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Long-term effects of metformin use in gestational diabetes mellitus on offspring health

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World Journal of Diabetes 2021年第11期12卷 1812-1817页

作者： Ayan Roy jayaprakash sahoo Department of Endocrinology and Metabolism All India Institute of Medical SciencesJodhpur 342005RajasthanIndia Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

Metformin is the first-line drug for the treatment of type 2 diabetes mellitus,but its role in gestational diabetes mellitus(GDM)management is not *** evidence suggests a certain beneficial effect of metformin in the treatment of GDM,but a high treatment failure rate leads to the initiation of additional medications,such as ***,since metformin crosses the placental barrier and reaches a significant level in the fetus,it is likely to influence the fetal metabolic *** evidence indicates the long-term safety in children exposed to metformin in utero except for mild adverse anthropometric *** follow-up of metformin-exposed offspring is warranted from the clinician’s point of view.

关键词： Anthropometry Fetal Gestational diabetes mellitus Long-term Metformin Offspring

Impact of surgery for chronic pancreatitis on the risk of pancreatic cancer:Untying the Gordian knot

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World Journal of Gastroenterology 2021年第27期27卷 4371-4382页

作者： Raja Kalayarasan Sankar Narayanan jayaprakash sahoo Pazhanivel Mohan Department of Surgical Gastroenterology JIPMERPuducherry 605006India Department of Endocrinology JIPMERPuducherry 605006India Department of Medical Gastroenterology JIPMERPuducherry 605006India

Pancreatic ductal adenocarcinoma is an aggressive tumor with poor long-term *** pancreatitis(CP)is considered a risk factor for the development of pancreatic cancer(PC).Persistent pancreatic inflammation and activation of pancreatic stellate cells play a crucial role in the pathogenesis of CPrelated PC by activating the oncogene *** genetic mutations increase the possibility of recurrent and persistent pancreatic inflammation,they are not directly associated with the development of *** studies suggest that early surgical intervention for CP might have a protective role in the development of CP-related ***,the physician faces the clinical question of whether early surgical intervention should be recommended in patients with CP to prevent the development of ***,the varying relative risk of PC in different subsets of CP underlines the complex gene-environment interactions in the disease ***,it is essential to stratify the risk of PC in each individual *** review focuses on the complex relationship between CP and PC and the impact of surgical intervention on PC *** proposed risk stratification based on the genetic and environmental factors could guide future research and select patients for prophylactic surgery.

关键词： Chronic pancreatitis Pancreatic adenocarcinoma Pancreatic cancer Surgery Hereditary pancreatitis Pancreatitis

Diabetes and pancreatic cancer:Exploring the two-way traffic

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World Journal of Gastroenterology 2021年第30期27卷 4939-4962页

作者： Ayan Roy jayaprakash sahoo Sadishkumar Kamalanathan Dukhabandhu Naik Pazhanivel Mohan Raja Kalayarasan Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India Department of Endocrinology and Metabolism All India Institute of Medical SciencesJodhpur 342005India Department of Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India Department of Surgical Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

Pancreatic cancer(PC)is often associated with a poor ***-standing diabetes mellitus is considered as an important risk factor for its *** risk can be modified by the use of certain antidiabetic *** the other hand,new-onset diabetes can signal towards an underlying PC in the elderly ***,several attempts have been made to develop an effective clinical tool for PC screening using a combination of history of new-onset diabetes and several other clinical and biochemical *** the contrary,diabetes affects the survival after treatment for *** describe this intimate and complex two-way relationship of diabetes and PC in this review by exploring the underlying pathogenesis.

关键词： Chronic pancreatitis Diabetes New onset diabetes Pancreatic adenocarcinoma Pancreatic cancer Type 3c diabetes

Treatment on Nature’s lap:Use of herbal products in the management of hyperglycemia

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World Journal of Diabetes 2023年第4期14卷 412-423页

作者： Somdatta Giri jayaprakash sahoo Ayan Roy Sadishkumar Kamalanathan Dukhabandhu Naik Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India Department of Endocrinology All India Institute of Medical SciencesKalyani 741245West BengalIndia

Diabetes mellitus(DM)is characterized by persistently elevated blood glucose concentration that lead to multisystem *** are about 400 medicinal plants cited to have a beneficial effect on *** must choose products wisely based on data derived from scientific ***,a major obstacle in the amalgamation of herbal medicine in modern medical practices is the lack of clinical data on its safety,efficacy and drug *** of these herbal products often underreport the side effects and other crucial intervention steps deviating from the standards set by Consolidated Standards of Reporting *** to a lack of knowledge of the active compounds present in most herbal medicines,product standardization is ***-effectiveness is another issue that needs to be kept in *** this mini-review,we focus on the antihyperglycemic effect of herbal products that are commonly used,along with the concerns stated above.

