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.

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.

Evaluation of the Three Glucometer Devices Performance in Comparison with the Cobas Integra 400 Plus Autoanalyzer in Measuring Blood Glucose Levels: A Comparative Cross-Sectional Study

Objective: The study aimed to evaluate the performance of the three glucometers compared to standard the laboratory method (Cobas Integra 400 Plus) in measuring blood glucose levels. Patients and Methods: A total of 100 Yemeni diabetic patients were randomly recruited into a comparative cross-sectional study. Venous and finger-pricked blood samples were obtained from all participants and used for blood glucose levels measurement following the standard procedures. Results: The mean blood glucose levels for one-hundred diabetic patients using the Gluco Contour TS and Gluco SD Codefree were not significantly different compared with the Cobas Integra 400 Plus (12.14 ± 6.89 mmol/L vs. 12.85 ± 8.83 mmol/L, P = 0.159;12.50 ± 7.18 mmol/L vs. 12.85 ± 8.83 mmol/L, P = 0.490), respectively. However, there is a significant difference using the Gluco Alert device from that of the Cobas Integra 400 Plus (11.83 ± 6.94 mmol/L vs. 12.85 ± 8.83 mmol/L, P = 0.046). Furthermore, using the ROC curve at a 95% confidence interval, the Cobas Integra 400 Plus showed a significant agreement with the Gluco Contour TS (51.4%), Gluco SD Codefree (50.4%), and Gluco Alert (39.3%), respectively. For determining accuracy, the sensitivity of the glucometer devices was the following: Gluco SD Codefree (87.3%), Contour TS (85.9%), and Gluco Alert (78.9%). In this regard, the highest specificity was related to Gluco Contour TS (65.5%). Conclusion: The correlation between both methods was good, with high sensitivity and specificity in measuring blood glucose levels as indicated by the ROC curve. Thus, we suggest using these glucometers at homes and hospitals as a point of care for diabetic patients.

Glucose metabolism profile recorded by flash glucose monitoring system in patients with hypopituitarism during prednisone replacement

BACKGROUND Commonly used glucocorticoids replacement regimens in patients with hypopituitarism have difficulty mimicking physiological cortisol rhythms and are usually accompanied by risks of over-treatment,with adverse effects on glucose metabolism.Disorders associated with glucose metabolism are established risk factors of cardiovascular events,one of the life-threatening ramifications.AIM To investigate the glycometabolism profile in patients with hypopituitarism receiving prednisone(Pred)replacement,and to clarify the impacts of different Pred doses on glycometabolism and consequent adverse cardiovascular outcomes.METHODS Twenty patients with hypopituitarism receiving Pred replacement[patient group(PG)]and 20 normal controls(NCs)were recruited.A flash glucose monitoring system was used to record continuous glucose levels during the day,which provided information on glucose-target-rate,glucose variability(GV),period glucose level,and hypoglycemia occurrence at certain periods.Islet β-cell function was also assessed.Based on the administered Pred dose per day,the PG was then regrouped into Pred>5 mg/d and Pred≤5 mg/d subgroups.Comparative analysis was carried out between the PG and NCs.RESULTS Significantly altered glucose metabolism profiles were identified in the PG.This includes significant reductions in glucose-target-rate and nocturnal glucose level,along with elevations in GV,hypoglycemia occurrence and postprandial glucose level,when compared with those in NCs.Subgroup analysis indicated more significant glucose metabolism impairment in the Pred>5 mg/d group,including significantly decreased glucose-target-rate and nocturnal glucose level,along with increased GV,hypoglycemia occurrence,and postprandial glucose level.With regard to islet β-cell function,PG showed significant difference in homeostasis model assessment(HOMA)-β compared with that of NCs;a notable difference in HOMA-βwas identified in Pred>5 mg/d group when compared with those of NCs;as for Pred≤5 mg/d group,significant differences were found in HOMA-β,and fasting glucose/insulin ratio when compared with NCs.CONCLUSION Our results demonstrated that Pred replacement disrupted glycometabolic homeostasis in patients with hypopituitarism.A Pred dose of>5 mg/d seemed to cause more adverse effects on glycometabolism than a dose of≤5 mg/d.Comprehensive and accurate evaluation is necessary to consider a suitable Pred replacement regimen,wherein,flash glucose monitoring system is a kind of promising and reliable assessment device.The present data allows us to thoroughly examine our modern treatment standards,especially in difficult cases such as hormonal replacement mimicking delicate natural cycles,in conditions such as diabetes mellitus that are rapidly growing in worldwide prevalence.

