Effects of needling at Sanyinjiao(SP6)acupuncture point on blood glucose levels and cardiovascular functions in patients with type 2 diabetes mellitus:a randomized placebo-controlled study

Objective To determine the effect of needling at Sanyinjiao(SP6)on random blood glucose(RBG)levels and cardiovascular function in patients with type 2 diabetes mellitus(T2DM).Methods In this randomized placebo-controlled study,T2DM patients(aged 35-65 years)were recruited from the Government Yoga and Naturopathy Medical College and Hospital,Chennai,India,between January 5,2022 and March 15,2023.Participants were randomly as-signed to either acupuncture group or sham acupuncture group.The acupuncture group re-ceived bilateral needling at Sanyinjiao(SP6)while sham acupuncture group received needling at a non-acupuncture point[1.5 cun lateral to Sanyinjiao(SP6)]for 30 min.Primary outcome was RBG,and secondary outcomes included systolic blood pressure(SBP),diastolic blood pressure(DBP),pulse rate(PR),pulse pressure(PP),mean arterial pressure(MAP),rate pressure product(RPP),and double product(Do-P).All parameters were assessed imme-diately before and after intervention.Results A total of 100 patients with T2DM were enrolled in the study,and blinded to acupuncture group(n=50)and sham acupuncture group(n=50).Intergroup analysis showed that significant reductions in RBG(P<0.001),SBP(P=0.035),DBP(P=0.008),and MAP(P=0.009)were found in acupuncture group compared with sham acupuncture group.Within-group analysis showed significant reductions in RBG(P<0.001),SBP(P<0.001),DBP(P=0.008),PP(P=0.023),MAP(P<0.001),RPP(P<0.001),and Do-P(P=0.002)in acupunc-ture group,whereas sham acupuncture group showed a significant decrease in PR(P=0.023)only in the post-test assessment compared with pre-test assessment.Conclusion A period of 30 min of needling at the Sanyinjiao(SP6)acupuncture point re-duces RBG and promotes cardiovascular function in patients with T2DM as compared with needling at non-acupuncture points.Sanyinjiao(SP6)acupuncture may offer an immediate,non-pharmacological intervention to strengthen glycemic control management and cardio-vascular health in T2DM patients.

Effect of dates on blood glucose and lipid profile among patients with type 2 diabetes

Poor fruit and vegetable consumption is one of the 10 major risk factors for mortality.There is a misconception regarding the consumption of dates among patients with diabetes.This manuscript assessed the effects of date consumption on fasting and postprandial blood glucose,glycated hemoglobin,total cholesterol,triglycerides,low-density lipoproteins,high-density lipoproteins,and microbial markers.Four literature databases were searched for relevant articles.Of the 595 studies retrieved,24 assessed the effects of dates on glycemic control and lipids.Overall,the evidence suggests that dates have a lowering effect on blood glucose.Dates reduce total cholesterol and triglyceride levels and increase high-density lipoprotein levels.Dates also promote the abundance of beneficial gut microbiota.Therefore,patients with diabetes and dyslipidemia can consume dates to reduce their blood glucose,cholesterol,and triglycerides.

Effect of exercise during pregnancy on offspring development through ameliorating high glucose and hypoxia in gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)women require prenatal care to minimize short-and long-term complications.The mechanism by which exercise during pregnancy affects organ development and whether glucose transporter(GLUT)1 plays a role in GDM offspring organ development remains unknown.AIM To determine the effect of exercise during pregnancy on the cardiac,hepatic and renal development of GDM mother’s offspring.METHODS Placenta samples were collected from humans and mice.GDM mouse models were created using streptozotocin along with a GDM with exercise group.The hearts,livers and kidneys of 3-and 8-week-old offspring were collected for body composition analysis and staining.The effects of high glucose levels and hypoxia were investigated using HTR8/SVneo.Transwell and wound-healing assays were performed to assess cell migration.Immunofluorescence accompanied with TUNEL and Ki67 staining was used to explore apoptosis and proliferation.RESULTS Exercise during pregnancy downregulated the GLUT1 and hypoxia inducible factor-1αexpression in placenta from individuals with GDM.Cobalt chloride induced hypoxia and high glucose levels also significantly decreased migration and apoptosis of HTR8/SVneo cells.In addition,exercise reduced inflammatory cell infiltration in the liver and decreased the tubular vacuolar area in the kidneys of offspring.CONCLUSION GDM affects the growth and development of organs in offspring.Exercise during pregnancy can reverse adverse effects of GDM on the development of the heart,liver,and kidney in offspring.

