The Important Role of Intermuscular Adipose Tissue on Metabolic Changes Interconnecting Obesity, Ageing and Exercise: A Systematic Review.

As age increases, adipose tissue infiltrates muscle tissue and leads to sarcopenia. When excessive accumulation of adipose tissue accompanied progressive decrease in lean body mass especially visceral fat, termed as sarcopenic obesity (SO) and related metabolic intermuscular adipose tissue (IMAT) is an ectopic tissue found between muscle groups, and is distinct from subcutaneous adipose tissue. Until now, the association between IMAT and metabolic health was not understood. This study is the first systematic review assessing the association between IMAT and metabolic health. The PubMed, Science Direct and Cochrane databases were searched for studies reporting IMAT and metabolic risk. The descriptions of the extracted data are guided by the Preferred Reporting Items for Systematic Reviews (PRISMA) statement with a Grading of Recommendations Assessment, Development and Evaluation approach. This study is registered at PROSPERO (identifier: CRD42022337518). Six studies were pooled and reviewed using critical appraisal by the Newcastle Ottawa Scale and Centre for Evidence-Based Medicine checklist. Two clinical trials and four observational trials were included. Our results reveal that IMAT is associated with metabolic risk, especially in older adults and patients with obesity. However, in a person with abdominal obesity, VAT has a more significant role in metabolic risk than IMAT. The largest decrease in IMAT was achieved by combining aerobic with resistance training.

Prompt and aggressive treatment of deep neck infection in neglected diabetic patient: A case report and literature review.

Background: Deep neck infection (DNI) is an infection that occurs in the deep neck fascia and spaces commonly found in diabetic patients. Impaired immune system due to hyperglycemic condition in diabetic patients leads to different clinical presentations, prognosis, and management and therapy in this group of patients. Case Presentation: We reported a deep neck infection and abscess in a diabetic patient that resulted in acute kidney injury and airway obstruction. We have done CT-scan imaging that supported the diagnosis of a submandibular abscess. Prompt and aggressive treatment of DNI with antibiotics, blood glucose control, and surgical incision has exhibited a favorable outcome. Conclusion: Diabetes mellitus is the most common comorbidity among patients with DNI. Studies showed that hyperglycemia impaired bactericidal functions of neutrophils, cellular immunity, and complement activation. Aggressive treatment, including early incision and drainage of abscess, dental surgery to eradicate the source of infection, prompt empirical antibiotic administration, and intensive blood glucose regulation will result in favorable results without a prolonged hospital stay.

Complementary and alternative medicine for glycemic control of diabetes mellitus: A systematic review.

The use of complementary and alternative medicine (CAM) is increasingly popular for the management of diabetes mellitus (DM). The aim of this study was to conduct systematic review of any types of complementary and alternative medicine for glycemic control of diabetes mellitus. Four databases was used in this study, the CINAHL, PUBMED, SCOPUS, and ProQUEST. The systematic review were reported according to the PRISMA guidelines. The keywords were used according to medical subject headings (MeSH) in this study were diabetes mellitus AND complementary and alternative medicine AND blood glucose levels or blood sugar or blood glucose. Articles were limited to 2015-2021 and only in English language. We obtained 231 articles from these databases: CINAHL six articles, PUBMED 85 articles, SCOPUS 66 articles, PROQUEST 74 articles. Then, the final results recorded 17 articles. The results of a systematic review showed the effectiveness of natural products as CAM for glycemic control of DM, namely Berberis aristata/Silybum marianum, fenugreek seed, bitter melon, cinnamon or whortleberry supplements, a combination of herbal plants (C. spinosa, R. canina, and S. securigera), Nigella sativa, Mulberry juice, chicory, chamomile tea, and bell pepper juice combined with an integrated approach of yoga therapy. Mind body practices such as auditory guided imagery (AGI), qigong and tai chi exercises, and relaxation. Whole system approach, such as acupressure. Health care providers consider CAM for DM management.

Brain Derived Neurotropic Factors in Speed vs. Inclined Treadmill in Young Adult Healthy Male With Occult Balance Disorder.

