Blood Glucose In Diabetic Patients Research Articles

Robust observer-based adaptive control of blood glucose in diabetic patients

The objective of this paper is to design a robust observer-based adaptive controller for an intravenous glucose tolerance test (IVGTT) model of Type 1 Diabetes Mellitus (T1DM) patients. The model is assumed to be nonlinear and uncertain. The robust observer estimates the states of the uncertain T1DM model. Once the states are estimated, an adaptive control technique based on Lyapunov's second method is proposed to achieve the desired closed-loop performance for an uncertain system. The results presented here depict that the design philosophy can avoid severe hypoglycaemia (glucose concentration level below 50 mg/dl), bringing down the glucose concentration to a safe level within a specified time of 120 min. Restoring and maintaining the plasma glucose concentration in T1DM patients in the euglycaemic range (70–180 mg/dl) by appropriate insulin infusion under meal disturbances and parametric variations of are effectively handled with the proposed controller. The realistic situation for the patient model like consideration of (i) only one measurable state, and (ii) uncertain as well as time-varying model parameters addressing inter- and intra-patient variability, respectively, are taken into account. The complexity of the T1DM model leads to a new integrated design methodology, combining robustness and adaptive philosophy for the first time.

The effects of mindfulness training on the level of happiness and blood sugar in diabetes patients.

The present study aimed at investigating the effect of mindfulness training on the level of happiness and blood glucose in diabetic patients in Zarghan city, Iran. This quasi-experimental study was conducted in 2018 in Fars province, Iran. 136 diabetic patients who were eligible (had diabetes for more than one year, older than 18years, willingness to participate in the research, and reside in Zarqan city) were selected based on convenience sampling method. Next the participants were randomly divided into two groups, each comprising 68 individuals. Both of the study samples and statistical analyser were blinded to intervention group (mindfulness training) and control group (without intervention). Before and three month after the intervention the patients' levels of happiness (based on Oxford Happiness Questionnaire), fasting blood sugar (FBS) and Glycated Hemoglobin test (HbA1c) were measured. The results indicated that after the sessions, the level of happiness in the Intervention group was significantly higher than the control group (p value <0.001). Also, the level of blood glucose and HbA1c after the sessions was significantly lower in the Intervention group compared to the control group (p value<0.001, p value = 0.004). After the intervention, there was a significant correlation between mean blood glucose levels and mean HbA1c levels in the Intervention group and their level of happiness (p value<0.01 and p value<0.001). The findings revealed that the mindfulness-based educational intervention can increase happiness in people with diabetes and regulate their blood glucose.

Using Sliding Mode Controller and Eligibility Traces for Controlling the Blood Glucose in Diabetic Patients at the Presence of Fault

Some people suffering from diabetes use insulin injection pumps to control the blood glucose level. Sometimes, the fault may occur in the sensor or actuator of these pumps. The main objective of this paper is controlling the blood glucose level at the desired level and fault-tolerant control of these injection pumps. To this end, the eligibility traces algorithm is combined with the sliding mode control. The eligibility traces algorithm is one of the newest solving methods of the Reinforcement Learning approach. The major disadvantage of the sliding mode control method is the chattering phenomenon. In this paper, the novel idea is the combination of these methods to remove the chattering phenomena in simulation results. To demonstrate the superiority of the proposed method, it is compared with another combinatory method that is the sliding mode control and Artificial Neural Networks. Simulation results reveal that the combination of the eligibility traces algorithm and the sliding mode control can control the blood glucose level and insulin with a higher speed and bring them to the desired level, even in the case the sensor and actuator faults are present in the system. When the proposed hybrid method is used, the injected dosage of the drug is lower, which will result in reduced side effects. Finally, the noise, as well as the uncertainty in system parameters and initial conditions are applied to the system to investigate the performance of the proposed controller, under the faulty condition.

Ficus deltoidea extract down-regulates protein tyrosine phosphatase 1B expression in a rat model of type 2 diabetes mellitus: a new insight into its antidiabetic mechanism.

