Average Glucose Research Articles

Prevalence of Dyslipidemia among Type 2 Diabetes Mellitus Patient in Combined Military Hospital, Sylhet

Introduction: Diabetes mellitus is a group of metabolic disorders that are caused by deficiency of insulin secretion or decreased ability of insulin to act effectively on target tissues, particularly muscle, liver and fat. Diabetes is associated with high risk of cardiovascular diseases and underlying lipid abnormalities. Its early identification can make aggressive cardiovascular preventive management possible. Objectives: To determine the prevalence and pattern of lipid abnormalities in type 2 diabetes mellitus. Methods: A Retrospective, descriptive cross-sectional study was conducted in Combined Military Hospital, Sylhet, Bangladesh over a period of 2 years from January 2018 to December 2019. Diagnosed patients of type 2 diabetes mellitus of different age group and both sex were selected for this study according to inclusion and exclusion criteria. The lipid profiles and fasting blood sugar values of 85 known diabetics were studied. Their serum samples were assessed for fasting blood glucose (FBG), total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) by using standard biochemical methods. Results: Present study comprised of 85 diagnosed patients of type 2 diabetes mellitus. Out of those 78.8% were male and 21.2% were female. The age range was from 26 to 85 years with an average of 50.4±13.9 years. The average fasting blood glucose was noted as 10.787±4.2053mmol/l. The average total cholesterol, triglycerides, LDL and HDL were 194.35±177.07mg/dl, 226.18±115.19mg/dl, 91.08±26.79mg/dl and 39.75±9.51 mg/dl respectively. The prevalence of dyslipidemia in the present study was found as 81.2%, 14.1% were having hypercholesterolemia, 65.88% patients were having hypertriglyceridemia, 25.88% patients were having increased LDL levels and 43.52% patients were having reduced HDL levels. In respect of pattern of dyslipidemia, we found isolated and combined dyslipidemia. Conclusion: In the diabetics higher frequencies of high TC, high TG and high LDL-C levels were noted indicating diabetic patients were more prone for dyslipidemia which may lead to cardiovascular disorders. JAFMC Bangladesh. Vol 18, No 2 (December) 2022: 3-6

Associations between avocado intake and measures of glucose and insulin homeostasis in Hispanic individuals with and without type 2 diabetes: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Background and AimsTo investigate associations between avocado intake and glycemia in adults with Hispanic/Latino ancestry. Methods and ResultsThe associations of avocado intake with measures of insulin and glucose homeostasis were evaluated in a cross-sectional analysis of up to 14,591 Hispanic/Latino adults, using measures of: average glucose levels (hemoglobin A1c; HbA1c), fasting glucose and insulin, glucose and insulin levels after an oral glucose tolerance test (OGTT), and calculated measures of insulin resistance (HOMA-IR, and HOMA-%β), and insulinogenic index. Associations were assessed using multivariable linear regression models, which controlled for sociodemographic factors and health behaviors, and which were stratified by dysglycemia status.In those with normoglycemia, avocado intake was associated with a higher insulinogenic index (β = 0.17 ± 0.07, P = 0.02). In those with T2D (treated and untreated), avocado intake was associated with lower hemoglobin A1c (HbA1c; β = −0.36 ± 0.21, P = 0.02), and lower fasting glucose (β = −0.27 ± 0.12, P = 0.02). In the those with untreated T2D, avocado intake was additionally associated with HOMA-%β (β = 0.39 ± 0.19, P = 0.04), higher insulin values 2-h after an oral glucose load (β = 0.62 ± 0.23, P = 0.01), and a higher insulinogenic index (β = 0.42 ± 0.18, P = 0.02). No associations were observed in participants with prediabetes. ConclusionsWe observed an association of avocado intake with better glucose/insulin homeostasis, especially in those with T2D.

Effect of Streptozocin on the Langerhans Islands in the pancreas of birds

In the current study, birds (Columba livia ) were used as a new model to study the effect of streptozotocin on the pancreas gland and the blood glucose level. Three concentrations of 75,65,55 mg/kg were adopted for five consecutive days with one IP dose daily. The experimental animals showed a gradual rise in blood glucose the average glucose in the first week of the experiment was usual for the three groups compared with the control group, while there was a significant change in the blood glucose level in the three groups at the end of the experiment (4th week), where the average glucose in the streptozotocin groups was 55 mg/kg (213.80 ± 12.43) mg/dl and the group 65 mg/kg(282.60 ± 16.78) mg/dl and a group of 75 mg/kg( 371.0 ± 38.39) mg/dl. Keywords: Streptozocin, Langerhans islands, pancreas.

