The endocannabinoid system (ECS) is involved in various processes, including brain plasticity, learning and memory, neuronal development, nociception, inflammation, appetite regulation, digestion, metabolism, energy balance, motility, and regulation of stress and emotions. Physical exercise (PE) is considered a valuable non-pharmacological therapy that is an immediately available and cost-effective method with a lot of health benefits, one of them being the activation of the endogenous cannabinoids. Endocannabinoids (eCBs) are generated as a response to high-intensity activities and can act as short-term circuit breakers, generating antinociceptive responses for a short and variable period of time. A runner’s high is an ephemeral feeling some sport practitioners experience during endurance activities, such as running. The release of eCBs during sustained physical exercise appears to be involved in triggering this phenomenon. The last decades have been characterized by an increased interest in this emotional state induced by exercise, as it is believed to alleviate pain, induce mild sedation, increase euphoric levels, and have anxiolytic effects. This review provides information about the current state of knowledge about endocannabinoids and physical effort and also an overview of the studies published in the specialized literature about this subject.

Diabetes mellitus is a chronic disease that, untreated or poorly controlled, can lead to serious complications, reducing life expectancy and quality. Diabetic patients are more likely to develop infections, including many common infections, but also pathognomonic ones such as emphysematous pyelonephritis, malignant otitis externa, mucormycosis and Fournier’s gangrene. Considering the fact that diabetic patients experience more frequently urinary tract infections (UTIs) with a worse prognosis than non-diabetic people, we conducted a review study based on data in the literature, following the particularities of UTIs in this group of patients, the risk factors, the mechanisms involved and the challenges in their management. The findings highlight that UTI in diabetic patients have some particularities, including a more frequent evolution to bacteremia, increased hospitalizations, and elevated rates of recurrence and mortality than non-diabetic patients. The possible risk factors identified seem to be female gender, pregnancy, older age, UTI in the previous six months, poor glycemic control and duration of diabetes. The mechanisms involved are related to glucosuria and bladder dysfunction, factors related to bacterial strains and host response. The bacterial strains involved in UTIs in diabetic patients and their antibiotic susceptibility profile are, with some exceptions, similar to those in non-diabetic people; however, the antimicrobial agents should be carefully chosen and the duration of the treatment should be as those required for a complicated UTI. The data related to the risk of developing UTIs in patients treated with SGLT-2 inhibitors, a new class of oral hypoglycaemic agents with cardiovascular and renal benefits, are controversial; overall, it was evidenced that UTIs occurred at the initiation of the treatment, recurrent infection was uncommon and the majority of UTIs responded to treatment with standard antibiotics. Moreover, interruption or discontinuation of SGLT-2 inhibitor as a result of UTI was rare and SGLT-2 inhibitors did not increase the risk of severe infections such as urosepsis and pyelonephritis.

Diabetes mellitus has become a major public health problem due to aspects such as an alarming increase in prevalence, the morbidity and mortality associated with its complications and, not least, the economic burden. SGLT2 inhibitors are a relatively new but valuable class of drugs that demonstrated multifaceted effects in addition to hypoglycemic action. Moreover, these drugs demonstrated cardiovascular and renal benefits, even in individuals without diabetes, being recommended by current guidelines to patients with a history of cardiovascular disease, or at high risk for it, as well as to patients with chronic kidney disease. The prescription of this class of drugs is limited by the risk of urogenital infections, despite their multiple demonstrated benefits. Data regarding the prevalence of SGLT2 inhibitors associated with urogenital infections depend on several factors related to the study carried out and to other additional conditions that could precipitate such infections. While SGLT2 inhibitors have a well-established association with the risk of genital infections, the association with urinary tract infections remains controversial and uncertain. This review will be focused on urogenital infections associated with the administration of SGLT2 inhibitors, highlighting their prevalence, risk factors, mechanisms involved, clinical relevance and particularities of management.

Glibenclamide and lipoic acid are two drugs frequently recommended for the management of diabetes mellitus, and so, the development of a new formulation containing both substances has a great benefit in terms of efficiency and compliance, acting also as a multi-target drug system. Accordingly, the aim of this study was the formulation and physicochemicalcharacterization of new polymeric systems based on chitosan (CS) in whose matrix were encapsulated glibenclamide (Gly) and lipoic acid (LA). The polymeric systems were prepared as microparticles (CS–Gly, CS–LA, and CS–Gly–LA) through ionic gelation method, using pentasodium tripolyphosphate (TPP) as crosslinking agent. The polymeric systems obtained were characterized in terms of particle size and morphology, IR spectroscopy, entrapment efficiency and drug loading, swelling degree, and therelease of the active substances from the chitosan matrix. The polymeric systems obtained were stable systems; the presence of glibenclamide and lipoic acid into the polymer matrix were proved by IR spectroscopy. The entrapment efficiency was 94.66% for Gly and 39.68% for LA. The developed polymeric systems proved a favorable swelling degree and drug release profile, the percentage of release being 88.68% for LA and 75.17% for Gly from CS–Gly–LA systems.

The study aim was to develop and validate a high-performance liquid chromatography–electrospray ionization mass spectrometry (HPLC-ESI-MS) method to simultaneously determine glibenclamide (Gli) and silymarin (Sil) released from chitosan (CS) microparticles in aqueous solutions. The CS microparticles were synthesized using an ionic gelation method, and their morphology, swelling degree, encapsulation efficiency and active substance release were investigated. Gli and Sil were loaded in different concentrations, and their identification and quantification were performed using the HPLC-ESI-MS method, which was further validated. The drugs’ characteristic m/z was found in the higher intensity of retention time (Rt) (Gli, 8.909 min; Sil A, 5.41 min; and Sil B, 5.66 min). The method selectivity and precision are very good, and the blank solution proved no interference. The linearity of the answer function is very good for Sil A (R² = 1), Sil B (R² = 0.9998) and Gli (R² = 0.9991). For Gli, we obtained a limit of detection (LOD) = 0.038 mg/mL and limit of quantification (LOQ) = 1.275 mg/mL; for Sil A, a LOD = 0.285 mg/mL and LOQ = 0.95 mg/mL; and for Sil B, a LOD = 0.045 mg/mL and LOQ = 0.15 mg/mL. A high-resolution HPLC-ESI-MS method was developed and validated, which allowed the simultaneous determination of Gli and Sil loaded in CS microparticles, in a concentration range of 0.025–1 mg/mL.

Background: Diabetes has become one of the most challenging public health problems due to the alarming increase in prevalence and the morbidity and mortality attributed to its acute and chronic complications. Objective: This study aimed to investigate the development of chronic microvascular complications in sulfonylureas-treated diabetic patients and their correlations with glycemic control, risk factors and duration of the disease. Methods: This study included 200 patients that presented to “Providența” Medical Center, Iași. The information was obtained in a retrospective manner based on the observation sheets of the patients. A database was created, analyzed and statistically processed using the Microsoft Excel software (Version 15) and the chi-square test of independence. Results: The prevalence of diabetic polyneuropathy was 33.5%, while diabetic retinopathy was found in 27% of cases. For diabetic polyneuropathy, the results of the statistical analysis demonstrated a statistically significant dependence of the risk factors hyperlipidemia (significance level = 0.01) and overweight/obesity (significance level = 0.05). For diabetic retinopathy, the results demonstrated a statistically significant dependence of the risk factors hypertension (significance level = 0.05) and hyperlipidemia (significance level = 0.01). Conclusions: The present study reveals a strong correlation between the presence of risk factors and the development of microvascular complications of diabetes.