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Medical nutrition therapy in physiological pregnancy and in pregnancy complicated by obesity and/or diabetes: SID-AMD recommendations

Annunziata Lapolla1 · Maria Grazia Dalfrà1 · Giuseppe Marelli2 · Mario Parrillo3 · Laura Sciacca4 · Maria Angela Sculli5 · Elena Succurro6 · Elisabetta Torlone7 · Ester Vitacolonna8

Received: 18 September 2024 / Accepted: 27 December 2024 / Published online: 22 January 2025 © Springer-Verlag Italia S.r.l., part of Springer Nature 2025

Abstract

Proper nutrition is essential during pregnancy to ensure an adequate supply of nutrients to the foetus and adequate maternal weight gain. In pregnancy complicated by diabetes (both gestational and pre-gestational), diet in terms of both the intake and quality of carbohydrates is an essential factor in glycaemic control. Maternal BMI at conception defines the correct weight increase during gestation in order to reduce maternal-foetal complications related to hypo- or hyper-nutrition. The recommendations presented here, which are based on national and international guidelines and the most recently published data on nutrition in physiological pregnancy and pregnancy complicated by hyperglycaemia and/or obesity, are designed to help healthcare professionals prescribe suitable eating patterns to safeguard the health of the mother and the foetus.

HYA ameliorated postprandial hyperglycemia in type 1 diabetes model rats with bolus insulin treatment

Yuta Yamamoto1 · Katsuya Narumi2 · Naoko Yamagishi1 · Yasunori Yonejima3 · Ken Iseki2 · Masaki Kobayashi2 · Yoshimitsu Kanai1

Received: 22 July 2024 / Accepted: 24 January 2025 / Published online: 3 February 2025 © The Author(s) 2025

Abstract

Aims The oral administration of linoleic acid immediately before glucose tolerance test (OGTT) ameliorated postprandial hyperglycemia via GPR120 pathway in normal and type 1 diabetes (T1DM) rats. Linoleic acid could promote inflammatory mediators, but 10-hydroxy-cis-12-octadecenoic acid (HYA) converted from linoleic acid by Lactobacillus plantarum has higher GPR120 agonistic activity without promoting inflammatory mediators. This study examined whether the oral-admin-istration of HYA immediately before OGTT also ameliorated the postprandial hyperglycemia in normal rats and T1DM rats injected with bolus insulin.

Methods Normal and T1DM male Sprague-Dawley rats received HYA immediately before OGTT. Other T1DM rats were given HYA and Humulin R immediately before OGTT. We measured the concentration of glucose, insulin, glucagon-like peptide 1 (GLP-1) and cholecystokinin in blood before and after OGTT. We also measured the amount of glucose in the gastric tract after OGTT, and the amount of uptake of methyl-α-D-glucopyranoside in CACO-2 cells.

Results Postprandial hyperglycemia was ameliorated by HYA in normal rats, and the postprandial blood glucose levels were slowly elevated by HYA in the T1DM model rats. HYA partially inhibited the uptake of methyl-α-D-glucopyranoside in CACO-2 cells. HYA slowed gastric motility and increased the plasma GLP-1 and cholecystokinin levels in normal rats. HYA also ameliorated the postprandial hyperglycemia in T1DM rats given bolus insulin.

Conclusion Oral administration of HYA immediately before OGTT ameliorated postprandial hyperglycemia through inhibi-tion of glucose absorption and slowing of gastric motility in normal rats. Furthermore, this beneficial effect of HYA was also revealed in T1DM rats injected with bolus insulin.

