Review on Diabetes Mellitus

Abstract

Diabetes mellitus is an endocrinological disorder with an increasing prevalence and incidence. High aldohexose/blood sugar glucose levels is a unit symptom of diabetes as a consequence of inadequate duct gland insulin or poor insulin-directed mobilization of glucose by target cells. Diabetes is aggravated by metabolic complications that may afterwards cause premature death. This review explores diabetes in terms of its historical perspective, organic chemistry basis, economic burden, management interventions together with the long run views.

Keywords

Diabetes mellitus, Glucose, Insulin.

Introduction

Diabetes mellitus (DM) is may be one among the oldest diseases best-known to man. Diabetes (DM), unremarkably stated as diabetes, may be a cluster of metabolic diseases during which there is a high glucose levels over a prolonged peroid. Symptoms of high glucose includes frequent excretion, exaggerated thirst, and exaggerated hunger. Diabetes will lead to several complications if left untreated [1-5]. Diabetes results either of the exocrine gland not producing enough insulin (insulin) or the cells of the body not responding properly to the insulin made. There are 3 main varieties of diabetes mellitus. Type 1 Diabetes mellitus results from the pancreas failure to supply enough insulin. This type is antecedently stated as insulin-dependent diabetes mellitus (IDDM) or juvenile diabetes. The cause is unknown [6]. Type 2 Diabetes mellitus begins with insulin resistance, a condition during which cells fail to retort to insulin properly. Because the unwellness progresses an absence of insulin may additionally develop. This type was antecedently stated as non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. The first cause is excessive weight and not had enough exercise to body [7,8]. Gestational diabetes is that the third main type and happens once pregnant ladies while not a previous history of diabetes develop high blood-sugar levels.

Prevention and treatment involve maintaining a healthy diet, regular work out, a traditional weight, and avoiding use of tobacco. Management of blood pressure and maintaining proper foot care are vital for folks with the un-wellness. Type 1 Diabetes mellitus should be managed with insulin injections. Type 2 Diabetes mellitus is also treated with medications with or while not with insulin. Insulin and a few oral medications will cause low glucose. Weight loss surgery in those with fatness is usually a good live in those with Type 2 Diabetes mellitus. physiological state diabetes typically resolves when the birth of the baby [9-15].

Epidemology

As of 2016, 422 million folks have diabetes worldwide, up from associate in nursing calculable 382 million folks in 2013 and from 108 million in 1980. Accounting for the shifting age structure of the world population, the prevalence of diabetes is 8.5% among adults, nearly double the speed of 4.7% in 1980. Type 2 Diabetes mellitus makes up concerning ninetieth of the cases. Some knowledge indicate rates area unit roughly equal in ladies and men, however male excess in diabetes has been found in several populations with higher Type 2 Diabetes mellitus of incidence, presumably thanks to sex-related variations in insulin sensitivity, consequences of fatness and regional body fat deposition, and different tributary factors comparable to high force per unit area, tobacco smoking and alcohol intake [16-20].

The World Health Organization (WHO) estimates that diabetes resulted in 1.5 million deaths in 2012, creating it the eighth leading reason behind death. But another pair of 2 million deaths worldwide were as a result of high glucose and also the exaggerated risks of upset and different associated complications (e.g. excretory organ failure) cause premature death and area unit often listed because the underlying cause of death certificates instead of diabetes. parenthetically, in 2014, the International diabetes Federation (IDF) calculable that diabetes resulted in four. Nine million deaths worldwide, mistreatment modelling to estimate the entire quantity of deaths that might be directly or indirectly attributed to diabetes [21-25].

Diabetes mellitus happens throughout the planet however additional common (especially Type 2) in additional developed countries. The best increase in rates has been seen in low and middle-income countries, wherever quite eightieth of diabetic deaths occur. The quickest prevalence increase is anticipated to occur in Asia and continent, wherever the majority with diabetes can in all probability board 2030. The rise in rates in developing countries follows the trend of urbanization and style changes, as well as more and more inactive lifestyles, less physically demanding work and also the world nutrition transition, marked by exaggerated intake of foods that area unit high energy-dense however nutrient-poor (often high in sugar and saturated fats, generally stated because the Western-style diet) [26-30].

