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| 1 | Diabetic neuropathic pain:Physiopathology and treatment显示文摘Diabetic neuropathy is a common complication of both type 1 and type 2 diabetes,which affects over 90% of the diabetic patients.Although pain is one of the main symptoms of diabetic neuropathy,its pathophysiological mechanisms are not yet fully known.It is widely accepted that the toxic effects of hyperglycemia play an important role in the development of this complication,but several other hypotheses have been postulated.The management of diabetic neuropathic pain consists basically in excluding other causes of painful peripheral neuropathy,improving glycemic control as a prophylactic therapy and using medications to alleviate pain.First line drugs for pain relief include anticonvulsants,such as pregabalin and gabapentin and antidepressants,especial y those that act to inhibit the reuptake of serotonin and noradrenaline.In addition,there is experimental and clinical evidence that opioids can be helpful in pain control,mainly if associated with first line drugs.Other agents,including for topical application,such as capsaicin cream and lidocaine patches,have also been proposed to be useful as adjuvants in the control of diabetic neuropathic pain,but the clinical evidence is insufficient to support their use.In conclusion,a better understanding of the mechanisms underlying diabetic neuropathic pain will contribute to the search of new therapies,but also to the improvement of the guidelines to optimize pain control with the drugs currently available. | Anne K Schreiber Carina FM Nones Renata C Reis Juliana G Chichorro Joice M Cunha | 2015 | World Journal of Diabetes2015，6，3： | 34 |
| 2 | Prevalence and features of fatty liver detected by physical examination in Guangzhou显示文摘AIM:To investigate the prevalence of fatty liver discovered upon physical examination of Chinese patients and determine the associated clinical characteristics.METHODS:A total of 3433 consecutive patients who received physical examinations at the Huangpu Division of the First Affiliated Hospital at Sun Yat-sen University in Guangzhou,China from June 2010 to December2010 were retrospectively enrolled in the study.Results of biochemical tests,abdominal ultrasound,electrocardiography,and chest X-ray were collected.The diagnosis of fatty liver was made if a patient met any two of the three following ultrasonic criteria:(1)liver and kidney echo discrepancy and presence of an increased liver echogenicity(bright);(2)unclear intrahepatic duct structure;and(3)liver far field echo decay.RESULTS:The study population consisted of 2201males and 1232 females,with a mean age of 37.4±12.8 years.When all 3433 patients were considered,the overall prevalence of hyperlipidemia was 38.1%,of fatty liver was 26.0%,of increased alanine aminotransferase(ALT)and/or aspartate aminotransferase(AST)levels was 11.9%,of gallstone was 11.4%,of hyperglycemia was 7.3%,of hypertension was 7.1%,and of hyperuricemia was 6.2%.Of the 2605 patients who completed the abdominal ultrasonography exam,677(26.0%)were diagnosed with fatty liver and the prevalence was higher in males(32.5%vs females:15.3%,P<0.001).The overall prevalence of fatty liver increased with age,with the peak prevalence(39.5%)found in the 60 to 70-year-old age group.Among patients between the ages of 18 to 50-year-old,the prevalence of fatty liver was significantly higher in males(20.2%vs females:8.7%,P<0.001);the difference in prevalence between the two sexes in patients>50-year-old did not reach statistical significance.Only 430 of the patients diagnosed with fatty liver had complete information;among those,increased ALT and/or AST levels were detected in only 30%,with all disturbances being mild or moderate.In these 430 patients,the overall prevalence of hypertriglyceridemia was 31.4%,of mixed type hyperlipidemia was 20.9%,of hypercholesterolemia was 12.3%,of hyperglycemia was 17.6%,of hypertension was 16.0%,of hyperuricemia was 15.3%,and of gallstone was 14.4%.Again,the prevalences of hypertriglyceridemia and hyperuricemia were higher in males(hypertriglyceridemia,36.0%vs females:12.0%,P<0.05;hyperuricemia,17.3%vs females:7.2%,P<0.05);in contrast,however,the prevalences of mixed type hyperlipidemia and hypercholesterolemia was higher in females(mixed type hyperlipidemia,18.7% vs females:30.1%,P<0.05,hypercholesterolemia,9.5%vs females:24.1%,P<0.05).Finally,comparison of the fatty liver group to the non-fatty liver group showed that prevalences of hyperlipidemia,hyperglycemia,hypertension,and hyperuricemia were higher in the former(all P<0.01).CONCLUSION:A high prevalence of fatty liver is detected upon physical examination in Guangzhou,and the primary associated clinical findings are hyperlipidemia,hyperglycemia,hypertension,and hyperuricemia. | Xian-Hua Liao Xu Cao Jie Liu Xiao-Hua Xie Yan-Hong Sun Bi-Hui Zhong | 2013 | World Journal of Gastroenterology2013，19，32： | 30 |