Ficus deltoidea var. deltoidea Jack (FD) is a well-known plant used in Malay folklore medicine to lower blood glucose in diabetic patients. For further research of the antihyperglycemic mechanisms, the protein tyrosine phosphatase 1B (PTP1B)-inhibitory effect of FD was analysed both in vitro and in vivo. To optimise a method for FD extraction, water, 50, 70, 80, 90 and 95% ethanol extracts were prepared and determined for their total phenolic and triterpene contents, and PTP1B-inhibition capacity. Among the tested extracts, 70% ethanol FD extract showed a significant PTP1B inhibition (92·0% inhibition at 200 µg/ml) and high phenolic and triterpene contents. A bioassay-guided fractionation of the 70% ethanol extract led to the isolation of a new triterpene (3β,11β-dihydroxyolean-12-en-23-oic acid; F3) along with six known compounds. In vivo, 4 weeks' administration of 70% ethanol FD extract (125, 250 and 500 mg/kg/d) to streptozotocin-nicotinamide-induced type 2 diabetic rats reversed the abnormal changes of blood glucose, insulin, total Hb, GLUT2, lipid profile, and oxidative stress in liver and pancreas. Moreover, FD reduced the mRNA expression of the key gluconeogenic enzymes (phosphoenolpyruvate carboxykinase and glucose 6-phosphatase) and restored insulin receptor and GLUT2 encoding gene (Slc2a2) expression. In addition, FD significantly down-regulated the hepatic PTP1B gene expression. These results revealed that FD could potentially improve insulin sensitivity, suppress hepatic glucose output and enhance glucose uptake in type 2 diabetes mellitus through down-regulation of PTP1B. Together, our findings give scientific evidence for the traditional use of FD as an antidiabetic agent.

Management of Blood Glucose in Diabetes Mellitus Using Modified Jawonjihwang-tang: A Retrospective Case Series of 76 Patients

Objectives The purpose of this study was to evaluate the effectiveness of the management of blood glucose in diabetes mellitus using modified Jawonjihwang-tang in a Korean medical clinic, retrospectively. Methods From 2006 to 2018, 150 patients diagnosed with diabetes who visited a Korean medical clinic were treated with Korean medicine. Then, 81 of them were prescribed Jawonjihwang-tang. Five cases who changed the formula during the procedure were excluded; therefore, 76 cases were finally selected. Their therapeutic effects were evaluated by the variance in glycated hemoglobin (HbA1c). Results After administration of Jawonjihwang-tang, most patients exhibited a decreased level of HbA1c, and 24 patients had normalized the level of HbA1c. The HbA1c level of all patients decreased from 9.1±2.2 to 7.8±2.2 significantly (p<0.001). Conclusions It is concluded that Jawonjihwang-tang may control blood glucose in diabetes patients. However, more prospective randomized clinical trials are warranted to verify this conclusion. Keywords: diabetes mellitus, Jawonjihwang-tang, glycated hemoglobin, herbal medicine, Korean medicine

Histological evidence of chitosan-encapsulated curcumin suppresses heart and kidney damages on streptozotocin-induced type-1 diabetes in mice model

High blood glucose in diabetic patients often causes cardiovascular diseases (CVDs) that threats to human life. Curcumin (Cur) is known as an antioxidant agent, possesses anti-inflammatory activity, and prevents CVDs. However, the clinical application of curcumin was limited due to its low bioavailability. This study aimed to investigate the ameliorative effects of chitosan-encapsulated curcumin (CEC) on heart and kidney damages in streptozotocin-induced type-1 diabetes C57BL/6 mice model. The results showed that Cur- and CEC-treatments downregulated the blood sugar and total cholesterol level as well as enhanced insulin secretion. However, blood pressure, triglycerides content, and very low-density lipoprotein-cholesterol content were not changed. Histochemistry analysis revealed that both curcumin and chitosan-encapsulated curcumin ameliorated cell hypertrophy and nucleus enlargement in the left ventricular of heart and reduced fibrosis in the kidney, especially after the chitosan-encapsulated curcumin treatment. Our study suggested that chitosan can effectively enhance the protective effect of curcumin on the heart and kidney damages in type-1 diabetes mice model.

