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Our purpose was to investigate the effects of electroacupuncture (EA) therapy on body weight and on levels of serum insulin, c-peptide and glucose in obese women. 52 healthy women were included in this study and were allocated into three groups: 1) Placebo EA group (n = 15; mean age = 41.8 ± 4.6 and mean body mass index {BMI} = 33.2 ± 3.5); 2) EA group (n = 20; mean age = 42.1 ± 4.4 and BMI = 35.9 ± 3.6) and 3) Diet restriction group (n = 20; mean age = 42.9 ± 4.3 and BMI = 34.7 ± 2.7). EA was applied to the ear points Hunger and Shen Men on alternating days and to the body points LI 4, LI 11, St 36 and St 44 once a day for 30 minutes over 20 days. Diet restriction that entailed a 1450 kilocalorie (kcal) diet program was applied to the three groups for 20 days. An increase in weight loss was observed when weight loss in the EA group (p < 0.000) was compared to that in the diet restricted and placebo EA groups using the Tukey HSD test. There were increases in the serum insulin (p < 0.001) and c-peptide levels (p < 0.000) in the women treated with EA compared to those in the women treated with the placebo EA and diet restriction groups. A decrease was observed in the glucose levels (p < 0.01)in both the EA and diet restriction groups compared to those in the placebo EA group. Our results suggest that EA therapy is an effective method in treating obesity. EA therapy also helps serum glucose levels to decrease through the increase of serum insulin and c-peptide levels.

Diabetes mellitus is a heterogeneous clinical syndrome characterized by hyperglycemia and long-term specific complications: retinopathy, neuropathy, nephropathy, and cardiomyopathy. Automatic neuropathy leads to visceral denervation producing a variety of clinical abnormalities: cardiac and respiratory dysrythaemias, gastrointestinal motility disorders, urinary bladder dysfunction and impotence. Diabetes mellitus is a leading cause of blindness; renal failure and limb amputation all over the world. The need to detect diabetic risk factors and treat organ disorders and complications associated with diabetes provides the impetus for us to develop the technology for assessment of diabetes, its etiology and severity, as well as for assessing the efficacy of pharmacological therapy.

This paper concerns:

(i) modelling of blood-glucose regulation and tolerance-testing,

(ii) demonstrating patient-simulation of the blood-glucose regulatory models, by means of which the model parameters can be evaluated and related to physiological parameters, and

(iii) elucidating how the glucose-regulatory system model's pole-zero representation and the blood glucose-insulin transfer-function can explain the blood glucose response data in intravenous and oral glucose tolerance tests.

An easy-to-implement simple clinical-application method is developed to simulate the response of the blood-glucose regulatory model in diabetic patients during intravenous glucose tolerance test and to estimate the model parameters, which can then enable differential diagnosis of diabetes and its severity as well as in early detection of risk-to-diabetes.

In the oral glucose-tolerance test, the role of the gut is to facilitate transport of glucose across the intestinal wall. The Michaelis-Menten equation, describing this enzyme-catalyzed reaction rate, can be employed to conclude that the intestinal glucose absorption rate into the blood-compartment from the gut during the oral glucose-tolerance test is constant, almost resembling a rectangular pulse Nevertheless, we have formulated a new rate-control model to simulate the oral glucose-tolerance test data, by means of the response-function of a second-order system of a single-compartment (consisting of the gut and the blood-glucose pool), with the oral glucose-bolus as the impulse-input.

We have also demonstrated application of this rate-control model to patients undergoing oral glucose-tolerance test, to evaluate the model parameters. By categorizing the ranges of these parameters for normals and diabetics (varying from mild to severe), we can reliably apply this model and procedure clinically.

Soluble microneedles (MNs) have recently become an efficient and minimally invasive tool in transdermal drug delivery because of their excellent biocompatibility and rapid dissolution. However, direct monitoring of structural and functional changes of MNs in vivo to estimate the efficiency of insulin delivery is difficult. We monitored the dissolution of MNs to obtain structural imaging of MNs’ changes by using optical coherence tomography (OCT). We also observed the effect of MNs on microvascular conditions with laser speckle contrast imaging (LSCI) and measured the blood perfusion of skin to obtain functional imaging of MNs. We determined the performance of two soluble MN arrays made from polyvinyl alcohol (PVA) and polyvinyl alcohol/polyvinylpyrolidone (PVA/PVP) by calculating the cross-sectional areas of the microchannels in mouse skin as a function of time. Moreover, the change in blood glucose before and after using MNs loaded with insulin was evaluated as an auxiliary means to demonstrate the ability of the soluble MNs to deliver insulin. Results showed that the structural imaging of these MNs could be observed in vivo via OCT in real time and the functional imaging of MNs could be showed using LSCI. OCT and LSCI are potential tools in monitoring MNs structural and functional changes.

