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Can Gestational Anti-Diabetic Plants Using in Cameroon Manage Preeclampsia?

Preeclampsia is a persistent hypertensive gestational disease that might happen during pregnancy (antepartum), during delivery (intrapartum) or after childbirth (postpartum). It is clinically characterized by maternal high hypertension (>140/90mmHg systolic/diastolic blood pressure) and massive proteinuria (>300mg/24h). Severe cases are manifested by the development of comorbidities such as eclampsia, liver damage, edema and scattered vascular coagulation in mother and the complications in the fetus like fetal growth restriction, premature birth and fetal death. In Africa, the prevalence of eclampsia varies from 1/100 to 1/1700 pregnancies, and Cameroon it happens in 0.92/1 100 deliveries. Our objective was to determine among antidiabetic and gestational plants used in Cameroon those that can control preeclampsia. To achieve this objective three following engines of research were used in Google, Google Scholar and PubMed: “a given antidiabetic plant treated gestational women with preeclampsia “; “a single given antidiabetic plant treated three complications of preeclampsia” and “a given antidiabetic plant may regulate hypertension in women with preeclampsia. Twelve (12) plants were recorded and belong to 10 families and 12 genera. Six plants (Curcuma longa, Brassica oleracea, Moringa oleifera, Passiflora incarnata, Passiflora edulis and Passiflora foetida) intervene in direct treatment of preeclampsia and all the twelve were used in symptomatic treatment of preeclampsia. The most important plants are Brassica oleracea and Solanum melongena with 127 and 99 repetitions respectively. Strong recommendation of further studies for finding non-toxic doses is necessary for developing anti-preeclampsia future phytodrugs.

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The Metabolic Syndrome Diseases – Interventions Using Micronutrients

Metabolic Syndrome is defined as a cluster of interrelated conditions such as central obesity, dyslipidemia, impaired glucose metabolism and hypertension [1]. In addition to genetic predisposition as in South Asians, a sedentary lifestyle and a high caloric intake contribute to the development of this cluster of metabolic conditions. The worldwide increase in the incidence of this condition has made it a global epidemic. The recent Finnish study [2] attests to the decrease in incidence of Type 1 diabetes following fortification of dietary milk products with cholecalciferol. Insulin resistance and central obesity standout as the common feature of this cluster of conditions. The binding of insulin-to-insulin receptor (IR) results in the dimerization of the alpha and beta subunits and auto phosphorylation of the beta subunit leading to the activation of the Ras – MAPK and PI3K – Akt signaling cascades. The activation of PI3K associated with insulin receptors IRS1 and IRS2 results in the phosphorylation Akt-Foxo1 and is central to the control of nutrient homeostasis. The inactivation of Akt – Foxo1 pathway with the resulting activation of the forkhead/winged helix family transcription factor through suppression of IRS1 and IRS2 in organs following hyperinsulinemia, are suggested to be key mechanisms in the development of the metabolic syndrome. Hence, targeting the IRS – Akt – Foxo1 signaling cascade will provide a therapeutic approach for the treatment of the metabolic syndrome cluster of conditions. The activation of Akt affects cell survival and energy homeostasis by increasing glycogen synthetase activity, decreasing gluconeogenesis, promoting hepatic lipogenesis and cardiac cell survival. These phosphorylation-mediated cell events are the result of insulin signaling in various cells and tissues. Insulin is at the centre of adaptive metabolic transition in insulin-responsive tissues. Hyperinsulinemia inhibits the acute action of insulin on Foxo1 phosphorylation as well as transcription of IRS2 gene in insulin-responsive tissues.

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Effect of Ramadan Fasting on Biochemical Parameters, Dietary Intake in Type 2 Diabetes Miletus in the State of Qatar

Background: During Ramadan, type 2 diabetic Muslims abstain from eating and drinking from sunrise to sunset. This long fasting period may cause changes in blood glucose, glycosylated hemoglobin, lipid profile and other biochemical parameters, eating behaviors, and nutrient intake. The purpose of this study was to assess the effects of Ramadan fasting on nutrient intake, changes in blood sugar, lipid profile and, other biochemical parameters in type 2 diabetic patients who fasted Ramadan in the state of Qatar.

