Diabetology, Volume 2, Issue 2 (June 2021) – 7 articles

Sex and gender can affect incidence, prevalence, symptoms, course and response to drug therapy in many illnesses, being sex (the biological side) and gender (the social-cultural one), variously interconnected. Indeed, women have greater longevity; however, this is accompanied by worse health than men, particularly when obesity is present. Sex-gender differences are fundamental also in both type 1 and type 2 diabetes. Just for example in the prediabetes situation impaired fasting glucose (expression of increased insulin resistance) is more common in men, while impaired glucose tolerance (expression of beta cell deficiency) is more common in female, indicating a possible different genesis of type 2 diabetes in the two sexes. In type 1 diabetes male and female are equivalent as incidence of the disease since puberty, while estrogens act as protective and reduce the incidence of type 1 diabetes in female after puberty. Considering macrovascular complications, diabetic women have a 3.5 fold higher increased cardiovascular risk than non diabetic women, against an observed increase of “only” 2.1 fold in male. Thus it is clear, although not fully explained, that sex-gender differences do exist in diabetes. Another less studied aspect is that also physician gender influences quality of care in patients with type 2 diabetes, female physicians providing an overall better quality of care, especially in risk management. The goal of this short commentary is to open the special issue of Diabetology: “Gender Difference in Diabetes” leaving to the individual articles to deepen differences in genesis, psychologists aspects and complications of the disease. Full article

Polyelectrolytic complexation has stood out due to its application in the development of drug delivery systems using biopolymers as raw materials. The formation of complexes between cashew gum and chitosan can be intermediated by cross-links, mediated by the action of the sodium tripolyphosphate crosslinking agent. These polymers have been used in the nanotechnological development of formulations to protect peptide drugs, such as insulin, allowing their oral administration. In this work, we describe the development of polyelectrolytic complexes from cashew gum and chitosan as biopolymers for oral administration of insulin. The obtained complexes showed a mean particle size of 234 nm and polydispersity index of 0.2. The complexes were 234 nm in size, PDI 0.2, zeta potential −4.5 mV and 22% trapping. The obtained complexes demonstrated considerable and promising characteristics for use as oral insulin delivery systems. Full article

Increased energy intake from carbohydrates and sugars has been associated with overweight and obesity, risk factors for type 2 diabetes. However, such an association is higher with westernised diets with higher amounts of processed foods. Our aim was to correlate the dietary intake of sugars and lipids from naturally present and added sources with fat mass in young individuals. We performed an observational study in 80 young non-obese individuals, who completed food frequency and nutritional knowledge (NK) questionnaires, as well as an anthropometric evaluation. Foods were divided into naturally or added sources of sugars and lipids, and the intake from both sources was calculated separately. Individuals with a higher fat mass percentage had lower NK and lower consumption of lipids and sugars from naturally present sources. Moreover, consumption of lipids and sugars from naturally present sources was negatively correlated with nutritional knowledge and anthropometric markers of overweight, especially body weight and waist circumference. In non-obese young adults, lower consumption of sugars and lipids from naturally present sources instead of added ones is higher in individuals with excessive fat mass percentage and correlated with anthropometric markers of fat mass. Such dietary imbalance is associated with lower nutritional knowledge, suggesting that it could be a strategy to strengthen the prevention of obesity and associated pathologies later in life. Full article

The prevalence of diet-induced obesity and type-2 diabetes remains a growing concern in the United States. As best management practices still include improved diet and physical activity, bioactive food components, contained within functional foods, show promise in curbing the cardiometabolic complications associated with excess weight and diabetes. Quinoa is an emerging candidate crop for its versatility in wide-ranging growing conditions as one approach to address food security, but it also contains several components that may serve as a dietary tool for post-industrial countries struggling with the health complications of caloric excess. Preliminary rodent feeding studies demonstrate that components within quinoa, namely, phytosteroids, phenolics, polysaccharides, and peptides, can prevent adiposity, dyslipidemia, and hyperglycemia. Mechanistic activity may involve reduced lipid absorption and adipogenesis, increased energy expenditure and glucose oxidation and corrected gut microbiota. Other intestinal actions may include blocked carbohydrate digestion with enhanced incretin signaling. Evidence in clinical trials is lacking and future research spanning cells to the clinic is needed to further elucidate the interesting preliminary reports reviewed here. Quinoa offers several unique attributes that could be harnessed to improve the dietary management of obesity and diabetes. Full article

“Continuity of Care” is the main prerequisite for the unhindered movement of people across borders within the European Union (EU). The COntinuity of care in MEtabolic diseases through modern TECHnology (COMETECH) project aims to address the problem of inadequate access to health system services to people who live in isolated communities in Greece and North Macedonia cross-border areas. As the project is almost completed, 4 e-health units—2 in each country—have been established in isolated and deprived communities, aiming at introducing “Continuity of Care” for patients with diabetes in the border region between those countries. The establishment of the e-health units allows affordable access to medical services within Greece-North Macedonia cross-border area. These units (equipped with state-of-the-art medical devices, supported by an advanced software application and medical staff) record data of local people and offer valuable and high-quality medical care services. The records of the EU citizens using the COMETECH services are safely and easily accessible by their physicians. This paper presents the user requirements of e-health units and the medical devices that are set up for the COMETECH Project for helping people with diabetes in the targeted countries. Full article

Low-protein diets have been recommended as diet therapy for the management of chronic kidney disease; however, its effect on chronic kidney disease has not been scientifically proven. Although several studies have reported significantly more favorable results with low-protein diet than with normal-protein diet, the renal protective effects of low-protein diets are still unclear in diabetic patients with chronic kidney disease. Moreover, some studies have reported that extremely low-protein diets may increase the risk of mortality. Thus, this paper describes the effectiveness and safety of low-protein diets for patients with diabetic kidney disease by reviewing the historical background of different low-protein diets that were critically examined in several studies. Full article

Diabetes mellitus has become a serious and chronic metabolic disorder that results from a complex interaction of genetic and environmental factors, principally characterized by hyperglycemia, polyuria, and polyphagia. Uncontrolled high blood sugar can result in a host of diabetic complications. Prolonged diabetes leads to serious complications some of which are life-threatening. The prevalence of diabetes patients is rising at epidemic proportions throughout the world. Every year, a major portion of the annual health budget is spent on diabetes and related illnesses. Multiple risk factors are involved in the etiopathogenesis of the disease and turning the disease into an epidemic. Diabetes, for which there is no cure, apparently can be kept under control by maintaining self-care in daily living, effective diabetes education, with comprehensive improvements in knowledge, attitudes, skills, and management. In this review, we focused on the biochemical aspects of diabetes, risk factors including both environmental and genetic, disease complications, diagnosis, management, and currently available medications for the treatment of diabetes. Full article