Objective: The aim of this study was to determine the frequency of type 2 diabetes, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) among patients visiting a tertiary level teaching hospital in south-western Nepal. Material & Methods: This is a retrospective study conducted among subjects (n=17082) who visited outpatient department of the Universal College of Medical Sciences Teaching Hospital (UCMSTH), Bhairahawa, Nepal for their medical checkup. Data related to age, sex, hospital number and blood glucose concentration of the study subjects were collected from hospital records and analyzed for the frequency study. Results: The average frequency of type 2 diabetes was found to be 6.1% over a period of five years and it was significantly (p=0.0232) higher in males (3.4%) than in females (2.8%). Frequency of IFG and IGT were found to be 2.31% and 2.70% respectively. The frequency of type 2 diabetes, IFG and IGT was significantly higher in males and age group of 51-60 years. Conclusion: The frequency of type 2 diabetes and impaired glycemia is increasing every year in south-western part of Nepal. We recommend that efforts be made by all the stakeholders to curb this emerging medical problem before it becomes epidemic in the general population. DOI: http://dx.doi.org/10.3126/ajms.v2i3.5485 Asian Journal of Medical Sciences 2 (2011) 202-206
Nuclear factor erythroid-2-related factor 2 (Nrf2) is a stress-activated transcription factor regulating antioxidant genes, and a deficiency thereof, slowing lymphangiogenesis, has been reported in diabetic foot ulcer (DFU). The mode of Nrf2 regulation in DFU has been less explored. Emerging studies on miRNA-mediated target regulation show miRNA to be the leading player in the pathogenesis of the disease. In the present study, we demonstrated the role of miR-27b in regulating Nrf2-mediated angiogenesis in DFU. A lower expression of mRNA targets, such as Nrf2, HO-1, SDF-1α, and VEGF, was observed in tissue biopsied from chronic DFU subjects, which was in line with miR-27b, signifying a positive correlation with Nrf2. Similarly, we found significantly reduced expression of miR-27b and target mRNAs Nrf2, HO-1, SDF-1α, and VEGF in endothelial cells under a hyperglycemic microenvironment (HGM). To confirm the association of miR-27b on regulating Nrf2-mediated angiogenesis, we inhibited its expression through RNA interference-mediated knockdown and observed disturbances in angiogenic signaling with reduced endothelial cell migration. In addition, to explore the role of miR-27b and angiogenesis in the activation of Nrf2, we pretreated the endothelial cells with two well-known pharmacological compounds—pterostilbene and resveratrol. We observed that activation of Nrf2 through these compounds ameliorates impaired angiogenesis on HGM-induced endothelial cells. This study suggests a positive role of miR-27b in regulating Nrf2, which seems to be decreased in DFU and improves on treatment with pterostilbene and resveratrol.
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