| 3 | Coronary microvascular dysfunction in diabetes mellitus:A review显示文摘The exploration of coronary microcirculatory dysfunction in diabetes has accelerated in recent years.Cardiac function is compromised in diabetes.Diabetic patients manifest accelerated atherosclerosis in coronary arteries.These data are confirmed in diabetic animal mod-els,where lesions of small coronary arteries have been described.These concepts are epitomized in the classic microvascular complications of diabetes,i.e.blindness,kidney failure and distal dry gangrene.Most importantly,accumulating data indicate that insights gained from the link between inflammation and diabetes can yield predictive and prognostic information of considerable clinical utility.This review summarizes the evidence for the predisposing factors and the mechanisms involved in diabetes,and assesses the current state of knowledge regarding the triggers for inflammation in this disease.We evaluate the roles of hyperglycemia,oxidative stress,polyol pathway,protein kinase C,advanced glycation end products,insulin resistance,peroxisome proliferator-activated receptor-γ,inflammation,and diabetic cardiomyopathy as a 'stem cell disease'.Furthermore,we discuss the mechanisms responsible for impaired coronary arteriole function.Finally,we consider how new insights in diabetes may provide innovative therapeutic strategies. | Andrea Picchi Stefano Capobianco Marta Focardi | 2010 | World Journal of Cardiology2010，2，11： | 24 |
| 4 | Structural and functional damage to the hippocampal neurovascular unit in diabetes-related depression显示文摘Previous studies have shown that models of depression exhibit structural and functional changes to the neurovascular unit. Thus, we hypothesized that diabetes-related depression might be associated with damage to the hippocampal neurovascular unit. To test this hypothesis, neurons, astrocytes and endothelial cells were isolated from the brain tissues of rat embryos and newborn rats. Hippocampal neurovascular unit co-cultures were produced using the Transwell chamber co-culture system. A model of diabetes-related depression was generated by adding 150 mM glucose and 200 μM corticosterone to the culture system and compared with the neuron + astrocyte and astrocyte + endothelial cell co-culture systems. Western blot assay was used to measure levels of structural proteins in the hippocampal neurovascular unit co-culture system. Levels of basic fibroblast growth factor, angiogenic factor 1, glial cell line–derived neurotrophic factor, transforming growth factor β1, leukemia inhibitory factor and 5-hydroxytryptamine in the hippocampal neurovascular unit co-culture system were measured by enzyme-linked immunosorbent assay. Flow cytometry and terminal deoxynucleotidyl transferase(TdT)-mediated dUTP nick end labeling staining was used to assess neuronal apoptosis in the hippocampal neurovascular unit. The neurovascular unit triple cell co-culture system had better barrier function and higher levels of structural and secretory proteins than the double cell co-culture systems. In comparison, in the model of diabetes-related depression, the neurovascular unit was damaged with decreased barrier function, poor structural integrity and impaired secretory function. Moreover, neuronal apoptosis was markedly increased, and 5-hydroxytryptamine levels were reduced. These results suggest that diabetes-related depression is associated with structural and functional damage to the neurovascular unit. Our findings provide a foundation for further studies on the pathogenesis of diabetes-related depression. | Jian Liu Yu-Hong Wang Wei Li Lin Liu Hui Yang Pan Meng Yuan-Shan Han | 2019 | Neural Regeneration Research2019，14，2： | 20 |
