Average Blood Glucose Level Research Articles

The Impact of Chronic Heart Failure Treatment on Glycemic Variability in Patients without Diabetes Mellitus

Background. According to statistics, about 26 million people worldwide suffer from heart failure (HF). Currently, sodium-glucose cotransporter 2 inhibitors are widely prescribed for treatment of HF with reduced left ventricular ejec-tion fraction (LVEF) throughout the world. Therefore, prescribing drugs that have anti-hypoglycemic effect in patients without diabetes mellitus still raises some concerns, considering the possible risk of developing hypoglycemia.
 The aim. To assess the effect of dapagliflozin on glycemic variability in treatment of HF with reduced LVEF in patients without diabetes mellitus.
 Materials and methods. The study was conducted at the premises of the Department of Cardiometabolic Diseases of the Ukrainian Children’s Cardiac Center. Twenty-three patients with HF with reduced LVEF of various etiologies without diabetes mellitus were evaluated. The variability of glycemia in the study group was assessed using continuous glucose monitoring. For this, the MiniMed iPro2 continuous glucose monitoring system (Medtronic, USA) was used.
 The sensor was inserted on day 1 and removed on day 7. Average value of glycemia during the day, time in range (TIR) and time below range (TBR) were calculated on the basis of data about the level of glucose in the intercellular fluid obtained for 6 days of monitoring. Dapagliflozin 10 mg once a day was prescribed to all the patients included in the study for the treatment of HF with reduced LVEF. The average follow-up period was 7 months.
 Results. The examined patients were divided according to clinical and laboratory characteristics. Assessment of daily variability of glycemia during 6 days of observation using continuous glucose monitoring in patients on dapagliflozin revealed average blood glucose level from 4.4 mmol/L (minimum value) to 6.0 mmol/L (maximum value). These results indicate minimal risk of hypoglycemia and safety of using dapagliflozin in case of HF with reduced LVEF without concomi-tant type 2 diabetes mellitus. TIR and TBR indicators were also evaluated in patients with and without prediabetes. The obtained data allows to assert the same safety of taking dapagliflozin in both these groups, due to the fact that time of glycemia <3.9 mmol/l does not exceed the indicator of 5%.
 Conclusion. The use of dapagliflozin as part of complex therapy of HF with reduced LVEF does not elevate the risk of developing hypoglycemia in patients without diabetes mellitus.

Augmented Glycemic Gap is a Marker for Predicting the Early Neurological Outcomes in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis

Background and Purpose: Glycemic Gap (GG) as an index reflecting the acute fluctuation of glycemia, has been proved to be associated with poor functional outcomes in Acute Ischemic Stroke (AIS) patients. However, it predictive value on post-thrombolysis Early Neurological Outcomes (ENOs) are still controversial. This study aimed to use GG to evaluate the influence of pretreatment relative glucose changes on post-thrombolysis ENOs, and we further explored the predictive value of GG in different glycemic control status. Methods: Early Neurological Deterioration (END) was defined as a National Institutes of Health Stroke Scale Score (NIHSS) =4, Early Neurological Improvement (ENI) was defined as a =4-point decrease in NIHSS score or a complete resolution of neurological deficits, between the time of admission and 24 hours after intravenous recombinant tissue-type plasminogen activator (IV-rtPA). GG was calculated as Admission Blood Glucose level (ABG)- estimated average blood glucose level (eAG), eAG could be derived from HbAlc according to the equation eAG=28.7*HbAlc-46.7 Results: Increased GG was significantly associated with post-thrombolysis END and poor functional outcome at discharge (OR, 1.982; 95% CI, 1.213-3.238; P=0.006) (OR, 2.079; 95% CI, 1.305-3.312; P=0.002). Its predictive value on END was more pronounce in diabetic patients (OR, 2.434; 95% CI, 1.079-5.491; P=0.032), after dichotomizing glycemic control status, its significance was only maintained in diabetic patients with good previous glucose control (OR, 6.946; 95% CI, 1.217-39.636; P=0.029). Conclusion: An evaluated GG was associated with high risk of post-thrombolysis END and poor functional outcome at discharge in AIS patients, and the previous glucose control should be considered when predicting ENOs.

