Abnormal Blood Glucose Research Articles

Transient hyperglycemia, impaired glucose tolerance and gestational diabetes mellitus (GDM) in preterm pregnant women receiving antenatal steroids

OBJECTIVE:To determine the frequency of transient hyperglycemia, impaired glucose tolerance and gestational diabetes mellitus(GDM) in preterm pregnant women receiving antenatal steroids.
 METHODOLOGY:This descriptive cross-sectional study was carried out in Maternal and Child Health Center unit 1 (MCH-1) at Pakistan Institute of Medical Sciences Islamabad Pakistan from January 2017 till August 2017. A total of 365 pregnant women presenting to emergency and outpatient department with preterm labor (alive morphologically normal babies), with preterm premature rupture of membranes (PPROM) and other conditions which require early delivery including preeclampsia, IUGR requiring preterm delivery, severe oligohydramnios, antepartum hemorrhage(APH), women receiving two doses dexamethasone and all those with BSR>126mg/dl were included in the study. Multiple pregnancies, advanced preterm labor (cervix > 5cm dilated), gestational diabetes mellitus (GDM) or type I/II diabetes mellitus (DM), chorioamnionitis and taking any medication that affects glucose metabolism were excluded from the study. After ethical approval, informed consent was taken from study participants. Blood sugar levels before the commencement of 1st dose of dexamethasone were noted. Blood sugar profile (fasting, 2 hours after lunch, 2 hours after dinner) were carried out. 2nd dose of dexamethasone was given after 12 hours of 1st dose. Profile was carried out till euglycemia or 5 days if sugars remain deranged. Patients having deranged levels for greater than 5 days were advised 75 g oral glucose tolerance test(OGTT) and labelled as having impaired glucose tolerance or gestational diabetes mellitus.
 RESULTS: In our study, 57.57%(n=213) were between 18-30 years, 42.43%(n=157) were between 31-40 years of age, mean age was calculated as 28.92+5.54 while mean gestational age was 31.19+1.92 weeks. Frequency of transient hyperglycemia, impaired glucose tolerance and gestational diabetes mellitus(GDM) in preterm pregnant women receiving antenatal steroids revealed 62.16%(n=230) had transient hyperglycemia, 9.46%(n=35) had impaired glucose tolerance, 2.16%(n=8) had gestational diabetes and 26.22%(n=97) had no blood glucose abnormality.
 
 CONCLUSION: We concluded that the frequency of abnormal glucose levels increases in preterm pregnant women receiving antenatal steroids. Therefore, single blood sugar level done routinely before dexamethasone therapy are insufficient to judge the glucose metabolic status and should be closely monitored during the use of antenatal corticosteroids.
 KEYWORDS:
 Preterm delivery, antenatal steroids, transient hyperglycemia, impaired glucose tolerance and gestational diabetes mellitus(GDM)

Transcriptomics study of coronary slow flow disease and verification of differentially expressed genes

Objective: To determine the differentially expressed genes between patients with coronary slow flow (SCF) and healthy controls, as well as to define the signal pathways and protein interactions related to the pathogenesis of the disease. Methods: A total of 43 hospitalized SCF patients in the year of 2018 and 43 healthy subjects, who underwent health checkup in the same year, were enrolled in this study. General data were obtained, blood samples were collected to determine the related indicators of glucose metabolism, lipid metabolism and kidney metabolism. RNA was extracted from blood monocytes, and the differential gene expression profiles were investigated by RNA-Seq. GO function annotation, KEGG pathway enrichment, protein interaction network analysis (PPI) and phenotype analysis were performed. The levels of related cytokines were detected by ELISA, and qPCR was used to verify differentially expressed genes of the two groups. Results: In the SCF group, there were 27 (62.79%) males and 16 females (37.21%), the average age was (54.3±8.8) years. In the control group, there were 29 males (67.44%) and 14 females (31.56%), the average age was (57.2±8.3) years. The percent of smoking history, abnormal fasting blood glucose, abnormal blood lipid levels and body mass index were significantly higher in the SCF group than in the control group (all P<0.01). There were 117 differentially expressed genes between SCF patients and healthy controls, of which 73 were up-regulated and 44 were down-regulated. Biological function analysis of the differentially expressed genes showed that these genes were mainly related to antigen processing and presentation, cell phagocytosis, immunoglobulin, intestinal immune network, Th1 and Th2 cell differentiation and Th17 cell differentiation pathways. The expression levels of inflammatory cytokines IL-6, IL-10, tumor necrosis factor-α and interferon-γ were significantly higher in SCF patients than in healthy controls (all P<0.05). Among the top 12 genes with the most significant differences between the two groups, qPCR analysis indicated consistent results with the transcriptome results in 11 out of 12 genes. PPI analysis showed that FPR2 and THBS3 proteins were at the core of the entire protein interaction network. Conclusion: Genes such as FPR2 and THBS3 may play important roles in the pathogenesis of SCF through immune-related pathways such as antigen processing and presentation and Th17 cell differentiation.

