2型糖尿病模型GK大鼠骨形态学和生物力学特点观察

目的观察2型糖尿病模型GK大鼠的骨代谢特点以及骨密度和骨生物力学特性的变化。方法采用雄性6月龄GK大鼠10只,以月龄、性别匹配的健康Wistar大鼠作为正常对照。颈静脉取血检测与骨代谢有关的生化指标。DXA法测定股骨和腰椎骨密度,并行股骨三点弯曲实验和腰椎压缩实验。甲基丙烯酸甲酯包埋胫骨干骺端以制备不脱钙骨切片。应用多媒体病理图像分析软件进行骨组织形态计量学分析。结果GK大鼠体重明显低于健康对照Wistar大鼠（P〈0.01）。与对照组相比,GK大鼠血清骨钙素水平明显降低[（4.97±0.49,6.75±0.71）μg/mL,P〈0.01],而抗酒石酸酸性磷酸酶活性明显升高[（17.92±5.23,8.31±2.69）U/L,P〈0.01],但血钙和血磷无明显变化（P〉0.05）;股骨和腰椎骨密度显著降低[（0.16±0.01,0.22±0.02;0.12±0.01,0.16±0.02）g/cm2,P〈0.01];骨强度和腰椎的弹性模量明显降低（P〈0.01）。骨形态学分析显示GK大鼠股骨长度和第五腰椎高度分别降低10.3%和9.5%（P〈0.01）,股骨和腰椎横截面积无明显变化（P〉0.05）。骨组织形态计量学分析显示,GK大鼠骨小梁体积、骨小梁厚度、类骨质表面和厚度明显降低[（15.72±1.18,19.13±1.13）%,（61.91±4.54,74.43±3.63）μm,（18.18±1.25,19.63±1.07）%,（3.68±0.48,4.34±0.35）μm,P〈0.01或0.05],动态参数如矿化表面、矿化沉积率和骨形成率也明显降低[（17.77±1.54,19.56±2.07）%,（1.07±0.22,1.35±0.16;0.20±0.03,0.26±0.04）μm/day,P〈0.05或0.01],而矿化延迟时间显著延长（2.66±0.56,2.12±0.35,P〈0.05）。结论非肥胖的GK大鼠表现有骨量减少和骨折危险性增加;2型糖尿病本身可干扰成骨细胞功能和活性而导致骨重建失衡。     

Ultra Rapid-Acting Inhaled Insulin Improves Glucose Control in Patients With Type 2 Diabetes Mellitus

ObjectiveTo determine whether the use of an inhaled insulin would improve HbA1c.MethodsThis study was performed in 20 type 2 diabetes mellitus (T2DM) participants with HbA1c values ≥7.5 (58) to ≤11.5% (102 mmol/mol) on a variety of glucose-lowering regimens. Prandial Technosphere insulin (TI) was rapidly titrated based on a treatment algorithm using postprandial blood glucose to calculate premeal doses. A 2-week baseline period was followed by 12 weeks of active treatment with TI. The primary outcome was change in HbA1c. Secondary outcomes included glucose time in range (time in range: 70-180 mg/dL) obtained by a blinded continuous glucose monitoring during the baseline period and at the end of 12 weeks. Goals were to assess how to rapidly and safely initiate TI intensification, determine dosing requirements, and establish an effective dose range in uncontrolled T2DM.ResultsMean HbA1c decreased by −1.6% (−17 mmol/mol) from 9.0% (75 mmol/mol) at baseline to 7.4% (57 mmol/mol) at 12 weeks (P < .0001). Mean time in range increased from 42.2% to 65.7% (P < .0002). Mean prandial doses of TI were 18 or 19 units for all meals. Time below range was 1.1% baseline and 2.6% post treatment (P = .01).ConclusionTreatment with inhaled TI dosed using a simple algorithm improved glycemic control measured by both HbA1c and time in range, with low rates of hypoglycemia. These data add significantly to understanding TI in the management of T2DM patients for whom prandial insulin is a consideration.     

