Diabetes mellitus is a syndrome characterized by chronic hyperglycemia, due to absolute or relative deficiency or diminished effectiveness of circulating insulin. It is the most common serious metabolic disease. Diabetes mellitus has been recognized as a clinical syndrome since ancient times and remains a crippling global health problem today. Diabetes may be divided into type 1 and type 2. Type 1 diabetes is caused by deficiency of insulin production, while type 2 diabetes is characterized by insulin resistance. The high medicinal treatment cost of diabetes, has led to a growing interest in alternative therapies for diabetes management. All the findings of this review paper highlighted the effectiveness of medicinal plants, the effectiveness of exercise therapy, diet and other lifestyle treatments for preventing type 2 diabetes and reducing mortality and morbidity among persons who are at an increased risk of developing the disease.

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High density lipoprotein cholesterol (HDL-C) is protective against the development of coronary artery disease (CAD) and microalbuminuria. Overall lipid index can be estimated by non-HDL cholesterol which is a better predictor of cardio vascular disease (CVD) than low density lipoprotein cholesterol (LDL-C) alone. Microalbuminuria is an important risk indicator for future development of nephropathy and CAD. Objectives of the current study were to find association between microalbuminuria with HDL-C and non-HDL-C in Saudi patients with diabetes. Both HDL-C and non-HDL-C were significantly associated with microalbuminuria while bivariate correlation of HDL-C was found to be negative. This indicates importance of microalbuminuria screening and considering non-HDL-C as an important indicator of dyslipidemia.

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Diabetes is associated with complications related to ischemia and oxidative stress. Diabetic nephropathy is one of the common vascular complications. The aim of the study was to evaluate the levels of ischemia modified albumin and nitric oxide in patients with diabetic nephropathy. Serum levels of ischemia modified albumin and nitric oxide were estimated in fifty patients with diabetic nephropathy and fifty patients with uncomplicated diabetes along with routine biochemistry investigations and compared with thirty healthy controls. The correlation of micoalbuminuria with ischemia modified albumin and nitric oxide was also calculated in patients with diabetic nephropathy. The levels of ischemia modified albumin and nitric oxide were found to be raised (p < 0.001) in patients with diabetic nephropathy as compared to uncomplicated diabetes and healthy controls. A positive correlation of these parameters was observed with microabuminuria. Thus, estimation of ischemia modified albumin and nitric oxide may help in better understanding of etiopathogenesis of diabetic nephropathy and may act as markers for this condition, if supported by further research.

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Hypertension and diabetes commonly occur together. The aim of this study was to investigate the role of oxidative stress in the link among Northern Nigerians. The study involved 200 subjects (aged 20 to 79 years) divided into four groups of 50 subjects each, viz.: Non Diabetic Normotensive Persons (NDNP) as controls, while Diabetic Normotensive Patients (DNP), Non Diabetic Hypertensive Patients (NDHP) and Diabetic Hypertensive Patients (DHP) as cases. Biomarkers of oxidative stress were correlated with some trace mineral elements in serum samples collected from all the subjects. A significant (p < 0.01) negative correlation was observed between the following: CAT/MDA and Fe2+/MDA in the 3 case groups; SOD/MDA, GSH/MDA in both DNP and DHP groups; Vitamin C/MDA, Se2+/MDA and Zn2+/MDA in both NDHP and DHP groups. The negative correlation of Vitamin E with MDA was found to be significant (p < 0.01) only in DHP group. The relationship between biomarkers of oxidative stress and trace mineral elements obtained in this study is implicated in the changes in antioxidant defense system which resulted in the pathophysiologic mechanisms underlying the complication of type 2 diabetes and associated hypertension.

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Obesity is a worldwide epidemic, associated with health related problems including type 2 diabetes. Diabetes is estimated to be responsible for 3.96 million adult deaths per year globally. The aim of this study was to determine lipid peroxidation and antioxidant status in patients with type 2 diabetes at a tertiary care hospital in relation to obesity in a section of Nepali population. Obesity is determined by the body mass index (BMI). Lipid peroxidation was determined by measurement of thiobarbituric acid reactive substances (TBARS) in plasma of the patients. The antioxidant status was estimated by determining the levels of vitamin C, vitamin E and total antioxidant activity in plasma. On BMI grading 49% male patients were of normal weight, 40% pre obese and 9.4% obese I and 2% were obese II. Similarly, among female patients 42% were normal, 45% pre obese, 5% were obese I and 8% were obese II. TBARS were increased in all the male patients except obese II. Vitamin E was decreased in male patients in normal BMI group and obese I but in female patients it was decreased in all the groups. Likewise, vitamin C was increased in all the groups in male patients and in female patients it was increased in the entire group, except pre obese. Severe obesity is rather uncommon in Nepal and in the present study it was absent in patients with type 2 diabetes. Conclusively, the results showed that male patients were relatively more prone to obesity and oxidative stress than females.

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A 22 year old male, with a history of cannabis and periodical alcohol abuse, patient of type 1 diabetes since the age of 19 years, presented to the emergency department after one day of lethargy and vomiting. At physical examination a dehydrated male with tachycardia, hypotension and Kussmaul's respiration was found. No other physical abnormalities were found, except for palpable skin, crepitations in the supraclavicular fossae that prompted immediate radiological investigations with chest X-ray and successive thorax computed tomography scan. Laboratory investigation was significant for metabolic acidosis. Pneumomediastinum is an uncommon complication of diabetic ketoacidosis that should be kept in mind to avoid unnecessary radiological investigations, dietary restriction and antibiotic administration with prolonged hospitalization and eventually delayed treatment of the underlying condition.

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