Investigation on influencing factors of blood indexes of interventional radiology workers

Objective: To analyze the influencing factors of blood indicators indexes of interventional radiology workers, and provide a theoretical basis for radiological occupational health monitoring, radiation protection monitoring and risk assessment. Methods: In March 2020, a total of 500 interventional radiology workers (interventional group) and 200 non-interventional radiology workers (control group) who underwent an occupational health examination in Liaoning Center for Disease Control and Prevention from 2018 to 2019 were selected as the subjects. The general information, occupation related information, blood routine, fasting blood glucose and thyroid stimulating hormone test results of the subjects were collected. The differences in the levels and abnormal detection rates of blood indexes between the two groups were compared. And the influencing factors of blood indexes of the intervention riodiology workers were analyzed. Results: The lymphocyte count of interventional group[2.10 (1.70, 2.50) ×10(9)/L] was lower than that of control group[2.20 (1.80, 2.60) ×10(9)/L], the difference was statistically significant (P<0.05) . The white blood cell count and lymphocyte count of interventional workers in the service age≤13 years were higher than those of service age≥28 years group, and fasting blood glucose was lower than those of service age ≥28 years group (P<0.05) . The detection rate of abnormal fasting blood glucose of interventional radiology workers in the service age ≤13 years group was lower than that of the service age 14-27 years and service age ≥28 years (P<0.05) . The lymphocyte count and platelet count of interventional radiology workers in annual effective dose<0.5 mSv group was higher than that of annual effective dose≥1 mSv group (P<0.05) . The results of multi-factor linear regression analysis showed that service age, annual effective dose and female gender were the influencing factors of lymphocyte count of interventional radiology workers (b=-0.008, -0.110, -0.167, P<0.05) . Conclusion: Long-term low-dose radiation exposure had certain influence on the lymphocyte count of interventional radiology workers. Service age, annual effective dose and gender are the influencing factors of lymphocyte count in interventional radiology workers. It should be reinforced to the radiological protection monitoring and risk assessment on interventional radiology workers.

A self-powered closed-loop brain-machine-interface system for real-time detecting and rapidly adjusting blood glucose concentration

The traditional methods of detecting and adjusting blood glucose concentration, such as blood analysis and insulin injection, may delay the treatment of metabolic disease. Here, a new self-powered closed-loop brain-machine-interface system for real-time detecting and rapidly adjusting blood glucose concentration has been fabricated. The system can work without external power supply and be self-powered by the body motion itself, which can meet the requirement of immediate treatment. The system mainly consists of active blood glucose sensor, energy harvester, micro-control unit and brain stimulator. The blood glucose sensor made of enzyme/ZnO nanowire arrays can output piezoelectric voltage under the driving of body motion, and the output can be treated as the glucose-detecting signal through the biosensing-piezoelectric coupling effect. A piezoelectric ceramic device as the energy harvester can convert the body mechanical energy into electricity for powering the whole system. The micro-control unit outputs brain stimulation pulse to the dorsomedial part of the ventromedial hypothalamus (VMHdm) in the brain upon abnormal blood glucose concentration. In mouse samples, the brain stimulator connected to the VMHdm augments the expression of regulatory nerve receptors to achieve rapid increase of blood glucose concentration (39% within 10 min). Thus, a closed loop is formed among the body, brain and system. This self-powered closed-loop approach improves the accessibility of physiological insights and extends brain-machine-interface application in precision medicine for metabolic diseases.

Prevalence of Diabetes and Hypertension Among King Abdulaziz University Employees: Data From First Aid and Cardiopulmonary Resuscitation Training Program.

