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 Table of Contents  
Year : 2023  |  Volume : 2  |  Issue : 3  |  Page : 1-8

Basic Sciences

Date of Web Publication10-Mar-2023

Correspondence Address:
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2773-1316.371186

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How to cite this article:
. Basic Sciences. Chron Diabetes Res Pract 2023;2, Suppl S1:1-8

How to cite this URL:
. Basic Sciences. Chron Diabetes Res Pract [serial online] 2023 [cited 2023 Mar 30];2, Suppl S1:1-8. Available from: https://cdrpj.org//text.asp?2023/2/3/1/371186

  1. Electrical Vestibular Nerve Stimulation as an Adjunctive Therapy in the Management of Type 2 Diabetes Top

Sai Sailesh Kumar Goothy*, Jason McKeown, Paul D. Mcgeoch, B. Srilatha, Rajagopalan Vijayaraghavan, Ravikanth Manyam, Mahadik Vijay Khanderao

*R.D.Gardi Medical College, Ujjain, Madhya Pradesh, India

E-mail: dr. [email protected]

Introduction: Vestibular nerve stimulation using the portable battery-operated vestibular nerve stimulator is a sophisticated method noninvasive, safe, and easy to operate. It was hypothesized that vestibular nerve stimulation is effective in the management of type 2 diabetes. Hence, the present study was undertaken to determine the effectiveness of vestibular nerve stimulation using a portable battery-operated vestibular nerve stimulator in the management of diabetes.

Methods: The present study was a double-blind randomized controlled trial with 1:1 split between the control and experimental groups. A total of 30 participants with type 2 diabetes were part of the study after obtaining the written informed consent. After recording the baseline values, the vestibular nerve stimulation was administered to the participants in the intervention group for 90 days. Sham stimulation was administered to the control group for 90 days. Outcome measures were recorded after 30 days and after 90 days of the intervention in both the groups.

Results: There was a significant decrease in the total body weight, fasting, postprandial blood glucose, glycosylated hemoglobin levels, leptin, and very low-density lipoproteins levels followed by the intervention. There was a significant improvement in both spatial and verbal memory scores. Depression and stress scores and systolic blood pressure decreased and remained in nosrmal limits.

Conclusion: The study results have proven the multimodal action of vestibular stimulation. It not only acts on the regulation of the glucose metabolism but also can regulate the autonomic activity and improve cognition and relieve stress. This is an interesting finding of our study, which needs detailed further research to support the implementation of vestibular nerve stimulation as an adjunctive therapy in the management of diabetes.

  2. Urinary α-1 Microglobulin as a Marker of Nephropathy in Type-2 Diabetes Mellitus Top

Shashikala M D*, Shreya Thadigotla

*Ramaiah Medical College, Bengaluru, Karnataka, India

E-mail: [email protected]

Introduction: Diabetic nephropathy is a consequence of long-standing diabetes mellitus. It is associated with an increased risk of mortality, cardiovascular diseases, and progression to end-stage renal disease, requiring costly renal replacement therapy in the form of dialysis or transplantation. Early detection is critical to delay renal impairment and for better management. Urinary biomarkers like α-1 microglobulin can be used as an inexpensive and non-invasive diagnostic tool.

The objective is to estimate urinary α-1 microglobulin levels and albumin-creatinine (AC) ratio in type-2 diabetes mellitus and study the relationship between AC ratio and estimated glomerular filtration rate (eGFR).

Methods: A cross-sectional study was conducted after EC approval.T2DM subjects aged 18–65 years were enrolled in two groups (36 - <5 years and 36 - >5 years duration of diabetes).

Results: In the present study, the urinary α1-microglobulin-creatinine ratio was increased (n ≤ 1.5 g/mol) in both the groups, where in groups 1 and 2 the mean values were 2.42 ± 2.41 and 4.63 ± 4.4 respectively. Subjects with a longer history of diabetes were found to have greater levels of urine - 1 microglobulin. Urinary creatinine and eGFR were decreased in group 2. In the comparison of urinary α1-microglobulin with eGFR and urinary creatinine, we observed that there is a decline in urinary creatinine and eGFR with the increase in α1-microglobulin-creatinine ratio and is statistically significant.

Conclusion: Our study demonstrates an increase in Urinary α1-microglobulin and it is preceding albuminuria, hence is useful for the early detection of renal disease in type 2 diabetes. eGFR determines kidney function and helps to stage kidney disease. The annual decline of eGFR indicates chronic kidney disease, and the most important risk factor is proteinuria, here in our study increase in Urinary α1-microglobulin was observed with a fall in eGFR and urinary creatinine even in normoalbuminuria subjects indicating a Urinary α1-microglobulin can be used as an early marker of diabetic nephropathy.