A-027 The Clinical Indications of Low or Non-reportable HbA1c Results

Abstract Background Hemoglobin A1c (HbA1c) is the major non-enzymatic glycation product of hemoglobin A (HbA) and usually measured as a percentage of total hemoglobin. It is widely used in the screening, diagnosis, and monitoring of diabetes because HbA1c correlates with the average blood glucose level over the past 8–12 weeks in patients with a normal RBC lifespan. However, many factors can cause inaccurate HbA1c measurements or invalidate this correlation. While a high HbA1c raises the concern of inadequate glycemic control, a low or non-reportable HbA1c may also indicate diverse clinical conditions or technical issues. This study analyzes the pathophysiological conditions and technical limits leading to a low or non-reportable HbA1c value and discusses the use of other lab values in HbA1c result interpretation. Methods HbA1c was measured by cation exchange HPLC (Tosoh G8, v5.24F). 37 cases with a low or non-reportable HbA1c (<4.0%) from January 1, 2022 to November 30, 2022 were reviewed. The relevant diagnoses, medical history, medications, and recent (±1 week from the HbA1c test) lab results (CBC, blood glucose, fructosamine, haptoglobin, LDH) were examined to identify the causes of low HbA1c values. The causes were grouped by pathological mechanisms or technical issues to calculate the frequency, and the association with other lab values was also explored. Results Low or non-reportable HbA1c cases accounted for 0.1% of total HbA1c tests (37/42 771), and about 30% (11/37) had been diagnosed with diabetes by the end of the review period. From the chart, 41% (15/37) cases had elevated blood glucose (>109 mg/dL), 73% (27/37) were anemic (Hb < 13.0 or 11.7 g/dL for male or female), and 46% (17/37) showed a high MCV (>96 fL). Among those cases, a minor portion was caused by method-specific technical issues (8%, 3/37) or unknown reasons (5%, 2/37). The majority (86%, 32/37) was attributed to the following mechanisms: intravascular hemolysis (51%, 19/37), hepatosplenic RBC destruction (27%, 10/37), and increased erythropoiesis (8%, 3/37). For those cases with intravascular hemolysis (51%), the causes were categorized as inherited RBC disorders (19%, 7/37, including hemoglobinopathy and G6PD deficiency), acquired hemolytic diseases (19%, 7/37, including autoimmune hemolytic anemia), and adverse effects of medications (13%, 5/37, including dapsone and hydroxychloroquine). For those cases with hepatosplenic RBC destruction (27%), most of them were caused by cirrhosis (19%, 7/37). In addition, increased erythropoiesis (8%) was observed in patients with recent hemorrhage or EPO treatment. Some hemoglobin variants like homozygous HbE resulted in non-reportable HbA1c (8%), which represented a technical limit of the HPLC method. Conclusion Although low or non-reportable HbA1c cases are rare (0.1%), a significant portion (30%) of them are diabetic patients, and their HbA1c results can be misleading. The majority of low HbA1c cases (86%) are associated with clinical conditions causing a shortened RBC lifespan, and the most common causes include inherited RBC diseases (19%), cirrhosis (19%), medication adverse effects (14%), and autoimmune diseases (11%). Because increased RBC destruction and compensatory erythropoiesis are the underlying mechanisms, hemoglobin, MCV, and markers assessing hemolytic anemia (haptoglobin, LDH, reticulocyte%) can aid in HbA1c interpretation.

