Obstructive sleep apnea:Overlooked comorbidity in patients with diabetes

In this review article,we explore the interplay between obstructive sleep apnea(OSA)and type 2 diabetes mellitus(T2DM),highlighting a significant yet often overlooked comorbidity.We delve into the pathophysiological links between OSA and diabetes,specifically how OSA exacerbates insulin resistance and disrupts glucose metabolism.The research examines the prevalence of OSA in diabetic patients and its role in worsening diabetes-related complications.Emphasizing the importance of comprehensive management,including weight control and positive airway pressure therapy,the study advocates integrated approaches to improve outcomes for patients with T2DM and OSA.This review underscores the necessity of recognizing and addressing OSA in diabetes care to ensure more effective treatment and better patient outcomes.

Rising tide: The global surge of type 2 diabetes in children and adolescents demands action now

Childhood-onset obesity has emerged as a major public healthcare challenge across the globe,fueled by an obesogenic environment and influenced by both genetic and epigenetic predispositions.This has led to an exponential rise in the incidence of type 2 diabetes mellitus in children and adolescents.The looming wave of diabetes-related complications in early adulthood is anticipated to strain the healthcare budgets in most countries.Unless there is a collective global effort to curb the devastation caused by the situation,the impact is poised to be pro-found.A multifaceted research effort,governmental legislation,and effective social action are crucial in attaining this goal.This article delves into the current epidemiological landscape,explores evidence concerning potential risks and consequences,delves into the pathobiology of childhood obesity,and discusses the latest evidence-based management strategies for diabesity.

Safety of Empagliflozin in Patients with Type 2 Diabetes Mellitus in Saudi Arabia: A Post-Authorisation Safety Study

Background: Empagliflozin, a sodium-glucose co-transporter-2 (SGLT2) inhibitor is used as a monotherapy or in combination for lowering the elevated blood glucose level in patients with type 2 diabetes mellitus (T2DM). It is often associated with certain adverse reactions (urinary tract infection (UTI), diabetes ketoacidosis (DKA), and genital infections). Thus, the Saudi Food and Drug Administration requested a post-authorisation safety study to monitor the safety of empagliflozin during the defined observation period. Methodology: The local, comparator, non-interventional, regulatory post-marketing study using “new user” design was conducted in patients with T2DM, treated with empagliflozin (10 or 25 mg) and dipeptidyl peptidase-4 (DPP-4) inhibitors (NCT03764631). Study was conducted from 2018 to 2020, wherein each patient was followed up for 12 months after the index period. Incidence and occurrence of DKA, severe UTIs, volume depletion and dehydration were observed along with metformin, insulin and treatment complexity status and adverse events in the index and Ramadan period. All data collected were analysed using descriptive statistics. Results: Among the 1502 patients enrolled (empagliflozin [n = 751] and DPP-4 inhibitors [n = 751]), 0.1% patients (n = 1) in each group and Conclusion: Empagliflozin was well tolerated over a period of 12 months, with no safety concerns and a favourable benefit/risk ratio.

Treatment of prediabetes

Progression of normal glucose tolerance(NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance(IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diabetes mellitus(type 2 DM) and even normoglycemic IGT patients manifest these defects. Beta cell dysfunction and insulin resistance also contribute to the progression of IGT to type 2 DM. Improving insulin sensitivity and/or preserving functions of beta-cells can be a rational way to normalize the GT and to control transition of IGT to type 2 DM. Loosing weight, for example, improves whole body insulin sensitivity and preserves beta-cell function and its inhibitory effect on progression of IGT to type 2 DM had been proven. But interventions aiming weight loss usually not applicable in real life. Pharmacotherapy is another option to gain better insulin sensitivity and to maintain beta-cell function. In this review, two potential treatment options(lifestyle modification and pharmacologic agents) that limits the IGT-type 2 DM conversion in prediabetic subjects are discussed.

