Abstract Herbal medicine has become a popular treatment among patients with chronic diseases worldwide. Many patients with diabetes mellitus use herbal medicine without consulting their health professionals. The aim of this study was to assess the prevalence, pattern of use, and perceptions in type 2 diabetes patients using herbal medicine. It was conducted between 1st January 2019 and end of June 2019 diabetes clinic in Farwaniya Hospital in Kuwait. In this cross sectional quantitative study, 350 patients were asked to complete ques tionnaire administered by nurses. The study found that 30.6% of sample used herbal medicine—women more than men. Black cumin (habba soda) i.e. Ni gella sativa was the most common herb used by diabetic patients. The study revealed that 70% of herbal medicine users had poor glycemic control (HbA1c≥ 7%). Diabetic complications were greater in herbal users than in those re ceiving conventional therapy. The study also showed that 95.3% of herbal medicine users did not inform their treating doctors. Our conclusion was that herbal medicine users needed to increase their awareness and education about the risks and complications of herbal medicine.

Abstract Aim: To investigate the relationship between sudomotor dysfunction and various body composition analysis indices in type 2 diabetic patients. Me thods: Between January 2016 and April 2021, 136 diabetic participants who had undergone body composition analysis (BCA) were recruited for this cross-sectional study. Sudomotor functions were assessed using SUDOSCAN, and participants were grouped into patients with normal (Group 1, n = 51), mildly reduced (Group 2, n = 46) and severely reduced (Group 3, n = 39) foot electrochemical skin conductance (FESC) levels. Results: The mean age was 60.4 ± 10.1 years, median diabetes duration was 12 (6 - 19) years, and 52.2% of participants were males. Among BCA parameters, the significant differ ences were found in total fat (TF) (p = 0.023), percentage of TF (%TF) (p = 0.025), percentage of android fat (%AF) (p = 0.048), fat mass (FM) in arms (p = 0.016), FM in legs (p = 0.002), appendicular fat mass (aFM) (p = 0.002), appendicular fat mass/body mass index (aFM/BMI) ratio (p = 0.009) between three groups. In Spearman correlation analysis, FESC was correlated with RBC, ESR and homocysteine (r = 0.171, r = −0.190, r = −0.192, p < 0.05), re spectively. Multivariate linear regression analysis revealed that FM in arms, FM in legs, aFM and aFM/BMI ratio were independently associated with FESC even after adjustment for age, diabetes duration, WC, systolic BP, HbA1c, FPG, HOMA-IR, ESR, HDL-C, LDL-C, Total Cholesterol, ALT (β =0.161, 0.155, 0.165, 0.185, p < 0.05, respectively). Conclusion: The progres sive decline of sudomotor function is positively associated with loss of sub cutaneous fat in arms and legs, suggesting that subcutaneous fat of extremi ties may be necessary to prevent DPN progression in type 2 diabetic pa tients.

Abstract There is a data gap in the relationship between chronic carbon monoxide intoxication and diabetes mellitus manifestation. This study aims to investigate if a cause-effect relationship exists using rabbits as a choice animal model. A total of twenty rabbits were used for the study comprising equal age and weight-matched control and experimental groups. The experimental group was further divided into 10th day, 20th day and 30th CO intoxicated sub-groups. Vitreous and serum glucose, proteins, lipids, electrolytes and renal function parameters were measured using WHO-approved methods. One-way ANOVA (Post hoc-LSD) and Pearson correlational analysis were used for the data analysis. The result showed a progressive significant increase (p < 0.05) in concentrations of vitreous glucose, urea and creatinine in the experimental groups, while the concentrations of vitreous total cholesterol, triglyceride, total protein, globulins, sodium, potassium and pH decreased significantly. In the same vein, the concentrations of serum glucose, triglyceride, and sodium increased significantly (p < 0.05), whereas concentrations of serum cholesterol, total proteins, globulins, potassium, and pH activity decreased significantly. Correlational relationships were also observed between glucose and some associated parameters in the vitreous humour and serum. In conclusion, some of the vitreous and serum biochemical parameters altered followed a similar predictive pattern and usual pathophysiology of diabetes mellitus. Therefore, we found that chronic CO intoxication could be included amongst the environmental agents known to be a causative agent of diabetes mellitus.