Diabetes Mellitus

Type 1 diabetes is characterized by loss of the insulin-producing beta cells of the islets of Langerhans within the exocrine gland, resulting in insulin deficiency. This type may be additional classified as immune-mediated or idiopathetic. The diabetes is of the immune-mediated nature, during which a T-cell-mediated response attack results in the loss of beta cells and so insulin. It causes more diabetes cases in North America and Europe. Sensitivity and responsiveness to insulin area unit typically traditional, particularly within the early stages [1,31]. Type 1 diabetes will have an effect on youngsters or adults, however was historically termed "juvenile diabetes" as a result of a majority of those diabetes cases were in youngsters. Diabetes additionally referred to as unstable diabetes or labile diabetes may be a term that was historically wont to describe the dramatic and perennial swings in aldohexose levels, usually occurring for no apparent reason in insulin-dependent diabetes. Type 1 diabetes may be in the middle of irregular and unpredictable high glucose levels, oft with symptom, and generally with serious low glucose levels. Different complications embody associate in nursing impaired counter regulatory response to low glucose, infection, gastro paresis [32-35].

Type 2 Diabetes mellitus is characterized by insulin resistance, which can be combined with comparatively reduced insulin. The defective responsiveness of body tissues to insulin is believed to involve the insulin receptor. However, the precise defects aren't best-known. Type 2 Diabetes mellitus is that the most typical variety of diabetes [36,37]. In the early stage of Type 2 Diabetes mellitus, the predominant abnormality is reduced insulin sensitivity. At this stage, high glucose may be reversed by a spread of measures and medications that improve insulin sensitivity or scale back the liver's glucose production.

Type 2 Diabetes mellitus is due to life style factors and genetic science. Variety of life style factors area unit best-known to be vital to the event of Type 2 Diabetes mellitus, as well as fatness (defined by a body mass index of larger than 30), lack of physical activity, poor diet, stress, and urbanization. Excess body fat is related to half-hour of cases in those of Chinese and Japanese descent, 60-80% of cases in those of European and African descent, and a hundred of Indians and Pacific Islanders. Even those that aren't rotund usually have a high waist-hip quantitative relation [38-45].

Gestational diabetes (GDM) resembles Type 2 Diabetes mellitus in many respects, involving a mix of comparatively inadequate insulin and responsiveness. It happens in concerning 2-10% of all pregnancies and should improve or disappear after delivery. But, when physiological condition some 5-10% of ladies with physiological state diabetes found to own diabetes, most typically Type 2 Diabetes mellitus of physiological state diabetes is totally treatable, however needs careful medical management throughout the physiological condition. Management might embody dietary changes, glucose observance, and in some cases, insulin is also needed [46-52]. Prediabetes indicates a condition that happens once an individual's glucose levels area unit more than traditional however not high enough for a diagnosing of Type 2 DM. Many folks destined to develop Type 2 Diabetes mellitus after a few years during a state of prediabetes.

Prevention and Management

There are no best-known precautions for Type 1 diabetes. Type 2 diabetes that accounts for 85-90% of all cases will usually be prevented or delayed by maintaining a traditional weight, partaking in work out, and overwhelming a healthful diet [22]. Higher levels of physical activity scale back the danger of diabetes. Dietary changes best-known to be effective in serving to stop diabetes embody maintaining a healthy diet in whole grains and fiber, and selecting sensible fats, comparable to the unsaturated fats found in loony, vegetable oils, and fish. Limiting honeyed beverages and uptake less meat and different sources of saturated fat can even facilitate stop diabetes. Tobacco smoking is additionally related to associate in Nursing exaggerated risk of diabetes and its complications, thus smoking surcease may be a very important precautions likewise [53-55]. Diabetes mellitus may be a chronic disease, that there's no best-known cure except in terribly specific things. Management concentrates on keeping glucose levels as near to traditional, while not inflicting low glucose. This may typically be accomplished with a healthy diet, exercise, weight loss, and use of applicable medications (insulin within the case of diabetes; oral medications, likewise as presumably insulin, in sort a pair of diabetes) [56-58].

Lifestyle

People with diabetes should get awareness concerning the disease and treatment, good nutrition to get a conventional weight, and exercise, with the objective of keeping both short term and long term glucose levels at interims worthy limits. Additionally, given the associated higher risks of upset, life style modifications are suggested to manage diabetes [59,60].