  3. Hydrogel-based dressing in diabetic foot ulcer treatment Top

Arunim*, Surabhi Bajpai

*Banasthali Vidyapith, Tonk District, Rajasthan, India

E-mail: [email protected]

Diabetic foot ulcer (DFUs) is an open sore or wound that typically develops on the bottom of the foot and affects 15% of people with diabetes. The main vehicle for the development of ulcers in the diabetic population is poor circulation and peripheral neuropathy. This chronic injury frequently leads to nontraumatic lower leg amputations due to a lack of wound healing. Wound healing is a process that heals or repairs the affected sites by secreting multiple growth factors and cytokines at the wound site to heal the chronic wound, any changes that interfere with the healing processes can aggravate tissue damage and extend the repair time. Dressings become an essential component for ulcer treatment, it provides very good antibacterial coverage and help in managing wound infection. It comes in various forms including hydrogel dressing. Hydrogels are a three-dimensional network which can be fabricated from natural polymers and synthetic polymers. They have become increasingly attractive in biomedical science research, drug delivery, and tissue engineering due to their tunability, versality, and biocompatibility applications. This review provides a broad overview of recent development and innovation in hydrogel-based dressings which is more effective than the contact wound dressing in DFU.

  4. Development, Design, and Utility of M-Health Enabled Nutrition Informatics Intervention for Self-care Management of Type 2 Diabetes in Home Settings Top

Abhijeet Prasad Sinha*, Manmohan Singhal, Mansi Gupta, Ashish Joshi

*DIT University, Delhi, India

E-mail: [email protected]

Diabetes represents an important public health challenge in India and Globally. It affects quality of life and is one of the leading causes of death and disability. The burden on global health is huge and about 463 million adults are currently living with diabetes. If call to action is not taken timely for this pandemic 578 million people will have diabetes by 2030. With this overwhelming trend 700 million will be affected by 2045 (IDF, 2019). In India, context and as per IDF  Atlas More Details 2019, 1 in 6 diabetes comes from India and 1.2 million deaths are attributable to Diabetes 77 million people in India in the age group of 20–79 years affected by this pandemic and total cost to health expenditure is 8 billion US dollars, therefore huge burden, and great economic cost on public health (IDF, 2019). It is exceedingly difficult to manage type 2 diabetes mellitus and it is known to be one of the most difficult chronic ailments to manage. The complications of diabetes and the amalgamation of complex self-management treatments into daily life leads to prominent levels of distress, frustration, and discouragement which impacts on person well-being (Huygens, 2016). Nonetheless, the management of diabetes is mostly done by patients and families and self-management regime has turned out to be the backbone of diabetes care. The self-management regime is the method aimed at improving behaviors for actively engaging in self-care activities to achieve goals. Self-management comprises of planning for meal nutrition planning, physical activity planning, monitoring of blood glucose, diabetes medications, and of dealing with high and low sugar level with episodes of illness. The various health care specialists such as doctors, nurses, dietitians, and pharmacist developed self-management action plans in consultant with individuals.

  5. Wound Healing Efficacy of Azadirachta indica and Pongamia pinnata in Diabetic Albino Mice Top

Meeta Burande*, Amit Burande, Vasudha Nikam, R. S. Patil, M. Abdel

*Dr. D.Y Patil Medical College and Surya Hospital, Kolhapur, Maharashtra, India

E-mail: [email protected]

Introduction: This study is to evaluate the wound healing efficacy of Azadirachta indica (Neem) and Pongamia pinnata (Karanj) oils in diabetic mice.

Methods: Conducted in DYPMCK after EC approval. Diabetic Adult Male albino mice (n = 7) were anaesthetized, depilated and full thickness excision wounds were created. Total wounds were divided in 3 groups. Group 1 – A. indica oil, Group 2 - Pongamia pinnata oil, Group 3 - Normal Saline (Applied topically once a day). Wound area was measured on day 0, 1, 4, 6, and 9 and Wound healing percentage is calculated considering 0 day area as 100%.


Day 1 - 32.39% ± 11.81% in Group 1, 34.22% ± 8.45% in Group 2, and 15.23% ± 6.29% in group 3 (Not significant).

Day 4 - 53.66% ± 14.98% in Group 1, 56.97% ± 10.04% in Group 2, and 25.99% ± 7.54% in Group 3.

Day 6 - 71.81% + 9.46% in Group 1, 67.17% ± 87.13% in Group 2, and 46.25% ± 7.36% in Group 3.

On Day 4 and 6, No significant difference between Groups 1 and 2, but healing was significant as compare to Group 3 (P < 0.01).

Day 9 - 95.41% ± 2.79% in Group 1, 87.36% ± 7.79% in Group 2, and 87.17% ± 6.49% in Group 3.

Significant difference in wound healing between Group 1 and 2 (P <0.05) and 1 and 3 (P < 0.01) while no significant difference was seen Group 2 and 3 (P >0.1).

Day 9, 90% of the wound closure was achieved in 100% of wound in Group 1, 50% of wounds in Group 2, and 40%of wounds in Group 3.

Conclusion: Wound healing effect of A. indica and Pongamia pinnata is equally efficacious and highly significant as compared to placebo till 6th day of wound healing but on day 9 wound healing effect of A. indica (neem) is persistent with significant difference in rate of wound closure as compare to Pongamia pinnata and placebo.