Influence of blood glucose fluctuations on chemotherapy efficacy and safety in type 2 diabetes mellitus patients complicated with lung carcinoma

BACKGROUND Patients with type 2 diabetes mellitus(T2DM)have large fluctuations in blood glucose(BG),abnormal metabolic function and low immunity to varying degrees,which increases the risk of malignant tumor diseases and affects the efficacy of tumor chemotherapy.Controlling hyperglycemia may have important therapeutic implications for cancer patients.AIM To clarify the influence of BG fluctuations on chemotherapy efficacy and safety in T2DM patients complicated with lung carcinoma(LC).METHODS The clinical data of 60 T2DM+LC patients who presented to the First Affiliated Hospital of Ningbo University between January 2019 and January 2021 were retrospectively analyzed.All patients underwent chemotherapy and were grouped as a control group(CG;normal BG fluctuation with a mean fluctuation<3.9 mmol/L)and an observation group(OG;high BG fluctuation with a mean fluctuation≥3.9 mmol/L)based on their BG fluctuations,with 30 cases each.BGrelated indices,tumor markers,serum inflammatory cytokines and adverse reactions were comparatively analyzed.Pearson correlation analysis was performed to analyze the correlation between BG fluctuations and tumor markers.RESULTS The fasting blood glucose and 2-hour postprandial blood glucose levels in the OG were notably elevated compared with those in the CG,together with markedly higher mean amplitude of glycemic excursions(MAGE),mean of daily differences,largest amplitude of glycemic excursions and standard deviation of blood glucose(P<0.05).In addition,the OG exhibited evidently higher levels of carbohydrate antigen 19-9,carbohydrate antigen 125,carcinoembryonic antigen,neuron-specific enolase,cytokeratin 19,tumor necrosis factor-α,interleukin-6,and highsensitivity C-reactive protein than the CG(P<0.05).Pearson analysis revealed a positive association of MAGE with serum tumor markers.The incidence of adverse reactions was significantly higher in the OG than in the CG(P<0.05).CONCLUSION The greater the BG fluctuation in LC patients after chemotherapy,the more unfavorable the therapeutic effect of chemotherapy;the higher the level of tumor markers and inflammatory cytokines,the more adverse reactions the patient experiences.

Self-monitoring of blood glucose in gestational diabetes mellitus patients during the COVID-19 pandemic in low- and middle-income countries

Self-monitoring of blood glucose(SMBG)is critical for gestational diabetes mellitus(GDM)care.However,there are several hurdles to its practice during the coronavirus disease 2019(COVID-19)pandemic in GDM patients in low-and middle-income countries when GDM care recommendations emphasize telemedicine-based care.Based on available knowledge,this letter proposes the following barriers to SMBG in these GDM patients during the ongoing COVID-19 pandemic:Poor internet connectivity,affordability of SMBG and digital applications to connect with healthcare providers,government-imposed social mobility restriction,psychological stress,and mental health conditions.Nevertheless,definitive evidence will only be acquired from rigorous research.

