High-fat diet and oral infection induced type 2 diabetes and obesity development under different genetic backgrounds

Background:Type 2 diabetes(T2D)is an adult-onset and obese form of diabetes caused by an interplay between genetic,epigenetic,and environmental components.Here,we have assessed a cohort of 11 genetically different collaborative cross(CC)mouse lines comprised of both sexes for T2D and obesity developments in response to oral infection and high-fat diet(HFD)challenges.Methods:Mice were fed with either the HFD or the standard chow diet(control group)for 12 weeks starting at the age of 8 weeks.At week 5 of the experiment,half of the mice of each diet group were infected with Porphyromonas gingivalis and Fusobacterium nucleatum bacteria strains.Throughout the 12-week experimental period,body weight(BW)was recorded biweekly,and intraperitoneal glucose tolerance tests were performed at weeks 6 and 12 of the experiment to evaluate the glucose tolerance status of mice.Results:Statistical analysis has shown the significance of phenotypic variations between the CC lines,which have different genetic backgrounds and sex effects in different experimental groups.The heritability of the studied phenotypes was estimated and ranged between 0.45 and 0.85.We applied machine learning methods to make an early call for T2D and its prognosis.The results showed that classification with random forest could reach the highest accuracy classification(ACC=0.91)when all the attributes were used.Conclusion:Using sex,diet,infection status,initial BW,and area under the curve(AUC)at week 6,we could classify the final phenotypes/outcomes at the end stage of the experiment(at 12 weeks).

Studying host genetic background effects on multimorbidity of intestinal cancer development,type 2 diabetes and obesity in response to oral bacterial infection and high-fat diet using the collaborative cross(CC)lines

Background:Multimorbidity of intestinal cancer(IC),type 2 diabetes(T2D)and obesity is a complex set of diseases,affected by environmental and genetic risk factors.High-fat diet(HFD)and oral bacterial infection play important roles in the etiology of these diseases through inflammation and various biological mechanisms.Methods:To study the complexity of this multimorbidity,we used the collaborative cross(CC)mouse genetics reference population.We aimed to study the multimorbidity of IC,T2D,and obesity using CC lines,measuring their responses to HFD and oral bacterial infection.The study used 63 mice of both sexes generated from two CC lines(IL557 and IL711).For 12 weeks,experimental mice were maintained on specific dietary regimes combined with co-infection with oral bacteria Porphyromonas gingivalis and Fusobacterium nucleatum,while control groups were not infected.Body weight(BW)and results of a intraperitoneal glucose tolerance test(IPGTT)were recorded at the end of 12 weeks,after which length and size of the intestines were assessed for polyp counts.Results:Polyp counts ranged between 2 and 10 per CC line.The combination of HFD and infection significantly reduced(P<.01)the colon polyp size of IL557 females to 2.5 cm 2,compared to the other groups.Comparing BW gain,IL557 males on HFD gained 18 g,while the females gained 10 g under the same conditions and showed the highest area under curve(AUC)values of 40000-45000(min mg/dL)in the IPGTT.Conclusion:The results show that mice from different genetic backgrounds respond differently to a high fat diet and oral infection in terms of polyp development and glucose tolerance,and this effect is gender related.

Assessing the host genetic background effects on type 2 diabetes and obesity development in response to mixed–oral bacteria and high-fat diet using the collaborative cross mouse model

