Romanian Journal of Diabetes Nutrition and Metabolic Diseases 2021-11-13T14:09:48+02:00 Dragoș Crețoiu Open Journal Systems <p>The <strong>Romanian Journal of Diabetes Nutrition and Metabolic Diseases</strong> is the journal of the <strong>Romanian Society of Diabetes Nutrition and Metabolic Diseases</strong>.</p> <p>It appeared for the first time in 1992, in Romanian language and beginning with 2006 it was published entirely in English. It is a peer reviewed journal, therefore the accepted articles were peer-reviewed by <strong>at least two scientific experts</strong> in the field.</p> <p>It contains <strong>original papers</strong>, including fundamental and clinical research, <strong>literature reviews</strong>, <strong>clinical reports</strong>, <strong>editorials</strong>, articles that contain the <strong>results of the most important clinical studies</strong>, reports from the important congresses and <strong>book reviews</strong>.&nbsp;</p> <p>In Romanian Journal of Diabetes Nutrition and Metabolic Diseases there may be published only papers exclusively sent to this journal, not published previously. The authors should include possible conflicts of interest and financing sources. The laws of copyright and international rules of scientific research are respected.</p> <p>The Romanian Journal of Diabetes Nutrition and Metabolic Diseases <strong>strictly requires</strong> for all the scientific work published <strong>to be 100% compliant</strong> with the&nbsp;<a title="ICMJE.ORG" href="" target="_blank" rel="noopener">Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals</a>&nbsp;and with the&nbsp;<a title="Best Practices" href="" target="_blank" rel="noopener">Principles of Transparency and Best Practice in Scholarly Publishing</a> (joint statement by COPE, DOAJ, WAME, and OASPA).</p> <p>This journal appears trimestrially (four numbers/year). 650-800 copies are printed on each number.</p> <p>ILEX Printing House, Bucharest, has the exclusivity for the typesetting, printing and distribution of the Romanian Journal of Diabetes, Nutrition and Metabolic Diseases.</p> <p>Our journal is recognized by the Romanian National University Research Council (CNCSIS - 2009) to be part in the B+ category, Code 322.</p> <p>The Romanian Journal of Diabetes Nutrition and Metabolic Diseases is currently indexed in:</p> <p>- Index Copernicus<br>- Get Cited<br>- SCOPUS<br>- Scirus<br>- Celdes<br>- CNKI Scholar (China National Knowledge Infrastucture)<br>- CNPIEC<br>- EBSCO - TOC Premier<br>- EBSCO Discovery Service<br>- Google Scholar<br>- J-Gate<br>- Naviga (Softweco)<br>- Primo Central (ExLibris)<br>- SCImago (SJR)<br>- Summon (Serials Solutions/ProQuest)<br>- TDOne (TDNet)<br>- Ulrich's Periodicals Directory/ulrichsweb<br>- WorldCat (OCLC)</p> Diabetes mellitus and disability 2021-11-09T14:08:55+02:00 Inna Borysova Natalia Pertseva Vitaliy Berezovskiy Daria Chub <p>Diabetes mellitus (DM) is not only a major medical but also an economic problem worldwide. Significant economic costs and social damage caused by the increasing prevalence of diabetes, comorbid pathology, complications, high disability and mortality. In the article we analyzed the indicators of disability in patients with diabetes in Dnepropetrovsk region and in Ukraine and identified methodical approaches to determining the degree of disability. Results of the study showed that the indicators of disability due to diabetes in Dnepropetrovsk region and Ukraine are stable and averages 1.7 and 1.5 per 10 thousand population, respectively, in 2014-2019. Intensive indicator of primary disability due to DM among the employable population in Dnipropetrovsk region is growing every year. It’s become much higher than disability indicator among total adult population. In our study we proposed criteria for determining the signs of disability based on criteria of life limitations.