Beetle (Ulomoides dermestoides) fat improves diabetes: effect on liver and pancreatic architecture and on PPARγ expression.

Ulomoides dermestoides is a beetle traditionally consumed to treat diabetes. In this study, we performed a composition analysis of U. dermestoides to obtain the principal fractions, which were used to assess the effect on glycemia, liver and pancreatic architecture, and PPARγ and GLUT4 expression. Normal mice and alloxan-induced diabetic mice were administered fractions of chitin, protein or fat, and the acute hypoglycemic effect was evaluated. A subacute study involving daily administration of these fractions to diabetic mice was also performed over 30 days, after which the liver and pancreas were processed by conventional histological techniques and stained with hematoxylin and eosin to evaluate morphological changes. The most active fraction, the fat fraction, was analyzed by gas chromatography-mass spectrometry (GC-MS), and PPARγ and GLUT4 mRNA expressions were determined in 3T3-L1 adipocytes. The protein and fat fractions exhibited hypoglycemic effects in the acute as well as in the 30-day study. Only the fat fraction led to elevated insulin levels and reduced glycemia, as well as lower intake of water and food. In the liver, we observed recovery of close hepatic cords in the central lobule vein following treatment with the fat fraction, while in the pancreas there was an increased density and percentage of islets and number of cells per islet, suggesting cellular regeneration. The GC-MS analysis of fat revealed three fatty acids as the major components. Finally, increased expression of PPARγ and GLUT4 was observed in 3T3-L1 adipocytes, indicating an antidiabetic effect.

CHEMICAL CHARACTERIZATION OF A HYPOGLYCEMIC EXTRACT FROM CUCURBITA FICIFOLIA BOUCHE THAT INDUCES LIVER GLYCOGEN ACCUMULATION IN DIABETIC MICE.

BACKGROUND: The aqueous extract of Cucurbita ficifolia (C. ficifolia) fruit has demonstrated hypoglycemic effect, which may be attributed to some components in the extract. However, the major secondary metabolites in this fruit have not yet been identified and little is known about its extra-pancreatic action, in particular, on liver carbohydrate metabolism. Therefore, in addition to the isolation and structural elucidation of the principal components in the aqueous extract of C. ficifolia, the aim of this study was to determine whether or not the hypoglycemic effect of the aqueous extract of Cucurbita ficifolia (C. ficifolia) fruit is due to accumulation of liver glycogen in diabetic mice. MATERIALS AND METHODS: The aqueous extract from fruit of C. ficifolia was fractionated and its main secondary metabolites were purified and chemically characterized (NMR and GC-MS). Alloxan-induced diabetic mice received daily by gavage the aqueous extract (30 days). The liver glycogen content was quantified by spectroscopic method and by PAS stain; ALT and AST by spectrometric method; glycogen synthase, glycogen phosphorylase and GLUT2 by Western blot; the mRNA expression of GLUT2 and glucagon-receptor by RT-PCR; while serum insulin was quantified by ELISA method. A liver histological analysis was also performed by H&E stain. RESULTS: Chemical fingerprint showed five majoritarian compounds in the aqueous extract of C. ficifolia: p-coumaric acid, p-hydroxybenzoic acid, salicin, stigmast-7,2,2-dien-3-ol and stigmast-7-en-3-ol. The histological analysis showed accumulation of liver glycogen. Also, increased glycogen synthase and decreased glycogen phosphorylase were observed. Interestingly, the histological architecture evidenced a liver-protective effect due the extract. CONCLUSION: Five compounds were identified in C. ficifolia aqueous extract. The hypoglycemic effect of this extract may be partially explained by liver glycogen accumulation. The bioactive compound responsible for the hypoglycemic effect of this extract will be elucidated in subsequent studies.

Anti-inflammatory and antioxidant effects of a hypoglycemic fructan fraction from Psacalium peltatum (H.B.K.) Cass. in streptozotocin-induced diabetes mice.