Medications

Medications used to treat diabetes by lowering glucose levels. There are various categories of anti-diabetic medications. Some are available in the market through orally taken, similar to metformin, whereas others are by injection such as GLP-1 agonists. Type 1 diabetes will solely be treated with insulin, usually with a mix of standard and NPH insulin, or artificial insulin analogs [61-66].

Metformin is usually suggested as a primary line treatment for Type 2 diabetes, as there's sensible proof that it decreases mortality. It works by decreasing the liver's production of glucose. Many different teams of medication, principally given orally, may additionally decrease glucose in Type 2 DM. These embody agents that increase insulin unharness, agents that decrease absorption of sugar from the intestines, and agents that create the body additional sensitive to insulin [67-71]. Once insulin is employed in sort a pair of diabetes, a long formulation is sometimes accessorial at the start, whereas continued oral medications [72-75].

Since upset may be a serious complication related to diabetes, some have suggested force per unit area levels below 130/80 mmHg. but, proof supports not up to or adequate to somewhere between 140/90 mmHg to 160/100 mmHg; the sole extra profit found for force per unit area targets at a lower place this vary was Associate in Nursing isolated decrease in stroke risk, Associate in Nursing this was in the middle of an exaggerated risk of different serious adverse events [76-84]. A 2016 review found potential hurt to treating not up to a hundred and forty mmHg. Among medications that lower force per unit area, vasoconstrictor changing accelerator inhibitors (ACEIs) improve outcomes in those with DM whereas the similar medications vasoconstrictor receptor blockers (ARBs) don't. Bayer is additionally suggested for folks with vessel issues, but routine use of Bayer has not been found to boost outcomes in uncomplicated diabetes [84-92].

Surgery

An exocrine gland transplant is often preferred for the people with Type 1 diabetes who have severe complications of their disease, including end stage kidney disease requiring kidney transplantation [93-95]. Weight loss surgery in obese people and Type 2 diabetes is usually a good option. Many are able to maintain normal blood sugar levels with little or no medications following surgery [81] and long-term mortality is decreased [82]. There however is some short-term mortality risk of less than 1% from the surgery [83]. The body mass index cutoffs for when surgery is appropriate are not yet clear [82]. It is recommended that this option be considered in those who are unable to get both their weight and blood sugar under control [96,97].

