Review Article
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Obesity and type 2 diabetes, which is rapidly increasing prevalence worldwide, are the most common subunits and potential risk factors for gestational diabetes mellitus (GDM). The diet plan is very important in the treatment of diabetes, but it has more importance during pregnancy due to fetal and maternal outcomes. Those patients who suffer from GDM need to have a well-planned diet plan and consultations with a dietitian to learn how to feed themselves during this period. This review emphasizes the effects of diet types on GDM. Most suggested diet types are low glycemic index (GI), low carbohydrate intake, calorie-restricted diet, and Mediterranean diet (MD). They all have specific, individualized points to apply and are effective in GDM treatment. Lastly, when a healthy diet plan and well-done consultation are mixed, the patient will start a new life with a healthy body and baby. The most important macronutrient in diabetes, carbohydrates, was clearly described in the study. The study aimed to investigate the beneficial diet types for GDM.
Review Article
Al Qarni A, AlSubaiee M, Alshaikh Husain M, Alkhazmari G, AlQahtani A, Aldossary I, Gado W, Albahrani Z, AlMukhaylid S, Alarfaj A, Almekhloof S, Alarfaj M, AlTaweel M* and AlMusaad A
The Impact of Diabetes Type 2 Treatment Interventions on Cardiovascular Outcomes – A Comprehensive Review Read More »
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Background: Type 2 diabetes mellitus (T2DM) is a chronic disease with significant cardiovascular (CV) implications. The management of diabetes plays a crucial role in reducing the risk of cardiovascular disease (CVD) and improving patient outcomes. This review examines the impact of various therapeutic strategies and their relevance to specific demographic groups, particularly the elderly and those with chronic kidney disease (CKD).
Methods: A comprehensive literature review was conducted focusing on randomized controlled trials (RCTs), meta-analyses, systematic reviews, and large observational studies from PubMed, Cochrane Library, and Google Scholar.
Results: Metformin and sodium-glucose cotransporter-2 (SGLT2) inhibitors consistently reduced CV mortality by 20–38% compared to other treatments. Incretin-based therapies like liraglutide and semaglutide reduced major adverse cardiovascular events (MACE) by 13–26%. Lifestyle interventions lowered CV risk when combined with medications. SGLT2 inhibitors conferred renal and CV protection in patients with CKD. Bariatric surgery (BS) has been associated with significant improvements in CV outcomes.
Conclusion: Metformin, SGLT2 inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), BS, and lifestyle modification conferred CV benefits. Management of type 2 diabetes with a view to reducing CV risk requires an individualized approach, taking into account patient characteristics, comorbidities, and the CV risk profiles of various treatment options.
Review Article
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Balance is critical to many aspects of life. Work-life balance ensures that we have time to enjoy the fruits of our labor. Hormones control bodily processes like - metabolism, homeostasis, growth and development, sexual function, reproduction, sleep-wake cycle, and mood. Most men see a gradual and progressive decline of testosterone, the primary male sex hormone, starting around age 30, at a rate of 1–2% per year, though in some men, the decline is faster than the body can adequately compensate. In these cases, the fallout can be felt throughout the body with symptoms that are both disruptive and inconvenient. It is produced in the testicles and the adrenal glands but regulated by the hypothalamic-pituitary-gonadal (HPG) axis, a feedback system that responds to circulating hormone levels.
Hormonal imbalance in men closely parallels the aging process. The most effective way of balancing male hormones is using testosterone replacement therapy (TRT).
Generally, a value < 300 ng/dL is considered low, leading to a condition called hypogonadism. While one-third of Indian men above 40 years of age suffer from hypogonadism, the proportion of them as appropriate candidates for testosterone therapy (TTh) is not clear, not only in India but also in most countries. TTh helps reverse the effects of hypogonadism, but it's unclear if it would benefit otherwise healthy older men.
Primary care physicians encounter clinical conditions of hormonal imbalances in males, such as precocious puberty, delayed puberty, and hypogonadism, in general practice, needing specialists’ consultation and guidance for their management.
Quoting half a dozen case reports of hormonal imbalance and their management, this article provides the evidence to prescribe or not to prescribe hormones for men.
Materials and Methods: Sample cases of precocious puberty, delayed puberty, male hypogonadism (MH) (general, diabetic, and intracranial hypertension), and a case of complication of TTh cases in adults and how they were diagnosed and managed. Literature review for current evidence for TTh in men globally and in Indian practices.
Review Article
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Obesity is a significant global health concern; the prevalence continues to rise in developing and developed countries. According to World Health Organization (WHO) data, 39% of the world population over the age of 18 is overweight, including 13% being obese.
