• Clinical and Experimental Reproductive Medicine
• /
• v.40 no.2
• /
• pp.100-105
• /
• 2013

Objective: The aim of this study was to investigate the effect of insulin sensitizing agents on hormonal and metabolic parameters as well as menstrual patterns in women with polycystic ovary syndrome (PCOS). Methods: One hundred and twenty-three patients with PCOS were included. Metformin was administered to patients at 1,500 mg or 1,700 mg daily for 3 months. If the patients had no improvement of the menstrual cycle or metformin-related adverse effects developed, the patients changed medication to a daily dose of either 15 mg pioglitazone or up to 45 mg. Then resumption of a regular menstrual cycle or recovery of ovulation was evaluated. Hormonal and metabolic profiles were compared between the response and non-response group to insulin sensitizing agents. Results: One hundred and five patients with PCOS were treated with metformin for 3 months. Forty-eight patients (45.7%) showed improvement of menstrual cycle regularity after 3 months of metformin use, whereas 57 patients (54.3%) had no change. The mean free testosterone measured after 3 months of treatment was significantly lower in metformin responders than in non-responders. The other parameters did not differ between the groups. Of the 23 patients who used pioglitazone for 3 to 6 months, 19 patients (82.6%) showed improvement in their menstrual cycles. Conclusion: Metformin treatment seems to be effective for the improvement of menstrual cyclicity irrespective of insulin resistance in women with PCOS. When metformin related adverse effect occurred, pioglitazone would be effective for aiding the resumption of the menstrual cycle.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.19 no.3
• /
• pp.311-318
• /
• 1997

Ludwig's angina has been defined as a potentially lethal, rapidly spreading cellulitis, involving the sublingual and submandibular spaces, and is manifesed by a brawny, suprahyoid induration, tender swelling in the floor of mouth, elevation and posterior displacement of tongue. This paper is of interest not only because of severity of infection but also because of associated diabetic mellitus. Diabetes mellitus is a complex syndrome of disordered metabolism and elevated blood glucose, it results from deficiency of insulin secretion of combination of insulin resistance and inadequate insulin secretion. The effects of diabetic mellitus include neuropathy, vascular insufficiency, decreased leukocytic function, hematologic change etc. Clinically this may be refelected by the increased severity of infections seen in diabetics. The treatment of infections in diabetics are reduction of number of microbes through the use of appropriated antimicrobial agents and proper surgical drainage and improvement of the host factors by tight control of insulin replacement and immediate intervention to correct abnormalities of the local factors by drainage, debriment, and removal of avoidance of foreign bodies. The authors present the report of the Ludwig's angina in patient with diabetic mellitus, with literature review and good clinical result.

• Diabetes and Metabolism Journal
• /
• v.42 no.6
• /
• pp.451-464
• /
• 2018

Latent autoimmune diabetes in adults (LADA) is a heterogeneous disease characterized by a less intensive autoimmune process and a broad clinical phenotype compared to classical type 1 diabetes mellitus (T1DM), sharing features with both type 2 diabetes mellitus (T2DM) and T1DM. Since patients affected by LADA are initially insulin independent and recognizable only by testing for islet-cell autoantibodies, it could be difficult to identify LADA in clinical setting and a high misdiagnosis rate still remains among patients with T2DM. Ideally, islet-cell autoantibodies screening should be performed in subjects with newly diagnosed T2DM, ensuring a closer monitoring of those resulted positive and avoiding treatment of hyperglycaemia which might increase the rate of ${\beta}-cells$ loss. Thus, since the autoimmune process in LADA seems to be slower than in classical T1DM, there is a wider window for new therapeutic interventions that may slow down ${\beta}-cell$ failure. This review summarizes the current understanding of LADA, by evaluating data from most recent studies, the actual gaps in diagnosis and management. Finally, we critically highlight and discuss novel findings and future perspectives on the therapeutic approach in LADA.

• Korean Journal of Pharmacognosy
• /
• v.36 no.4 s.143
• /
• pp.291-298
• /
• 2005

Anti-hyperglycemic effects of 17 medicinal plants that have been used for ameliorating diabetes in oriental medicine were evaluated using glucose transport assay in 3T3-L1 adipocytes. Higher activities were obtained by treating water or alcohol extract of Phellodendri Cortex (PC), which showed enhancing effects both on basal and insulin-stimulated glucose uptake. The latter effect of PC was completely inhibited by wortmannin, a specific inhibitor for phosphatidyl inositol 3-kinase (PI 3-kinase), but not affected by SB203580, A specific inhibitor for p38 mitogen-activatedprotein kinase(MAPK). Genistein, an inhibitor for tyrosine kinases, abolished the PC effects completely. Treatment of vanadate, an inhibitor for tyrosine phosphatases, together with PC showed no significant synergic enhancement in glucose uptake. The results of inhibitors associated with insulin signaling pathway indicated that extracts of PC enhance glucose uptake by PI-3 kinase activation which is an upstream event for GLUT4 translocation. Antidiabetic effects of PC extract might be also due to enhanced tyrosine phosphorylation and reduced tyrosine dephosphorylation. In addition, PC accelerated insulin-stimulated glucose uptake in insulin-resistant cells, recovering the uptake level close to that of normal cells. These findings may offer a new way to utilize extracts of PC as novel anti-hyperglycemic agents.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.6 no.1
• /
• pp.42-44
• /
• 2008