Background: Host genetic background and sex, play central roles in defining the pathogenesis of type 2 diabetes(T2 D), obesity and infectious diseases. Our previous studies demonstrated the utilization of genetically highly diverse inbred mouse lines, namely collaborative cross(CC), for dissecting host susceptibility for the development of T2 D and obesity, showing significant variations following high-fat(42% fat) diet(HFD). Here, we aimed to assessing the host genetic background and sex effects on T2 D and obesity development in response to oral-mixed bacterial infection and HFD using the CC lines.Materials and Methods: Study cohort consists of 97 mice from 2 CC lines(both sexes), maintained on either HFD or Standard diet(CHD) for 12 weeks. At week 5 a group of mice from each diet were infected with Porphyromonas gingivalis(Pg) and Fusobacterium nucleatum(Fn) bacteria(control groups without infection). Body weight(BW) and glucose tolerance ability were assessed at the end time point of the experiment.Results: The CC lines varied(P <.05) at their BW gain and glucose tolerance ability(with sex effect) in response to diets and/or infection, showing opposite responses despite sharing the same environmental conditions. The combination of diet and infection enhances BW accumulation for IL1912, while restraints it for IL72. As for glucose tolerance ability, only females(both lines) were deteriorated in response to infection.Conclusions: This study emphasizes the power of the CC mouse population for the characterization of host genetic makeup for defining the susceptibility of the individual to development of obesity and/or impaired glucose tolerance.

Association of obesity with hypertension and type 2 diabetes mellitus in India:A meta-analysis of observational studies

AIM To perform a meta-analysis of the association of obesity with hypertension and type 2 diabetes mellitus(T2DM) in India among adults. METHODS To conduct meta-analysis, we performed comprehensive, electronic literature search in the PubM ed, CINAHL Plus, and Google Scholar. We restricted the analysis to studies with documentation of some measure of obesity namely; body mass index, waist-hip ratio, waist circumference and diagnosis of hypertension or diagnosis of T2DM. By obtaining summary estimates of all included studies, the meta-analysis was performed using both RevM an version 5 and "metan" command STATA version 11. Heterogeneity was measured by I^2 statistic. Funnel plot analysis has been done to assess the study publication bias.RESULTS Of the 956 studies screened, 18 met the eligibility criteria. The pooled odds ratio between obesity and hypertension was 3.82(95%CI: 3.39 to 4.25). The heterogeneity around this estimate(I^2 statistic) was 0%, indicating low variability. The pooled odds ratio from the included studies showed a statistically significant association between obesity and T2DM(OR = 1.14, 95%CI: 1.04 to 1.24) with a high degree of variability.CONCLUSION Despite methodological differences, obesity showed significant, potentially plausible association with hypertension and T2DM in studies conducted in India. Being a modifiable risk factor, our study informs setting policy priority and intervention efforts to prevent debilitating complications.

Frequency of Modifiable Cardiovascular Risk Factors Such as Obesity, Diabetes Mellitus and Hypertension in a Benin Rural Area

The fight against cardiovascular diseases requires the knowledge of their modifiable risk factors. This study aimed to assess the level of modifiable cardiovascular risk factors in a rural area in order to develop a prevention program. Methods: This is an analytical and cross-sectional study on data collected during a fairground medical consultation of adults from 20 to 25 May 2013, in both border districts of the municipality of Djidja (Agouna and Houto). The studied parameters were the capillary blood glucose profile, blood pressure profile, waist circumference (WC) and Body Mass Index (BMI). Diabetes is defined by a fasting blood glucose ≥ 1.26 g/L two times. Hypertension is defined according to the criteria of JNC VII and obesity by BMI ≥ 30 kg/m2;abdominal obesity is defined by a WC above 102 cm in men and 88 cm in women. Data were analyzed using SPSS software version 18.0. Results: A total of 926 people were included among whom 57.8% were women. The average age was 38.43 ± 15.84 years. The prevalence of diabetes mellitus was 2.9%. The prevalence of obesity (BMI ≥ 30 kg/m2) was 8.4%;10.8% of studied population had abdominal obesity and 19.2% had hypertension. Age above 35 years and obesity were significantly associated with hypertension. Risk factors of obesity (IMC ≥ 30 kg/m2) were the place of residence (Agouna), the female gender, age between 35 and 64 and abdominal obesity. Conclusion: The frequency of cardiovascular risk factors, although small compared to the national level, remains a concern in the investigated rural communities. This must lead to undertake a survey on the lifestyle and dietary habits of the inhabitants of these areas.