ObjectivesSaudi Arabia has a very high rate of chronic illnesses, especially hypertension (HTN) and diabetes. This study aimed to investigate the prevalence and control of diabetes and hypertension among employees at a university in Saudi Arabia, including the associated risk factors, and to evaluate the need for early screening among these individuals.MethodsThis retrospective study used data from the first aid training program. In total, there were 3964 employees who completed the program, and only 1000 employees were enrolled. The program was conducted at King Abdulaziz University (KAU), Jeddah, Saudi Arabia. Blood pressure (BP), random blood sugar, and body mass index (BMI) were measured in all employees. Descriptive data, including mean, standard deviation (SD), crosstab, chi-square, and linear regression, were analyzed. Categorical variables were described using frequencies and percentages.ResultsThe prevalence of hypertension and diabetes was 31% and 5%. There were 365 males and 635 females. Employees with risk factors such as gender, age, and body mass index had significant effects on having high blood pressure and random blood glucose measurements. Of the employees who reported being free from chronic diseases, 2.9% had abnormal random blood glucose readings (prediabetic and diabetic ranges), while 37.4% had abnormal blood pressure readings (prehypertensive and hypertensive ranges).ConclusionThe high prevalence of hypertension and diabetes reflects the crucial role of early screening in diabetes and hypertension protocols and raising awareness regarding protocol implementation in Saudi Arabia to improve quality of life (QoL) at the individual and community levels.

The Factors Correlated With the Blood Pressure Control Among the Elderly Hypertension in Hangzhou

Abstract Background To evaluate the effectiveness of community health management of elderly hypertension, and to describe the status and related risk factors of blood pressure control. Methods This was a cross-sectional study. Hypertensive patients aged 60 years and above who took part in community health management in Hangzhou were selected. Data on lifestyle, obesity, blood lipids, fasting plasma glucose, and blood pressure were collected. Systolic blood pressure ≥140 and/or diastolic blood pressure ≥90 mm Hg were used to calculate the blood pressure control rate. Results There were 209,768 subjects with mean age (70.7 ± 7.1) years in the present study. The mean value of systolic and diastolic blood pressures was (141.4 ± 16.9) and (80.2 ± 10.0) mm Hg, respectively. The blood pressure control rate was 48.39%. The rate of the subjects with unhealthy lifestyles, obesity (or central obesity), dyslipidemia, and abnormal fasting plasma glucose was 86.27%, 38.20%, 58.16%, and 14.72%, respectively. The unhealthy lifestyle, obesity, abnormal fasting plasma glucose, and dyslipidemia, affected blood pressure control rate, with an odds ratio (95% confidence interval) of 1.18 (1.15–1.21), 1.23 (1.21–1.25), 1.44 (1.40–1.48), and 1.10 (1.09–1.11), respectively. When 4 risk factors were combined, odds ratio (95% confidence interval) was 1.96 (95% confidence interval 1.83–2.09) for poor blood pressure control. Overall, the percentage of isolated systolic hypertension was 34.87% and increased with age. Conclusions The blood pressure control rate of the elderly hypertension patients in the community health management by national essential public health service was 48.39%. Obesity, unhealthy lifestyle, abnormal fasting blood glucose, and dyslipidemia are risk factors of poor blood pressure control and have cumulative effects.

Factors associated with destination of pediatric EMS transports.

Pediatric patients comprise 13% of emergency medical services (EMS) transports, and most are transported to general emergency departments (ED). EMS transport destination policies may guide when to transport patients to a children's hospital, especially for medical complaints. Factors that influence EMS providers 'decisions about where to transport children are unknown. Our objective was to evaluate the factors associated with pediatric EMS transports to children's hospitals for medical complaints. We performed a cross-sectional study of a large, urban EMS system over a 12-month period for all transports of patients 0-17years old. We electronically queried the EMS database for demographic data, medical presentation and management, comorbidities, and documented reasons for choosing destination. Distances to the destination hospital and nearest children's and community hospital (if not the transport destination) were calculated. Univariate and multiple logistic regression analyses were conducted to determine the association between independent variables and the transport destination. We identified 10,065 patients, of which 6982 (69%) were for medical complaints. Of these medical complaints, 3518 (50.4%) were transported to a children's hospital ED. Factors associated with transport to a children's hospital include ALS transport, greater transport distance, protocol determination, developmental delay, or altered consciousness. Factors associated with transport to general EDs were older age, unknown insurance status, lower income, greater distance to children's or community hospital, destination determined by closest facility or diversion, abnormal respiratory rate or blood glucose, psychiatric primary impression, or communication barriers present. We found that younger patient age, EMS protocol requirements, and paramedic scene response may influence pediatric patient transport to both children's and community hospitals. Socioeconomic factors, ED proximity, diversion status, respiratory rate, chief complaints, and communication barriers may also be contributing factors. Further studies are needed to determine the generalizability of these findings to other EMS systems.

Lipid and Lipoprotein Profile in HIV-Infected and Non-Infected Diabetic Patients: A Comparative Cross-Sectional Study Design, Southwest Ethiopia.