P734Research on the mechamism of renal sympathetic denervation in the treatment of insulin resistance

Abstract Background Insulin resistance is the main pathogenesis of type 2 diabetes. In order to better control the blood glucose of diabetic patients, the key is to improve the insulin sensitivity. With the in-depth study on the mechanism of insulin resistance, sympathetic nerve is an important part of it, but the specific mechanism is not clear. Objective This experiment aims to observe the effects of RDN on insulin resistance and skeletal muscle mitochondrial function in spontaneous diabetes ZDF rats. Methods 6 SPF healthy male ZDF (fa/+) rats were selected as control group, 12 healthy males ZDF (fa/fa) rats were randomly divided into sham group and RDN group. In the sham group and RDN group, the rats were treated with sham operation or bilateral renal sympathetic denervation respectively. Insulin sensitivity was tested in all rats with Hyperinsulinemic-euglycemic clamp test 2 weeks after RDN. The skeletal muscle ATPsyn, COXIV, UCP3 and SOD2 were tested by Western-blot method. Results The result showed that 2 weeks after RDN, the blood glucose level of the RDN group decreased significantly (P=0.000) when compared with the sham group. The glucose infusion rate (GIR) in sham and RDN group decreased significantly when compared with the control group (P=0.000). After RDN, the GIR in RDN group increased significantly. ATPsyn, COXIV which were the key enzyme of oxidative metabolism in skeletal muscle mitochondria decreased significantly in the sham and RDN group when compared with control group (P=0.001). However, parameters improved dramatically after RDN (P=0.001). Table 1. Comparision of Baseline in each group 2 weeks after RDN Control (n=6) Sham (n=6) RDN (n=6) Pa Pb Pc Weight (g) 311.1±8.5 410.8±10.7 377.9±15.3 0.000 0.001 0.002 BBG (mmol/L) 5.97±0.16 21.42±1.45 7.91±0.54 0.000 0.001 0.000 BISN (ng/mL) 100.67±4.18 162.17±3.13 134.67±2.50 0.000 0.001 0.001 TG (mmol/L) 2.71±0.28 6.90±0.24 4.88±0.23 0.000 0.001 0.002 TC (mmol/L) 2.38±0.17 6.98±0.15 5.40±0.09 0.000 0.000 0.000 HDL-C (mmol/L) 7.92±0.44 2.95±0.22 5.35±0.19 0.000 0.000 0.000 LDL-C (mmol/L) 3.72±0.37 4.12±0.17 3.98±0.17 0.001 0.000 0.000 aCompared with Control Group and Sham Group. bCompared with RDN Group and Sham Group. cCompared with Sham Group and RDN Group. Relative results Conclusion Our results showed that RDN improved the insulin sensitivity in diabetes rats. The mechanism may be related to the decrease of oxidative stress and function improvement in skeletal muscle mitochondrial by RDN.

Vanadium compounds induced damage of human umbilical vein endothelial cells and the protective effect of berberine.

This study was conducted to investigate the damage caused by vanadium compounds and to explore the protective effects of berberine (BBR) in human umbilical vein endothelial cells (HUVECs). BBR is a biologically active small molecule found in Coptis rhizome, a remedy used in traditional Chinese medicine to treat diabetes. BBR has also been shown to lower blood glucose in diabetic patients. MTT assay was performed to observe the influence of bis(acetylacetonato)-oxidovanadium [VO(acac)2] or sodium metavanadate (NaVO3) and BBR on viability of HUVECs. The monolayer permeability of the HUVECs was assessed by measuring the transendothelial electrical resistance (TER). The endothelial nitric oxide synthase (eNOS) activity was detected by ELISA. Flow cytometry was performed to detect the generation of reactive oxygen species (ROS). The results showed that the viability of HUVECs was decreased by treatment with vanadium compounds 50-400μM in a concentration-dependent manner, while 0.01-1μM BBR effectively protected HUVECs from the inhibitory effects of vanadium compounds on cell viability. Also 100 and 200μM VO(acac)2 induced high permeability and decreased eNOS activity in HUVECs. While 0.01-1μM BBR showed no improvement in the permeability, and failed to reverse the VO(acac)2-induced changes of eNOS activity, but BBR treatment increased the eNOS activity in control cells. The addition of 200μM VO(acac)2 significantly induced ROS generation in HUVECs, while 0.01 or 0.1 μM BBR reversed the change of ROS. In summary, BBR has protective effects in HUVECs damage induced by vanadium compounds, which is not mediated by eNOS, but related to reduced intracellular ROS.

