolic syndrome, obesity, and adiposity in those diagnosed with mild GDM and randomized to nutritional counseling and medical therapy (treated) were compared with those who underwent routine pregnancy management (untreated). Multivariable analyses were performed adjusting for race/ethnicity and years between randomization and follow-up visit. RESULTS Four-hundred fifty-seven women with mild GDM during the index pregnancy were included in this analysis (243 treated; 214 untreated) and evaluated at a median 7 years after their index pregnancy. Baseline and follow-up characteristics were similar between treatment groups. Frequency of diabetes (9.2 vs. 8.5%, p =0.80), metabolic syndrome (32.2 vs. 34.3%, p =0.63), as well as adjusted mean values of homeostasis model assessment for insulin resistance (2.5 vs. 2.3, p =0.11) and BMI (29.4 vs. 29.1 kg/m2, p =0.67) were also not different. CONCLUSION Identification and treatment of women with mild GDM during pregnancy had no discernible impact on subsequent diabetes, metabolic syndrome, or obesity 7 years after delivery.
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Obesity, Diabetes and COVID-19: An Infectious Disease Spreading From the East Collides With the Consequences of an Unhealthy Western Lifestyle.
Holly, JMP, Biernacka, K, Maskell, N, Perks, CM
Frontiers in endocrinology. 2020;:582870
Abstract
The pandemic of COVID-19, caused by the coronavirus, SARS-CoV-2, has had a global impact not seen for an infectious disease for over a century. This acute pandemic has spread from the East and has been overlaid onto a slow pandemic of metabolic diseases of obesity and diabetes consequent from the increasing adoption of a Western-lifestyle characterized by excess calorie consumption with limited physical activity. It has become clear that these conditions predispose individuals to a more severe COVID-19 with increased morbidity and mortality. There are many features of diabetes and obesity that may accentuate the clinical response to SARS-CoV-2 infection: including an impaired immune response, an atherothrombotic state, accumulation of advanced glycation end products and a chronic inflammatory state. These could prime an exaggerated cytokine response to viral infection, predisposing to the cytokine storm that triggers progression to septic shock, acute respiratory distress syndrome, and multi-organ failure. Infection leads to an inflammatory response and tissue damage resulting in increased metabolic activity and an associated increase in the mechanisms by which cells ingest and degrade tissue debris and foreign materials. It is becoming clear that viruses have acquired an ability to exploit these mechanisms to invade cells and facilitate their own life-cycle. In obesity and diabetes these mechanisms are chronically activated due to the deteriorating metabolic state and this may provide an increased opportunity for a more profound and sustained viral infection.
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Pharmacological potential of the combination of Salvia miltiorrhiza (Danshen) and Carthamus tinctorius (Honghua) for diabetes mellitus and its cardiovascular complications.
Orgah, JO, He, S, Wang, Y, Jiang, M, Wang, Y, Orgah, EA, Duan, Y, Zhao, B, Zhang, B, Han, J, et al
Pharmacological research. 2020;:104654
Abstract
Metabolic syndrome, such as diabetes mellitus, obesity, atherosclerosis, and high blood pressure (HBP), are closely linked pathophysiologically. However, current monotherapies for metabolic syndrome fail to target the multifactorial pathology via multiple mechanisms, as well as resolving the dysfunctionality of the cells and organs of the body. We aimed to provide a comprehensive and up-to-date review of the pharmacological advances, therapeutic potential, and phytochemistry of Salvia miltiorrhiza, Carthamus tinctorius, and Danhong injection (DHI). We discussed the molecular mechanisms of the bioactive constituents relating to diabetes mellitus and metabolic disease for further research and drug development. Interestingly, Salvia miltiorrhiza, Carthamus tinctorius, and DHI have anti-inflammatory, anti-glycemic, anti-thrombotic, and anti-cancer properties; and they mainly act by targeting the dysfunctional vasculatures including the inflammatory components of the disease to provide vascular repair as well as resolving oxidative stress. The major bioactive chemical constituents of these plants include polyphenolic acids, diterpene compounds, carthamin, and hydroxysafflor yellow A. Treatment of diabetes mellitus and its associated cardiovascular complication requires a comprehensive approach involving the use of appropriate traditional Chinese medicine formula. Danshen, Honghua, and DHI target the multiple risk factors regulating the physiologic function of the body and restore normalcy, apart from the traditional advice on exercise and diet control as treatment options in a metabolic syndrome patient.