BackgroundLipoproteins are complexes of lipids and proteins that are essential for the transport of cholesterol, triglycerides, and fat-soluble vitamins. The linkage between chronic diseases like diabetes mellitus and HIV infection increases the complication of the diseases and worsens the clinical outcome of the patients.PurposeTo assess and compare lipid and lipoprotein profiles among HIV-infected and non-infected diabetic patients, and to identify independent predictor variables for abnormal lipid and lipoprotein profiles.Patients and MethodsA comparative cross-sectional study design was used to carry out the research, and a convenient sampling technique was used to include 96 adult diabetic patients (48 HIV-infected and 48 non-infected diabetics). Socio-demographic and clinical data were collected by interviewer-administered questionnaire. Five milliliter blood sample was collected and processed for lipid and lipoprotein profile measurement. Multivariate and bivariate logistic regressions were used to identify independent predictor variables for abnormal lipid and lipoprotein profiles.ResultsThe prevalence of diabetic dyslipidemia was 41.7% and 37.5% in HIV-infected and non-infected diabetic patients, respectively. Hypercholesterolemia was more commonly detected among HIV-infected diabetic patients than non-HIV-infected, 25.0% versus 18.8%, respectively. Similarly, hypertriglyceridemia was more commonly observed in HIV-infected (31.3%) than non-infected diabetic patients (20.8%). About 25.0% HIV-infected diabetic patients had combined hyperlipidemia (hypercholesterolemia plus hypertriglyceridemia); and about 4.2% had hypoalphalipoproteinemia or isolated low HDL-C. Being female and long duration of diabetes mellitus were independent predictor variables for abnormal lipid and lipoprotein profiles in HIV-infected patients. Similarly, being female and high blood pressure were independent predictor variables in non-HIV-infected diabetic patients.ConclusionHigh prevalence lipid and lipoprotein abnormalities were detected in HIV-infected diabetic patients even though the abnormalities were also common in non-HIV co-morbid diabetic patients. Hence, proactive screening and treatment of blood glucose, lipid, and lipoprotein abnormalities are critically important and should be part of comprehensive HIV care.

Continuous glucose monitoring systems for monitoring cystic fibrosis-related diabetes.

Cystic fibrosis(CF) is one of the most common life-shortening autosomal-recessive genetic conditions with around 100,000 people affected globally. CF mainly affects the respiratory system, but cystic fibrosis-related diabetes(CFRD) is a common extrapulmonary co-morbidity and causes excess morbidity and mortality in this population. Continuous glucose monitoring systems(CGMS) are a relatively new technology and, as yet, the impact of these on the monitoring and subsequent management of CFRD remains undetermined. To establish the impact of insulin therapy guided by continuous glucose monitoring compared to insulin therapy guided by other forms of glucose data collection on the lives of people with CFRD. We searched the Cochrane Cystic Fibrosis Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. Date of latest search: 23 September 2021. We also searched the reference lists of relevant articles and reviews and online trials registries.Date of last search: 23 September 2021. Randomised controlled studies comparing insulin regimens led bydata from CGMS (including real-time or retrospective data, orboth) with insulin regimens guided by abnormal blood glucose measurements collected through other means of glycaemic data collection in people with CFRD. Studies with a cross-over design, even with a washout period between intervention arms, are not eligible for inclusion due to the potential long-term impact of each of the interventions and the potential to compromise the outcomes of the second intervention. No studies were included in the review, meaning that no data were available to be collected for analysis. Review authors screened 14 studies at the full-text stage against the review'sinclusion criteria. Consequently, seven were excluded due to the study type being ineligible (not randomised), two studies were excluded due to their cross-over design, and two studies was excluded since theintervention used was not eligible and one was a literature review. One study in participants hospitalised for a pulmonary exacerbation is ongoing. Investigators are comparing insulin dosing via insulin pump with blood sugar monitoring by a CGMS to conventional diabetes management with daily insulin injections (or on an insulin pump if already on an insulin pump in the outpatient setting) and capillary blood glucose monitoring. The participants in the control arm will wear a blinded continuous glucose monitoring system for outcome assessment. In addition to this, one further study is still awaiting classification, and will be screened to determine whether it is eligible for inclusion, or is to be excluded, in an update of this review. No studies were included in the review, indicating that there is currently insufficient evidence to determine the impact of insulin therapy guided by CGMS compared to insulin therapy guided by other forms of glucose data collection on the lives of people with CFRD, nor on potential adverse effects of continuous glucose monitoring in this context. Randomised controlled studies are needed to generate evidence on the efficacy and safety of continuous glucose monitoring in people with CFRD. There is one relevant ongoing study that may be eligible for inclusion in a future update of this Cochrane Review, and whose results may help answer the review question.