In vivo corneal confocal microscopy in diabetes: Where we are and where we can get

In vivo corneal confocal microscopy(IVCCM) is a novel,reproducible, easy and noninvasive technique that allows the study of the different layers of the cornea at a cellular level. As cornea is the most innervated organ of human body, several studies investigated the use of corneal confocal microscopy to detect diabetic neuropathies, which are invalidating and deadly complications of diabetes mellitus. Corneal nerve innervation has been shown impaired in subjects with diabetes and a close association between damages of peripheral nerves due to the diabetes and alterations in corneal sub-basal nerve plexus detected by IVCCM has been widely demonstrated. Interestingly, these alterations seem to precede the clinical onset of diabetic neuropathies, paving the path for prevention studies. However, some concerns still prevent the full implementation of this technique in clinical practice. In this review we summarize the most recent and relevant evidences about the use of IVCCM for the diagnosis of peripheral sensorimotor polyneuropathy and of autonomic neuropathy in diabetes. New perspectives and current limitations are also discussed.

Physical activity,sedentary behaviors,physical fitness,and their relation to health outcomes in youth with type 1 and type 2 diabetes:A review of the epidemiologic literature

Diabetes is a leading chronic disease of childhood and adolescence. In addition to the well-known auto-immune, insulin-dependent diabetes mellitus （type 1 diabetes （T 1D））, the past two decades have witnessed the emergence of type 2 diabetes （T2D） in children and adolescents, which previously was only seen in middle-aged or older adults. One of the key components of diabetes management is physical activity （PA）. The beneficial effects of increased PA and decreased sedentary behavior are extremely important in youth with diabetes because of the markedly increased long-term risk of cardiovascular disease in this population compared to persons without diabetes. This review aims to comprehensively summarize the epidemiologic, observational research published and listed in PubMed between 1970 and 2012 on PA and sedentary behaviors, as well as physical fitness in children and adolescents with T1D and T2D. Additionally, we describe briefly the state of knowledge on perceived barriers of PA in persons with diabetes, with a focus on hypoglycemia. Finally, we provide an overview of the epidemiological literature pertaining to health benefits of increased PA in youth with TID and T2D and briefly discuss the topic of exercise-related hypoglycemia, Copyright ~ 2012, Shanghai University of Sport. Production and hosting by Elsevier B.V. All rights reserved.

Hepatocyte growth factor, a biomarker of macroangiopathy in diabetes mellitus

Atherosclerotic involvements are an essential causal element of prospect in diabetes mellitus(DM), with carotid atherosclerosis(CA) being a common risk-factor for prospective crisis of coronary artery diseases(CAD) and/or cerebral infarction(CI) in DM subjects. From another point of view, several reports have supplied augmenting proof that hepatocyte growth factor(HGF) has a physiopathological part in DM involvements. HGF has been a mesenchymal-derived polyphenic factor which modulates development, motion, and morphosis of diverse cells, and has been regarded as a humor intermediator of epithelial-mesenchymal interplays. The serum concentrations of HGF have been elevated in subjects with CAD and CI, especially during the acute phase of both disturbances. In our study with 89 type 2 DM patients, the association between serum concentrationsof HGF and risk-factors for macrovascular complicationsinclusive of CA were examined. The average of serumHGF levels in the subjects was more elevated than thereference interval. The serum HGF concentrations associated positively with both intimal-media thickness(IMT)(r = 0.24, P = 0.0248) and plaque score(r = 0.27, P =0.0126), indicating a relationship between the elevatedHGF concentrations and advancement of CA involvements. Multivariate statistical analysis accentuated thatserum concentrations of HGF would be associated inde-pendently with IMT(standardized = 0.28, P = 0.0499).The review indicates what is presently known regardingserum HGF might be a new and meaningful biomarkerof macroangiopathy in DM subjects.