Correlation between blood glucose level and poor wound healing after posterior lumbar interbody fusion in patients with type 2 diabetes.

To investigate the correlation of blood glucose level with poor wound healing (PWH) after posterior lumbar interbody fusion (PLIF) in patients with type 2 diabetes (T2D). From January 2016 to January 2023, a case-control study was conducted to analyse the clinical data of 400 patients with T2D who were treated by PLIF and internal fixation at our hospital. The following data were recorded: gender; age; body mass index (BMI); surgical stage; average perioperative blood glucose level; perioperative blood glucose variance; perioperative blood glucose coefficient of variation; glycated haemoglobin level; preoperative levels of total protein, albumin and haemoglobin; postoperative levels of total protein, albumin and haemoglobin; surgical time; intraoperative bleeding volume; operator; postoperative drainage volume; and postoperative drainage tube removal time of each group. The indicators for monitoring blood glucose variability (GV) included the SD of blood glucose level (SDBG), coefficient of variation (CV) and maximum amplitude of variation (LAGE) before and after surgery. According to the diagnostic criteria for PWH, patients with postoperative PWH were determined and assigned to two groups: Group A (good wound healing group; n = 330 patients) and Group B (poor wound healing group; n = 70 patients). The preoperative and postoperative blood GV indicators, namely SDBG, CV and LAGE, were compared between these two groups. We also determined the relationship between perioperative blood GV parameters and PWH after PLIF surgery and its predictive value through correlation analysis and receiver-operating characteristic curve. Of the 400 enrolled patients, 70 patients had PWH. Univariate analysis revealed significant differences between the two groups in the course of diabetes, mean fasting blood glucose (MFBG), SDBG, CV, LAGE, preoperative hypoglycaemic program, surgical segment, postoperative drainage time, incision length and other factors (p < 0.05). However, no significant differences were noted in factors such as gender, age, body mass index, hypertension, coronary heart disease, admission fasting blood glucose, preoperative haemoglobin A1c, surgical time, intraoperative bleeding volume, intraoperative blood transfusion volume and postoperative drainage volume (p > 0.05). The area under the curve (AUC) values of preoperative SDBG, CV and LAGE were 0.6657, 0.6432 and 0.6584, respectively. The cut-off values were 1.13 mmol/L, 6.97% and 0.75 mmol/L, respectively. The AUC values for postoperative SDBG, CV and LAGE were 0.5885, 0.6255 and 0.6261, respectively. The cut-off values were 1.94 mmol/L, 24.32% and 2.75 mmol/L, respectively. The multivariate ridge regression analysis showed that preoperative MFBG, SDBG, CV and LAGE; postoperative SDBG, CV and LAGE; postoperative long drainage time; and multiple surgical segments were independent risk factors for T2D patients to develop surgical site infection after PLIF (p < 0.05). The perioperative blood GV in patients with T2D is closely related to the occurrence of PWH after PLIF. Reducing blood GV may help to reduce the occurrence of PWH after PLIF.

Physicochemical Properties and Sensory Qualities of Wine Produced from Galigiuan (Paratrophis glabra) Fruit

The study used a rather underutilized “galigiuan” [Paratrophis glabra (Merr.) Steenis] fruits inthe production of wine beverages using a research development process and descriptive method.It aims to determine the physicochemical properties using Bruker Alpha FT-IR SpectrometerWine Analyzer and evaluate the sensory qualities of the wine product in terms of appearance,aroma, taste, texture/finish, and general acceptability using consumer rating test through a 4- and7-point hedonic scale. Physicochemical analysis showed that galigiuan wine is within standards forfruit wine as to acetic acid (0.41 g/L), alcohol (10.24%), citric acid (3.09 g/L), density (1), fructose(5.44 g/L), glycerol (10.08 g/L), lactic acid (0.31 g/L), pH (3.67), saccharose (1.60 g/L), and totalsugar (7.30 g/L) but less in total acid (2.55 g/L) based on the overall average. The average valuesfor glucose, tartaric acid, and malic acids were negative. The wine product had good appearance,aroma, taste, texture/finish, and acceptability as fruit wine comparable to that of Bignay wine.Utilizing Paratrophis glabra fruits in wine production could minimize the wastage of its fruitsduring its peak fruiting season and can be an alternative source of wine beverage and livelihood.

