Objective: We studied the effect of pioglitazone on insulin levels, inflammation markers, high-density lipoprotein (HDL) composition and subclasses distribution, in young women with uncomplicated systemic lupus erythematosus (SLE). Methods: This double-blind trial included 30 premenopausal women (30 ±8 years old) with SLE, who were randomized to pioglitazone (30 mg/day) or ...

OBJECTIVE: To evaluate levels of resistin in female subjects with systemic lupus erythematosus (SLE) compared to age and race-matched controls and to determine the relationship between resistin and systemic inflammation, disease measures, and coronary artery calcification (CAC). METHODS: Resistin levels were measured on stored samples from 159 women with SLE ...

The use of bariatric surgery is increasing at an enormous rate in all countries but the indications for the operation on the basis of metabolic derangements are not clear as only one controlled randomized trial has been performed so far. Thus, it is not clear whether bariatric surgery should be ...

AIMS/HYPOTHESIS: Several risk stratification systems have been proposed for predicting development of diabetic foot ulcer. However, little has been published that assesses their similarities and disparities, diagnostic accuracy and evidence level. Consequently, we conducted a systematic review of the existing stratification systems. METHODS: We searched the MEDLINE database for studies ...

We report a patient with neuropsychiatric systemic lupus erythematosus (NPSLE) complicated by diabetes mellitus (DM) who showed pneumatosis cystoides intestinalis (PCI) while being treated with prednisolone (PSL) and an alpha-glucosidase inhibitor (αGI). The PCI was ameliorated with the cessation of the αGI and tapering of PSL in addition to transient ...

The Food and Drug Administration in collaboration with the National Institutes of Health presented a public workshop to facilitate medical device innovation in the development of the artificial pancreas (or autonomous system) for the treatment of diabetes mellitus on November 10, 2010 in Gaithersburg, Maryland. The purpose of the workshop ...

This study was to compare the effect of intensive insulin therapy (IIT) to conventional insulin therapy (CIT) on postoperative outcomes among type 2 diabetes mellitus (DM) patients who underwent D2 gastrectomy for gastric cancer. We randomly assigned gastric cancer patients with type 2 DM who underwent radical gastrectomy to receive ...

The development of an artificial pancreas (AP) made huge strides from 2006 to 2008 and a large number of activities are going on in this area of research. Until now, most AP systems under development were tested only under highly controlled conditions. The aim of our project, funded by the ...

Insulin therapy has enabled patients with diabetes to maintain blood glucose control to lead healthier lives. Today, rather than injecting insulin manually using syringes, a patient can use a device such as an insulin pump to deliver insulin programmatically. This allows for more granular insulin delivery while attaining blood glucose ...

To investigate the rate of type 2 diabetes remission after gastric bypass and banding and establish the mechanism leading to remission of type 2 diabetes after bariatric surgery. Glycemic control in type 2 diabetic patients is improved after bariatric surgery. In study 1, 34 obese type 2 diabetic patients undergoing ...

Diabetes is the most common cause of gastroparesis and it is now recognized that the relationship between gastric emptying and glycemia is complex and intertwined. Postprandial blood glucose levels influence, and are influenced by, the rate of gastric emptying, highlighting the difficulty in determining which is the cause and which ...

Background  Gastric emptying (GE) is delayed in 30-50% of patients with longstanding diabetes. Scintigraphy represents the 'gold standard' for measurement of GE, but is associated with a radiation burden. Three-dimensional (3D) ultrasonography has recently been demonstrated to provide a valid measure of liquid GE in healthy subjects; however, the technique ...

BACKGROUND: Numerous hormones secreted by the gut, during both the fasted state and in response to a meal, influence gastrointestinal motor and/or sensory function, and appear to contribute to the pathogenesis of delayed gastric emptying associated with gastroparesis, functional dyspepsia (FD) and feed intolerance in critical illness. Gut hormones are, ...