ETHNOPHARMACOLOGICAL IMPORTANCE: Psacalium peltatum (H.B.K.) Cass. (Asteraceae) is used medicinally to treat diabetes, rheumatic pains, as well as gastrointestinal and kidney ailments. Previous pharmacological and chemical assays have demonstrated that an aqueous fraction from Psacalium peltatum (AP-fraction) contains a carbohydrate-type compound with hypoglycemic activity. Nevertheless, studies have not yet considered the hypoglycemic action of the AP-faction by sub-chronic administration nor on other healing properties, some of which might be associated with DM2 and other inflammatory processes. AIM OF STUDY: To determine whether a hypoglycemic carbohydrate fraction (AP-fraction) from Psacalium peltatum roots has antioxidant and anti-inflammatory effects in streptozotocin-induced diabetes mice. MATERIAL AND METHODS: Healthy mice received either saline, the AP-fraction with a high content of fructans, or pioglitazone (a positive control) daily by gavage. After 15 days of treatment, these animals received a single intraperitoneal administration of streptozotocin and all treatments were continued for additional 33 days. The antioxidant and anti-inflammatory properties of the AP-fraction were evaluated through the quantification of biomarkers of oxidative stress (glutathione (GSH) and malondialdehyde (MDA)) and inflammation (interleukin (IL)-6, tumor necrosis factor alpha (TNF-α), interferon-gamma (IFN-γ), and IL-10). RESULTS: The AP-fraction reduced glycemia and the glycated hemoglobin. Furthermore, animals treated with the AP-fraction had increased GSH, while MDA was decreased in the liver and the heart, without changes in the kidneys and the pancreas. The AP-fraction significantly reduced TNF-α serum levels but did not modify IL-6; in addition, this fraction increased IFN-γ and IL-10 levels. The increase in IL-10 levels may indicate an inhibition of the production of pro-inflammatory cytokines such as TNF-α, whereas the increase in IFN-γ might be indicative of a beneficial effect on the immune system. CONCLUSIONS: The AP-fraction hypoglycemic fructans from Psacalium peltatum roots showed antioxidant and anti-inflammatory properties in mice with streptozotocin-induced diabetes. The Psacalium peltatum hypoglycemic fructans may be valuable in preventing insulin resistance, as well as the development and progression of diabetic complications caused by chronic inflammation.

The Starr County Diabetes Education Study: development of the Spanish-language diabetes knowledge questionnaire.

OBJECTIVE: This study reports the psychometric properties of the 24-item version of the Diabetes Knowledge Questionnaire (DKQ). RESEARCH DESIGN AND METHODS: The original 60-item DKQ was administered to 502 adult Mexican-Americans with type 2 diabetes who are part of the Starr County Diabetes Education Study. The sample was composed of 252 participants and 250 support partners. The subjects were randomly assigned to the educational and social support intervention (n = 250) or to the wait-listed control group (n = 252). A shortened 24-item version of the DKQ was derived from the original instrument after data collection was completed. Reliability was assessed by means of Cronbach's coefficient alpha. To determine validity, differentiation between the experimental and control groups was conducted at baseline and after the educational portion of the intervention. RESULTS: The 24-item version of the DKQ (DKQ-24) attained a reliability coefficient of 0.78, indicating internal consistency, and showed sensitivity to the intervention, suggesting construct validation. CONCLUSIONS: The DKQ-24 is a reliable and valid measure of diabetes-related knowledge that is relatively easy to administer to either English or Spanish speakers.

Gender and treatment differences in knowledge, health beliefs, and metabolic control in Mexican Americans with type 2 diabetes.

PURPOSE: The purpose of this project was to describe metabolic control, knowledge, and health beliefs of Mexican Americans with type 2 diabetes. METHODS: The study site was Starr County, Texas, a border community located on the Rio Grande River and bordering northern Mexico. Of the total sample of 360 persons, 252 agreed to participate in this intervention study and were randomized either to the treatment group or the control group that waited 1 year to begin the intervention. RESULTS: The majority of individuals were Spanish-speaking females with a mean age of 54 years and a mean diabetes duration of 8 years. For those treated with diet only, males exhibited higher fasting blood glucose levels than females. Gender effects were seen for cholesterol level, with females exhibiting higher levels than males. Males expressed stronger perceptions of control and social support for diet. Bivariate relationships were found between acculturation and diabetes knowledge. The health belief subscales of control and impact on job together explained 16% of the variance in HbA1c values. CONCLUSIONS: Males and females held differing beliefs about ability to control their diabetes and degree of social support for diet. The impact of gender differences on ability to integrate diabetes self-care and on effectiveness of diabetes programs has not been determined but should be considered in future research.

