Study of the Pathogenesis of Hypertension Associated with Non-Insulin Dependent Diabetes Mellitus

In order to study the pathogenesis of hypertension associated with noninsulin dependent diabetes mellitus (NIDDM), Plasma glucose, insulin levels at fasting and following an oral glucose load were measured. Na +K +pump and Ca 2+ pump activities of red blood cell membrane were also assessed. Hypertensive patients with normal or impaired glucose tolerance (NGT, or IGT) had hyperinsulinemia. Obese hypertensive patients also had hyperinsulinemia, while nonobese hypertensive patients had no hyperinsulinemia, but exhibited a delay in insulin response to oral glucose tolerance test (OGTT). In multivariate analysis, considering the factors of age, BMI and plasma glucose level, DBP were still positively related to both 30 min insulin level and IAUC, but negatively correlated to activities of Na +K +pump and Ca 2+ pump. These results demonstrated that a link between obesity, hpertension and NIDDM is the insulin resistance and/or hyperinsulinemia.

Effects of Supplemented Taohe Chengqi Decoction (桃核承气汤) in Treating Insulin Resistance in Rats with Non-Insulin Dependent Diabetes Mellitus

Objective: To investigate the effect of supplemented Taohe Chengqi Decoction (桃核承气汤,STHCQD) in treating non-insulin dependent diabetes mellitus (NIDDM). Methods: The model of rats withNIDDM was formed with injection of streptozotocin and fed on high calorie diet to study the effects of STHCQDon the release of insulin sensitivity. Results: (l ) Fasting serum glucose, serum insulin, intake of food and waterwere significantly decreased (P < 0. 05 -- 0. 01 ) in STHCQD-treated diabetic rats as compared with untreated diabetic rats, while the insulin sensitivity was significantly increased (P < 0. 05 ). (2) The liver cell membranesfrom STHCQD-treated diabetic rats released the quantity of insulin receptor which inhibited adenylate cyclaseactivity, but this effect was blunted in untreated diabetic rats (P < 0. 05). (3) A significantly increased glucoseoxidation in adipocyte of STHCQD-treated diabetic rats was found as compared with those of untreated diabeticrats (P< 0. 05). Conclusions: STHCQD therapy Increased sensitivity and responsiveness of target cells to insulin, i. e. it might decrease insulin resistance at receptor sites and POst--receptor sites in rats with NIDDM, butcould not.reverse the insulin resistance.

Clinical Study on Jiang Tang San（降糖散）in Treating Non－Insulin Dependent Diabetes Mellitus Patiente

The therapeutic effect of Jiang Tang San (JTS) on 30 cases with non-insulin dependent dia-betes mellitus (NIDDM) , was observed, whose fasting blood glucose ranged trom 11. 1 mmol/L to 13. 8mmol/L. The results suggested that JTS has significant effect on NIDDM patients in lowering blood glucose,blood lipid and blood pressure levels. Clinical symptoms and blood glucose improved rapidly. JTS promotedthe elevation of serum insulin level 1 hour after meal. The total effective rate of lowering blood glucosereached 86. 7% . The results showed JTS is better than berberine on lowering blood glucose ( P< 0. 01 ) andwhen patients failed to respond to other hypoglycemics or on recurrence JTS was still effective. There wereno marked side-effects during the course of treatment.

Therapeutic Effect of Berberine on 60 Patients with Non－Insulin Dependent Diabetes Mellitus and Experimental Research

The effects of berberine on 60 cases with noninsulin dependent diabetes mellitus and ex-perimental research results were observed in this study. The results suggest berberine has significant ef-fects on noninsulin dependent diabetes mellitus patients and experimental diabetes in animals in the re-duction of blood glucose levels. The clinical symptoms basically disappeared and the level of serum insulinrose. The total effective rate was up to 90 percent and there were no signiticant side-effects. It was foundthat berberine has an effect on the recovery of pancreas islet cells, through pathological examination onthe animal subjects.

Modified upper abdominal cluster transplantation in patients with end-stage liver diseases associated with insulin dependent type 2 diabetes mellitus

Objective Modified upper abdominal cluster transplantation ( MCT) ,which was inspired by classical cluster transplant technique,has been proven more effective and feasible in the treatment of patients with end stage liver diseases associated with insulin - dependent

CLINICAL ANALYSIS OF 52 CASES OF JUVENILE DIABETES MELLITUS

The clinical significance of 52 cases of juvenile diabetes mellitus is reported in the article.The ratio of male to female was 1:2.5. 21.2% had the episode of infection prior to the onset of the disease;6.5% had positive family history.It is suggested from the article that more attention should be paid to nontypical cases which would incur misdiagnosis and improper treatment;and it might be necessary to differentiate the ketoacidosis from just positive ketonuria reaction. As for the latter,insulin hypodermic injection probably is more feasible than intravenous effusion.