References

1. Global report on diabetes. World Health Organization. 2016.
2. Shoback, Greenspan's basic & clinical endocrinology. 9th ed. New York: McGraw-Hill Medical, New York, 2011.
3. The top 10 causes of death Fact sheet N°310. World Health Organization. 2013.
4. Irwin RS, et al. Manual of intensive care medicine. 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 2010.
5. Picot J, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. HTA. 2009;13:1-190.
6. Shi Y and Hu FB. The global implications of diabetes and cancer. Lancet. 2014;383: 1947-1948.
7. Vos T, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2014;380:2163-2196.
8. IDF Diabetes Atlas. 7th ed. International Diabetes Federation. 2015.
9. Gale EA and Gillespie KM. Diabetes and gender. Diabetologia. 2001; 44:3-15.
10. Meisinger C, et al. Sex differences in risk factors for incident type 2 Diabetes Mellitus: The Monica Augsburg Cohort Study. JAMA Int Med. 2002;162:82-89.
11. Public Health Agency of Canada, Diabetes in Canada: Facts and figures from a public health perspective. Ottawa, 2011.
12. Mathers CD and Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3:e442.
13. Wild S, et al. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047-1053.
14. Rother KI. Diabetes treatment-bridging the divide. NEJM. 2007;356:1499-1501.
15. National Diabetes Clearinghouse (NDIC): National Diabetes Statistics 2011. U.S. Department of Health and Human Services. 2014.
16. Kyu, et al. Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013. BMJ. 2016:i3857.
17. Krentz AJ and Bailey CJ. Oral antidiabetic agents: current role in type 2 diabetes mellitus. Drugs. 2005;65:385-411.
18. Mark N. Drug treatment of elevated blood pressure. Australian Prescriber 2010;33:108-112.
19. Schulman AP, et al. Metabolic surgery for treatment of type 2 diabetes mellitus. Endocr Pract. 2015;15:624-631.
20. Colucci RA. Bariatric surgery in patients with type 2 diabetes: a viable option. Postgrad Med J. 2011;123:24-33.
21. Dixon JB et al. Bariatric surgery for type 2 diabetes. Lancet. 2012;379:2300-2311.
22. Polisena J, et al. Home telehealth for diabetes management: a systematic review and meta-analysis. Diabetes Obes Metab. 2009;11:913-930.
23. Rotella MC, et al. Role of Insulin in the Type 2 Diabetes Therapy: Past, Present and Future. Int J Endocr met. 2013;11:137-144.
24. Stewart WF, et al. Lost productive time and costs due to diabetes and diabetic neuropathic pain in the US workforce. J Occup Environ Med. 2007;49:672-679.
25. Laios K, et al. Aretaeus of Cappadocia and the first description of diabetes. Hormones 2012;11:109-113.
26. Wild S, et al. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047-1053.
27. Frachetti KJ and Goldfine. Bariatric surgery for diabetes management. Curr Opin Endocrinol Diabetes Obes. 2009;16:119-124.
28. Schulman AP, et al. Metabolic surgery for treatment of type 2 diabetes mellitus. Endocrine Practice. 2009;15:624-631.
29. Cheng J, et al. Effect of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on All-Cause Mortality, Cardiovascular Deaths, and Cardiovascular Events in Patients With Diabetes Mellitus: A Meta-analysis. JAMA internal medicine. 2014;174:773-785.
30. Saydah SH, et al. Postchallenge hyperglycemia and mortality in a national sample of U.S. adults. Diabetes Care. 2001;24:1397-1402.
31. de la Monte SM. Type 3 diabetes is sporadic Alzheimer׳s disease: mini-review. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology. 2014;24:1954-1960.
32. Lee IM, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy". The Lancet. 2012;380:219-229.
33. Malik VS, et al. Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes: A meta-analysis". Diabetes Care. 2010;33:2477-2783.
34. Visser J, et al. Tight junctions, intestinal permeability, and autoimmunity: celiac disease and type 1 diabetes paradigms. Ann N Y Acad Sci. 2009;1165: 195-205.
35. Serena G, et al. The Role of Gluten in Celiac Disease and Type 1 Diabetes. Nutrients. 2015;7:7143-7162.
36. Butalia S, et al. Environmental Risk Factors and Type 1 Diabetes: Past, Present, and Future. Can J Diabetes.2016.
37. Dorner M, et al. Essential labile diabetes. MMW Munch Med Wochenschr (in German). 1977;119:671-674.
38. Lambert P and Bingley PJ. What is Type 1 Diabetes?. Medicine. 2002;30:1-5.
