Diabetes is a metabolic disease characterized by high blood sugar. Hyperglycemia is caused by defective insulin secretion, impaired biological action, or both. Types of diabetes are divided into type 1 and type 2. The pathology of type 1 diabetes is a significant decrease in the number of pancreatic β cells and insulitis. In addition, there may be islet atrophy and vacuolar degeneration of β cells. The pathology of type 2 diabetes is characterized by amyloidosis of pancreatic islets. Furthermore, islets may have fibrosis, decreased or normal number of islet β cells, increased glucagon cells, and no significant changes in the number of other endocrine cells. Diabetes can lead to long-term hyperglycemia, which induces chronic damage and dysfunction of various tissues, including eyes, kidneys, nerves, heart, and blood vessels, accompanied by a surge in endotoxin levels in patients. Therefore, the detection of endotoxin content in human blood is imperative for early diagnosis of diabetes and evaluation of its curative effect.
Figure 1. Major microvascular and macrovascular complications associated with diabetes mellitus. (Aramabašić J J, et al., 2021)
Endotoxins, also known as lipopolysaccharides (LPS), are components of the outer membrane of Gram-negative bacteria. It stimulates multiple inflammatory responses in the body, and elevated levels of endotoxin have been detected in the blood of diabetic patients and animal models. Diabetes causes an imbalance of intestinal flora, a reduction in proteins related to intestinal barrier function, an increase in permeability of the intestinal wall, and an excessive release of endotoxins that lead to chronic inflammation, impairs insulin signal transduction, destroys pancreatic islet B cells, and impairs insulin secretion at a low level. Thus, clinical research would benefit from a rapid and accurate diagnosis method for diabetes.
Endotoxins can accelerate the development of type 2 diabetes by affecting macrophages and promoting metabolic inflammation. Most patients with high serum endotoxin activity have been reported to exhibit dyslipidemia and insulin resistance features. At present, the main methods for clinical diagnosis of diabetes are blood glucose monitoring, glycosylated hemoglobin, and urine ketone determination. The accuracy rate is high, but it takes a long time. However, the results can be obtained quickly and accurately by using the limulus amoeba cell lysate detection method to detect the plasma endotoxin concentration of patients and conduct a comparative analysis. The detection of endotoxin levels is of great significance for improving the accuracy of early diagnosis of diabetes, providing a basis for early diagnosis of diabetic patients, and providing a reliable basis for treatment. In summary, the quantitative detection of endotoxin can judge the onset of diabetes early and provide a basis for clinical treatment.
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