In patients with T2DM, treatment with resveratrol regulates energy expenditure through increased skeletal muscle SIRT1 and AMPK expression. These findings indicate that resveratrol may have beneficial exercise-mimetic effects in patients with T2DM.

Obesity is a major public health problem in the twenty-first century. Mutations in genes that regulate substrate metabolism, subsequent dysfunction in their protein products, and other factors, such as increased adipose tissue inflammation, are some underlying etiologies of this disease. Increased inflammation in the adipose tissue microenvironment is partly mediated by the presence of cells from the innate and adaptive immune system. A subset of the innate immune population in adipose tissue include macrophages, termed adipose tissue macrophages (ATMs), which are central players in adipose tissue inflammation. Being extremely plastic, their responses to diverse molecular signals in the microenvironment dictate their identity and functional properties, where they become either pro-inflammatory (M1) or anti-inflammatory (M2). Endurance exercise training exerts global anti-inflammatory responses in multiple organs, including skeletal muscle, liver, and adipose tissue. The purpose of this review is to discuss the different mechanisms that drive ATM-mediated inflammation in obesity and present current evidence of how exercise training, specifically endurance exercise training, modulates the polarization of ATMs from an M1 to an M2 anti-inflammatory phenotype.

Type 2 Diabetes Mellitus (T2DM) which is characterised by insulin resistance, is closely linked to the triad of glucolipotoxicity, inflammation and oxidative stress. Increased adiposity, leading to increased free fatty acids (FFAs), contributes to insulin resistance by disrupting the signal transduction pathway of insulin mediated glucose disposal, and causes impaired insulin secretion. Hyperglycaemia and dyslipidaemia driven oxidative stress resulting from enhanced free-radical formation and/or defects in antioxidant defence is implicated in the pathogenesis of diabetic neuropathy (DN). This and other inflammatory pathways account for a complex network of interacting metabolic factors responsible for causing diabetes and her complications. There is growing evidence that Alpha Lipoic Acid (ALA) has beneficial effects on the treatment of T2DM and some of its complications. It represents an attractive pharmacological target in the treatment of T2DM by modulating the signal transduction pathways in insulin resistance and antagonizing the oxidative and inflammatory stresses, which are major players in the pathogenesis of this disorder. A potent anti-oxidant and free radical scavenger, ALA also targets cellular signal transduction pathways which increases glucose uptake and utilization, thus providing specific targeted therapy in the treatment of insulin resistance and diabetic neuropathy. Apart from the rare risk of Insulin Autoimmune Syndrome (IAS), ALA has shown to be relatively safe, even in patients with renal and liver failure. This review focuses and summarises the molecular mechanisms of T2DM, and underlines the therapeutic value of ALA in this globally significant disease.

Objectives. We aimed to develop and validate a carbohydrate and insulin dosing knowledge quiz for adult Asian patients with diabetes mellitus.Methodology. A self-administered quiz was developed to test carbohydrate recognition; single food carbohydrate estimation; meal carbohydrate estimation and food label reading; and insulin dosing calculation for carbohydrate, blood glucose and for a meal in a multi-ethnic Asian population. The subjects' carbohydrate knowledge and insulin dosing ability were rated by the study dietitian and the subjects' primary physicians, respectively. We compared the quiz scores with the dietitians' and physician ratings and the subjects' HbA1c. Reliability of the quiz was tested by measuring internal consistency and split half reliability.Results. Seventy-five subjects completed the study. Median (inter-quartile range) quiz score was 71.9 (60.2 to 83.6)%. The quiz score was found to be correlated with the healthcare provider assessments (r=0.652, p<0.001) and the subjects' HbA1c (r=-0.375, p=0.001). Cronbach alpha was 0.897 and Guttman split half coefficient was 0.930.Conclusions. Our analysis suggested that this newly developed quiz had good reliability and validity for testing carbohydrate and insulin dosing knowledge in a group of Asian subjects with diabetes mellitus. This can be a useful screening tool in clinical practice.