The Screening of Diabetes, Obesity and Hypertension Risks Associated with Hepatitis C Within the Egyptian Population in a Community Pharmacy Setting

Background:Diabetes and hypertension have been identified as risk factors for HCV complications in previous studies.This has sparked the interest in the field of prevention by identifying at-risk individuals and increasing investments for screening among pharmacists.The aim of this study was to screen for risk factors,including age,gender,BMI,hypertension,diabetes,and obesity,in Egyptian patients with HCV Methods:A prospective cross-sectional study was carried out from September 2018 to February 2019,with a total of 1,959 medical records collected.By comparing the patients'characteristics,variables related to metabolic risk,and body composition measurements,regression models have been established to determine any confounding factors.Results:The prevalence of HCV antibody was 41.0%in men and 59.0%in women.Among the variables included in the regression analysis,age,BMI,and uncontrolled hypertension were found to have statistically significant associations with diabetes in HCV positive cases(p<0.001).HCV patients>40 years old with high BMI were found to have significant associations with both,diabetes and hypertension(p<0.001).Hypertensive HCV patients were found to have significant associations with gender,age>40,and DM(p<0.001).Conclusion:HCV infection and metabolic disorders have a closed cycle relationship.Reducing the complications of DM has a promising prospective of limiting the complications of HCV .

Prevalence and Risk Factors for Hypertension, Diabetes and Obesity among Lecturers and Support Staff of Bishop Stuart University in Mbarara, Uganda

Aim: To establish the prevalence and risk factors for hypertension, diabetes and obesity among teaching and non-teaching staff of Bishop Stuart University, Mbarara-Uganda. Background: None communicable diseases (NCDs) are projected to exceed communicable diseases as the most common causes of death by 2030 in Africa. Most sub-Saharan African countries however lack detailed countrywide data on hypertension and other NCDs risk factors. Cognizant of Uganda’s recent inclusion of Hypertension and diabetes in the health policy agenda, this study was conducted among the university staff in a rural setting to provide benchmark information for design of appropriate interventions. Study Design: This was a descriptive cross-sectional, institutional based survey design. Place and duration of the study: This study was conducted among the teaching and none teaching staff of Bishop Stuart University Mbarara, Uganda from 18th April-6th June 2017. Methodology: A structured questionnaire was used to gather social demographic and risk factors data from the university workers at their work stations. Blood pressure of each participant was measured and Hypertension was defined as systolic BP > 140 and/or diastolic (BP) > 90 mmHg. Anthropometric measurements: Body Mass index (BMI) was done by weight in (Kg) and Height in (M2) to establish weight levels. Obesity was considered at BMI > 40. A random Blood Sugar (RBS) > 200 mg/dl was considered as diabetic. Epi-info version 7 was used to enter data, analyzed using SPSS version 19. Results: A total of 156 University staff aged 25 - 75 years of both sexes, mean age 42 ± 8 were interviewed of whom 51% were males. About 15% were administrative staff, 55% teaching staff, 3% senior lecturers and professors and 25% non-teaching staff. The prevalences of Hypertension, Diabetes, and obesity were 7.7%, 16%, and 28% respectively. But also majority (60.2%) were found at risk of developing both hypertension and diabetes. Less than 20% of the participants were knowledgeable on causes, signs and symptoms and preventive measures for Hypertension but had moderate knowledgeable of the risk factors, the most frequently mentioned risk by 71% was lack of exercise. Despite the awareness of risk factors, majority (61.3%) had not done any form of exercise and 64.1% had not had regular Blood pressure check ups. The study also demonstrated a statistically significant relationship between those aged more than 40 years and having hypertension (X2 = 5.82, P = 0.015, OR = 4.2). Likewise the risk of Diabetes increased with increasing age. Lecturers aged 40 years and above were 5.6 times likely to have diabetes compared to those aged less than 40 years (OR = 5.6, X2 = 16 , P = 0.0005). A significant number of respondents 57/156 (36.5%) reported history of HPT among their family members. Prevalence of obesity and overweight was observed higher in senior administrative staff and lecturers than in lower cadre staff 49% and 34% (p 0.01). Conclusion: Hypertension, Diabetes and obesity are conditions prevalent among the teaching and none teaching staff of BSU, but knowledge on risk factors, clinical presentation and preventive strategies is limited. Routine physical exercises...