Point-of-care detection of glycated hemoglobin using a novel dry chemistry-based electrochemiluminescence device

As a good biomarker to reflect the average level of blood glucose, glycated hemoglobin (HbA1c) is mainly used for long-term glycemic monitoring and risk assessment of complications in diabetic patients. Previous analysis methods for HbA1c usually require complex pretreatment processes and large-scale biochemical analyzers, which makes it difficult to realize the point-of-care testing (POCT) of HbA1c. In this work, we have proposed a three-electrode dry chemistry-based electrochemiluminescence (ECL) biosensor and its self-contained automatic ECL analyzer. In this enzymatic biosensor, fructosyl amino-caid oxidase (FAOD) reacts with the hydrolysis product of HbA1c, and the produced hydrogen peroxide further reacts with luminol under the appropriate driving voltage, generating photons to realize the quantitative detection of HbA1c. Under optimized conditions, the biosensors have a good linear response to different concentrations of fructosyl valine (FV) ranging from 0.05 to 2 mM, with a limit of detection of 2 μM. The within-batch variation is less than 15%, and the biosensors still have 78% of the initial response after the accelerated aging test of 36 h at 37 °C. Furthermore, the recoveries for different concentrations of samples in whole blood were within 92.3–99.7%. These results illustrate that the proposed method has the potential for use in POCT of HbA1c.

The effect of Cocoa Fruits (Theobroma cacao L.) extracts on serum blood glucose levels in white rats (Rattusnovergicus)

Checking blood glucose levels supports healthy lifestyle and pattern changes to avoid foods that contain high glucose, which can increase blood glucose levels. This study aims to analyze the administration of cocoa pod extract (Theobroma cacao L.) to describe serum blood glucose levels in white rats (Rattusnovergicus). This study used an RCT (randomized controlled trial) design involving five groups of cocoa pod extract samples through an evaporation process using a rotary vacuum evaporator after going through the maceration process for 3 x 24 hours divided into three concentrations of 50 mg/Kg body wt, 100 mg/Kg body wt, 150 mg/Kg body wt. Furthermore, serum blood glucose levels will be measured on the 3rd, 7th, and 14th day after administration of metformin and waste extract of cocoa pod shell (Theobroma cacao L.). Analysis of the research data used a paired t-test. The results showed that the average fasting blood glucose levels of K1 rats (Mus musculus) to the average fasting glucose levels in K2, K3, K4, and K5, respectively, were as follows: 0.037 (p <0.05); 0.000 (p < 0.05); 0.028 (p < 0.05); and 0.015 (p <0.05). This shows that the average fasting blood glucose level is significantly different (p <0.05). The average fasting blood glucose levels of K2 (metformin group) to the average glucose levels in K3 (extract group 50 mg/kg body wt), K4 (extract group 100 mg/kg body wt), and K5 (extract group 150 mg/kg body wt) respectively are as follows: 0.157 (p > 0.05); 1.000 (p > 0.05); and 0.995 (p > 0.05). This shows that the average blood glucose levels between K2, K3, K4, and K5 did not differ significantly (p <0.05) after measuring cocoa pod extract for two days. Based on the results of data analysis from this experimental study, it can be concluded that there is an effect of giving cocoa pod extract (Theobroma cacao L.) on fasting blood glucose levels of mice (Mus musculus) with type 2 diabetes mellitus hypercholesterolemia model. Keywords: Diabetes mellitus; Cacao; Blood Glucose; Rats

The sGC Activator Runcaciguat Has Kidney Protective Effects and Prevents a Decline of Kidney Function in ZSF1 Rats.