Keywords HYA · Postprandial hyperglycemia · GLP-1 · CCK · Type 1 diabetes mellitus

The UBR5 protein facilitates mesangial cell hypertrophy and glycolysis induced by high glucose by increasing the phosphorylation levels of AKT

Lin Liao1 · Qiming Xu2 · Jie Xu3 · Jie Chen1 · Wenrui Liu1 · Wenhao Chen1 · Yunqing Tang1 · Lianxiang Duan1 · Yue Guo1 · Ziyang Liu1 · Pengyu Tao2 · Yu Cao2 · Jianrao Lu1 · Jing Hu1,4

Received: 14 June 2024 / Accepted: 31 January 2025 / Published online: 13 February 2025 © The Author(s) 2025

Abstract

Aims One of the primary pathological features in the early stages of diabetic nephropathy is mesangial cell (MC) hypertro-phy in the glomerulus. Considering the role of E3 ubiquitin ligases in regulating MC hypertrophy, the aim of this study was to identify the functional ubiquitin protein ligase E3 component N-recognin 5 (UBR5) during MC hypertrophy under high glucose conditions.

Methods Human MCs (HMCs) transduced with UBR5 silencing or overexpression vector were treated with high glucose, AKT inhibitor, or glycolysis inhibitor. Cell proliferation, cell cycle, hypertrophy and glycolysis were evaluated in the HMCs after indicated treatment. m6A methylated RNA immunoprecipitation, luciferase reporter assay, and RNA immunoprecipi-tation were performed to determine the regulation of UBR5 by Wilms tumor 1-associating protein (WTAP)/insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1) induced m6A modification. Western blot was performed to determine the protein expression levels.

Results UBR5 expression was upregulated in db/db mice and in high glucose-induced HMCs. UBR5 silencing inhibited high glucose-induced HMC cell cycle arrest, cell hypertrophy, and glycolysis. UBR5 facilitated HMC hypertrophy and gly colysis by promoting the phosphorylation levels of AKT. Additionally, the promoting effect of glycolysis on cell hypertrophy were also elucidated. Further investigation into upstream regulators revealed that WTAP promoted m6A modification of UBR5 through the m6A reader IGF2BP1.

Conclusions Our study unveils a novel mechanism involved in high glucose-induced cell hypertrophy, offering new insights into the understanding and treatment of early pathological mechanisms in diabetic nephropathy.

Keywords High glucose · Hypertrophy · Glycolysis · UBR5, AKT phosphorylation

HbA1c variability as an independent risk factor for diabetic retinopathy: results from a screening program

Maria Ida Maiorino1,2 · Carlo Gesualdo3,4 · Silvia Angelino5 · Settimio Rossi3 · Nicole Di Martino2 · Clemente Iodice3,5 · Miriam Longo1,4 · Lorenzo Scappaticcio1,2 · Giuseppe Bellastella1,2 · Francesca Simonelli3 · Katherine Esposito1,2,5

Abstract

Aims To investigate the independent association between long-term glycemic variability, measured as the coefficient of variation (CV) of HbA1c, and the presence of diabetic retinopathy (DR) in a cohort of adults with diabetes within a system-atic eye screening program.

Methods This study screened 379 adults with type 1 and type 2 diabetes. Long-term glycemic variability was calculated as the CV of serial HbA1c measurements. DR was assessed via dilated fundus photography. The association between HbA1c CV and DR was analyzed using multivariable logistic regression adjusting for confounders.

Results DR incidence of 12.4%, mostly mild non-proliferative. The median HbA1c CV was 7.0% (53 mmol/mol). In unad-justed bivariate analysis, the incidence of mild DR was higher in the low- glycemic variability group (CV<5%) compared to the high- glycemic variability group. However, the multivariable logistic regression analysis revealed that higher HbA1c CV was independently associated with the presence of DR (β=0.643, P=0.042), alongside diabetes duration (P<0.001) and age (P<0.001).

Conclusions In conclusion, in a cohort of individuals with both type 1 and type 2 diabetes and a low incidence of DR, long-term glycemic variability, estimated as HbA1c CV, was independently associated with an increased risk of this complication.