  6. Obesity-induced Pathophysiological Adipose Tissue Microenvironment Promotes miR-210-Mediated AT Inflammation and Insulin Resistance Top

Debarun Patra, Satpal Singh, Suman Dasgupta,

Kulbhusan Tikoo, Durba Pal*

*Indian Institute of Technology, Ropar, Punjab, India

E-mail: [email protected]

Diabetes is primarily a lifestyle-related disease that has increased alarmingly across all age groups in India, and the prevalence among the younger population has also risen above 10%. Increasing accumulation of body fat or obesity is considered the highest risk factor for developing several metabolic diseases, including Type 2 diabetes. Obesity-associated hypertrophic expansion of adipocytes and poor vascularization create a pathophysiological adipose tissue microenvironment exhibiting higher lipid content and less oxygen availability. Both increased level of free fatty acids and low oxygen tension (hypoxia) in the adipose tissue leads to the higher expression of miR-210-3p in the human adipose tissue macrophages (ATMs) of obese diabetic patient that promotes macrophage inflammation and its polarization toward the pro-inflammatory state. Mechanistically, miR-210-3p targets binding to 3'UTR of SOCS1 and prevents SOCS1-mediated proteasomal degradation of the NF-kBp65 subunit. As a result, increased miR-210-3p expression in ATMs promotes NF-kB activation-dependent pro-inflammatory cytokines expressions along with the downregulation of anti-inflammatory cytokines expression. Interestingly, we found that high miR-210-3p expression is exported from the ATMs through exosome vesicles and showed paracrine communications with neighboring adipocytes at the pathophysiological AT microenvironment. miR-210-3p affects the function of the adipocytes by directly targeting 3'UTR of insulin signaling molecules and preventing glucose uptake. The administration of anti-miR-210-3p LNA in visceral adipose tissue of obese diabetic mice, markedly rescued from obesity-induced adipose tissue inflammation and insulin resistance. These results demonstrate that macrophage-derived miR-210-3p is involved in adipocyte-macrophage crosstalk and influences insulin insensitivity at pathophysiological conditions. Thus, miR-210 can be a potential target for managing obesity-induced adipose tissue inflammation and insulin resistance.

  7. Hydrogel Lens as Tropical Implant to Treat Diabetic Retinopathy Top

Mayank Goswami, Sangita Mahapatra*,

Rajkumar Sadasivama, Gopinath Packirisamy

*Indian Institute of Technology, Roorkee,

Uttarakhand, India

E-mail: [email protected]

Diabetic retinopathy (DR) is one of the leading causes of vision loss globally that affects the sight of the patient on a microvascular level. More than 9.3% of the global adult population (20–74 years of age) is suffering today from diabetes mellitus with one-third having signs of DR and further one-third suffering from vision-threatening DR. DR affects the sight of a normal person through damaging and disrupting the retinal layers. The appropriate treatment for DR is limited due to various blood-retinal junction barriers present in the eye. Thus, soft hydrogel prepared from PHEMA loaded with Avastin drug can be used as tropical implanting to treat DR. The lens is produced with the aid of a novel, low costing 3D-printed platform, i.e., easy to design. The resultant lens is as effective as the commercial contact lens with a provision of great comfort and has the additional property of being a drug delivery vehicle. The cumulative drug released in percentage is found to be 60% in a time range between 0 and 1500 min. The drug release kinetics follows the Korsmeyer-Pappas release model with 40%–60% anti-vascular endothelial growth factor effects. The amount of light transmitted by the hydrogels is investigated using an ultraviolet-visible spectrophotometer that shows 85%–89.9% total transmissivity in the spectral region (400–1000 nm). The animal testing is due in future.

  8. Observational Study of Childhood Obesity and Lifestyle Among Age Group of 2–18 Years in Pune Top

Gayatri Kulkarni

Kothari Endoscopy Centre, Pune, Maharashtra, India

E-mail: [email protected]

Introduction: This study aims to study childhood obesity in the age group of 2–18 years.

Methods: We studied 92 children (aged 2–18 years in which male children were 49; by studying their anthropometric measurements at the beginning and during follow up visits.) Male children were classified in overweight and obese. Total 7 male children came above (overweight) category and 42 male children came above (obese) category. Female children was 43; in which 9 female children came above (overweight) category and 34 female children came above (obese) category.

Results: Gender – Male and Female

  • Body mass index (BMI) (below 23) - 4 1
  • BMI (above 23 adult equ.) - 9 6
  • BMI (above 28 adult equ.) - 29 34
  • Not following - 8 1.

Daily carbohydrate intake was monitored at the first time of consultation, and the average intake was 200–250 g/day which reduced to 130–140 g for next 3 months. Calorie intake was 1800–2000 kcal (no restriction for next 3 months) and protein intake was 20 g/day which was increased up to 40–45 g for 3 months. Advised physical activity. Advised to avoid Junk food intake in meals as well as during snacks time. Reduced Sugar intake in the form of biscuits, Bournvita and table sugar.

