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World Journal of Diabetes May 2024In this editorial, we comment on the article by Liu published in the recent issue of the (Relationship between GCKR gene rs780094 polymorphism and type 2 diabetes with...
In this editorial, we comment on the article by Liu published in the recent issue of the (Relationship between GCKR gene rs780094 polymorphism and type 2 diabetes with albuminuria). Type 2 diabetes mellitus (T2DM) is a chronic disorder characterized by dysregulated glucose homeostasis. The persistent elevated blood glucose level in T2DM significantly increases the risk of developing severe complications, including cardiovascular disease, re-tinopathy, neuropathy, and nephropathy. T2DM arises from a complex interplay between genetic, epigenetic, and environmental factors. Global genomic studies have identified numerous genetic variations associated with an increased risk of T2DM. Specifically, variations within the glucokinase regulatory protein (GCKR) gene have been linked to heightened susceptibility to T2DM and its associated complications. The clinical trial by Liu further elucidates the role of the GCKR rs780094 polymorphism in T2DM and nephropathy development. Their findings demonstrate that individuals carrying the CT or TT genotype at the GCKR rs780094 locus are at a higher risk of developing T2DM with albuminuria compared to those with the CC genotype. These findings highlight the importance of genetic testing and risk assessment in T2DM to develop effective preventive strategies and personalized treatment plans.
PubMed: 38766433
DOI: 10.4239/wjd.v15.i5.814 -
Cureus Feb 2024Acute pancreatitis is a pancreatic inflammatory disorder that often leads to multi-organ dysfunction associated with systemic inflammatory response. Optic neuropathy is...
Acute pancreatitis is a pancreatic inflammatory disorder that often leads to multi-organ dysfunction associated with systemic inflammatory response. Optic neuropathy is an extremely rare ocular manifestation that can occur especially in alcoholic pancreatitis most likely due to ischemic complications and is a vision-threatening condition that has to be recognized early as it can cause permanent vision loss. In this case report, a 51-year-old lady, an occasional consumer of alcohol, post-cholecystectomy status, presented with severe abdominal pain of four days' duration associated with multiple episodes of vomiting. She was diagnosed with moderate to severe acute pancreatitis and needed ionotropic support initially. She had improvement in gastrointestinal symptoms. However, she had left peri-orbital pain and lacrimation with blurring of vision on Day 11 of illness. Subsequently, an ophthalmic evaluation revealed optic disc oedema and a mild decrease in visual acuity but normal visual field and colour vision. Therefore, left optic neuropathy was diagnosed and a high-dose oral steroid was started on a tapering dose. Follow-ups after four and 12 weeks showed significant improvement in optic disc oedema and other symptoms. Therefore, though optic neuropathy is rarely reported in acute pancreatitis, it has to be considered in clinical practice along with Purtscher-like retinopathy, which presents with ocular symptoms in acute pancreatitis.
PubMed: 38496136
DOI: 10.7759/cureus.54234 -
Neurology International Feb 2024Wernicke-Korsakoff Syndrome (WKS) is a severe neurological disorder resulting from thiamine deficiency, commonly associated with alcohol consumption but also stemming...
Wernicke-Korsakoff Syndrome (WKS) is a severe neurological disorder resulting from thiamine deficiency, commonly associated with alcohol consumption but also stemming from dietary imbalances or other clinical conditions. Cognitive deficits, affecting memory and executive functions, pose a serious concern, with partial recovery often not complete. A 28-year-old woman underwent surgery for acute necrotizing hemorrhagic pancreatitis, leading to admission for post-acute intensive treatment due to prolonged bed rest syndrome. Clinical examinations revealed sensory-motor neuropathy, denervation in the active phase, mammillary body hyperintensity, and cognitive impairment. The patient exhibited poor orientation, lacked awareness of her clinical condition, and experienced impaired nonverbal memory, practical constructive issues, and planning difficulties-consistent with WKS. The patient received high-dose thiamine (300 mg TDS), coupled with daily physiokinesitherapy and occupational therapy. A final neuropsychological evaluation three months later showed substantial remission of executive and memory difficulties, improved spatial-temporal orientation, and enhanced awareness. The complex case required timely multidisciplinary intervention for accurate diagnosis and effective rehabilitation. The patient experienced rapid clinical improvement and cognitive recovery with high-dose thiamine and physiotherapy.