Methods: The study was conducted among 38 Muslim subjects with type 2 diabetes mellitus who undertook fasting during Ramadan. All subjects were subjected to a dietary assessment at three stages, i.e., Before Ramadan (BR), During Ramadan (DR), and After Ramadan (AR), by a trained dietician. The 24-hour dietary recall method was the tool for dietary assessment. Energy, macronutrients, sodium, and calcium intake were assessed using a 24-hour recall through a face-to-face interview in each stage. 5ml blood sample was collected to measure FBS, HbA1c, lipid profile, creatinine, BUN, sodium, and calcium were measured before, during and after Ramadan.

Results: Significant decrease in fasting blood sugar (P=0.03), HbA1c level (P=0.04), BUN (P=0.04), and creatinine (P=0.03). While the non-significant increases in lipid profile including total cholesterol, LDL-C, HDL‐C and TG were noticed (P>0.05). There is no change was noticed in albumin, hemoglobin, and vitamin D. Daily consumption of energy, carbohydrate, and protein was significantly reduced during Ramadan (p < 0.000) when compared to before Ramadan. While fat, sodium, and calcium intake were significantly increased during Ramadan fasting (p < 0.000).

Conclusion: Ramadan fasting improve fasting blood sugar, HbA1-c, and some of biochemical parameters but has no effect on lipid profile. Reduce total energy and variations in macro and micronutrients intake during Ramadan fasting.

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Effect of Diabetes and other Risk Factors on Bone Health

Diabetes Mellitus (DM) affects a significantly large part of the population globally. Several kinds of research are being conducted every day around the world trying to understand the underlying mechanisms of the disease better to develop better treatments. One of the significant effects of diabetes is on the skeletal system of the patients. The disease affects the bone quality, mineral density, bone turnover and in turn bone health at large. This effect on bone health is worsened by several risk factors as well. This mini review aims at presenting some of the most important mechanisms behind this deterioration of bone health and how risk factors affect them according to latest research done in this field.

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The Effect of Metformin in Treating Prediabetic Patients

Prediabetic is a state when the blood sugar level is high but not reaching the diagnostic status of diabetes mellitus. As defined by American Diabetic Association (ADA), it includes impaired fasting glucose (FBS 5.6-6.9mmol/L) and/or impaired glucose tolerance (glucose 7.8-11.0mmol/L, 2 hours after ingestion of a 75-g oral glucose load) and/or HbA1c 5.7-6.4%. The risk of progressing to diabetes is greater in patient with both IFG and IGT compared with isolated IFG or isolated IGT alone [1,2]. Although patients with prediabetes are asymptomatic, but they carry comparable macrovascular complication and retinopathy like diabetes mellitus. The progression to type 2 DM may vary from one individual to another depend on degree of insulin deficiency/resistance along with other risk factors. Several risk factors have been contributing to the development of prediabetes and it is almost like that factor related to development of type 2DM. These include increasing age, physical inactivity, obesity (BMI>=30KG/M2), family history of DM 2, High risk ethnic groups and past history of GDM and PCOS. Several approaches have been tried to manage prediabetic status to delay and/or prevent the progression to DM2 including pharmacological approach and lifestyle management. This article will give an overview about the use of metformin as a treatment of prediabetes.

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The Pathogenesis and Influencing Factors of Diabetes

Diabetes is an endocrine and metabolic disease and has become a pandemic disease that threatens the health of almost all human beings. Diabetes is a metabolic syndrome with glycolipid, protein and amino acid metabolism disorder and the increase of blood sugar caused by absolute or relative deficiency of insulin. Hyperglycemia is the main feature of diabetes and the main cause of various complications [1]. In recent years, the number of patients with diabetes has increased year by year. In the 21st century, diabetes will be one of the most serious public health problems throughout the world, which not only imposes a great burden on society and individuals, but also is accompanied by higher residual rate and mortality [2]. In a word, diabetes has seriously threatened people’s life.