Keywords Diabetic retinopathy · Glucose variability · Type 1 diabetes · Type 2 diabetes · Retinopathy screening · HbA1c coefficient of variation

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Effect of hypochlorous acid in open wound healing 2026-08-03 00:00

Spurgeon raj Jalem¹ & Purimitla Usharani²,*

¹Department of Emergency medicine and critical care, Bliss Hospital, Murad Nagar Road, Mehidipatnam, Hyderabad - 500028,

Telangana, India;²Department of Microbiology, Dr. Patnam Mahender Reddy Institute of Medical Sciences, Chevella, Ranga Reddy,

Telangana, India; *Corresponding author

Abstract:

Wound healing is a complex process involving multiple stages to restore the integrity and function of damaged tissues. Researchers are exploring the therapeutic potential of HOCl in treating infections and inflammatory conditions, given its efficacy in killing pathogens and modulating immune responses. The present study is a prospective study aimed to know the wound healing nature of HOCl on open wounds in patients attending out-patient department. The study was conducted for a period of one year Jan 2023 to Jan 2024 at Bliss Hospital, Hyderabad, Telangana district, India. Hypochlorous acid (Vida solutions, Pvt.Ltd) was used to irrigate the open wound. Among the 10 reported cases, three were females and seven were males. Most of the cases were reported from middle-age and old-age persons except one paediatric case of age 3 years a female girl. A male patient of age 72 years with co-morbidities diabetes and hypertension suffering with chronic wound on left leg for a period of 35 years because of thorn prick injury. The】 complete wound healing took nearly 15 weeks in this patient. The wound healing takes place 8 to 15 weeks maximum in all the 10 cases and the above findings concluded that, these features lead to a stabilized HOCl solution as an ideal wound care agent.

Keywords: Hypochlorous acid, chronic wound, infection, co-morbidities
Hypochlorous Acid: An Ideal Wound Care Agent With Powerful Microbicidal, Antibiofilm, and Wound Healing Potency 2026-08-01 00:00

Serhan Sakarya, MD; Necati Gunay, MS; Meltem Karakulak, MS; Barcin Ozturk, MD; Bulent Ertugrul, MD Wounds. 2014;26(12):342-350.

Abstract and Introduction

Abstract

Introduction Chronic wounds and the infections associated with them are responsible for a considerable escalation in morbidity and the cost of health care. Infection and cellular activation and the relation between cells are 2 critical factors in wound healing.

Since chronic wounds offer ideal conditions for infection and biofilm production, good wound care strategies are critical for wound healing. Topical antiseptics in chronic wounds remain in widespread use today. These antiseptics are successful in microbial eradication, but their cytotoxcity is a controversial issue in wound healing.

Objective The aim of this study was to investigate the effect of stabilized hypochlorous acid solution (HOCl) on killing rate, biofilm formation, antimicrobial activity within biofilm against frequently isolated microorganisms and migration rate of wounded fibroblasts

and keratinocytes.

Materials and Methods. Minimal bactericidal concentration of stabilized HOCl solution for all standard microorganisms was 1/64 dilution and for clinical isolates it ranged from 1/32 to 1/64 dilutions.

Results All microorganisms were killed within 0 minutes and accurate killing time was 12 seconds. The effective dose for biofilm impairment for standard microorganisms and clinical isolates ranged from 1/32 to 1/16. Microbicidal effects within the biofilm and

antibiofilm concentration was the same for each microorganism.

Conclusion. The stabilized HOCl solution had dose-dependent favorable effects on fibroblast and keratinocyte migration

compared to povidone iodine and media alone. These features lead to a stabilized HOCl solution as an ideal wound care agent.