Nutritional and Clinical Profiles of Elderly People with Diabetes and Hypertension at Conakry University Hospitals

Introduction: In Guinea, there is few data on dietary practices socio-economic and clinical characteristics of elderly diabetics and hypertensives. Methods: This was a descriptive cross-sectional study of people aged 60 years and over, seen in consultation or hospitalised in Conakry University hospitals during the period from 5 September to 15 December 2023 inclusively. Results: Among the 320 subjects included in the study, there were more men (50.6%). The average age was 67 ± 7.69 years;53.43% had hypertension and 46.57% had diabetes. Sex was significantly associated with diabetes (p = 0.035). Women in the study were more affected by diabetes (55.7%), 64.4% of diabetic subjects were married and more than 64% of them had dependent children. 26.2% of diabetics were not employed;85.9% had an income;34.9% had an income of less than one million Guinean francs per month and 74.5% of them had 3 meals a day. Physical activity, 24-hour recall for lunch (p Conclusion: Effective management of diabetes and hypertension in the elderly should necessarily involve nutrition education in hospitals.

Hypertension, diabetes mellitus, overweight and obesity in employees under health transition at the railways company in Congo-Brazzaville

Background and Aim: Cardiovascular risk (CVR) factors, namely hypertension (HT), diabetes mellitus and obesity, are a public health problem in sub-Saharan Africa because of health transition. The additional effect of the social gradient within the railway companies in Congo-Brazzaville on high CVR is not yet established. The aim of this study was to determine the extent of hypertension, diabetes mellitus, overweight, and obesity and to identify the contributing factors of fatness and hypertension. Methods: This was a cross-sectional study conducted in April 2013. A simple random sample of 255 out of all 2550 workers from the railway companies of Congo was examined for epidemiological, clinical and biological variables. Results: Out of the study sample, 231 (90.6%), 79 (31%), and 52 (20.4%) were men, rural dwellers, and senior executives, respectively. The mean age was 45 ± 13 years (range 19 to 63 years). The rates of overweight, hypertension, obesity, and diabetes mellitus were 40.3% (n = 103), 29.4% (n = 75), 7.5% (n = 19), and 3.5% (n = 9), respectively. In univariate analysis, female sex (OR 2.7, 95% CI 1.13 - 6.45, p = 0.01), senior executive (OR 2.4;95% CI: 1.3 - 4.5;p = 0.003) and physical inactivity (OR 2.5;95% CI: 1.5 - 4.2;p < 0.001) were significantly associated with overweight. Female sex (OR 7.5, 95% CI: 2.6 - 21;p < 0.001) and senior executive (OR 3.17;95% CI: 1.2 - 8.3) were also significantly associated with obesity. In logistic regression, overweight (OR = 4.8, 95% CI 2.8 - 11, p < 0.0001), and obesity (OR = 6.8, 95%CI 2.1 - 22, p = 0.01) were identified as the most important and independent determinants of hypertension. Conclusions: Fatness is emerging and it is the most contributing factor of hypertension among workers at the Congolese railway companies. There is also a significant interaction between non-modifiable factors (genetic: females and family history) and modifiable factors (inactivity, fatness) for higher risk of hypertension. Health promotion should be emphasized by physical activity programs.