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## Perspectives of diabetes educators and dental hygienists regarding strategies to improve oral health for people with diabetes 2021-11-09T14:08:55+02:00 Hon K Yuen Hannah L Shultz Martin M Davis Laura K Vogtle <p>Aims: This study aims to explore the opinions of dental hygienists and diabetes educators on improving oral health for people with diabetes. Methods: Registered dental hygienists (RDHs) and certified diabetes educators (CDEs) who provided written responses to the same open-ended question from two state-wide mailing surveys (one for RDHs and the other for CDEs) “what more can you tell us to help improve oral health for people with diabetes?” were included in this study. The surveys were sent to all RDHs (n=2237) and CDEs (n=250) in the state of South Carolina, United States. Results: Of the 1125 valid returned questionnaires&nbsp;from both surveys, 474 provided written responses to this question. Qualitative analysis revealed three main themes from participants’ written responses which were: Education (3 subthemes: resources for patients, educate the public, and professional practice resources), interprofessional collaborative care (3 subthemes: role of medical and dental professionals in oral health promotion&nbsp;for people with diabetes, and role of dental and diabetes professional organizations, and companies in the oral healthcare&nbsp;industry), and dental insurance. Conclusions: The three themes that emerged are interrelated indicating that strategies to improve oral health for people with diabetes are multi-faceted.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## Combine treatment with N-acetylcysteine, anti-CD4/CD8 antibodies and physical exercise reduces histopathological damage in salivary glands of spontaneously diabetic mice 2021-11-09T14:08:56+02:00 Raphael Oliveira Ramos Franco Netto Eliézer Guimarães Moura Renato Ferretti Magda Jaciara Andrade de Barros Rafael Dias Mâncio Rodrigo Eduardo da Silva Débora Chaves Cajazeiro Barros Victor Augusto Ramos Fernandes Renato Sartori Bortolato Luan Oenning Col Eduardo José Caldeira <p>Background and aims: The reactive oxygen species (ROS) shows intensification of tissue damage caused by type I diabetes mellitus,&nbsp;and N-acetylcysteine (NAC) can modulate this process by reducing its action. However, in diabetics, NAC seems to potentiate these damages because it stimulates a high infiltration of CD4 and CD8 T lymphocytes, which leads to an important therapeutic association with anti-CD4 / CD8 antibodies. Besides, physical exercise can complement this treatment by stimulating the body’s natural antioxidant defense. The purpose of this study was to analyze the effects of a combined treatment with NAC, anti-CD4 / CD8, and physical exercise on the reduction of damage in the salivary tissues on NOD mice. Material and methods: Female mice were divided into 5 groups with 6 animals each, composed by: Balb/c; NOD; NOD + Ex; NOD + NAC + CDs NOD + NAC + CDs + Ex. The NAC was applied intraperitoneally for 21 days at a dosage of 50mg/kg. The anti-CD4/CD8 were applied intravenously at a dosage of 25 μg/ml on days 0, 7, 14, and 21. During the experimental period, the animals of the exercise groups were subjected daily to 30 minutes of swimming exercise. After 21 days, the tissues were assessed by light microscopy analysis, stereological and immunofluorescence techniques for verification of INS-R insulin receptors. Results: For animals in the NOD + Ex groups; NOD + NAC + CDs; NOD + NAC + CDs + Ex, it was noticed a decrease in lymphocytes and inflammatory processes, as well as a significant increase in the relative neutrophils numbers. There was also a statistically significant difference in the increase of nuclear, and cytoplasmic volume, and an intense INR-S marking when compared to the NOD group without treatment. Conclusion: The therapy&nbsp;used, when associated with NAC to anti-CD4/CD8 promoted the recovery of glandular architecture and INS-R, along with benefit in the reduction of inflammatory processes. It was also found that physical exercise potentiated the therapeutic action of the drug in the tissue restructuring of the salivary glands.