| 5 | Uncarboxylated osteocalcin ameliorates hepatic glucose and lipid metabolism in KKAy mice via activating insulin signaling pathway显示文摘Osteocalcin,expressed in osteoblasts of the bone marrow,undergoes post-translational carboxylation and deposits in mineralized bone matrix.A portion of osteocalcin remains uncarboxylated(uncarboxylated osteocalcin,GluOC)that is released into blood where it functions as a hormone to regulate insulin secretion and insulin sensitivity.As insulin resistance is closely associated with metabolic syndrome,this study is aimed to elucidate how GluOC regulates glucose and lipid metabolism in KKAy mice,an animal model displaying obese,hyperglycemia,hyperinsulinemia,insulin resistance,and hepatic steatosis.GluOC(3,30 ng/g per day,ig)was orally administered to female KKAy mice for 4 weeks.Whole-body insulin sensitivity,glucose metabolism,hepatic steatosis,dyslipidemia were examined using routine laboratory assays.We found that GluOC administration significantly enhanced insulin sensitivity in KKAy mice by activating hepatic IRβ/PI3K/Akt pathway and elevated the whole-body insulin sensitivity with decreased FPI and HOMA-IR index.Furthermore,GluOC administration alleviated hyperglycemia through suppressing gluconeogenesis and promoting glycogen synthesis in KKAy mice and in cultured hepatocytes in vitro.Moreover,GluOC administration dose-dependently ameliorated dyslipidemia and attenuated hepatic steatosis in KKAy mice by inhibiting hepatic de novo lipogenesis and promoting fatty-acidβ-oxidation.These results demonstrate that GluOC effectively enhances hepatic insulin sensitivity,improves hyperglycemia and ameliorates hepatic steatosis in KKAy mice,suggesting that GluOC could be a promising drug candidate for treating metabolic syndrome. | Xiao-lin Zhang Ya-nan Wang Lu-yao Ma Zhong-sheng Liu Fei Ye Jian-hong Yang | 2020 | Acta Pharmacologica Sinica2020，41，3： | 13 |
| 6 | Hyperglycemia is a significant prognostic factor of hepatocellular carcinoma after curative therapy显示文摘AIM:To evaluate whether metabolic factors are related to distant recurrence of hepatocellular carcinoma(HCC) and survival after curative treatment.METHODS:This retrospective study included 344 patients whose HCC was treated curatively by radiofrequency ablation(RFA) therapy.The mean age was 67.6 years and the mean observation period was 4.04 years.The etiological background of liver disease was hepatitis B virus infection in 30,hepatitis C virus infection in 278,excessive alcohol drinking in 9,and other in 27 patients.The Child-Pugh classification grade was A(n = 307) or B(n = 37).The number of HCC nodules was one in 260,two in 61,and three in 23 patients.For surveillance of HCC recurrence after curative therapy with RFA,patients were radiologically evaluated every 3 mo.Factors associated with distant recurrence of HCC or survival were studied.RESULTS:Inadequate maintenance of blood glucose in diabetic patients was associated with higher incidence of distant recurrence.The 1-,2-,and 3-year recurrence rates were significantly higher in diabetic patients with inadequate maintenance of blood glucose compared with the others:50.6% vs 26.8%,83.5% vs 54.4%,and 93.8% vs 73.0%,respectively(P = 0.0001).Inadequate maintenance of blood glucose was an independent predictor of distant recurrence [adjusted relative risk 1.97(95%CI,1.33-2.91),(P = 0.0007)] after adjustment for other risk factors,such as number of HCC nodules [2.03(95%CI,1.51-2.73),P < 0.0001] and initial level of serum alpha fetoprotein(AFP) [1.43(95%CI,1.04-1.97),P = 0.028].Obesity was not an independent predictor of recurrence.The incidence of distant recurrence did not differ between diabetic patients with adequate maintenance of blood glucose and non-diabetic patients.Among 232 patients who had HCC recurrence,138 had a second recurrence.The 1-,2-,and 3-year rates of second recurrence were significantly higher in diabetic patients with inadequate maintenance of blood glucose than in the others:9.0% vs 5.9%,53.1% vs 24.3%,and 69.6% vs 42.3%,respectively(P = 0.0021).Inadequate maintenance of blood glucose in diabetic patients [1.99(95%CI,1.23-3.22),P = 0.0049] and presence of multiple HCC nodules [1.53(95%CI,1.06-2.22),P = 0.024] were again significantly associated with second HCC recurrence.Inadequate maintenance of blood glucose in diabetic patients was also a significant predictor of poor survival [2.77(95%CI,1.38-5.57),P = 0.0046] independent of excessive alcohol drinking [6.34(95%CI,1.35-29.7),P = 0.019],initial level of serum AFP [3.40(95%CI,1.88-6.18),P < 0.0001] and Child-Pugh classification grade B [2.24(95%CI,1.12-4.46),P = 0.022].Comparing diabetic patients with inadequate maintenance of blood glucose vs the others,the 1-,2-,and 3-year survival rates were significantly lower in diabetic patients with inadequate maintenance of blood glucose:92% vs 99%,85% vs 96%,and 70% vs 92%,respectively(P = 0.0003).CONCLUSION:Inadequate maintenance of blood glucose in diabetic patients is a significant risk factor for recurrence of HCC and for poor survival after curative RFA therapy. | Takanori Hosokawa Masayuki Kurosaki Kaoru Tsuchiya Shuya Matsuda Masaru Muraoka Yuichiro Suzuki Nobuharu Tamaki Yutaka Yasui Toru Nakata Takashi Nishimura Shoko Suzuki Ken Ueda Hiroyuki Nakanishi Jun Itakura Yuka Takahashi Namiki Izumi | 2013 | World Journal of Gastroenterology2013，19，2： | 12 |