Gastroparesis is characterized by delayed gastric emptying without obstruction. Diabetes is frequently associated with poor glycemic control and delayed gastric emptying. Gastric emptying scintigraphy (GES) is the standard for measuring gastric emptying. Serum hemoglobin A1C (HbA1C) measures prolonged glycemic control with normal as < 7% glycated. To date, no correlation ...

The global prevalence of type 2 diabetes mellitus and impaired glucose metabolism continues to rise in conjunction with the pandemic of obesity. The metabolic Roux-en-Y gastric bypass operation offers the successful resolution of diabetes in addition to sustained weight loss and excellent long-term outcomes in morbidly obese individuals. The procedure ...

Diabetic gastroparesis is a disorder that occurs in both type 1 and type 2 diabetes. It is associated with considerable morbidity among these patients and with the resultant economic burden on the health system. It is primarily a disease seen in middle-aged women, although the increased predisposition in women still ...

Gastroparesis and/or dyspeptic symptoms occur in around 50% of type 1 diabetic patients. The aim of our study was to evaluate the prevalence of gastroparesis in patients with type 1 diabetes using 13C-octanoic acid breath test (13C-OBT) and the relationship between dyspeptic symptoms and gastric emptying. METHODS Gastric emptying of ...

OBJECTIVE: Small case series suggest bariatric surgery may be an effective treatment for type 2 diabetes mellitus in patients who do not meet body weight criteria for morbid obesity (body mass index [BMI], <35 kg/m), but large multi-institutional series, which allow better assessment of the safety and efficacy of treatment, ...

We have demonstrated previously that in vivo supplementation of tetrahydrobiopterin (BH₄); a co-factor for neuronal nitric oxide synthase (nNOS) significantly restored delayed gastric emptying and attenuated nitrergic relaxation in diabetic rat. In this study, we have investigated whether supplementation of sepiapterin (SEP), a precursor for BH₄ biosynthesis via salvage pathway ...

OBJECTIVE: To compare the incidence of anesthetic complications in diabetic and nondiabetic dogs undergoing general anesthesia and phacoemulsification cataract surgery. PROCEDURE: The medical and anesthetic records of all dogs undergoing phacoemulsification cataract surgery at Davies Veterinary Specialists between 2005 and 2008 were reviewed. Anesthetic records were evaluated by an ECVAA ...

a diabetic haemodialysis patient with refractory gastroparesis treated with 16 sessions of acupuncture through 8 weeks as an adjunct to conventional drug treatment including prokinetics and antiemetics which remained the same during the treatment course. After the treatment, the total Gastroparesis Cardinal Symptom Index (GCSI) score (range 0-5) was reduced ...

In vitro starch digestion is used for predicting the in vivo glucose response, but their relationship has not been defined thoroughly. To clarify, in vitro starch digestion using a modified Englyst-assay was compared to portal glucose appearance in pigs. Four portal vein-catheterized pigs (43.2 +/- 4.8 kg body weight) were ...

OBJECTIVE: To determine the acute effects of exogenous glucagon-like peptide-1 on gastric emptying, glucose absorption, glycemia, plasma insulin, and glucagon in critically ill patients. DESIGN: Randomized, double-blind, crossover study. SETTING: Intensive care unit. SUBJECTS: Twenty-five mechanically ventilated patients, without known diabetes, studied on consecutive days. INTERVENTIONS: Intravenous glucagon-like peptide-1 (1.2 ...

The protective effects of telmisartan, the angiotensin II-receptor antagonist, were investigated in rats with type 2 diabetes mellitus exposed to acute gastric ulceration. Following successful induction of diabetes, telmisartan treatment (1 mg/kg/day, orally) was started and continued for 8 weeks, after which acute gastric ulceration was induced by indomethacin. Telmisartan ...

Diabetic gastroparesis is associated with increased oxidative stress attributable to loss of upregulation of heme oxygenase-1 (HO1), with resultant damage to interstitial cells of Cajal and delayed gastric emptying. These changes can be reversed by induction of HO1. HO1 catalyzes the breakdown of heme into iron, biliverdin and, carbon monoxide ...