Background: There is an increase in fall risk among elders and young adults consecutively due to various causes. Occult balance disorder may be among the abnormal causes of falling in young adults as well as elders. The One Leg Stance (OLS) test is used to diagnose this balance performance; it's a proven test to measure static balance function which would lead to dynamic balance function. It has been proven that aside from cardiopulmonary exercises, treadmill workout can be used as a dynamic balance exercise. The Brain Derived Neurotropic Factor (BDNF) increases balance function through the treadmill exercise (the inclination and speed). This hormone is one of the tropical hormones generated in neurons, muscles, hematopoietic tissue and it is characterized by neurons morphology regulation and neuroplasticity. Materials and Methods: We divided 20 healthy young adult men to work out on inclination and speed groups treadmill exercise. The workout lasted for 2 weeks. We immediately observed the effect of exercise on serum BDNF as two tests were taken on before and 30 min after the workout. Result: There were significant increases of pre-exercise serum BDNF level in speed group between the first and the last exercise (p = 0.001), post-exercise between the first day and the last exercise (p = 0.001). No significant increase of serum BDNF in speed group pre- and post-exercise on the first exercise (p = 0.159), pre- and post-exercise on the last exercise (p = 0.892). There was no significant increase in serum BDNF in inclination group on all parameters (p > 0.05). The serum BDNF is actually a neurotropic factor that affects not just the neuronal system, but also molecular energy and metabolism regulation. This serum is dependent on the aerobic capacity, lactate production, muscle calcium uptake, and muscle fiber type used in exercises. Furthermore, the serum BDNF is increased by treadmill exercises in escalated speed. Conclusion: Treadmill exercises with average speed escalation increase the serum BDNF.

Clinical safety and effectiveness of biphasic insulin aspart 30 in type 2 diabetes patients switched from biphasic human insulin 30: results from the Indonesian cohort of the A1chieve study.

AIM: To evaluate the safety and effectiveness of biphasic insulin aspart 30 (BIAsp 30) in Indonesian type 2 diabetes patients switched from biphasic human insulin 30 (BHI 30) as a sub-analysis of the A1chieve study. METHODS: Clinical safety and effectiveness over 24 weeks was evaluated in Indonesian patients who switched from BHI 30 to BIAsp 30 at the discretion of their physician. RESULTS: A total of 244 patients with mean age ± SD 55.6 ± 9.5 years, BMI 24.6 ± 3.8 kg/m(2), and mean diabetes duration 7.8 ± 5.7 years were included. The mean pre-study BHI 30 dose was 0.56 ± 0.25 IU/kg and the baseline BIAsp 30 dose was 0.60 ± 0.26 U/kg titrated up to 0.65 ± 0.25 U/kg by Week 24. No serious adverse drug reactions were reported throughout the study. Overall hypoglycaemia decreased from 2.18 to 0.06 events/patient-year with a significant decrease in the proportion of patients affected (p < 0.0001). No nocturnal or major hypoglycaemia was reported at Week 24. HbA1c improved from 8.8 ± 1.2% at baseline to 7.3 ± 0.8% at Week 24. A total of 45 patients achieved HbA1c <7.0% as compared to 5 patients with HbA1c <7.0% at baseline. FPG and PPPG improved significantly after 24 weeks (p < 0.001). Quality of life was positively impacted (change in visual analogue scores, 3.0 ± 11.6 points, p < 0.001). CONCLUSION: Switching from BHI 30 to BIAsp 30 in this Indonesian cohort was well-tolerated and improved glycaemic control with a decreased risk of hypoglycaemia.

Microalbuminuria prevalence study in hypertensive patients with type 2 diabetes in Indonesia.

AIM: To assess the prevalence of macroalbuminuria and microalbuminuria in hypertensive patients with type 2 diabetes in 10 Asian countries. METHODS: This cross-sectional clinic-based epidemiological study is a subanalysis of data collected from patients attending three medical centres in Indonesia from May 2002 to October 2002. A total of 207 patients were enrolled, of which 177 patients constituted the per protocol population (patients with bacteriuria and haematuria were excluded). RESULTS: Overall, the prevalence of diabetic kidney disease was high, with macroalbuminuria comprising 44.7% (41.2-48.1;95% confidence interval) and microalbuminuria comprising 33.0% (29.7-36.3; 95% confidence interval). While the majority (91.53%) of patients were receiving treatment for hypertension, only 6.21% of the patients had systolic/diastolic blood pressures below the 130/85 mmHg target. CONCLUSION: The prevalence of microalbuminuria and macroalbuminuria was high in hypertensive patients with type 2 diabetes in Indonesia, which is indicative of an impending pandemic of diabetic cardiovascular and renal diseases in the region.