• Title/Summary/Keyword: Diabetic Complications

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Hemorheology and clinical application : association of impairment of red blood cell deformability with diabetic nephropathy

  • Shin, Se-Hyun;Ku, Yun-Hee
    • Korea-Australia Rheology Journal
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    • v.17 no.3
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    • pp.117-123
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    • 2005
  • 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.

Therapy of Diabetes Mellitus Using Experimental Animal Models

  • Min, T.S.;Park, Soo Hyun
    • Asian-Australasian Journal of Animal Sciences
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    • v.23 no.5
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    • pp.672-679
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    • 2010
  • Diabetes mellitus is a worldwide epidemic with high mortality. As concern over this disease rises, the number and value of research grants awarded by the National Research Foundation of Korea (NRF) have increased. Diabetes mellitus is classified into two groups. Type 1 diabetes requires insulin treatment, whereas type 2 diabetes, which is characterized by insulin resistance, can be treated using a variety of therapeutic approaches. Hyperglycemia is thought to be a primary factor in the onset of diabetes, although hyperlipidemia also plays a role. The major organs active in the regulation of blood glucose are the pancreas, liver, skeletal muscle, adipose tissue, intestine, and kidney. Diabetic complications are generally classified as macrovascular (e.g., stroke and heart disease) or microvascular (i.e., diabetic neuropathy, nephropathy, and retinopathy). Several animal models of diabetes have been used to develop oral therapeutic agents, including sulfonylureas, biguanides, thiazolidinediones, acarbose, and miglitol, for both type 1 and type 2 diseases. This review provides an overview of diabetes mellitus, describes oral therapeutic agents for diabetes and their targets, and discusses new developments in diabetic drug research.

Changes in in vivo Lipid Peroxidation and Antioxidant Defense System in Streptozotocin-Induced Diabetic Rats: a Time Course Study (스트렙토조토신-당뇨쥐에서 지질과산화 및 항산화계의 경시적 변화)

  • 이수자;박수현;이혜성
    • Journal of Nutrition and Health
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    • v.34 no.3
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    • pp.253-264
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    • 2001
  • This study was carried out to examine a part of the mechanism for the etiology of diabetic complications. Thirty normal and forty streptozotocin(STZ)-induced diabetic rats were used as the animal models. The animals were sacrificed at the time points of 3 days, 1,2,4 and 6 weeks after STZ-injection and a time course changes in the concentrations of thiobarbituric acid-reactive substances(TBARS) in blood, urine, and tissues, along with the levels of conjugated dienes in tissues were measured as indices of in vivo lipid peroxidation. The activities of antioxidant enzymes, catalase, superoxide dismutase, glutathione peroxidase and the levels of blood retinol and alpha-tocopherol were also measured. The diabetic rats maintained a slightly higher plasma TBARS level throughout the experiment. The urinary TBARS level was significantly higher in diabetic group and gradually increased with time. Concentrations of TBARS in liver, heart, and kidney tissues from diabetic animals were higher than those from the normal group. An increase of conjugated dienes was also observed in the all tissues examined. The kidney tissue of diabetic animals revealed more significant lipid peroxidation state than any other organ tissues. The activities of hepatic antioxidant enzymes such as catalase, superoxide dismutase, glutathione peroxidase were higher in diabetic animals compared to the control ones and increased with the duration of diabetes mellitus. The plasma levels of vitamin A and E were loser in diabetic animals than in normal controls throughout the experimental period. The level of vitamin E in diabetic animals was significantly decreased with the duration of the disease. The results of this study suggest that an effective regimen to suppress the adverse changes in lipid peroxidation and antioxidant defense system is required from the early stage of the disease to prevent the development of diabetic complications. (Korean J Nutrition 34(3) : 253∼264, 2001)

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The pathophysiology of diabetic foot: a narrative review