Impact of Knowledge and Practice on Fasting Blood Glucose Levels among Diabetics During Ramadan Fasting

The aim of the present study was to investigate the impact of knowledge and practice on the fasting blood glucose of diabetic patients during the month of Ramadan. The simple random sampling technique was used to calculate sample size and the computed sample size was 112. Participants were recruited from the diabetic outpatient clinics at King Fahad Hospital of the University, Dammam, Saudi Arabia. The participants included male and female adults with either type 1 or 2 diabetes, aged 15–70 years. Children, pregnant women, and those who were unable to complete at least 3 weeks of fasting during the study period were excluded from the study. Fasting blood glucose reading of the participants was extracted during Ramadan and in Shawwal (after 30 days) and a first-visit questionnaire related to the knowledge and practice was provided to them. Statistical Package for Social Sciences (version 22) was used for data entry and analysis. A two way ANOVA test, two independent sample t-tests and Chi-square test were used to compare between the groups. A p-value at 0.05 was considered statistically significant. The study found that fasting blood glucose of a participant during the holy month of Ramadan (144.2) was statistically significant with p-value 0.0003 as compared with after Ramadan (178.5). Moreover, it was found that as the level of knowledge (poor, average, good) improved, the fasting blood glucose goes down with p-values 0.036 and 0.037. Our results revealed that fasting during Ramadan significantly decreases blood glucose. The overall level of knowledge and practice concerning diabetes among the participants studied during the month Ramadan is average.

The Effect of Isopropyl Alcohol and Chlorhexidine Gluconate on the Blood Glucose in Diabetic Patients Referring to the Emergency Department

The Effect of Isopropyl Alcohol and Chlorhexidine Gluconate on the Blood Glucose in Diabetic Patients Referring to the Emergency Department

Glucose metabolism modeling of diabetes patients with different intensities of aerobic exercise: an in silico study

Exercise is vital for diabetics to improve their blood glucose level. However, the quantitative relationship between exercise modes (including types, intensity, time, etc.) and the blood glucose is still not clear. In order to answer these questions, this paper established a blood glucose metabolic model based on ordinary differential equation method. Furthermore, a silico method was adopted to study the effects of different aerobic exercise intensities (light, moderate and vigorous) on blood glucose and optimal strategies of insulin infusion for type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Additionally, the universality of proposed model and insulin infusion strategies was verified based on 1 000 virtual diabetes patients' simulation. The experimental results showed that: (1) Vigorous-intensity aerobic exercise may result in hypoglycemia (< 3.89 mmol/L), which was so harmful to health that diabetics should avoid. Compared with moderate-intensity exercise, the light-intensity aerobic exercise intuitively lowered blood glucose slowly and caused a relative long high-blood-glucose (> 6.11 mmol/L) period, however, its overall blood glucose risk index (BGRI) was lower. (2) Insulin dosage of the optimized strategies decreased by 50% and 84% for T1DM and T2DM when they did moderate intensity exercise. As for light intensity exercise, the dosage of insulin was almost the same as they didn't do exercise, but BGRI decreased significantly. (3) The simulations of 1 000 virtual diabetic patients manifested that the proposed model and the insulin infusion strategies had good universality. The results of this study can not only help to improve the quantitative understanding about the effects of aerobic exercise on blood glucose of diabetic patients, but also contribute to the regulation and management of blood glucose in exercise mode.

MON-152 Less Is More: Human Regular U-500 Insulin

Introduction: Human Regular U-500 Insulin is used to control high blood glucose in diabetic patients who need more than 200 units of insulin daily. High-dose insulin therapy may be limited because the volumes of insulin necessary to achieve these very high doses are difficult to administer subcutaneous and there is a decrease in the absorption rate. We report a case of a woman with DM2 and severe insulin resistance who achieved glycemic control using off-label U-500 via continuous subcutaneous insulin infusion (CSII) but with fixed bolus given manually by patient and remained controlled over the next six years. Clinical Case: A 66-year-old woman with DM2, HTN, metabolic syndrome and adiposity based chronic disease referred to endocrinologist office for glycemic control. Patient treated for diabetes with metformin and premixed insulin and HTN treated with CCB/ACE inhibitor and beta blocker/thiazide combinations. Clinical examination reveals an obese female (BMI: 37.9kg/m2) with acanthosis nigricans. Initial laboratory test showed HbA1c of 13.9%, FBS 293mg/dL, cholesterol 195mg/dL, TGs 147mg/dL and LDL 103mg/dL. Patient was treated with multiple insulin regimens, including U-500 insulin by subcutaneous route of administration and oral antihyperglycemic agents including followed up by nutritionist, where the lowest HbA1c was 9.1%. Patient total daily dose of insulin was 220 units. Although U-500 insulin is not FDA-approved for use in CSII and the ideal candidate should be intellectually able to deal with insulin pump therapy, this treatment was effective for our patient who required high insulin doses and failing other treatment regimen, achieving glycemic control and weight loss in six weeks. The only way this patient used this mode of insulin administration was on a single basal rate and fixed insulin bolus doses before each meal and with bedtime snack. All of these parameters were adjusted by 5 for the use of concentrated insulin in the pump device. HbA1c decreased from 10.5% to 8.5% with only six weeks of treatment and at one year decreased to even more 7.0%. Currently patient had been using CSII with U-500 for six years and patient HbA1c range is between 7.5-7.9% evaluated approximately every 3 months. Conclusion: The increase in the prevalence of obesity and diabetes has been an issue in treating patients who require high doses of insulin. The use of U-500 for CSII allows for better absorption of high insulin doses and improvement of glycemic control thus improving quality of life, weight loss, decreasing multiple daily injections and preventing diabetes complications. To our knowledge this is the first case report demonstrating long-term glycemic control with U-500 via CSII and on a fixed dose regimen on CSII without using carb counting or corrections to make this regimen easier for certain patients without the knowledge for complicated regimens.

