Prediabetes and atrial fibrillation risk stratification,phenotyping,and possible reversal to normoglycemia

Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables.The shared pathophysiology between these three serious but common diseases and their association with atherosclerotic cardiovascular risk factors establish a vicious circle culminating in high atherogenicity.Because of that,it is of paramount importance to perform risk stratification of patients with prediabetes to define phenotypes that benefit from various interventions.Furthermore,stress hyperglycemia assessment of hospitalized patients and consensus on the definition of prediabetes is vital.The roles lifestyle and metformin play in prediabetes are well established.However,the role of glucagon-like peptide agonists and metabolic surgery is less clear.Prediabetes is considered an intermediate between normoglycemia and diabetes along the blood glucose continuum.One billion people are expected to suffer from prediabetes by the year 2045.Therefore,realworld randomized controlled trials to assess major adverse cardiac or cerebrovascular event risk reduction and reversal/prevention of type 2 diabetes among patients are needed to determine the proper interventions.

Chemo-profiling of eucalyptus and study of its hypoglycemic potential

Constant escalations in the number of diabetics worldwide and the failure of conventional therapy to restore normoglycemia without adverse effects,in spite of tremendous strides in modern medicine,calls for naturopathy and alternative medicine.Because diabetes is multi-factorial and has secondary complications,prevention of hyperglycemia is the central dogma for its management.To date,no oral hypoglycemic exists which can achieve tight glycemic control without side effects.Dietary adjuncts,lifestyle interventions and a resurgence of interest in phyto-therapy have consequently gained ground.Natural hypoglycemics have attracted attention due to ease of incorporation in everyday diet,affordability,less adverse effects,and long term safety.Ethno botanical literature reports more than 800 anti-diabetic plants species.Eucalyptus is well represented in the Aboriginal Pharmacopoeias for its various pharmacological activities.Its hot aqueous decoction has been used as a hypoglycemic in various regions of world.This editorial attempts to summarize the data on the hypoglycemic potential of the different eucalyptus species,highlight the value of its natural biomolecules for the prophylaxis and treatment of type2 diabetes,describe their mechanistic actions,shed light on the posology and safety aspects of eucalyptusand assess its applicability as a reinforcement to currently used therapy.

Mathematical Model for the Dynamics of Glucose, Insulin and β-Cell Mass under the Effect of Trauma, Excitement and Stress

In this work, we presented a mathematical model for the dynamics of glucose, insulin and beta-cell mass under the influence of trauma, excitement and/or stress, the model is an improvement on the work by?[1]. We defined and incorporated a parameter??to represent the effectiveness of epinephrine in suppressing insulin secretion and a parameter?Ge?representing epinephrine induced glucose increase as the factors that affect glucose and insulin homeostasis. The model which consists of a system of three nonlinear ordinary differential equations was used to investigate the effect of epinephrine on glucose, insulin and beta-cell mass dynamics. The result of the study showed that;In the presence of epinephrine, the blood glucose increased and the blood insulin decreased due to suppression by the hormone, despite the fact that there is an increase in beta-cell mass the system remained extremely hyperglycemic. Furthermore, the result of the numerical experiment carried out indicated that frequent epinephrine secretion into the blood induced prolong and extreme hyperglycemia. Frequent epinephrine secretion increases the risk of diabetes in humans. In view of the findings of this study, we recommend that there should be massive and continuous health education, especially for communities living in the areas where the stated agents (trauma, excitement and stress) of epinephrine secretion are common.

高胰岛素-正常血糖水平控制策略在重症患者中应用的可行性

目的评价高胰岛素-正常血糖水平控制策略在重症患者中应用的可行性。方法将2020年1月-2021年10月廊坊市第四人民医院急诊重症监护室发生应激性高血糖的重症患者随机分为试验组和对照组,试验组采用高胰岛素-正常血糖水平控制策略,对照组采用传统血糖控制策略,比较两组治疗过程中平均血糖水平、血糖变异性(用血糖标准差反映)、血糖达标率、严重低血糖发生率、异常高血糖发生率等指标,从安全性和有效性2个方面评价高胰岛素-正常血糖水平控制策略在重症患者中应用的可行性。非正态分布的计量资料以中位数(下四分位数,上四分位数)表示。结果共纳入80例患者,每组40例。与对照组相比,试验组平均血糖水平[6.00(5.74,6.70)vs.9.51(8.74,10.01)mmol/L,P<0.001]、血糖标准差[1.58(1.11,2.15)vs.2.20(1.21,2.76)mmol/L,P=0.028]和血糖不稳定指数[175.52(100.51,346.69)vs.408.51(205.56,651.91)mmol^(2)/(L^(2)·h·d),P<0.001]均更低。试验组血糖达标率为77.34%,而对照组仅为5.33%,差异有统计学意义(P<0.001)。两组均未发生严重低血糖,试验组异常高血糖发生率低于对照组(5.08%vs.36.16%,P<0.001)。结论高胰岛素-正常血糖水平控制策略可以稳定血糖水平,降低血糖波动,实现良好的血糖控制,在重症患者中应用安全有效,可能成为重症患者血糖管理的新模式。