Effect of sakuranin on carbohydrate-metabolizing enzyme activity modifications in streptozotocin-nicotinamide-induced diabetic wistar rats

This study is to assess the glucose lowering activity of sakuranin in diabetes induced rats by streptozotocin (STZ) and nicotinamide (NA). Diabetic rats were treated sakuranin for 45 days (20, 40, 80 mg/kg) by orally. Sakuranin (80 mg/kg body weight) was normalized the changes of abnormal blood glucose plasma glucose and plasma insulin levels. Hence, we have continued the further research with this active dose of 80 mg/kg sakuranin. The plasma glucose and glycosylated hemoglobin (HbA1c) reduced and insulin, glycogen and hemoglobin levels increased by Sakuranin administration in diabetic rats. Additionally, hexokinase and glucose-6-phophate dehydrogenase activities increased and glucose-6-phosphatase and fructose-1,6-bisphosphatase activities decreased in diabetic condition while administration of treated compound. In this observed result signified that sakuranin may have potential role of diabetic condition rats by evidenced with reducing glucose and increasing insulin and also protect the carbohydrate metabolic changes.

Children's Neurological Status Epilepticus and Poor Prognostic Factors through Electroencephalogram Image under Composite Domain Analysis Algorithm.

This study aimed to analyze the application of composite domain analysis algorithm for electroencephalogram (EEG) images of children with epilepsy and to investigate the risk factors related to poor prognosis. 70 children with neurological epilepsy admitted to the hospital were selected as the research objects. Besides, the EEG of the children during the intermittent and seizure phases of epilepsy were collected, so as to establish a composite domain analysis algorithm model. Then, the model was applied in EEG analysis. The clinical disease type and prognosis of children were statistically analyzed, and the risk factors that affected the prognosis of children were investigated. The results showed that the EEG signal values of the detail coefficients (d51 and d52) and the approximate coefficient (c5) during the epileptic seizure period were higher markedly than the signal values of the epileptic intermittent period; the EEG signal of the epileptic intermittent period was a transient waveform, which appeared as sharp waves or spikes. The EEG signal of epileptic seizures was continuous, with a composite waveform of sharp waves and spikes, and the change amplitude of the wavelet envelope spectrum during epileptic seizures was also higher hugely than that of intermittent epilepsy. The accurate identification rate, specificity, and sensitivity of EEG analysis with the composite domain algorithm were higher than those without the algorithm. Among the five types of epileptic seizures in children, the proportion of systemic tonic-clonic status was the largest, and the proportion of myoclonic status was equal to that of complex partial epileptic status, both of which were relatively small. The proportion of children with a better prognosis was 75.71% (53/70), which was higher than those with a poor prognosis 24.29% (17/70). Abnormal imaging examination (odds ratio (OR) = 3.823 and 95% confidence interval (CI) = 1.643–8.897); seizure duration greater than 1 hour (OR = 1.855 and 95% CI = 1.076–3.199); C-reactive protein (CRP) (OR = 5.089 and 95% CI = 1.507–17.187); and abnormal blood glucose (OR = 3.077, 95%CI = 1.640–5.773) were all independent risk factors for poor prognosis (all P < 0.05). The composite domain analysis algorithm was helpful for clinicians to find the difference in the EEG signals between the epileptic seizure period and the epileptic intermittent period in a short time, thereby improving the doctor's analysis of the results, which could reflect its marked superiority. In addition, abnormal imaging examinations, convulsion duration greater than 1 hour, CRP, and abnormal blood glucose were independent risk factors for poor prognosis in children. Therefore, the invasion of related risk factors could be reduced clinically by prognostic review with medical advice, attention to food safety and hygiene, and improvement of children's immunity.

Current Evidence Relating Oral Health and Diabetes Mellitus

Diabetes mellitus is a systemic disease characterized by increased blood glucose levels and abnormalities of lipid metabolism due to deficiency of insulin or insulin resistance. Being a systemic disease, diabetes affects most body parts, which in case of oral health can lead to periodontitis.