39. Verrotti A, Scaparrotta A, Olivieri C, Chiarelli F. Seizures and type 1 diabetes mellitus: current state of knowledge. European Journal of Endocrinology. 2012;167:749-758.
40. Cooke DW and Plotnick L. Type 1 diabetes mellitus in pediatrics. Pediatr Rev. 2008;29:374-384.
41. Bartoli E, et al. The oral glucose tolerance test (OGTT) revisited. European journal of internal medicine. 2011;22:8-12.
42. Willi C, et al. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA: The Journal of the American Medical Association. 2007;298:2654-2664.
43. National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes. 1979;28.12:1039-1057.
44. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes care. 2006;29:S43.
45. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes care.2005;28:S37.
46. Tuomilehto, Jaakko, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. NEJM. 2001;344.18:1343-1350.
47. DeFronzo Ralph A. Pharmacologic therapy for type 2 diabetes mellitus. Annals of internal medicine. 1999;131.4:281-303.
48. Chobanyan N, et al. Evaluation of Environmental Risk Factors for Type 2 Diabetes in Sint Maarten. J Environ Anal Toxicol. 2016;6:386.
49. Zaini RG and Abdulsatar S Detection of Undiagnosed Diabetes among Saudi Female at Four Campaigns in Taif City, Saudi Arabia. J Diabetes Metab. 2016;7:689.
50. Liu H, et al. Anti-diabetes and Anti-inflammatory Activities of Phenolic Glycosides from Liparis odorata. Med chem (Los Angeles). 2016;6:500-505.
51. Rachel C, et al. The -765G>C Cyclooxygenase-2 Promoter Polymorphism is associated with Type 2 Diabetes Mellitus, Low High-density Lipoprotein and Manifest Angina. J Diabetes Metab. 2016;7:686.
52. Janet LP and LeAnne MH. Validity of the Community Integration Questionnaire as a Measure of Participation in Persons with Diabetes Mellitus. J Diabetes Metab 2016;7:687.
53. Dyke KV. New Concepts in Prevention and Treatment of Diabetes 1 and 2. Transl Med (Sunnyvale) 2016;6:179.
54. Chen C, et al. Elevated Interleukin-17 Levels in Patients with Newly Diagnosed Type 2 Diabetes Mellitus. Biochem Physiol. 2016;5:206.
55. Inancli SS, et al. Evaluation of Thyroid Autoimmunity in Gestational Diabetes Mellitus. J Diabetes Metab. 2016;7:682.
56. Tagliente I, et al. Management and Treatment of Type 1 And 2 Diabetes: State of Art. Gen Med (Los Angeles). 2016;4:259.
57. Bayramova AN. Gastroenterological Diseases as a Complications of Type 2 Diabetes Mellitus. J Gastrointest Dig Syst. 2016;6:442.
58. Tang X, et al. A Randomized Controlled Clinical Trial on the Treatment of Type 2 Diabetes with Depression by Wu Ling Capsule. J Clin Trials. 2016;6:273.
59. Hernandez HE, et al. Baseline Anemia Analysis of Hispanic Dialysis Patients with and without Type 2 Diabetes. J Mol Histol Med Physiol. 2016;1:105.
60. Mitchell S, et al. Women in Control: Pioneering Diabetes Self-Management Medical Group Visits in the Virtual World. J Clin Trials. 2016;6:272.
61. Fang W, et al. The Effect on Gut Microbiota Structure of Primarily Diagnosed Type 2 Diabetes Patients Intervened by Sancai Lianmei Particle and Acarbose: A Randomized Controlled Trial. J Clin Trials. 2016;6:270.
62. Yadav H, et al. Gut Microbiome Derived Metabolites to Regulate Energy Homeostasis: How Microbiome Talks to Host. Metabolomics. 2016;6:e150.
63. Mesquita C, et al. Effect of the Endoplasmic Reticulum Stress on Diabetes Mellitus Type 2 in Hypothalamic Cells. Endocrinol Metab Syndr. 2016;5:243.
64. Norouzi Z, et al. The Prevalence of Depression in Patients with Diabetes Mellitus Type II in the Shahid Rahimi Hospital of Khorramabad, Iran. Epidemiology (Sunnyvale). 2016;6: 249.
65. Parveen S and Anjum S. To Investigate Prevalence of Diabetes Type 1 and Type 2 in HCV Infected Individuals. Epidemiology (Sunnyvale). 2016;6:246.
66. Szybinski Z. Primary Prevention of Obesity and Type 2 Diabetes Mellitus. Epidemiology (Sunnyvale). 2016;6:243.
67. Demchuk MP, et al. Efficacy of Fetal Stem Cells use in Complex Treatment of Patients with Insulin-resistant Type 2 Diabetes Mellitus. J Stem Cell Res Ther. 2016;6:342.
68. Cakir OO, et al. Visceral Fat Volume is a Better Predictor for Insulin Resistance than Abdominal Wall Fat Index in Patients with Prediabetes and Type 2 Diabetes Mellitus. Intern Med. 2016;6: 220.
69. Raina SK. From NHM to NPCDCS: Epidemiological Transition and Need for a National Program for Diabetes in India. J Metabolic Synd. 2016;5:204.
