Abstract:
Diabetes mellitus (DM) and premenstrual syndrome (PMS) are global health challenges. Both disorders are often linked to a range of physical and psychological symptoms that significantly impact the quality of life of many women. Yet, the exact relation between DM and PMS is not clear, and the management of both conditions poses a considerable challenge. In this review, we aimed to investigate the interplay between DM, anti-diabetic drugs, and the different theories and symptoms of PMS. Female sex hormones are implicated in the pathophysiology of PMS and can also impair blood glucose control. In addition, patients with diabetes face a higher susceptibility to anxiety and depression disorders, with a significant number of patients experiencing symptoms such as fatigue and difficulty concentrating, which are reported in patients with PMS as well. Complications related to diabetic medications, such as hypoglycemia (with sulfonylurea) and fluid retention (with thiazolidinediones) may also mediate PMS-like symptoms. DM can, in addition, disturb the normal gut microbiota (GM), with a consequent loss of beneficial GM metabolites that guard against PMS, particularly the short-chain fatty acids and serotonin. Among the several available anti-diabetic drugs, those (1) with an anti-inflammatory potential, (2) that can preserve the beneficial GM, and (3) possessing a lower risk for hypoglycemia, might have a favorable outcome in PMS women. Yet, well-designed clinical trials are needed to investigate the anti-diabetic drug(s) of choice for patients with diabetes and PMS.
摘要:
糖尿病(DM)和经前期综合征(PMS)是全球健康挑战。这两种疾病通常都与一系列身体和心理症状有关,这些症状严重影响许多妇女的生活质量。然而,DM和PMS之间的确切关系尚不清楚,这两个条件的管理都构成了相当大的挑战。在这次审查中,我们的目的是调查DM之间的相互作用,抗糖尿病药物,以及PMS的不同理论和症状。女性性激素与PMS的病理生理学有关,也会损害血糖控制。此外,糖尿病患者对焦虑和抑郁障碍的易感性更高,大量患者出现疲劳和难以集中注意力等症状,在PMS患者中也有报道。与糖尿病药物有关的并发症,如低血糖(磺酰脲)和液体潴留(噻唑烷二酮)也可能介导PMS样症状。DM可以,此外,扰乱正常的肠道微生物群(GM),随之而来的是有益的转基因代谢物的损失,以防止PMS,特别是短链脂肪酸和血清素。在几种可用的抗糖尿病药物中,那些(1)具有抗炎潜力,(2)可以保存有益的转基因,(3)低血糖风险较低,PMS女性可能有一个有利的结果。然而,需要精心设计的临床试验来研究糖尿病和PMS患者的抗糖尿病药物选择。