Downregulation of Nrf2 and HO-1 expression contributes to oxidative stress in type 2 diabetes mellitus: A study in Juana Koslay City, San Luis, Argentina

Oxidative stress is associated with diabetes mellitus, a condition characterized by increased prevalence and progression rate of cardiovascular disease. NFE2-related factor 2 (Nrf2) is a master regulator of cellular detoxification responses and redox status. The aim of this study was to examine associations between type 2 Diabetes Mellitus (T2DM), oxidative stress and the expression of NFE2-related factor 2 (Nrf2) in a population of diabetic patients living in Juana Koslay City, San Luis, Argentina. In addition, we evaluated the functional relevance of Nrf2 by measuring the HO-1 expression among persons with type 2 diabetes. We measured clinical and biochemical parameters related to lipid metabolism and oxidative stress in a population of Type 2 Diabetes Mellitus patients (T2DM, n = 40) and controls (Co, n = 30). Compared to Co, T2DM patients had higher fasting serum glucose, glycated hemoglobin, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and thiobarbituric acid reactive substances and lower high-density lipoprotein cholesterol. T2DM individuals had also higher atherogenic index and body mass index than controls. We also founded that HO-1 mRNA in whole blood was lower in T2DM than controls, suggesting that T2DM may have an altered antioxidant response to oxidative stress. Interestingly, we found reduced Nrf2 mRNA in whole blood from T2DM compared to Co. The results from this study provide novel evidence that genes associated to antioxidant defense mechanisms are markedly reduced in patients with type 2 diabetes, and that the reduction in the expression of these genes could be associated to hyperglycemia and increased levels of MDA. Linear regression analysis revealed that there was a strong and positive correlation between the changes of Nrf2 and HO-1 expression levels.

The Use of Standardized Reporting and Time-in-Range in the Management of Diabetes: A Consensus Report

Introduction: The exhaustion of healthcare resources due to the rising prevalence in Saudi Arabia mandates the search for each method that can help in better control of diabetes. Methods: The gathered task force gath-ered to develop an explicit, evidence-based consensus for the use of time-in-range targets as guidance for better glycemic control while using continuous glucose monitoring (CGM). This article has the recommenda-tions of this expert panel. Results: HbA1c and self-monitoring blood glu-cose (SMBG) are not enough to detect blood glucose (BG) fluctuations on a daily basis. The incorporation of technology like FreeStyle Libre with its applications like Libre View is now used in many institutes in Saudi Ara-bia. This system is comprehensive and has all the standardized metrics needed. However, training and support are always needed. Barriers and challenges include the awareness & experience of the technology, the time barrier, the patients’ barriers, the technical barriers, and of course, the availability barrier. All the barriers and challenges should be dealt with by designing new training programs. Conclusion: The expert panel recom-mended using CGMs technology in people with type 1 diabetes (T1DM) children and adults, type 2 diabetes (T2DM) on multiple insulin injections, gestational diabetes (GDM) who need further glycemic control, and those at high risk for hypoglycemia. In addition, we recommend using them for a short period for those who require intensive BG control or during acute illness or stress. In addition, Ambulatory Glucose Profile (AGP) could be used as an educational tool for any individuals with DM to study the im-pact of certain elements of lifestyle modifications on their immediate BG level.

Diabetes and Technology: Continuous Glucose Monitoring among Pregnant Women in Real Time

The objective of this paper is to assess if real-time intermittent Continuous Glucose Monitoring (CGM) helps to improve the control of glycemic and outcome of pregnancy in women with diabetes. A total of 123 women with type 1 diabetes and 31 women with type 2 diabetes respectively were used at random in the Continuous Glucose Monitoring for a total of 6 days at different stages of pregnancy. Results revealed that intermittently using real-time Continuous Glucose Monitoring in pregnancy plus plasma glucose which is self-monitored does not really help to improve the control of glycemic or outcome of pregnant women with diabetes.

Hyperglycemia promotes overexpression of SR-BII isoform of the scavenger receptor class B type I in type 2 diabetes mellitus: A study in Juana Koslay City, San Luis, Argentina