70. Ignacio BA et al. Diabetes Mellitus and Neuromuscular Blockade: Review. J Diabetes Metab. 2016;7:678.
71. Lambadiari V, et al. Short Term, Low Dose Thyroxin Treatment of Euthyroid Patients with Type 2 Diabetes improves Peripheral Blood Flow and Overall Insulin Sensitivity. J Diabetes Metab. 2016;7:677.
72. Berezin AE. Can Osteoprotegerin be a Target of Therapy in Type 2 Diabetes Mellitus? Metabolomics. 2016;6:172.
73. Hayashi A and Suganuma N. Physical Activity for Gestational Diabetes Mellitus. Clinics Mother Child Health. 2016;13:238.
74. Sunanda T, et al. Role of HbA1c at Admission on Severity and Functional Outcome of Ischemic Stroke in Patients with Diabetes Mellitus. J Neurol Neurophysiol. 2016;7:377.
75. Hines TA and Kumar S. Certified Electronic Health Records and Quality of Health Care in Type II Diabetes Mellitus Patients. J Health Med Informat. 2016;7:231.
76. Tina L, et al. Diabetes Mellitus and Airway Obstruction: Is there an Association? Adv Practice Nurs. 2016;2:116.
77. Demirsoy IH, et al. TCF7L2 rs7903146 Gene Variation Is Associated with Risk of Type 2 Diabetes in Turkish Population. J Clin Med Genom. 2016;4:141.
78. Nayeri A, et al. Type 2 Diabetes Mellitus is an Independent Risk Factor for Postoperative Complications in Patients Surgically Treated for Meningioma. J Neurol Neurophysiol. 2016;7:368.
79. Merlo S et al. Polymorphisms rs699 and rs4762 of the Angiotensinogen Gene and Progression of Carotid Atherosclerosis in Patients with Type 2 Diabetes Mellitus. J Diabetic Complications Med. 2016;1:107.
80. Kobashi C, et al. Diabetic Ketoacidosis due to Simultaneous Acute-onset Type 1 Diabetes and Graves’ Disease. J Diabetes Metab. 2016;7:671.
81. Wu X, et al. Development of Type-2 Diabetes Mellitus is associated with Low Levels of ApoA1. J Diabetes Metab. 2016;7:669.
82. Kurioka S, et al. Combination Therapy of Pitavastatin and Sitagliptin Improves the Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes. J Diabetes Metab. 2016;7:667.
83. Wamique M and Ali W. CETP Gene and Its Role in Diabetes Mellitus Type II - A Review. J Community Med Health. 2016;6:425.
84. Abdulrhman MA  Honey as a Sole Treatment of Type 2 Diabetes Mellitus. Endocrinol Metab Syndr. 2016;5:232.
85. Jena PK, et al. Influence of Gut Microbiota on Inflammation and Pathogenesis of Sugar Rich Diet Induced Diabetes. Immunome Res. 2016;12:109.
86. Lin Y, et al. Discussion of EZSCAN Parameters for Diabetes Screening in Chinese. Biochem Anal Biochem. 2016;5:263.
87. Nørgaard SK, et al Prepregnancy Body Mass Index and Offspring Birth Weight in Women with Type 1 and Type 2 Diabetes. J Preg Child Health. 2016;3:244.
88. El-Sappagh S and Elmogy M.  A Decision Support System for Diabetes Mellitus Management. Diabetes Case Rep. 2016;1:102.
89. Siddique MAH, et al. Comparison of Antioxidative Effects of Biguanides and Sulfonylureas Monotherapy on Total Antioxidant Status in Newly-Diagnosed Patients with Type 2 Diabetes Mellitus. Diabetes Case Rep. 2016;1:104.
90. Yaguchi Y, et al. Objective Evaluation of Zonular Weakness: Measurement of Lens Movement at the Start of Capsulorhexis Using Extracted Porcine Eyes . J Clin Exp Ophthalmol. 2016;7:541.
91. Siddique MAH, et al. Comparison of Antioxidative Effects of Biguanides and Sulfonylureas Monotherapy on Total Antioxidant Status in Newly-Diagnosed Patients with Type 2 Diabetes Mellitus. Diabetes Case Rep. 2016;1:104.
92. Yaguchi Y, et al. Objective Evaluation of Zonular Weakness: Measurement of Lens Movement at the Start of Capsulorhexis Using Extracted Porcine Eyes . J Clin Exp Ophthalmol. 2016;7:541.
93. Arthur G. Synaptor and Foot Net Bavaria-New Age in Diabetic Foot Survey. Clin Res Foot Ankle. 2016;4:e107.
94. Fitzner KA, et al. State-level Legislative Efforts to Improve Diabetes Care and thereby Mitigate Complications. J Diabetic Complications Med. 2016;1:105.
95. Huttada L, et al. Enhancing the Activity of Peroxisome Proliferator- Activated Receptor’s (PPAR) Activity through Natural Ligand Binding in Diabetes: Substantial Computational Approach. Nat Prod Chem Res. 2016;4:213.
96. Wong SN, et al. A Review on the Clinical Impact of Point of Care Capillary Blood Glucose Measurement in Diabetes Patients in Public Primary Care Clinics in Hong Kong. J Clin Diabetes Pract. 2016;1:105.
97. Sharma JN. The Role of Bradykinin System in Type 2 Diabetes. J Diabetes Metab. 2016;7:658.