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▪ Abstract  The significance of type I interferons (IFN-α/β) in biology and medicine renders research on their activities continuously relevant to our understanding of normal and abnormal (auto) immune responses. This relevance is bolstered by discoveries that unambiguously establish IFN-α/β, among the multitude of cytokines, as dominant in defining qualitative and quantitative characteristics of innate and adaptive immune processes. Recent advances elucidating the biology of these key cytokines include better definition of their complex signaling pathways, determination of their importance in modifying the effects of other cytokines, the role of Toll-like receptors in their induction, their major cellular producers, and their broad and diverse impact on both cellular and humoral immune responses. Consequently, the role of IFN-α/β in the pathogenesis of autoimmunity remains at the forefront of scientific inquiry and has begun to illuminate the mechanisms by which these molecules promote or inhibit systemic and organ-specific autoimmune diseases.

Nanotechnology has shown immense promise for advancing blood glucose control. This technology offers the potential to safeguard pancreatic cells from autoimmune destruction by driving the creation of innovative therapeutic agents that can be delivered to specific targets. In this book, you will find a comprehensive exploration of diabetes and its approved medical treatments. The book delves into how nanotechnology can amplify the efficacy of current treatment modalities, potentially paving the way for a gene therapy solution to combat this disease. Starting with the history of diabetes treatment, the book explains treatment challenges for diabetes before getting into the three ways nanoscience is helping in diabetes treatment: insulin delivery, drug delivery and nucleotide delivery. Each chapter is contributed by accomplished experts in their respective fields, who strive to offer a thorough, yet accessible discussion of the subject. Readership General readers, science enthusiasts and scholars interested in diabetes medicine.

For the last 10 years, online pre-service teacher distance education has increased significantly in Brazil. As a result, research on this educational modality has also increased, in particular, research investigating the different roles students and teachers play in these courses. The purpose of this paper is to analyze the role of digital technologies in two specific contexts: how teachers, tutors, and students play a role in producing interactive digital didactic material and how digital technologies themselves can play a role in teaching distance learning courses. But for these roles to emerge, we point to the need for participants of online courses to interact collaboratively. To identify these roles, grounded theory, a branch of qualitative research, was used as the two roles were articulated. Data were produced from virtual observations in virtual learning environments and virtual interviews. The results stress that both highlighted roles are related. They transform teacher and student roles and participation in the virtual classroom, and an \"agency of media\" emerges in online mathematics education.

We investigated whether the peripheral co-administration of leptin and liraglutide (a glucagon-like peptide-1 receptor agonist) improved glucose metabolism in a mouse model of insulin-dependent diabetes mellitus (IDDM). Twelve-week-old male C57BL/6J mice were injected intraperitoneally with a high dose of streptozotocin to induce IDDM or vehicle-treated. Mice with IDDM were divided into four groups: leptin treatment alone (LEP), liraglutide treatment alone (LIRA), co-administration of leptin and liraglutide treatment (LEP+LIRA), untreated mice (UNT). Vehicle-treated mice were the healthy controls (HC). The blood glucose (BG) levels were measured, and a glucose tolerance test (GTT) was performed to compare the five groups. Leptin was administered peripherally at 20 μg/day using an osmotic pump, while liraglutide was administered subcutaneously at 1000 μg/kg/day. Monotherapy with leptin or liraglutide significantly improved glucose metabolism, as assessed by comparing BG levels and GTTs with those of the UNT group. Mice in the LEP+LIRA group showed even greater improvements in glucose metabolism than the monotherapy groups. Notably, glucose metabolism in the LEP+LIRA group improved comparably with the HC group. Thus, the peripheral co-administration of leptin and liraglutide effectively improved glucose metabolism in mice with IDDM without the use of insulin.

