BackgroundAlthough several studies have found probiotics encouraging in prevention of gestational diabetes mellitus (GDM), the evidence for the use of probiotics in diagnosed GDM is largely limited. The aim of this study was to assess the effect of a probiotic supplement capsule containing four bacterial strains on glucose metabolism indices and weight changes in women with newly diagnosed GDM.MethodsSixty-four pregnant women with GDM were enrolled into a double-blind placebo-controlled randomized clinical trial. They were randomly assigned to receive either a probiotic or placebo capsule along with dietary advice for eight consecutive weeks. The trend of weight gain along with glucose metabolism indices was assayed.ResultsDuring the first 6 weeks of the study, the weight gain trend was similar between the groups. However, in the last 2 weeks of the study, the weight gain in the probiotic group was significantly lower than in the placebo group (p < 0.05). Fasting blood sugar (FBS) decreased in both intervention (from 103.7 to 88.4 mg/dl) and control (from 100.9 to 93.6 mg/dl) groups significantly, and the decrease in the probiotic group was significantly higher than in the placebo group (p < 0.05). Insulin resistance index in the probiotic group had 6.74 % reduction over the study period (p < 0.05). In the placebo group, however, there was an increase in insulin resistance index (6.45 %), but the observed change in insulin resistance was not statistically significant. Insulin sensitivity index was increased in both groups. The post-intervention insulin sensitivity index in the probiotic group was not significantly different from placebo when adjusted for the baseline levels.ConclusionsThe probiotic supplement appeared to affect glucose metabolism and weight gain among pregnant women with GDM. This needs to be confirmed in other settings before a therapeutic value could be approved.
Athrosclerosis is conceived as a chronic inflammatory status affecting cells from vascular walls. Different mechanisms and pathological features are evident at the onset of atherosclerotic changes via the engaging different cells from the vascular wall and circulatory cells. Attempts are currently focused on the detection of cell compensatory mechanisms against atherosclerotic changes to restore cell function and/or postpone severe vasculitis. Autophagy is an intracellular self-digesting process commonly protrudes exhausted organelles and injured cytoplasmic constituents via double-lipid bilayer membrane vesicles out the target cells. Recent investigations point to the critical and defensive role of autophagy in the vascular cells behavioral function such as endothelial cells and smooth muscle cells against different insults. Autophagy response and related effectors could be modulated in the favor to restore cell function and reduce pro-inflammatory status under pathological conditions. In this review, the recent findings were collected regarding the role of autophagy during atherosclerotic changes. We aimed to answer the question of how autophagy stimulation and/or inhibition could provide a promising effect on developing a sophisticated treatment for AS.
We examine the effects of metformin on insulin resistance (IR) and mood including in adolescent and adult women with polycystic ovary syndrome (PCOS). This trial was conducted in 19 adolescents (age ≤18 years) and 25 adult (age >18 years) women with PCOS. Anthropometric and measurements including, serum glucose, endocrine panel, and lipid profile were performed at baseline. IR was measured by Homeostasis Model Assessment IR (HOMA-IR). Anxiety and depression were measured by Beck's Anxiety (BAI) and Depression Inventories (BDI-II). All tests were repeated after a 90-day treatment with metformin (1,500 mg/day). The severity of depression and anxiety decreased after 90-day treatment with metformin in women diagnosed with PCOS. The BAI scores were higher in adolescent group while BDI-II scores were higher in the adult group (p = .016). After 90-day metformin treatment, both BDI-II and BAI scores were decreased by 3.3 and 3.4, respectively (p < .001). Indicators of IR and obesity were improved with this therapy. Although the adolescents weighed lower than the adults, baseline HOMA-IR 5.5 ± 1.7 was higher in this group than 4.4 ± 1.2 in the adult women (p =.022). The findings suggest that metformin decrease IR and improve mood both in adolescent and adult women with PCOS.
Thyroid diseases may cause signs and symptoms of neuromuscular dysfunction. Hypothyroidism has been associated with the clinical features of proximal muscle weakness, mononeuropathy, and sensorimotor polyneuropathy. This study aimed at evaluating the electrophysiologic findings in patients with untreated spontaneous hypothyroidism and comparing them with a healthy control group. In a case-control cross-sectional study, 40 patients with definite diagnosis of clinical hypothyroidism and 40 healthy control subjects were evaluated by electromyography and nerve conduction studies in the specialized clinic of the Tabriz University of Medical Sciences during an 18-month period. Seven male and 33 female patients with a mean age of 39.5 ± 11.8 years were enrolled. In this group, there were 12 cases (30%) with clinical muscle weakness, with severity of approximately 4/5, 18 cases (45%) with decreased or absent deep tendon reflexes, 6 cases (15%) with neuropathy, including 4 sensory and 2 sensorimotor, of which 5 cases were mild and 1 case was moderate, 3 cases (7.5%) with myopathy, and 13 cases (32.5%) with carpal tunnel syndrome, which was mild in 7, moderate in 10, and severe in 2 hands. Patients with neuropathy were significantly older than those without neuropathy (P = 0.001). There was no significant relation between gender, duration of the disease, serum TSH level, and the presence of clinical muscle weakness with the occurrence of neuropathy or myopathy. Female gender, increasing age, duration of the disease, and the frequency of clinical weakness were, however, significantly related to the presence of carpal tunnel syndrome (P < 0.05). In conclusion, in patients with untreated primary hypothyroidism, majority had the carpal tunnel syndrome. Mild neuropathy mainly of sensory type and myopathy were uncommon and rare findings, respectively. Early treatment would hinder the progression of mentioned abnormalities and minimize their occurrence.
Okra (Abelmoschus esculentus) has traditionally been used in diabetes treatment. This study investigated the effect of Okra whole fruit on blood glucose level of patients with diabetes mellitus type 2 with concomitant use of oral hypoglycemic agents. In this double-blind randomized clinical trial, 120 diabetic patients were assigned to okra group (n = 60) and control group (n = 60). The okra group received 1,000 mg of A.esculentus whole fruit capsules orally, every 6 hr for 8 weeks. The control group received placebo capsule in the same manner. The levels of FBS (fasting blood sugar), BS (blood sugar), and Hemoglobin A1C (HgA1c) were measured at baseline and after intervention in both groups. The levels of FBS, BS, and HgA1c were significantly decreased in okra group within the intervention compared to control group (p < .05).Moreover, the numbers to treat (NNT) for FBS, BS, and HgA1C were seven, eight, and seven, respectively. Okra whole fruit supplementation has a promising antihyperglycemic effect in patients with diabetes mellitus type 2 who received oral agents. Diabetic patients could benefit from adjuvant therapy of okra with other medication.
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