मधुमेह जटिलताओं और चिकित्सा जर्नल

Background: Our study was designed to test the possible association between either polymorphisms T889C (rs1800587) or C3954T (rs1143634) of the interleukin-1 alpha (IL-1α) gene with subclinical markers of carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM). Moreover, the effect of both polymorphisms on progression of carotid atherosclerosis in 3.8-year follow-up was studied. Patients and methods: 595 subjects with T2DM were enrolled in the prospective study. Subclinical markers of carotid atherosclerosis were assessed with ultrasound at the time of recruitment and after 3.8-years. Genotyping of two polymorphisms (rs1800587, rs1143634) was performed with real-time PCR System. Results: The comparison of atherosclerosis parameters was performed with regard to different genotypes of IL-1α rs1800587 and rs1143634 polymorphisms upon enrolment. Multiple linear regression analysis revealed the association of IL-1α rs1143634 on total plaque thickness progression in a 3.8 year follow up. Conclusions: An association between either the IL-1α rs1800587 or rs1143634 and total plaque thickness at the time of recruitment was reported. Additionally, we demonstrated the effect of the IL-1α rs1143634 on total plaque thickness progression in the 3.8-year follow-up in patients with T2DM.

The authors evaluate a novel compression device, Sequential Contraction Compression Therapy Device (SCCD) on patients with hypo esthetic Diabetic Peripheral Neuropathy. The authors selected 15 patients all of whom had a diagnosis of DPN and were currently taking 150 mg. of Pregabalin twice daily. After thirty days of treatment with SCCD, patients were evaluated for improvement in their pain score, amount of rescue drugs used, and the amount of sleep interference they experienced. All patients experience statistically significant improvement in all three measurements.

Objective: To gain a better understanding of the Epidermal Growth Factor (EGF) Receptor (EGFR) activation, trafficking and biological response in diabetic foot ulcers (DFU), exposed to recombinant human EGF via intra-ulcer infiltration as a healing alternative.

Methods: We studied by immunoelectron microscopy the intracellular localization of the EGFR and Proliferating Cell Nuclear Antigen (PCNA) in fibroblast-like cells (FLC) from granulation tissue of DFU patients, collected before and at different time points after EGF treatment.

Results: EGF therapy appears to increase EGFR immunolabeling. At early time-points, EGFR labeling is observed predominantly in the nucleus, suggesting a fast EGFR internalization and nuclear translocation. Interestingly EGFR is also detected in the mitochondrial outer membrane. PCNA expression and trafficking were also detected in a time-dependent manner after EGF infiltration.

Conclusion: Differential subcellular distribution of EGFR and PCNA and accumulation in the nucleus, in a timepoint specific manner, supports the induction of an EGF-mediated activation program that is sustained for at least 24 hours after the EGF administration. These findings substantiate the therapeutic ability of EGF to restore the healing process in DFU.

Deficiency of vitamin D is emerging as one of the important nutritional risk factors for development of insulin resistance (IR) and Type 2 Diabetes Mellitus (T2DM). It is also observed to be associated with poor glycemic control and progression of complications among diabetics. In India, in spite of adequate sunlight exposure throughout year, several reports documented prevalent finding of deficiency of vitamin D. With the context of rising surge of T2DM and hypovitaminosis D among Indians, relation between vitamin D and T2DM and related studies have been reviewed in the present article. Vitamin D plays important roles in the metabolism of glucose. It directly stimulates insulin secretion from beta cells of pancreas. It increases intracellular calcium levels, which attenuates insulin synthesis. Also it improves insulin sensitivity in peripheral muscle and fats cells. T2DM is a state of chronic low-grade chronic inflammation and being anti-inflammatory in nature, vitamin D exerts beneficial effects on glycemic control and prevention of complications. Current data about vitamin D status in T2DM is based on small sporadic studies from different regions of India. Researchers have reported conflicting results about the association of hypovitaminosis D with development of T2DM and its complications. This warrants an urgent need of population based; large sample sized prospective studies to prove the role of vitamin D in every stage, from prevention to management

Women with a history of gestational diabetes mellitus (GDM) are known to be at increased risk for diabetes and cardiovascular disease. Other cardiovascular risk factors that integrate the metabolic syndrome also seem to be more prevalent in this group of women. On the other hand, several studies have shown that there is an ethnic effect on disease risk. Prevalence of type 2 diabetes, gestational diabetes and other cardiovascular risk factors vary greatly in populations of different ethnicity. Therefore, we have reviewed the available evidence on the prevalence of the metabolic syndrome components in women with previous GDM along with the differential characteristics of each ethnic group.