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## Characteristics of cytokine status in intra-abdominal infection with underlying diabetes mellitus: An experimental study 2021-11-09T14:08:56+02:00 Fedir Vasilyevich Grynchuk Ihor Yulievich Polianskiy Andriy Fedirovich Grynchuk Michael Ivanovich Sheremet Vitaliy Vasilyevich Maksymyuk Volodymyr Volodymyrovich Tarabanchuk Valeriy Stepanovich Vasylovych <p>Background and aims: Diabetes mellitus (DM) is known to have an increased susceptibility to infections and poor treatment outcomes, intraabdominal infections (IAI), in particular. Changes in the functioning of mechanisms for regulating inflammation&nbsp;under the DM influence are the main reason. It is crucial to study the state of the cytokine network. Since cytokines (Ctk) play a major role in the immune response and inflammation regulation. Our study aims to compare changes in cytokine status in IAI with underlying DM in the experiment. Material and method: The object of the studies is 100 mature albino nonlinear rats. Their weight is 180–200 g. To create the IAI model, animals have undergone a transesophageal gastric perforation. DM has been induced by subcutaneous administration of a 1.6% alloxan solution in distilled water at a dose of 16 mg per 100 g of body weight. The animals have been divided into the following groups: intact animals, animals with DM models, intact animals with peritonitis models (group 1), animals with peritonitis models with underlying DM (group 2). IAI has been modeled 3 months following the DM simulation. The blood has been taken from the cervical vein both before the IAI simulation and in 6, 12, 24, 48 hours of its simulation. The content of tumor necrosis factor α (TNFa) and interleukins (IL) 2, 6, and 10 in blood plasma have been studied. Results: The content of proinflammatory Ctk in animals with DM models has been significantly higher than in intact ones. The IL 10 content has been lower. After 6 hours of IAI modeling, the plasma content of all Ctk, most notably TNFa, has significantly<br>increased in group 1. The amount of TNFa has slightly changed in group 2. The amount of IL 2, IL 6 (table 4) has significantly&nbsp;increased. The amount of IL 10 has increased more than 50 times. The amount of TNFa, IL 6, and 10 have been significantly decreased. The amount of IL has remained at the same level. The number of all Ctk has immediately decreased in group 2. The TNFa number has been the lowest. After 24 hours, the number of TNFa has slightly increased in group 1 since the IAI simulation. The number of other Ctk is unlikely to have been decreased. IL 2 is the most pronounced to have been decreased. The number of TNFa has remained quite the same in group 2. The number of remaining Ctk has continued to decrease rapidly. After 48 hours, the number of TNFa and IL 10 have decreased in group 1 since the IAI simulation. Moreover, the number of IL 10 has become less than the initial indicators. The number of IL 6 has slightly changed, and the number of IL 2 has increased significantly. The number of IL 6 has increased significantly in group 2. The number of IL 6 has increased slightly, while the number of TNFa and IL 10 has remained almost unchanged. Conclusions: DM modeling causes a disparity in cytokine status. The reason is a higher number of pro-inflammatory Ctk in the background of a less number of IL 10. Intact animals with IAI models have shown signs of cyclical changes in the activity of various mechanisms of inflammatory regulation within 48 hours. At the same time, in 48 hours, there have been signs of impaired function of the regulation mechanisms of the immune response. There have been differences in the functioning of various mechanisms of inflammatory regulation in 6 hours in animals with IAI models with underlying DM. There have been signs of immunosuppression in 12 hours. These changes have been progressing later on and the signs of immune insufficiency&nbsp;have been shown in 48 hours.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## Association of inflammatory marker, glycosylated hemoglobin, circulating lipids with microvascular complications and glycemic control of type 2 diabetes mellitus in South Indian population 2021-11-09T14:08:57+02:00 Geetha Pandavar Sahayam Shanmugasundaram Palani <p>Background and Aims: Inflammatory processes provoke the synthesis of various acute-phase proteins like C-reactive protein (CRP) in the liver and orchestrate a predominant role in the development of insulin resistance. Against this backdrop, the present&nbsp;study was undertaken to evaluate the association of inflammatory markers, glycated hemoglobin, and circulating lipids with microvascular complications in type 2 DM patients. Material and Methods: Prospective hospital-based longitudinal study was conducted with 384 patients to complete the study. The metabolic profiles were measured at baseline, 3rd month (review I), 6th month (review II), and at 12th month (review III). Lipid profiles were measured at baseline. CRP was measured at baseline, 6th month and at 12th month. Results: The recruited patients were followed for three reviews. Blood sugar level, HbA1c, and CRP were significantly decreased when compared to baseline. In this study baseline, CRP showed a positive correlation with baseline sugar levels, LDL, total cholesterol, renal parameters except for VLDL and a strong negative correlation with baseline HDL and ankle-brachial index but no significant correlation was observed with cardiac autonomic neuropathy and vibration perception threshold. Conclusion: This study concluded that due to effective pharmacotherapy the CRP level and the metabolic profiles were reduced after 12 months of follow-up.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## Dynamics of antioxidant status and nitrogen oxide systems in rats with metabolic syndrome after bariatric surgeries 2021-11-09T14:08:57+02:00 Ihor Y. Dziubanovskyi Svitlana R. Pidruchna Andrii M. Prodan Natalya A. Melnyk Liliya M. Palytsya <p>Background and aims: Metabolic syndrome still requires the development of new treatments. The aim of the study was to study the state of the nitric oxide system, lipid peroxidation and antioxidant system in the body of animals with metabolic syndrome, which has received surgical treatment of obesity by different methods. Material and methods: The studies were performed on 40 white male Wistar rats. Male rats of the main group (n = 8) were fed a high-fat diet (HFD) for 16 weeks, thus simulating the development of MS. After exposure to a high-fat diet for 16 weeks, rats in the HFD cohort were randomly assigned to non-surgical HFDs and HFDs who underwent appropriate surgery intervention. Results: Surgical treatment of obesity reduces the intensity of lipid peroxidation, nitrooxidative stress and improves antioxidant defense mechanisms in all studied groups of animals with simulated&nbsp;metabolic syndrome. However, only in the group of rats that underwent left gastric artery ligation surgery, the improvement&nbsp;of the pro- and anti-oxidant (the level of superoxide dismutase increased in 1.52 times; p &lt;0.05) system and the nitric oxide system (the level of NO-synthase decreased in 41.17%; p &lt;0.05) was statistically significant for all studied indicators.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## Nutrition and academic performance among adolescences 2021-11-09T14:08:57+02:00 Tengiz Verulava Rozi Devnozashvili <p>Introduction: Nutrition affects the mental development of students. Consequently, it correlates with their academic performance. The study aims to examine the connection between nutrition and the academic performance of school students. Methodology:&nbsp;Within the quantitative cross-sectional research, 492 students of VII–X grades of public and private schools of Georgia have been interviewed through preliminarily structured online questionnaires. Outcomes: The study showed that 54% of school students hardly eat their breakfast during a week. The majority of students eat unhealthy meals, as they contain fewer protein products, dairy foods, vegetables, fruits, and consume excessive carbohydrate-containing produce. Academic performance correlates with meal frequency (p=0.043), breakfast and supper quality (p=0.000), fruit variety (p=0.000), as well as with the consumption of carbonated beverages (p=0.000) and chips (p=0.010). The study has also demonstrated that obesity (6%) and overweight (14%) are apparent problems. In addition, obesity is more common in boys (p=0.003). Conclusion: Reliable connection between eating habits and academic performance has been statistically confirmed. Obesity and overweight in adolescents is significant problem. It is reasonable to undertake targeted interventions, develop and introduce students’ healthy eating manual, tailored to their needs and interests, that will be positively reflected in student academic achievement. Each member of the school community (student, parent, pedagogue, school administration) shall realize the importance of nutrition in terms of students’ health and academic performance.