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The Indian Fruit Phyllanthus Emblica (Amala) is an Immunity Enhancer and Anti-Obesity Agent: Prefect Fruit for Corona Era

The Indian society has been reverent to nature since ancient times. We bow before mother nature like a God. We worship the sun which lights us up and illuminates the world and drives away all the darkness. We wake up in the morning, touch the earth because we get so much from it, necessary to support life. We worship Tulsi and Peepal because these give us oxygen for 24 hours and are also used in several Ayurvedic medicines. Phyllanthus embilica or Embelica officinalis, commonly known as Indian gooseberry or Amla has a superior therapeutic value in indigenous medicinal system, Ayurveda (Figure 1). The extracts from various parts of Embelica officinalis, especially fruit, contain various phytoconstituents like polyphenols (gallic acid, ellagic acid), different tannins, minerals, vitamins amino acids, fixed oils and flavonoids like rutin and quercetin. The extract or the powder of the fruit has curative effect against a variety of ailments like inflammation, cancer, osteoporosis, neurological disorders, hypertension and many others. These actions are attributed to either regulation of various molecular pathways involved in several pathophysiology or antioxidant property which prevents the damage of cellular compartments from oxidative stress. Amla keeps digestive system on right track and induces appetite. It strengthens the digestive system by converting calories in food stuffs into energy which has a direct bearing on obesity. The ingredients of Amla fight symptoms of fatty liver and high cholesterol and help reduce unwanted fat. Since ancient times, Amla (which is known as nectar fruit in India), is worshiped in India and it is said that 90% of the diseases of the body are cured by eating Amla in any of the forms viz. Morabba, Amla Candy, Chutney, Pickle etc. It is the main constituent of the general Ayurvedic tonic, Chyavanprash, a valued product of several Ayurvedic pharmacies.

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A Novel Method to Quantify Carbohydrate Routine Consumption: A Reliable, Valid, Sensitive and Simple Alternative to 24-Hour Dietary Recall

Objective: Growing evidence suggests postprandial hyperglycemia, driven largely by carbohydrate consumption, adversely affects A1c and cardiovascular health. The standard for quantifying carbohydrate intake is 24-hour dietary recall (ASA24). While sophisticated in terms of quantifying grams of micro and macro nutrients, it is often not practical in most clinical and some research settings. A simpler alternative is needed.

Research design and methods: We developed the Carbohydrate Routine Consumption (CRC) scale, which samples weekly servings of 16 common high and low glycemic load foods and takes 5 minutes to complete and score. We administered the CRC and the ASA24 to 204 adults with type 2 diabetes.

Results: The CRC was reliable, correlated with the ASA24 and had similar construct and discriminant validity.

Conclusion: The CRC is psychometrically sound and easily administered and scored by clinicians and researchers to document routine carbohydrate consumption and change in consumption.

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What is the Relationship Between Diabetes and Obesity from an Energy Perspective?

If we review what is in the medical literature, most studies say that type 2 diabetes comes from hormonal and metabolic imbalances generated by the obese patient. According to the article written by Nguyen (2010) entitled Relationship Between Obesity and Diabetes in a US Adult Population: Findings from the National Health and Nutrition Examination Survey, 1999-2006, the prevalence of diabetes increases with high weight classes. But only half of the diabetes adults’ patients were considered obese. In this article, he is suggesting that weight loss is an important aim nowadays to reduce the impact of diabetes in the health care system [1]. The author will write this article according to Hippocrates (460 bce - 375 bce), father of Medicine, who said that we should follow older medicines, before current medical practice. So, the doctor will explain this theme according to the teachings of traditional Chinese medicine [2]. If we look at the article written by Huang [3] entitled Why Are Diabetic Patients Still Having Hyperglycemia Despite Diet Regulation, Antiglycemic Medication and Insulin? and if we look at the energy alterations of obese patients, published by Huang [3] in an article entitled Energy Alterations in Obese Patients, if we look at it from the point of view of traditional Chinese medicine, which exists for more than 5,000 years, we can observe that what the two diseases have in common are energy imbalances or deficiencies in the five internal massive organs [4,5].

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Factors Contributing to Obesity and Associated Health Risks

Obesity is a serious health issue in both developed and developing societies of the world. Apart from being a problem itself, obesity may also result in many chronic health conditions. Uncontrolled obesity may lead to diabetes, cancer, arthritis as well as liver and kidney problems. Obesity is always stigmatized to overeating rather several other factors including metabolic health, cultural and lifestyle factors are also associated with disease progression. Risk of chronic diseases due to genetic factors is less as compared to environmental, behavioral and dietary factors. Behavioral/lifestyle modification is recommended. Developed countries face problem due to high fat (junk food) and sugar containing food (refined carbohydrates) consumption along with amplified alcohol consumption and smoking. Dietary changes like replacing high fat and sugar containing food with high fiber, low sugar and fat foods would impact health status of the individuals in positive way by decreasing risk of chronic diseases.