Abstract Diabetes Mellitus is a chronic disease that affects important body organs in a very serious manner. The consequences of this disease turn out to be a significant problem for the patient, who tries to cope with the new condition his organism has been placed in. The most common effect of the disease, hyperglycaemia, leads over time to serious damage to various body systems, such as nerves and blood vessels. What is not widely known among the population is that diabetes may have harmful effects on the reproductive system of the men suffering from diabetes type 1 and 2 and that such a parameter could lead to or might be the reason for infertility problems for couples, for example, miscarriage or embryonic failure. AGEs is a number of products which are believed to play an important role, because their presence has been detected in increased level in diabetic men. This implies that those glycation products might play a key role in diabetic complications. Their receptor, RAGE, member of the immunoglobulin superfamily has been detected in the reproductive tract of diabetic men. Reactive oxygen species (ROS), a possible product of AGEs appear in high levels in seminal plasma and are believed to be the cause of DNA fragmentation. The objective of this review was to gather all the available material i.e. studies on diabetes mellitus in one article, to study the research which has already been conducted and the conclusions that have been drawn, in order to offer, if possible, new pathways and perspectives to the scientists, who focus on fertility problems, sometimes intractable.

Abstract Type 2 diabetes is in epidemic proportion in Papua New Guinea. Although many people are at high-risk of developing diabetes, there is no diabetes prevention policy and services in Papua New Guinea to address this problem. A literature search was carried out to assess the available evidence in the primary prevention of type 2 diabetes mellitus among the population with prediabetes. The result shows that the primary preventative studies conducted on lifestyle modification and the use of metformin in prediabetes patients reduced overt type 2 diabetes mellitus. The application of the evidence in the prevention of the type 2 diabetes epidemic in Papua New Guinea, driven by a policy is feasible to address the diabetes epidemic.

Abstract Background: Experimental and observational studies have indicated that poor sleep quantity and quality are associated with an increased risk of chronic diseases including insulin resistance. Additionally, sleep disorders have been reported to aggravate diabetes due to decreased glucose metabolism and elevated cortisol levels as well as it can increase the risk for the development of diabetes. Objectives: To assess the sleep quality and its determinants and impact on glycemic control of type II diabetic patients. Methods: A cross sectional study was adopted among a representative sample of patients diagnosed with type II Diabetes seen in Prince Mansour Military Hospital Diabetic Center in Taif throughout the study period (March-July 2021). A self administered questionnaire was utilized in the present study including 5 main parts: demographic data of the patients, medical and social history, the Pittsburgh Sleep Quality Index (PSQI) to assess the subjective sleep quality, weight and height measurements and the most recent glycated hemoglobin (HbA1c) level. Results: The study included 270 type II diabetic patients out of a targeted 282 with a response rate of 95.7%. Most of them aged either between 51 and 60 years (34.8%) or over 60 years (42%). Females represent 63% of them. Majority of patients (87.8%) had HbA1c ≥ 7%, indicating uncontrolled blood glucose levels. Overall, poor sleep quality, based on PSQI was observed among 41.1% of type II diabetic patients. Results of multivariate logistic regression analysis revealed that compared to patients whose income was lower than 5000 SR/month, those with income of 50,001 - 1000 and >15,000 SR/month were at lower significant risk for having poor sleep (Adjusted odds ratio “AOR” = 0.44, 95% confidence interval “CI” = 0.22 - 0.86, p = 0.016 and AOR = 0.21, 95% CI = 0.06 - 0.77, p = 0.019; respectively). Opposed to diabetic patients with a duration of less than one year of DM, those with a duration exceeding 10 years were at almost 6-folds higher risk for poor sleep quality (AOR = 6.39, 95% CI = 1.12 - 36.43, p = 0.037). Patients with a history of social stressors were at a higher significant risk for poor sleep quality compared to those without such a history (AOR = 4.99, 95% CI = 1.71 - 14.67, p = 0.003). Conclusion: A considerable proportion of type II diabetic patients attending the diabetic center, Prince Manasour Military hospital in Taif, Kingdom of Saudi Arabia expressed poor sleep quality. However, there was no association between glycemic control level and poor sleep quality.

