Journal of Diabetes and Clinical Research

We recently published our multi-institutional experience performing primary robot-assisted retroperitoneal lymph node dissection (RA-RPLND) for men with non-seminomatous germ cell tumor (NSGCT). We concluded that primary RA-RPLND for NSGCT can be performed safely with low complication rates, acceptable early oncologic outcomes, and lower overall theoretical chemotherapy burden. In this commentary, we explore outcomes in clinical stage I patients stratified by clinical risk factors (RF) and estimate reductions in chemotherapy burden.

Wound healing is a dynamic process whereby cellular structures and the tissue layers are reconstructed. Adult wound healing can be categorized into three stages: inflammatory phase, proliferative phase, and remodelling phase. Blood cells like macrophages, neutrophils, extracellular matrix and mediators, various proteins, and various genes play an important role in these phases.

Gastric cancer (GC), also known as stomach cancer, is a worldwide health problem. Anatomically, it can occur from the gastroesophageal junction to distal portions of the stomach. Considering both sexes, worldwide, it is the 5th most common neoplasm (5.7%) and the 3rd cause of mortality among malignancies, leading to approximately 782,000 deaths in 2018. The incidence varies geographically but 50% of new cases are diagnosed in developed countries. High incidence is observed in Asia, Latin America, and in the central and eastern parts of Europe. There are several ways to classify GC, but the most used is Lauren’s Classification, which proposes two main histological groups: intestinal and diffuse. This classification is important because there are marked etiological, pathological, and epidemiological differences between the subgroups, guiding the clinical approach for each patient.

Results of epidemiological studies show that obesity and type 2 diabetes mellitus have become a public health concern globally, which has substantial health, social and economic impacts. A common characteristic of human obesity and type 2 diabetes is insulin resistance, which a given amount of insulin produces less than normal physiological responses, usually demonstrated as diminished glucose lowering effect of insulin.

Obesity has reached a global epidemic and it predisposes to the development of insulin resistance, type 2 diabetes and related metabolic diseases. Current interventions against obesity and/or type 2 diabetes such as calorie restriction, exercise, genetic manipulations or established pharmacological treatments have not been successful for many patients with obesity and/or type 2 diabetes.

Diabetes mellitus is a common metabolic disorder that present with abnormal glucose metabolism. This metabolic disease is prevalent in many countries, worldwide. It is no doubt there might be a chance that diabetes mellitus might co-occur with other medical problems.

Insulinomas are insulin secreting tumors arising from spontaneous mutations of the ductal, acinar, or islet cells of the pancreas. They are rare, having an incidence of only four cases per million people per year. Patients typically present with fasting hypoglycemia, experiencing neurologic symptoms like confusion, changes in vision, or abnormal behavior and autonomic symptoms like palpitations, diaphoresis, or tremulousness.

In 2018, our group published a letter in The Lancet detailing a case in which a patient had taken a herbal preparation to treat her diabetes [1]. In essence, our laboratory was approached by the treating physician after the patient, a 58 year old lady of south Asian origin with a 30 year history of type 2 diabetes said that, during the previous two years, she had replaced some of her prescribed anti-diabetic medication with a herbal remedy purchased in India.

In 2017, approximately 424.9 million adults (age 20- 79 yrs) were affected by diabetes, with 4 million deaths. Global diabetes burden is estimated to increase up to 628.9 million people. Moreover, diabetes care costed approximately $727 billion in 2017.

ASD refers to a group of complex neurodevelopmental disorders, characterized by deficits in social communication, interaction and demonstrating restricted, repetitive, and stereotyped patterns of behavior. Centers for Disease Control and Prevention forecasted that the prevalence of ASD would be 1 in 45 in USA.

Type 2 diabetes (T2D) remains undiagnosed for many years in large number of persons living in developing countries. The cost of diagnostic tests and the invasive procedures involved in conventional screening methods remain a major setback to timely testing

The question of whether or not correction of vitamin D deficiency might reduce the risks of later type 2 diabetes mellitus (T2DM) has been under debate for many decades. The necessity of vitamin D for normal insulin secretion was first identified experimentally in the 1980s.

Epidemiological survey indicated that majority of Chinese T2DM patients were with postprandial hyperglycemia, which may be related to more significant decline of ? cell function and more carbohydrates in dietary structure.

With increasing rates of obesity, rates of type 2 diabetes and diabetic complications are expected to rise exponentially over the next few decades (American Diabetic Association). A key feature of type 2 diabetes is a resistance to insulin. Insulin signaling is key to a number of physiological processes, including glucose metabolism, cell growth, general gene expression, and apoptosis.

Type 2 diabetes mellitus (T2DM) is a metabolic disease defined by hyperglycemia. If not treated, chronic and even short periods (i.e. weeks) of undesirable hyperglycemia increases the risk for developing diabetic microvascular complications such as retinopathy, neuropathy, nephropathy, foot ulcers and amputations, and macrovascular complications such as cardiovascular disease including stroke

Lactulose, either as crystals or liquid syrup, is a frequently prescribed osmotic laxative agent in patients with diabetes mellitus (DM). During the manufacturing process, carbohydrate impurities can arise which could increase blood glucose levels with a possible impact on glycemic control. This important issue has now been addressed for the first time in individuals with type 2 DM. A recent RCT confirmed that there is no need to consider carbohydrate impurities in oral lactulose products administered at the recommended doses of 20 g/day and 30 g/day for blood glucose management.

This is a commentary on the recent work by our group on fasting during Ramadan by young people with diabetes which was published as ISPAD Clinical Practice Consensus Guidelines. In this commentary, themes of selected studies published following the guidelines release are highlighted.

The neuropeptide Calcitonin Gene-Related Peptide (CGRP) is a 37-amino acid peptide, with a wide-range of biological activities including vasodilation, neurogenic inflammation, immune function and hypertension. In addition to these various roles, it has also been heavily implicated in metabolic disease, with roles in feeding, energy dissipation processes and pancreatic β-cell insulin secretion.

Type 2 diabetes mellitus (T2DM) is one of the most prevalent metabolic disorders, characterized by impaired metabolism of carbohydrates, lipids and proteins. The prevalence of diabetes worldwide has grown from about 108 million adults (4.7% of population) in 1980 to 463 million (9.3%) in 2019 and it is estimated that it will rise to 700 million by 2045

The World Health Organization defines quality of life (QoL) as “the perception that an individual has of his life, in the context of the culture in which he lives, integrating personal goals, expectations and concerns, well-being and discomfort”.