PubMed: 38392959
DOI: 10.3390/neurolint16010018 -
Case Reports in Ophthalmology 2023A 56-year-old man with a medical history of alcoholic cirrhosis presented with acute bilateral loss of vision. On admission, the patient had pale skin and low arterial...
A 56-year-old man with a medical history of alcoholic cirrhosis presented with acute bilateral loss of vision. On admission, the patient had pale skin and low arterial pressure. Ophthalmic examination demonstrated a visual acuity of 6/9 in the right eye and the absence of light perception in the left. Automated perimetry revealed a superior altitudinal defect in the right eye. Optic disc swelling, flame-shaped hemorrhages, and several cotton-wool spots were evident in both eyes on fundoscopy. Lab results confirmed severe anemia. Following prompt correction of the anemia, the altitudinal defect remained unchanged. However, visual acuity in the right eye improved significantly in a few days. The potential association of anemia with both papilledema and non-arteritic anterior ischemic optic neuropathy (NA-AION) is discussed, with a focus on possible pathophysiological mechanisms. The necessity for routine anemia screening, encompassing complete blood count, serum iron, and vitamin B12 levels, and subsequent rapid correction in these patients, is emphasized.
PubMed: 37901626
DOI: 10.1159/000531999 -
Frontiers in Endocrinology 2023Worldwide, diabetes and its complications have seriously affected people's quality of life and become a serious public health problem. C-peptide is not only an indicator... (Review)
Review
Worldwide, diabetes and its complications have seriously affected people's quality of life and become a serious public health problem. C-peptide is not only an indicator of pancreatic β-cell function, but also a biologically active peptide that can bind to cell membrane surface signaling molecules and activate downstream signaling pathways to play antioxidant, anti-apoptotic and inflammatory roles, or regulate cellular transcription through internalization. It is complex how C-peptide is related to diabetic complications. Both deficiencies and overproduction can lead to complications, but their mechanisms of action may be different. C-peptide replacement therapy has shown beneficial effects on diabetic complications in animal models when C-peptide is deficient, but results from clinical trials have been unsatisfactory. The complex pattern of the relationship between C-peptide and diabetic chronic complications has not yet been fully understood. Future basic and clinical studies of C-peptide replacement therapies will need to focus on baseline levels of C-peptide in addition to more attention also needs to be paid to post-treatment C-peptide levels to explore the optimal range of fasting C-peptide and postprandial C-peptide maintenance.
Topics: Animals; Humans; C-Peptide; Quality of Life; Diabetes Complications; Diabetes Mellitus
PubMed: 37745697
DOI: 10.3389/fendo.2023.1256093 -
Pharmacological Research Oct 2023There is an increasing interest in the use of nutraceuticals and plant-derived bioactive compounds from foods for their potential health benefits. For example, as a... (Review)
Review
There is an increasing interest in the use of nutraceuticals and plant-derived bioactive compounds from foods for their potential health benefits. For example, as a major active ingredient found from cruciferous vegetables like broccoli, there has been growing interest in understanding the therapeutic effects of sulforaphane against diverse metabolic complications. The past decade has seen an extensive growth in literature reporting on the potential health benefits of sulforaphane to neutralize pathological consequences of oxidative stress and inflammation, which may be essential in protecting against diabetes-related complications. In fact, preclinical evidence summarized within this review supports an active role of sulforaphane in activating nuclear factor erythroid 2-related factor 2 or effectively modulating AMP-activated protein kinase to protect against diabetic complications, including diabetic cardiomyopathy, diabetic neuropathy, diabetic nephropathy, as well as other metabolic complications involving non-alcoholic fatty liver disease and skeletal muscle insulin resistance. With clinical evidence suggesting that foods rich in sulforaphane like broccoli can improve the metabolic status and lower cardiovascular disease risk by reducing biomarkers of oxidative stress and inflammation in patients with type 2 diabetes. This information remains essential in determining the therapeutic value of sulforaphane or its potential use as a nutraceutical to manage diabetes and its related complications. Finally, this review discusses essential information on the bioavailability profile of sulforaphane, while also covering information on the pathological consequences of oxidative stress and inflammation that drive the development and progression of diabetes.