USING CAPILLARY WHOLE BLOOD GLUCOSE TEST IN SCREENING FOR GESTATIONAL DIABETES MELLITUS

To discuss whether the capillary whole blood glucose （CBG） test can be used in glucose screening test （GST） for gestational diabetes mellitus （GDM） compared to the venous plasma glucose （ VPG） method, and to determine the cutoff value of CBG. Methods This was a self-control test. The 50-g oral GST was conducted among 1 557 pregnant women between 24-28 weeks. Every woman was measured CBG and VPG at the same time and same arm. Three hundred and forty women underwent 100-g 3-h oral glucose tolerance test （OGTT）. Receiver operation curve （ROC） was used to determine the potential cutoff level of CBG and VPG. Diagnose criteria of GDM was based on NDDG criteria. OGTT diagnosed GDM and VPG ≥ 7. 8 mmol/L were used as golden standard for ROC. Results There was good relationship between CBG and VPG （ P 〈0.01 ）. Correlation coefficient was O. 86. The value of CBG was lower than VPG. The statistical and high-sensitivity cutoff values were 7. 4 mmol/L in CBG and 7. 8 mmol/L in VPG when GDM was used as golden standard. Cutoff value of CBG was 7. 0 mmol/L when VPG≥7. 8 mmol/L was used as golden standard. The pregnant outcomes of positive cases of three thresholds had no significant differences. But it was better in case of the pregnant woman when the CBG value was more than 7. 4 mmol/L. Conclusion CBG can be used in GST, the threshold of CBG was suggested as 7. 4 mmol/L. CBG test was more convenience and effective than VPG test.

Associations of serum D-dimer and glycosylated hemoglobin levels with third-trimester fetal growth restriction in gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and development.AIM To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM patients.METHODS The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the Obstetrics and Gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed retrospectively.Among these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative analysis.The diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic regression.RESULTS Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,respectively.The AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,respectively.High D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can indicate the occurrence of FGR in GDM patients in the third trimester of pregnancy to some extent,and their combination can be used as an important index for the early prediction of FGR.

Gestational diabetes mellitus: Screening with fasting plasma glucose

Fasting plasma glucose(FPG) as a screening test for gestational diabetes mellitus(GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-conducted studies. This review:(1) traces the history;(2) weighs the advantages and disadvantages;(3) addresses the significance in early pregnancy;(4) underscores the benefits after delivery; and(5) emphasizes the cost savings of using the FPG in the screening of GDM. It also highlights the utility of fasting capillary glucose and stresses the value of the FPG in circumventing the cumbersome oral glucose tolerance test. An understanding of all the caveats is crucial to be able to use the FPG for investigating glucose intolerance in pregnancy. Thus, all health professionals can use the patient-friendly FPG to simplify the onerous algorithms available for the screening and diagnosis of GDM-thereby helping each and every pregnant woman.

Effect of hospital discharge plan for children with type 1 diabetes on discharge readiness,discharge education quality,and blood glucose control

BACKGROUND Type 1 diabetes is one of the most common chronic diseases in childhood.The number of type 1 diabetes patients in China still ranks fourth in the world.Therefore,children with type 1 diabetes in China are a group that needs attention.The management of type 1 diabetes mellitus(T1DM)involves many aspects of daily life.It is extremely challenging for children and their families.T1DM children have complex medical care needs.Despite the continuous development of therapeutic medicine and treatment technologies,blood glucose control in children with T1DM is still not ideal.They and their parents need to acquire more knowledge and skills before being discharged.AIM To explore the influence of hospital discharge plan based on parental care needs of children with T1DM on discharge readiness,quality of discharge education and blood glucose control level.METHODS In total,102 parents of children with type 1 diabetes were divided into control group and intervention group according to admission time.Fifty cases from February to June 2019 were selected as the control group,and 52 cases from July to October 2019 were selected as the intervention group to implement the discharge plan.The Readiness for Hospital Discharge Scale,Hospital Discharged Education Quality Scale and children's blood glucose metabolism indicators were used to compare the differences in discharge preparation,discharge education quality and blood glucose control between the two groups of children and their parents.RESULTS On the day of discharge,the two groups of children had the following scores of readiness for discharge:The intervention group score was 225.34±32.47,and the control group score was 208.68±29.31.The P value was 0.007,and the difference was statistically significant.The discharge education quality scores were as follows:The intervention group score was 135.11±19.86,the control group score was 124.13±15.56,the P value was 0.002 and the difference was statistically significant.Three months after discharge,the blood glucose metabolism indicator showed that the glycosylated hemoglobin value of the two groups was(7.45%±1.04%),and that of the control group was(8.04%±1.27%),P=0.012.Therefore,the improvement of parents'readiness for discharge,quality of discharge education and blood glucose metabolism indicators(glycosylated hemoglobin,fasting blood glucose and postprandial blood glucose)in the intervention group were better than those in the control group(P<0.05),and the difference was statistically significant.CONCLUSION The discharge plan for children with T1DM can help the children and their families realize the transition from hospital care to home self-management and improve the parents'readiness for discharge,thereby improving children’s blood glucose control levels.

