Background: Hypertension is a highly prevalent risk factor for cardiovascular disease in patients with type 1 diabetes mellitus. Elevated blood pressure (BP) promotes the development and progression of microvascular complications, eg, nephropathy and retinopathy. The purpose of this study was to identify and detect early BP changes in diabetic children and adolescents, aiming for the early prediction of future renal and cardiovascular disease risk during childhood. Methods and materials: Ambulatory BP monitoring was undertaken for 40 normotensive type 1 diabetic children with mean age of 11.56±2.82 years, and 24 healthy children as control group with matched age and sex. Albumin/creatinine ratio and glycated hemoglobin were tested. BP indices and standard deviation scores were calculated using reference standards. The data were analyzed by SPSS software version 20 using mean and standard deviations for descriptive data. Correlation and regression analysis tests were used to study relations between BP indices and diabetic parameters. Results: All parameters of BP z-scores were highly significantly increased in diabetic patients compared with controlled group (P<0.0001). The frequency of non-dipping was greater and highly significant in microalbuminuric diabetic patients (P<0.0001). Regression analysis revealed that BP parameters were significantly related to albumin/creatinine ratio, glycated hemoglobin, insulin dose, and body mass index. Conclusion: Our observation revealed a clear link between the nocturnal BP and microalbuminuria which mandates BP follow-up via ambulatory BP monitoring with therapeutic intervention to prevent renal and cardiovascular diabetic complications in adulthood.

Ascaris lumbricoides is a neglected parasite that induces changes in host immune response. This study is conducted to define the serum levels of tumor necrosis factor alpha (TNF-α), interleukin-4 (IL-4), and interleukin-5 (IL-5) in some Egyptian children and their relations to intensity of infection, age, and ascariasis symptoms. Stool samples were examined using formol-ether concentration and Kato-Katz thick smear techniques. Sera of 60 A. lumbricoides-infected children and 20 controls were tested by enzyme-linked immunosorbent assay. The mean sera concentrations of TNF-α, IL-4, and IL-5 were 7.41±2.5 pg/mL, 107.60±18.3 pg/mL, and 389.52±28.0 pg/mL, respectively. The controls had mean serum TNF-α 7.10±2.4 pg/mL, IL-4 25.49±2.6 pg/mL, and IL-5 88.76±22.7 pg/mL. The difference in the concentration of sera cytokines was statistically significant for IL-4 and IL-5 (P<0.01) between A. lumbricoides-infected children and controls. The intensity of infection correlated positively with IL-4 and IL-5 at r=0.959 and r=0.919, respectively. The concentrations of IL-4 and IL-5 correlated positively with the age at r=0.845 and r=0.934, respectively. Asthma and gastrointestinal tract upsets were correlated positively with IL-4 and IL-5. These data indicate that A. lumbricoides infection in our locality is associated with significantly high levels of IL-4 and IL-5.

Background: This 24-week randomized controlled trial aimed to evaluate the impact of multistrain probiotic supplementation on telomere length in patients with type 2 diabetes (T2DM). The study also assessed secondary outcomes including high-sensitivity C-reactive protein (hs-CRP) and glycated hemoglobin (HbA1c). Methods: A total of 124 participants with T2DM were randomly assigned to either a probiotic group (n = 62) or a placebo group (n = 62). Participants in the probiotic group consumed a supplement containing fourteen live microbial strains, including Lactobacillus plantarum, L. fermentum, L. acidophilus, L. casei, L. rhamnosus, L. reuteri, L. salivarius, L. paracasei, L. gasseri, Bifidobacterium bifidum, B. lactis, B. breve, Streptococcus thermophilus, and Saccharomyces boulardii, with each strain providing 2.148 billion CFUs per capsule, totaling 30 billion CFUs. The placebo group received vitamin B12 capsules without probiotics. The primary outcome was telomere length, and secondary outcomes included hs-CRP and HbA1c levels. Data were analyzed using intention-to-treat (ITT) and per-protocol (PP) methods. Results: The probiotic group exhibited a statistically significant decrease in telomere shortening compared to the placebo group (p < 0.001). The hs-CRP levels decreased more significantly in the probiotic group (p < 0.001), suggesting potential anti-inflammatory effects. The HbA1c levels improved in the probiotic group, with a reduction of 0.44% (p = 0.004). An age-stratified analysis revealed more substantial improvements in the 30–49 years cohort, which showed greater reductions in telomere shortening, inflammatory markers, and metabolic indicators compared to the 50–69 years group. Conclusions: Multistrain probiotic supplementation shows potential benefits in reducing telomere shortening and improving glycemic control. However, further long-term studies are needed to understand the underlying mechanisms and therapeutic implications of probiotics in T2DM. Trial registration: This trial was registered at the Clinical Trials Registry-India (CTRI/2023/07/055647).