Chronic kidney disease (CKD) progression is associated with persisting oxidative stress, which impairs the NO-sGC-cGMP signaling cascade through the formation of oxidized and heme-free apo-sGC that cannot be activated by NO. Runcaciguat (BAY 1101042) is a novel, potent, and selective sGC activator that binds and activates oxidized and heme-free sGC and thereby restores NO-sGC-cGMP signaling under oxidative stress. Therefore, runcaciguat might represent a very effective treatment option for CKD/DKD. The potential kidney-protective effects of runcaciguat were investigated in ZSF1 rats as a model of CKD/DKD, characterized by hypertension, hyperglycemia, obesity, and insulin resistance. ZSF1 rats were treated daily orally for up to 12 weeks with runcaciguat (1, 3, 10 mg/kg/bid) or placebo. The study endpoints were proteinuria, kidney histopathology, plasma, urinary biomarkers of kidney damage, and gene expression profiling to gain information about relevant pathways affected by runcaciguat. Furthermore, oxidative stress was compared in the ZSF1 rat kidney with kidney samples from DKD patients. Within the duration of the 12-week treatment study, kidney function was significantly decreased in obese ZSF1 rats, indicated by a 20-fold increase in proteinuria, compared to lean ZSF1 rats. Runcaciguat dose-dependently and significantly attenuated the development of proteinuria in ZSF1 rats with reduced uPCR at the end of the study by -19%, -54%, and -70% at 1, 3, and 10 mg/kg/bid, respectively, compared to placebo treatment. Additionally, average blood glucose levels measured as HbA1C, triglycerides, and cholesterol were increased by five times, twenty times, and four times, respectively, in obese ZSF1 compared to lean rats. In obese ZSF1 rats, runcaciguat reduced HbA1c levels by -8%, -34%, and -76%, triglycerides by -42%, -55%, and -71%, and cholesterol by -16%, -17%, and -34%, at 1, 3, and 10 mg/kg/bid, respectively, compared to placebo. Concomitantly, runcaciguat also reduced kidney weights, morphological kidney damage, and urinary and plasma biomarkers of kidney damage. Beneficial effects were accompanied by changes in gene expression that indicate reduced fibrosis and inflammation and suggest improved endothelial stabilization. In summary, the sGC activator runcaciguat significantly prevented a decline in kidney function in a DKD rat model that mimics common comorbidities and conditions of oxidative stress of CKD patients. Thus, runcaciguat represents a promising treatment option for CKD patients, which is in line with recent phase 2 clinical study data, where runcaciguat showed promising efficacy in CKD patients (NCT04507061).

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.

The rs17782313 polymorphism near MC4R gene confers a high risk of obesity and hyperglycemia, while PGC1α rs8192678 polymorphism is weakly correlated with glucometabolic disorder: a systematic review and meta-analysis.

The relationships of the rs17782313 polymorphism near melanocortin 4 receptor gene (MC4R) and the rs8192678 polymorphism in peroxisome proliferator-activated receptor gamma coactivator 1 alpha gene (PGC1α) with metabolic abnormalities have been explored in many populations around the world, but the findings were not all consistent and sometimes even a bit contradictory. Electronic databases including Medline, Scopus, Embase, Web of Science, CNKI and Google Scholar were checked for studies that met the inclusion criteria. Data were carefully extracted from eligible studies. Standardized mean differences (SMDs) were calculated by using a random-effects model to examine the differences in the indexes of obesity, glucometabolic disorder and dyslipidemia between the genotypes of the rs17782313 and rs8192678 polymorphisms. Cochran's Q-statistic test and Begg's test were employed to identify heterogeneity among studies and publication bias, respectively. Fifty studies (58,716 subjects) and 51 studies (18,660 subjects) were respectively included in the pooled meta-analyses for the rs17782313 and rs8192678 polymorphisms. The C-allele carriers of the rs17782313 polymorphism had a higher average level of body mass index (SMD = 0.21 kg/m2, 95% confidence interval [95% CI] = 0.12 to 0.29 kg/m2, p < 0.001), waist circumference (SMD = 0.14cm, 95% CI = 0.06 to 0.23cm, p < 0.001) and blood glucose (SMD = 0.09 mg/dL, 95% CI = 0.02 to 0.16 mg/dL, p = 0.01) than the TT homozygotes. Regarding the rs8192678 polymorphism, no significant associations with the indexes of obesity, glucometabolic disorder and dyslipidemia were detected. However, significant correlations between the rs8192678 polymorphism and multiple glucometabolic indexes were observed in subgroup analyses stratified by sex, age, ethnicity and health status. The meta-analysis demonstrates that the C allele of the MC4R rs17782313 polymorphism confers a higher risk of obesity and hyperglycemia, and the PGC1α rs8192678 polymorphism is weakly correlated with glucometabolic disorder. These findings may partly explain the relationships between these variants and diabetes as well as cardiovascular disease. https://www.crd.york.ac.uk/prospero/, identifier CRD42022373543.

