Background: Reduced deformability of red blood cells (RBCs) may play an important role on the pathogenesis of chronic vascular complications of diabetes mellitus. However, available techniques for measuring RBC deformability often require washing process after each measurement, which is not optimal for dayto-day clinical use at point of care. The objectives of the present study are to develop a device and to delineate the correlation of impaired RBC deformability with diabetic nephropathy. Methods: We developed a disposable ektacytometry to measure RBC deformability, which adopted a laser diffraction technique and slit rheometry. The essential features of this design are its simplicity (ease of operation and no moving parts) and a disposable element which is in contact with the blood sample. We studied adult diabetic patients divided into three groups according to diabetic complications. Group I comprised 57 diabetic patients with normal renal function. Group II comprised 26 diabetic patients with chronic renal failure (CRF). Group III consisted of 30 diabetic subjects with end-stage renal disease (ESRD) on hemo-dialysis. According to the renal function for the diabetic groups, matched non-diabetic groups were served as control. Results: We found substantially impaired red blood cell deformability in those with normal renal function (group I) compared to non-diabetic control (P = 0.0005). As renal function decreases, an increased impairment in RBC deformability was found. Diabetic patients with chronic renal failure (group II) when compared to non-diabetic controls (CRF) had an apparently greater impairment in RBC deformability (P = 0.07). The non-diabetic cohort (CRF), on the other hand, manifested significant impairment in red blood cell deformability compared to healthy: control (P = 0.0001). Conclusions: The newly developed slit ektacytometer can measure the RBC deformability with ease and accuracy. In addition, progressive impairment in cell deformability is associated with renal function loss in all patients regardless of the presence or absence of diabetes. In diabetic patients, early impairment in RBC deformability appears in patients with normal renal function.
Objectives : This study aimed to evaluate the anti-diabetic effect of Wen-Pi-Tang-Hab-Wu-Ling-San (WHW) extract in streptozotocin(STZ)-induced type-1 diabetic rats. Methods : Experimental diabetes were induced by intraperitoneal injection of streptozotocin (60 mg/kg). Two groups of STZ-induced diabetic rats were given the following treatments for 2 weeks by oral Administrations : (1) WHW 10 mg/kg, (2) WHW 100 mg/kg. In addition, vehicle-treated diabetic and nondiabetic controls were used in the experiment. The effects of WHW extract on STZ-induced diabetes were observed by measuring the changes of body weights and the levels of fasting blood glucose, insulin, urea nitrogen (BUN) and creatinine level in sera of rats, respectively. Results : In comparison control group, WHW-treated groups (100 mg/kg) were significantly decreased fasting blood glucose levels and increased serum insulin levels in STZ-induced diabetic rats. Moreover, WHW-treated groups (100 mg/kg) were reduced s-creatinie levels in STZ-induced diabetic rats. In addition, the changes related to diabetic nephropathy with body weight were significantly lower in WHW extract-dosing groups than in the diabetic control. Conclusions : The study thus showed that WHW extract enhanced the anti-diabetic effect in STZ-induced diabetic rats by improving the hypoglycemia. It also increased pancreatic insulin content in these rats.
