Propolis contains a variety of chemical compounds, including polyphenols, flavonoids, phenolic aldehydes, amino acids and vitamins, and presents numerous biological and pharmacological properties. The aim of the present study was to evaluate the effect of propolis on blood examination data in patients with type 2 diabetes. In the double‑blind, 8‑week randomized controlled study, 80 patients with type 2 diabetes were enrolled. Patients were randomly assigned to receive Brazilian green propolis (226.8 mg/day for 8 weeks) (n=41) or the placebo (n=39). The primary endpoint was to detect changes in blood examination data associated with metabolic disorders in patients suffering from diabetes mellitus, including the homeostasis model assessment of insulin resistance (HOMA‑IR), uric acid and estimated glomerular filtration rate (eGFR) from baseline to the end of this study. The value of HOMA‑IR was not significantly changed by the 8‑week administration of propolis or placebo from the baseline data. Values of blood uric acid and eGFR in patients taking the placebo became worse at 8 weeks compared to the baseline, whereas this did not occur in patients consuming Brazilian green propolis. However, HOMA‑IR was not improved by propolis intake. A randomized, controlled 8‑week trial suggests that Brazilian green propolis (226.8 mg/day) prevents patients with type 2 diabetes from developing worse blood uric acid and eGFR.

Clinical and experimental studies have shown that sodium glucose co-transporter 2 inhibitors (SGLT2i) contribute to the prevention of diabetic kidney disease progression. In order to clarify its pharmacological effects on the molecular mechanisms underlying the development of diabetic kidney disease, we administered different doses of the SGLT2i, ipragliflozin, to type 2 diabetic mice. A high-dose ipragliflozin treatment for 8 weeks lowered blood glucose levels and reduced urinary albumin excretion. High- and low-dose ipragliflozin both inhibited renal and glomerular hypertrophy, and reduced NADPH oxidase 4 expression and subsequent oxidative stress. Analysis of glomerular phenotypes using glomeruli isolation demonstrated that ipragliflozin preserved podocyte integrity and reduced oxidative stress. Regarding renal tissue hypoxia, a short-term ipragliflozin treatment improved oxygen tension in the kidney cortex, in which SGLT2 is predominantly expressed. We then administered ipragliflozin to type 1 diabetic mice and found that high- and low-dose ipragliflozin both reduced urinary albumin excretion. In conclusion, we confirmed dose-dependent differences in the effects of ipragliflozin on early diabetic nephropathy in vivo. Even low-dose ipragliflozin reduced renal cortical hypoxia and abnormal hemodynamics in early diabetic nephropathy. In addition to these effects, high-dose ipragliflozin exerted renoprotective effects by reducing oxidative stress in tubular epithelia and glomerular podocytes.

Introduction: It is unclear how the transient remission of nonalcoholic fatty liver disease (NAFLD) affects incident type 2 diabetes mellitus (T2DM). Here, we sought to determine the effect of the transient remission of NAFLD on incident T2DM in Japanese men. Materials and methods: We used a population-based health check-up program. The primary outcome was set as incident T2DM. We divided the participants who showed NAFLD at the time of enrollment into three groups according to their clinical course of NAFLD: the Regression group, in which the participants showed a regression of NAFLD and no relapse during the follow-up period; the Transient Remission group, in which participants achieved a transient remission of NAFLD, but had a relapse of NAFLD; and the Persistent group, in which participants showed NAFLD throughout the follow-up. The Never group of participants who did not show NAFLD throughout the follow-up served as a reference. Results: The incidence rates of T2DM in the Never group, the Regression group, the Transient Remission group, and the Persistent group were 4.7% (62/1306), 9.2% (14/153), 18.0% (25/139), and 35.1% (120/342), respectively. In a multivariate Cox regression analysis with covariates, the adjusted hazard ratios for incident T2DM compared with the Never group were as follows: Regression group: 1.08 [95% confidence interval (CI) 0.53–2.04, P=0.81], Transient Remission group: 2.12 (95% CI 1.22–3.57, P<0.01), and Persistent group: 3.44 (95% CI 2.29–5.21, P<0.001). The adjusted hazard ratio of the Transient Remission group was significantly lower than that of the Persistent group (P<0.05). Conclusion: Transient remission of NAFLD significantly decreased the risk of developing T2DM.

Objective: The purpose of this study was to determine the relationship between serum γ-glutamyltranspeptidase (GGT) and brachial-ankle pulse wave velocity (baPWV) as an indicator for atherosclerosis in Japanese men and women after adjusting for fatty liver. Design: A cross-sectional study. Setting: A health check-up centre in Japan. Participants: 912 Japanese men and women aged 24–84 years recruited from people who received a medical health check-up programme with a standardised questionnaire and an automatic waveform analyser to measure baPWV. Main outcome measures: We measured serum GGT concentrations and baPWV. Fatty liver was diagnosed by standardised criteria using abdominal ultrasonography. The postmenopausal state was defined as beginning 1 year after the cessation of menses. Results: In women, log ₂ GGT was positively associated with baPWV (β=0.11, 95% CI 0.02 to 0.19, p<0.05), independent of age, body mass index, systolic blood pressure, fasting plasma glucose, triglycerides, estimated glomerular filtration rate, fatty liver, menopausal state and parameters of lifestyles. However, in men, the positive association of log ₂ GGT with baPWV was not significant (β=−0.04, 95% CI −0.10 to 0.03, p=0.28) in multivariable linear regression analyses. Conclusions: The serum GGT level was associated with baPWV, independently of covariates including fatty liver or menopausal state just in women, but not in men.

Background/Aims. Protein intake is important for maintaining muscle mass in general population. However, it remains to be elucidated the association between dietary protein intake and skeletal muscle mass in elderly patients with type 2 diabetes.Methods. In this cross-sectional study of 168 elderly patients with type 2 diabetes, we investigated the relationship between skeletal muscle index (SMI) and protein intake. Bioimpedance analysis was used for measurement for skeletal muscle mass (kg) and SMI (%), which was defined as skeletal muscle mass (kg)/total body weight (kg) × 100. Habitual food and nutrient intake were estimated by a questionnaire.Results. Protein intake was independently correlated with SMI after adjusting for age, hemoglobin A1c, C-peptide index, exercise, smoking, insulin treatment, total energy intake, and C-reactive protein (standardized regression coefficient = 0.664,P<0.001in men and standardized regression coefficient = 0.516,P=0.005in women). Additionally, the animal protein to vegetable protein ratio was negatively correlated with SMI after adjusting for covariates in men (standardized regression coefficient = −0.339,P=0.005).Conclusions. We found that total protein intake, especially vegetable protein intake, was positively associated with skeletal muscle mass in elderly patients with type 2 diabetes.