A cohort study on the association between fasting plasma glucose level over 5. 3 mmol / L and risks of abnormal glucose metabolism and cardiovascular diseases in the elderly

Objective To evaluate the association of fasting plasma glucose(FPG)level over 5.3 mmol/L with the development of abnormal glucose metabolism and cardiovascular disease(CVD).Methods This was a retrospec-tive cohort study with 1 064 non-diabetic subjects(980males;84 females)aged 60 or over,who carried out annual health check-up in Chinese PLA General

Investigation and analysis of negative emotion in patients with diabetic retinopathy after vitrectomy

BACKGROUND As the incidence of diabetes continues to increase,the number of patients with diabetic retinopathy(DR)also increases each year.After undergoing vitrectomy for DR,patients often experience negative emotional problems that negatively affect their recovery.AIM To investigate negative feelings in patients with DR after vitrectomy and to explore related influencing factors.METHODS A total of 146 individuals with DR who were accepted for treatment at The Third People’s Hospital of Changzhou from May 2021 to April 2023 were recruited to participate in this study.All patients underwent vitrectomy.The self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to assess the degree of anxiety and depression 2-3 days after the operation.The participants were divided into a healthy control group and a negative emotion group.The patients’general demographic characteristics and blood glucose levels were collected.Logistic regression analysis was used to analyze the factors influencing negative feelings post-operation.Pearson’s correlation coefficient was used to analyze the association between SAS scores,SDS scores,and blood glucose levels.RESULTS The control group included 85 participants.The negative emotion group comprised 40 participants with anxiety,13 with depression,and eight with both.Logistic regression showed that being female(OR=3.090,95%CI:1.217-7.847),a family per capita monthly income of<5000 yuan(OR=0.337,95%CI:0.165-0.668),and a longer duration of diabetes(OR=2.068,95%CI:1.817-3.744)were risk factors for negative emotions in patients with DR after vitrectomy(P<0.05).The concentrations of fasting plasma glucose(FPG),2-hour postprandial glucose(2hPG),and glycated hemoglobin(HbA1c)in the negative emotion group exceeded those in the control group(P<0.05).SAS scores were positively associated with FPG(r=0.422),2hPG(r=0.334),and HbA1c(r=0.362;P<0.05).SDS scores were positively correlated with FPG(r=0.218)and 2hPG(r=0.218;P<0.05).CONCLUSION Sex,income level,and duration of diabetes were factors that influenced negative emotions post-vitrectomy.Negative emotions were positively correlated with blood glucose levels,which can be used to develop intervention strategies.

Epidemiological and Hemato-Biochemical Profiles of Diabetic Patients at the Diabetology, Endocrinology, and Metabolic Diseases Department of the Alpha Oumar Diallo Regional Hospital, Kindia (Republic of Guinea)

This study aims to enhance the healthcare services for diabetic patients in the administrative region of Kindia by suggesting dietary interventions to assist diabetics in better managing their condition. Conducted over a period of six months, from February 18 to July 18, 2021, this prospective and descriptive cross-sectional study involved 220 diabetic patients. Among these, 48 patients (22%) maintained balanced glucose levels (2 g/l). Positive glycosuria was observed in 54% of the patients, whereas 46% demonstrated normal glycosuria. An analysis of urinary parameters revealed that 15% of the patients had abnormal Ketone Bodies. Normal HbA1c levels (9%) HbA1c levels. Hematological assessments indicated significant variation: 56% of the patients had low hemoglobin levels, 4% suffered from hyper-eosinophilia, and 1% each from hyper-basophilia and hyper-hemoglobinemia. The anemic profile was characterized as mild anemia in 75%, moderate anemia in 20%, and severe anemia in 5%. Furthermore, 25% of patients were affected by Microcytic anemia and 75% by Normocytic anemia. Demographically, women constituted 65% of the study group compared to 35% of men. The most represented age bracket was 41 to 60 years, accounting for 52% of the patients, while those between 61 and 80 years comprised 36%. Every district in Kindia was impacted by diabetes.