This study was carried out to determine whether a short-tenn zinc supplementation contributes to beneficial changes in glycemic control among type 2 diabetic patients. Seventy-six diabetic subjects and 72 normal adults participated in this study. Subjects were divided into supplemented and control groups. Forty-four diabetic patients and 34 normal subjects were supplemented with 50 mg zinc daily as zinc gluconate for 4 weeks. Zinc status was assessed from fasting plasma levels and urinary excretion. The effects of zinc supplementation on fasting blood glucose, $HbA_{1c}$, insulin, and C-peptide were measured at the beginning of the study and after 4 weeks of supplementation. The changes in glycemic control indicators were compared between diabetic groups, classified by baseline $HbA_{1c}$ levels, and by diabetic duration. At baseline, the incidence of marginal zinc deficiency in the diabetic group, as determined by plasma zinc level, was approximately twice as high as in the normal adult group. The changes of $HbA_{1c}$ concentration, and fasting blood glucose following supplementation were not statistically significant in diabetic subjects. In normal subjects, a significant decrease of $HbA_{1c}$ occurred only in the zinc supplemented group. No significant changes were observed for serum insulin and C-peptide in diabetic as well as normal subjects. However, when the changes were compared by baseline $HbA_{1c}$ level, we found that diabetic subjects with $HbA_{1c}\;{\geq}\;7.5%$ showed significantly improved levels of $HbA_{1c}$ and fasting glucose after Zn supplementation. While such improvement in fasting blood glucose was significant among diabetics with shorter diabetic duration, significant levels of increase in serum insulin and C-peptide were observed in zinc supplemented subjects with longer diabetic duration. Fasting blood glucose was significantly decreased, whereas serum insulin and C-peptide were increased in diabetics with marginal zinc status. Therefore, we suggest that Zn supplementation for a short-term period may improve glycemic control in diabetic patients with higher $HbA_{1c}$ levels and marginal zinc status.
Jang, Hana;Han, Jung Hoon;Bang, Joon Seok;Sohn, Uy Dong
Korean Journal of Clinical Pharmacy
/
v.24
no.1
/
pp.33-38
/
2014
Background: Diabetes is accompanied by complications. One of the chronic complications, diabetic retinopathy is the most common cause of the loss of eyesight and thus has enormous impacts on the quality of life to the patients. It has been reported that thorough glucose regulation can prevent or postpone the outset of diabetic retinopathy in diabetic patients and that the patients who received anti-diabetic manage & care education would be capable of more thorough glucose-level regulation than those who did not. Method: This study set out to investigate the current state of education on anti-diabetic manage & care in South Korea and connections between anti-diabetic manage & care education and occurrence of diabetic retinopathy in diabetic patients based on the Korea National Health and Nutrition Examination Survey of 2011. Results: Of the 410 diabetes patients, 74 received anti-diabetic manage & care education, which means that only 15% of diabetic patients benefited from the education in the nation. The occurrence rate of diabetic retinopathy was 28% in the education group and 24% in the non-education group with no significant differences between them. The anti-diabetic manage & care education group recorded a higher occurrence rate of diabetic retinopathy, one of the chronic diabetic complications, than the non-education group contrary to the hypothesis. One of the reasons was that the educated group had a significantly longer duration of diabetes and significantly higher HbA1c than the noneducated group, which indicates that anti-diabetic manage & care education is provided to those who have progressed farther along the course of diabetes instead of the early stage and cannot regulate their glucose-level well in the nation. Conclusion: Those findings raise a need for active educational policies in order to provide anti-diabetic manage & care education under the goals of preventing complications through anti-diabetic education for many patients in early stages of diabetes.
In order to elucidate the molecular mechanism of the intracellular $Ca^{2+}$ overload frequently reported from diabetic heart, diabetic rats were induced by the administration of streptozotocin, the membrane vesicles of junctional SR (heavy SR, HSR) were isolated from the ventricular myocytes, and SR $Ca^{2+}$ uptake and SR $Ca^{2+}$ release were measured. The activity of SR $Ca^{2+}-ATPase$ was $562{\pm}14$ nmol/min/mg protein in control heart. The activity was decreased to $413{\pm}30$ nmol/min/mg protein in diabetic heart and it was partially recovered to $485{\pm}18$ nmol/min/mg protein in insulin-treated diabetic heart. A similar pattern was observed in SR $^{45}Ca^{2+}$ uptakes; the specific uptake was the highest in control heart and it was the lowest in diabetic heart. In SR $^{45}Ca^{2+}$ release experiment, the highest release, 45% of SR $^{45}Ca^{2+}$, was observed in control heart. The release of diabetic heart was 20% and it was 30% in insulin-treated diabetic heart. Our results showed that the activities of both SR $Ca^{2+}-ATPase$ and SR $Ca^{2+}$ release channel were decreased in diabetic heart. In order to evaluate how these two factors contribute to SR $Ca^{2+}$ storage, the activity of SR $Ca^{2+}-ATPase$ was measured in the uncoupled leaky vesicles. The uncoupling effect which is able to increase the activity of SR $Ca^{2+}-ATPase$ was observed in control heart; however, no significant increments of SR $Ca^{2+}-ATPase$ activities were measured in both diabetic and insulin-treated diabetic rats. These results represent that the $Ca^{2+}$ storage in SR is significantly depressed and, therefore, $Ca^{2+}-sequestering$ activity of SR may be also depressed in diabetic heart.