关键词： Herbal product HbA1C Diabetes mellitus Active compound Natural therapy Cost-effectiveness

Islet cell dysfunction in patients with chronic pancreatitis

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World Journal of Diabetes 2020年第7期11卷 280-292页

作者： Ayan Roy jayaprakash sahoo Sadishkumar Kamalanathan Dukhabandhu Naik Pazhanivel Mohan Biju Pottakkat Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India Department of Medical Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India Department of Surgical Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

Chronic pancreatitis(CP)is characterized by progressive inflammation and fibrosis of the pancreas that eventually leads to pancreatic exocrine and endocrine *** in the background of CP is very difficult to manage due to high glycemic variability and concomitant *** beta cell loss leading to insulin deficiency is the cardinal mechanism underlying diabetes development in *** cell dysfunction leading to deranged glucagon secretion has been described in different studies using a variety of stimuli in ***,the emerging evidence is varied probably because of dependence on the study procedure,the study population as well as on the stage of the *** mechanism behind islet cell dysfunction in CP is *** intra-islet alpha and beta cell regulation of each other is often ***,secretion of the incretin hormones such as glucagon like peptide-1 and glucose-dependent insulinotropic polypeptide is *** significantly contributes to islet cell *** and progressive inflammation with changes in the function of other cells such as islet delta cells and pancreatic polypeptide cells are also implicated in *** addition,the different surgical procedures performed in patients with CP and antihyperglycemic drugs used to treat diabetes associated with CP also affect islet cell ***,different factors such as chronic inflammation,dysregulated incretin axis,surgical interventions and anti-diabetic drugs all affect islet cell function in patients with *** therapies targeting alpha cell function and beta cell regeneration would be useful in the management of pancreatic diabetes in the near future.

关键词： Alpha cell Beta-cell Chronic pancreatitis Diabetes Incretins Pancreatic diabetes

Incretin based therapy and pancreatic cancer:Realising the reality

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World Journal of Gastroenterology 2022年第25期28卷 2881-2889页

作者： Varun Suryadevara Ayan Roy jayaprakash sahoo Sadishkumar Kamalanathan Dukhabandhu Naik Pazhanivel Mohan Raja Kalayarasan Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India Department of Endocrinology All India Institute of Medical SciencesKalyani 741245West BengalIndia Department of Medical Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India Department of Surgical Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

Incretin-based therapies like glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors help maintain the glycaemic control in patients with type 2 diabetes mellitus with additional systemic benefits and little risk of *** medications are associated with low-grade chronic pancreatitis in animal models *** incidence of acute pancreatitis was also reported in some human *** inflammation provides fertile ground for developing pancreatic carcinoma(PC).Although the data from clinical trials and population-based studies have established safety regarding PC,the pathophysiological possibility that low-grade chronic pancreatitis leads to PC *** review the existing literature and describe the relationship between incretin-based therapies and PC.

关键词： Diabetes mellitus Dipeptidyl peptidase-4 inhibitor Glucagon-like peptide-1 receptor agonist Incretin Pancreatitis Pancreatic Cancer

Dipeptidyl peptidase-4 inhibitor-induced autoimmune diseases:Current evidence

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World Journal of Diabetes 2021年第9期12卷 1426-1441页

作者： Ayan Roy jayaprakash sahoo Niya Narayanan Chandhana Merugu Sadishkumar Kamalanathan Dukhabandhu Naik Department of Endocrinology and Metabolism All India Institute of Medical SciencesJodhpur 342005India Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

Dipeptidyl peptidase-4 inhibitors(DPP-4i)have an important place in the management of type 2 *** DPP-4 enzyme is ubiquitously distributed throughout the human body and has multiple substrates through which it regulates several important physiological ***-4 regulates several immune functions,including T-cell activation,macrophage function,and secretion of *** have reported an increase in autoimmune diseases like bullous pemphigoid,inflammatory bowel disease,and arthritis with DPP-4i *** relationship of DPP-4i and autoimmune diseases is a complex one and warrants further research into the effect of DPP-4 inhibition on the immune system to understand the pathogenesis more *** a particular cluster of autoimmune diseases is associated with DPP-4i use remains an important contentious ***,a heightened awareness from the clinicians is required to identify and treat any such *** this review,we explore the clinical and pathophysiological characteristics of this association in light of recent evidence.