Introduction

Wound healing is a sequence of complex and well-orchestrated events. Although the precise mechanism of wound healing is not fully understood, 3 interrelated phases—inflammation, migration, and remodeling—require coordinated activity for successful wound healing, which is a progressive series of events facilitated by platelets, leukocytes, fibroblasts, and keratinocytes. Platelets facilitate homeostasis and the release of growth factors, then leukocytes participate in the inflammatory process. Fibroblasts and keratinocytes have a critical role in wound healing by enhancing reepithelization and the remodeling of the extracellular matrix (ECM).[1–3] Most chronic wounds are related to diabetes mellitus, venous stasis, peripheral vascular diseases, and pressure ulcerations. An open wound is a favorable niche for bacterial colonization and infection. Infection in chronic wounds starts with contamination, then colonization and critical colonization take place before an infection forms. Biofilm formation is now recognized as a serious problem in chronic wound infections.[4] Biofilm is a complex structure of microorganisms that generate a protective shell, allowing bacteria to collect and proliferate.[5] Most of the microorganisms that form biofilms can also be found growing in microbial infections. The same species of bacteria have significant differences in existence that range either free floating and living within the biofilm. The biofilm structure of microorganisms renders phagocytosis difficult,[6] increases resistance to antibiotics,[7] and adheres to unfavorable niches such as chronic wounds.[8] One of the remarkable features of the immune system against invading pathogens is its ability to generate an effective and rapid response by developing a group of highly reactive chemicals, such as reactive oxygen species (ROS). The mitochondrial membrane-bound enzyme nicotinamide adenine dinucleotide phosphate-oxidase (NADPH) is a primary enzyme responsible for ROS production.[9] During the activation of neutrophils, respiratory bursts generate hydrogen peroxide (H2O2) and the activated granule enzyme myeloperoxidase converts H2O2 to hypochlorous acid (HOCl) in the presence of Cl- and H+.[10] Hypochlorous acid leads to cell death by the oxidation of sulfhydryl enzymes and amino acids, ring chlorination of amino acids, loss of intracellular contents, decreased uptake of nutrients, inhibition of protein synthesis, decreased oxygen uptake, oxidation of respiratory components, decreased adenosine triphosphate production, breaks in DNA, and depressed DNA synthesis.[11–15] Hypochlorous acid is highly active against all bacterial, viral, and fungal human pathogens[16] and a small amount of HOCl can kill spore-forming and non-spore bacteria in a short time period.[17,18] Since most of the etiologic factors in chronic wound infections are forming biofilm,[19] and most of the topical antiseptics impair wound healing with their cytotoxic effect, therapeutic strategies against biofilm with high microbial eradication and good wound healing effects will decrease the morbidity and mortality rates of patients and reduce the economic burden. The aim of this study was to investigate the effect of stabilized HOCl solution on microbial and biofilm eradication, antimicrobial activity within biofilm against frequently isolated microorganisms, and migration rate of wounded fibroblasts and keratinocytes.
Rapid, high level inactivation of infectious HPV16 and HPV18 using hypochlorous acid (HOCl) 2026-07-31 00:00

Craig Meyers¹, Janice Milici¹, Lori Robins², Luis Contreras², Jeffrey Williams³, Richard Robison4 ¹Department of Microbiology and Immunology, Penn State College of Medicine, Hershey, Pennsylvania 17033, USA; ²Physical Science Division, School of STEM, University of Washington Bothell, Bothell, Washington 98011, USA; ³Briotech Inc., Woodinville, Washington 98072, USA; 4Department of Microbiology and Molecular Biology, Brigham Young University, Provo, Utah 84602, USA

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主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

文献精选

Medical nutrition therapy in physiological pregnancy and in pregnancy complicated by obesity and/or diabetes: SID-AMD recommendations

HYA ameliorated postprandial hyperglycemia in type 1 diabetes model rats with bolus insulin treatment

The UBR5 protein facilitates mesangial cell hypertrophy and glycolysis induced by high glucose by increasing the phosphorylation levels of AKT

HbA1c variability as an independent risk factor for diabetic retinopathy: results from a screening program

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主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

文献精选

Medical nutrition therapy in physiological pregnancy and in pregnancy complicated by obesity and/or diabetes: SID-AMD recommendations

HYA ameliorated postprandial hyperglycemia in type 1 diabetes model rats with bolus insulin treatment

The UBR5 protein facilitates mesangial cell hypertrophy and glycolysis induced by high glucose by increasing the phosphorylation levels of AKT

HbA1c variability as an independent risk factor for diabetic retinopathy: results from a screening program

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