PubMed: 37703962
DOI: 10.1016/j.phrs.2023.106918 -
European Review For Medical and... Aug 2023The aim of this study was to investigate the prevalence of microvascular and macrovascular diabetic complications and the associated comorbidities in newly diagnosed...
OBJECTIVE
The aim of this study was to investigate the prevalence of microvascular and macrovascular diabetic complications and the associated comorbidities in newly diagnosed pre-diabetic individuals.
PATIENTS AND METHODS
This cross-sectional study includes 100 newly diagnosed pre-diabetic individuals. Fasting plasma glucose, HbA1c, and oral glucose tolerance (OGTT) were tested according to the American Diabetes Association's diagnostic criteria for pre-diabetes, besides anthropometric measurements, lipid profiles, and demographic and biochemical parameters. Comorbidities like hypertension, obesity, dyslipidemia etc., were evaluated. All participants were screened for microvascular (retinopathy, nephropathy, neuropathy) and macrovascular [coronary artery disease (CAD) and cerebrovascular event-peripheral artery disease] complications.
RESULTS
Microvascular complications were found in 12% of the participants (neuropathy: 4%, nephropathy: 8%) and 19% had macrovascular complications. Of the participants, 21% of the cases presented hypertension, 21% dyslipidemia and 48% obesity. A high probability of developing non-alcoholic fatty liver disease-related fibrosis [estimated using non-alcoholic fatty liver disease fibrosis score (NFS)] was found in 68% of cases. History of dyslipidemia (OR: 5.00, 95% CI: 1.10-22.56; p=0.037) was an independent risk factor for the development of vascular complications.
CONCLUSIONS
Diabetic vascular complications were found in approximately one-third of pre-diabetic cases. Dyslipidaemia was found to be an important risk factor for the development of vascular complications in these individuals.
Topics: Humans; Prediabetic State; Cross-Sectional Studies; Non-alcoholic Fatty Liver Disease; Cardiovascular Diseases; Hypertension; Obesity; Fibrosis
PubMed: 37667932
DOI: 10.26355/eurrev_202308_33407 -
Bioscience Trends Nov 2023Studies have found that intermittent fasting (IF) can prevent diabetes, cancer, heart disease, and neuropathy, while in humans it has helped to alleviate metabolic...
Studies have found that intermittent fasting (IF) can prevent diabetes, cancer, heart disease, and neuropathy, while in humans it has helped to alleviate metabolic syndrome, asthma, rheumatoid arthritis, Alzheimer's disease, and many other disorders. IF involves a series of coordinated metabolic and hormonal changes to maintain the organism's metabolic balance and cellular homeostasis. More importantly, IF can activate hepatic autophagy, which is important for maintaining cellular homeostasis and energy balance, quality control, cell and tissue remodeling, and defense against extracellular damage and pathogens. IF affects hepatic autophagy through multiple interacting pathways and molecular mechanisms, including adenosine monophosphate (AMP)-activated protein kinase (AMPK), mammalian target of rapamycin (mTOR), silent mating-type information regulatory 2 homolog-1 (SIRT1), peroxisomal proliferator-activated receptor alpha (PPARα) and farnesoid X receptor (FXR), as well as signaling pathways and molecular mechanisms such as glucagon and fibroblast growth factor 21 (FGF21). These pathways can stimulate the pro-inflammatory cytokines interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α), play a cytoprotective role, downregulate the expression of aging-related molecules, and prevent the development of steatosis-associated liver tumors. By influencing the metabolism of energy and oxygen radicals as well as cellular stress response systems, IF protects hepatocytes from genetic and environmental factors. By activating hepatic autophagy, IF has a potential role in treating a variety of liver diseases, including non-alcoholic fatty liver disease, drug-induced liver injury, viral hepatitis, hepatic fibrosis, and hepatocellular carcinoma. A better understanding of the effects of IF on liver autophagy may lead to new approaches for the prevention and treatment of liver disease.