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 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.

Determining the risk factors for hyperglycemia and glucose variability after total knee arthroplasty with continuous glucose monitoring: An observational cohort study

Introduction: Periprosthetic joint infection after total knee arthroplasty (TKA) is a devastating complication and different risk factors, including hyperglycemia and increased glucose variability, have been suggested for this condition in previous literature. Our study aims to investigate the risk factors for postoperative hyperglycemia and glucose variability in patients undergoing unilateral primary TKA with continuous glucose monitoring (CGM) technology. Methods: Demographic factors, diabetic statuses, hemoglobin A1c (HbA1c) levels, and fructosamine levels of patients undergoing unilateral primary TKA were recorded preoperatively. These patients would either received 16 mg intravenous dexamethasone or no dexamethasone before their surgery as part of perioperative management. From the day of admission to postoperative day 4, CGM device monitored these patients’ blood glucose level, time of hyperglycemia, and glucose variability. Correlation and multivariate regression analysis were performed between the risk factors and the outcome measures, with multicollinearity between the predictor variables checked, to find out the most potent risk factors for postoperative hyperglycemia. Results: Eighty-three patients with primary unilateral TKA were analyzed. Diabetic, prediabetic, and nondiabetic patients were composed of 26.5%, 47.0%, and 26.5%, respectively. The average of HbA1c and fructosamine level was 6.0% and 249.3 mmol/L, respectively; 65.1% of the patients received 16 mg dexamethasone perioperatively. Multivariate regression analysis found that HbA1c, fructosamine, and dexamethasone injections are the significant risk factors for the percentage of time in hyperglycemia ( R2 = 0.374, p &lt; 0.001) and average blood glucose level ( R2 = 0.493, p &lt; 0.001), with HbA1c having the highest standardized coefficient, followed by fructosamine and dexamethasone injections. Although dexamethasone usage was significant in multivariate regression analysis on predicting glucose variability, the effect size of the model is very weak ( R2 = 0.05, p &lt; 0.05). Conclusion: The most potent risk factor for hyperglycemic time and increased average blood glucose is HbA1c level, followed by fructosamine level and dexamethasone injections. No strong correlation was found between the factors in our study and patients’ glucose variability.

Metformin and Other Sulfonylureas for Glycemic Control in Type 2 Diabetic Patients at a Tertiary Care Hospital in Jammu &amp; Kashmir

BACKGROUND&#x0D; Diabetes mellitus (DM) is a common disease that causes high blood sugar levels and a wide range of symptoms, including polydipsia, polyuria, and changes in weight. The A1C level is very important when it comes to the main treatment for diabetes. It's called the A1C level because it shows the average blood glucose level over the last two to three months. People with diabetes are treated with lifestyle changes and a combination of pharmacological agents to keep their blood sugar levels in check for a long time. The objective of this study was to evaluate the information about Metformin and other Sulfonylureas for Glycemic Control in Type 2 Diabetic Patients at a Tertiary Care Hospital in Jammu &amp; Kashmir.&#x0D; METHODS&#x0D; A 4 month-long observational study was set up with a prospective design and a convenient sampling method. From a diabetes clinic in Jammu and Kashmir, 200 people were chosen to be part of the study. People between the ages of 20 and 60 who had diabetes and were taking Metformin and Sulfonylureas were included in this study. People who had Retinopathy, Nephropathy, and Cognitive impairment were not included.&#x0D; RESULTS&#x0D; In our study, 34 percent of the people who went to the Diabetic Management Center of the hospital were men, and 66 percent were women. Out of 200 patients, 85 percent of them had time to exercise, 56 percent had diabetes because it ran in their families, and 44 percent had diabetes because of metabolic causes. Metformin was given to about 80% of the patients, and sulfonylureas were used by only 20% of the people. In a very bad situation, out of 50 people who took the survey, only 5% used insulin. HbA1C tests were ordered for 90% of the patients in the group of 200.&#x0D; CONCLUSIONS&#x0D; All over the world, people are suffering from type II diabetes. Several other metabolic disorders are linked to type II diabetes. Excessive hepatic glucose generation, peripheral insulin resistance, and impaired beta-cell secretory activity are the primary pathological abnormalities in diabetes. When it comes to glycemic control, Metformin does not raise insulin levels, but it does reduce the amount of glucose absorbed from the intestines. Sulfonylureas reduce hypoglycemia in metabolic disorders.

