Diabetes is chronic illness characterized by the body’s inability to produce sufficient quantities of insulin or an inability to use insulin effectively. The illness poses a major threat to public health. Biomedical advances have significantly helped to improve the quality of life of afflicted individuals, reducing morbidity and mortality rates. Diabetes is a multifaceted problem, characterized by wide-ranging biopsychosocial implications. It can cause considerable health complications if it remains untreated. The process of adjustment may be too overwhelming for some, resulting in anxiety and depression. A diabetes diagnosis may also affect family members who may be worried about potential health problems of their loved ones. Some individuals who are diagnosed with diabetes seem to go through stages of grief as they come to terms with their illness. This article discusses the broader biopsychosocial implications of diabetes and the importance of addressing the illness from a holistic perspective.

An effect of metformin on weight and biochemical parameter for 6 month or longer is extensively studied while the effect of only 3 months is not fully elaborated. In our retrospective study we collect and analyze data for the effect of metformin (3 months) on obese newly diagnosed diabetic on diet control (Mediterranean diet with reduce total calories intake) following a registered Nutritionist at Elkodes clinic. We include data of all overweight and obese newly diagnosed diabetics before and after 3 months period of starting metformin in addition to diet control. Patients on anti-lipid or weight reduction therapy and patient with known liver or renal disease were excluded. Paired T test was used. The mean weight, T cholesterol, Triglyceride, LDL-C and as expected HbA1c (72.04 Kg, 182.4 mg/dl, 135 mg/dl, 85.6 mg/dl, 6.1) was significantly lower after metformin compared to before therapy (83.6 Kg, 208.5 mg/dl, 169mg /dl, 113mg/dl, 7.9) respectively. Renal and liver functions were not statistically different. Our study shows that metformin can have significant favorable effect on weight and lipid profile even for (3 months) use without effect on liver function. Most previous evidence demonstrates the effect of metformin after 6 months or longer.

Diabetes is becoming a major chronic disease burden all over the world. Little is known about the prevalence of intestinal parasitic infections in them. The aim of this study was to determine this prevalence in type 2 diabetes mellitus in Benghazi, Libya. A cross sectional case control study recruited two hundred type 2 diabetics from Benghazi diabetic center and one hundred non-diabetic individuals which served as control group was taken from Benghazi medical center and Elhiaa clinic .Their ages ranged between 18 to 55 years with and without diarrhea between January and December 2016. Socio demographic characteristics were taken during the interview. Fresh stool specimens were collected and processed, and data was analyzed. The prevalence of intestinal parasites was higher among diabetic patients (40.0%) than amongnon diabetic patients (16.0%).Specifically, the following intestinal parasites were highly prevalent in diabetic subjects Entamoeba coli (10.5%), Cryptosporidium parvum (8.5%), while in control group Entamoeba histolytica (10%), Ascaris Lumbricoides (3%) were the most isolated parasite. There was a significant relationship between prevalence of parasite and diarrhea (p=0.001), education (p=0.000), single and multiple infections (p=0.001). Relation was not significant between parasitic infections with sex and age in all sample (p=0.203, p=0.56) respectively .The present study emphasizes the necessity of increasing awareness among clinicians regarding the occurrence of intestinal parasites at higher prevalence in type 2 diabetic patients.

The analysis presented here was to identify some responsible variables for the prevalence of diabetes for different duration in Bangladeshi adults. For this, 995 adults of ages 18 years and above whom visited different diagnostic centres in both urban and semi-urban areas were interviewed. Out of 995 respondents, 67.0% were diabetic patients and they were suffering for, on an average, 6.59 years with standard deviation of 4.06 years. The percentage of adults suffering for minimum 10 years was 17.1. The corresponding percentage was significantly higher for males (23.5%), single adults (27.5%0, elderly people (63.1%), farmers (22.1%) and business persons (20.1%), adults of families having medium income(17.9%), smokers (25.5%), adults involved in sedentary activity (23.3%), obese adults (30.3%) and hypertensive adults (64.4%).The risk of prevalence of diabetes for males was 14% more as it was for females. Similar higher risk was observed for single persons (43%), elderly people (36%), literate people (19%), businessmen ( 11%), obese adults ( 13%), smokers (10%), adults involved in sedentary activity ( 16%) and hypertensive adults ( 26%), The binary logistic regression analysis indicated that gender variation, marital status, age, occupation, body mass index, and blood pressure were the responsible variables for the prevalence of diabetes.

We have earlier reviewed both etiopathogenesis along with therapy of both type1 diabetes mellitus (DM) (T1D) as well as (T2D) thoroughly along with advances in therapy. Despite that, there is no permanent cure and with the growing epidemic of obesity and thus the parallel enhancement of worldwide prevalence. Extracellular vesicles(ECV) by definition are physiologically bilayer vesicles that carry bioactive receptors, lipids, proteins as well as nucleic acids which cross-react with target cells, driving the modification of target cells. Maximum cells liberate ECV as well as recently have been shown to not only work as promising biomarkers for the disease but work as therapeutic agents for some diseases. ECV represent a heterogeneous population of small membrane vesicles (30-2000nm) liberated from various types of activated or apoptotic cells. In view of their ability of carrying out cell-cell communication , lot of significance has been given to them regarding their role as biomarkers or as utilization for therapy by trying to overtake cell-based therapy. DM T1D or T2D both if uncontrolled for long have the potential of causing a lot of complications like kidneys, cardiac, neuronal, eyes, feet problems ending with chronic end-stage kidney disease, blindness, stroke, myocardial infarction (MI) , erectile dysfunction, diabetic foot ulcers and gangrene , hence some permanent methods are sought to cure these. Here we conducted a systematic review utilizing the MeSH terms; Type1Diabetes mellitus; T2D; stem cells sources for DM therapy; exosomes; Extracellular vesicles; treatment potential in DM by utilizing the search engine Pubmed, Google Scholar, Web of science, Embase, Cochrane review library from 2000 to 2020. We found a total of 550 articles out of which we selected 128 articles for this review. No meta-analysis was carried out. Here we have tried to discuss the details of what are EVs, how they can be obtained, their contents, mechanism of actions in curing diabetes along with its complications like diabetic wound healing, diabetic retinopathy, diabetic nephropathy, stroke, diabetic peripheral neuropathy along with diabetic foot ulcers, erectile dysfunctions. Further the place clinically in trials we have reached in utilizing clinically as well as challenges faced in translation as well as bulk generation, methods utilized for their preservation. Hopefully, these will be overcome gradually and soon can get translated into clinical medicine.