| 7 | Steroid hyperglycemia: Prevalence, early detection and therapeutic recommendations: A narrative review显示文摘Steroids are drugs that have been used extensively in a variety of conditions. Although widely prescribed for their anti-inflammatory and immunosuppressive properties, glucocorticoids have several side effects, being hyperglycemia one of the most common and representative. In the present review, we discuss the main epidemiologic characteristics associated with steroid use, with emphasis on the identification of high risk populations. Additionally we present the pathophysiology of corticosteroid induced hyperglycemia as well as the pharmacokinetics and pharmacodynamics associated with steroid use. We propose a treatment strategy based on previous reports and the understanding of the mechanism of action of both, the different types of glucocorticoids and the treatment options, in both the ambulatory and the hospital setting. Finally, we present some of the recent scientific advances as well as some options for future use of glucocorticoids. | Héctor Eloy Tamez-Pérez Dania Lizet Quintanilla-Flores René Rodríguez-Gutiérrez José Gerardo González-González Alejandra Lorena Tamez-Pena | 2015 | World Journal of Diabetes2015，6，8： | 12 |
| 8 | Hypoglycemic mechanism of polysaccharide from Cyclocarya paliurus leaves in type 2 diabetic rats by gut microbiota and host metabolism alteration显示文摘Diabetes mellitus is a serious threat to human health.Cyclocarya paliurus(Batal.)Iljinskaja(C.paliurus)is one of the traditional herbal medicine and food in China for treating type 2 diabetes,and the C.paliurus polysaccharides(CP)were found to be one of its major functional constituents.This research aimed at investigating the hypoglycemic mechanism for CP.It was found that CP markedly attenuated the symptoms of diabetes,and inhibited the protein expression of Bax,improved the expression of Bcl-2 in pancreas of diabetic rats,normalized hormones secretion and controlled the inflammation which contributed to the regeneration of pancreaticβ-cell and insulin resistance.CP treatment increased the beneficial bacteria genus Ruminococcaceae UCG-005 which was reported to be a key genus for protecting against diabetes,and the fecal short-chain fatty acids levels were elevated.Uric metabolites analysis showed that CP treatment helped to protect with the diabetes by seven significantly improved pathways closely with the nutrition metabolism(amino acids and purine)and energy metabolism(TCA cycle),which could help to build up the intestinal epithelial cell defense for the inflammation associated with the diabetes.Our study highlights the specific mechanism of prebiotics to attenuate diabetes through multi-path of gut microbiota and host metabolism. | Qiqiong Li Jielun Hu Qixing Nie Xiao Chang Qingying Fang Junhua Xie Haishan Li Shaoping Nie | 2021 | Science China(Life Sciences)2021，64，1： | 11 |
| 9 | Diabetes mellitus carries a risk of gastric cancer:A metaanalysis显示文摘AIM:To investigate the association and quantify the relationship between diabetes mellitus(DM) and gastric cancer(GC) by an updated meta-analysis.METHODS:The initial PubMed search identified 1233publications. Studies not reporting GC or those not reporting actual number of GC were excluded. Twelve pertinent studies were retrieved from the PubMed database or from a manual search and considered for the meta-analysis. Pooled risk ratios and 95%CI were estimated by a random-effects model. Subgroup analysis was performed according to gender or geographical regions. Heterogeneity and publication bias were evaluated by I2and funnel plot analysis,respectively.RESULTS:DM was significantly associated with GC with a RR of 1.41(P = 0.006)(95%CI:1.10-1.81).Subgroup analyses revealed that both sexes showed a significant association with GC,with a greater magnitude of risk in females(RR = 1.90; 95%CI:1.27-2.85;P = 0.002) than in males(RR = 1.24; 95%CI:1.08-1.43;P = 0.002). In addition,the link between DM and GC was significant in East Asian DM patients(RR = 1.77;95%CI:1.38-2.26; P < 0.00001) but not in Western DM patients(RR = 1.23; 95%CI:0.90-1.68; P = 0.2).There was no evidence of publication bias,but the results indicated significant heterogeneity.CONCLUSION:This updated meta-analysis has provided evidence of positive DM-GC associations. The limited information on potentially important clinical confounding factors in each study deserves further investigation. | Shouji Shimoyama | 2013 | World Journal of Gastroenterology2013，19，40： | 11 |