Efficacy and safety of closed-loop control system for type one diabetes in adolescents a meta analysis

This meta-analysis compares the efficacy and safety of Closed-Loop Control (CLC) to Sensor-Augmented Insulin Pump (SAP) for adolescent patients with Type 1 Diabetes Mellitus (T1DM). Eleven randomized-controlled trials were included with a total of 570 patients, from a total of 869 articles found adhering to PRISMA guidelines. The efficacy of the therapies were evaluated from the day, night and during physical activities monitoring of the of the mean blood glucose (BG), Time In Range (TIR), and Standard Deviation (SD) of the glucose variability. The safety measure of the therapies, was assessed from the day and night recording of the hypoglycemic and hyperglycemic events occurred. Pooled results of comparison of mean BG values for day, night and physical activities, − 4.33 [− 6.70, − 1.96] (P = 0.0003), − 16.61 [− 31.68, − 1.54] (P = 0.03) and − 8.27 [− 19.52, 2.99] (P = 0.15). The monitoring for day, night and physical activities for TIR − 13.18 [− 19.18, − 7.17] (P < 0.0001), − 15.36 [− 26.81, − 3.92] (P = 0.009) and − 7.39 [− 17.65, 2.87] (P = 0.16). The day and night results of SD of glucose variability was − 0.40 [− 0.79, − 0.00] (P = 0.05) and − 0.86 [− 2.67, 0.95] (P = 0.35). These values shows the superiority of CLC system in terms of efficacy. The safety evaluation, of the day, night and physical activities observations of average blood glucose goal hypoglycemic events − 0.54 [− 1.86, 0.79] (P = 0.43), 0.04 [− 0.20, 0.27] (P = 0.77) and 0.00 [− 0.25, 0.25] (P = 1.00) and hyperglycemic events − 0.04 [− 0.20, 0.27] (P = 0.77), − 7.11 [− 12.77, − 1.45] (P = 0.01) and − 0.00 [− 0.10, 0.10] (P = 0.97), highlights the commendable safety factor of CLC. The CLC systems can be considered as an ideal preference in the management of adolescents with type 1 diabetes to be used during a 24 h basis.

Bi-weekly Glycated Albumin Measurement was Useful to Encourage Behavioral Changes in People with Type2 Diabetes Mellitus.

HemoglobinA1c (HbA1c), representing the average blood glucose over 1-2months, is the most commonly used glycemic marker in people with diabetes. Glycated albumin (GA) reflects the average blood glucose over the most recent 1-2weeks. We considered whether the faster response of GA compared with HbA1c could make people with diabetes realize their glycemic control intuitively and effectively. We randomized 61 people with diabetes into the control and intervention groups. Blood samples were collected from both every fortnight over an 8-week period (five times; visit1-5). Only the intervention group was notified of the GA levels on the same day. At the beginning and end of the study, International Physical Activity Questionnaire and Eating Behavior Questionnaire assessments, and body composition measurements were conducted. The body weight change was significantly lower in the intervention group at visit2 and visit5. The percent body fat change was lower, while the percent skeletal muscle mass change at visit5 was higher in the intervention group. Increasing GA trend was observed in the control group, but not in the intervention group. The fasting plasma glucose and HbA1c changes at visit5 were similar in the two groups. Physical activity level change tended to be higher in the intervention group. The YN Eating Behavior Questionnaire score changes were similar in the two groups. Bi-weekly GA measurement over an 8-week period in people with type2 diabetes induced behavioral changes. Development of this method is expected to improve diabetes management. UMIN000037795.

Whole Blood-based Transcriptional Risk Score for Nonobese Type 2 Diabetes Predicts Dynamic Changes in Glucose Metabolism.

The performance of peripheral blood transcriptional markers in evaluating risk of type 2 diabetes (T2D) with normal body mass index (BMI) is unknown. We developed a whole blood-based transcriptional risk score (wb-TRS) for nonobese T2D and assessed its contributions on disease risk and dynamic changes in glucose metabolism. Using a community-based cohort with blood transcriptome data, we developed the wb-TRS in 1105 participants aged ≥40 years who maintained a normal BMI for up to 10 years, and we validated the wb-TRS in an external dataset. Potential biological significance was explored. The wb-TRS included 144 gene transcripts. Compared to the lowest tertile, wb-TRS in tertile 3 was associated with 8.91-fold (95% CI, 3.53-22.5) higher risk and each 1-unit increment was associated with 2.63-fold (95% CI, 1.87-3.68) higher risk of nonobese T2D. Furthermore, baseline wb-TRS significantly associated with dynamic changes in average, daytime, nighttime, and 24-hour glucose, HbA1c values, and area under the curve of glucose measured by continuous glucose monitoring over 6 months of intervention. The wb-TRS improved the prediction performance for nonobese T2D, combined with fasting glucose, triglycerides, and demographic and anthropometric parameters. Multi-contrast gene set enrichment (Mitch) analysis implicated oxidative phosphorylation, mTORC1 signaling, and cholesterol metabolism involved in nonobese T2D pathogenesis. A whole blood-based nonobese T2D-associated transcriptional risk score was validated to predict dynamic changes in glucose metabolism. These findings suggested several biological pathways involved in the pathogenesis of nonobese T2D.