Effect of Fenugreek Use on Fasting Blood Glucose, Glycosylated Hemoglobin, Body Mass Index, Waist Circumference, Blood Pressure and Quality of Life in Patients with Type 2 Diabetes Mellitus: A Randomized, Double-Blinded, Placebo-Controlled Clinical Trials.

Background: Diabetes mellitus is a major cause of death globally. It causes multiple problems in various organs and incurs heavy costs for patients and the community health system.The present study was conducted to evaluate the effect of fenugreek intake on fasting blood sugar (FBS), HbA1C, body mass index (BMI), waist circumference, blood pressure and quality of life of type 2 diabetes mellitus (T2DM) patients. Materials and Methods: This randomized, double-blinded clinical trial study was conducted on patients with T2DMin Tehran, Iran in 2018. The treatment group received 5 g of fenugreek powder,and the placebo group received 5 g of wheat flour twice daily for two months before meals. Results: This study was performed on 62 patients (50% male and 50% female). Both groups had similar demographic characteristics. The results showed a significant difference between the mean FBS (P<0.001), HgA1C (P<0.001), BMI (P<0.001), waist circumference (P<0.001), diastolic blood pressure (P=0.005), and quality of life (P=0.015). There was no significant difference in mean systolic blood pressure (P=0.189) between groups. Conclusion: Given the positive effect of fenugreek on FBS, hemoglobin, HbA1C, BMI, waist circumference, blood pressure and quality of life, it can be recommended for controlling blood glucose in diabetic patients.

Effect of Fenugreek Use on Fasting Blood Glucose, Glycosylated Hemoglobin, Body Mass Index, Waist Circumference, Blood Pressure and Quality of Life in Patients with Type 2 Diabetes Mellitus: A Randomized, Double-Blinded, Placebo-controlled Clinical Trials

Background: Diabetes mellitus is a major cause of death globally. It causes multiple problems in various organs and incurs heavy costs for patients and the community health system. The present study was conducted to evaluate the effect of fenugreek intake on fasting blood sugar (FBS), HbA1C, body mass index (BMI), waist circumference, blood pressure and quality of life of type 2 diabetes mellitus (T2DM) patients. Materials and Methods: This randomized, double-blinded clinical trial study was conducted on patients with T2DM in Tehran, Iran in 2018. The treatment group received 5 g of fenugreek powder, and the placebo group received 5 g of wheat flour twice daily for two months before meals. Results: This study was performed on 62 patients (50% male and 50% female). Both groups had similar demographic characteristics. The results showed a significant difference between the mean FBS (P&lt;0.001), HgA1C (P&lt;0.001), BMI (P&lt;0.001), waist circumference (P&lt;0.001), diastolic blood pressure (P=0.005), and quality of life (P=0.015). There was no significant difference in mean systolic blood pressure (P=0.189) between groups. Conclusion: Given the positive effect of fenugreek on FBS, hemoglobin, HbA1C, BMI, waist circumference, blood pressure and quality of life, it can be recommended for controlling blood glucose in diabetic patients.[GMJ. 2019;inpress:e1432]