Background: In patients with type 2 diabetes mellitus, the development of diabetic retinopathy (DR) correlates positively with elevated serum chemerin levels. This study was aimed at investigating the probable association between the serum chemerin level and the development of DR in patients with type 1 diabetes mellitus (T1DM). Methods: In this cross-sectional study, we included Egyptians and classified them into four groups: group 1, including healthy individuals; group 2, including patients with T1DM without DR; group 3, including patients with T1DM with non-proliferative DR (NPDR); and group 4, including patients with T1DM with proliferative DR (PDR). The assessment included best-corrected distance visual acuity assessment, slit-lamp biomicroscopy, funduscopy, fundus fluorescein angiography, and macular ocular coherence tomography. Fasting blood samples were obtained from all participants to measure serum chemerin, glycated hemoglobin (HbA1c), total cholesterol, triglyceride, and creatinine levels. Serum chemerin levels were compared among the groups, and their correlations with age, duration of diabetes, HbA1c, total cholesterol, triglyceride, and creatinine levels were analyzed. Results: We recruited 209 participants, including 46 healthy individuals in group 1, 52 patients (T1DM and no DR) in group 2, 61 patients (T1DM and NPDR) in group 3, and 50 patients (T1DM and PDR) in group 4, with comparable mean ages and sex ratios among groups. The diabetes duration, body mass index, HbA1c, total cholesterol, triglyceride, and serum chemerin levels differed significantly among the groups (all P < 0.001), whereas the creatinine level did not (P > 0.05). The serum chemerin level was significantly higher in group 4 than in groups 3 and 2, in group 3 than in group 2, and in groups 3 and 4 than in group 1 (all P < 0.001). However, it was comparable between groups 1 and 2 (P > 0.05). It correlated with the duration of T1DM and HbA1c, total cholesterol, triglyceride, and creatinine levels but not with age. Conclusions: Patients with T1DM with DR showed higher serum chemerin levels than those with T1DM without DR or healthy individuals. Serum chemerin levels were higher in those with PDR than in those with NPDR. Thus, serum chemerin levels are a potential biomarker of the development and severity of DR in patients with T1DM. Nevertheless, future diagnostic accuracy studies are required to confirm these potential applications.

Pharmacological and Molecular Perspectives on Diabetes is a compilation of reviews on clinical and scientific aspects of diabetes mellitus. It presents 11 contributions by eminent scholars that give the reader rational pharmacological and genetic perspectives of the disease and its treatment. The reviews approach diabetes from different angles, and highlight research that has been done to understand some questions about the molecular biology of diabetes in experimental settings. Topics of clinical significance such as the use of different hypoglycemic agents, and diabetic complications in clinical settings are also covered. Topics included in this book are: · Epigenetic alterations and type 2 diabetes mellitus · Responses to nutritional chromium supplements for type 2 diabetes mellitus · Endocrine role of osteocalcin in homeostatic regulation of glucose metabolism · Effect of diabetes on memory · Osteoarthritis in relation to type 2 diabetes mellitus: prevalence, etiology, symptoms and molecular mechanism · Infection of novel coronavirus in patients with diabetes mellitus · Role of an anti-inflammatory agent in the management of type 2 diabetes mellitus · Role of antidiabetic agents which helps regulates TCF7L2 variations in type 2 diabetes mellitus· Relationship between type 2 diabetes mellitus, PCOD and neurological disorders: role of antidiabetic drugs · Comparison of different types of insulin available for type 1 diabetes treatment · Circadian rhythm disruption: special reference to type 2 diabetes mellitus · Type 2 diabetes mellitus and its complications: pharmacogenetics based correlations and circulating microRNA as biomarkers Pharmacological and Molecular Perspectives on Diabetes should prove to be of interest to all pharmaceutical and molecular biology scientists who are involved in research in anti-diabetic drug design and discovery, and practicing endocrinologists who wish to keep abreast of recent developments in the field.

ObjectiveTo estimate the frequency of diabetic retinopathy in children with type 1 diabetes mellitus visiting diabetic clinic, National Institute of Child Health, Karachi.Case Report(s)Methodology: A retrospective cross sectional study was designed in which 100 children of T1DM were enrolled from Paediatrics endocrinology out-patient department of National Institute of Child Health (NICH) Karachi. Patients between the age of 10-17 years of either gender with duration of T1DM for more than 5 years and no previous known eye or systemic disease other than T1DM were included. The medical records of eye examination of 100 children from January to December 2017 were reviewed and analyzed. Patients were selected through non probability consecutive sampling technique and SPSS version 16 was used to analyze data.ResultsOne hundred patients of T1DM were enrolled, 82 were male and 18 were females. Mean age of the patients were 11.70±2.38 years (10–17 years) and 59% were <15 years. Mean duration diagnosis of T1DM was 7.05±0.7 years. Mild non proliferative Diabetic retinopathy (NPDR) was found in 17% patients and none had proliferative diabetic retinopathy.Conclusion(s)Mild Non Proliferative Retinopathy is quite high in our study population which could later on Progresses Proliferative Retinopathy. Screening for all the children should be mandatory for early diagnosis, management and future of eye complications. The screening for eye complications for all children Type I diabetes mellitus should be initiated annually after 5 years of diagnosis and in the children who are 10 years are older.