PENGARUH KONSUMSI MINUMAN SEGAR BUAH Etlingera hemisphaerica (MSBE) TERHADAP KADAR GLUKOSA DARAH PADA PEKERJA TAMBANG EMAS

Etlingera hemisphaerica has been used by the community for generations as medicine. E. hemisphaerica contains flavonoids, saponins, tannins which can lower blood glucose levels. This study aims to determine the effect of giving E. hemisphaerica fruit fresh drink (MSBE) on blood glucose levels. This research is a limited clinical trial with trials of measuring blood glucose levels before and after treatment. The research prospectus consisted of gold mine workers and non-workers. Data collection was carried out before and after giving MSBE for 7 days to the probandus. Based on the T test, the results obtained are t hit ˃ t tab. In 10 probandus, the average blood glucose level before treatment was 117.5 mg/dL and blood glucose level after treatment was 93.4 mg/dL. Whereas in the 5 probands of mining workers, the average blood glucose level before treatment was 133,200 mg/dL and blood glucose level after treatment was 100,400 mg/dL. In the 5 non-mining probandus, the average blood glucose level before treatment was 101,800 mg/dL and blood glucose level after treatment was 86,400 mg/dL. Based on the results of the study it was concluded that MSBE administration had the potential to reduce blood glucose levels in 10 probandus.

EE462 The Financial Impact of Closing the Diabetes Hemoglobin HBA1C Care Gap at Blue Cross and Blue Shield of Louisiana

HbA1c is the average blood glucose levels for the previous two to three months. It’s the main test to help health care teams manage patients’ diabetes. Closing the HbA1c gap in diabetes care is essential. But few studies explore the relationship between healthcare cost and HbA1c care gap closure. This study seeks to quantify the financial impact of diabetic HbA1c care gap closure on healthcare cost.

EVALUATION OF HBA1C IN THE DIAGNOSIS OF DIABETES MELLITUS

Diabetes mellitus is a prevalent metabolic disorder that requires early detection and effective management. Glycated hemoglobin (HbA1c) evaluation has emerged as a valu- able tool in diagnosing diabetes mellitus. This study evaluated 62 cases, with 21 diabetic and 41 non-diabetic, and found a significant p-value for HbA1c levels. The mean HbA1c level was 6.36, with a standard deviation of 1.90 and a variance of 3.6189. Comparative analysis showed an increased case detection rate in HbA1c testing. HbA1c testing improves accuracy and convenience of diabetes diagnosis, correlates with long-term glycemic control, and is a prognostic marker for cardiovascular risk. The study highlights the importance of incorporating HbA1c testing into clinical practice, monitoring treatment effectiveness and guiding therapeutic decisions. The findings support the growing recognition of HbA1c as a reliable diagnostic tool for diabetes mellitus, with its ability to reflect average blood glucose levels over a prolonged period. Further research is needed to explore its applicability across different populations and establish standardized guidelines for HbA1c interpretation and utilization. Keywords: Diabetes mellitus, HbA1c, Diagnostic tool, Glycemic control, Fasting, Post prandial

The Effect of Butterfly Pea Extract on Blood Glucose Levels in White Rats with Metabolic Syndrome Model

