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The current study aimed to establish the mechanisms of antidiabetic activity of methanolic extract of Punica granatum leaves (MEPGL) in nicotinamide/streptozotocin-induced type 2 diabetes in rats. Phytochemical screening, HPLC analysis, and acute toxicity study of MEPGL were carried out. Various concentrations of MEPGL (100, 200, 400, and 600 mg/kg) were administered orally to diabetic rats for 45 days on a daily basis. The antidiabetic effect of MEPGL was examined by measuring blood glucose, plasma insulin, and glycated hemoglobin (HbA1c) levels, as well as with an oral glucose tolerance test. The antioxidant effect of MEPGL was determined by analyzing hepatic and renal antioxidant markers, namely superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH), and lipid peroxidation. The other biochemical markers alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), urea, and creatinine, as well as total cholesterol, triglycerides, and high-density lipoprotein (HDL) were also studied. Type 2 diabetes significantly altered these parameters, while oral administration of the MEPGL significantly ameliorated them. Moreover, the pancreatic histopathological changes were attenuated with MEPGL treatment. In a nutshell, oral MEPGL administration in diabetic rats showed antidiabetic activity due to its antioxidant activity, most probably due to the gallic acid, ellagic acid, and apigenin found in MEPGL.

These results clearly indicate that J. humile is effective in scavenging free radicals and has the potential to be a powerful antioxidant. Thus, the results obtained in the present study indicate that J. humile leaves extract could be considered as a potential source of natural antioxidants and that could be used as an effective source against bacterial diseases.

Background: Neuropathy is the most prevalent broad-spectrum microvascular complication of diabetes. The present study aims to evaluate the effect of empagliflozin with vitamin D supplementation on diabetic peripheral neuropathy.Methods: A prospective, randomized, controlled study was conducted for six months including 150 type 2 diabetic patients, divided into three groups (n=50/group): Group 1, patients on oral hypoglycemic agents; Group 2, patients on empagliflozin and Group 3, patients on empagliflozin with vitamin D. Biochemical parameters were estimated for outcome measurements and patients' neuropathic pain was analysed using Douleur Neuropathique 4 Questions, Neuropathic Pain Symptom Inventory and Ipswich Touch the toes test questionnaire. Data were analysed using a one-way analysis of variance.Results: Diabetic neuropathy in males was more prevalent (more than 50%) as compared to females in all three groups, with an average age of 50±6 years, along with a diabetic history of 15±4.5 years and a glycated hemoglobin A1C (HbA1C) level of >10%. The mean value of serum vitamin D level significantly increased by 64.7% (19±5 to 54±8 ng/mL; p<0.05). A remarkable decrease (by 17.4%) from baseline in the HbA1C level was observed after six months of treatment only in Group 3, whereas in other groups (1 and 2), there was a nonsignificant decrease in HbA1C levels when compared to baseline. Moreover, a significant improvement in neuropathic condition was seen only in Group 3. Conclusion:The results indicated that empagliflozin with vitamin D supplementation significantly controlled or reduced HbA1C and improved diabetic neuropathic symptoms in patients. It is suggested that this combination can be considered as the primary therapeutic approach for neuropathic complications in diabetic patients.

Background:The biothesiometer allows for a quick and accurate measurement of vibration thresholds, which, when combined with centile charts, provides an objective estimate of diabetic peripheral neuropathy progression. The goal of the current study was to assess diabetic patients' early detection of peripheral neuropathy and associated consequences. Materials and Methods: Study was conducted on diabetes patients of medicine department of Maharishi Markandeshwar Super Speciality Hospital, MMIMSR, MM (DU), Mullana, after approval by the Institutional Ethics Committee (IEC). Patients were analysed for the vibration perception threshold (VPT) using Biothesiometer. After receiving their consent, socio-demographic parameters and previous medical history were noted on a case report form and patient's QoL (Quality of Life) was analyzed using Diabetic Neuropathy (DN) 22 QoL questionnaire. The DN4 questionnaire was used to assess the presence of peripheral neuropathy pain. Results: In this research study total of 100 patients participated, of whom 55 were male patients and 45 were female patients The ages of these patients ranged from 26 to 86 years and mean of these patients was 55 years. The patients were divided into two distinct age groups: those under 50 and those above 50. Only 15 patients reported numbness, while the remaining 85 patients reported no abnormal sensations in their feet. However, when left foot and right foot readings were valuate on the biothesiometer, 9 patients had grade 1 say normal (15 volts), 12 patients had grade 2 (16-25 volts), and 79 patients had grade 3 (>25 volts). Conclusion: It was concluded that VPT was determined to be the gold standard or say best fit for detection of peripheral neuropathic pain in diabetes patients. Measuring VPT in diabetic patients with a biothesiometer may reduce the risk of developing neuropathic foot ulcers and foot amputations.