The scavenger receptor class B type I (SR-BI) is a high-density lipoprotein (HDL) receptor involved in reverse cholesterol transport. Some studies reported the association to be stronger in the presence of diabetes. The full length gene encoding SR-BI is comprised in 13 exons that are alternatively spliced to produce two major transcripts: the full length SR-BI and the splice variant SR-BII, in which exon 12 is skipped. Considering that type 2 diabetes status is characterized by changes in the concentration of plasma lipids, modifications in lipoprotein size and composition, which may be important modulators of the SR-BI expression;the aims of the study were to examine the influence of SR-BI polymorphism (rs838895) on lipid profile and SR-BI mRNA expression in a population of diabetic patients living in Juana Koslay City. Blood samples were drawn from controls (n = 40) and Type 2 diabetic patients (n = 66) and DNA and total RNA were obtained. SR-BI mRNA expression was measured by RT-PCR and SR-BI polymorphism was detected by Tetra Primer ARMSPCR. Compared to controls, diabetic patients had higher fasting serum glucose, glycated hemoglobin, triglycerides, total cholesterol, lowdensity lipoprotein cholesterol, and lower highdensity lipoprotein cholesterol. SR-BI mRNA expression was lower in T2DM when compared to controls, suggesting that the hyperglycemia presents in T2DM patients down-regulates SR-BI mRNA expression. Interestingly, we found that decreased SR-BI expression resulted in markedly increased plasma LDL concentrations in T2DM subjects, and the overexpression of SRBII isoform is responsible for the markedly increased plasma LDL-c concentrations. The polymorphism (rs838895) did not modify the mRNA level of SR-BI in leucocytes from control and diabetic patients. This study provides novel evidence suggesting that hyperglycemia may affect reverse cholesterol transport by controlling SRBI expression in diabetic patients. LDL cholesterol levels are associated with low SR-BI mRNA expression in T2DM.

The Impact of the FreeStyle LibreTM Flash Glucose Monitoring System on Glycemic Control in Patients with Diabetes;Observational Multicenter 15-Months Study

Objectives: The study was to determine the impact of using the FreeStyle LibreTM flash glucose monitoring system on glycemic control and the rate of events due to diabetes in people with diabetes from different types and age groups. Methods: a retrospective cohort chart review study was carried out at three centers in the Taif region in the Kingdom of Saudi Arabia: The study was approved by an accredited centralized institutional review board. Paper or electronic medical records were included for individuals of any age with diabetes (type 1, type 2, gestational diabetes) managed with diet, insulin therapy, or/and oral antihyperglycemic medication and/or non-insulin injection therapy. The primary outcome measure was the laboratory HbA1c level as well as reduction. Secondary outcome measures were frequency of severe hypoglycemia, admission to hospital or ER visit related to diabetes complications, and severe hyperglycemia (DKA or HHS). Results: Data was analyzed from 1695 patients. The average HbA1c before using the flash glucose monitoring system was 9.60% ± 1.44% and 3 months HbA1c after using the FreeStyle LibreTM flash glucose monitoring system was 8.70% + 1.45% for a difference of -0.90% ([95% CI -0.92: -0.88];p 65 years, (p-values Conclusion: The benefits of using the FreeStyle LibreTM flash glucose monitoring system are self-evident in reducing HbA1c and events due to hyperglycemia or hypoglycemia.

Myelin lipid deficiency:a new key driver of Alzheimer’s disease

Lipids play essential biological functions that include acting as components of biological membranes,energy storage,signaling,nutrients,transporters,enzyme activators,among others.Compared with the multiple research methods to assess DNA,RNA,and protein content,location,and function in cells,there are relatively fewer methods to study lipids.Therefore,lipid-oriented mechanistic studies remain rare and challenging.

Elevated retinol binding protein 4 levels are associated with atherosclerosis in diabetic rats via JAK2/STAT3 signaling pathway