On nutritional intervention, 4 male children came down to normal BMI from 23 adult equivalent (overweight) category. 9 male children came down to 23 adult equivalent (overweight category) from 28 adult equivalent (obese) category. Two female children came down to 23 adult equivalent (overweight category) from obese category. A total of 9 children were not following the diet properly.

Conclusion: In the above short study, it is proved how nutrition and physical activity improve BMI factor and long study is required.

  9. Elevated Level of Glycated KQTALVELVK Peptide of Albumin is Associated With the Risk of Diabetic Nephropathy Top

Arvindkumar H. Chaurasiya*, Meera R. Jaiswal, B. Santhakumari, Shweta Kahar, Shalbha Tiwari, A. G. Unnikrishnan, Mahesh J. Kulkarni

*CSIR-National Chemical Laboratory, Pune, Maharashtra, India

E-mail: [email protected]

Introduction: Diabetic nephropathy is a leading cause of end-stage renal disease. Hence, early detection of diabetic nephropathy is essential to mitigate the disease burden. Microalbuminuria, the currently used diagnostic marker of diabetic nephropathy, is not efficient in detecting it at an early stage. Therefore, there is a need of marker for predicting the risk of diabetic nephropathy.

Methods: We explored the utility of glycated human serum albumin (HSA) peptides for risk prediction of diabetic nephropathy. Three glycation-sensitive HSA peptides, namely, FKDLGEENFK, KQTALVELVK, and KVPQVSTPTLVEVSR, with deoxy fructosyl lysine (DFL) modification were quantified by targeted mass spectrometry (high-resolution multiple reaction monitoring approach) in a study population comprising of 25 subjects each from healthy, type II diabetes without nephropathy and type II diabetes with nephropathy group. ROC curve analysis was used to compare the diabetic nephropathy risk prediction by glycated HSA peptides. Correlation analysis of glycated HSA peptides with clinical parameters was performed.

Results: Mass spectrometry, receiver operating characteristic curve, and correlation analysis revealed that the DFL-modified KQTALVELVK peptide was better than other glycated HSA peptides and glycated hemoglobin for identifying diabetic nephropathy.

Conclusion: DFL-modified KQTALVELVK peptide could be a potential marker for risk prediction of diabetic nephropathy.

  10. Sequential Window Acquisition of all Theoretical Mass Spectra Reveals that Bisphenol A and Its Analogs Regulate Pathways Leading to Insulin Resistance and Obesity Top

Shabda Kulsange*, Monika Sharma, Mahesh Kulkarni,

B. Santhakumari

*CSIR- National Chemical Laboratory, Pune, Maharashtra, India

E-mail: [email protected]

Objectives: To study the role of Bisphenol's (BPA, BPF and BPS) in developing Insulin resistance and obesity.

Methods: 3T3-L1 cells were treated with 200 nM BPA, BPF, and BPS (n = 12, n = 3, respectively), followed by protein extraction in Rapigest, sample acquisition on ABSciex Triple TOF mass spectrometer, for Sequential Window Acquisition of all Theoretical SWATH acquisition. For proteins that are differently regulated, DAVID analysis and statistical analysis (Student t test) were conducted.

CHO-HIRc-mycGLUT4eGFP cells were treated with 2 and 200 nM BPA, BPF, and BPS respectively. Insulin signaling assay like Glucose uptake, GLUT4 translocation and western blot for IR, AKT-2 and PPAR-Gamma were carried out.

Results: Western blot of major Insulin signaling molecules such as insulin receptor, AKT-2, and PPAR-γ demonstrated that treatment of BPA analogs led to disruption in insulin signaling as reflected by impaired GLUT4 translocation and reduced glucose uptake supporting the hypothesis that the BPA analogs also contribute to the development of insulin resistance. Furthermore, 3T3-L1 cell proteomics demonstrated that bisphenols treated cells differently regulate proteins involved in adipogenesis, lipid metabolism, fatty acid oxidation, oxidative stress, and redox pathway.

Conclusion: This research sheds light on how bisphenols contribute to the emergence of insulin resistance, obesity, and oxidative stress.

  11. Yoga Therapy Attenuates the Progression of Diabetes: A Proteomics and Metabolomics Analysis Top

Babasaheb Sonwane*, Smita Godbole, B. Santhakumari, Jyotsna Chitalkar, Pooja Raut, Mahesh Kulkarni

*CSIR- National Chemical Laboratory, Pune, Maharashtra, India

E-mail: [email protected]

Introduction: Despite improvements in therapeutics, diabetes management remains challenging and many diabetic subjects develop a variety of complications. Various studies have shown that physical exercise has helped in better management of diabetes. Therefore, we have studied the effect of yoga therapy on the diabetes progression by using proteomics and metabolomics approaches.

Methods: A yoga intervention longitudinal study was conducted for three months involving healthy, prediabetic, and diabetic subjects. Blood glucose, glycated hemoglobin (HbA1c), and lipids profile was measured before and after the yoga intervention. To understand the molecular mechanism in the attenuation of diabetes progression, proteomic and metabolomic analysis was performed.