| 10 | Diabetes and cancer: Epidemiological and biological links显示文摘The incidence of diabetes and cancer has increased significantly in recent years.Furthermore,there are many common risk factors for both diabetes and cancer,such as obesity,sedentary lifestyle,smoking,and ageing.A large body of epidemiological evidence has indicated that diabetes is considered as an independent risk factor for increased rates of heterogeneous types of cancer occurrence and death.The incidence and mortality of various types of cancer,such as pancreas,liver,colorectal,breast,endometrial,and bladder cancers,have a modest growth in diabetics.However,diabetes may work as a protective factor for prostate cancer.Although the underlying biological mechanisms have not been totally understood,studies have validated that insulin/insulin-like growth factor(IGF)axis(including insulin resistance,hyperinsulinemia,and IGF),hyperglycemia,inflammatory cytokines,and sex hormones provide good circumstances for cancer cell proliferation and metastasis.Insulin/IGF axis activates several metabolic and mitogenic signaling pathways;hyperglycemia provides energy for cancer cell growth;inflammatory cytokines influence cancer cell apoptosis.Thus,these three factors affect all types of cancer,while sex hormones only play important roles in breast cancer,endometrial cancer,and prostate cancer.This minireview consolidates and discusses the epidemiological and biological links between diabetes and various types of cancer. | Mina Wang Yingying Yang Zehuan Liao | 2020 | World Journal of Diabetes2020，11，6： | 10 |
| 11 | New insights into insulin: The anti-inflammatory effect and its clinical relevance显示文摘Hyperglycemia, a commonly exhibited metabolic disorder in critically ill patients, activates the body's inflammatory defense mechanism, causing the waterfall release of numerous inflammatory mediators and cytokines, and eventually leads to organ damage. As the only glucose-lowering hormone in the body, insulin not only alleviates the detrimental effects of hyperglycemia through its metabolic regulation, but also directly modulates inflammatory mediators and acts upon immune cells to enhance immunocompetence. In this sense, hyperglycemia is pro-inflammatory whereas insulin is anti-inflammatory. Therefore, during the past 50 years, insulin has not only been used in the treatment of diabetes, but has also been put into practical use in dealing with cardiovascular diseases and critical illnesses. This review summarizes the recent advances regarding the anti-inflammatory effects of insulin in both basic research and clinical trials, with the hope of aiding in the design of further experimental research and promoting effective insulin administration in clinical practice. | Qiang Sun Jia Li Feng Gao | 2014 | World Journal of Diabetes2014，5，2： | 9 |
| 12 | Interstitial lung disease and diabetes显示文摘Diabetes mellitus (DM) is a chronic metabolic disease and its prevalence has beensteadily increasing all over the world. DM and its associated micro andmacrovascular complications result in significant morbidity and mortality. Themicrovascular complications are usually manifested as retinopathy, neuropathy,nephropathy and macrovascular complications generally affect the cardiovascularsystem. In addition to these complications, DM also affects the lungs because of itsrich vascularity and abundance in connective tissue (collagen and elastin). DMhas been found to cause microvascular complications and proliferation ofextracellular connective tissue in the lungs, leading to decline in lung function in arestrictive pattern. Interstitial lung disease (ILD) includes a diverse group ofdisease conditions characterized by different degrees of inflammation and fibrosisin the pulmonary parenchyma. Idiopathic pulmonary fibrosis (IPF) is one of thecommon type of idiopathic interstitial pneumonia with a high mortality rate. IPFis characterized by chronic progressive fibrosis leading to progressive respiratoryfailure. In this review we focus on lung as the target organ in DM and theassociation of DM and ILD with special emphasis on IPF. | Venkat Rajasurya Kulothungan Gunasekaran Salim Surani | 2020 | World Journal of Diabetes2020，11，8： | 9 |