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## Metabolic and hormonal prognostic markers of essential arterial hypertension considering the genes polymorphism AGTR1 (rs5186) and VDR (rs2228570) 2021-11-09T14:08:57+02:00 Marianna Semianiv Larysa Sydorchuk Larysa Fedonyuk Zoia Nebesna Olexandr Kamyshnyi Andrii Sydorchuk Valentyna Vasiuk Valentyna Dzhuryak Igor Semianiv Ruslan Sydorchuk <p>Background and aims: Essential arterial hypertension (EAH) is the most common global non-communicable disease. Material and method: 100 subjects with EAH and target-organ damaging (2nd stage), moderate, high, very high cardiovascular risk was involved in the case-control study. The control group consisted of 60 healthy individuals of relevant gender and age. All recruited subjects were tested for serum levels of fasting glucose, ionized calcium, parathyroid hormone, 25-hydroxyvitamin D. AGTR1 gene genotyping was performed for 72 patients and 48 healthy individuals, VDR gene – for 100 patients and 60 healthy subjects. Results: EAH associates with increased parathormone (&gt;65.0 pg/ml) by 16.04% in C-allele carriers of AGTR1 gene (rs5186) and decreased 25-hydroxyvitamin D (&lt;30 ng/ml) regardless of the genotypes AGTR1 (rs5186) and VDR (rs2228570) genes. Reduced serum level of 25-hydroxyvitamin D escalates the risk of EAH almost threefold, fasting hyperglycemia leads to growth of EAH risk almost 15 times. Changes in parathormone, ionized calcium concentration, as well as VDR gene do not influence the risk of EAH in the examined. Conclusions: Low level of 25-hydroxyvitamin D, fasting hyperglycemia increases the EAH risk regardless AGTR1 (rs5186) and VDR (rs2228570) genes’ alleles. C-allele of AGTR1 gene is a prognostic marker of EAH in the observed population.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## Submandibular abscess of dental origin and its evolution, in immunosuppressed and non-collaborated patients. Clinical case 2021-11-09T14:08:57+02:00 Ciprian Venter Amorin Popa Emil Marginean Felicia Manole Maria Domuta <p>We present a case of a 36-year-old female patient with type 2 (non-insulin-dependent) diabetes mellitus, who was admitted urgently to the ER service accused the following signs and symptoms: asymmetry of the face with Celsus signs present at the submandibular on the right side, trismus, febrile syndrome. The clinically conscious patient refuses hospitalization, therefore it was the reason for leaving the ER (emergency room) with oral treatment, and a recommendation to perform a dental consultation as soon as possible. Surgical intervention is performed, with multiple incisions, both external and endo-oral incisions, with the collection of secretion for culture (no germs have grown). Medical treatment drugs parenteral antibiotics, oral anti-diabetics, and insulin was administered continued. The purpose of the paper was to highlight patient compliance and cooperation. In our case, delaying the discharge of an abscess, by about 48 hours with an uncooperative patient with diabetes, led to multiple complications&nbsp;and prolonged hospitalization.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## Serum profiles of proinflammatory cytokines in patients with diabetic retinopathy 2021-11-09T14:08:57+02:00 Marta Horecha Lyubov Lapovets Viorika Akimova Nataliia Lapovets Olha Martianova <p>Background and aims: Due to the steadily increasing numbers of patients with diabetes mellitus (DM), the prevalence of diabetic<br>complications is also on the rise. One of the most prognostically adverse complications is diabetic retinopathy (DR), which leads to blindness and vision disability of employable population. Cytokine imbalance is one of the factors in the development of DR. &nbsp;The aim was to study the changes in IL-6, IL-8, and TNF-α levels in biological fluids of patients with DR, as these cytokines are produced by endothelial cells, fibroblasts, monocytes/macrophages and by other cells in response to pathogens. Material and method: The objective of this work was to assess serum levels of IL-6, IL-8, and TNF-α in 130&nbsp;patients with diabetic retinopathy (70&nbsp;patients with decompensated diabetes mellitus [Group&nbsp;1] and 60&nbsp;patients with compensated diabetes mellitus [Group&nbsp;2]). The age of patients ranged from 20 to 55&nbsp;years. The laboratory results were compared with respective values in the control group, which included 30&nbsp;virtually healthy individuals. Interleukin levels were determined