A Case of Euglycemic Diabetic Ketoacidosis in Patient with Type 2 DM

Diabetic ketoacidosis (DKA) can cause significant morbidity and mortality in patient with both type 1 and type 2 diabetes mellitus. A subset of DKA cases termed euglycemic diabetic ketoacidosis (EDKA) is characterized by euglycemic (<200 mg/dl), high anion gap metabolic acidosis, and increased plasma ketone concentration. This clinical syndrome is primary related to a general state of starvation, resulting in the development of ketosis while maintaining normoglycemia. It can lead to severe complication, such as extreme dehydration, altered mental status and coma. Early recognition and treatment are essential to avoid this life-threatening complication. EDKA represents approximately 2.6% to 3.2% of total DKA admissions, making it a rare condition. In this case report, a male patient was diagnosed with type 2 DM, 1 week prior to his symptoms and admission in hospital. Despite normal glucose levels at the time of presentation to the ED, he displayed severe acidemia and ketonemia, and was diagnosed with EDKA.

An inherent acceleratory effect of insulin on small intestinal transit and its pharmacological characterization in normal mice

AIM： To study an inherent effect of insulin on small intestinal transit and to explore involvement of various systems/mechanisms in normal mice. METHODS： Insulin at the doses of 2 μU/kg, 2 mU/kg, 2 U/kg or vehicle was subcutaneously administered to four groups of overnight fasted normal male mice. Blood glucose （BG） levels were measured 2 min before insulin administration and 2 min before sacrificing the animals for the measurement of small intestinal transit （SIT）. Charcoal meal was administered （0.3 mL） intragastrically 20 min after insulin administration and animals were sacrificed after 20 min and SIT was determined. For exploration of the various mechanisms involved in insulin-induced effect on SIT, the dose of insulin which can produce a significant acceleration of SIT without altering BG levels was determined. The following drugs, atropine （1 mg/kg）, clonidine （0.1 mg/kg）, ondansetron （1 mg/kg）, naloxone （5 mg/kg）, verapamil （8 mg/kg） and glibenclamide （10 mg/kg）, were administered intravenously 10 min prior to the administration of insulin （2 μU/kg）. RESULTS： The lower doses of insulin （2 μU/kg and 2 mU/kg） produced a significant acceleration of SIT from 52.0% to 70.7% and 73.5% without lowering blood glucose levels （P〈0.01）, while the highest dose of insulin （2 U/kg） produced a fall in blood glucose levels which was also associated with significant acceleration of SIT （P〈0.01）. After pretreatment of insulin （2 μU/kg） group with atropine, insulin could reverse 50% of the inhibition produced by atropine. In clonidine-pretreated group, insulin administration could reverse only 37% of the inhibition produced by clonidine and inhibition of SIT was significant compared with vehicle ＋ insulintreated group, i.e. from 74.7% to 27.7% （P〈0.01）. In ondansetron-pretreated group, insulin administration could produce only mild acceleration of SIT （23.5%）. In naloxone-pretreated group, insulin administration could significantly reverse the inhibition of SIT produced by naloxone when compared with naloxoneperse group, i.e. from 32.3% to 53.9% （P〈0.01）. In verapamil-pretreated group, insulin administration could only partially reverse the inhibition （65%）. In glibenclamide-pretreated group, insulin administration produced further acceleration of SIT （12.2%）. CONCLUSION： Insulin inherently possesses an acceleratory effect on SIT in normal mice. Adrenergic and cholinergic systems can play a significant role. Calcium channels and opioidergic system can play a supportive role; in addition, enhancement of endogenous insulin release can augment the effect of exogenously administered insulin on SIT.

Improved performance of naringenin herbosomes over naringenin in streptozotocin- induced diabetic rats: In vitro and in vivo evaluation