Association Studies of 3 Candidate Genes with Type 2 Diabetes Mellitus in a Chinese Population

Objectives To explore the relationship between the polymorphisms of the selected short tandem repeats (STRs) of the candidate genes and type 2 diabetes mellitus (DM) in a Chinese population,the role of genetic and environmental factors in the development of type 2 diabetes. Methods STRs including D11S916 of uncoupling protein 3 (UCP3) gene,binucleotide repeat (CA)n within intron 6 [HSLi6(CA)] of hormone-sensitive lipase(HSL)gene and D20S501 of protein tyrosine phosphatase-1B (PTP-1B)gene polymorphisms were detected, by poiymerase chain reaction(PCR) ,poly-acrylamide gel electrophoresis and silver staining in 106 patients with type 2 DM and 102 control subjects. Results The allele distribution of UCP3 and HSL gene differed significantly between patients with type 2 diabetes and control subjects (X2 = 26. 12,P<0. 005; X2 = 10. 33,P<0. 005,respectively). For UCP3 and HSL gene,the frequencies of alleles A6,A7,A8 and allele B9 were much higher in diabetic patients than in control subjects (0. 090 vs 0. 020,P<0. 005; 0. 109 vs 0. 015,P <0. 005; 0. 033 vs 0. 000,P<0. 05; 0. 033 vs 0. 005,P<0. 05,respectively),while the frequencies of allele A1 and allele B5 were lower in diabetic patients than in control subjects (0. 090 vs 0. 206,P<0. 005; 0. 057 vs 0. 118,P<0. 05,respectively). At D20S501 locus,The allele distribution of PTP-1B gene had no significant difference in two groups (X2 = 3. 77, P>0. 05). Multi-variate logistic regression analysis showed positive correlation between alleles A6,A7 of UCP3 gene,systolic blood pressure, apolipoprotein B, lipoprotein (a) and type 2 diabetes. Conclusion Our data show that D11S916 of UCP3 gene and HSLi6(CA) of HSL gene polymorphisms are associated with type 2 diabetes in Chinese suggesting that UCP3 and HSL might represent susceptibility genes for type 2 diabetes. D20S501 of PTP-IB gem polymorphism is not associated with type 2 diabetes in Chinese. Alleles A6, A7 of UCP3 gene, systolic blood pressure, apolipoprotein B,Upoprotein (a) may play some role in the development of type 2 diabetes.

Celiac disease in Middle Eastern and North African countries:A new burden?

Celiac disease(CD) is now recognized as a common disorder among Middle Eastern(ME) and North African(NA) populations.The aim of this review is to assess the available data regarding CD in the ME and NA and to compare this information with that of Western countries.A literature review was performed using the electronic databases PubMed and Medline(1950-2008) as search engines,and "celiac disease" was used as a Mesh term.The search was limited to ME and NA countries.The prevalence of CD in ME and NA countries among low risk populations is similar to that of Western countries,but is higher in high risk populations such as those with type 1 diabetes.It is underestimated because of lack of clinical suspicion and lack of patient awareness.Clinical presentations in term of gastrointestinal,hematologic,skeletal,and liver manifestations are similar between both populations except for a high prevalence of short stature in some ME and NA countries.Few studies have addressed atypical or silent CD.As in the West,diagnosis is initially made by serological tests and is confirmed by small intestinal biopsies.Gluten-free diet is the main mode of treatment with a higher apparent adherence rate than in the West.Most disease complications result from malabsorption.The disease is strongly associated with HLA DQ2 and to a lesser extent with HLA DQ8 alleles.In conclusion,CD prevalence is underestimated,with little data available about its malignant complications.Disease parameters in the ME and NA are otherwise similar to those in Western countries.