using reagent kits manufactured by ‘VECTOR-<br>BEST Ukraine’ on a ‘STAT FAX 303 plus’ analyzer. Results: The levels of IL-6 in groups of patients with DR with both uncompensated<br>and compensated diabetes were not significantly different from the respective levels in the control group. The level of IL-8 in patients of the first group of study subjects was increased 8-fold compared to the control group and was 1.4&nbsp;times higher than the respective level in patients of the second group. The level of IL-8 in patients of Group&nbsp;2 was 5.6&nbsp;times higher than in the control group. The concentration of TNF-α in both groups of patients with DR was 8&nbsp;times higher than in the control group. Conclusions:<br>As a result of our study, we have found patients with diabetic retinopathy (both with compensated and decompensated DM) to have increased serum levels of TNF-α and IL-8. The level of IL-8 in the blood of patients with DR is a potential diagnostic marker for decompensation of diabetes mellitus.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## A case report on IgA nephropathy 2021-11-09T14:08:57+02:00 Rashmi Sabaratnavel Anuradha Ganesan Sumathy S. <p>IgA nephropathy (IgAN) is one of the most common glomerulonephrites in the Western world. Its diagnosis is based on clinical&nbsp;history, laboratory data, and histopathological reports. The clinical picture and spectrum of severity upon presentation vary between cases. In this case report, we present a previously healthy 23-year-old Indian male with rapidly progressing IgA nephropathy&nbsp;leading to severe acute renal impairment. This case report highlights histopathological and clinical characteristics of a case of severe IgA nephropathy.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## Luteolin: protective effects against diabetes and diabetes associated complications 2021-11-09T14:08:55+02:00 Chanky Mehta Kriti Kushwaha Jeena Gupta <p>Diabetes is known to be associated with a deficiency of insulin affecting directly or indirectly other important parts of the human body. There are various forms of treatment in Ayurveda and other traditional medicinal systems which use naturally occurring compounds for the treatment of diseases. One such widely studied phytochemical is Luteolin. Luteolin is known to be present in a wide variety of plant species, especially edible plants like carrots and cucumbers. Luteolin belongs to the group of flavonoids having&nbsp;its unique properties and is known to inhibit pro-inflammatory cytokines. The cellular actions and properties make luteolin a potent anti-diabetic compound. Luteolin’s antioxidant function, together with its hypoglycemic ability, protects the pancreas and facilitates the secretion of insulin which makes it effective and important for medicinal studies. In this review, we will focus upon the ability of luteolin to treat diabetes and its related complications.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## Hydrogen sulfide metabolism and its role in the development of periodontal diseases 2021-11-09T14:08:56+02:00 Inna Krynytska Roman Khudan Nino Svanishvili Zaza Dumbadze Mariya Marushchak Mykhaylo Korda <p>Hydrogen sulfide (H2S) is a signaling molecule that is actively synthesized in the tissues and regulates a wide range of physiological&nbsp;processes, namely cardiovascular, neuronal, immune, respiratory, gastrointestinal, liver, and endocrine systems, by influencing&nbsp;cellular signaling pathways and sulfhydration of target proteins. The influence of H2S signaling in cell cycle and cell death pathways is associated with tumor growth, angiogenesis, and neurodegenerative diseases. The relationship between H2S and oral cavity pathologies, especially periodontal diseases, is controversial, but should not be underestimated. Further research is needed in order to clarify the exact mechanisms and conditions, which cause the H2S molecule to exhibit cytoprotective/antioxidant or cytotoxic proprieties in the oral cavity.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## Management of non-alcoholic fatty liver disease in patients with diabetes mellitus 2021-11-09T14:08:56+02:00 Georgiana Diana Cazac Cristina Mihaela Lăcătușu Elena Daniela Grigorescu Alina Onofriescu Bogdan Mircea Mihai <p>Non-alcoholic fatty liver disease (NAFLD) is an emerging global epidemic, closely related to obesity, diabetes and metabolic syndrome.