Proteomics for early prenatal screening of gestational diabetes mellitus

In this editorial,we comment on the article by Cao et al.Through applying isobaric tags for relative and absolute quantification technology coupled with liquid chromatography-tandem mass spectrometry,the researchers observed significant differential expression of 47 proteins when comparing serum samples from pregnant women with gestational diabetes mellitus(GDM)to the healthy ones.GDM symptoms may involve abnormalities in inflammatory response,complement system,coagulation cascade activation,and lipid metabolism.Retinol binding protein 4 and angiopoietin like 8 are potential early indicators of GDM.GDM stands out as one of the most prevalent metabolic complications during pregnancy and is linked to severe maternal and fetal outcomes like pre-eclampsia and stillbirth.Nevertheless,none of the biomarkers discovered so far have demonstrated effectiveness in predicting GDM.Our topic was designed to foster insights into advances in the application of proteomics for early prenatal screening of GDM.

Prevalence of Gestational Diabetes Mellitus in Puerto Rico: A Study from 2016 to 2021

Background: Gestational diabetes mellitus (GDM) is a temporary form of insulin resistance during pregnancy and is linked to adverse outcomes for both mothers and offspring. Maternal risks include an increased prevalence of pre-eclampsia, cesarean delivery, and the development of type 2 diabetes within five to ten years post-delivery. For offspring, exposure to elevated maternal glucose levels is associated with macrosomia. A significant challenge in evaluating the prevalence of GDM in Puerto Rico is the lack of recent research quantifying this condition in pregnant women living in Puerto Rico. Objective: This study aimed to estimate the prevalence of Gestational Diabetes Mellitus from 2016 to 2021 by analyzing data collected by Puerto Rico’s Department of Health. Methods: We obtained publicly accessible data from the Division of Children, Mothers, and Adolescents from Puerto Rico’s Department of Health to estimate the prevalence of GDM across the island. Additionally, we correlated the prevalence with socioeconomic, educational, and demographic variables using beta regression models to assess their significance. Results: The prevalence of GDM ranged from 3.2% to 4.5% for the six years studied, with an average prevalence of 3.68%. Regression analysis revealed a significant positive relationship between maternal age and educational level. Higher educational attainment was associated with a reduced risk of GDM, while increasing maternal age was linked to a higher prevalence of the condition. Conclusion: This statistical analysis provides evidence of a steady increase in the prevalence of GDM in Puerto Rico from 2016 to 2021, highlighting the importance of ongoing surveillance and specific interventions to mitigate risk factors.

Macrosomia in non-gestational diabetes pregnancy:glucose tolerance test characteristics and feto-maternal complications in tropical Asia Pacific Australia

Objective:To look into the glucose tolerance test characteristics and determine complications in non-gestational diabetes pregnant subjects.Methods:From 2006 to 2009 all non-gestational diabetes mellitus(non-CDM)pregnant women who delivered macrosomia at the North Australia's Townsville Hospital were retrospectively reviewed by extracting data from clinical record.Glucose tolerance tests results were analysed in the light of an earlier diagnosis of non-GDM.Results:Ninety-one non-CDM mothers with macrosomia were studied and compared with 41normoglycemic subjects without macrosomia.Of the subjects with non-GDM macrosomia,45(49.4%)had normal SO g glucose challenge test(GCT)without further testing,another 8(8.8%)had abnormal GCT but normal 75 g oral glucose tolerance test(OGTT).A total of 4(4.4%)subjects had normal GCT and OGTT.Interestingly.14 out of 16(87.5%)subjects who were tested with OGTT owing to past history of macrosomia had normal results but delivered macrosomic babies.Only 12 subjects had both GCT and OGTT,the rest of the cohort had either of the two tests.Subjects with non-CDM macrosomia had higher frequency of neonatal hypoglycaemia 34%as compared to 10%in nonmacrosomic babies(P=0.003).Other feto-maternal complications were similar in both groups.Conclussions:No significant pattern of glucose tolerance characteristics was identified in nonGDM mothers with macrosomic babies.In spite of being normoglycemic significant neonatal hypoglycaemia was recorded in non-GDM macrosomic babies.Further prospective studies on a larger population are needed to verify our findings.