ARA 290, a Nonerythropoietic Peptide Engineered from Erythropoietin,Improves Metabolic Control and Neuropathic Symptoms in Patients with Type 2 Diabetes

Although erythropoietin ameliorates experimental type 2 diabetes with neuropathy, serious side effects limit its potential clinical use. ARA 290, a nonhematopoietic peptide designed from the structure of erythropoietin, interacts selectively with the innate repair receptor that mediates tissue protection. ARA 290 has shown efficacy in preclinical and clinical studies of metabolic control and neuropathy. To evaluate the potential activity of ARA 290 in type 2 diabetes and painful neuropathy, subjects were enrolled in this phase 2 study. ARA 290 (4 mg) or placebo were self-administered subcutaneously daily for 28 d and the subjects followed for an additional month without further treatment. No potential safety issues were identified. Subjects receiving ARA 290 exhibited an improvement in hemoglobin A_1c (Hb A_1c) and lipid profiles throughout the 56 d observation period. Neuropathic symptoms as assessed by the PainDetect questionnaire improved significantly in the ARA 290 group. Mean corneal nerve fiber density (CNFD) was reduced significantly compared with normal controls and subjects with a mean CNFD >1 standard deviation from normal showed a significant increase in CNFD compared with no change in the placebo group. These observations suggest that ARA 290 may benefit both metabolic control and neuropathy in subjects with type 2 diabetes and deserves continued clinical evaluation.     

Glucose Tolerance and Insulin Response in Atherosclerosis

Oral glucose tolerance tests were carried out on 51 men with atherosclerotic peripheral vascular disease, none of whom were known diabetics or had suffered recent myocardial infarction. The plasma insulin and blood sugar responses were compared with 47 age and sex-matched controls. There was no significant difference in obesity between the two groups. The patient group showed an increased plasma insulin response with a delay in return to fasting levels, and the blood sugar response was similar. These results suggest that hyperinsulinaemia and hyperglycaemia are often associated with atherosclerosis, and may have a role in its aetiology.     

胰岛素信号通路相关因子在2型糖尿病合并骨质疏松大鼠肝组织的表达

通过高糖高脂饲料联合小剂量链脲佐菌素和去卵巢手术制备2型糖尿病合并骨质疏松大鼠模型,探讨2型糖尿病合并骨质疏松大鼠肝组织胰岛素信号通路相关因子的表达及意义。结果表明:随着时间延长,2型糖尿病合并骨质疏松组(DOVX组)肝组织IGF-1、IRS-1较其他组mRNA及蛋白表达减少,单纯去卵巢组(NOVX组)IGF-1、IRS-1 mRNA及蛋白表达较假手术对照组(NS组)降低;糖尿病组(DS组)IRS-2较NS组mRNA及蛋白表达下降,但NOVX组与NS组IRS-2 mRNA及蛋白表达比较无明显差别。以上结果表明,2型糖尿病合并骨质疏松的发生可能与肝脏胰岛素信号通路受抑制有关。     

栀子水提取物对实验性2型糖尿病大鼠血糖及同型半胱氨酸水平的影响

观察栀子提取物对实验性2型糖尿病大鼠血糖、血脂及同型半胱氨酸水平的影响.采用Wistar雄性大鼠70只,随机抽取10只作为正常对照组,喂以普通维持饲料,其余60只高糖高脂饲料喂养4周后,ip链脲佐菌素(STZ)30 mg/kg建立2型糖尿病模型,7d后选取成模大鼠50只随机分为模型对照组(生理盐水)、盐酸二甲双胍对照组、栀子提取物低、中、高剂量组(0.2、0.4、0.6 g/kg),每组10只.连续ig给药4周后,观察各组大鼠血糖、血脂及同型半胱氨酸水平等变化.栀子提取物ig能降低糖尿病大鼠的血糖、甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白(LDLC),同时能升高高密度脂蛋白(HDLC),降低同型半胱氨酸水平.     

Effects of Relaxation Training on Glucose Tolerance and Diabetic Control in Type II Diabetes

The present study examined the effects of progressive relaxation training and EMG biofeedback on acute glucose disposal in diabetic subjects, as measured by glucose tolerance and three other measures of diabetic metabolic control. Twenty subjects with non-insulin-using Type II diabetes took part in progressive relaxation training and EMG biofeedback in a pre-post treatment versus wait-list experimental design. Treatment effects were assessed on glucose tolerance along with three measures of diabetic control: fasting blood glucose, two-hour postprandial blood glucose, and fructosamine. Stress reduction and relaxation was assessed with two physiological measures and two subjective questionnaires. The training program produced significant reductions in stress, as measured by State Anxiety, and significant changes in physiological measures of muscle activity and skin conductance compared to the control condition. However, no changes were found in glucose tolerance (while practicing relaxation) nor in any of the three measures of general diabetic metabolic control. The major implication of this study is that relaxation training does not appear to directly improve diabetic control in mildly stressed non-insulin-using Type II diabetic patients.     