Exenatide improves postprandial glycemic excursions in type 2 diabetes. Exenatide could benefit type 1 diabetes as well. We aimed to determine an effective and safe glucose-lowering adjuvant exenatide dose in adolescents with type 1 diabetes. Eight subjects completed a three-part double-blinded randomized controlled study of premeal exenatide. Two doses of ...

In diabetic dogs, many concurrent diseases can cause resistance to exogenous insulin. The most common concurrent disorders in diabetic dogs are hyperadrenocorticism, urinary tract infection, acute pancreatitis, neoplasia, and hypothyroidism. When a concurrent disorder is treated, the insulin dose should be decreased to avoid possible hypoglycemia when an underlying cause ...

BACKGROUND: It is commonly presumed that diabetics are more prone to gastroparesis when compared to non-diabetics. Objective: To ascertain whether diabetes is an independent predictor of gastroparesis in symptomatic patients who are referred for gastric emptying studies. METHODS: This was a cross sectional observational study. The study cohort consisted of ...

Gastroparesis is a debilitating disease predominantly affecting young women. Recently, dysregulation of neuronal nitric oxide synthase (nNOS) in myenteric plexus neurons has been implicated for delayed solid gastric emptying/gastroparesis in diabetic patients. In this study, we have explored the role of tetrahydrobiopterin (BH4), a major cofactor for nNOS activity and ...

Gastroparesis is a well-recognized complication of diabetes. In diabetics, up-regulation of heme oxygenase-1 (HO1) in gastric macrophages protects against oxidative stress-induced damage. Loss of up-regulation of HO1, the subsequent increase in oxidative stress, and loss of Kit delays gastric emptying; this effect is reversed by induction of HO1. Macrophages have ...

The aim of the present study was to assess the effect of drugs that increase gastric vascular endothelial growth factor (VEGF) and suppress gastric tumor necrosis factor-alpha (TNF-alpha) in gastric ulcer healing in streptozotocin-induced diabetic rats. Sixty male albino rats were made diabetic by intraperitoneal (i.p.) streptozotocin injection and ten ...

CONTEXT: Severe hypoglycemia after Roux-en-Y gastric bypass surgery (RYGB) is an increasingly recognized condition, characterized by neuroglycopenia and inappropriately elevated insulin concentrations that occur primarily in the postprandial state. Both pathophysiology and treatment of this disorder remain elusive, but it has been postulated that hyperplasia and/or hypertrophy of beta-cells due ...

Obesity has reached epidemic proportions and is continuing to grow into one of the leading healthcare issues worldwide. With this development, bariatric surgery has emerged as an acceptable treatment for morbid obesity, generally achieving meaningful and sustained weight loss. In a surprising turn of events, bariatric surgery was also found ...

The aim of this study was to investigate the effects and mechanisms of electroacupuncture (EA) on gastric accommodation, gastric dysrhythmia, and gastric emptying (GE) in streptozotocin (STZ)-induced diabetic rats. Five experiments were performed in five groups of STZ-induced diabetic rats to study the effects of EA at ST-36 (Zusanli) on ...

BACKGROUND: Ghrelin is produced by enteroendocrine cells in the gastric mucosa and stimulates gastric emptying in healthy volunteers and patients with gastroparesis in short-term studies. The aim of this study was to evaluate effects of intravenous ghrelin on gastrointestinal motility and glucose homeostasis during a 6-h infusion in humans. METHODS: ...

Gastroparesis and other types of gastric dysfunction result in substantial morbidity in diabetes patients. The pathophysiology of these disorders is incompletely understood. This article reviews techniques applicable to the assessment of gastric function in diabetes patients, including the measurement of emptying, accommodation, and contractility. Available treatment options are also reviewed, ...

Several gastrointestinal (GI) operations that were designed to promote weight loss can powerfully ameliorate type 2 diabetes mellitus (T2DM). Although T2DM is traditionally viewed as a chronic, relentless disease in which delay of end-organ complications is the major treatment goal, GI surgery offers a novel endpoint: complete disease remission. Ample ...