| 13 | Antihyperglycemic and antioxidant effects of Solanum xanthocarpum leaves(field grown & in vitro raised) extracts on alloxan induced diabetic rats显示文摘Objective:To investigate antidiabetic efficacy of the extract of field grown and in vitro raised leaves of Solanum xanthocarpum(S.xanthocarpum) against alloxan induced diabetic rats. Methods:The antidiabetic activity of the crude methanol extracts of the field grown and in vitro raised leaves of S.xanthocarpum at different concentrations(100-200 mg/kg bw) was tested against alloxan induced diabetic rats.The antidiabetic efficacy was validated through various biochemical parameters and the antioxidant effect was also determined.The phytochemical analyses of field grown S.xanthocarpum and in vitro rasied 5.xanthocarpum leaves were done by estimating their chlorophyll,carotenoids,total sugar,protein,amino acid and minerals contents. Results:The results revealed that the methanol extracts of both the leaves(field grown and in vitro raised) of S.xanthocarpum was efficient anti hyperglycemic agents at a concentration of 200 mg/kg bw and posses potent antioxidant activity.However,the extracts of in vitro rasied S.xanthocarpum raised leaves exhibit higher efficacy than the field grown leaves in all tested concentrations.Proximal composition and mineral analysis of S.xanthocarpum revealed higher concentration of contents in in vitro rasied S.xanthocarpum than field grown S.xanthocarpum. Conclusions:From the results it can be concluded that the leaves extracts of S.xanthocarpum can be a potential candidate in treating the hyperglycemic conditions and suits to be an agent to reduce oxidative stress. | K Poongothai P Ponmurugan K Syed Zameer Ahmed B Senthil Kumar SA Sheriff | 2011 | Asian Pacific Journal of Tropical Medicine2011，4，10： | 9 |
| 14 | Statin use and risk of diabetes mellitus显示文摘The 3-hydroxy-methylglutaryl coenzyme A reductase inhibitors, statins, are widely used in the primary and secondary prevention of cardiovascular diseases to lower serum cholesterol levels. As type 2 diabetes mellitus is accompanied by dyslipidemia, statins have a major role in preventing the long term complications in diabetes and are recommended for diabetics with normal low density lipoprotein levels as well. In 2012, United States Food and Drug Administration released changes to statin safety label to include that statins have been found to increase glycosylated haemoglobin and fasting serum glucose levels. Many studies done on patients with cardiovascular risk factors have shown that statins have diabetogenic potential and the effect varies as per the dosage and type used. The various mechanisms for this effect have been proposed and one of them is downregulation of glucose transporters by the statins. The recommendations by the investigators are that though statins can have diabetogenic risk, they have more long term benefits which can outweigh the risk. In elderly patients and those with metabolic syndrome, as the risk of diabetes increase, the statins should be used cautiously. Other than a subset of population with risk for diabetes; statins still have long term survival benefits in most of the patients. | Bharti Chogtu Rahul Magazine KL Bairy | 2015 | World Journal of Diabetes2015，6，2： | 8 |
| 15 | 糖尿病,胰岛素和癌症风险显示文摘 There is a consensus that both type 1 and type 2 diabetes are associated with a spectrum of cancers but the underlying mechanisms are largely unknown.On the other hand,there are ongoing debates about the risk association of insulin use with cancer.We have briefly reviewed recent related research on exploration of risk factors for cancer and pharmacoepidemiological investigations into drug use in diabetes on the risk of cancer,as well as the current understanding of metabolic pathways implicated in intermediary metabolism and cellular growth.Based on the novel findings from the Hong Kong Diabetes Registry and consistent experimental evidence,we argue that use of insulin to control hyperglycemia is unlikely to contribute to increased cancer risk and that dysregulations in the AMPactivated protein kinase pathway due to reduced insulin action and insulin resistance,the insulin-like growth factor-1(IGF-1)-cholesterol synthesis pathway and renin-angiotensin system,presumably due to reduced insulin secretion and hyperglycemia,may play causal roles in the increased risk of cancer in diabetes.Further exploration into the possible causal relationships between abnormalities of these pathways and the risk of cancer in diabetes is warranted. | Juliana CN Chan | 2012 | World Journal of Diabetes2012，3，4： | 8 |
