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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

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

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

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

Effect of Frey's procedure on islet cell function in patients with chronic calcific pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2018年第4期17卷 358-362页

作者： Ritesh Kumar Jaya Prakash Sahoo Biju Pottakat sadishkumar kamalanathan Pazhanivel Mohan Vikram Kate Sitanshu Sekhar Kar Jayakumar Selviambigapathya Department of Endocrinology Metabolism Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)Pondicherry 605006India Department of Surgical Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)Pondicherry 605006India Department of Medical Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)Pondicherry 605006India Department of Surgery Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)Pondicherry 605006India Department of Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)Pondicherry 605006India

Background: Frey’s procedure involves both drainage and resection of the pancreas in subjects with chronic calcific pancreatitis(CCP). The procedure may affect the pancreatic endocrine function after surgery. The present study was to evaluate the effect of Frey’s procedure on both beta and alpha cell function in CCP ***: Thirty CCP patients who underwent Frey’s procedure were included. According to the glycemic status, patients were divided into the diabetes mellitus(DM), prediabetes, and normal glucose tolerance(NGT) groups. Islet cell function was assessed before and 3 months after ***: At baseline, there was a significant difference in beta cell function among the three groups [NGT group 1.71(1.64–2.07) vs prediabetes group1.50(0.83–1.61) vs DM group 0.33(0.12–0.55), P < 0.0001], but the insulin resistance was not different among them. Post glucose hyperglucagonemia representing alphacell dysfunction during oral glucose tolerance test was present in all of them, but showed no significant difference [NGT group 0.15(0.06–0.31) vs prediabetes group 0.32(0.05–0.70) vs DM group 0.07(0.02–0.18), P = 0.20]. Frey’s procedure did not change beta cell function and insulin resistance. However, alphacell dysfunction deteriorated after surgery [0.10(0.03–0.27) vs 0.33(0.09–0.68), P = 0.004].Conclusions: Although Frey’s procedure does not affect the beta cell function and insulin resistance in CCP patients, the alpha-cell dysfunction deteriorates after surgery.

关键词： Beta-cell Diabetes mellitus Glucagon Insulin secretion sensitivity index Matsuda index

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

Dipeptidyl peptidase 4 inhibitors in COVID-19:Beyond glycemic control

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World Journal of Virology 2022年第6期11卷 399-410页

作者： Niya Narayanan Dukhabandhu Naik Jayaprakash Sahoo sadishkumar kamalanathan Department of Endocrinology Baby Memorial HospitalKozhikode 673005KeralaIndia Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

Coronavirus disease 2019(COVID-19)is associated with a high risk of mortality and complications in patients with diabetes *** good glycemic control is very important in diabetic patients to reduce complications and mortality due to *** studies have shown the mortality benefit and anti-inflammatory effects of Dipeptidyl-peptidase-4 inhibitors(DPP-4i)in diabetic patients with ***-4i may have a beneficial role in halting the severity of infection primarily by three routes,namely viral entry inhibition,anti-inflammatory and anti-fibrotic effects and glycemic *** has raised the promising hypothesis that DPP-4i might be an optimal strategy for treating COVID-19 in patients with *** review aims to summarise the possible therapeutic non-glycemic effects of DPP-4i in diabetic patients diagnosed with COVID-19 in the light of available evidence.

关键词： Dipeptidyl-peptidase-4 Diabetes mellitus COVID-19 Mortality

Evidence for current diagnostic criteria of diabetes mellitus

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World Journal of Diabetes 2016年第17期7卷 396-405页

作者： Ritesh Kumar Lakshmana Perumal Nandhini sadishkumar kamalanathan Jayaprakash Sahoo Muthupillai Vivekanadan Department of Endocrinology and Metabolism Jawaharlal Institute of Postgraduate Medical Education and Research

Diabetes mellitus is a non-communicable metabolicderangement afflicting several millions of individuals globally. It is associated with several micro and macro-vascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Asso-ciation(ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of *** review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies. The controversy arises when describing the normal lower limit of fasting plasma glucose(FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications.

关键词： Diabetes Prediabetes Post glucose Microvascular complications Macrovascular complications