Gut microbiota in a population highly affected by obesity and type 2 diabetes and susceptibility to COVID-19

Coronavirus disease 2019(COVID-19)is a disease produced by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and it is currently causing a catastrophic pandemic affecting humans worldwide.This disease has been lethal for approximately 3.12 million people around the world since January 2020.Globally,among the most affected countries,Mexico ranks third in deaths after the United States of America and Brazil.Although the high number of deceased people might also be explained by social aspects and lifestyle customs in Mexico,there is a relationship between this high proportion of deaths and comorbidities such as high blood pressure(HBP),type 2 diabetes,obesity,and metabolic syndrome.The official epidemiological figures reported by the Mexican government have indicated that 18.4%of the population suffers from HBP,close to 10.3%of adults suffer from type 2 diabetes,and approximately 36.1%of the population suffers from obesity.Disbalances in the gut microbiota(GM)have been associated with these diseases and with COVID-19 severity,presumably due to inflammatory dysfunction.Recent data about the association between GM dysbiosis and metabolic diseases could suggest that the high levels of susceptibility to SARSCoV-2 infection and COVID-19 morbidity in the Mexican population are primarily due to the prevalence of type 2 diabetes,obesity,and metabolic syndrome.

Effect of the Mediterranean Diet on BMI in Middle-Aged Hispanic Women with Pre-Obesity and Obesity Central Washington State

Background: Conclusive evidence has yet to emerge regarding the effectiveness and applicability of the Mediterranean diet on middle-aged Hispanic women, the largest female minority group in the United States who is at-risk of metabolic disorders. Objective: The aim of this study is to evaluate the effect of the Mediterranean diet (MED) on the BMI in middle-aged Hispanic women with pre-obesity and obesity in Central Washington State. Design: A prospective study was performed to determine the effect of Mediterranean diet on the BMI of 67 Hispanic women with pre-obesity and obesity between 45 to 65 years of age in Central Washington State. The study was carried out for eight weeks. Dietary adherence was monitored to ensure consistent results. Results: The proportion of Hispanic women who reported a reduction in BMI was 94%, with a decrease in mean BMI after eight weeks of 2.8 (95% CI: 2.5 to 3.0) and P = 0.02, with an odds ratio of 2.6. Multiple linear regression analysis was used to adjust for age, education, physical activity, and smoking. Conclusion: The reduction in BMI demonstrates that the Mediterranean diet can be a promising, culturally appropriate therapy to address the obesity epidemic that is prevalent among Hispanic women.

Metabolically healthy obesity increase risk for hypertension,T2DM and the metabolic syndrome:A community-based cohort study

Objective:To investigate the prevalence of metabolically healthy obesity(MHO)and its relationship with incidence of metabolic syndrome(MetS),type 2diabetes mellitus(T2DM)and hypertension in individuals in the city of Yulin.Methods:We studied 1,666 participants,aged over18years at baseline,with free of components of the MetS except waist criteria.Participants were divided into three groups based on body mass index(Ibm):lean/normal weight(Ibm<23kg/m2),overweight(Ibm,23-24.9kg/m2),obesity(Ibm≥25 kg/m2).The cumulative incidence of MetS,T2DM and hypertension over 5.21years among groups was assessed.Results:The prevalence of MHO was 19.5%in the baseline population.During an average 5.21year follow-up,the cumulative incidence of MetS,T2DM and hypertension in1,666participants were 16.4%,19.1%and 3.9%,respectively.The obesity group had a significantly higher cumulative incidence of MetS(16.4%vs.3.2%,P<0.001),hypertension(19.1%vs.3.7%,P<0.001),and T2DM(3.9%vs.1.6%,P<0.001)compared to the lean/normal weight group.Each kg/m2 of Ibm carried increased risk for T2DM(19%),hypertension(11%)and MetS(13%).Conclusion:Metabolically healthy obesity individuals confer increased risk for hypertension,T2DM and the MetS than their non-obese counterparts.