OBJECTIVE:--The purpose of this study was to examine risk factors for mortality in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS--Baseline risk factors were measured in the EURODIAB Prospective Cohort Study with 2,787 type 1 diabetic patients (51% men and 49% women) recruited from 16 European countries. Mortality data were collected during a 7-year follow-up. RESULTS:--There was an annual mortality rate of 5 per 1,000 person-years in patients with type 1 diabetes (mean age at baseline 33 years, range 15-61 years); of the total 2,787 subjects, 102 died. The final multivariable model contained age at baseline (standardized hazard ratio 1.78 [95% CI 1.44-2.20]), A1C (1.18 [0.95-1.46]), waist-to-hip ratio (WHR) (1.32 [1.14-1.52]), pulse pressure (1.33 [1.13-1.58]), and non-HDL cholesterol (1.33 [1.12-1.60]) as risk factors for all-cause mortality. Macroalbuminuria (2.39 [1.19-4.78]) and peripheral (1.88 [1.06-3.35]) and autonomic neuropathy (2.40 [1.32-4.36]) were the most important risk markers for mortality. Similar risk factors were found for all-cause, non-cardiovascular disease (CVD), unknown-cause, and CVD mortality. CONCLUSIONS:--Important risk factors for the increased total and non-CVD mortality in type 1 diabetic patients are age, WHR, pulse pressure, and non-HDL cholesterol. Microvascular complications from macroalbuminuria and peripheral and autonomic neuropathy are strong risk markers for future mortality exceeding the effect of the traditional risk factors.

Background This meta-analysis was conducted given the contradictory findings from studies on the influence of diabetes duration or age at onset on mortality in patients with insulin-dependent diabetes mellitus (IDDM). Methods Electronic databases (PubMed, Embase, Cochrane, Web of Knowledge, Scopus, and CINHAL) were comprehensively searched to identify relevant studies until October 31, 2022. All of the selected articles contained statistics on hazard ratios, relative risks (RRs), or odds ratios, or data for estimating the association between diabetes duration or age at onset and total mortality in IDDM patients. Regardless the heterogeneity assessed by the I 2 statistic, pooled RRs and 95% confidence intervals (CI) for total mortality were acquired via random effect meta-analysis with inverse variance weighting. Results This meta-analysis finally included 19 studies involving 122, 842 individuals. Both age at onset and diabetes duration were positively associated with an increased mortality rate in IDDM patients. Specifically, the pooled RRs for age at onset and diabetes duration were 1.89 (95%CI 1.43–2.50) and 1.89 (95%CI 1.16–3.09) respectively. Subgroup analyses revealed that only prepubertal onset was associated with a greater survival advantage than pubertal or postpubertal onset. Conclusions The findings of this meta-analysis and systematic review suggest that a later age at onset or longer diabetes duration is associated with increased risk of total mortality in IDDM patients. However, this conclusion shall be interpreted with caution due to the possibility of residual confounding and be confirmed in the future by well-designed studies.

Aims/hypothesis Type 1 diabetes is associated with a higher risk of major vascular complications and death. A reliable method that predicted these outcomes early in the disease process would help in risk classification. We therefore developed such a prognostic model and quantified its performance in independent cohorts. Methods Data were analysed from 1,973 participants with type 1 diabetes followed for 7 years in the EURODIAB Prospective Complications Study. Strong prognostic factors for major outcomes were combined in a Weibull regression model. The performance of the model was tested in three different prospective cohorts: the Pittsburgh Epidemiology of Diabetes Complications study (EDC, n  = 554), the Finnish Diabetic Nephropathy study (FinnDiane, n  = 2,999) and the Coronary Artery Calcification in Type 1 Diabetes study (CACTI, n  = 580). Major outcomes included major CHD, stroke, end-stage renal failure, amputations, blindness and all-cause death. Results A total of 95 EURODIAB patients with type 1 diabetes developed major outcomes during follow-up. Prognostic factors were age, HbA 1c , WHR, albumin/creatinine ratio and HDL-cholesterol level. The discriminative ability of the model was adequate, with a concordance statistic (C-statistic) of 0.74. Discrimination was similar or even better in the independent cohorts, the C-statistics being: EDC, 0.79; FinnDiane, 0.82; and CACTI, 0.73. Conclusions/interpretation Our prognostic model, which uses easily accessible clinical features can discriminate between type 1 diabetes patients who have a good or a poor prognosis. Such a prognostic model may be helpful in clinical practice and for risk stratification in clinical trials.