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Ten Weeks Protocol of Physical Exercise for an Elderly Person Diagnosed with Diabetes Mellitus and Hypertension: An Evidence-Based Case Report

The prescription of physical exercises for groups of people who need special care during prescribing and monitoring is an area of Physical Education and Exercise Physiology that needs more scientific reports, as evidence-based practical interventions can help professionals who work with exercise prescription for their audiences. In this work, we report the prescription of physical exercises for an elderly aged 82, diagnosed with type 2 diabetes mellitus, diabetic neuropathy and nephropathy, arterial hypertension, and a history of stroke. The choice of exercises was based mainly on the exercise recommendations of the Brazilian Society of Diabetes, Brazilian Society of Arterial Hypertension, World Health Organization, and the possibilities of available materials and adequacy of scientific information to the student’s reality at home.

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Association Between Type of Cooking Fuel and Body Mass Index Among Women in Cambodia

Introduction: Solid cooking fuel is the primary source of energy for almost half of the world’s population. Studies have examined the association between solid cooking fuel and respiratory and cardiovascular disease, negative pregnancy outcomes, and shortened life expectancy. However, no study has examined the association between solid cooking fuel and Body Mass Index (BMI) among women in Cambodia.

Methods: Data was taken from the 2014 Cambodia Demographic and Health Survey (N=3249), women aged 15-49 years. Multivariable logistic regression analysis was used to determine the association between type of cooking fuel and BMI, controlling for age, education, marital status, parity, employment status, kitchen being a separate room, location of cooking food, and household wealth index.

Results: Compared to younger women, older women were more likely to be overweight/obese shown by multivariable adjusted odds ratio (95% confidence interval) for women aged 25-34 years 2.64 (1.80, 3.86), and for women aged 35-49 years 4.97 (3.20, 7.72). Compared to women who reside in poor households, the odds of being overweight/obese were higher for women residing in a middle household wealth index 2.62 (1.52, 4.52), and women residing in rich household wealth index 2.78 (1.83, 4.24). When adjusting for potential confounding variables, the association between type of cooking fuel and BMI observed in the unadjusted model disappeared (p=0.103).

Conclusion: These findings indicate that type of cooking fuel is not significantly associated with BMI in a nationally representative sample of women in Cambodia.

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Managing Type 1 Diabetes from Gynecological Waste: Trash to Treasure

Type 1 Diabetes Mellitus (T1D) is an autoimmune disease that destroys β cells. β cells play a critical role in glucose homeostasis by sensing blood glucose and releasing insulin to maintain physiologic glucose levels within a relatively narrow range. Human UCB cells pose a lower risk of viral contamination due to the low placental transmission rates during prenatal life. They have superiorities including low immunogenicity, non-invasive harvest procedure, gynecological waste, easy expansion in vitro, and ethical access compared with stem cells from other sources. Based on available preclinical data and therefore the agreement that infusion of minimally manipulated autologous cord blood cells was likely to be extremely safe. Thus, the UCB-derived stem cells transplant does not require a perfect match of MHC as bone marrow transplants do. Depending on the degree of differentiation, the ability to regenerate themselves, and the origin of many stem cell types can be differentiated. In terms of their plasticity totipotent, pluripotent, multipotent and weak stem cells are present. The use of Stem Cells (SCs) holds great promise for the cure of T1D due to their propitious immunological characteristics and their regenerative capabilities. Because it is free from ethical complications and straightforward to isolate without invasive methods, human Umbilical Cord Blood (hUCB) has become a precious medical product.

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Can Antidiabetic Plants Used in Cameroon Play as Key for the Treatment of Childhood, Adolescent and Adult Obesity?

Overweight and obesity are defined as an abnormal or excessive accumulation of fat which can be harmful to health. These are major risk factors for a number of chronic diseases, including diabetes, cardiovascular disease, and cancer. The channel from obesity to diabetes is made by an enlightened deficiency in insulin secretion coupled with an enlightened rise in insulin resistance. Both insulin resistance and defective insulin secretion appear very prematurely in obese patients, and both worsen similarly towards diabetes. Once considered a problem only in high-income countries, overweight and obesity are now on a dramatic increase in low- and middle-income countries. These are major risk factors for a number of chronic diseases, including diabetes, cardiovascular disease, and cancer. Once considered a problem only in high-income countries, overweight and obesity are now on a dramatic increase in low- and middle-income countries. In 2016, more than 1.9 billion adults aged 18 and over were overweight. More than 650 million adults were obese. About 18.5% of children ages 2 to 19 are considered obese in the United States. Cameroon, with 8.6% of its obese population in 2014, is not immune to the upsurge in the number of obese people in the world. In Cameroon obesity is rarely considered as a disease by most traditional healers, especially in the hinterland.