Results: Healthy subjects did not show a significant difference in blood glucose, lipid profile, HbA1c, and glycated albumin. However, prediabetic and diabetic subjects showed a significant decrease in these parameters.

Conclusion: Proteomics and metabolomics analysis provided the molecular bases of the effect of yoga on the attenuation of diabetic progression in prediabetes and diabetic subjects.

  12. Self-RNA Mediated Activation of RIG-1 Like Receptors: Role in Pathogenesis of Type 1 Diabetes Top

Deep Maheshwari*, Naresh Sachdeva, Sanjay K. Bhadada, Devi Dayal

*Post Graduate Institute of Medical Education and Research, Chandigarh, India

E-mail: [email protected]

Introduction: Self-RNA has been reported to activate RIG-1-like receptors (RLRs). In recent-onset type 1 diabetes (T1D), aberrant RLR expression may result in the elevated secretion of type-1 interferons and disease progression. In this study, we investigated the role of self RNA mediated activation of RLRs in pathogenesis of T1D.

Methods: Plasmacytoid dendritic cells (pDCs) and monocytes were isolated from the peripheral blood of T1D (n = 20) and healthy control (HC, n = 10) subjects. Variations in RLR genes were analyzed by whole exome sequencing. pDCs and monocytes were stimulated in vitro with RLR agonist, polyinosinic: polycytidylic acid (poly I: C) for 18 h. The expression of phosphorylated IRF3 (pIRF3) and IRF7 (pIRF7), as markers of RLR activation was assessed by flow cytometry. Relative expression of RLR genes, DDX58 and IFIH1, was analyzed by Taqman RT PCR. Internalization of self RNA-LL37 complex in pDCs and monocytes was checked by confocal microscopy.

Results: Basal expression of pIRF3 was similar in the monocytes and pDCs of T1D and HC subjects. Whole exome sequencing of IFIH1 gene showed heterozygous variants in a few T1D subjects at exons 13 (C>T, n = 3) and 15 (A>G, n = 4), respectively. Poly I: C stimulation (500 ng/ml) enhanced the expression of pIRF3 in pDCs (MFI: 21.27% ± 2.74%) and monocytes (MFI: 15.21% ± 2.49%). Upregulation of RLR genes (DDX58 and IFIH1) was higher in T1D subjects following poly I: C stimulation. The expression of pIRF3 and pIRF7 in pDCs and monocytes upon stimulation with RNA-LL37 complex was higher than poly I: C stimulation. Confocal microscopy confirmed that RLR activation was induced by internalisation of RNA-LL37 complexes in pDCs and monocytes.

Conclusion: Stimulation of RLRs by self RNA-LL37 complexes induces the expression of DDX58 and IFIH1, which may trigger the autoimmune destruction of beta cells. In addition, variations in RLR genes might contribute toward the pathogenesis of T1D in susceptible subjects.

  13. Antigen-Specific Regulatory T Cell (Treg) Derived Exosomes Loaded With Immune Checkpoint Ligands: Developing A New Immunomodulatory Therapy For Remission of Autoimmune Responses in Type-1 Diabetes Top

Preetam Basak*, Naresh Sachdeva, Sanjay Bhadada,

Devi Dayal, Rakesh Kumar

*Postgraduate Institute of Medical Education and Research, Chandigarh, India

E-mail: [email protected]

Introduction: Targeted delivery of agonist ligands against immune checkpoint molecules (ICMs) through exosomes can suppress autoreactive CD8+ T cells. In this study, we attempted to inhibit autoimmune responses in type-1 diabetes (T1D) by delivering ICM ligands through exosomes derived from preproinsulin (PPI)-specific Tregs.

Methods: The relative expression of ICMs (PD-1, CTLA4, TIGIT, TIM3, LAG3, CD160, and BTLA) was analyzed on peripheral CD8+ T cells of T1D (n = 40) and healthy control (n = 10) subjects by flow cytometry (FC). Exosomes were isolated from peripheral Tregs of T1D subjects that were expanded in vitro in presence of PPI-derived peptides. Exosomes were characterized by transmission electron microscopy (TEM), western blotting (WB), FC and ζ-potential analyzer. Ligands binding to the most frequently expressed ICMs were loaded in the exosomes by sonication. The ICM-ligand-loaded exosomes were incorporated in autologous Tregs and confirmed by confocal microscopy. The immunomodulatory potential of ICM-ligand loaded exosomes was determined by suppression of autologous effector T (Teff) cells and by assessing changes in expression of perforin, granzyme B and IFN-γ in PPI-pulsed CD8+ T cells by FC.

Results: The expression of ICMs, TIGIT, PD-1, and BTLA were higher on peripheral CD8+T cells of T1D subjects. The PPI-Treg-derived exosomes had a typical spherical shape and size (~100–150 nm) as visualized by TEM and their integrity was confirmed by ζ-potential (−14.07 ± 3.55 mV). The exosomes expressed characteristic markers (CD63, CD81 and CD9) as confirmed by FC and WB analysis. Confocal microscopy confirmed internalization of exosomes within Tregs. The immunosuppression assay showed up to 30% ± 0.47% (mean ± standard deviation) suppression of autologous Teff cells by ICM ligand loaded exosomes. Finally, the PPI-specific Tregs containing ICM ligand loaded exosomes showed significant downregulation of perforin, granzyme B and IFN-γ in PPI-pulsed CD8+ T cells (P < 0.05).

