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   2012| October-January  | Volume 3 | Issue 3  
    Online since January 11, 2017

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A systematic review of trends of gestational diabetes mellitus in Asia
JE Hirst, CH Raynes-Greenow, HE Jeffery
October-January 2012, 3(3):5-5
As Asian countries undergo economic, social and nutritional transition, type 2 diabetes mellitus and Gestational diabetes mellitus (GDM) may be increasing. To determine trends of GDM prevalence in Asian countries, a search of Medline and Embase using defined criteria was performed. Studies included were conducted in Asia between 1990 - 2011, documented patient selection, defined GDM criteria, were in English, had a quality grade of Scottish Intercollegiate Guideline Network (SIGN) ≥ 2+ and recruited ≥ 500 women. Data was extracted using a standardized form. Within country comparisons of studies using the same diagnostic criteria were made; study heterogeneity limited results to a narrative synthesis. From 1460 titles and abstracts, 19 papers were included. There was evidence of GDM increasing in Tianjin, China (2.4% in 2002 to 6.8% in 2008), in Hong Kong (7.4% in 1986 to 10.4% in 1998 to 2001) and in Bangkok, Thailand (2.0% in 1987 - 89 to 3.0% in 2001 - 02). Prevalence in India varied markedly by location and diagnostic criteria, with high rates in urban Chennai, 17.7% in 2001 and 17.8% in 2005 to 2007. There was no evidence of increase in GDM in Tokyo, Japan (1.8% in 1996 - 2000 to 1.6% in 2008 - 10) or in Seoul, Korea (2.2% in 1991-94 to 2.4% in 1993-97). Other countries lacked data for comparison. Despite the lack of comparative data there is an increasing trend of GDM prevalence in some Asian countries. The choice of diagnostic criteria greatly affects prevalence.
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Drug-dietary interaction potential of garlic on glimepiride treated type 2 diabetic Wistar rats
P Mittal, V Juyal
October-January 2012, 3(3):3-3
The present study evaluates the drug dietary interaction potential of garlic with glimepiride. Type 2 diabetes mellitus was induced in overnight fasted wistar rats by streptozotocin and Nicotinamide. Six groups of rats viz. group 1(normal control), group 2 (diabetic control), group 3(standard) and groups 4, 5 and 6 (groups having standard drug glimepiride with aqueous extract of garlic i.e. 125 mg/kg, 250 mg/kg and 500 mg/kg body weight respectively) were employed in the study and each group contained seven animals. Blood glucose, cholesterol, triglycerides and HDL levels were estimated from 1st day to 28th day and statistically significant hypoglycaemic and anti-hyperlipidaemic effects seen with co-administration of glimepiride and garlic at a dose of 250 mg/kg and 500 mg/kg body weight as compared to glimepiride alone (p < 0.05). There were slight increases in HDL levels, however these were not statistically significant compared to the first day values. This study revealed that a drug interaction also provides some beneficial effects. As in this study; use of glimepiride with garlic treatment not only resulted in tight glycaemic control in diabetic rats but also provide beneficial hypolipidaemic effect, closely related to diabetes progression.
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Gastroparesis carrying poor prognostic sign in Chinese patients with diabetes: a retrospective cohort study
S Law, FH Lo, KK Li, HW Wong
October-January 2012, 3(3):2-2
The present study aims to investigate the prevalence, clinical and laboratory characteristics, management and outcomes of patients with diabetic gastropareis (DG). This was a retrospective cohort study. Patients diagnosed with DG were selected and each patient was paired with 3 randomly selected patients with diabetes (controls) based on initial site of enrollment of the cases. Their medical records were studied. Between 2001 and 2010, 39 patients (4 type 1; 18 males) had DG. They were associated with lower body mass index (20.1 vs. 22.9 kg/m2; p = 0.01), longer duration of diabetes (12.5 vs 6.6 years; p < 0.01), more insulin users (72.4 vs 23.1%; P < 0.01) and diabetic complications (retinopathy, 36.7 vs 22.8%, p = 0.04; nephropathy, 63.3 vs 43.9%, p < 0.02; autonomic neuropathy, 53.3 vs 8.8%, p < 0.01) compared to the controls. The common symptoms in patients with DG were nausea and vomiting (67.6%), epigastric pain (32.4%) and bloating (24.3%). Sixteen (41%) and 15 (38.5%) patients developed depression and complications [hematemesis in 5 (33.3%), ≥ 5% dehydration in 6 (40%) and insulin induced hypoglycemia in 6(40%)] respectively. All responded well to prokinetics without any adverse effects. Twenty four (70.6%) patients required lower dosage of antidiabetic regimen (p = 0.001) one year afterwards, together with the improvement of HbA1c (p < 0.01) and lipoprotein metabolism (p < 0.05). Nineteen (48.7%) patients needed hospitalization due to recurrence of gastroparetic symptoms (Mean time ΁ Standard deviation, 9.9 ΁ 5.7 months). Lastly, DG patients were associated with higher morbidities (mean number of hospitalization/year, 5.8 vs 1.3, p < 0.01; in-patient day/year, 33.9 vs 6.9 days, p < 0.01) and mortality (53.8 vs 28.2%, p < 0.01) compared to the controls. Gastroparesis is associated with higher morbidity and mortality among Chinese patients with diabetes.
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Stem Cells: Source for diabetes cell therapy
H Kaur, N Bhaskar, S Ishaq, Q Najeeb
October-January 2012, 3(3):4-4
One adult in ten will have diabetes by 2030, figures signify that the number of people living with diabetes is estimated to rise from 366 million in 2011 to 552 million by 2030. Between 2010 and 2030, there will be a 69% increase in number of adults with diabetes in developing countries and a 20% increase in developed countries. One of the principal effects is the reduction in β-cell mass, which is ubiquitous in almost all patients with type 1 diabetes and most patients with type 2 diabetes. Current therapy focuses primarily on administration of insulin to restore glucose homeostasis. However, the method is imprecise and does not entirely control the minute-to-minute fluctuations in systemic blood glucose. Because of these shortcomings, recent research has been directed towards establishing cellular-based therapies that circumvent the need for exogenous insulin delivery by conventional injection or more modern pump technology. One of the most fascinating of these strategies involves substitution of insulin-producing islet-cells by transplantation therapy. But the lack of fresh feasible donor material coupled with problems of immunocompatibility and life-long immunosuppression to thwart graft rejection has made the widespread application of both techniques nearly unfeasible. These restrictions have led to exploration of other sources of β-cells. Of late, stem cells have generated incredible interest for repairing failing tissues and organs. In this article, we review the diverse approaches in the field of stem cells developed to create insulin producing cells for the treatment of diabetes.
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Emphysematous prostatitis in a patient with diabetes
CA Sohoni
October-January 2012, 3(3):1-1
Emphysematous prostatitis is a rare condition that is characterized by gas and pus accumulation in the prostate. We report a 70 year old man with emphysematous prostatitis caused by Escherichia coli (E.coli). He had a history of long standing diabetes mellitus. He was admitted with fever and dysuria. Computed tomography (CT) scans corroborated the existence of air collection in the prostate. Under the impression of emphysematous prostatitis, the patient was successfully treated with antibiotics without the need for any major surgical intervention.
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