The effects of early time restricted eating plus daily caloric restriction compared to daily caloric restriction alone on continuous glucose levels.

The median eating duration in the U.S. is 14.75h, spread throughout the period of wakefulness and ending before sleep. Food intake at an inappropriate circadian time may lead to adverse metabolic outcomes. Emerging literature suggests that time restricted eating (TRE) may improve glucose tolerance and insulin sensitivity. The aim was to compare 24-h glucose profiles and insulin sensitivity in participants after completing 12weeks of a behavioral weight loss intervention based on early TRE plus daily caloric restriction (E-TRE+DCR) or DCR alone. Eighty-one adults with overweight or obesity (age 18-50years, BMI 25-45kg/m2) were randomized to either E-TRE+DCR or DCR alone. Each participant wore a continuous glucose monitor (CGM) for 7days and insulin sensitivity was estimated using the homeostatic model assessment of insulin resistance (HOMA-IR) at Baseline and Week 12. Changes in CGM-derived measures and HOMA-IR from Baseline to Week 12 were assessed within and between groups using random intercept mixed models. Forty-four participants had valid CGM data at both time points, while 38 had valid glucose, insulin, HOMA-IR, and hemoglobin A1c (A1c) data at both timepoints. There were no significant differences in sex, age, BMI, or the percentage of participants with prediabetes between the groups (28% female, age 39.2±6.9years, BMI 33.8±5.7kg/m2, 16% with prediabetes). After adjusting for weight, there were no between-group differences in changes in overall average sensor glucose, standard deviation of glucose levels, the coefficient of variation of glucose levels, daytime or nighttime average sensor glucose, fasting glucose, insulin, HOMA-IR, or A1c. However, mean amplitude of glycemic excursions changed differently over time between the two groups, with a greater reduction found in the DCR as compared to E-TRE+DCR (p=0.03). There were no major differences between E-TRE+DCR and DCR groups in continuous glucose profiles or insulin sensitivity 12weeks after the intervention. Because the study sample included participants with normal baseline mean glucose profiles and insulin sensitivity, the ability to detect changes in these outcomes may have been limited.

CORRELATION OF WATER QUALITY FACTORS AND STOCK DENSITY TO GLUCOSE AND CORTISOL LEVELS IN CANTANG GROUPER (EPINEPHELUS FUSCOGUTTATUS X EPINEPHELUS LANCEOLATUS) RAISED IN CONVENTIONAL PONDS

The purpose of this study was to find a correlation between density and water quality with glucose and cortisol levels in Cantang grouper (Epinephelus fuscoguttatus x Epinephelus lanceolatus) reared in ponds as an indicator of stress. This study uses a time series sampling method in its implementation. There were 10 Cantang grouper samples taken in this study per pond with sizes ranging from 20-30 cm. Fish samples were taken from 3 different ponds so that a total of 30 cantang grouper samples were found, while 1.5 L of water samples were taken from each pond. The results of measuring glucose levels showed that the highest average glucose levels in fish blood were obtained in pond number 6 (51.22 ± 14.9 mg dl-1) while the lowest was in pool number 5 (40.95 ± 15.2 mg dl-1). Similar to glucose levels, the results of blood cortisol measurements showed that the highest average cortisol levels in fish blood were obtained in pond number 6 (116.45 ± 5.49 ng ml-1) while the lowest was in pool number 5 (112.64 ± 4.55 ng ml-1). Based on the results of the regression analysis between the variables of water quality factors and stocking density on glucose levels (Figure 1), an R-value of 0.729 is obtained, which means that there is a 72.9% relationship between the variables of water quality factors and stocking density on glucose (moderate relationship). While the results of the regression analysis between the variables of water quality factors and stocking density on cortisol levels (Figure 2), an R-value of 0.722 was obtained, which means that there is a 72.2% relationship between the variables of water quality factors and stocking density on cortisol (moderate relationship). According to this research study, water quality factors that had a significant effect (p&gt;0.05) on glucose levels in Cantang grouper were Temperature, DO, Salinity and Ammonia.