Reactivity of Human Preformed Natural Antibodies with Various Porcine Pancreatic Cells

The reactivity of human preformed natural antibodies (PNAbs) with various porcine pancreatic cells and its isotypes was investigated. Eighteen serum samples from patients with insulin dependent diabetes mellitus (IDDM) and 20 serum samples from healthy human subjects were collected. The frozen sections of the pig pancreas were incubated with these sera, and subsequently incubated with FITC conjugated goat antihuman IgG and IgM monoclonal antibodies. The reactivity of human PNAbs with various porcine pancreatic cells was determined by indirect immunofluorescence staining technique. The results showed that 55.6 % of IDDM patients and 55.0 % of healthy human individuals contained PNAbs against porcine endocrine cells. However, the percentage of strongly reacting sera in the patient group was significantly increased as compared with that in the control group. All used sera from IDDM patients and 95 % of sera from healthy controls could react to one or more of the various pancreatic cell types, including: endocrine cells, exocrine cells, vascular endothelial cells, ductal epithelial cells and macrophages. The isotypes of PNAbs contained both IgG and IgM. In view of strongly positive reactivity of PNAbs with various porcine pancreatic cells, pretransplantly cross matching test and graft pretreatment may be necessary for survival of islet transplants.

STUDY ON THE IMMUNE FUNCTION OF ERYTHROCYTE IN PATIENT WITH NIDDM

The author measured the immune function of erythrocyte in 50 cases of noninsulin dependent diabetes mellitus(NIDDM),and researched the effect of erythrocyte immune adherence adjustmeat factor on the immune function of erythrocyte. The results showed that in patients with NIDDM,erythrocyte C3b receptor rosette forming rate(ECRRFR)was much higher(P<0.01),erythrocyte immune adherence exciting factor(EIAEF)was much lower than that of normal controlgroup(P<0.01);erythrocyte immune complexes rosette forming rate(EICRFR)was much lower,and erythrocyte immune adherence inhibiting factor(EIAIF)was much nigher than that of normalPersons(P<0.01).The study also showed that a significant positive correlation was found betweenthe activation of erythrocyte C3b receptor and EIAEF,and a significant negative correlation wasfound between the activation of erythrocyte C3b receptor and EIAIF.

Rhabdomyolysis and Acute Pancreatitis in Diabetic Ketoacidosis: A Case Report and Review of Literature

Diabetic ketoacidosis (DKA) is a life-threatening complication in patients with Type 1 or Type II. Diabetes Mellitus resulting in fluid shifts, electrolytes imbalance and acid-base disorders, can lead to multi-organ Failure. The Pancreas and skeletal muscles are not commonly affected in DKA. We present a case of 41-year-old female who was initially admitted in intensive care unit for treatment of Diabetic ketoacidosis, and was treated appropriately later she complained of abdominal pain and generalized myalgia. Hospital course was complicated with Acute pancreatitis and Rhabdomyolysis. Serum electrolytes were significant for hypo-phosphatemia. Workup for myositis and acute pancreatitis were negative. The exact etiology is unknown, but it is proposed in many literature articles that serum hyper-osmolarity and/or electrolyte abnormalities can be the culprits in triggering the complications.

A review on Malaysian medicinal plants having anti-hyperglycemic activity

The use of natural products as a source of remedies has long history since ancient times.Currently,medicinal plants are traditional practices for an extensive range of therapeutics and pharmacological activities like hypoglycemic,immunological,antiviral,anti-inflammatory,anti-hepatic,cardiovascular and central nervous effect.In the past,the use of plant based medicines was mainly restricted to developing countries because of insufficient resources,but currently the trend is changed and natural products as a source of medicines are growing rapidly in developed countries.It is confirmed from research articles that nearly about 75%-80%of the reserved zone inhabitants used natural products for their health remedies.In all,about 250000-500000 species of plants exist worldwide and almost 800 plants have been documented for use in folklore systems of medicine.Regarding to this,Malaysia is being accepted as one of the largest biodiversity countries.In Malaysia,12000 species of natural products exist and 1200 are documented to have remedial potential against various diseases.In the market,a variety of allopathic drugs are available,but are linked to various side effects.Hence,there is rising interest in the direction to plant based medicines remedies with a basic tactic towards the nature.The anti-diabetic drugs from natural products source in current use and their same way of producing action are preferred mainly due to affordable price,easy availability and minor harmful effect on human beings.Therefore,the aim of the present research work was to review various Malaysian medicinal plants having potential in attenuation of high level of blood glucose.All over the world,diabetes mellitus is claimed to be one of the most common chronic hereditary non-communicable disease,fourth leading cause of mortality in the most developed countries.The disease is also spreading in many developing and newly industrialized nations.According to International Diabetes Federation,the diabetes will affect 592 million people in 2035.