Glucokinase activator improves glucose tolerance and induces hepatic lipid accumulation in mice with diet-induced obesity

Background and aims:Type 2 diabetes mellitus remains a substantial medical problem with increasing global prevalence.Pharmacological research is becoming increasingly focused on personalized treatment strategies.Drug development based on glucokinase(GK)activation is an important strategy for lowering blood glucose.This study aimed to investigate the effect of GK activation on glucose and lipid metabolism in diet-induced obese mice.Materials and methods:Mice were fed with a high-fat diet(HFD)for 16 weeks to induce obesity,followed by a GK activator(GKA,AZD1656)or vehicle treatment by gavage for 4 weeks.The effect of GKA treatment on glucose metabolism was evaluated using glucose and insulin tolerance tests.Hepatic lipid accumulation was assessed by hematoxylin and eosin staining,Oil Red O staining,and transmission electron microscopy.The underlying mechanism of GK activation in glucose and lipid metabolism in the liver was studied using transcriptomic analysis,with a mechanistic study in mouse livers in vivo and AML12 cells in vitro.Results:GK activation by GKA treatment improved glucose tolerance in HFD-fed mice while increasing hepatic lipid accumulation.Transcriptomic analysis of liver tissues indicated the lipogenesis and protein kinase RNA-like endoplasmic reticulum kinase(PERK)-unfolded protein response(UPR)pathway activations in GKA-treated HFD-fed mice.Inhibition of the ACC activity,which is an important protein in lipogenesis,attenuated GKA treatment-induced lipid accumulation and PERK-UPR activation in vitro.Conclusions:GK activation improved glucose tolerance and insulin sensitivity while inducing hepatic lipid accumulation by increasing the lipogenic gene expression,which subsequently activated the hepatic PERK-UPR signaling pathway.

Abnormal Change in Body Weight and Non-Fasting Blood Glucose Levels of Mouse Strain C57BL/6J in Generating Type 2 Diabetes Model

The commercially available inbred obesity-prone C57BL/6J （B6） and outbred stock ICR mice （3-week old） purchased from a breeder of Beijing were weaned onto high-fat diet （HFD）, HFD-3% fructose water （HFDF） and standard rodent chow, respectively. After exposure to the diets for six weeks, HFD and HFDF fed mice were injected intraperitoneally with streptozotocin （STZ, 100mg/kg body weight） and kept on the same diet for next four weeks. Body weight was recorded weekly. Non-fasting blood glucose levels of HFD and HFDF fed mice were measured before and after STZ injections. The body weight of HFD-fed and HFDF-fed B6 mice were significantly lower than that of the control, but body weight of HFD-fed and HFDF-fed ICR mice were significantly higher than that of the control. After injection of STZ, blood glucose levels were above the stardardized criterion （11 mmol/L） for the diabetes mouse model in both HFD and HFDF fed ICR mice, but reverse in B6 mice. The type 2 diabetes model was generated successfully in ICR but not in B6 mice, regardless of whether fructose was supplied. The current results indicated that ICR mouse is still a useful and economical strain for HFD-induced/STZ-treated type 2 diabetes model, and that some variation may occur in the genetic composition among B6 mice bred by different breeders.

Diabetes and Hypertension in a Santhal Tribe in Bangladesh: A Population Based Study