Kombucha tea as an anti-hyperglycemic agent in humans with diabetes - a randomized controlled pilot investigation.

Kombucha is a popular fermented tea that has attracted considerable attention due, in part, to its suggested health benefits. Previous results from animal models led us to hypothesize kombucha may reduce blood sugar levels in humans with diabetes. The objective of this pilot clinical study was to evaluate kombucha for its anti-hyperglycemic activities in adults with diabetes mellitus type II. The study was organized as a prospective randomized double-blinded crossover study at a single-center urban hospital system. Participants (n = 12) were instructed to consume either a kombucha product or a placebo control (each 240 mL) for 4 weeks. After an 8-week washout period, participants consumed the alternate product. Fasting blood glucose levels were self-determined at baseline and at 1 and 4 weeks during each treatment period. Secondary health outcomes, including overall health, insulin requirement, gut health, skin health, mental health, and vulvovaginal health were measured by questionnaire at the same time points. The kombucha microbiota was assessed by selective culturing and 16S rRNA gene (bacteria) and ITS (fungi) sequencing. Fermentation end products were assessed by HPLC. Statistical significance of changes in fasting blood glucose was determined using paired, two-tailed student's t-tests. Kombucha lowered average fasting blood glucose levels at 4 weeks compared to baseline (164 vs. 116 mg/dL, p = 0.035), whereas the placebo did not (162 vs. 141 mg/dL, p = 0.078). The kombucha microbiota, as assessed by cultural enumeration, was mainly comprised of lactic acid bacteria, acetic acid bacteria, and yeast, with each group present at about 106 colony forming units (CFU)/mL. Likewise, 16S rRNA gene sequencing confirmed that lactic acid and acetic acid bacteria were the most abundant bacteria, and ITS sequencing showed Dekkera was the most abundant yeast. The primary fermentation end products were lactic and acetic acids, both less than 1%. Ethanol was present at 1.5%. Although this pilot study was limited by a small sample size, kombucha was associated with reduced blood glucose levels in humans with diabetes. Larger follow-up studies are warranted. ClinicalTrials.gov, identifier NCT04107207.

The Effectiveness of Continuous Glucose Monitoring Devices in Managing Uncontrolled Diabetes Mellitus: A Retrospective Study.

This retrospective study aimed to assess the effectiveness of continuous glucose monitoring (CGM) devices in managing uncontrolled diabetes mellitus (DM). The study cohort comprised 25 patients with uncontrolled diabetes who received treatment at an internal medicine resident clinic. The objective was to evaluate the impact of transitioning from self-monitoring of blood glucose (SMBG) to CGM devices on glycemic control, as measured by changes in hemoglobin A1c (HbA1c) levels, average blood glucose levels, hypoglycemic events, time spent within the target blood sugar range, and glucose variability. The findings indicated significant improvements in glycemic control with the adoption of CGM devices, highlighting their potential benefits for optimizing diabetes management. The study is particularly interesting because it was done in an internal medicine continuity clinic with the main participation of the internal medicine residents under the supervision of an endocrinologist. It was not done as the majority of the other studies used CGM in specialized endocrinology clinics.

Relationship between HbA1c with Hypoglycaemic Attack and Diabetic Complications of Patients Admitted in a Tertiary Hospital

Background: Hypoglycemia is a major complication of diabetes mellitus and common causes of admission in hospital. Those who have long duration of diabetes having poor glycemic control, frequently experienced such events were self treated at home. The present study pointed to identify whether hemoglobin A1c (HbA1c) a marker of average plasma glucose, relates with severe hypoglycemia and diabetic complications or not.&#x0D; Materials and methods: A retrospective observational study was conducted in the Department of Medicine, Maa-Shishu-O-General Hospital, Agrabad, Chattogram from April 2019 to September 2021. Total 36 patients were selected, as presenting in Medicine Department with documented hypoglycaemia. All data was taken meeting exclusion criteria and analysed.&#x0D; Results: Hypoglycaemic episodes mostly occurred in elder cases (&gt;61 year of ages) n=16, 44% and HbA1c mostly belongs to between 7.6 to 8 groups. Confusion is the most common presentation, N=63, 63.9%. Neuropathy was found as common complication, (30.6% , n=11) cases and most of the neuropathy found in HbA1c 7.6 to 8.5 groups 54.54% , n=6 . Most of the patients were taking sulfonylurea group of drugs 47.2% , n=17, and mixed acting insulin n=21 ,58.3%.&#x0D; Conclusion: Hypoglycemic admission is not related to extensive Diabetic control rather with related to elder patients , various Diabetic complications and injudicious use of ant diabetic agents.&#x0D; Chatt Maa Shi Hosp Med Coll J; Vol.22 (1); January 2023; Page 44-47