Effect of Fenugreek Use on Fasting Blood Glucose, Glycosylated Hemoglobin, Body Mass Index, Waist Circumference, Blood Pressure and Quality of Life in Patients with Type 2 Diabetes Mellitus: A Randomized, Double-Blinded, Placebo-Controlled Clinical Trials

Background: Diabetes mellitus is a major cause of death globally. It causes multiple problems in various organs and incurs heavy costs for patients and the community health system.The present study was conducted to evaluate the effect of fenugreek intake on fasting blood sugar (FBS), HbA1C, body mass index (BMI), waist circumference, blood pressure and quality of life of type 2 diabetes mellitus (T2DM) patients. Materials and Methods: This randomized, double-blinded clinical trial study was conducted on patients with T2DMin Tehran, Iran in 2018. The treatment group received 5 g of fenugreek powder,and the placebo group received 5 g of wheat flour twice daily for two months before meals. Results: This study was performed on 62 patients (50% male and 50% female). Both groups had similar demographic characteristics. The results showed a significant difference between the mean FBS (P&lt;0.001), HgA1C (P&lt;0.001), BMI (P&lt;0.001), waist circumference (P&lt;0.001), diastolic blood pressure (P=0.005), and quality of life (P=0.015). There was no significant difference in mean systolic blood pressure (P=0.189) between groups. Conclusion: Given the positive effect of fenugreek on FBS, hemoglobin, HbA1C, BMI, waist circumference, blood pressure and quality of life, it can be recommended for controlling blood glucose in diabetic patients. [GMJ.2019;8:e1432] &#x0D; Â

Antidiabetic and Cardioprotective Effects of Pharmacological Inhibition of GRK2 in db/db Mice.

Despite the availability of several therapies for the management of blood glucose in diabetic patients, most of the treatments do not show benefits on diabetic cardiomyopathy, while others even favor the progression of the disease. New pharmacological targets are needed that might help the management of diabetes and its cardiovascular complications at the same time. GRK2 appears a promising target, given its established role in insulin resistance and in systolic heart failure. Using a custom peptide inhibitor of GRK2, we assessed in vitro in L6 myoblasts the effects of GRK2 inhibition on glucose extraction and insulin signaling. Afterwards, we treated diabetic male mice (db/db) for 2 weeks. Glucose tolerance (IGTT) and insulin sensitivity (ITT) were ameliorated, as was skeletal muscle glucose uptake and insulin signaling. In the heart, at the same time, the GRK2 inhibitor ameliorated inflammatory and cytokine responses, reduced oxidative stress, and corrected patterns of fetal gene expression, typical of diabetic cardiomyopathy. GRK2 inhibition represents a promising therapeutic target for diabetes and its cardiovascular complications.

Selfcare in Type I Diabetes with Continuous Glucose Monitoring

Introduction: The number of diabetes patients are increasing. If the blood glucose is not controlled in diabetics, patients will face with complications. Self-care is important to control the blood glucose of diabetic patients and prevention of complications such as neurological complications, heart, eye disease, amputations and so on. Therefore aim of this study is to identify the effect of Continuous blood Glucose Monitoring or CGM on the blood glucose control in type I diabetes.Materials and methods: The study was done on 20 patients chosen from an online data set available in http://www.jaeb-diabetes.net/ . These patients used CGM to test blood glucose and the result of three month test was measured. To analyze the data, the software SPSS 21, independent Mann- Whitney test was used.Results: The results showed that blood glucose in patients of the experimental group reduced significantly rather than patient of the control group in the second and third month. Also, HbA1C of the patients has reduced.Conclusion: The CGM has an effective role in controlling blood glucose and prevention of complications. Therefore it is recommended that educational programs on the use of monitoring blood glucose, such as CGM as a requirement to be developed.