Conclusion: PPI-Treg derived exosomes loaded with ICM agonist ligands can exert immunosuppression in T1D.

  14. Understanding the Regulation of Meteorin-Like Protein and Advancing Its Therapeutic Potential Top

S. Shiva Shankar*, Reema M. Banarajee, Swaraj M. Jathar, Sureshkumar Ramasamy, Mahesh J. Kulkarni

*CSIR-National Chemical Laboratory, Pune, Maharashtra, India

E-mail: [email protected]

Introduction: Meteorin-like protein (Metrnl, also known as subfatin and cometin) is a newly discovered adipo-myokine expressed in adipose tissue, skeletal muscle and intestinal epithelial cells. It has been found that Metrnl increases during acute exposure to cold, induces thermogenesis-associated genes in white adipose tissue, and induces adipose browning by alternate macrophage activation. Metrnl increases insulin-induced AKT phosphorylation through PPARγ signaling hence, it has been found that Metrnl deficiency leads to adipocyte insulin resistance. Metrnl plays a vital role in various different functions and disease-related expression in specific tissues. Various reports showed the Metrnl expression in diabetic conditions using an assay-based approach. However, there is conflicting data about expression levels of Metrnl in type 1 diabetes mellitus and obesity, therefore, we have analyzed the regulation of Metrnl proteins in diabetic conditions.

Methods: To study the expression levels of Metrnl, ELISA was performed using plasma samples from healthy and diabetic patients. Furthermore, the regulation of Metrnl in adipocytes under insulin resistance conditions was studied using 3T3 cells in culture.

Results: The plasma levels of Metrnl were found to be increased in plasma from diabetic patients and also correlated with the glycated hemoglobin and post-prandial blood glucose levels. Furthermore, the plasma Metrnl levels showed a strong inverse correlation with plasma total cholesterol, low-density lipoprotein, very-low-density lipoprotein, and triglycerides.

Conclusion: The Metrnl level is elevated in diabetic conditions compared to the healthy subjects. Understanding Metrnl regulation will help us make better therapeutic proteins for various metabolic disorders.

  15. Formulation and Assessment of Millet Based Gluten Free Snack Box for Diabetes Management: A Response Surface Analysis Top

S. Sai Dharshini*, M. Meera

*Sri Sathya Sai Institute of Higher Learning, Anantapur,

Andhra Pradesh, India

E-mail: [email protected]

Introduction: To design and assess a millet-based gluten-free snack box in diabetic management using Response Surface Modeling (RSM). Celiac disease occurs as a comorbidity with type 1 diabetes. A gluten-free diet is necessary for people with celiac disease, an autoimmune response to gluten that causes the body to attack the small intestine, causing stomach pain, nausea, bloating, or diarrhea.

Methods: The contents of the snack box include millet bars, millet muesli, millet smoothie, and millet thins. The major raw ingredient addition percentage was optimized using RSM. The samples were subjected to sensory evaluation (9-point Hedonic Scale) for optimization and water activity, texture, pH, and TSS using instrumentation methods. Total protein, TDF, ACH, IPD and anti-oxidant capacity, and total polyphenols were analyzed using AOAC protocols; Vitamin-E and fat-profiling using high-performance liquid chromatography. The cost and shelf-life of the products were evaluated.

Results: The optimized product has protein content in the range of 12 to 15 g/100g, total calorific count 390 to 400 kcal/100g, total dietary fiber 8 to 10 g/100 g, and fat 18 to 22 g per/100 g for the developed samples. The available carbohydrate content was found in the range of 40 to 45 g/100 g, which indicates less carbohydrate content and better dietary nutrient availability. The overall acceptability was in the range of 8.5 to 8.8 indicating high likeliness towards the developed product. The in vitro protein digestibility and antioxidant assay indicated product suitability and prolonged shelf stability. The developed products were nutrient-dense with good sensorial acceptability, shelf stability, and economical compared to commercial products.

Conclusion: The developed millet-based gluten-free snack products would be beneficial as one of the nutrition intervention strategies for the management of celiac disease, and diabetes and food security. The formulation outfits the fast-growing demand for whole grain, climatarian, and gluten-free diets.

  16. How to Track Blood Glucose from the Continuous Glucose Monitors? Top

Sayantan Majumdar*, Saurabh D. Kalamkar, Shashikant Dudhgaonkar, Saroj Ghaskadbi, Pranay Goel

*Indian Institute of Science Education and Research, Pune, Maharashtra, India

E-mail: [email protected]

Introduction: The diagnosis of diabetes and its treatments are generally based on and guided by the measurements of blood glucose (BG), including glycated hemoglobin. These can be measured directly from the blood. On the other hand, continuous glucose monitors (CGM) devices allow us to obtain a series of consecutive interstitial fluid glucose concentration (ISF) measurements. How can these measurements be used to estimate the corresponding BG? We demonstrate various methods for estimating a BG trace from an ISF trace.