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Uncontrolled Glycemia in Diabetes Affects Oral Health-Related Quality of Life

Diabetes Mellitus (DM) is considered as one of the main public health problems worldwide and increases the rate of hospitalizations, disabilities, and mortality. The World Health Organization estimates that, in 2014, 422 million adults in the world (8.5% of the population) had diabetes, and since 1980, this number has quadrupled. This increase is related to the risk factors such as being overweight, sedentary lifestyle, and alimentation. DM is characterized by prolonged increased levels of glucose in the blood which leads to the development of microvascular complications (retinopathy, neuropathy, nephropathy, amputation, and periodontitis) and macrovascular complications (cardiovascular and stroke) [1-6]. Glycated hemoglobin (HbA1c) is the gold standard for monitoring glycemic control and higher levels of HbA1c (>6.5%) has been associated to increase the risk to develop diabetes complications. There is strong evidence that periodontitis is associated with DM and both diseases have a bidirectional relationship. Therefore, an uncontrolled glycemia in DM patients triggers immunological repercussion, physiological, psychological, and social problems. Oral Health-Related Quality of Life (OHRQL) can be assessed using the Spanish version of the Oral Health Impact Profile-14 (OHIP-14sp), which is an instrument validated in the Spanish speaking population and measures physical, social, and psychological aspect in individual’s life that adversely affects oral health. Some studies have demonstrated that quality of life is affected among patients that present loss of epithelial attachment, loss of teeth, and cavities among others.

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Importance of Antidiabetic Medicinal Plants in the Prevention and Management of Insulin Resistance: Case of Gestational Diabetes in Cameroon

During pregnancy, insulin resistance increase over time. So in the last four months of the pregnancy, insulin resistance upsurges significantly and can become severe, specifically in women with gestational diabetes and type 2 diabetes. Various factors including placental hormones, obesity, and inactivity, an unhealthy nourishment, and inherited and epigenetic influences negatively impacts insulin resistance in pregnancy, but the causal mechanisms are multifaceted and still not completely elucidated. Therefore in this review, we seek to identify among antidiabetic plants usually used in Cameroon those which can regulate insulin resistance in pregnant women, with diabetes. To achieve this objective a literature search was performed in Google, Google Scholar and PubMed, using the key “plants improving insulin sensitivity or insulin resistance in gestational diabetes”. The phytochemicals with insulin resistance and insulin sensitivity of recorded antidiabetic plants and their action mechanisms were compared with those of antidiabetic plants regularly used In Cameroon. The phytochemicals and their active mechanisms were searched using the keys «what is a given compound) chemical group(s). A list of Cameroonian known antidiabetic plants improving insulin sensitivity and insulin resistance were established. Nineteen (19) antidiabetic medicinal plants usually castoff in Cameroon have been reported to have a beneficial effect on insulin sensitivity and insulin resistance with regard to the presence of molecules which improve insulin sensitivity and insulin resistance in their chemical composition. Finally, well-chemical study, well mechanisms elucidation and well-designed randomized controlled trials with lasting consumption are still required to assure the bioactivity and safety of these medicinal plants and compounds for gestational diabetic patients.

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Indigenous Plants of Odisha having Anti-Diabetic Activity: A Database

Diabetes mellitus consists of a group of syndromes characterized by hyperglycemia; altered metabolism of lipids, carbohydrates, and proteins; and an increased risk of complications from vascular disease. Diabetes mellitus, is associated with an increase in the blood sugar level beyond the threshold (hyperglycemia) and overflow in of excess sugar into urine (glycosuria). diabetes is the damage to micro capillaries (small blood vessels) of two vital organs-eyes & kidneys, leading to impaired vision and diseases of kidney. In this present review we are providing a brief descriptive data of various indigenous anti-diabetic plants grown at Odisha state, India.

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