Parsimonious Model for Blood Glucose Level Monitoring in Type 2 Diabetes patients

To establish the parsimonious model for blood glucose monitoring in patients with type 2 diabetes receiving oral hypoglycemic agent treatment. One hundred and fifty-nine adult Chinese type 2 diabetes patients were randomized to receive rapid-acting or sustained-release gliclazide therapy for 12 weeks.

The Use of Glycated Albumin in the Diagnosis of Gestational Diabetes Mellitus

Gestational diabetes mellitus is the most common endocrine disorder in pregnancy and a cause of maternal and fetal morbidities and mortalities. The oral glucose tolerance test is the gold standard for diagnosing gestational diabetes mellitus. Nevertheless, the oral glucose tolerance test is time-consuming and requires patient preparation. On the contrary, Glycated albumin does not require patient preparation or administration of any substance. Most studies on glycated albumin in pregnancy were among the non-African population, and black Americans have higher glycated albumin levels than Caucasians. This study determined the use of glycated albumin in diagnosing gestational diabetes mellitus among pregnant women. The study was a prospective study of 160 pregnant women between 24 and 28 weeks of gestation at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was based on the World Health Organization 2013 criteria. The diagnostic value of glycated albumin was determined using the area under the receiver operator characteristic curve. The prevalence of gestational diabetes mellitus was 9.4% and the mean glycated albumin was 16.91% (±2.77). The area under the receiver operator characteristic curve for glycated albumin was 0.845 (95% CI 0.733 - 0.956;p = 0.0001). The optimal cut-off value of glycated albumin in the diagnosis of gestational diabetes mellitus was 18.9%. Glycated albumin was useful in the diagnosis of gestational diabetes mellitus at 24 to 28 weeks of gestation.

Effect of Konjac Food on Blood Glucose Level in Patients with Diabetes

Seventy-two type II diabetic subjects were given Konjac food for 65 days. The data analyzed by multiple F test indicate that the fasting blood glucose (FBG) and the 2-h postprandial blood glucose (PBG) on the 30th and the 65th days after the food was ingested were significantly reduced (P = 0.001, P < 0.001, respectively), as was the glycosylated hemoglobin level at the end of the trial (P < 0.05). The final FBG and PBG of the subjects with initial FBG-O >200 mg% decreased on the average by 51.8 and 84.6 mg%. respectively; those with FBG-0 150-200 mg% decreased by 24.1 and 68.7 mg%; and those with FBG-O < 150 mg% decreased by 4.8 and 21.4 mg%. No significant changes in blood lipid indexes were observed, except that the triglycer-ide values of subjects with hypertriglyceridemia (>200 mg%) significantly decreased by 118.7 mg%. It was concluded that Konjac food is very useful in the prevention and treatment of hyperglycemia. (C)1990 Academic Press. Inc.

Effects of DPP-4 inhibitor combined with metformin on blood glucose control, oxidative stress and inflammatory response in patients with type 2 diabetes mellitus