  • Jiyoun Kim
    • Journal of Yeungnam Medical Science
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    • v.40 no.4
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    • pp.328-334
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    • 2023
  • An aging population and changes in dietary habits have increased the incidence of diabetes, resulting in complications such as diabetic foot ulcers (DFUs). DFUs can lead to serious disabilities, substantial reductions in patient quality of life, and high financial costs for society. By understanding the etiology and pathophysiology of DFUs, their occurrence can be prevented and managed more effectively. The pathophysiology of DFUs involves metabolic dysfunction, diabetic immunopathy, diabetic neuropathy, and angiopathy. The processes by which hyperglycemia causes peripheral nerve damage are related to adenosine triphosphate deficiency, the polyol pathway, oxidative stress, protein kinase C activity, and proinflammatory processes. In the context of hyperglycemia, the suppression of endothelial nitric oxide production leads to microcirculation atherosclerosis, heightened inflammation, and abnormal intimal growth. Diabetic neuropathy involves sensory, motor, and autonomic neuropathies. The interaction between these neuropathies forms a callus that leads to subcutaneous hemorrhage and skin ulcers. Hyperglycemia causes peripheral vascular changes that result in endothelial cell dysfunction and decreased vasodilator secretion, leading to ischemia. The interplay among these four preceding pathophysiological factors fosters the development and progression of infections in individuals with diabetes. Charcot neuroarthropathy is a chronic and progressive degenerative arthropathy characterized by heightened blood flow, increased calcium dissolution, and repeated minor trauma to insensate joints. Directly and comprehensively addressing the pathogenesis of DFUs could pave the way for the development of innovative treatment approaches with the potential to avoid the most serious complications, including major amputations.

Characteristics of Antidiabetic Effect of Dioscorea rhizoma(1) - Hypoglycemic Effect - (산약의 항당뇨 특성 연구(1) - 혈당 강하 효과 -)

  • Kang, Tong-Ho;Choi, Sang-Zin;Lee, Tae-Ho;Son, Mi-Won;Kim, Sun-Yeou
    • The Korean Journal of Food And Nutrition
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    • v.21 no.4
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    • pp.425-429
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    • 2008
  • Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Type 1 diabetes, or juvenile-onset diabetes, results from a cellular-mediated autoimmune destruction of the ${\beta}$-cells of the pancreas. Type 2 diabetes, or adult-onset diabetes, is a term used for individuals who have insulin resistance, a condition that makes it harder for the cells to properly use insulin, and usually have relative insulin deficiency. The diabetes causes the onset of chronic complications and diabetic neuropathy is one of the most debilitating complications. In this study, the hypoglycemic effect and the preventive effect of diabetic complications of Dioscorea rhizoma extract(DRE) were examined in rodent model. We investigated the glucose tolerance test and long term hypoglycemic effect of DRE in Type 1 streptozotocin-induced diabetic rats and Type 2 diabetic db/db mice. DRE showed a hypoglycemic effect on blood glucose levels than that of control group in Type 1 streptozotocin-induced diabetic rats and Type 2 diabetic db/db mice. On the basis of our results, we conclude that long-term use of DRE might help decrease blood glucose level and prevention of diabetes-associated complication.

Association of carotid atherosclerosis and obesity in type 2 diabetic patients (제2형 당뇨병 환자에서 비만과 경동맥 경화증과의 관계)

  • Gang, Se-Hun;Kim, Gyeong-Min;Jo, Dong-Hyeok;Gang, Ho-Cheol;Jeong, Dong-Jin;Jeong, Min-Yeong
    • Journal of Korea Association of Health Promotion
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    • v.4 no.1
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    • pp.12-27
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    • 2006
  • "본 논문은 대한내과학회지 2006년 제70권 제3호에 실렸던 논문으로 대한내과학회 편집위원회의 승인을 득하고 본 협회지에 게재함. Background : Diabetes mellitus is a major independent risk factor for atherosclerosis. In recent years non-invasive high resolution B-mode ultrasound methods have been developed to measure the intima-media thickness(IMT) of the carotid artery as an indicator for early atherosclerosis. Itis known that obesity plays a role in the development of type 2 diabetes and cardiovascular disease, and it has also been reported that not only the amount but also the distribution of body fat is important. This study investigated the relationship between obesity and the development of carotid atherosclerosis in type 2 diabetic patients. Methods: Carotid IMT was measured by ultrasound B-mode imaging in 144 patients with type 2diabetes mellitus. All subjects underwent assessment for the degree and distribution of obesity, the presence of coronary artery disease risk factors, and the presence of diabetic complications. Resuts: Carotid IMT was increased in the abdominal obese group defined by waist circurference. However, there was no significant difference in carotid TMT between the non-obese group and obese group as defined by body mass index, waist to hip ratio, and total body fat percent measured by bio electrical impedance analysis. There were positive correlations between carotid IMT and age, duration of diabetes, systolic blood pressure, and waist circumference. Multiple linear regression analysis revealed the variable that interacted independently with carotid IMT was age in type 2 diabetic patients. Carotid IMT was significantly increased in type 2 diabetic patients with macrovascular complications and microvascvlar complications .Conclusion: This study suggested that abdominal obesity rather than general obesity was associated with carotid atherosclerosis reflected by increment of carotid IMT in type 2 diabetic subjects.