The aim of this study was to develop and apply a list of meals and standard recipes using barley for diabetic patients. The degree of interest and requirements of diabetic patients were investigated for the development of meals. The ingredients of the meals were selected through the diabetic literature and previous research. While developing a list of meals, dietetic therapies for diabetic patients were considered. After developing 15 kinds of meals and modifying them through sensory evaluation, a standard recipe was completed. In the standard recipe, the menu name, the ingredients, quantity, and recipe were stated and the nutritional components were indicated. Photographs of the meals were included. The calorie prescription for the diabetic patients was aimed at elderly women, that is, those 65 years old or above, based on research showing this to be the average age of diabetics. The prescribed calories were 1,500 kcal based on the food exchange list. Weekly lists of meals including the developed dishes were made for diabetic patients. The list were modified after consultation with a clinical nutritionist. When completed, one meal item was selected for each day and cooked. A photograph was taken and presented diabetic patients. This article presents the standardized recipes of the developed list of meals and applies them to modifying the diabetic diet, with an aim to be of service to diabetic patients attempting to meet their dietetic therapy goals. We also provide basic data on institutional food services for diabetic patients and nutrition education.
Purpose: To observe the histologic changes and clusterin expression in the acinar cells of the submandibular gland in streptozotocin-induced diabetic rat following irradiation. Materials and Methods: Mature Sprague-Dawley rats were divided into three groups: control, diabetic, and diabetic-irradiated groups. Diabetes mellitus was induced in the Sprague-Dawley rats by injecting streptozotocin, while the control rats were injected with citrate buffer only. After 5 days, rats in diabetic-irradiated group were irradiated with single absorbed dose of 10 Gy to the head and neck region. The rats were killed at 1, 3, 7, 14,21, and 28 days after irradiation. The specimen including the submandibular gland were sectioned and observed using histologic and immunohistochemical methods. Results : Morphologic change of acinar cells was remarkable in the diabetic group, but was not observed in the diabetic-irradiated group. Necrotic tissues were observed in the diabetic-irradiated group. Coloring of toluidine blue stain was most increased at 14 days in the diabetic group, however there were no significant change throughout the period of the experiment in the diabetic-irradiated group. Expression of clusterin was most significant at 14 days in the diabetic group, but gradually decreased with time after 7 days in the diabetic-irradiated group. Degeneration of clusterin was observed in the diabetic-irradiated group. Conclusion : This experiment suggests that the acinar cells of submandibular gland in rats are physiologically apoptosed by the induction of diabetes, but that the apoptosis is inhibited and the acinar cells necrotized after irradiation.