Objective: To investigate the effects of DPP-4 inhibitor combined with metformin on blood glucose control, oxidative stress and inflammatory response in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 138 patients with newly diagnosed T2DM who were treated in the hospital between March 2016 and April 2017 were divided into routine group (n=69) and combined treatment group (n=69) by random number table method. Routine group were treated with metformin alone and combined treatment group received DPP-4 inhibitor combined with metformin therapy. The differences in blood glucose control as well as oxidative stress-related indicator and inflammatory factor contents were compared between the two groups before and after treatment. Results: Before treatment, the differences in blood glucose index levels in peripheral blood as well as the oxidative stress index and inflammatory mediator contents in serum were not statistically significant between the two groups. After 4 weeks of treatment, blood glucose indexes FBG and HOMA-IR levels in peripheral blood of combined treatment group were lower than those of routine group;oxidative stress indexes MDA and LHP contents in serum were lower than those of routine group whereas GSH-Px and T-AOC contents were higher than those of routine group;inflammatory mediators hs-CRP, IL-1 and IL-6 contents in serum were lower than those of routine group. Conclusion: DPP-4 inhibitor combined with metformin therapy can effectively control the blood glucose and suppress the systemic oxidative stress and inflammatory response in T2DM paients.

Spouses of patients with diabetes mellitus type 2 at increased risk of high blood glucose levels

Introduction: Diabetes mellitus type 2 is a growing threat in developing countries already burdened with high levels of infectious disease. Screening the general population has debatable advantages. This study aims to determine whether spouses of patients with diabetes mellitus have higher random blood glucose (RBG) levels as well as the benefit of RBG testing as a targetted screening tool. Methodology: The survey employed a cross-sectional comparative study of spouses’ of diabetics and non-diabetics attending the general out-patient department of the LagosStateUniversityTeaching Hospital (LASUTH), Ikeja. A modified WHO STEPS Surveillance Instrument and a one-touch Glucometer were used to collect data. Blood pressures and BMI were measured and correlated to blood glucose levels. Results: Prevalence of high RBG was found to be 7% among spouses of diabetics and 3.3% among spouses of non-diabetic patients. Mean RBG was 5.57 mmol/L and 7.7 mmol/L within the age group 40 - 49 years and 50 - 59 years respectively among spouses of diabetic patients compared to 5.4 mmol/L and 5.5 mmol/L within the same age group among the spouses non-diabetics. Spouses of patients with diabetes mellitus had higher systolic and diastolic blood pressures and BMI compared to spouses of non-diabetics. Conclusion: Being male, married to a diabetic patient, lower educational levels and higher body mass index are significantly associated with higher random blood glucose in the spouses of diabetic patients. Random blood glucose measurements are an effective screening tool and spouses of diabetic patients can benefit from targeted screening in controlled clinical settings.

Relationship between Positive Glucose Screening, Obesity and Pregnancy Outcome in the Absence of Gestational Diabetes: A Retrospective Cohort Study

Background: Currently pregnant women with abnormal glucose screening test (GCT), performed at 26?-?28 weeks gestation with a subsequent normal glucose tolerance test (GTT) receive routine care. Could these women be at risk of adverse pregnancy? Objective: Compare rate of caesarean section (CS), induction of labour (IOL), macrosomia, admission to special care nursery and neonatal hypoglycaemia. Designs: Retrospective cohort study. Setting: Ipswich Hospital, Ipswich, Queensland. Participants: Pregnant women having had the test at the hospital laboratory. Methods: Charts review of outcome measures including induction of labour, caesarean section, macrosomia, RDS and short-term neonatal morbidity. Results: We reviewed 882 charts (441 cases and 441 controls). There was a higher IOL rate among cases 21.1% versus 16.6% (OR and 95% CI 1.45;1.03?-?2.06) and a higher CS rate, 30.4 versus 23.6 (OR and 95% CI 1.41;1.05?-?1.91). Compared to women with BMI 18.5 - 24.9, women with BMI of 30 and above had a significantly higher IOL rate (47.1% versus 22.6%), higher CS rate (47.2% versus 25.7%) and higher rate of macrosomic baby (79.2% versus 4.2%). There were more women amongst the cases who were older, smoked, had a BMI 30 and above and had previous history of GDM. After adjusting for maternal age, BMI and smoking status, there was still an increased odds of CS, IOL and macrosomia, but this did not reach statistical significance. Conclusion: Abnormal glucose screening test in the absence of gestational diabetes is associated with adverse pregnancy outcome. This is largely contributed by maternal obesity.