BACKGROUND Atherosclerosis is a major cause of mortality worldwide and is driven by multiple risk factors,including diabetes,which results in an increased atherosclerotic burden,but the precise mechanisms for the occurrence and development of diabetic atheroscerosis have not been fully elucidated.AIM To summarize the potential role of retinol binding protein 4(RBP4) in the pathogenesis of diabetic atheroscerosis,particularly in relation to the RBP4-Janus kinase 2/signal transducer and activator of transcription 3(JAK2/STAT3)signaling pathway.METHODS Male Wistar rats were randomly divided into three groups,including a control group(NC group),diabetic rat group(DM group),and diabetic atherosclerotic rat group(DA group).The contents of total cholesterol(TC), high-density lipoprotein cholesterol(HDL-c), triglycerides(TG), low-density lipoprotein cholesterol(LDLc), fasting insulin(FINS),fasting plasma glucose,and hemoglobin A1 c(HbA1 c)were measured.Moreover,the adipose and serum levels of RBP4,along with the expression levels of JAK2, phosphorylated JAK2(p-JAK2), STAT3,phosphorylated STAT3(p-STAT3), B-cell lymphoma-2(Bcl-2), and Cyclin D1 in aortic tissues were also measured.Besides,homeostasis model assessment of insulin resistance(HOMA-IR) and atherogenic indexes(AI) were calculated.RESULTS Compared with the NC and DM groups,the levels LDL-c,TG,TC,FINS,HOMAIR,RBP4,and AI were upregulated,whereas that of HDL-c was downregulated in the DA group(P <0.05);the mRNA levels of JAK2,STAT3,Cyclin D1,and Bcl-2 in the DA group were significantly increased compared with the NC group and the DM group;P-JAK2,p-JAK2/JAK2 ratio,p-STAT3,p-STAT3/STAT3 ratio,Cyclin D1,and Bcl-2 at protein levels were significantly upregulated in the DA group compared with the NC group and DM group.In addition,as shown by Pearson analysis,serum RBP4 had a positive correlation with TG,TC,LDL-c,FINS,HbA1 C,p-JAK2,p-STAT3,Bcl-2,Cyclin D1,AI,and HOMA-IR but a negative correlation with HDL-c.In addition,multivariable logistic regression analysis showed that serum RBP4,p-JAK2,p-STAT3,and LDL-c were predictors of the presence of diabetic atherosclerosis.CONCLUSION RBP4 could be involved in the initiation or progression of diabetic atherosclerosis by regulating the JAK2/STAT3 signaling pathway.

Association of 25-hydroxy-vitamin D levels with semen and hormonal parameters

Vitamin D levels have been linked to various health outcomes including reproductive disorders. The purpose of this study was to explore the association between serum vitamin D level （25-hydroxy-vitamin D, or 250HD） and semen and hormonal parameters. This is a cross-sectional study that included 170 healthy men recruited for the study of spermatogenesis from the general population. Men completed general and reproductive health questionnaires, and donated blood and semen samples. The main measures were hormonal （total and free testosterone, sex hormone-binding globulin, estradiol, follicle-stimulating hormone and luteinizing hormone） and semen parameters, adjusted （n= 147） for age, body mass index （BMI）, season, alcohol intake and smoking, in relation to categories of vitamin D levels, determined apriori. The mean age of the study population was 29.0±8.5 years and mean BMI was 24.3±3.2 kg m-2. The mean 250HD was 34.1± 15.06 ng m1-1. BMI showed a negative association with 250HD. Sperm concentration, sperm progressive motility, sperm morphology, and total progressively motile sperm count were lower in men with ‘250HD ≥ 50 ng ml-1＇ when compared to men with‘20 ng ml-1 ≤ 250H D〈 50 ng ml-1,. Total sperm count and total progressive motile sperm count were lower in men with ‘250HD〈20 ng ml-1＇ when compared to men with‘20 ng ml-1≤250HD〈50 ng ml-1＇. The adjusted means of various hormonal parameters did not show statistical difference in the different categories of 250HD. In conclusion, serum vitamin D levels at high and low levels can be negatively associated with semen parameters.

Association between population vitamin D status and SARS-CoV-2 related serious-critical illness and deaths:An ecological integrative approach