Methods: We collected CGM traces from several subjects (n = 50 subjects: 19 non-diabetic, 15 prediabetic, and 16 diabetic patients). We used the mathematical technique of trajectory optimization to compute a corresponding BG for each measured ISF in a CGM.

Results: The BG traces obtained from this method were approximately 1.25 times the ISF.

Conclusion: Trajectory optimization techniques provide a novel method to obtain estimates of BG from CGM data.

  17. Understanding the Role of Histidine-Containing Dipeptides in the Human Central Nervous System: Biomarker Discovery Towards Alzhemier's and Diabetes Top

Vaibhav Kumar Pandya*, Mijin Jung, Xiaobei Pan, Swathine Chandrasekharan, Mahesh J. Kulkarni,

Emma L. Cunningham, Brian D. Green

*Institute for Global Food Security, Queen's University, Belfast,

United Kingdom

E-mail: [email protected]

Histidine-containing dipeptides (HCDs) play an important physiological role in combating oxidative stress and have been linked to neurodegenerative diseases such as Alzheimer's disease as well as diabetes-related complications. Their role and homeostasis in the central nervous system are poorly understood and progress is hampered by the lack of methods for measuring HCDs in cerebrospinal fluid (CSF). This study developed and optimized a high-throughput liquid chromatography-Mass spectrometry (MS)/MS method for simultaneously and accurately measuring CSF levels of carnosine, anserine and homocarnosine (Hcar), and also their constituent amino acids. Two types of sample preparation (direct dilution and protein precipitation) were evaluated resulting in intra-and inter-assay variations of 2.4%–3.8% and 6.5%–9.6%, respectively. Hcar was most abundant (1.2–2.4 μM) in CSF, followed by anserine (220–690 nM), with carnosine the least abundant overall (5–20 nM). The hydrolysis rate of HCDs in CSF was also determined for the first time, which appears to be substantial, and primarily be mediated by the action of carnosinase (CN1). Substrate specificity ranked from highest to lowest was: carnosine > anserine > Hcar. In conclusion, this study simultaneously and accurately quantified the levels of all 3 known HCDs in CSF for the first time, and it highlights their potential instability. Given the strong antioxidant potential of HCDs the systematic evaluation of these dipeptides in neurodegenerative disease cohorts is clearly warranted.

  18. Effect of Diabetes Mellitus on Foot Biomechanics and Gait Dysfunction in Patients With Diabetic Foot Top

Sukhpreet Pabla*, Dilip Apturkar

*Pravara Institute of Medical Sciences, Loni, Maharashtra, India

E-mail: [email protected]

Introduction: Diabetic Foot is one of the most unnoticed and overlooked characteristics of Diabetic Care across Indian scenario. DF complications signifies substantial rate of Morbidity and Mortality which leads to the hike in amputation rates in the lower extremity. Diabetic Neuropathy is a regular complication of Diabetes Mellitus which contributes to the alteration of Gait. Glycosylation is responsible for the alteration of gait in patients with Diabetic Foot. Therefore, the present study is planned to spotlight the alteration in Gait of Persons with Diabetic Foot and also the effect of glycosylation on foot Biomechanics.

Methods: An observational study was conducted in Pravara Rural Hospital in patients having Diabetes Mellitus with Diabetic Foot (Grading according to Wagner's Classification) along with radiographs for Anatomical Changes. The recruited patients were screened for demographic data along with consent. Detailed assessment of patients was done by using POMA (Tinetti Performance Oriented Mobility Index) which scores 16 items (nine for evaluation of balance, seven for assessment of gait).

Results: Patients with diabetes frequently exhibit a conservative gait strategy where there is slower walking speed, wider base of gait, and prolonged double support time. Glycosylation affects are observed in the lower extremities. On observation, it was concluded that there is reduction in speed and alteration in balance due to DF, which may be due initially skin thickness decreases and skin hardness increases tendons thicken muscles atrophy, etc.

Conclusion: By the end of the Study, we have concluded there does appear to be gait changes in patients with diabetes. Understanding biomechanics and basic anatomy of the foot is essential for managing diabetic foot patients and will also help in planning appropriate intervention and prevention. Further studies are required to assess early implementation of the biomechanical changes to improve the quality of life.

  19. Food Insecurity: A Risk Factor for Type 2 Diabetes Top

Amber Srivastav

Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India

E-mail: [email protected]

Introduction: Households with food insecurities experience numerous health disadvantages, one of these extensive possible health disorders is diabetes. Albeit associations between risk factors of diabetes and food insecurity have been vividly identified, the relationship has been hardly researched. This study aimed to investigate this relationship.

Methods: Data were obtained from patients who had undergone the fasting plasma glucose test during 2020–2021 at a single institution. The inclusion criteria were fasting blood sugar ≥ 125 mg/dl. The exclusion criteria were a history of other cardiovascular diseases, diabetes, taking medications, etc.