Abnormal expression of CD44 aggravates liver disease progression in patients with non-alcoholic fatty liver disease accompanied with hepatitis B virus replication

Objective: To analyze the expression of CD44 in non-alcoholic fatty liver disease (NAFLD) accompanied with hepatitis B virus (HBV) infection and its clinical significance. Methods: Blood sample of hospitalized patients with NAFLD, chronic hepatitis B, cirrhosis, and healthy population (control) was collected. The study was approved by the hospital ethics committee. Serum CD44 level and clinopathological characteristics were analyzed quantitatively by enzyme-linked immunosorbent-assay. Flow cytometry was used to analyze the proportion of CD44(+)T lymphocytes in patients with NAFLD and chronic hepatitis B. NAFLD model was prepared with high-fat diet to verify the abnormal expression of CD44. Results: Compared with the healthy control group, the expression of serum CD44 in the cirrhosis group, chronic hepatitis B group and NAFLD group was increased, and the difference between the groups were statistically significant (P < 0.01). NAFLD patients graded as mild or severe group were equally accompanied by hepatocyte injury, abnormal blood glucose, lipid or CD44. In NAFLD patients accompanied with HBV infection, serum CD44 concentrations were significantly higher in HBsAg, HBeAg and HBV DNA positive group than HBsAg, HBeAg and HBV DNA negative group (P < 0.01). The proportion of CD44(+)T lymphocytes in peripheral blood of NAFLD and chronic hepatitis B group were 78.2% ± 16.3% and 68.5% ± 20.9%, respectively, and both groups (NAFLD and chronic hepatitis B) were significantly higher than the healthy control group (46.5% ± 20.5%) (P < 0.05). The high-fat diet model confirmed that in rat liver tissues the CD44 was overexpressed with fat deposition accompanied with liver cell damage, especially remarkable in liver tissues containing carcinogens. Conclusion: The abnormal expression of CD44 in patients with NAFLD may be related to the malignant transformation of HBV-related liver disease.

Self-Care Experiences of Empty-Nest Elderly Living With Type 2 Diabetes Mellitus: A Qualitative Study From China.

BackgroundThe number of type 2 diabetes mellitus (T2DM) cases among empty-nest elderly increases with increasing aging in China. Self-care plays an important role in preventing and reducing adverse outcomes of diabetes; however, few studies focus on self-care experiences of empty-nest elderly with T2DM.ObjectiveTo explore self-care experiences for a chronic disease among empty-nest elderly patients with T2DM in mainland China.MethodsA descriptive phenomenological design was used in this study. Semi-structured interviews were conducted for 15 empty-nesters with T2DM. Interviews were implemented in department of endocrinology at a tertiary teaching hospital located in Shandong province, east of China.ResultsThe participants were poorly adept with monitoring their blood glucose and lacked the ability to deal with abnormal blood glucose levels. Most participants had a good relationship with medication and physical activity. Living without children was perceived as a benefit that improved dietary management and is a disadvantage in terms of economic and emotional support and access to medical resources. Elderly empty-nesters also lacked knowledge about diabetes and paid little attention to potential complications.ConclusionEmpty-nest elderly patients with T2DM value medication compliance and lifestyle modification more than blood glucose monitoring, complication prevention, and coping with negative emotions. Friends and spouses play indispensable roles in patients’ self-care motivation and maintenance. Diabetes education on self-care, access to medical resources, and social support is needed for better diabetes management.

Lipid profile, abnormality of serum glucose levels and their associated factors in multidrug-resistant tuberculosis patients

Background: The rise of multidrug-resistant tuberculosis (MDR-TB) has become a major public health concern around the world. Most patients with pulmonary tuberculosis have low body nutrients, hypocholesterolemia, and lower values were strongly associated with mortality in these patients. Representative data on lipid profile, fasting blood glucose abnormalities and their associated factors among MDR TB patients are lacking. Objective: To determine lipid profile, fasting blood glucose abnormalities and their associated factors among multi-drug resistant TB patients during therapy with anti-MDR-TB regimen in St.peter’s Specialized Hospital Addis Ababa, Ethiopia from January to November 2020. Methods and materials: A cross-sectional study was conducted among multi-drug resistant TB patients during MDR therapy regimen in St. Peter’s Specialized Hospital in Addis Ababa, Ethiopia from January to November 2020.Using the Consecutive sampling method a total of 162 blood samples was collected in SST tubes and analyzed by using the Cobas chemistry analyzer. Data were analyzed using SPSS software version 23 packages. Simple descriptive statistics were used to present the socio-demographic and clinical characteristics of the study participants. Other associations were performed with Pearson’s correlation coefficient. A p-value of &lt;0.05 at the 95 % confidence level were considered as statistically significant in all the analyses. Results: Mean age of the study participant was 35.9 ± 13.6 years. The prevalence of diabetes was 16%. Out of those who had diabetes (9.8%) was newly diagnosed and 6.2% already knew their diabetes status.The most common serum lipid profile abnormalities were 92.6 % HDL-C and 35.8% had TG levels above the borderline. Among MDR-TB patients, 25.9% had a fasting blood glucose level that was higher than normal (hyperglycemic). Conclusion: Lipid profile abnormalities and an increased risk of diabetes have been observed in patients with multidrug-resistant tuberculosis. Factors associated with abnormal blood glucose needed attention to avoid further complications and also the finding of this research calls for the implementation of active case finding of DM in patients diagnosed for MDR-TB.