BACKGROUND Vitamin D population status may have possible unappreciated consequences to the coronavirus disease 2019(COVID-19)pandemic.Αsignificant association between vitamin D sufficiency and reduction in clinical severity and inpatient mortality from COVID-19 disease has recently been shown,while a recent study has claimed lower COVID-19 cases in European countries with a better vitamin D status.Low serum 25-hydroxyvitamin-D[25(OH)D]was identified as an independent risk factor for COVID-19 infection and hospitalization,and administration of 0.532 mg(21280 IU)of calcifediol or 25(OH)D,followed by 0.266 mg on days 3 and 7 and then weekly until discharge or intensive care unit admission significantly reduced the need for intensive care unit treatment.AIM To elucidate the role of vitamin D European population status in the COVID-19 pandemic,data from the Worldometer were analyzed.METHODS Linear regression explored the correlation between published representativestandardized population vitamin D concentrations and the number of total cases/million(M),recovered/M,deaths/M and serious-critically ill/M from COVID-19 for 26 European countries populated>4 M(Worldometer).Life expectancy was analyzed with semi-parametric regression.Weighted analysis of variance/analysis of covariance evaluated serious-critical/M and deaths/M by the vitamin D population status:Deficient<50,insufficient:50-62.5,mildly insufficient>62.5-75 and sufficient>75 nmol/L,while controlling for life expectancy for deaths/M.Statistical analyses were performed in XLSTAT LIFE SCIENCE and R(SemiPar Library).RESULTS Linear regression found no correlation between population vitamin D concentrations and the total cases-recovered/M,but negative correlations predicting a reduction of 47%-64%-80%in serious-critical illnesses/M and of 61%-82%-102.4%in deaths/M further enhanced when adapting for life expectancy by 133-177-221%if 25(OH)D concentrations reach 100-125-150 nmol/L,sustained on August 15,2020,indicating a truthful association.Weighted analysis of variance was performed to evaluate serious-critical/M(r2=0.22)by the vitamin D population status and analysis of covariance the deaths/M(r2=0.629)controlling for life expectancy(r2=0.47).Serious-critical showed a decreasing trend(P<0.001)from population status deficient(P<0.001)to insufficient by 9.2%(P<0.001),to mildly insufficient by 47.6%(P<0.044)and to sufficient by 100%(reference,P<0.001).For deaths/M the respective decreasing trend(P<0.001)was 62.9%from deficient(P<0.001)to insufficient(P<0.001),65.15%to mildly insufficient(P<0.001)and 78.8%to sufficient(P=0.041).CONCLUSION Achieving serum 25(OH)D 100-150 nmol/L(40-60 ng/mL)(upper tolerable daily doses followed by maintenance proposed doses not requiring medical supervision,Endocrine Society)may protect from serious-critical illness/death from COVID-19 disease.

Metaphysical Energy Therapy in the Treatment of Cranial Nerve Palsies with Special Reference to Bell’s Palsy

Neuropathy, or nerve injury, is a severe and common impediment of diabetes. Studies evaluate that 50% of people with diabetes will develop neuropathy. Diabetic nerve injury is impairment of a single solitary nerve (also named mononeuropathy). Com- monly 2 cranial nerves Viz., cranial nerve VII and cranial nerve VI are involved in facial nerve palsies. The former one is called Bell’s palsy and is acute Lower Motor Neuron facial nerve paralysis (>80%) causing an inability to control facial muscles on the affected side. The later one is sixth nerve palsy, (the abducens nerve), which is responsible for triggering contraction of the lateral rectus muscle to abduct (i.e., turn out) the eye resulting in double vision on the affected side. In recent times, we have found to our amazement, rapid restoration of normalcy within a few hours to a few days, of Cranial Nerve palsies in diabetic subjects at our centre. We are presenting a group of cases having Type2DM over different time periods from 6 to 20 years and those who suddenly suffered facial nerve palsy and they came to VHSDRC for treatment. They were started on the new modality called the Dynamic Acupuncture Mediated Meta-physical Energy Therapy (DAMM Therapy), to recover from the facial palsy. The DAMM therapy is a unique novel way of infusing and transferring healing energy from the therapist to the patient. Within 2 - 7 sittings of DAMM therapy patients showed 75% - 100% improvement in their clinical condition.