Results: Successful data collection revealed that those patients who belonged to insecure households were two times more likely to develop Type 2 diabetes. This finding was in comparison to those patients who were from secure households (hazard ratio [HR] = 2.40, 95% confidence interval [CI] = 1.17–4.94). Adjustments for Body Mass Index diminished the association between type 2 diabetes and food insecurity among patients (HR = 2.08, 95% CI = 0.99–4.36).

Conclusion: The findings of this study revealed that food insecurity is independent of an increase in diabetes risks. A comprehensive study of biological and socioeconomic pathways is crucial for interventions to mitigate future pressure of diabetes.

  20. Correlates of Time to Microvascular Complications among Type 2 Diabetes Mellitus Patients Top

Amit Bhondve*, Vijaykumar Singh, Vishal Karande

*Seth GS Medical College and KEM Hospital, Diabease Sugar and Thyroid Clinic, Mumbai, Maharashtra, India

E-mail [email protected]

Introduction: To identify the risk factors involved in the development of microvascular complications of type 2 diabetes mellitus (T2DM), and to estimate average survival times for the time to the development of microvascular complications of patients with diabetes.

Methods: The study was conducted among 130 T2DM patients attending the Diabetes outpatient department at Urban Health Centre, Malvani, Malad, Mumbai. The participants were diagnosed and were on treatment with T2DM for at least 3 years excluding gestational diabetes mellitus and other variants. We abstracted clinical data from semi-structured pre-validated interview schedule. Other parameters patient's investigation reports and treatment sheet were referred.

Results: Amongst 130 study participants 75% (67.6%) were males. The mean age amongst both males and females was 56.5 ± 11.4 years. 64 (25%) participants were unmarried. Almost half of the participants were non-professionals and educated less than higher secondary grade. The mean duration of diabetes among study participants was 7.9 ± 4.6 years. 26 (19.1%) participants showed unsatisfactory glycaemic control (HbA1c level ≥8%). The prevalence of microvascular complications during the follow-up period in the studied population was 33, (24.6%) and was more prevalent in women (63.6%). Only diabetic retinopathy was seen in 7 (5.1%) of the study participants. Only neuropathy and only nephropathy were seen in 7 (5.1%) and 6 (4.4%) participants respectively. 2 study participants had all three microvascular complications. Factors associated with increased risk of microvascular complications among the sampled diabetes mellitus patients as identified by the Weibull model were older age >50 years (hazard ratio [HR] = 2.25, 95% confidence interval [CI]: 1.018–3.43, P = 0.039), female sex (HR = 1.87, 95% CI: 1.063–4.26, P = 0.021), Unsatisfactory control (HR = 4.1, 95% CI: 2.045–6.1, P = 0.41). The median duration of microvascular complication amongst unsatisfactory control patients was 12.0 with (95% CI: 11.3–12.6, P = 0.01).

Conclusion: The incidence microvascular complications among T2DM patients remains a significant public health problem. Unsatisfactory control, previous admission to hospital, hypertension, dyslipidemia, female sex, addiction are significant predictors of microvascular.

  21. Antidiabetic Efficacy of Mulberry (Morus indica L.) leaves: Mode of Action in Streptozotocin-Diabetic Rats Top

B. Andallu

Sri Sathya Sai Institute of Higher Learning, Anantapur, Andhra Pradesh, India

E-mail: [email protected]

Introduction: To investigate antidiabetic efficacy of mulberry (Morus indica L.) leaves by testing their influence on carbohydrate metabolic enzymes in the liver of experimentally-induced diabetic rats.

Methods: Streptozotocin-induced diabetic male Wistar rats and normal rats were used as models; both the experimental groups (normal and diabetic) were given 25% dry mulberry leaf powder mixed with the standard feed, and both the control groups (normal and diabetic) were given standard feed for 8 weeks. The mode of antidiabetic effect of mulberry leaves was assessed by testing their influence on blood glucose, hepatic glycogen, and on the activity of hepatic enzymes of carbohydrate metabolism and compared with that of diabetic controls.

Results: Mulberry-treated diabetic rats showed a significant decrease in blood glucose levels indicating a good glycemic control. The treatment significantly increased hepatic glycogen, and the activity of glycogen synthetase while decreasing the activity of glycogen phosphorylase indicating improved glycogenesis and controlled glycogenolysis which is one of the modes of antidiabetic action of phytochemicals. Besides, mulberry leaves significantly decreased the activity of gluconeogenic enzymes namely glucose-6-phosphatase, fructose1,6 diphosphatase, phosphoenol pyruvate carboxy kinase, indicating control over the synthesis of glucose through gluconeogenesis while such effects were not shown by diabetic control rats, which reveals multimodal therapeutic approach (improving glycogenesis and controlling gluconeogenesis) of phytochemicals in mulberry leaves reported as deoxynojirimycin (DNJ), galactopyranosyl–DNJ, Moran A, fagomine and some unidentified phytochemicals also might have played a role in this regard for the observed effects.

Conclusion: Mulberry leaves have the potential to regulate metabolic abnormalities in diabetic rats.


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