The effect of turning and backrub on mixed venous oxygen saturation in critically ill patients.

OBJECTIVE: To examine the effect of a change in body position (right or left lateral) and timing of backrub (immediate or delayed) on mixed venous oxygen saturation in surgical ICU patients. METHODS: A repeated-measures design was used to study 57 critically ill men. Mixed venous oxygen saturation was recorded at 1-minute intervals for 5 minutes in each of three periods: baseline, after turning, and after backrub. Subjects were randomly assigned to body position and timing of backrub. Subjects in the immediate-backrub group were turned and given a 1-minute backrub. Mixed venous oxygen saturation was measured at 1-minute intervals for 5 minutes at two points: after the backrub and then with the patient lying on his side. For subjects in the delayed-backrub group, saturation was measured at 1-minute intervals for 5 minutes at two different points: after the subject was turned to his side and after the backrub. RESULTS: Both position and timing of backrub had significant effects on mixed venous oxygen saturation across conditions over time. Subjects positioned on their left side had a significantly greater decrease in saturation when the backrub was started. At the end of the backrub, saturation was significantly lower in subjects lying on their left side than in subjects lying on their right side. The pattern of change differed according to the timing of the backrub, and return to baseline levels of saturation after intervention differed according to body position. CONCLUSIONS: Two consecutive interventions (change in body position and backrub) cause a greater decrease in mixed venous oxygen saturation than the two interventions separated by a 5-minute equilibration period. Turning to the left side decreases oxygen saturation more than turning to the ride side does. Oxygen saturation returns to clinically acceptable ranges within 5 minutes of an intervention. In patients with stable hemodynamic conditions, the standard practice of turning the patient and immediately giving a backrub is recommended. However, it is prudent to closely monitor individual patterns of mixed venous oxygen saturation, particularly in patients with unstable hemodynamic conditions.

On the levels of enzymatic substrate specificity: implications for the early evolution of metabolic pathways.

The most frequently invoked explanation for the origin of metabolic pathways is the retrograde evolution hypothesis. In contrast, according to the so-called "patchwork" theory, metabolism evolved by the recruitment of relatively inefficient small enzymes of broad specificity that could react with a wide range of chemically related substrates. In this paper it is argued that both sequence comparisons and experimental results on enzyme substrate specificity support the patchwork assembly theory. The available evidence supports previous suggestions that gene duplication events followed by a gradual neoDarwinian accumulation of mutations and other minute genetic changes lead to the narrowing and modification of enzyme function in at least some primordial metabolic pathways.

Pancreas transplantation.

This article summarizes the historic and current perspectives related to pancreatic and islet cell transplantation. The nursing care of patients who are recipients of these types of transplantations is described. The complications and risks for these types of transplantations along with the most common surgical and medical regimens are also described.

Diabetes education in a Mexican-American population: pilot testing of a research-based videotape.

A diabetes education videotape was designed and pilot tested in a sample of 30 Spanish-speaking Hispanic diabetic adults in a rural Texas-Mexico border community. The videotape provided an overview of diabetes, with emphasis on the concept of blood glucose; relationships between food, medications, exercise, and blood glucose levels; and blood glucose monitoring. Outcomes of videotape effectiveness were based on a 20-item knowledge test and interview data to assess acceptability of videotapes as a learning tool. Comparison of the knowledge test scores of the experimental group (those who viewed the tape before taking the knowledge test) with the control group (those who took the test before viewing the tape) produced a positive, moderate effect size of 0.61. Interviews with subjects indicated enthusiastic acceptance of the videotape as a means of transmitting diabetes information.