Fasting C-Peptide Response, and Its Clinical Impact in Type I Diabetics to a Novel Metaphysical Energy Healing Therapy—Preliminary Experience and Observations

Type 1 diabetes is classically the true form of insulinopaenic diabetes usually occurring in young children below the age of 15 years and occasionally up to 20 years and characterised by very low/ negligible fasting C-peptide in their blood due to extensive irreversible Beta cell damage. T1DM probably accounts for 5% to 10% of all diagnosed diabetes. The worldwide prevalence of T1DM is 0.1% to 0.3%, with 78,000 new cases every year, especially among young individuals (15. Type I diabetes is very much lower (20 times) in countries like Japan and India, than the western countries. The European Nicotinamide Diabetes Intervention Trial (ENDIT) is focused on the use of nicotinamide in the prevention of diabetes. In high doses (nicotinamide), it may cause a degree of sedation, a feeling of depression, and in very large dosages, liver toxicity. Because the vitamin cannot be marketed as a drug, the study is not getting a great deal of support from pharmaceutical companies. GAD antibodies (GADA) are a major diagnostic marker for Type 1 diabetes. Phase II clinical trials of a vaccine containing alum and recombinant GAD65, an auto antigen involved in type 1 diabetes, were promising, as of 2014 Phase III trial had failed. In our quest for improving the clinical condition & quality of life of type I DM & also to reduce the economic burden on them, we have embarked on a novel metaphysical energy therapy which we have been trying for the past 3 years at our research Centre. We have so far treated some 15 cases with this DAMM therapy. Among the 15 cases, 6 cases have shown significant improvement in fasting C-peptide levels. With the advent of this new modality of treatment (DAMM Therapy) the cost of treatment will be greatly reduced. This DAMM Therapy apparently has no side effects. This mode of treatment will open a new light in the world of Type I diabetes.

Chronic complications risk among type 2 diabetes patients with a family history of diabetes

Family history of diabetes(FH+)has been associated with early metabolic alteration including insulin resistance,lipid metabolism,and ectopic fat accumulation even in healthy individuals.1-3 Furthermore,normoglycemic firstdegree relatives of type 2 diabetes mellitus(T2DM)have been documented having increased carotid intimamedia thickness_and pro-inflammatory cytokines.4.s Taken together,individuals with FH+,who were otherwise healthy,have shown to possess susceptibility for diabetes mellitus(DM)chronic complication.Hence,this study aimed to investigate whether FH+increased the risk of chronic complications in patients with overt T2DM.

Taq1B CETP Polymorphism and Cardiovascular Risk in an Endogamous Pop-ulation of Diabetic Men: A Study in Santa Rosa Del Conlara, San Luis, Argentina

Objectives: Type 2 diabetes mellitus (T2DM) patients are at increased risk of cardiovascular diseases (CVDs). Several polymorphisms in the cholesterol ester transfer protein (CETP) gene have been reported. The aim of this study was to determine the distribution and effect of the Taq1B polymorphism in the CETP gene on clinical and biochemical indicators of CVD risk in a population of endogamous-T2DM men. Methods: 102 men (57.5 ± 9.3 years old) inhabitants of Santa Rosa del Conlara, San Luis, Argentina, were recruited and assigned into two groups (22 control and 80 T2DM). Further, these two groups were subdivided according to their Taq1B CETP gene genotypes (i.e., B1B1, B1B2 and B2B2). Clinical and fasting-plasma biochemical indicators of CVD risk were measured and their association with the B1 allele was determined. Results: Compared to control, T2DM men had more central obesity, hypertension, atherogenic index, insulin resistance and poorly controlled diabetes. Compared to T2DM men having the B2 allele, those T2DM men having the B1 allele have increased risk of CVD as assessed by systolic blood pressure (156 ± 16.0 vs 135.8 ± 19.2, p = 0.015), atherogenic index (6.15 ± 1.3 vs 4.4 ± 0.7, p = 0.0008), HDL-c levels (38.9 ± 5.3 vs 64.4 ± 8.2, p ± 3.0 vs 2.4 ± 0.78, p = 0.004). Interestingly, only body mass index (r = ﹣0.559, p = 0.01) and HDL-c concentration (r = ﹣0.492, p = 0.02) negatively correlated with CVD risk in the endogamous population of B1B1 and B1B2 T2DM men. Conclusion: The B1 allele of the CETP gene predicts cardiovascular complications in an endogamous population of T2DM men.