Monday, February 25, 2019

Obesity Research Journal- Lupine Publishers



Diabetes Mellitus is a chronic disorder characterized by hyperglycemia due to insulin deficiency or insulin resistance. There is no permanent cure for Diabetes. Only way is to replace insulin producing beta-cells. Whole pancreatic transplantation and purified pancreatic islets transplantation are the answer to cure for diabetes. But scarcity of suitable donor and morbidity, high cost involved are limiting factors for pancreatic transplantation. Islet cell transplantation is less invasive procedure and safer than total pancreatic transplantation established in year 2000. Isolated islets carry less antigenic property.


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Monday, February 18, 2019

Obesity Journal- Lupine Publishers



Since 2010, the American Diabetes Association has endorsed both HbA1C (A1C) and fasting plasma glucose (FPG) to determine diabetes risk. Given the discordance between classifications based on FPG and A1C and higher A1C levels among African Americans (AAs) than whites, we sought to examine the prevalence of normoglycemia, prediabetes, and diabetes among a community sample of adult AAs (n=704) screened for enrollment in a randomized Diabetes Prevention Program (DPP). We conducted a retrospective analysis to estimate the degree of discordance between risk categories based on FPG and A1C and examine the risk factors that predicted A1C and FPG levels. To determine differential effects on risk categories defined using FPG and A1C, we examined the effects of the program on the measures at 12 weeks post-intervention among the intervention arm participants.

The tests revealed different prevalence levels at baseline: A1C, 36.2% normoglycemia, 52% prediabetes and 11.8% diabetes; FPG, 81.1%, 16.8%, and 2%, respectively. There was discordance among A1C and FPG and among the risk categories (p<0.001). Both final regression models included age and waist circumference as predictors. For FPG, additional predictors were family history of diabetes and male gender. Post intervention, only those classified in the prediabetes category defined in terms of either test demonstrated intervention effects. Screening test choice results in different sample composition; both A1C and FPG respond to intervention effects among individuals classified in the prediabetes group only. These results have implications for research and clinical practice.


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Monday, February 11, 2019

Diabetes Journals- Lupine Publishers



Low grade inflammatory condition which is predominately cytokine-mediated is observed to be closely involved in the pathogenesis of type 2 diabetes as well as role this inflammatory condition cannot be ruled out in involvement in pathogenesis of type 1 diabetes. Since maximum world populations are at high risk of developing diabetes, we tested this hypothesis by estimating circulating acute phase proteins in freshly diagnosed type 2 (T-2) as well as type1(T-1) diabetic patients.

The acute phase proteins, α1- antitrypsin, α1- acid glycoprotein, ceruloplasmin and fibrinogen were estimated in the plasma in freshly diagnosed twenty-five T-2 cases and twelve T-1cases. Thirty normal controls to match the age and sex of the test groups were also studied. The levels of these proteins were correlated with their BMI and random plasma glucose values.



In comparison with the controls, the values of all the four proteins studied were significantly elevated in the T-2 patients (p<00001). In case of T-1 patient level of ceruloplasmin and fibrinogen are significantly elevated. Interestingly, no correlation was found with BMI or the degree of hyperglycemia in either of the types. A low-grade inflammatory process is definitely implicated in the pathogenesis of type 2 diabetes. Same can be ruled out in type-1 diabetic patients also. The comparative study of the states of all these inflammatory markers in case of T-2 and T-1 patients is of interest in this present study.



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Monday, February 4, 2019

Diabetes and Obesity Journals- Lupine Publishers



Just the other day, I wrote an Editorial for another journal on World Diabetes Day. Before that, it was the World Thrombosis Day. Think of just metabolic diseases, you have, - World Hypertension Day (May 17), World Obesity Day (Oct 11), World Heart Day (Sept 29), World Thrombosis Day (Oct 13), World Diabetes Day (Nov 14). The list keeps growing every year. Whenever I am asked to participate, in these World Observation Days or asked to write about these important annual days, I ask myself, what have we done to arrest, reduce or prevent these chronic metabolic diseases? What can be done about the raising epidemics of chronic diseases? These are hard questions to ask? Much harder, to answer.

All that we can do is, just like we do for New Year’s Day, take a pledge to do something that will make a difference. Metabolicdiseases, such as hypertension, excess weight, obesity, type-2 diabetes, and vascular diseases, have reached epidemic proportions worldwide. In the last three decades globally, obesity has increased two-fold and diabetes, four-fold. No country has stopped, reversed or prevented the trends, in the increase of these chronic metabolic diseases. We and others are of the opinion, that if the metabolic risks are recognized earlier, then just lifestyle modifications may be enough to prevent or postpone the development of diabetes and associated chronic clinical complications.


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