ARA 290 Improves Symptoms in Patients with Sarcoidosis-Associated Small Nerve Fiber Loss and Increases Corneal Nerve Fiber Density

Small nerve fiber loss and damage (SNFLD) is a frequent complication of sarcoidosis that is associated with autonomic dysfunction and sensory abnormalities, including pain syndromes that severely degrade the quality of life. SNFLD is hypothesized to arise from the effects of immune dysregulation, an essential feature of sarcoidosis, on the peripheral and central nervous systems. Current therapy of sarcoidosis-associated SNFLD consists primarily of immune suppression and symptomatic treatment; however, this treatment is typically unsatisfactory. ARA 290 is a small peptide engineered to activate the innate repair receptor that antagonizes inflammatory processes and stimulates tissue repair. Here we show in a blinded, placebo-controlled trial that 28 d of daily subcutaneous administration of ARA 290 in a group of patients with documented SNFLD significantly improves neuropathic symptoms. In addition to improved patient-reported symptom-based outcomes, ARA 290 administration was also associated with a significant increase in corneal small nerve fiber density, changes in cutaneous temperature sensitivity, and an increased exercise capacity as assessed by the 6-minute walk test. On the basis of these results and of prior studies, ARA 290 is a potential disease-modifying agent for treatment of sarcoidosis-associated SNFLD.     

A Mixed Mirror-image DNA/RNA Aptamer Inhibits Glucagon and Acutely Improves Glucose Tolerance in Models of Type 1 and Type 2 Diabetes

Excessive secretion of glucagon, a functional insulin antagonist, significantly contributes to hyperglycemia in type 1 and type 2 diabetes. Accordingly, immunoneutralization of glucagon or genetic deletion of the glucagon receptor improved glucose homeostasis in animal models of diabetes. Despite this strong evidence, agents that selectively interfere with endogenous glucagon have not been implemented in clinical practice yet. We report the discovery of mirror-image DNA-aptamers (Spiegelmer®) that bind and inhibit glucagon. The affinity of the best binding DNA oligonucleotide was remarkably increased (>25-fold) by the introduction of oxygen atoms at selected 2′-positions through deoxyribo- to ribonucleotide exchanges resulting in a mixed DNA/RNA-Spiegelmer (NOX-G15) that binds glucagon with a K_d of 3 nm. NOX-G15 shows no cross-reactivity with related peptides such as glucagon-like peptide-1, glucagon-like peptide-2, gastric-inhibitory peptide, and prepro-vasoactive intestinal peptide. In vitro, NOX-G15 inhibits glucagon-stimulated cAMP production in CHO cells overexpressing the human glucagon receptor with an IC₅₀ of 3.4 nm. A single injection of NOX-G15 ameliorated glucose excursions in intraperitoneal glucose tolerance tests in mice with streptozotocin-induced (type 1) diabetes and in a non-genetic mouse model of type 2 diabetes. In conclusion, the data suggest NOX-G15 as a therapeutic candidate with the potential to acutely attenuate hyperglycemia in type 1 and type 2 diabetes.     

TAZ Is a Negative Regulator of PPARγ Activity in Adipocytes and TAZ Deletion Improves Insulin Sensitivity and Glucose Tolerance

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Glucose Tolerance and Serum Insulin in Identical Twins of Diabetics

Glucose tolerance with serum insulin assay has been carried out in 24 apparently unaffected identical twins of diabetics. Glucose values were significantly higher and insulin values significantly lower than in control subjects, but there was considerable individual variation and in half the cases glucose tolerance was normal. There was no case of increased insulin response. In these twins glucose tolerance and insulin response were not correlated with weight, family history of diabetes, age at diagnosis of diabetes in the affected twin, time since that diagnosis, nor with age at testing the unaffected twin. On retesting 12 of the twins after two years no significant differences were found from the first testing.We conclude that not all these twins are likely to develop diabetes, that the assumption that identical twins of diabetics are necessarily “prediabetic” is probably erroneous, and that factors other than genetic ones are important in the aetiology of diabetes.     