| 16 | The relationship between multiple clinicopathological features and nerve invasion in pancreatic cancer显示文摘BACKGROUND:Nerve invasion is a specific type of tumor expansion and characteristic manifestation of pancreatic cancer(PC),with an incidence rate ranging from 50% to 100%.It is an important prognostic factor for pancreatic cancer,and its early detection is helpful in the management of the disease.This study was undertaken to analyze retrospectively the relationship between neural invasion and multiple clinicopathological features and to provide evidences for clinicians in the management of neural invasion in patients with PC.METHODS:Formalin-fixed paraffin-embeded specimens of PC taken from 215 patients were examined for the presence of neural invasion under a light microscope.Analyzed was the relationship between neural invasion and multiple clinicopathological feature including preoperative fasting blood glucose level,amylase level,serum CA19-9 level,abdominal pain,lumbar and back pain,and the expressions of p53 and Ki67 in tumor tissues.RESULTS:Preoperative fasting blood glucose level,serum CA19-9 level and p53 positive cells in cancer tissue were increased with the rise of pathological grade(P<0.05).These indices were significantly higher in patients with neural invasion than in those without(P<0.05).Further analysis revealed a positive correlation between p53 and Ki67 overexpression and lymphatic metastasis(P<0.05).Referred pain was positively correlated with neural invasion(P<0.05).Patients with PC perineural invasion were more likely to have a higher pathological grade(P<0.05).CONCLUSIONS:Our data indicated that the preoperative fasting blood glucose level,serum CA19-9 level,and referred pain are novel predictive markers for neural invasion in patients with PC.p53 and Ki67 play important roles in neural invasion of PC.Management of hyperglycemia may serve as an auxiliary treatment to curb neural invasion in PC. | Pao-Hsun Wang Ning Song Liu-Bin Shi Qun-Hua Zhang Zong-You Chen | 2013 | Hepatobiliary & Pancreatic Diseases International2013，12，5： | 8 |
| 17 | Hyperglycemia in acute ischemic stroke: physiopathological and therapeutic complexity显示文摘Diabetes mellitus and associated chronic hyperglycemia enhance the risk of acute ischemic stroke and lead to worsened clinical outcome and increased mortality. However, post-stroke hyperglycemia is also present in a number of non-diabetic patients after acute ischemic stroke, presumably as a stress response. The aim of this review is to summarize the main effects of hyperglycemia when associated to ischemic injury in acute stroke patients, highlighting the clinical and neurological outcomes in these conditions and after the administration of the currently approved pharmacological treatment, i.e. insulin. The disappointing results of the clinical trials on insulin(including the hypoglycemic events) demand a change of strategy based on more focused therapies. Starting from the comprehensive evaluation of the physiopathological alterations occurring in the ischemic brain during hyperglycemic conditions, the effects of various classes of glucose-lowering drugs are reviewed, such as glucose-like peptide-1 receptor agonists, DPP-4 inhibitors and sodium glucose cotransporter 2 inhibitors, in the perspective of overcoming the up-to-date limitations and of evaluating the effectiveness of new potential therapeutic strategies. | Federica Ferrari Antonio Moretti Roberto Federico Villa | 2022 | Neural Regeneration Research2022，17，2： | 7 |
| 18 | Antiglycation,antioxidant and toxicological potential of polyphenol extracts of alligator pepper,ginger and nutmeg from Nigeria显示文摘Objective:To evaluate the antioxidant and antiglycation potential of polyphenols from three spices;alligator pepper,ginger and nutmeg.Methods:Polyphenol extracts of these spices were subjected to brine-shrimp lethality assay,phyloloxicily test,DPPH and superoxide anion radical scavenging as well as BSA-glucose antiglycation assay.Results:Results obtained showed that polyphenol extract of ginger has the highest anlioxidant potential with IC_(50)0.075 and 0.070 mg/mL.for DPPH and superoxide anion radical scavenging assay while alligator pepper displayed highest antiglycation activity with IC_(50)0.125 mg/mL.However,nutmeg extract exhibited weakest cytotoxic and phytotoxic potential with LD_(50)4359.70 and 1490μg/mL respectively.Conclusions:It can be concluded that the polyphenol extracts of alligator pepper,ginger and nutmeg displayed good antioxidant as well as antiglycation potential and are,safe for consumption. | Kazeem MI Akanji MA Hafizur Rahman M Choudhary MI | 2012 | Asian Pacific Journal of Tropical Biomedicine2012，2，9： | 7 |