Objective:To prepare naringenin herbosome and evaluate its antidiabetic activity.Methods:Herbosomes were prepared by the solvent evaporation method.In vitro parameters like particle size,polydispersity index,zeta potential,and entrapment efficiency were estimated and in vitro diffusion study was performed.The in vivo studies were also performed in streptozotocin-induced diabetic male Sprague Dawley rats to evaluate blood glucose,total cholesterol,triglyceride,blood urea nitrogen,total protein,albumin level,aspartate aminotransferase,and alanine aminotransferase levels.Results:The optimized herbosome batch showed a particle size of 564.4 nm,a polydispersity index of 0.412,and zeta potential of−39.3 mV.The percentage entrapment of this formulation was 84.04%,with complete drug release within 8 h.Treatment of diabetic rats with naringenin herbosomes for 28 d significantly reduced the elevated level of plasma glucose as compared to plain naringenin.In biochemical parameters,the treatment showed a significant decrease in total cholesterol,triglyceride,and blood urea nitrogen;while elevated levels of aspartate aminotransferase and alanine aminotransferase were returned to normal.Pure naringenin and herbosome formulation at high dose increased the total protein whereas albumin level significantly increased in naringenin herbosomes at the highest dose but not in the pure naringenin treatment group.Conclusions:Naringenin herbosomes could improve the metabolic profile of diabetic rats,indicating enhanced antidiabetic activity of herbosome formulation.

Effects of 95%ethanol extract of Aquilaria sinensis leaves on hyperglycemia in diabetic db/db mice

The leaves of Aquilaria sinensis（Lour.） Gilg have been used in folk medicine for the treatment of diabetes in Guangdong Province,China.In this study,effects of ethanol extract of Aquilaria sinensis leaves on hyperglycemia were investigated in diabetic db/db mice.After 4 weeks of administration,the 95%ethanol（EtOH） extract of Aquilaria sinensis leaves （AE）,especially at high dose level（600 mg/kg）,activated AMP-activated protein kinase（AMPK）,resulting in reduced fasting blood glucose and glycosylated hemoglobin levels in db/db mice.In addition,the oral glucose tolerance test（OGTT test） showed that AE could remarkably improve insulin resistance.Compared to Thiazolinediones（TZDs）,no weight gain was observed after AE administration,which is a severe side effect of TZDs.The data suggested that AE could act as an activator of AMPK,and might be used as an alternative to TZDs in the management of obesity-related diabetes.

Cesarean Section Rate in Singleton Primiparae and Related Factors in Beijing, China

Background： The cesarean section rate （CSR） bas been a main concern worldwide. The present study aimed to investigate the CSR in Beijing, China, and to analyze the related lactors of CS delivery. Methods： An observational study was conducted in 15 medical centers in Beijing using a systemic cluster sampling naethod. In total, 15, 194 pregnancies were enrolled in the study between ,lune 20, 2013 and November 30, 2013. Independent t-tests and Pearson＇s Chi-square test were nsed to examine differences between two groups, and related factors of the CSR were examined by multivariable logistic regression. Results： The CSR was 41.9% （4471/10,671） in singleton primiparae. Women who were more than 35 years old had a 7.4-fold increased risk of CS delivery compared with women 〈25 years old （odd ratio [OR] 7.388, 95% confidence interval [Cl] = 5.561-9.816, P 〈 0.001 ）. Prepregnancy obese women had a 2-1bid increased risk of CS delivery compared with prepregnancy normal weight women （OR = 2.058. 95% CI = 1.640-2.584, P〈 0.001 ）. The excessive weight gain group had a 1.4-fold increased risk of CS delivery compared with the adequate weight gain group （OR 1.422, 95% CI = 1.289 1.568, P〈 0.001 ）. Gestational diabetes mellitus （GDM） women and DM women had an increased risk of CS delivery （ 1.2- and 1.7-fold, respectively） compared with normal blood glucose women. Women who were born in rural areas had a lower risk of CS delivery than did those who were born in urban areas （OR 0.696, 95% CI = 0.625-0.775, P 〈 0.001 ）. The risk of CS delivery gradually increased with a decreasing education level. Neonates weighing 3000-3499 g had the lowest CSR （36.2%）. Neonates weighing 〈2500 g had a 2-fold increased risk of CS delivery compared with neonates weighing 3000 3499 g （OR - 2.020, 95% CI=1.537 2.656, P 〈 0.001 ）. Neonates weighing ≥4500 g had an 8.3-fold increased risk of CS delivery compared with neonates weighing 3000-3499 g （OR = 8.313.95% CI= 4.436-15.579, P 〈 0.001）. Conclusions： Maternal age, prepregnancy body mass index, geslational weight gain, blood glncose levels, residence, education level, and singleton fetal birth weight arc all factors that might significantly affect the CSR.