The Effects of Dietary Iron and Capsaicin on Hemoglobin,Blood Glucose,Insulin Tolerance,Cholesterol, and Triglycerides,in Healthy and Diabetic Wistar Rats

ObjectiveOur aim was to assess the effects of dietary iron, and the compound capsaicin, on hemoglobin as well as metabolic indicators including blood glucose, cholesterol, triglycerides, insulin, and glucose tolerance.ResultsHealthy rats fed a low-iron diet exhibited significantly reduced total cholesterol and triglyceride levels, compared with rats fed a control diet. Significantly reduced blood lipid was also provoked by low dietary iron in diabetic rats, compared with those fed a control diet. Insulin, and glucose tolerance was only improved in healthy rats fed the low-iron diet. Significant increases in total cholesterol were found in diabetic rats fed a high-iron diet, compared with healthy rats fed the same diet, although no statistical differences were found for triglycerides. Hemoglobin levels, which were not statistically different in diabetic versus healthy rats fed the high-iron diet, fell when capsaicin was added. Capsaicin also provoked a fall in the level of cholesterol and triglycerides in diabetic animals, versus diabetics fed with the high iron diet alone. In conclusion, low levels of dietary iron reduced levels of serum triglycerides, hemoglobin, and cholesterol, and significantly improved insulin, and glucose tolerance in healthy rats. In contrast, a high-iron diet increased cholesterol significantly, with no significant changes to triglyceride concentrations. The addition of capsaicin to the high-iron diet (for diabetic rats) further reduced levels of hemoglobin, cholesterol, and triglycerides. These results suggest that capsaicin, may be suitable for the treatment of elevated hemoglobin, in patients.     

Cell Treatment for Stroke in Type Two Diabetic Rats Improves Vascular Permeability Measured by MRI

Treatment of stroke with bone marrow stromal cells (BMSC) significantly enhances brain remodeling and improves neurological function in non-diabetic stroke rats. Diabetes is a major risk factor for stroke and induces neurovascular changes which may impact stroke therapy. Thus, it is necessary to test our hypothesis that the treatment of stroke with BMSC has therapeutic efficacy in the most common form of diabetes, type 2 diabetes mellitus (T2DM). T2DM was induced in adult male Wistar rats by administration of a high fat diet in combination with a single intraperitoneal injection (35mg/kg) of streptozotocin. These rats were then subjected to 2h of middle cerebral artery occlusion (MCAo). T2DM rats received BMSC (5x10⁶, n = 8) or an equal volume of phosphate-buffered saline (PBS) (n = 8) via tail-vein injection at 3 days after MCAo. MRI was performed one day and then weekly for 5 weeks post MCAo for all rats. Compared with vehicle treated control T2DM rats, BMSC treatment of stroke in T2DM rats significantly (p<0.05) decreased blood-brain barrier disruption starting at 1 week post stroke measured using contrast enhanced T₁-weighted imaging with gadopentetate, and reduced cerebral hemorrhagic spots starting at 3 weeks post stroke measured using susceptibility weighted imaging, although BMSC treatment did not reduce the ischemic lesion volumes as demarcated by T₂ maps. These MRI measurements were consistent with histological data. Thus, BMSC treatment of stroke in T2DM rats initiated at 3 days after stroke significantly reduced ischemic vascular damage, although BMSC treatment did not change infarction volume in T2DM rats, measured by MRI.     

Miglitol (BAY m 1099) Treatment of Diabetic Hypothalamic-Dietary Obese Rats Improves Islet Response to Glucose

AXEN, KATHLEEN V., XUE LI, AND ANTHONY SCLAFANI. Miglitol (BAY m 1099) treatment of diabetic hypothalamic-dietary obese rats improves islet response to glucose. Obes Res. 1999;7:83–89. Objective : The well-absorbed α-glucosidase inhibitor, miglitol (BAY m 1099), was included in the diets of hypothalamic-dietary obese diabetic rats to investigate its ability to improve glycemia and thereby reverse glucotoxic effects on islet secretory response. Research Methods and Procedures : Female rats received bilateral electrolytic lesions of the ventromedial hypothalamus and were fed high-fat, sucrosesupplemented diets until hyperinsulinemia and hyperglycemia were observed after 3 hours of food deprivation (nonfed). Diabetic animals were assigned to miglitol-treated (40 mg/17 g of diet) or untreated groups for 3 weeks; pancreatic islets were isolated for incubation experiments. Results : No differences in food intake, body weights, or nonfed plasma glucose or insulin levels were seen between treated and untreated diabetic rats. Islets isolated from untreated diabetic rats showed elevated basal insulin release and no insulin secretory response to an elevation in glucose concentration. In contrast, islets obtained from miglitol-treated rats showed more normal basal release and a significant insulin secretory response to glucose. Incubation of islets, obtained from normal control rats or untreated diabetic rats, in media containing miglitol at levels estimated to exist in plasma of treated rats had no effect on islet insulin secretory responses to glucose. Discussion : Islet secretory response was improved despite continued hyperglycemia and severe insulin resistance. Miglitol treatment may improve islet sensitivity to glucose either through effects on islet metabolism requiring prolonged exposure or by improvement in postmeal glycemia, despite persistent hyperglycemia.     