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Screening of Inhibitory Effect on Aldose Reductase of Vietnam Herbal Medicines (II) (베트남 약용식물 추출물의 알도즈 환원 효소 억제 효능 검색(II))

  • Lee, Yun-Mi;Kim, Jong-Min;Kim, Young-Sook;Jang, Dae-Sik;Kim, Joo-Hwan;Bae, Ki-Hwan;Kim, Jin-Sook
    • Korean Journal of Pharmacognosy
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    • v.39 no.4
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    • pp.324-329
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    • 2008
  • Aldose reductase (AR), the key enzyme in the polyol pathway, plays an important role in the pathogenesis of diabetic complications such as cataract formation. AR inhibitors (ARI) can prevent or reverse early abnormalities in diabetic complications. However, none of ARI has achieved worldwide use because of limited efficacy or undesirable side effects. Therefore, evaluating natural sources for ARI potential may lead to the development of safer and more effective agents against diabetic complications. 49 Vietnam herbal medicines have been investigated with an in vitro evaluation system using aldose reductase inhibitory activities. Of these, 7 herbal medicines, Artemisia annua (leaf, stem), Duranta repens (leaf, stem), Excoecaria cochinchinensis (aerial part), Flueggea virosa (leaf, stem), Khaya senegalensis (leaf), Polygonum orientale (aerial part), Toxicodendron succedanea (leaf, stem) exhibited a significant inhibitory activity against aldose reductase. Particularly, Duranta repens (leaf, stem) and Toxicodendron succedanea (leaf, stem) showed two times more potent inhibitory activity than the positive control, 3.3-tetramethyleneglutaric acid (TMG).

Prevention of Cardiovascular Events with Antiplatelet Agents in Diabetic Patients

  • Kim, Mi-Jung;Lee, Suk-Hyang
    • Proceedings of the PSK Conference
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    • 2002.10a
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    • pp.430.2-431
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    • 2002
  • Cardiovascular complications are high in the diabetic patients. Especially, acute coronary heart diseases (CHD) can be prevented by use of antiplatelet agents. This study was to determine the efficacy of antiplatelet therapy on prevention of cardiovascular events in diabetic patients. METHODS: The medical charts of 132 diabetic patients at Hanyang University. Kuri Hospital from January 1996 to January 2000 were reviewed retrospectively. (omitted)

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Gamma-tocopherol ameliorates hyperglycemia-induced hepatic inflammation associated with NLRP3 inflammasome in alloxan-induced diabetic mice

  • Lee, Heaji;Lim, Yunsook
    • Nutrition Research and Practice
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    • v.13 no.5
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    • pp.377-383
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    • 2019
  • BACKGROUND/OBJECTIVES: Hyperglycemia-induced hepatic damage has been recognized as one of the major cause of complications in diabetes. Hepatic complications are associated with inflammation and oxidative stress in diabetes. In this study, we investigated the hypothesis that gamma-tocopherol (GT) supplementation ameliorates NLRP3 inflammasome associated hepatic inflammation in diabetes. MATERIALS/METHODS: Diabetes was induced by the intraperitoneal injection of alloxan (150 mg/kg. BW) in ICR mice. All mice were fed with a control diet (AIN-76A). After diabetes was induced (fasting glucose level ${\geq}250mg/dL$), the mice were treated with tocopherol-stripped corn oil or GT-supplemented (35 mg/kg) corn oil, respectively, by gavage for 2 weeks. RESULTS: GT supplementation reduced fasting blood glucose levels in diabetic mice relative to non-treated diabetic mice. Moreover, GT supplementation ameliorated hyperglycemia-induced hepatic damage by regulation of NOD-like receptor protein 3 (NLRP3)-inflammasome associated inflammation represented by NLRP3, apoptosis-associated speck-like protein containing a caspase-recruitment domain, caspase-1, nuclear $factor-{\kappa}B$ pathway as well as oxidative stress demonstrated by nuclear factor erythroid 2-related factor 2, NAD(P)H dehydrogenase quinone 1, catalase and glutathione-dependent peroxidase in diabetic mice. CONCLUSION: The findings suggested that GT supplementation ameliorated hepatic damage by attenuating inflammation and oxidative stress in alloxan-induced diabetic mice. Taken together, GT could be a beneficial nutrient that can ameliorate inflammatory responses associated with NLRP3 inflammasome in hyperglycemia-induced hepatic damage.