Novel appearance of hyperglycemia/diabetes,associated with COVID-19

In a recent meta-analysis the prevalence of coronavirus disease 2019 (COVID-19)-associated hyperglycemia was 25%, and that of COVID-19-associated new-onset diabetes was 19%. An association between hyperglycemia or new-onset diabetes and COVID-19 has been suggested. In a recent relevant study of critically and non-critically ill patients with COVID-19, we found that indeed beta-cell function was compromised in critically ill patients with COVID-19 and that these patients showed a high glycemic gap. Nevertheless, one quarter of critically ill patients with no history of diabetes have stress hyperglycemia, a finding which could obscure the prevalence of hyperglycemia or new-onset diabetes that could be attributed to COVID-19 per se.     

Chronopharmacology of dapagliflozin-induced antihyperglycemic effects in C57BL/6J mice

Chronopharmacology is the study of the varying responses of drugs to changes in biological timing and endogenous periodicities. The selective sodium-glucose cotransporter 2 inhibitor, dapagliflozin, is a globally prescribed antihyperglycemic drug. Although dapagliflozin is usually administered once a day, the specific intake time is generally not mentioned. Therefore, this study aimed at investigating the diurnal effects of dapagliflozin on high-fat diet (HFD)-induced obesity in mice. Five-week-old male C57BL/6J mice were fed a normal (control) diet or HFD for 10 weeks. During the last 2 weeks, the mice were administered olive oil/ethanol emulsion or dapagliflozin (1 mg/kg, p.o.) in the light or dark phase. At the end of the experiment, the mice were euthanized after an 18 h fasting period, and plasma and tissue samples (epididymal white adipose tissues, liver, and kidney) were collected. Dapagliflozin administration in the light phase significantly decreased plasma glucose levels, insulin levels, adipose adipokines, and decreased the size of adipocytes, compared with the HFD group. In contrast, these parameters remained unchanged in the mice treated during the dark phase. Our data therefore suggests that dapagliflozin portrays definite chronopharmacology, which may provide valuable information on the importance of drug administration timing for maximal pharmacological effects.     

Hyperglycemia in COVID-19 infection without diabetes mellitus: Association with inflammatory markers

BACKGROUND New onset hyperglycemia is common in patients with severe coronavirus disease 2019(COVID-19) infection. Cytokine storm due to COVID-19 infection is an essential etiology for new-onset hyperglycemia, but factors like direct severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)-induced pancreatic β-cell failure have also been postulated to play a role.AIM We plan to investigate further the mechanisms underlying SARS-CoV-2 infectioninduced hyperglycemia, particularly the rationale ...     

糖尿病大鼠冠状动脉内皮细胞凋亡的研究

目的　探讨糖尿病大鼠冠状动脉内皮细胞(下称内皮细胞)凋亡的机制,以及凋亡与Fas基因、bcl-2基因表达之间的关系。　方法　实验大鼠分为未治疗组、胰岛素治疗组和正常对照组,每组8只,分别于第0周和第16周时处死检测一般指标,并观察内皮细胞的凋亡百分数(TUNEL法)、bcl-2基因、Fas基因的表达(免疫组化法)、内皮细胞超微结构的改变(电镜)。　结果　(1)16 周时,未治疗组比治疗组、正常对照组大鼠体重减轻,差异有统计学意义(P<0.05);血糖及糖化血红蛋白(HbA1c)显著高于后两组(P<0.05),内皮细胞凋亡数目明显增加,差异有统计学意义(P<0.05)。未治疗组Fas基因表达增加,而 bcl-2 基因表达降低,差异有统计学意义(P<0.01)。未治疗组可观察到较明显的内皮细胞凋亡的形态学改变。　结论　高血糖是实验大鼠内皮细胞凋亡强烈相关因素,凋亡的发生与Fas基因表达上调、bcl-2基因表达降低相关。     

A study on the glycemic,lipid and blood pressure control among the type 2 diabetes patients of north Kerala,India

AimThe aim of the study was to detect the level of comprehensive diabetes control among the diabetic patients of Kerala, India.MethodsPatients (1200) were randomly selected from a diabetes care center. Their blood sugar, biochemical and anthropometric measurements were done and statistically analyzed.ResultsOnly 28.3% had their HbA1c at or below 7% and 45% above 9%. One-third of the female and one-fifth of the male patients had coronary artery disease. The prevalence of hypertension was almost equal in both sexes. However, there was a statistically significant higher systolic blood pressure (mean 162.12 mmHg vs 147.49 mmHg, p = 0.01044) among females. The total cholesterol was above 200 mg/dl in 42.1% of males and 45.61% of females. The triglyceride was >150 mg/dl in 38.6% males and 50.88% females. Low high density lipoprotein (HDL) cholesterol levels were found in 20.07% of males and 41.12% of females (p = 0.0445). The mean low density lipoprotein (LDL) was 121.75 (± 32.29)ConclusionThe mean blood sugar values are found to be high, which will lead to a predictable increase in vascular disease, which in turn will affect the quality of health and productivity of the individual and the economic growth of the society as a whole. Studies suggest that therapeutic interventions to improve glycemic control may reduce the risk of cardiovascular disease and microvascular disease.This study shows that the level of diabetes control in Kerala is unsatisfactory. We need more medications, better strategies and more emphasis on glycemic management than we are currently able to apply.     

Prevention of diabetes-induced albuminuria in transgenic rats overexpressing human aldose reductase

Studies using pharmacologic inhibitors have implicated the enzyme aldose reductase in the pathogenesis of albuminuria and diabetic renal disease. However, a clear conclusion is not easily drawn from such studies since these pharmacologic inhibitors have nonspecific properties. To examine further the role of aldose reductase, we have overexpressed the human enzyme in a transgenic rat model. Transgene expression in the kidney was predominantly localized to the outer stripe of the outer medulla, compatible with the histotopography of the straight (S3) proximal tubule. The effect of enzyme overexpression on diabetes-induced renal function and structure was then investigated. Contrary to what may have been anticipated from the previous enzyme inhibition studies, diabetes-induced albuminuria was completely prevented by the overexpression of aldose reductase. No effect of overexpression of aldose reductase on renal structure nor on urinary excretion of β₂-microglobulin and N-acetyl-β-d-glucosaminidase was observed in this transgenic rat model. In conclusion, our study strongly suggests that multiple roles for aldose reductase may give it a more complex place in diabetic nephropathy than is currently recognized.