Molecular cloning, sequencing and expression of obese gene in the Chinese

Objective To construct the human obese(ob) cDNA clone in the Chinese, and analyze the expression of the ob gene in adipose tissue of obese, non obese subjects and nooinsulin dependent diabetes mellitus (NIDDM) Chinese patients Methods A ob cDNA clone was isolated by reverse transcription polymerase chain reaction (RT PCR) Four groups of Chinese subjects participated in the study: 1) 12 obese subjects [body mass index (BMI): 28 5±2 3? kg/m 2]; 2) 11 non obese subjects (BMI: 21 0±1 5? kg/m 2); 3) 8 obese NIDDM patients (BMI: 27 0±1 4?kg/m 2); 4) 11 non obese NIDDM patients (BMI: 21 2±1 4?kg/m 2) The expression of ob gene mRNA in abdominal subcutaneous adipose tissue was examined using RNA dot blot hybridization with a digoxigenin labeled human ob cDNA probe The hybridized signals were quantitated by densitometry Results A full human ob cDNA fragment which included a glutamine codon at +49 was obtained A base substitution (A to G) in the coding region at position 287 was found, resulting in a glutamine being replaced by an arginine Expression of the ob gene was significantly higher in Chinese obese subjects compared to non obese ones ( P <0 05), and positively correlated with the BMI No significant difference in the amount of ob mRNA was detected between non diabetic and diabetic groups at the same BMI level Conclusions We constructed a full length human ob cDNA clone. The expression of the ob gene was significantly higher in Chinese obese subjects than in non obese ones. The metabolic and hormonal changes associated with NIDDM are not the main factors regulating the expression of the ob gene.

Clinical Observation on Diabetic Nephropathy Treated with Alcohol Extraction of Flos Abelmoschus Manihot

Sixty-eight cases of Non-Insulin Dependent Diabetes Mellitus complicated with Nephropathywere randomly divided into two groups : the treated group, 35 cases treated with alcohol extraction of Flos A-belmoschus manihot, Gliclazide and Captopril Tablets; and the control group, 33 cases treated with Gli-clazide and Captopril Tablets, over a period of 8 weeks. The total effective rate in the treated and controlgroup were 83.87% and 31.03% respectively (P< 0 . 01 ) , urinary micro-albumin were 31 . 7 and 76.3mg/L(P < 0. 05) , proteinuria were 0. 41 and 0 . 77g/24hr ( P < 0. 01 ) , blood 2-microglobulin were 3317. 8 and3473. 1 hg/ml ( P < 0. 05) , urinary 2-microglobulin were 367. 2 and 641 . 5ng/ml ( P < 0. 01 ) , urinary N-acetyl- -glucosaminidase (NAG) were 26. 3 and 66. 7u/L ( P < 0. 01 ) , plasma lipid peroxide (LPO) were6. 13 and 8. 78 nmol/L ( P<0. 05) , and plasma superoxide anion were 8. 36 and 10. 42 kcpm respectively( P< 0. 05) . It was suggested that alcohol extraction of Abelmoschus manihot could eliminate oxygen freeradicals, alleviate renal tubular-interstitial diseases, improve renal function, and reduce proteinuria.

Relationship between angiotensinogen gene M235 Tvariant with diabeticnephropathy in Chinese N I D D M

Objective To investigate whether angiotensinogen (AGT) gene M235T variant is associated with non insulin dependent diabetes mellitus without nephropathy (DN -), and diabetic nephropathy (DN +) in Chinese non insulin dependent diabetes mellitus (NIDDM) Methods The subjects in DN + group, DN - group and control group were well matched with sex, age and duration of disease, and the two case groups were divided into two subgroups as with and without hypertension respectively The M235T polymorphism of AGT gene of 84 cases with DN -, 96 patients with DN + and 98 controls were determined by polymerase chain reaction (PCR) amplification and restriction fragment length polymorphism (RFLP) analysis of the region of the variant, i e M235T polymorphism Results The increased frequencies of T allele (0 82) and TT genotype (0 70) were observed in 96 subjects with DN + as compared with 98 control subjects (0 63 and 0 43, respectively, P =0 003, P =0 0004) The odds ratio associated with TT genotype was 3 47 (95%CI: 1 51-7 94; P =0 0033) for diabetic nephropathy in analysis adjusted for several risk factors of diabetic nephropathy, such as body mass index, systolic and diastolic blood pressure, serum cholesterol, low density lipoprotein and high density lipoprotein Subgroup analysis of the 67 patients in DN + group with hypertension revealed similar distributions of M235T genotypes and alleles to those in the DN + without hypertension subgroup There was no difference in allele and genotype distribution between 84 DN - patients and the controls Similarly, frequencies of the AGT M235T genotype and allele were not different between two DN - subgroups Conclusions AGT gene M235T polymorphism is associated with diabetic nephropathy in NIDDM TT genotype of the AGT gene might be an independent risk factor of diabetic nephropathy in Chinese NIDDM patients