| 19 | Utility of different glycemic control metrics for optimizing management of diabetes显示文摘The benchmark for assessing quality of long-term glycemic control and adjustment of therapy is currently glycated hemoglobin(Hb A1c). Despite its importance as an indicator for the development of diabeticcomplications, recent studies have revealed that this metric has some limitations; it conveys a rather complex message, which has to be taken into consideration for diabetes screening and treatment. On the basis of recent clinical trials, the relationship between Hb A1 c and cardiovascular outcomes in long-standing diabetes has been called into question. It becomes obvious that other surrogate and biomarkers are needed to better predict cardiovascular diabetes complications and assess efficiency of therapy. Glycated albumin, fructosamin, and 1,5-anhydroglucitol have received growing interest as alternative markers of glycemic control. In addition to measures of hyperglycemia, advanced glucose monitoring methods became available. An indispensible adjunct to Hb A1 c in routine diabetes care is selfmonitoring of blood glucose. This monitoring method is now widely used, as it provides immediate feedback to patients on short-term changes, involving fasting, preprandial, and postprandial glucose levels. Beyond the traditional metrics, glycemic variability has been identified as a predictor of hypoglycemia, and it might also be implicated in the pathogenesis of vascular diabetes complications. Assessment of glycemic variability is thus important, but exact quantification requires frequently sampled glucose measurements. In order to optimize diabetes treatment, there is a need for both key metrics of glycemic control on a day-to-day basis and for more advanced, user-friendly monitoring methods. In addition to traditional discontinuous glucose testing, continuous glucose sensing has become a useful tool to reveal insufficient glycemic management. This new technology is particularly effective in patients with complicated diabetes and provides the opportunity to characterize glucose dynamics. Several continuous glucose monitoring(CGM) systems, which have shown usefulness in clinical practice, are presently on the market. They can broadly be divided into systems providing retrospective or real-time information on glucose patterns. The widespread clinical application of CGM is still hampered by the lack of generallyaccepted measures for assessment of glucose profiles and standardized reporting of glucose data. In this article, we will discuss advantages and limitations of various metrics for glycemic control as well as possibilities for evaluation of glucose data with the special focus on glycemic variability and application of CGM to improve individual diabetes management. | Klaus-Dieter Kohnert Peter Heinke Lutz Vogt Eckhard Salzsieder | 2015 | World Journal of Diabetes2015，6，1： | 6 |
| 20 | Glycemia management in critical care patients显示文摘Over the last decade, the approach to clinical management of blood glucose concentration (BGC) in critical care patients has dramatically changed. In this editorial, the risks related to hypo, hyperglycemia and high BGC variability, optimal BGC target range and BGC monitoring devices for patients in the intensive care unit (ICU) will be discussed. Hypoglycemia has an increased risk of death, even after the occurrence of a single episode of mild hypoglycemia (BGC < 80 mg/dL), and it is also associated with an increase in the ICU length of stay, the major determinant of ICU costs. Hyperglycemia (with a threshold value of 180 mg/dL) is associated with an increased risk of death, longer length of stay and higher infective morbidity in ICU patients. In ICU patients, insulin infusion aimed at maintaining BGC within a 140-180 mg/dL target range (NICE-SUGAR protocol) is considered to be the state-of-the-art. Recent evidence suggests that a lower BGC target range (129-145 mg/dL) is safe and associated with lower mortality. In trauma patients without traumatic brain injury, tight BGC (target < 110 mg/dL) might be associated with lower mortality. Safe BGC targeting and estimation of optimal insulin dose titration should include an adequate nutrition protocol, the length of insulin infusion and the change in insulin sensitivity over time. Continuous glucose monitoring devices that provide accurate measurement can contribute to minimizing the risk of hypoglycemia and improve insulin titration. In conclusion, in ICU patients, safe and effective glycemia management is based on accurate glycemia monitoring and achievement of the optimal BGC target range by using insulin titration, along with an adequate nutritional protocol. | Federico Bilotta Giovanni Rosa | 2012 | World Journal of Diabetes2012，3，7： | 5 |
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