Efficacy of Fixed-dose Combination of Dapagliflozin and Sitagliptin in Type 2 Diabetes Mellitus Using Continuous Glucose Monitoring: A Real-world Study in India

Background: Type 2 diabetes mellitus (T2DM) is a progressive disease with multifactorial aetiology. Metformin monotherapy is commonly used as the initial treatment, but is often inadequate in achieving optimal glycaemic control, necessitating the need of second and third-line therapies. Fixed dose combination (FDC) of dapagliflozin and sitagliptin in Indian setting is gaining popularity. Time-in-target has become a useful blood glucose indicator that goes "beyond HbA1c" to understand glycaemic control in people with diabetes better. Aims and Objectives: To assess the efficacy of a FDC of dapagliflozin and sitagliptin in Indian T2DM patients. Materials and Methods: This was a single-arm, single-centre, real-world study. Twenty-eight consented T2DM patients age &gt;18 years, either sex, not hospitalized, and estimated glomerular filtration rate &gt;60 ml/min/1.73m2 were administered a continuous glucose monitoring system (CGMS) (Freestyle Libre Pro). Once daily fixed-dose combination (FDC) of dapagliflozin (10mg) and sitagliptin (100mg) was given along with CGMS administration on a background of existing therapy for those who were not to target for glycemic parameters. Since the FDC reaches at its peak concentration after 3-4 days of administration, the efficacy of FDC was considered from 5th day. Hence the baseline was calculated taking the mean of first 4 days after FDC administration. Patients' characteristics, including age (years), sex, weight (kg), body mass index (kg/m2), estimated glycated haemoglobin (%), history of oral hypoglycaemic agents, and dose of insulin were recorded. For efficacy assessment, average daily glucose (ADG), time in target (TIT), time below target (TBT), and time above target (TAT) were recorded at baseline.) and end of the study (day 15th of CGMS administration) from the daily glucose summary of Freestyle Libre Pro CGMS. The percentage improvement of each efficacy parameters were assessed. Results: A statistically significant improvement (p&lt;0.05) in ADG (19.41% decrease), TIT (34.47% increase), and TAT (31.13% decrease) was observed, whereas TBT was increased by 29.23%. Mean age (n=28), weight (n=23), body mass index (n=19) and estimated HbA1c (n=19) was 56.70±9.8 years, 64.67±9.52 Kg, 24.99±4.23 Kg/m2 and 6.84±1.63 % respectively. The majority were on triple drug (n=14; 50%) therapy before CGMS administration than dual (n=5; 17.9%) and monotherapy (2; 7.1%). Fifteen (53.8%) were on insulin with a mean insulin dose of 16.40 IU. Conclusion: Once daily FDC of dapagliflozin and sitagliptin in Indian T2DM patients significantly improves AGD, TIT, and TAT at the end of 15 days.

Oral Manifestations of Type II Diabetes Mellitus and Comparison of Blood and Salivary Glucose Levels.

Background and introduction Diabetes mellitus is a common systemic disease in nearly all countries. Its prevalence has been increasing. Thus, early detection and control of this disorder are urgent tasks. The average blood glucose, salivary glucose, and glycosylated hemoglobin (HbA1c) levels must be estimated. Aim and objective This study aimed to assess oral manifestations of type 2 diabetes mellitus in relation to HbA1c and compare glucose levels in the saliva and blood. Materials and methods This study examined 60 patients with diabetes who were visiting the Departmentof Oral Medicine and Radiology as well as the DepartmentofMedicineat Vinayaka Mission's Sankarachariyar Dental College,Salem, Tamil Nadu, India. In all patients, the blood glucose, saliva glucose, and HbA1c levels were estimated. Results and statisticalanalysis The patients (aged 40-60 years) have type 2 diabetes mellitus; among them, patients aged 56-60 years were predominant. In the Pearson correlation analysis, a positive correlation was obtained in random blood glucose, salivary glucose, and HbA1c levels. The p-value was 0.001**, which indicated significance. Conclusion This study revealed a clear-cut correlation between blood and salivary glucose levels. Thus, salivary glucose levels can very well become a substitute for blood glucose levels. If the estimated salivary glucose level is used in practice to estimate glucose levels in patients with diabetes, the use of any invasive procedures may be avoided.

