Onion extract benefits high blood sugar and cholesterol; Impact of insulin pump therapy on erectile dysfunction in Type 2 diabetes

The extract of onion bulb, Allium cepa, is found to be effective in reducing high blood glucose (sugar) and total cholesterol levels. The study was presented at Endocrine Society's 97th Annual meeting in San Diego.

To three groups of rats with medically induced diabetes, lead investigator Ojieh ( MBBS (MD), MSc, of Delta State University in Abraka, Nigeria) and his colleagues gave metformin and varying doses of onion extract--200, 400 and 600 milligrams per kilograms of body weight daily (mg/kg/day) - to see if it would enhance the drug's effects. They also gave metformin and onion extract to three groups of non-diabetic rats with normal blood sugar, for comparison. Two control groups, one non-diabetic and one diabetic, received neither metformin nor onion extract. Another two groups (one with diabetes, one without) received only metformin and no onion extract. Each group contained five rats.

Two doses of onion extract, 400 and 600 mg/kg/day, strongly reduced fasting blood sugar levels in diabetic rats by 50 percent and 35 percent, respectively, compared with "baseline" levels at the start of the study before the rodents received onion extract, Ojieh reported. Allium cepa also reportedly lowered the total cholesterol level in diabetic rats, with the two larger doses again having the greatest effects.

The onion extract used for the experiment was a crude preparation from onion bulb, which is available in the local market. If this were to be administered to humans, it would usually be purified so that only the active ingredients would be quantified for adequate dosing, Ojieh said.

Impact of insulin pump therapy on erectile dysfunction in Type 2 diabetes

This original research from Jothydev’s Diabetes Research Centre was presented at ATTD (Advanced Technologies & Treatments for Diabetes) in February 2015 and published in Diabetes Technology & Therapeutics.

Erectile dysfunction is common in men with T2DM. We investigated the effect of continuous subcutaneous insulin infusion (CSII) in men with T2DM and ED. Twenty men were recruited for this pilot study. All patients were put on insulin +/- OHAs and a statin, with CSII in trial arm and multiple daily injections (MDI)/biphasic/basal insulin regimens in control arm. Antihypertensives were used as required.

The study was a 6-month, parallel arm, open label, non-randomized, single-blind (outcomes assessor) study. The primary endpoint was International Index of Erectile Function (IIEF). All subjects also answered Patient Health Questionnaire-9 (PHQ-9) for depression, a global assessment question of whether erections improved, and a neuropathic pain scale for peripheral neuropathy at the end of the study. Other assessments included vibration perception threshold (VPT) and tests for HbA1c, free testosterone, lipid profile, & TSH. Baseline measurements were compared using independent sample t-test. Linear regression for final IIEF score corrected for age and baseline IIEF score. All patients had normal testosterone and TSH levels. Age, A1c, PHQ-9 score, and IEEF scores were not statistically significantly different between groups at baseline (CSII: mean age 52.8 years, mean A1c 8.1; Control: 50.8 yrs, 7.8 A1c).

Patients in the CSII arm showed statistically significant improvement in total IEEF score, t(14)=5.89, p<0.0001, and in the five subdomains of IEEF. Final A1c in the CSII group was 7.5 ± 0.9 vs 8.6 ± 0.9 in the control group. More men in the CSII arm answered 'yes' to the global assessment question at the end of the study (7 vs 3). This is the first study to report improvement of erectile dysfunction with CSII.

Role of Home blood Pressure Monitoring in halting  the progression of diabetic kidney disease: 6 year follow up data

This original research from Jothydev’s Diabetes Research Centre was presented at ATTD (Advanced Technologies & Treatments for Diabetes) in February 2015 and published in Diabetes Technology & Therapeutics.

Chronic Kidney Disease (CKD) is the most disabling and expensive complications of diabetes.The rapid progression of CKD are heralded partly by glucose and partly by fluctuations in blood pressure. Maintenance of acceptable blood pressure is pivotal in preventing the progression of CKD to one requiring renal replacement therapies.

We extracted data of CKD patients from our electronic medical records with an average estimated glomerular filtration rate (eGFR) below 50 mL/min/1.73m2 (CKD stage 3 and 4) and have completed at least 6 years of telemedicine follow up with our Diabetes Tele Management System(DTMS®) to titrate dosages of medications. From this, data of 22 patients who used digital automatic BP apparatus(Omron HEM-7120) at their home for blood pressure monitoring were de-identified. We compared serum creatinine, HbA1c, hemoglobin (Hb), systolic BP, diastolic BP, eGFR at baseline and at six years. Comparison of means was made by paired t-test.

There was no statistically significant change in HbA1c (6.9 vs 7.3, p=0.053). There was a decline in serum creatinine (1.6 vs 2.3, p<0.0001), systolic BP (136 vs 162, p<0.0001), diastolic BP (70 vs 78) and an increase in Hb (12.8 vs. 11.2, p<0.0001) and eGFR (48.5 vs 32.7, p<0.0001).

Compared to those on physical visits to the hospital once in 3 months, those subjects on home BP monitoring, at the end of 6 years showed evidence of stable CKD. Home BP monitoring should be strongly advocated as a cost effective tool in the management of diabetic kidney disease and in prevention of renal replacement therapy.

Birth weight and factors influencing early and late pregnancy

The impact of specific maternal fuels and metabolic measures during early and late gestation on neonatal body composition is not well defined.

In a prospective pre-birth cohort study, Tessa L. Crume, of the University of Colorado, and colleagues evaluated 804 pregnant women at 24 weeks or less gestation recruited from prenatal obstetrics clinics at the University of Colorado Hospital in Aurora, Colorado. Participants were asked to participants in two in-person evaluations, the first in early pregnancy (median gestational age, 17 weeks) and the second in mid to late pregnancy (median gestational age, 27 weeks).

The researchers discovered a substantial positive correlation between maternal estimated homeostasis model assessment insulin resistance (HOMA-IR) in the first half of pregnancy and neonatal fat mass and fat mass percent. This finding was independent of maternal BMI prior to pregnancy.

“In the first half of pregnancy maternal insulin resistance is an independent predictor of neonatal adiposity; later on, maternal glycemia, even within the normal range, becomes a main driver of fat accretion. Importantly, these relationships are independent of pre pregnancy BMI and gestational weight gain. This data provide additional insights on potential maternal factors responsible for fetal fat accretion and early development of adiposity.