Metformin which is an oral hypoglycemic agents, acts by enhancing insulin sensitivity, decreasing hepatic glucose production and increasing peripheral utilization of glucose. Deliberate self poisoning with oral hypoglycemic agents is rare. The lactic acidosis associated with metformin toxicity is well described in the medical literature. Metformin overdose even in otherwise healthy patients may produce a profound and life threatening lactic acidosis. We report a case of massive metformin ingestion(75g) in a patient presenting with lactic acidosis and hypotension. She died 24h after presenting to our emergency department despite bicarbonate treatment and hemofiltration therapy.

• Journal of Microbiology and Biotechnology
• /
• v.25 no.10
• /
• pp.1742-1750
• /
• 2015

Human insulin is composed of 21 amino acids of an A-chain and 30 amino acids of a B-chain. This is the protein hormone that has the role of blood sugar control. When the recombinant human proinsulin is expressed in Escherichia coli, a serious problem is the formation of an inclusion body. Therefore, the inclusion body must be denatured and refolded under chaotropic agents and suitable reductants. In this study, H27R-proinsulin was refolded from the denatured form with β-mercaptoethanol and urea. The refolding reaction was completed after 15 h at $15^{\circ}C$, whereas the reaction at $25^{\circ}C$ was faster than that at $15^{\circ}C$. The refolding yield at $15^{\circ}C$ was 17% higher than that at $25^{\circ}C$. The refolding reaction could be carried out at a high protein concentration (2 g/l) using direct refolding without sulfonation. The most economical and optimal refolding condition for human preproinsulin was 1.5 g/l protein, 10 mM glycine buffer containing 0.6 M urea, pH 10.6, and 0.3 mM β-mercaptoethanol at $15^{\circ}C$ for 16 h. The maximum refolding yield was 74.8% at $15^{\circ}C$ with 1.5 g/l protein. Moreover, the refolded preproinsulin could be converted into normal mature insulin with two enzymes. The average amount of human insulin was 138.2 g from 200 L of fermentation broth after enzyme reaction with H27R-proinsulin. The direct refolding process for H27R-proinsulin was successfully set up without sulfonation. The step yields for refolding and enzyme reaction were comparatively high. Therefore, our refolding process for production of recombinant insulin may be beneficial to the large-scale production of other biologically active proteins.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.22 no.2
• /
• pp.340-345
• /
• 2008

Extract of Acanthopanax senticosus has recently been demonstrated to possess significant antidiabetic potential, in accordance with the traditional use of this plant as an antidiabetic natural health product. The present study evaluated the effects of fermented extract (FE) of this plant on glucose-stimulated insulin secretion, glucose uptake, and streptozotocin-induced type 1 diabetes model. A 3 h pretreatment with FE prevented $IL-1{\beta}$ and $IFN-{\gamma}$ toxicity in isolated rat islets. However, it did not affect insulin-stimulated glucose uptake in C2C12 myotubes. In addition, pretreatment of mice with FE blocked the destruction of streptozotocin-induced islets and the development of type 1 diabetes. FE reduced blood glucose level, increased insulin secretion, and improved glucose tolerance in streptozotocin-treated mice, whereas nonfermented extract (NFE) had moderate effects. Immunohistochemical staining for insulin clearly showed that pretreatment with FE blocked the STZ-induced islets destruction and restored the number of islet cells that secreted insulin to the level of the control. Although the active principles and their mechanisms of action remain to be identified, FE may nevertheless represent a novel complementary therapy and a source of novel therapeutic agents against type 1 diabetes mellitus.

• Nutrition Research and Practice
• /
• v.15 no.5
• /
• pp.568-578
• /
• 2021

BACKGROUND/OBJECTIVES: Psidium guajava L. (guava) leaves have been shown to exhibit hypoglycemic and antidiabetic effects in rodents. This study investigated the effects of guava leaf extract on adipogenesis, glucose uptake, and lipolysis of adipocytes to examine whether the antidiabetic properties are mediated through direct effects on adipocytes. MATERIALS/METHODS: 3T3-L1 cells were treated with 25, 50, 100 ㎍/mL of methanol extract from guava leaf extract (GLE) or 0.1% dimethyl sulfoxide as a control. Lipid accumulation was evaluated with Oil Red O Staining and AdipoRed assay. Immunoblotting was performed to measure the expression of adipogenic transcription factors, fatty acid synthase (FAS), and AMP-activated protein kinase (AMPK). Glucose uptake under basal or insulin-stimulated condition was measured using a glucose analog 2-[N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl) amino]-2-deoxy-D-glucose. Lipolysis from fully differentiated adipocytes was measured by free fatty acids release into the culture medium in the presence or absence of epinephrine. RESULTS: Oil Red O staining and AdipoRed assay have shown that GLE treatment reduced lipid accumulation during adipocyte differentiation. Mitotic clonal expansion, an early essential event for adipocyte differentiation, was inhibited by GLE treatment. GLE inhibited the expression of transcription factors involved in adipocyte differentiation, such as peroxisome proliferator-activated receptor 𝛄 (PPAR𝛄), CCAAT/enhancer-binding protein α (C/EBPα), and sterol regulatory element-binding protein-1c (SREBP-1c). FAS expression was also decreased while the phosphorylation of AMPK was increased by GLE treatment. In addition, GLE increased insulin-induced glucose uptake into adipocytes. In lipid-filled mature adipocytes, GLE enhanced epinephrine-induced lipolysis but reduced basal lipolysis dose-dependently. CONCLUSIONS: The results show that GLE inhibits adipogenesis and improves adipocyte function by reducing basal lipolysis and increasing insulin-stimulated glucose uptake in adipocytes, which can be partly associated with antidiabetic effects of guava leaves.