BACKGROUND: Published data on sleeve gastrectomy (SG) have indicated better remission of type 2 diabetes mellitus (T2DM) and improvement in satiety compared with other restrictive procedures. Mechanisms in addition to rapid, extensive weight loss are responsible for the restoration of the euglycemic state. To prospectively evaluate the role of laparoscopic ...

Hyperglycemia resolves quickly after bariatric surgery, but the underlying mechanism and the most effective type of surgery remains unclear. To examine glucose metabolism and beta-cell function in patients with type 2 diabetes mellitus (T2DM) after two types of bariatric intervention; Roux-en-Y gastric bypass (RYGB) and gastric restrictive (GR) surgery. Prospective, ...

BACKGROUND: The surgical treatment of diabetes had witnessed progressive development and success since the first case of pancreatic transplantation. Although this was a great step, wide clinical application was limited by several factors. Bariatric surgery such as gastric bypass is emerging as a promising option in obese patients with type ...

According to our knowledge and for the first time we refer about the combination therapy with gastric electric stimulation and injection of botulinus toxin into the pylorus at a patient with increased symptomatic diabetic gastroparesis for the first time. The prospectively documented gastroparesis-symptom-score improved dramatically under this combination therapy, while ...

Methylglyoxal is a reactive dicarbonyl compound produced from cellular glycolytic intermediates that reacts non-enzymatically with proteins to form products such as argpyrimidine at arginine residue. The aim of the present study was to investigate the role of methylglyoxal in the delayed healing of gastric ulcer in diabetes, and to identify ...

Surgical treatment of morbid obesity has been shown to be efficient for long-term weight loss and to improve obesity-related complications. The improvement of type 2 diabetes (T2DM) is dependent of the type of surgery, and is more frequent with gastric bypass than with gastric band. Normalization of glucose metabolism is ...

Gastric bypass (GBP) surgery was originally developed to treat patients with severe obesity. Nevertheless, in those with type 2 diabetes, GBP also exerts a spectacular effect on glucose metabolism, leading to remission of the diabetes in many cases. In this report, the basic principles of the surgical procedure are outlined ...

To examine after gastric bypass the effect of peroral versus gastroduodenal feeding on glucose metabolism. A type 2 diabetic patient was examined on 2 consecutive days 5 weeks after gastric bypass. A standard liquid meal was given on the first day into the bypassed gastric remnant and on the second ...

INTRODUCTION: The role of glucagon-like peptide-1 (GLP-1) in the regulation of gastric emptying is uncertain. The aim of this study was to determine the effects of endogenous GLP-1 on gastric emptying, glucose absorption, and glycemia in health. METHODS: Ten healthy fasted subjects (eight males, two females; 48 +/- 7 yr) ...

OBJECTIVE: Constipation is one of the most common gastrointestinal complications suspected to degrade the quality of life in diabetic patients. Mosapride citrate is a novel selective 5-HT4 receptor agonist, which enhances gastric emptying and motility in the upper gastrointestinal tract facilitating acetylcholine release from the enteric cholinergic neurons. Since the ...

BACKGROUND: Gastric electrical stimulation (GES) may improve delayed gastric emptying in diabetic gastroparesis, but whether enteric nervous system (ENS) is directly involved in its mechanism of improvement in gastric motility is unclear. The aims were to investigate the correlation between the changes in ENS and effects of long pulse GES ...

Lifestyle modifications and pharmacologic therapy have been the mainstays of treatment for patients with type 2 diabetes mellitus. Bariatric surgery, originally designed as a weight loss treatment, has been proven to ameliorate and even cure diabetes. The significant improvement in glycemic control found after bariatric surgery in patients with diabetes ...

Bariatric surgery is the most effective therapy for severe obesity in terms of reduction of morbidity and mortality and quality of life improvement. Different bariatric procedures distinctly differ with regard to their effectiveness to reduce body weight and to improve morbidities, such as type 2 diabetes. In this regard, the ...