关键词： Autoimmune disease Bullous pemphigoid Diabetes Dipeptidyl peptidase-4 inhibitors Gliptins Inflammation

Role of bisphosphonates in the management of acute Charcot foot

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World Journal of Diabetes 2018年第7期9卷 115-126页

作者： Harsh Durgia jayaprakash sahoo Sadishkumar Kam-alanathan Rajan Palui Kalyani Sridharan Henith Raj Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and Research

Diabetes mellitus is the most common cause of Charcot neuropathy affecting foot and ankle. Acute Charcot foot(CF) presents with a red and swollen foot in co-ntrast to the painless deformed one of chronic CF. En-hanced osteoclastogenesis plays a central role in the pathogenesis of acute CF. Many studies have shown elevated levels of bone turnover markers in patients with acute CF confirming it. These findings have led cl-inicians to use anti-resorptive agents [bisphosphonates(BP), calcitonin, and denosumab] along with immobi-lization and offloading in acute CF patients. The ma-ximum evidence among all anti-resorptive agents is available for BPs, although its quality is low. Pamidronate has been shown to reduce the markers of activity of CF like raised skin temperature, pain, edema, and bone turnover markers in the majority of studies. Intravenous BPs are known to cause acute phase reactions leading to flu-like illness following their first infusion, which can be ameliorated by oral acetaminophen. Alendronate is the only oral BP used in these patients. It needs to be taken on an empty stomach with a full glass of water to avoid esophagitis. The side-effects and contraindications to BPs should be kept in mind while treating acute CF patients with them.

关键词： Charcot foot Diabetes mellitus Charcot neuroarthropathy Bisphosphonates Pamidronate

SGLT-2 inhibitors in non-alcoholic fatty liver disease patients with type 2 diabetes mellitus: A systematic review

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World Journal of Diabetes 2019年第2期10卷 114-132页

作者： Henith Raj Harsh Durgia Rajan Palui Sadishkumar Kamalanathan Sandhiya Selvarajan Sitanshu Sekhar Kar jayaprakash sahoo Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and Research Puducherry 605006 India Department of Clinical Pharmacology Jawaharlal Institute of Postgraduate Medical Education and Research Puducherry 605006 India Department of Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and Research Puducherry 605006 India

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is a common comorbidity with type 2 *** existing therapeutic options for NAFLD are not *** diet and exercise is the cornerstone of therapy in *** is the only drug recommended in diabetes patients with biopsy proven non-alcoholic *** frequent coexistence of NAFLD and type 2 diabetes with their combined adverse health consequences and inadequate therapeutic options makes it necessary to search for newer *** To assess the effect of sodium glucose cotransporter-2(SGLT-2)inhibitors on liver enzymes in type 2 diabetes patients with *** We searched PubMed/MEDLINE,Cochrane library,Google scholar,and *** for the relevant articles to be included in this systematic *** studies done in type 2 diabetes patients with NAFLD treated with SGLT-2 inhibitors for at least 12 wk were *** from eight studies(four randomised controlled trials and four observational studies)were extracted and a narrative synthesis was done.A total of 214 patients were treated with SGLT-2 inhibitors in these studies(94 in randomised controlled trials and 120 in observational studies).RESULTS The primary outcome measure was change in serum alanine aminotransferase *** of eight studies,seven studies showed a significant decrease in serum alanine aminotransferase *** of the studies revealed reduction in serum level of other liver enzymes like aspartate aminotransferase and gamma glutamyl *** studies that reported a change in hepatic fat exhibited a significant reduction in hepatic fat content in those treated with SGLT-2 ***,among the three studies that evaluated a change in indices of hepatic fibrosis,two studies revealed a significant improvement in liver ***,there was an improvement in obesity,insulin resistance,glycaemia,and lipid parameters in those subjects taking SGLT-2 *** st

关键词： Alanine aminotransferase Hepatic fat Hepatic fibrosis Non-alcoholic fatty liver disease Sodium-glucose cotransporter-2 inhibitor Type 2 diabetes mellitus