Role of Pancreatic Stellate Cell-Derived Exosomes in Pancreatic Cancer-Related Diabetes: A Novel Hypothesis.

Simple SummaryPancreatic Ductal Adenocarcinoma (PDAC) is a rapidly fatal disease. Diabetes mellitus is a major association of PDAC and is both a cause as well as a consequence of cancer. Notably, at the time of diagnosis of PDAC, more than 80% of patients have abnormal fasting blood glucose levels. Even more intriguing is the observation that a third of patients reports being diagnosed with diabetes within 3 years prior to their cancer diagnosis. This new onset diabetes, also called pancreatic cancer-related diabetes (PCRD) may be a harbinger of asymptomatic PDAC. Elucidating the mechanisms mediating PCRD will enable the identification of biomarkers for early diagnosis and/or novel molecular pathways that can be therapeutically targeted to improve patient outcomes.Pancreatic ductal adenocarcinoma (PDAC) is a devastating condition characterised by vague symptomatology and delayed diagnosis. About 30% of PDAC patients report a history of new onset diabetes, usually diagnosed within 3 years prior to the diagnosis of cancer. Thus, new onset diabetes, which is also known as pancreatic cancer-related diabetes (PCRD), could be a harbinger of PDAC. Diabetes is driven by progressive β cell loss/dysfunction and insulin resistance, two key features that are also found in PCRD. Experimental studies suggest that PDAC cell-derived exosomes carry factors that are detrimental to β cell function and insulin sensitivity. However, the role of stromal cells, particularly pancreatic stellate cells (PSCs), in the pathogenesis of PCRD is not known. PSCs are present around the earliest neoplastic lesions and around islets. Given that PSCs interact closely with cancer cells to drive cancer progression, it is possible that exosomal cargo from both cancer cells and PSCs plays a role in modulating β cell function and peripheral insulin resistance. Identification of such mediators may help elucidate the mechanisms of PCRD and aid early detection of PDAC. This paper discusses the concept of a novel role of PSCs in the pathogenesis of PCRD.

Does Participation in Sport Protect Former Saudi Arabian Athletes from High Blood Glucose after Retirement?

Introduction: The prevalence of type 2 diabetes (T2D) has increased dramatically in the last decades in developed and developing countries. In this regard, the purpose of this study is to investigate the prevalence of prediabetes and diabetes in retired athletes in Saudi Arabia and compare it to nonathletes. This study hypothesizes that early participation in sport can prevent former athletes from abnormal blood glucose levels after retirement. Methods: : The leading methods of researching the issues of the study include the analysis of theoretical sources, analysis of statistics, and comparison. Seventy-three former athletes and 26 nonathletes aged between 20 and 60 years participated in this study. Height, weight, and blood glucose levels were collected by the researcher. The former athletes were divided into 3 groups according to their type of training: endurance, mixed sports, and power sports. Results: The study results showed that 40.59% of former athletes had prediabetes compared to 16.83% of nonathletes. Furthermore, 8.91% of the former athletes had T2D, while 3.96% of the nonathletes had T2D. The results of this study indicated that former athletes had lower average blood glucose than nonathletes. Also, the study results indicated that no statistically significant differences were found between former athletes and nonathletes after retirement. About fasting blood glucose, former power athletes had higher average blood glucose than endurance athletes and mixed sports athletes. Conclusion: It was concluded that no statistically significant differences were found between the former athlete groups.

Admission Blood Glucose in the Emergency Department is Associated with Increased In-Hospital Mortality in Nontraumatic Critically Ill Patients.