Associations between glucagon prescribing, hospital admissions for hypoglycaemia and continuous glucose monitoring metrics in adults with type 1 diabetes

AimsTo assess features associated with glucagon prescribing and hospital admissions with hypoglycaemia in type one diabetes. MethodsObservational study of 4462 adults. Outcome measures were features associated with glucagon prescriptions and predictors of hospital admissions with hypoglycaemia and high levels of glucagon prescribing. Results74 % did not collect any glucagon prescriptions and 2.7 % collected >6 over 3.5 years. Hospital admission with hypoglycaemia (P = 0.032), impaired awareness (P = 0.049) and female sex (P < 0.001) were associated with glucagon collection. More frequent prescribing of glucagon was associated with diabetes duration (P < 0.001) and socioeconomic deprivation (P < 0.001). Higher average glucose (P = 0.047), higher time above 13.9 mM (P = 0.008) and higher SD (P = 0.002) were associated with glucagon prescribing. Diabetes duration (P < 0.001) and HbA1c (P < 0.001) were higher in people with hospitalised hypoglycaemia. Higher time above 13.9 mM (P = 0.004) and SD glucose (P < 0.001) were most clearly associated with hospitalised hypoglycaemia. ConclusionsA minority of people with type 1 diabetes have access to glucagon suggesting more could be done to better target this treatment. Individuals with risk factors and those with frequent glucagon prescriptions should be identified for interventions known to reduce hypoglycaemia.

Relationship between the level of anti-diabetic medication adherence and fasting blood glucose levels among patients with type II diabetes mellitus at RSUD Subang

Background: Diabetes mellitus is known as the "mother of all diseases" because of the many complications it causes. One effort that can be made to reduce these complications is to control blood glucose levels by maintaining adherence to medication. Purpose: To analysis relationship between anti-diabetic medication adherence and fasting blood glucose level in patients with type II diabetes mellitus. Method: This cross-sectional studied was conducted on 69 patients with type II diabetes mellitus who were recruited used a purposive sampling technique at RSUD Kabupaten Subang. Data collection on adherence anti-diabetic medication was carried out used MMAS-8 and Easy Touch GCU was used to collect data fasting blood sugar levels. The collected data were analyzed used the Spearman's rho test. Result: The findings of this study showed that the average level of adherence to taking anti-diabetic medication was 4.56 and the average fasting blood glucose level in type II diabetes mellitus patients was 176.13 mg/dL. This study founded that there is a relationship between the level of adherence to taking anti-diabetic medication and fasting blood glucose level in patients with type II diabetes mellitus (p &lt;0.001) with a positive correlation coefficient, the greater the medication adherence score, the more normal the fasting blood glucose level, Conclusion: Medication adherence has significantly a relationship with fasting blood glucose level in patients with type II diabetes mellitus. Findings suggest that it is important to adhere to anti-diabetic medication for patients with type 2 diabetes, as it potentially enables patients to deal with their diabetes journey and requires further research.

Temporal changes in bio-behavioral and glycemic outcomes following a produce prescription program among predominantly Hispanic/Latino adults with or at risk of type 2 diabetes

In the United States (U.S.), consumption of fresh vegetables and fruits is below recommended levels. Enhancing access to nutritious food through food prescriptions has been recognized as a promising approach to combat diet-related illnesses. However, the effectiveness of this strategy at a large scale remains untested, particularly in marginalized communities where food insecurity rates and the prevalence of health conditions such as type 2 diabetes (T2D) are higher compared to the background population. This study evaluated the impact of a produce prescription program for predominantly Hispanic/Latino adults living with or at risk of T2D. A total of 303 participants enrolled in a 3-month observational cohort received 21 medically prescribed portions/week of fresh produce. A subgroup of 189 participants used continuous glucose monitoring (CGM) to assess the relationship between CGM profile changes and HbA1c level changes.For 247 participants completing the study (76% female, 84% Hispanic/Latino, 32% with T2D, age 56·6 ± 11·9 years), there was a reduction in weight (−1·1 [-1·6 to −0·6] lbs., p < 0.001), waist circumference (−0·4 [-1·0 to 0·6] cm, p = 0·007) and systolic blood pressure (SBP) for participants with baseline SBP >120 mmHg (−4·2 [-6·8 to −1·8] mmHg, p = 0·001). For participants with an HbA1c ≥ 7·0% at baseline, HbA1c fell significantly (−0·5 [-0·9 to −0·1] %, p = 0·01). There were also improvements in food security (p < 0·0001), self-reported ratings of sleep, mood, pain (all p < 0·001), and measures of depression (p < 0·0001), anxiety (p = 0·045), and stress (p = 0·002) (DASS-21). There was significant correlation (r = 0·8, p = 0·001) between HbA1c change and the change in average glucose for participants with worsening HbA1c, but not for participants with an improvement in HbA1c.In conclusion, medical prescription of fresh produce is associated with significant improvements in cardio-metabolic and psycho-social risk factors for Hispanic/Latino adults with or at risk of T2D.