In 2021, the United Nations Committee on Development Policy adopted a resolution that Bangladesh would graduate from least developed country (LDC) status after a period of 5 years. This means that in 2026 Bangladesh would have to forego its exemption to intellectual property (IP) provisions of the World Trade Organization (WTO). Bangladesh has taken advantage of the policy space it was granted under the LDC exemption to build a generic medicines industry that not only serves Bangladesh but also other LDCs. We examine how IP provisions in the WTO will impact the price of insulin in Bangladesh and the subsequent impacts on welfare and poverty. We find that LDC graduation will trigger a significant jump in insulin prices that could cause about a 15% decline in the welfare of households in Bangladesh with one or more members living with diabetes, increasing the poverty rate of such households unless policy adjustments are carried out.

Mathematical modeling is very helpful for noninvasive investigation of glucose-insulin interaction. In this paper, a new time-delay mathematical model is proposed for glucose-insulin endocrine metabolic regulatory feedback system incorporating the $\beta$-cell dynamic and function for regulating and maintaining bloodstream insulin level. The model includes the insulin degradation due to glucose interaction. The dynamical behavior of the model is analyzed and two-dimensional bifurcation diagrams with respect to two essential parameters of the model are obtained. The results show that the time-delay in insulin secretion in response to blood glucose level, and the delay in glucose drop due to increased insulin concentration, can give rise to complex dynamics, such as periodic oscillation. These dynamics are consistent with the biological findings and period doubling cascade and chaotic state which represent metabolic disorder that may lead to diabetes mellitus.

Alcoholic fatty liver (AFL) is a reversible condition, but it can potentiate the development of alcoholic hepatitis and even cirrhosis by increasing oxidant generation, which is one of the key pathogenic factors and could result in alcoholic liver disease (ALD). Total flavonoids from Litsea coreana (TFLC), an active component extracted from Litsea coreana leve, have been shown to have therapeutic effects on hyperlipidemia. The present study was to evaluate the protective effects of TFLC on alcoholic fatty liver (AFL) in rats, and investigate the potential mechanism. An AFL model in rats was established by intaking different doses of alcohol (concentration from 5% to 40%) over 12 weeks. Serum levels of TG, TC, LDL-C, HDL-C, TNF-α, insulin, and glucose were measured, histopathologic changes were determined, and expression of adipose differentiation-related protein (ADRP) in the liver were evaluated by Western blotting and immunohistochemistry, respectively. The results showed that treatment with TFLC resulted in decreased serum levels of TG, TC, LDL-C, TNF-α, glucose and insulin, as well as improved liver index. Morphological evaluation revealed rats in model group developed a severe steatosis, but the severities of liver steatosis were effectively ameliorated in TFLC (200 and 400 mg/kg) treated groups. Expression of hepatic ADRP were increased in model group, and suppressed in TFLC treated groups. These results suggest that TFLC had a protective effect on AFL rats; the mechanism may be involved in regulation serum lipid profiles via down-regulation of hepatic expression of ADRP in AFL rats.

Understanding Diabetes

Prediabetes: The Gap between the Onset of Disease and Initiation of Treatment.

Diabetes: A Dietitian’s Perspective.

Use of Modelling for Better Diabetes Care.

No More Highs and Lows with Toujeo®: A New and Improved Insulin Injection.

Insulin resistance as well as insulin deficiency are said to be principal to the development of type 2 diabetes mellitus (T2Dm). Heme has also been suggested to play an important role in the disease etiology since many of the heme deficiency symptoms constitute the common pathological features of T2Dm. Besides, iron overload, higher heme iron intake and transfusion requiring diseases are associated with a higher risk of T2Dm development. In this study the interaction between these two key components i.e. heme and insulin has been studied spectroscopically under different conditions which include the effect of excess peptide as well as increasing pH. The resultant heme-insulin complexes in their reduced state are found to produce very little partially reduced oxygen species (PROS) on getting oxidized by molecular oxygen. The interaction between insulin and previously reported T2Dm relevant heme-amylin complex were also examined using absorption and resonance Raman spectroscopy. The corresponding data suggest that insulin sequesters heme from heme-amylin to form the much less cytotoxic heme-insulin.

In this study, the ability of salvianolic acids A, B, C, F, G and calix[$n$]arenes ($n=4$, 5, 6 and 8) with different upper rims in the inhibition of insulin amyloid fibril formation was studied using molecular docking. The results were analyzed from a molecular point of view. All of the considering ligands interacted with significant residues of insulin, which had a crucial role in the process of insulin fibrillation. The interactions among the ligands and insulin residues could be done through hydrogen bonding and hydrophobic interactions with good binding affinity. So, these ligands could prevent the formation of the insulin fibril. The good consistency of the docking results of $P$-sulfonatocalix[4]arene and $P$-sulfonatocalix[6]arene with the experimental results in the previous literature represented the capacity of the current theoretical method to supplement and interpret experimental findings. Also, in this study, salvianolic acids A, C, F and G were suggested as new inhibitors of the insulin amyloid fibril.