Traumatic intracranial pseudoaneurysms of cortical middle cerebral artery and posterior cerebral artery branches presenting as subdural hematomas in elderly patients: A two-case report.

Diabetes mellitus (DM) is a complex metabolic disease characterized by defective insulin secretion or resistance leading to persistent hyperglycemia (Petersmann et al. ), presenting symptoms such as excessive urination, sweating, dehydration, blurred vision, frequent tiredness, unintentional weight loss, and organ dysfunctions in severe or complicated cases (Ramachandran ; Mezil and Abed ). DM is classified into four: (i) Type 1 DM (T1DM) caused by deficient insulin secretion because of autoimmune destruction of pancreatic β‐cells; (ii) Type 2 DM (T2DM), which is known to be non‐insulin dependent; (iii) Gestational DM, which occurs during pregnancy and may disappear or progress after birth; and (iv) Juvenile DM, which occurs in children (Onikanni et al. ; ADA ). Type 2 diabetes mellitus (T2DM) is the most prevalent form of diabetes, representing 90% to 95% of all reported cases. It is more common in developed countries, primarily due to lifestyle factors, and poses a significant socio‐economic burden (Janssen et al. ; Malek et al. ). The disease ranked among the world's top 10 causes of death in 2024 (Zhou et al. ). Furthermore, an upsurge to over 1.31 billion by 2050 has been projected from the 529 million (6.1% of the world population) diabetic cases recorded in 2021 (Ong et al. ). Thus, there is an urgent need for development of more effective drugs to combat diabetes. Oxidative stress and inflammation triggered by hyperglycemia and hyperlipidemia have been extensively implicated in the progression of T2DM and its complications. A hyperglycemic state results in free radical generation including reactive nitrogen species (RNS) and reactive oxygen species (ROS), glucose autooxidation, and endogenous antioxidants depletion, leading to oxidative stress, inflammation, and dysfunction of pancreatic β‐cells which results in decreased insulin secretion (Yaribeygi et al. ). Free radicals disrupt insulin signaling, leading to insulin resistance. High levels of oxidative stress activate NF‐κB, triggering the release of proinflammatory mediators that damage cells and impair their function. Studies in both animals and humans have shown that excessive ROS accumulation, NF‐κB activation, and resulting inflammation play a significant role in the development and progression of T2DM. This highlights the importance of inflammation in the pathogenesis and pathophysiology of T2DM (Suryavanshi and Kulkarni ; Tishkowski and Gupta ). The interplay between oxidative stress and inflammatory conditions contributes to the development of diabetic complications which include retinopathies, diabetic encephalopathy, nephropathies, coronary heart disease, and hypertension (Tomic et al. ). Therefore, therapeutic approaches targeting improvement of oxidative defense and reduction of inflammatory responses would be helpful in the management of DM and its complications. Current antidiabetic medications are effective in managing diabetes by lowering glucose levels through increased insulin sensitivity or secretion. However, their use is limited due to loss of efficacy and severe side effects like acute hepatitis, diarrhea, skin sensitivity, and lactic acidosis (Onikanni et al. ; Arumugam et al. ; Thakare et al. ). Therefore, there is a need for development of alternative targeted therapeutic approaches that lower blood glucose and protect β‐cells from oxidative and inflammatory damage. Over the years, natural products, especially medicinal plants, have been shown to be effective and have minimal side effects when compared with conventional treatments based on evidence from traditional health practices and experimental studies (Onikanni et al. ). Similarly, preclinical studies have demonstrated potent antioxidant and anti‐inflammatory properties of plant‐derived extracts and compounds in the management of diabetes and its complications (Lukman et al. ; Abdulrasheed‐Adeleke et al. ; Yusuf et al. ). Therefore, exploring medicinal plant extracts and their bioactive metabolites may improve the prognosis of diabetes and its complications while modulating oxidative stress and inflammatory abnormalities and subsequently improve the morphological and physiological integrity of pancreatic β‐cells.