Skin pH is lower in type 1 diabetes subjects and is related to glycemic control of the disease.

BACKGROUND: Diabetes is a systemic disease affecting many organs, including skin. Skin may reflect the condition of internal organs. The aim of our study was to measure skin pH in type 1 diabetes mellitus (T1DM) patients and in healthy controls and to evaluate the association between metabolic control of diabetes and skin acidity in T1DM patients. MATERIALS AND METHODS: The study was conducted on 105 patients with T1DM and 53 age- and sex-matched healthy people. Skin surface pH was measured in three different areas of the body (cheek, forearm, and foot) in diabetes patients and healthy controls. The results were compared for patients' and controls' clinical characteristics and for patients' metabolic control and also evaluated according to the presence of complications of diabetes. RESULTS: Patients with T1DM had lower skin pH compared with the control group in three measured areas: within the cheek (5.49 ± 0.42 vs. 5.69 ± 0.31; P = 0.001), forearm (5.41 ± 0.46 vs. 5.73 ± 0.69; P = 0.004), and foot (5.20 ± 0.53 vs. 5.41 ± 0.41; P = 0.008). In the multiple linear regression skin pH was negatively correlated with fasting plasma glucose on the cheek (ß = -0.34, P = 0.0004), forearm (ß = -0.30, P = 0.0009), and foot (ß = -0.18, P = 0.04). Diabetes patients with glycated hemoglobin (HbA1c) ≥ 8% had significantly lower skin pH than patients with better glycemic control (HbA1c < 8%). However, we observed a statistically significant difference only on the foot (5.09 ± 0.50 vs. 5.34 ± 0.55; P = 0.019). CONCLUSIONS: Skin surface pH is lower in individuals with diabetes, and it is negatively related to actual and chronic hyperglycemia.

Hypoglycaemic effect of quinolizidine alkaloids--lupanine and 2-thionosparteine on non-diabetic and streptozotocin-induced diabetic rats.

The hypoglycaemic effects of two quinolizidine alkaloids: lupanine and 2-thionosparteine were examined in non-diabetic and in streptozotocin-induced diabetic rats. The model of experimental diabetes can be considered to be related to diabetes mellitus type 2 with regards to the impairment of beta-cells' secretory function. A single intraperitoneal injection of 2-thionosparteine at a dose of 8.6 mg/kg lowered the blood glucose levels in diabetic rats at 90 and 120 min after administration and showed similar hypoglycaemic effects to glibenclamide and sparteine, which were used as reference substances. In contrast to glibenclamide, 2-thionosparteine did not result in a significant increase in plasma insulin levels in diabetic rats; an increase was only observed in the non-diabetic group. It was found that lupanine did not exert hypoglycaemic potency in diabetic and in non-diabetic animals and did not significantly increase plasma insulin concentration independent of the group examined. From this study we can state that 2-thionosparteine, but not lupanine, is confirmed to be a possible plasma glucose lowering agent. It is possible that 2-thionosparteine-dependent decrease in blood glucose level is not the only result of this drug's related insulin secretion.

IL-15 is elevated in serum patients with type 1 diabetes mellitus.

IL-15 is a 14-15 kD cytokine produced by monocytes/macrophages and shares some biological actions with IL-2. The serum concentration of IL-15 in type 1 diabetic patients has not been reported seriously. Our studies were performed on 51 patients (28 women and 23 men) with type 1 diabetes mellitus. Healthy control subjects (n=22, 12 women and 10 men, mean age 29 years, range 24-32 years) were recruited from medical staff. IL-15 serum levels were detected by ELISA (R & D systems, USA). Short-term and long-term metabolic control parameters, lipid profile and C-reactive protein levels were also estimated. There was a statistically significant increase of serum IL-15 in type 1 diabetic patients in comparison to the control subjects (4.4 (1.5-11.8) versus 2.9 (1.5-6.0) pg/ml, p<0.05). Diabetic patients with higher IL-15 serum levels had higher HbA1c values. A correlation was found between IL-15 serum concentration and HbA1c (N(s)=0.31, p=0.029). There was no relation between acute hyperglycaemic episodes and IL-15 serum level. The potential associations between IL-15 serum level and long-term diabetic control lead us to speculate that IL-15 may serve as a target for future treatment in patients with prediabetes and/or for prevention of late diabetic complications.

1,5-anhydro-D-glucitol: a novel marker of glucose excursions.

In recent years a great deal of discussion has focused on postprandial hyperglycaemia as a risk factor for cardiovascular mortality. Routinely used parameters of metabolic control such as fasting plasma glucose (FPG) and HbA1c are not useful for determination of daily glucose excursions. 1,5-Anhydro-D-glucitol (1,5-AG) in human plasma has been proposed for several years as a short-term, retrospective marker of glycaemic control and seems to be the most suitable parameter for monitoring glucose excursions. The plasma level of 1,5-AG reflects acute episodes of hyperglycaemia more sensitively than HbA1c does and is correlated with FPG and postprandial hyperglycaemic peaks. The maximal glycaemic value observed in a patient ultimately determines the plasma 1,5-AG level. 1,5-AG could be helpful in detection of hyperglycaemic excursions, even in those patients with diabetes who self-monitor blood glucose and in those patients who are monitored routinely for FPG and HbA1c. In non-diabetic patients the plasma 1,5-AG level may serve as a screening marker for postprandial hyperglycaemia-associated cardiovascular risk.