Background: Diabetes mellitus and prediabetes have been shown to be associated with high rates of developing severe COVID 19 complications resulting in morbidity and mortality. Emerging reports suggest that COVID 19 is associated with glycaemic control aberrations although the extent is not clear at present. Accordingly, in this review, the efforts are directed to shed light on why we can anticipate an increase in diabetes cases amid or post-COVID 19 pandemic. Methods: Articles reviewed were identified using Google Scholar database, and the search was done using English language. Results: Previous studies have shown that viral inflammation triggers insulin resistance which can progress to overt diabetes. SARS-CoV-2 has also been shown to cause acute pancreatitis, which can increase the risk of developing diabetes mellitus. The control of the COVID 19 pandemic partly relied on non-pharmaceutical measures which included lockdowns. This resulted in a lack of physical activity and unhealthy eating behaviour which could contribute to obesity and ultimately insulin resistance. Conclusion: While there is no concrete data that has been estabilished on the possibility of seeing an increase in diabetes prevalence due to COVID 19, studies are necessary to establish the link. Despite the unavailability of data at present, however, we suggest that frequent screening of diabetes and prediabetes should be encouraged, especially in those individuals with a history of COVID 19 infection.
Vanadium has demonstrated antihyperglycemic effects in diabetes mellitus (DM) but is, however, associated with toxicity. Therefore, new vanadium complexes envisaged to possess heightened therapeutic potency while rendering less toxicity are being explored. Accordingly, the aim of the study was to investigate the effects of a dioxidovanadium (V) complex, cis-[VO2 (obz) py], on selected glucose metabolism markers in streptozotocin (STZ)-induced diabetic rats. STZ-induced diabetic rats were treated orally with cis-[VO2 (obz) py] (10, 20, and 40 mg/kg) twice every 3rd day for 5 weeks. Blood glucose concentrations, body weight, and food and water intake were monitored weekly, for 5 weeks. Rats were then euthanized after which blood, liver, and muscle tissues were collected for biochemical analysis. The administration of dioxidovanadium complex significantly decreased blood glucose concentrations throughout the 5-week period in comparison with the diabetic control (DC). The attenuation of hyperglycemia was accompanied by an increased glycogen concentration in both liver and muscle tissues in the treated groups. Furthermore, a significant increase was observed in the expression of glucose transporter type 4 (GLUT4) in the skeletal muscle tissues and glycogen synthase in the liver tissues. These findings indicate that our vanadium complex cis-[VO2 (obz) py] may exert antihyperglycemic effects through increased glucose uptake, glycogen synthesis, and increased GLUT4 and glycogen synthase expression.
Since the discovery of insulin, continuous developments of this peptide have led to better management of diabetes mellitus, thus leading to a decrease in diabetes-related mortality. Despite these developments, we have seen an increase in diabetes cases, which has further necessitated for more innovative methods of diabetes management. The subcutaneous administration of insulin remains the mainstay therapy for type 1 diabetes mellitus. However, despite the availability of insulin analogues with improved pharmacokinetics, challenges with the conventional administration exists. The challenges associated with insulin injections include hypoglycaemic episodes, needle phobia, and injection-site inflammation which all have been reported to reduce patient compliance. Ongoing research on diabetes management strives to develop therapies that provide improved glycaemic control with minimal side effects. It is, in part, for these reasons that we have seen an increase in the search and development of alternative insulin delivery systems that are envisaged to circumvent the shortfalls associated with the conventional administration route. In the last century, several alternative drug delivery systems such as oral, pulmonary, buccal, nasal and transdermal have been explored. These efforts have not been without victory, as we have seen the emergence of pulmonary (Exubera and Afrezza) and buccal insulin delivery systems licenced for therapeutic use. Despite the success seen in these two systems, their marketability and popularity have been severely compromised due to reported safety concerns. Although oral insulin delivery has always shown promise in the past decades, however it was only limited to preclinical trials. The main challenge associated this with delivery route is poor bioavaialabiltiy which necessitates high insulin concentration to be administered. Recent developments have however seen oral insulin reaching phase 3 clinical trials. It is believed that patients would welcome oral insulin as their preference is often observed for oral antidiabetics over injected ones. In the last decade, transdermal insulin has also gained interest, where delivery of insulin with concomitant reducation in blood glucose concentration have been demonstrated in vivo. However, at present, there are no clinical studies that have reported the efficacy of transdermal insulin administration With technological advancement, there is a potential to develop yet another insulin delivery system which would likely enter the markets. Although these novel delivery systems are welcome, however, emerging competing products should be welcome and appreciated
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