Could gestational diabetes mellitus be managed through dietary bioactive compounds? Current knowledge and future perspectives

Gestational diabetes mellitus (GDM) is a serious problem growing worldwide that needs to be addressed with urgency in consideration of the resulting severe complications for both mother and fetus. Growing evidence indicates that a healthy diet rich in fruit, vegetables, nuts, extra-virgin olive oil and fish has beneficial effects in both the prevention and management of several human diseases and metabolic disorders. In this review, we discuss the latest data concerning the effects of dietary bioactive compounds such as polyphenols and PUFA on the molecular mechanisms regulating glucose homoeostasis. Several studies, mostly based on in vitro and animal models, indicate that dietary polyphenols, mainly flavonoids, positively modulate the insulin signalling pathway by attenuating hyperglycaemia and insulin resistance, reducing inflammatory adipokines, and modifying microRNA (miRNA) profiles. Very few data about the influence of dietary exposure on GDM outcomes are available, although this approach deserves careful consideration. Further investigation, which includes exploring the 'omics' world, is needed to better understand the complex interaction between dietary compounds and GDM

Short-term effects of glucagon-like peptide 1 (GLP-1) receptor agonists on fat distribution in patients with type 2 diabetes mellitus: an ultrasonography study

AIMS:Glucagon-like peptide 1 receptor agonists (GLP-1 RA) induce weight loss and reduction in adipose tissue, but the effects of GLP-1 RA on the distribution of fat deposits have been poorly investigated. METHODS: In 25 patients with type 2 diabetes (16 females and 9 males, mean age 63.5 ± 8.8 years), treated with GLP-1 RA (exenatide, n. 12; liraglutide, n.13), both before and 3 months after starting treatment, an abdominal ultrasonographic scan, with Doppler of renal arteries, and echocardiography were performed. Subcutaneous fat width (peri-umbilical and sub-xiphoid), deep fat deposits (pre-aortic, peri-renal, and epicardial), and renal resistive index (RI) were evaluated. RESULTS: GLP-1 RA induced highly significant (p < 0.001) decrease in BMI and in fat thickness at all the assessed sites, without differences between exenatide and liraglutide treatment. A slight decrease in RI (p = 0.055) was also found. The percent changes of fat thickness was different between sites (p < 0.025), and the changes in subcutaneous deposits showed no significant correlation (p = 0.064) with those of deep fat deposits. CONCLUSIONS: A short course of treatment with GLP-1 RA, besides weight loss, induces a redistribution of adipose tissue deposits, possibly contributing to a better cardiovascular risk profile in patients with type 2 diabetes mellitus

Endothelial dysfunction markers as a therapeutic target for Sildenafil treatment and effects on metabolic control in type 2 diabetes

Endothelial dysfunction (ED) plays a role in diabetic cardiovascular complications. Hyperglycemia increases cytockines involved in vascular inflammation. Inhibition of phosphodiesterase type 5 (PDE5) exerts a relaxation on corpora cavernosa and has cardioprotective properties. The effect of chronic sildenafil treatment, on ED markers and metabolic parameters in a non-randomized study on men with type 2 diabetes (T2DM), was investigated

The impairment of renal function is not associated to altered circulating vascular endothelial growth factor in patients with Type 2 diabetes and hypertension.

Abstract. Background. Metabolic and hemodynamic factors concur to the development of diabetic nephropathy. Moreover, in diabetes, the presence of hypertension may accelerate the development of renal damage. Vascular Endothelial Growth Factor (VEGF) stimulates microvascular permeability, endothelium-dependent vasodilation and angiogenesis, and its synthesis is enhanced by hyperglycemia, Advanced Glycation End-products (AGEs), tissue hypoxia and hypertension. VEGF appears to play a central role in mediating diabetic vasculopathy, and although VEGF and its receptors are expressed at renal level, its action in renal pathophysiology is unknown. The aim of this study was to elucidate whether presence and/or severity of renal dysfunction is related to circulating VEGF in patients with type 2 diabetes and hypertension. Design and Methods. Fifty hypertensive type 2 diabetic patients and ten non-diabetic patients, were included in the study. Renal function parameters such as albumin excretion rate, (AER), and glomerular filtration rate (GFR), and VEGF plasma levels were analysed in all subjects, whereas %HbA1c and AGEs levels were evaluated in diabetic patients. Results. GFR was significantly decreased in diabetic patients compared with the control subjects (74.3615.95 vs. 118.0821.86 ml/min, p<0.0001). Three diabetic patients showed AER abnormalities (53.82.3 mg/24h). VEGF in diabetic patients was higher than in the control group (77.959.33 vs. 48.9214.77 pg/ml), but not significantly. %HbA1c and AGE levels were 6.60.2% and 11.598.09 UAGE, respectively. No correlation was found between renal function, circulating VEGF levels and metabolic control. Conclusions. Diabetes, in association with hypertension, significantly decreases renal function, but circulating VEGF may not reflect its concentration and action at renal level