&lt;p class="AbstractNormal"&gt;&lt;strong&gt;Introduction:&lt;/strong&gt; Metabolic syndrome is an accumulation of several disorders, one of which is hyperglycemia. &lt;em&gt;Clitoria ternatea&lt;/em&gt; is a plant that contains lots of flavonoids and is known to reduce blood glucose levels in metabolic syndrome. This study aimed to determine the effect of butterfly pea extract (&lt;em&gt;Clitoria ternatea&lt;/em&gt;) on blood glucose levels in white rats with metabolic syndrome models.&lt;/p&gt;&lt;p class="AbstractNormal"&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This research is an experimental study using animal models with pre and post-test control group design method. The number of samples was 30 male white rats which were divided into 5 groups: group 1–negative control group; group 2–positive control group; group 3, group 4, and group 5 were the metabolic syndrome group which was given &lt;em&gt;Clitoria ternatea&lt;/em&gt; extract with doses of 100, 200, and 400 mg/kgBW, respectively for 28 days. Measurement of blood glucose levels for all groups was carried out on the 36&lt;sup&gt;th&lt;/sup&gt; day as the pre-test and the 64&lt;sup&gt;th&lt;/sup&gt; day as the post-test. Blood glucose levels were obtained through retroorbital venous blood which was analyzed with the Easy Touch blood glucose stick meter. One-way ANOVA was used to analyze data, followed by post-hoc LSD test, and paired T-test.&lt;/p&gt;&lt;p class="AbstractNormal"&gt;&lt;strong&gt;Results: &lt;/strong&gt;The average post-test random blood glucose levels decreased by 135.16 mg/dl, 163.18 mg/dl, and 168.35 mg/dl. There was a significant difference (p&amp;lt;0.05) between the pre-test and post-test blood glucose levels along with the average blood glucose level amongst groups.&lt;/p&gt;&lt;p class="AbstractNormal"&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Butterfly pea (&lt;em&gt;Clitoria ternatea&lt;/em&gt;) could decrease blood glucose levels and cause further decrease with higher doses.&lt;/p&gt;

Fitterfly Diabetes CGM Digital Therapeutics Program for Glycemic Control and Weight Management in People With Type 2 Diabetes Mellitus: Real-world Effectiveness Evaluation.

Digital therapeutic platforms facilitate health care through patient-centered strategies based on multidisciplinary teams and shared decision-making. Such platforms can be used for developing a dynamic model of diabetes care delivery, which can help in improving glycemic control by promoting long-term behavior changes in people with diabetes. This study aims to evaluate the real-world effectiveness of the Fitterfly Diabetes CGM digital therapeutics program for improving glycemic control in people with type 2 diabetes mellitus (T2DM) after the completion of 90 days in the program. We analyzed deidentified data of 109 participants in the Fitterfly Diabetes CGM program. This program was delivered through the Fitterfly mobile app coupled with continuous glucose monitoring (CGM) technology. This program consists of 3 phases: the first phase is observation, wherein the patient's CGM readings are observed for 7 days (week 1); the second phase is the intervention; and the third phase aims at sustaining the lifestyle modification introduced during the second phase. The primary outcome of our study was the change in the participants' hemoglobin A1c (HbA1c) levels after program completion. We also evaluated the changes in participant weight and BMI after the program, changes in the CGM metrics in the initial 2 weeks of the program, and the effects of participant engagement in the program on improving their clinical outcomes. At the end of the 90 days of the program, the mean HbA1c levels, weight, and BMI of the participants were significantly reduced by 1.2% (SD 1.6%), 2.05 (SD 2.84) kg, and 0.74 (SD 1.02) kg/m2 from baseline values of 8.4% (SD 1.7%), 74.45 (SD 14.96) kg, and 27.44 (SD 4.69) kg/m2 in week 1, respectively (P<.001). The average blood glucose levels and time above range values showed a significant mean reduction by 16.44 (SD 32.05) mg/dL and 8.7% (SD 17.1%) in week 2 from week 1 baseline values of 152.90 (SD 51.63) mg/dL and 36.7% (SD 28.4%), respectively (P<.001 for both). Time in range values significantly improved by 7.1% (SD 16.7%) from a baseline value of 57.5% (SD 25%) in week 1 (P<.001). Of all the participants, 46.9% (50/109) showed HbA1c reduction ≥1% and 38.5% (42/109) showed weight loss ≥4%. The average number of times the mobile app was opened by each participant during the program was 108.80 (SD 127.91) times. Our study shows that participants in the Fitterfly Diabetes CGM program showed a significant improvement in their glycemic control and reduction in weight and BMI. They also showed a high level of engagement with the program. Weight reduction was significantly associated with higher participant engagement with the program. Thus, this digital therapeutic program can be considered as an effective tool for improving glycemic control in people with T2DM.