Is nonlinear model predictive control with fuzzy predictive model proper for managing the blood glucose level in typeI diabetes?

In recent decades, due to the increasing risk of diabetes, the measurement and control of the blood sugar is of great importance. In typeI diabetes, because of the lack of insulin secretion, the cells cannot absorb glucose, and thus have a low level of glucose. To control blood glucose, the insulin must be injected to the body. In fact, the injection must be in a completely controlled environment. If the level of the insulin exceeds the physiological limits, it may cause death. This paper presents an online approach to control the blood glucose level using a nonlinear model predictive control. This method, maintains the level of blood glucose concentration within a normal range. Thus, the blood glucose level is measured in each minute and predicted for the next time interval. If that is not in the normal range, amount of the insulin which must be injected will be determined. The proposed control approach includes important features such as model uncertainties and prevents acute decrease in the blood glucose level, and instability. In order to assess performance of the proposed controller, computer simulations have been carried out in Matlab/Simulink. Simulation results will reveal the effectiveness of the proposed nonlinear model predictive controller in adjusting the blood glucose level by injecting required insulin. So if the nutrition of the person decreases instantly, the hypoglycemia does not happen.

Utility of oral glucose tolerance test in predicting type 2 diabetes following gestational diabetes:Towards personalized care

BACKGROUND Women with gestational diabetes mellitus(GDM)are at a seven-fold higher risk of developing type 2 diabetes(T2D)within 7-10 years after childbirth,compared with those with normoglycemic pregnancy.Although raised fasting blood glucose(FBG)levels has been said to be the main significant predictor of postpartum progression to T2D,it is difficult to predict who among the women with GDM would develop T2D.Therefore,we conducted a cross-sectional retrospective study to examine the glycemic indices that can predict postnatal T2D in Emirati Arab women with a history of GDM.AIM To assess how oral glucose tolerance test(OGTT)can identify the distinct GDM pathophysiology and predict possible distinct postnatal T2D subtypes.METHODS The glycemic status of a cohort of 4603 pregnant Emirati Arab women,who delivered in 2007 at both Latifa Women and Children Hospital and at Dubai Hospital,United Arab Emirates,was assessed retrospectively,using the International Association of Diabetes and Pregnancy Study Groups(IADPSG)criteria.Of the total,1231 women were followed up and assessed in 2016.The FBG and/or the 2-h blood glucose(2hrBG)levels after a 75-g glucose load were measured to assess the prevalence of GDM and T2D,according to the IADPSG and American Diabetes Association(ADA)criteria,respectively.The receiver operating characteristic curve for the OGTT was plotted and sensitivity,specificity,and predictive values of FBG and 2hrBG for T2D were determined.RESULTS Considering both FBG and 2hrBG levels,according to the IADPSG criteria,the prevalence of GDM in pregnant Emirati women in 2007 was 1057/4603(23%),while the prevalence of pre-pregnancy T2D among them,based on ADA criteria,was 230/4603(5%).In the subset of women(n=1231)followed up in 2016,the prevalence of GDM in 2007 was 362/1231(29.6%),while the prevalence of prepregnancy T2D was 36/1231(2.9%).Of the 362 pregnant women with GDM in 2007,96/362(26.5%)developed T2D;142/362(39.2%)developed impaired fasting glucose;29/362(8.0%)developed impaired glucose tolerance,and the remaining 95/362(26.2%)had normal glycemia in 2016.The prevalence of T2D,based on ADA criteria,stemmed from the prevalence of 36/1231(2.9%)in 2007 to 141/1231(11.5%),in 2016.The positive predictive value(PPV)for FBG suggests that if a woman tested positive for GDM in 2007,the probability of developing T2D in 2016 was approximately 24%.The opposite was observed when 2hrBG was used for diagnosis.The PPV value for 2hrBG suggests that if a woman was positive for GDM in 2007 then the probability of developing T2D in 2016 was only 3%.CONCLUSION FBG and 2hrBG could predict postpartum T2D,following antenatal GDM.However,each test reflects different pathophysiology and possible T2D subtype and could be matched with a relevant T2D prevention program.