Abstract Total cholesterol (CHOL) levels have been shown in many studies, to be higher in people with several types of cancer. Similar results are observed for both triglycerides (TG) and low-density cholesterol (LDL), as opposed to high-density cholesterol (HDL). Chemotherapy seems to reduce CHOL and LDL, leading to a reduction. Furthermore, the recurrence of high levels of CHOL, TG and LDL, as well as low levels of HDL, after receiving treatment, or when patients appear to have been cured, are signs of a possible recurrence of the disease. Lipoprotein α (Lpa), occurs at higher levels in patients than in healthy people, whereas lipokines resistin and bisfatin, “hormonal” products of adipose tissue exhibited high levels in cancer cases, compared to control groups.

Abstract Background and Aims: Several studies have shown that hypoglycaemia, especially a severe episode is associated with an increased mortality rate in diabetes mellitus subjects with previous cardiovascular disease or acute coronary syndrome. One of the presumed mechanisms is the proarrhythmic effect of hypoglycaemia related to the prolongation of the action potential, or the catecholamine surge that follows an episode. The aim of this case series analysis was to investigate the relationship between hypoglycaemia and glucose variability with arrhythmic events in type 2 diabetes patients who suffered an acute myocardial infarction. Materials and Methods: We selected patients admitted consecutively to the cardiology department of Clinical Emergency Hospital in Bucharest for a period of three months with acute myocardial infarction and previously diagnosed type 2 diabetes. For each patient, a retrospective continuous glucose monitoring system (CGMS) or glucose sensor (Medtronic® Enlite, USA) and a dual electrocardiograph and blood pressure monitor for 24 hours were available. Also, patients had an oscillometric device (Arteriograph® TensioMed Ltd) for 24 hours or non-invasive monitoring of central blood pressure, pulse wave velocity and augmentation index. The data were analysed using Medtech®, TensioWin® and Carelink iPro® softwares. We used SPSS® version 20.0 (IBM) for the statistical analysis. The results are presented as median and interquartile range (IQR). Results and Discussion:Ten type 2 diabetes patients (4 males, 6 females) with anterior (4/10) and in ferior acute myocardial infarction (6/10) were included. They were treated with insulin (3/10), sulphonylurea (Gliclazide) plus Metformin (4/10), Metformin monotherapy (2/10), or all three (1/10). The patients had a median age of 67.5 (3.25) years with a median disease duration of 8 (7.75) years. The median body mass index was 29.54 (5.65) kg/m2. The median HbA1c was 7.9% (3.15) % and C-peptide 3.3 (2.66) ng/ml. There were no significant differences regarding the number of atrial or ventricular premature beats, ventricular or atrial tachycardia or fibrillation, the duration of QT interval, systolic and diastolic blood pressure, aortic pressure, augmentation index, pulse wave velocity between subjects with hypoglycaemia and those without. There was a negative correlation between QTc and glucose values in patients with hypoglycaemia (Spearman coefficient correlation r = −0.232; p < 0.01). Conclusion: Mild hypoglycaemia in type 2 diabetes patients with systolic dysfunction after ST-elevated myocardial infarction did not increase the number of supraventricular premature beats and QTc duration. We suggest that nonsevere hypoglycaemia does not increase the risk of arrhythmias in patients with type 2 diabetes.