BACKGROUND: Santhal (Santals) tribe is one of the oldest and largest aboriginal pre Aryan populations in India and Bangladesh. There was no published report on the prevalence of diabetes and hypertension. OBJECTIVE: To determine the prevalence of type 2 diabetes mellitus (T2DM) and hypertension in a Santhal tribe of Bangladesh. RESEARCH DESIGN AND METHODS: Eight villages inhabited largely by Santhal tribe were purposively selected. All Santhals aged 20 years or more were considered eligible and enlisted for the study. Investigations included socio-demographic information (age, sex, education, income), clinical history (general illness), anthropometry (height, weight, waist-girth, hip-girth) and blood pressure. Body mass index (BMI) and waist-to-hip ration (WHR) were calculated. Blood samples were collected for fasting plasma glucose (FPG), total cholesterol (Chol), triglycerides (TG), urea and creatinine. RESULTS: Thirteen hundred eligible Santhals were enlisted. Of them, 1049 (80.7%) participated in the study. The male and female participants were 40% and 60%, respectively. The prevalence of T2DM was 0.6% and hyperglycemia (FPG > 5.5 mmol/l) was 10.0%. The prevalence of systolic hypertension (sHTN) was 24.4% and diastolic hypertension (dHTN) was 24.6%. Compared with the males the females had significantly higher prevalence of sHTN (OR, 2.20 with 95% CI, 1.62 - 3.02) and dHTN (OR, 1.81 with CI, 1.34 - 2.0);whereas, the prevalence of T2DM and IFG did not differ. Regarding obesity 45% of the participants had BMI 23.1. Logistic regression estimated that the increasing age, female sex, higher FPG (>5.5 mmol/l) and higher Chol (>160 mg/dl) had independent risk for sHTN and dHTN. CONCLUSIONS: The Santhals had less risk for diabetes but increased risk for hypertension. The Santhal females had excess risk of hypertension. Advancing age, female sex, hyperglycemia and hypercholesterolemia were found to have significant risk for hypertension. Obesity had no effect on diabetes or hypertension. High dietary salt intake among Santhals might have contributed to the development of hypertension. Further study may confirm the study findings and to understand why this tribe is less susceptible to diabetes and more to hypertension.

Recent advances in the managements of type 2 diabetes mellitus and natural hypoglycemic substances

Diabetes has become a global concern at present,among which type 2 diabetes mellitus(T2DM)accounts for approximately 90%-95%of patients.T2DM is a type of metabolic disorder syndrome that results from a genetic defect,and it is based on insulin resistance and an insulin secretion disorder.The occurrence of T2DM is usually the outcome of both genetic and environmental factors and their interactions.The etiology and pathogenesis of diabetes have not been fully elucidated,and no radical therapeutic cure has been found.Patients with T2DM suffer from complications such as the development of a chronic hyperglycemic condition and even serious metabolic disorders and organ damage in the body and depression and dementia,in addition to other chronic complications.Many studies have suggested that diet is crucial in the development of diabetes and the control of blood glucose.Natural substances have the characteristics of low toxicity and few side effects and may be key to the development of diabetic health products and preventive treatments.This paper reviews the etiology,pathogenesis,risks,treatments and diets related to T2DM to summarize the types of recently available natural products,from both local and foreign sources,for lowering blood glucose at home and their application in supplementary hypoglycemic foods.The key findings and conclusions suggest that there are various known T2DM-inducing factors,including genetic and environmental factors and three types of hybrid factors.

Obesity: Body Relief Surgeries before Bariatric Surgery for Risk Reduction

Depending on the treatment and weight of the breasts or abdomen, they may exceed volumes considered giant and morbidly obese. In these cases, and when the patient’s BMI is high above 40 kg/m2, the weight of the breasts or abdomen produces what we consider suffocation when the patient is placed in horizontal position on surgical tables, decreasing his respiratory capacity and increasing the difficulty in treating respiratory or embolic risks. An 8-kg breast on the patient’s chest prevents normal breathing. An abdomen with a volume of 30 kg causes difficulties in all senses, making the physiological expansion of the lungs impossible and even preventing surgical assistance to patients. These patients are almost always customers who sleep in the sitting position to breathe better. The gigantic extirpation of the surgical parts facilitates a better respiratory expansion reducing by a large percentage the risk of death, what we call body relief. This relief does not free the patient from bariatric surgery for a possible weight loss, which is vital for the proper functioning of the organs and decreasing arterial hypertension and diabetes.