Effect of Metformin Monotherapy and Combination Therapy with Glimepiride on Lipid Profile in Drug Naive Type-2 Diabetes Patients: A Prospective Observational Study

Background: Dyslipidemia is an important risk factor for development of macrovascular disease. Altered lipid metabolism and abnormality in serum lipid profile results atherogenic dyslipidemia this can worsen the prognosis of diabetic patients and increases risk of cardiovascular disease and stroke. This study aims to evaluate the effect of metformin monotherapy and combination therapy with glimepiride on lipid profile of drug naive type-2 diabetes patients after 10-12 weeks of treatment.&#x0D; Methods: In this study, prescriptions of 120 OPD (Outpatient department) patients of drug naive type-2 diabetes were collected. The detailed observation of: demographic, drug details and investigations done were noted in a specially designed preform. The data was analyzed statistically and results were expressed as numbers and percentage.&#x0D; Results: The total of 120 patients prescriptions was analyzed. Among these male was 62.5% and female were 37.5%, most common affected age group was between 31-50 years with mean age of 43.82 yrs. Metformin was most commonly prescribed drug 42% followed by its combination with glimepiride 58%. Average blood glucose level prior therapy was 193.4mg/dl and post therapy it was 135.2mg/dl. After 10-12 weeks of metformin monotherapy and combination therapy with glimepiride LDL was significantly reduced from 92.3mg/dl to 83.2mg/dl, TG was reduced from 145.5mg/dl to 132 mg/dl and HDL increased from 29.1 mg/dl to 32.9 mg/dl.&#x0D; Conclusion: Metformin monotherapy and combination therapy with glimepiride appreciably improved dyslipidemia in drug naive type-2 diabetes patients.

Adherence therapy for adults with type 2 diabetes: a feasibility study of a randomized controlled trial

BackgroundAdherence Therapy is a candidate intervention to promote consistent medication taking in people with type 2 diabetes. The aim of this study was to establish the feasibility of conducting a randomized controlled trial of adherence therapy in people with type 2 diabetes who were non-adherent with medication.MethodsThe design is an open-label, single-center, randomized controlled feasibility trial. Participants were randomly allocated to receive either eight sessions of telephone-delivered adherence therapy or treatment as usual. Recruitment occurred during the COVID-19 pandemic. Outcome measures—adherence, beliefs about medication, and average blood glucose (sugar) levels (HbA1c)—were administered at baseline and after 8 weeks (TAU group) or at the completion of the treatment (AT group). Feasibility outcomes included the number of people approached to participate in the trial and the numbers that consented, completed study measures, finished treatment with adherence therapy, and dropped out of the trial. Fieldwork for this trial was conducted in the National Guard Hospital, a tertiary care provider, in the Kingdom of Saudi Arabia.ResultsSeventy-eight people were screened, of which 47 met eligibility criteria and were invited to take part in the trial. Thirty-four people were excluded for various reasons. The remaining thirteen who consented to participate were enrolled in the trial and were randomized (AT, n = 7) (TAU, n = 6). Five (71%) of the seven participants in the adherence therapy arm completed treatment. Baseline measures were completed by all participants. Week 8 (post-treatment) measures were completed by eight (62%) participants. Dropout may have been linked to a poor understanding of what was involved in taking part in the trial.ConclusionsIt may be feasible to conduct a full RCT of adherence therapy, but careful consideration should be given to developing effective recruitment strategies, consent procedures, rigorous field testing, and clear support materials.Trial registrationThe trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12619000827134, on the 7th of June 2019.