Topics: Humans; Intermittent Fasting; Liver; Fatty Liver; Hepatocytes; Autophagy
PubMed: 37661370
DOI: 10.5582/bst.2023.01207 -
Cureus Jul 2023A 40-year-old female with a history of chronic alcohol use disorder presented with an acute intractable left-sided headache for three days and progressively worsening...
A 40-year-old female with a history of chronic alcohol use disorder presented with an acute intractable left-sided headache for three days and progressively worsening unsteady gait requiring a wheelchair to ambulate. The patient had a history of chronic alcoholism since 2019 but reported abstinence since September 2021. One month after quitting alcohol, she experienced a sudden deterioration in bilateral extremity neuropathy, forgetfulness, difficulty writing, and severe mood swings, which continued to worsen until her presentation in July 2022. Laboratory tests, including complete blood count and electrolyte levels, were within normal ranges. A previous MRI performed during the investigation for alcoholic neuropathy a few months before she quit drinking showed no abnormalities. However, a subsequent MRI during work-up for the current acute symptoms revealed significant signal abnormalities involving the central pons, bilateral cerebral peduncles, and medullary pyramids, consistent with chronic central pontine myelinolysis (CPM) with extrapontine myelinolysis (EPM) extending into the peduncles. The patient received treatment with folate and multivitamins and was scheduled for outpatient follow-up with physical therapy for rehabilitation. This case highlights CPM as a consequence of alcohol withdrawal and emphasizes the importance of timely diagnosis and appropriate management in such patients.
PubMed: 37565130
DOI: 10.7759/cureus.41640 -
World Journal of Clinical Cases May 2023Methanol is a highly toxic, non-potable alcohol. Outbreaks of methanol toxicity occur due to its fraudulent addition to alcoholic beverages as a cheaper substitute for...
BACKGROUND
Methanol is a highly toxic, non-potable alcohol. Outbreaks of methanol toxicity occur due to its fraudulent addition to alcoholic beverages as a cheaper substitute for ethanol. Recently, alongside the coronavirus disease 2019 (COVID-19) pandemic, rumors circulated on social media that consuming alcohol can prevent or cure the virus, leading to a COVID-19 and methanol-induced optic neuropathy (MON) syndemic.
AIM
To investigate the impact of erythropoietin (EPO) on the outcomes of patients diagnosed with MON.
METHODS
In this prospective study, 105 patients presenting with acute bilateral visual loss secondary to methanol intoxication were enrolled from March to May 2020 at Farabi Eye Hospital. A comprehensive ocular examination was conducted for all participants. Recombinant human EPO and methylprednisolone were administered intravenously to all patients for three consecutive days.
RESULTS
The mean age of the participants was 39.9 years (± 12.6). Ninety-four patients were male and eleven were female. The mean pre-treatment best corrected visual acuity (BCVA) improved from 2.0 ± 0.86 to 1.39 ± 0.69 logarithm of the minimum angle of resolution post-treatment ( < 0.001), with significant improvement observed in all age categories and genders ( < 0.001). Visual acuity improvement was also significant regardless of whether the patient presented before or after 72 h ( < 0.001), and the post-treatment BCVA remained significant at all monthly follow-up visits ( < 0.001).
CONCLUSION
EPO and methylprednisolone therapy have been shown to be effective in improving visual outcomes in patients with MON when administrated within the first month of exposure. Public awareness efforts are necessary to prevent further outbreaks of methanol toxicity in the current COVID-19 era.
PubMed: 37383889
DOI: 10.12998/wjcc.v11.i15.3502