Compromised Wound Healing in Ischemic Type 2 Diabetic Rats

Ischemia is one of the main epidemic factors and characteristics of diabetic chronic wounds, and exerts a profound effect on wound healing. To explore the mechanism of and the cure for diabetic impaired wound healing, we established a type 2 diabetic rat model. We used an 8weeks high fat diet (HFD) feeding regimen followed by multiple injections of streptozotocin (STZ) at a dose of 10mg/kg to induce Wister rat to develop type 2 diabetes. Metabolic characteristics were assessed at the 5th week after the STZ injections to confirm the establishment of diabetes mellitus on the rodent model. A bipedicle flap, with length to width ratio 1.5, was performed on the back of the rat to make the flap area ischemic. Closure of excisional wounds on this bipedicle flap and related physiological and pathological changes were studied using histological, immunohistochemical, real time PCR and protein immunoblot approaches. Our results demonstrated that a combination of HFD feeding and a low dose of STZ is capable of inducing the rats to develop type 2 diabetes with noticeable insulin resistance, persistent hyperglycemia, moderate degree of insulinemia, as well as high serum cholesterol and high triglyceride levels. The excision wounds on the ischemic double pedicle flap showed deteriorative healing features comparing with non-ischemic diabetic wounds, including: delayed healing, exorbitant wound inflammatory response, excessive and prolonged ROS production and excessive production of MMPs. Our study suggested that HFD feeding combined with STZ injection could induce type 2 diabetes in rat. Our ischemic diabetic wound model is suitable for the investigation of human diabetic related wound repair; especically for diabetic chronic wounds.     

Hydrogen Improves Glycemic Control in Type1 Diabetic Animal Model by Promoting Glucose Uptake into Skeletal Muscle

Hydrogen (H₂) acts as a therapeutic antioxidant. However, there are few reports on H₂ function in other capacities in diabetes mellitus (DM). Therefore, in this study, we investigated the role of H₂ in glucose transport by studying cultured mouse C2C12 cells and human hepatoma Hep-G2 cells in vitro, in addition to three types of diabetic mice [Streptozotocin (STZ)-induced type 1 diabetic mice, high-fat diet-induced type 2 diabetic mice, and genetically diabetic db/db mice] in vivo. The results show that H₂ promoted 2-[¹⁴C]-deoxy-d-glucose (2-DG) uptake into C2C12 cells via the translocation of glucose transporter Glut4 through activation of phosphatidylinositol-3-OH kinase (PI3K), protein kinase C (PKC), and AMP-activated protein kinase (AMPK), although it did not stimulate the translocation of Glut2 in Hep G2 cells. H₂ significantly increased skeletal muscle membrane Glut4 expression and markedly improved glycemic control in STZ-induced type 1 diabetic mice after chronic intraperitoneal (i.p.) and oral (p.o.) administration. However, long-term p.o. administration of H₂ had least effect on the obese and non-insulin-dependent type 2 diabetes mouse models. Our study demonstrates that H₂ exerts metabolic effects similar to those of insulin and may be a novel therapeutic alternative to insulin in type 1 diabetes mellitus that can be administered orally.     

明日叶查尔酮对2型糖尿病大鼠骨骼肌细胞胰岛素抵抗的干预作用

目的:研究明日叶查尔酮对2型糖尿病大鼠骨骼肌胰岛素抵抗的干预作用.方法:将2型糖尿病大鼠随机分成四组,高、中、低剂量组分别每日经口灌胃给予明日叶查尔酮30、10和5mg/(kg·bw),糖尿病对照组给予等量生理盐水.各组均以高脂饲料喂养.四周后采用葡萄糖氧化酶法检测空腹血糖;放射免疫法检测血清胰岛素含量;免疫组化法检测葡萄糖转运体1和葡萄糖转运体4蛋白表达水平.结果:经图像分析,高剂量组骨骼肌细胞中葡萄糖转运体1和葡萄糖转运体4蛋白表达平均光密度值分别为0.054± 0.0064和0.063±0.0139,均较糖尿病对照组显著性升高(P＜0.05).高剂量组空腹血糖和胰岛素水平分别为(12.3± 1.64)mmol/L和(25.65±3.34) (μIU/mL),均较糖尿病对照病显著性降低(P＜0.05).结论:明日叶查尔酮可增加2型糖尿病大鼠骨骼肌葡萄糖转运体l和葡萄糖转运体4蛋白表达水平,降低空腹血糖和胰岛素水平,改善胰岛素抵抗状况.