Intermittent energy restriction in type 2 diabetes: A short discussion of medication management

AIM To discuss type 2 diabetes mellitus(T2DM) medication changes required during the popular 5:2 intermittent energy restriction(IER) diet. METHODS A search was conducted in MEDLINE, EMBASE, AMED, CINAHL and Cochrane library for original research articles investigating the use of very low calorie diets(VLCD) in people with T2 DM. The search terms used included "VLCD" or "very low energy diet" or "very low energy restriction" or "IER" or "intermittent fasting" or "calorie restriction" or "diabetes mellitus type 2" and "type 2 diabetes". Reference lists of selected articles were also screened for relevant publications. Only research articles written in English, which also included an explanation of medication changes were included. A recent pilot trial using the 5:2 IER method, conducted by our research group, will also be summarized.RESULTS A total of 8 studies were found that investigated the use of VLCD in T2 DM and discussed medication management. Overall these studies indicate that the use of a VLCD for people with T2 DM usually require the cessation of medication to prevent hypoglycemia. Therefore, the 5:2 IER method will also require medication changes, but as seen in our pilot trial, may not require total cessation of medication, rather a cessation on the 2 IER days only. CONCLUSION Guidelines outlined here can be used in the initial stages of a 2-d IER diet, but extensive blood glucose monitoring is still required to make the necessary individual reductions to medications in response to weight loss.

Peroxisome proliferator-activated receptors for hypertension

Peroxisome proliferator-activated receptors(PPARs) are ligand-activated transcription factors belonging to the nuclear receptor superfamily, which is composed of four members encoded by distinct genes(α, β, γ, and δ). The genes undergo transactivation or transrepression under specific mechanisms that lead to the induction or repression of target gene expression. As is the case with other nuclear receptors, all four PPAR isoforms contain five or six structural regions in four functional domains; namely, A/B, C, D, and E/F. PPARs have many functions, particularly functions involving control of vascular tone, inflammation, and energy homeostasis, and are, therefore, important targets for hypertension, obesity, obesity-induced inflammation, and metabolic syndrome in general. Hence, PPARs also represent drug targets, and PPARα and PPARγ agonists are used clinically in the treatment of dyslipidemia and type 2 diabetes mellitus, respectively. Because of their pleiotropic effects, they have been identified as active in a number of diseases and are targets for the development of a broad range of therapies for a variety of diseases. It is likely that the range of PPARγ agonist therapeutic actions will result in novel approaches to lifestyle and other diseases. The combination of PPARs with reagents or with other cardiovascular drugs, such as diuretics and angiotensin Ⅱ receptor blockers, should be studied.This article provides a review of PPAR isoform characteristics, a discussion of progress in our understanding of the biological actions of PPARs, and a summary of PPAR agonist development for patient management. We also include a summary of the experimental and clinical evidence obtained from animal studies and clinical trials conducted to evaluate the usefulness and effectiveness of PPAR agonists in the treatment of lifestyle-related diseases.

High Protein Diet that Cause Weight Loss and Lower Blood Glucose Level Have a Serious Impact on the Kidney Functions of Male Diabetic Obese Albino Rats

Background: High protein (HP) diets are increasingly being recommended as one of the management strategies for weight control in overweight and obese individuals. The health benefits of high protein diets are well-established, but the mechanisms of action on body systems responsible for the changes in body weight and glycaemic control are not well-clear. Objective: The present study aimed to examine the effect of HP diets on the kidney functions of diabetic obese albino rats. Material and Methods: Eighty male adult male albino rats were used in this study. The animals were divided into eight equal groups (10 rats for each). Type 2 DM and obesity were induced. At the end of the 12 weeks, samples were collected for biochemical analysis. Results: The high protein diet led to significant decrease in BW, FI, BG, TC, LDL, TG, Lactate dehydrogenase, albumin, urine pH and urine citrate;while serum insulin, HDL, urea, creatinine, total protein, urine volume and urinary excretion of Ca were significantly higher in high protein diet groups. Conclusion: A high protein intake in diabetic obese albino rats for 12 weeks led to changes in the serum and urine levels of markers of renal function which indicated abnormalities in the functions of the kidney.