Impact of xylan on field productivity and wood saccharification properties in aspen.

Xylan that comprises roughly 25% of hardwood biomass is undesirable in biorefinery applications involving saccharification and fermentation. Efforts to reduce xylan levels have therefore been made in many species, usually resulting in improved saccharification. However, such modified plants have not yet been tested under field conditions. Here we evaluate the field performance of transgenic hybrid aspen lines with reduced xylan levels and assess their usefulness as short-rotation feedstocks for biorefineries. Three types of transgenic lines were tested in four-year field tests with RNAi constructs targeting either Populus GT43 clades B and C (GT43BC) corresponding to Arabidopsis clades IRX9 and IRX14, respectively, involved in xylan backbone biosynthesis, GATL1.1 corresponding to AtGALT1 involved in xylan reducing end sequence biosynthesis, or ASPR1 encoding an atypical aspartate protease. Their productivity, wood quality traits, and saccharification efficiency were analyzed. The only lines differing significantly from the wild type with respect to growth and biotic stress resistance were the ASPR1 lines, whose stems were roughly 10% shorter and narrower and leaves showed increased arthropod damage. GT43BC lines exhibited no growth advantage in the field despite their superior growth in greenhouse experiments. Wood from the ASPR1 and GT43BC lines had slightly reduced density due to thinner cell walls and, in the case of ASPR1, larger cell diameters. The xylan was less extractable by alkali but more hydrolysable by acid, had increased glucuronosylation, and its content was reduced in all three types of transgenic lines. The hemicellulose size distribution in the GALT1.1 and ASPR1 lines was skewed towards higher molecular mass compared to the wild type. These results provide experimental evidence that GATL1.1 functions in xylan biosynthesis and suggest that ASPR1 may regulate this process. In saccharification without pretreatment, lines of all three constructs provided 8-11% higher average glucose yields than wild-type plants. In saccharification with acid pretreatment, the GT43BC construct provided a 10% yield increase on average. The best transgenic lines of each construct are thus predicted to modestly outperform the wild type in terms of glucose yields per hectare. The field evaluation of transgenic xylan-reduced aspen represents an important step towards more productive feedstocks for biorefineries.

The Relationship between Acute-to-Chronic Glycemic Ratio and SYNTAX Score in Diabetic Patients Presenting with Acute Coronary Syndrome.

A new index called the acute-to-chronic (A/C) glycemic ratio has been proposed to better represent the true acute glycemic rise in people with acute disease. However, there has been no previous study investigating the relationship between A/C glycemic ratio and SYNTAX score in patients with diabetic acute coronary syndrome (ACS). The aim of this study is to evaluate the role of A/C glycemic ratio in predicting coronary artery disease severity and SYNTAX score in diabetic patients presenting with ACS. The study included 131 consecutive patients hospitalized for ACS in our hospital, previously diagnosed with diabetes and undergoing percutaneous coronary intervention. The relationship between A/C glycemic ratio and SYNTAX score calculated at the time of admission was determined in univariate and multivariate linear regression analyses. The sample size was divided into three parts (T1, T2, and T3) according to the admission blood glucose (ABG)/estimated average glucose (eAG) ratio. When ABG/eAG and SYNTAX scores were compared, there was no significant difference between the T1 and T2 groups, but a significant increase was found in the T3 group compared with the other two groups (T1: 14.26, T2: 14.77, T3: 24.41; p < 0.001). When multivariate modeling was performed with the two or three most relevant variables (age, estimated glomerular filtration rate [eGFR], and ABG/eAG ratio), the upper tertile of the ABG/eAG variable was correlated with the severity of coronary atherosclerosis and higher SYNTAX score. This study shows that there is a significant relationship between higher ABG/eAG ratio and higher SYNTAX score in diabetic patients presenting with ACS.