• YAKHAK HOEJI
• /
• v.39 no.5
• /
• pp.541-547
• /
• 1995

In order to investigate the usability of PALMIWON as antidiabetic immuno-modulating prescription for Insulin-dependent diabetes, we studies the effects of PALMIWON on immune cell and ${\beta}-cell$. U937 was used as the model of immune cell and RINm5F as the model of ${\beta}-cell$. The effects of PALMIWON was measured by cell viability in terms of MIT assay. As a result, PALMIWON and the compositional drugs showed the different effects m immune cell and ${\beta}-cell$. Cell viability of U937 was significantly decreased wheras that of RINm5F was no significantly difference between drug treated group and control, or significantly less reduction compared with U937. It implies that PALMIWON is useful as immunotherapeutic agents in the prevention and therapy of type 1 diabetes.

• Journal of Ginseng Research
• /
• v.11 no.2
• /
• pp.145-252
• /
• 1987

Isolated rat adipocytes are well known to possess opposite pathways of lipid metabolism: lipolysis and ipogenesis. Both of the metabolism respond to various biologically active substances such as epinephrine, ACTH and insulin. Epinephrine and ACTH stimulate lipolysis and insulin accelerates lipogenesis. Recently, Korean red ginseng powder was found to contain adenosine and an acidic poptide which inhibited epinephrine-induced lipolysis and sl imulated insulin-mediated lipogenesis from added glucose. The acidic peptide is consisted mainly of glutamic acid and glucose. Ginsenosides Rb1 and Re inhibited ACTH-induced lipolysis in isolated rat adipocytes, while they did not affect insulinstimulated lipogenesis, Thus, all these substances extracted from Korean red ginseng exhibited selective modulations toward the opposite metabolic pathways in rat adipocyte; They inhibited the lipolysis but not the lipogenesis. We call these substances"selective modulators". Recently, we isolated a toxic substance named "toxohormone-L " from ascites fluid of patients with various malignant tumors. The toxohormone-L stimulated lipolysis in rat adipocytes and induced anorexia in rats. Both the lipolytic and the anorexigenic actions of toxohormone-L were found to be inhibited by ginsenoside Rb2 in Korean red ginseng. Based on these results, physiological signifi¬cances of these substances in Korean red ginseng were discussed. Pan ax ginseng is a medicinal plant long used in treatment of various pathological states including general complaints such as head ache, shoulder ache, chilly constitution and anorexia in cancer patients, There have been many pharmacological studies on Panax ginseng roots. Petkovllreported that oral administration of an aqueous alcoholic extract of ginseng roots decreased the blood sugar levtl of rabbits. Saito2lreported that Panax ginseng suppressed hyperglycemia induced by epinephrine and high carbohydrate diets. These findings suggest that Panax ginseng roots contain insulin-like substances. Previously, we demonstrated that gin¬seng roots contain an insulin-like peptide which inhibits epinephrine-induced lipolysis and stimulated insulin-mediated lipogenesis. In 1984, we suggested that such an insulin-like substance should be called a selective modulator4). Present investigation describes the details of the selective modulators in ginseng roots. During progressive weight loss in patients with various neoplastic disease, depletion of fat stores have been observed. The depletion of body fat during growth of neoplasms is associated with increase in plasma free fatty acids. Recently, we found that the ascites fluid from patients with hepatoma or ovarian tumor and the pleural fluid from patients with malignant lymphoma elicited fatty acid release in slices of rat adipose tissue in vitro. The lipolytic factor, named"toxohormone-L". was purifed from the ascites fluid of patients with hepatoma. The isolated preparation gave a single band on both disc gel electrophoresis and sodium dodecyl sulfate(SDS)-acrylamide gel electrophoresis in the presence of ${\beta}$-mercaptoethanol. Its molecular weight was determined to be 70,000-75,000 and 65,000 by SDS-acrylamide gel electrophoresis and analytical ultracentrifugation, respectively. Injection of toxohormone-L into the lateral ventricle of rats significantly suppressed food and water intakes. There was at least 5 hr delay between its injection and appearance of its suppressive effect. In the present study, we also tried to find a inhibitory substance toward toxohormone-L from root powder of ginseng.