Abnormal admission blood glucose was reported as a useful predictor of outcome in critically ill patients. To identify patients at higher risk, this study aimed to evaluate the relationship between admission blood glucose levels and patient mortality during the management of nontraumatic critically ill patients in the emergency department (ED). In this prospective, single-center observational study in a German university ED, all adult patients admitted to the resuscitation room of the ED were included between September 1, 2014 and August 31, 2015. Directly after resuscitation room admission, blood samples for admission blood glucose were taken, and adult patients were divided into groups according to predefined cut-offs between the admission blood glucose. Study endpoint was in-hospital mortality. During the study period, 532 patients were admitted to the resuscitation room. The data of 523 patients (98.3%) were available for analysis. The overall in-hospital mortality was 34.2%. In comparison with an in-hospital mortality of 25.2% at an admission blood glucose of 101-136 mg/dL (n=107), admission blood glucose of ≤ 100 mg/dL (n=25, odds ratio [OR] 6.30, 95% confidence interval [CI] 2.44-16.23, p < 0.001), 272-361 mg/dL (n=63, OR 2.53, 95% CI 1.31-4.90, p=0.007), and ≥ 362 mg/dL (n=44, OR 2.96, 95% CI 1.42-6.18, p=0.004) were associated with a higher mortality. Abnormal admission blood glucose is associated with a high in-hospital mortality. Admission blood glucose is an inexpensive and rapidly available laboratory parameter that may predict mortality and help to identify critically ill patients at risk in a general nontraumatic critically ill ED patient cohort. The breakpoint for in-hospital mortality may be an admission blood glucose ≤ 100 and ≥ 272 mg/dL.

Practice Patterns in the Acceptance of Medically Complex Living Kidney Donors with Obesity, Hypertension, Family History of Kidney Disease, or Donor-Recipient Age Discrepancy.

Background To assess the practice patterns of the acceptance of medically complex living kidney donors (MCLKDs). Methods We distributed a survey to nephrologists and transplant surgeons (TS) across the world through major international transplant societies. The survey contained questions regarding obesity, abnormal blood glucose profile, mild hypertension, donor-recipient age discrepancy, or family history of kidney disease of unknown etiology. Results In total, 239 respondents from 29 countries (42% were nephrologists and 58% were TS). Most respondents would allow donations from obese donors, especially if they intended to lose weight but would be cautious if these donors had abnormal blood glucose or family history of diabetes mellitus. In hypertensive donors, future pregnancy plans mattered in decisions regarding the acceptance of female donors. Most respondents would allow young donors but would be more cautious if they had a future risk of hypertension or a family history of kidney disease of unknown etiology. They would also allow donations from an older person if prolonged waiting time was anticipated. We found multiple areas of consensus of practice among the diverse members of international transplant societies, with some interesting variations among nephrologists and TS.Conclusions This survey highlights the practice patterns of the acceptance of MCLKDs among the international community. In the absence of clear guidelines, this survey provides additional information to counsel kidney donors with these conditions.

THE POSSIBLE EFFECT OF FLAXSEED EXTRACT ON LETROZOLE-INDUCED POLYCYSTIC OVARY RAT MODEL: CORRELATIVE HISTOLOGICAL AND FUNCTIONAL STUDY

Background: Polycystic Ovary Syndrome (PCOS) is one of the most common metabolic disorders affecting women in the reproductive age leading to infertility/subfertility. It may occur as a complication of Letrozole (LTZ) therapy in breast cancer patients. Objective: This was a preliminary study to assess the possible protective and/or curative effect of flaxseed extract in a letrozole-induced PCO rat model. Material and Methods: Thirty-six adult female albino rats were divided into five main groups: Group I kept as the control group, Group II (Letrozole-induced PCO group), received letrozole solution (3 mg/kg) orally once daily by gastric tube for 21 days. Group III (combined flaxseed and letrozole group), received aqueous flaxseed extract (500 mg /kg/day) orally one hour before letrozole in the same dose and duration as group II, Group IV (recovery group), received letrozole in the same dose and duration as group II and then left without treatment for the next 4 weeks after PCO induction, Group V (flaxseed-treated group), treated with aqueous flaxseed extract orally once daily for the next 4 weeks after PCO induction. At the end of the experiment, final body weight, ovarian weight, blood glucose, serum antioxidants assay, and sex hormones levels were measured. Also, specimens of ovaries were processed for light and electron microscopic studies. Histomorphometric and statistical analyses were done. Results: letrozole-induced PCO resulted in a significant increase in final body weight, ovarian weight as well as abnormal blood glucose, sex steroids hormone levels, and antioxidant assays. Moreover, numerous ovarian cystic follicles, widespread cytoplasmic vacuolation in the granulosa lutein cells, congested blood capillaries, and increased fibrosis within the ovarian medulla were evident in the PCO group in concomitant with a significant increase in area percentage of collagen fibers. The ultrastructural assessment confirmed these distortions. The protective and curative potential of flaxseed is mostly comparable revealed improvement in the final body weight, biochemical markers and histological changes, with the protective effect was more pronounced than the curative one. Conclusion and Recommendation: Flaxseed succeeded in ameliorating letrozole-induced polycystic ovary owing to its phytochemicals, antioxidant and anti-inflammatory properties with folliculogenesis potentials. So, it is recommended to use flaxseed as a co-therapy with letrozole to reduce its hyperandrogenic effects.