Numerous studies have identified an association between obesity and cardiovascular diseases (CVD), including heart failure (HF). Obesity is additionally related to an increase in the occurrence of cardiovascular (CV) disorders, including hypertension (HTN), diabetes mellitus (DM), dyslipidemias, and sleep apnea syndrome.
This review investigates the various mechanisms and pathogenesis of obesity-related HF and the obesity paradox phenomena, aiming to shed light on futuristic directive approaches in treating HF-related obesity.
Commentary
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Review Article
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Propolis, a resinous, dark-colored product produced by honeybees has been gaining attention in terms of its multiple proven health benefits. This natural product has different types and varieties but close to similar chemical compositions according to the environment and location where it is produced, as well as its plant source. It is mainly composed of resinous, balsamic, and gummy materials, waxes and essential oils, and pollen from the plants. Propolis contains plenty of polyphenols and it’s a rich source of magnesium, calcium, iodine, potassium, sodium, copper, zinc, manganese, and iron as well as thiamin, riboflavin, vitamins B6, C, E, D, and provitamin A. It has been proven that propolis may help to reduce diet-induced obesity through its caffeic acid content. Studies proved the antibacterial, antiviral, anti-inflammatory, anticancer, antifungal, and antitumor effects of propolis and positive outcomes on diet-induced obesity, and diabetes. In this review, we aim to explain propolis extensively in terms of its types, chemical composition, bioactive compounds, digestion, health benefits on obesity and diabetes, as well as possible drug interactions, dosage, and safety.
Perspective Article
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Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy today. As per the American Diabetes Association (ADA) 2022, the latest definition of GDM is diabetes diagnosed in the second or third trimester of pregnancy that was not clearly overt diabetes prior to gestation. Blood sugar more than normal and less than diabetes in the first trimester is defined as hyperglycemia in early pregnancy. GDM has been associated with adverse pregnancy effects and outcomes such as preeclampsia, macrosomia, large for gestational age (LGA), shoulder dystocia, stillbirth, as well as neonatal complications. Dietary counseling and physical activity are the primary treatment for GDM. If sugar is not controlled through diet and exercise, metformin and or insulin are other treatment options.
Research Article
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Neuroendocrine tumors (NETs) with oncocytic features are rare. To date, few studies have described the metastatic characteristics of these tumors, most of which were limited by the low number of cases. One article characterized intermediate to high grade (G2 and G3) oncocytic NETs of the pancreas as having an ominous outcome; however, metastatic features of low-grade oncocytic NETs have, to our knowledge, been hitherto unexplored. Our study characterized the clinicopathological and metastatic features of 32 low to intermediate-grade oncocytic NETs of various organs. The most frequent metastatic site was the liver (63%). The metastatic rate of our cases was compared with Riihimaki’s study (metastatic rate of G1/G2 NETs was reported), as well as Heetfeld’s study and Lithgow’s study (metastatic rate of G3 NETs was reported). The overall metastatic rate of our cases is 84.4%, which is significantly higher than that of the G1/2 NETs from Riihimaki’s study (84.4% vs. 25%, p < 0.0001), while similar to that of the G3 NETs from Heetfeld’s study (84.4% vs. 86.5%, p > 0.05) and Lithgow’s study (84.4% vs. 80.8%, p > 0.05). These data indicate that oncocytic features could potentially be characterized as high-risk features in addition to high Ki-67 index, mitotic count, and necrosis. Thus, imaging studies such as liver magnetic resonance imaging (MRI) may be warranted to detect liver metastases in NETs with distinctive oncocytic cytologic features even in the absence of other high-risk features.
Mini-Review
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This mini-review describes at first the ontopathogenic model based on the concept of developmental origins of health and disease (DOHaD) and thereafter explains the possible roles of glucocorticoids (GC) and stress in age-related tendencies to sarcopenia, osteoporosis, and obesity. The interactions between GC, stress and pro-inflammatory cytokines in these disorders are also considered. It is concluded that excessive exposure to stress and/or exogenous GC should be adequately prevented or controlled from the very beginning of human life.
Case Report
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Glycogenic hepatopathy (GH) refers to a relatively rare complication of diabetes mellitus (DM) type 1 which constitutes of reversible accumulation of excess hepatic glycogen, usually manifesting in the form of liver enzyme elevation along with hepatomegaly. The occurrence of the disorder is most commonly related to inadequate control of blood sugars. Herein, we report upon a case of an 18-year-old girl presenting with severe transaminase elevations owing to poor metabolic control, as well as the progression of her enzymes and general condition during and after her hospitalization.