Objectives : This study conducted to investigate oral care abilities in diabetic patients to find a good dental method which may efficiently control diabetes. Methods : The diabetic group consisted of 40 patients with type 2 diabetics, while the non-diabetes were 34 persons with no signs of diabetics, who had visited a Public Health Center and dental clinic of a general hospital in Gwangju city from Dec. 2008 to Sep. 2009. Periodontal disease, gingivitis, dental caries, tongue plaque and halitosis between diabetic group and non-diabetic group were examined and at the same time a questionnaire survey was conducted. The data were analyzed with chi-square, t-test, pearson correlation coefficients using the SPSS WIN 15.0 program. Results : The mean values of both the community periodontal index and the gingival index of diabetic group were 2.18 and 1.75, respectively, and those were higher than those (1.79 and 1.50) of non-diabetic group with no statistical significance. The mean saliva secretion of non-diabetics was 16.74 mL, which was higher than 13.90 mL of diabetic patients(p<0.05). The oral care ability(mean 3.10) acquired from plague index in diabetic group was worse than in non-diabetic(mean 2.33). Conclusions : The high blood sugar concentration in diabetic patients causes low saliva secretion and high saliva viscosity, with the results halitosis and periodontal disease take place. This study suggested that good oral care ability of diabetic patients was very helpful to prevent periodontal disease and halitosis. In addition to this, it may reduce complications of diabetic patients.
Kim, Jin-Mi;Youn, Sung-Sik;An, So-Hyun;Choi, Jeong-Sik;Cho, Chung-Sik;Son, Chang-Gue;Kim, Chul-Jung
The Journal of Korean Medicine
/
v.30
no.5
/
pp.127-136
/
2009
Objective: This study aimed to analyze the current status of treatments and patients with diabetic peripheral neuropathy, and then map out of a strategy for development of generalized-treatments for diabetic peripheral neuropathy in Traditional Korean Medicine. Methods: We selected research materials from various databases such as PubMed, Google, KStudy, KoreanTK, OIM, KOMS and books. Also, to understand current tendencies of medical examination and treatment related with diabetic peripheral neuropathy, we requested Health Insurance Review and Assessment Service clinical data from 2003 to 2007. Results: It is reported that the incidence of diabetic peripheral neuropathy is increasing in an aging society. The medical fees of National Health Insurance related with diabetic peripheral neuropathy show a year-on-year increase. There are no particularly effective therapies for diabetic peripheral neuropathy in Western medicine, and in some papers, it was reported that treatment of diabetic peripheral neuropathy using Traditional Korean Medicine was effective. However, patients usually visit on Western medical center rather than seek Traditional Korean Medicine. To take charge of clinical fields related with diabetic peripheral neuropathy by Traditional Korean Medicine, we need more studies and experiments of diabetic peripheral neuropathy using Traditional Korean Medicine and should make a standardized protocol. Conclusion: Various studies related with diabetic peripheral neuropathy using Traditional Korean Medicine will have to be undertaken hereafter. We expect that Traditional Korean Medicine will play a vital role in treating of diabetic peripheral neuropathy.
Journal of the Korean Society of Food Science and Nutrition
/
v.25
no.5
/
pp.831-838
/
1996
This study was undertaken in order to elucidate the effects of raw, roast and steamed buckwheat on fecal protein, Pancreas weight, the activities of $\alpha-amylase,$ chymotrypsin and lipase 91 the pancreas, and $\alpha-amylase,$ chymotrypsin and trypsin activities of the feces in streptozotocin-induced diabetic rats. Fecal proteins of raw, roast and steamed buckwheat diabetic groups were increased up to 99%, 91%, 103%, respectively compared to those of the diabetic control group. Feeding of buckwheat diet increased pancreas weight, especially raw buckwheat diabetic group(p<0.05). Pancreatic chymo-trypsin activity was decreased in buckwheat diabetic groups compared to diabetic control group, wheres any significant difference was observed in $\alpha-amylase$ and lipase activities. Fecal chymotrypsin activi-ty was significantly increased in all buckwheat diabetic groups. Fecal trypsin activity was increased in roast buckwheat diabetic groups compared to diabetic control group and fecal $\alpha-amylase$ activity in buckwheat diabetic group was not significantly different. These results suggest that feeding of buckwheat diet enhances the impaired exocrine pancreatic function of diabetic rat.
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