<br>Its association with obesity, dyslipidemia, insulin resistance and type 2 diabetes supports the notion that NAFLD is the hepatic manifestation of the metabolic syndrome. NAFLD, nowadays the most common cause of abnormal liver function tests, affects approximately 25% of the general population and includes a wide spectrum of liver disease, ranging from simple steatosis to non-alcoholic steatohepatitis (NASH) with the possibility of progression to cirrhosis and hepatocellular carcinoma (HCC).<br>The aim of this paper is to describe the therapeutic strategies contributing to the management of fatty liver disease in type 2 diabetes patients and the pathways these drugs interfere with to stop the development or even induce the regression of the liver disease.<br>The progression of NAFLD to its various stages needs to be stopped. Besides insulin resistance, which is the main target in the therapeutic strategy, the ongoing studies provide new evidence on mechanisms that need to be interfered with to help deal with the metabolic syndrome components and improve the cardiovascular disease (CVD) risk factors.<br>Dietary changes and other lifestyle modification measures form the primary line of treatment. New molecules are currently developed for the management of NAFLD that act on various therapeutic targets, besides the anti-diabetic treatment. Metabolic surgery remains the last option of NAFLD therapy, as it is highly invasive, even though it provides good results.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## Reconsidering the properties of papaya fruit as anti-diabetes type 2 2021-11-09T14:08:56+02:00 Pushparaja Shetty Akshatha Shetty <p>Diabetes mellitus (DM) is a condition that contributes to an impairment of the ability of the body to use food effectively triggered by the inability of the pancreas to generate insulin or body’s dysfunction to adequately use insulin. Type 2 DM can induce oxidative&nbsp;stress leading to changes in endogenous antioxidant activity as well as a rise in biomolecular oxidative stress. This disease causes significant amounts of exogenous antioxidant supplementation to be prescribed in individuals with type 2 Diabetes to prevent oxidative damage in the body. Papaya (Carica papaya Linn) is one of the medicinal herbs which has anti-hyperglycemic activity as well as high antioxidants. Based on analysis of several studies it is noted that papaya supplies vitamin C, fiber saponins as well as flavonoids which can lower blood glucose levels. Nonetheless, to confirm this effect, even more, clinical studies are needed to be done.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement## Effectiveness of vitamin D-based therapy in reducing clinical impact of Covid-19 patients: A systematic review 2021-11-13T14:09:48+02:00 Mawadatul Khoiroh Dominikus Raditya Atmaka Putri Ramadhani Ayuningtyas <p>Cases of the COVID-19 pandemic have spread throughout the world and caused a high mortality rate. This virus is self-limiting, so the healing process is related to the immune system. One of the medical therapies given to hospitalized COVID-19 patients is vitamin D-based therapy to boost the immune system against the COVID-19 virus. This paper aimed to determine the effectiveness of vitamin D-based therapy to reduce the clinical impact on COVID-19 patients. The clinical impacts observed in this systematic review were the length of hospital stay, length in the ICU stay, cure rate, severity, mortality rate, and signs of inflammation.&nbsp; A literature search was carried out on the Scopus, Sciencedirect, and PUBMED databases. Search articles using the keyword "vitamin D therapy in COVID-19 patients". The final result of the search found 6 articles that met the specified inclusion and exclusion criteria. Vitamin D in its active form (1,25(OH)2D3) can enhance chemotaxis, phagocytic response, and production of antimicrobials such as cathelicidin from macrophages as a series of innate immune responses. Administration of vitamin D-based therapy can also reduce the severity, decrease proinflammatory cytokines, and mortality in COVID-19 patients. The paper shows that vitamin D-based therapy therapy can reduce the clinical impact in COVID-19 patients.</p> 2021-10-31T00:00:00+03:00 ##submission.copyrightStatement##