Effect of Otostegia persica extract on blood glucose in patients with type II diabetes

Introduction: Type 2 diabetes mellitus is an important metabolic disease that causes disability and involves small and large vessels. Many herbal drugs have been used for the treatment of high blood sugar (BS) with promising results. One of these medicinal drugs used conventionally in medicine by the people and active physicians is Otostegia persica. The aim of this study was to investigate the effect of O. persica extract on blood glucose in diabetic patients with insulin therapy. Materials and Methods: A total of 56 patients with type 2 diabetes were included in the study and were divided into two groups of 28 each. The intervention and nonintervention groups included 22 (78.6%) and 6 (21.4%) female patients as well as 19 (67.9%) and 9 (32.1%) male patients, respectively. Results: Due to homogenization resulting from random selection among aspartate transaminase, alanine transaminase, creatinine, insulin, blood urea nitrogen, Antibiotics (Antib), An mdaB mutant strain in a quinone reductase (MdaB) variables, significant differences were not observed between the two groups of participants before the study. Furthermore, there was no significant difference among the variables of H1c, BS5, HD1, fasting BS (FBS), low-density lipoprotein (LDL), and triglycerides in two groups before the study. However, there were differences among variables H1c, BS5, FBS, high-density lipoprotein (HDL), LDL, and HDL between the two groups of participants after the study, but they were not statistically significant (P > 0.05). Conclusions: The results of the test did not show statistically significant differences among these variables during 3 months. Therefore, in order to conclude more comprehensive and safer application for diabetes treatment, it is suggested to examine the effects of these drugs in a more extensive area using oral and injection doses as well as investigate pure effects of active materials.

Effect of sleep status on thyroid hormone and blood glucose level in hyperthyroidism complicated with diabetes

Objective To observe the effects of different sleep status on thyroid secretion and glucose metabolism in hyperthyroidism patients complicated with diabetes mellitus. Methods From March 2014 to August 2017, 288 hyperthyroidism patients complicated with diabetes in the People's Hospital of Zhuji were selected as study objects.The fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), serum free three iodine thyroid (FT3), free four iodine thyroid (FT4) and thyroid stimulating hormone (TSH) levels were measured.The patients were grouped according to sleep time( 7-8h in 72 cases, >8h in 56 cases), sleep quality[pittsburgh sleep quality index (PSQI) score 12-17 points in 54 cases, >17 points in 46 cases] and nap time(no nap in 63 cases, 2h in 36 cases), and the levels of FPG, HbA1c, FT3, FT4 and TSH among groups were compared. Results There were statistically significant differences in FPG, HbA1c, FT3, FT4 and TSH levels among the groups with different sleep quality PSQI scores (F=12.725, 15.682, 7.026, 9.258 and 6.147; P=0.000, 0.000, 0.000, 0.000 and 0.000). Comparison of FPG, HbA1c, FT3, FT4 and TSH levels in the different sleep time groups, although there were statistically significant differences in the levels of 7-8h groups (all P 7-8h group had no statistically significant differences (all P>0.05). There were statistically significant differences in the levels of FPG, HbA1c, FT3, FT4 and TSH among the patients with different nap time (F=10.925, 14.008, 9.607, 11.120 and 7.251; P=0.000, 0.000, 0.000, 0.000 and 0.000). The sleep quality PSQI score was negatively correlated with the levels of FPG, HbA1c, FT3 and FT4 in patients with hyperthyroidism and diabetes mellitus (r=-0.856, -0.879, -0.816 and -0.849; P=0.001, 0.000, 0.011 and 0.004), and was positively correlated with TSH (r=0.757, P=0.021). The nap time was positively correlated with the levels of FPG, HbA1c, FT3 and FT4 in patients with hyperthyroidism and diabetes mellitus (r=0.867, 0.855, 0.793, 0.844, P=0.000, 0.000, 0.014, 0.003), and was negatively correlated with TSH (r=-0.802, P=0.012); but the nocturnal sleep time was not correlated with the levels of FPG, HbA1c, FT3, FT4 and TSH in patients with hyperthyroidism and diabetes mellitus (P>0.05). Conclusion To improve the quality of sleep, sleep at night security appropriate time and increase the sleep midday can effectively reduce the level of blood glucose in diabetic patients with hyperthyroidism and thyroid hormone secretion, improve glucose metabolism and thyroid function. Key words: Hyperthyroidism; Diabetes mellitus; Sleep; Blood glucose; Thyroxine

The effect of garlic on lipid profile and glucose parameters in diabetic patients: A systematic review and meta-analysis

PurposeSeveral studies have been published about the effect of garlic on lipid profile and blood glucose in diabetic patients. Which, the results mostly contradict with each other. This study aimed to investigate the effect of garlic on lipid profile and serum glucose levels in diabetic patients using a systematic review and meta-analysis. MethodsThis study was a systematic review and meta-analysis of articles published between 1988 and 2016. For this purpose, two independent researchers searched SID medical information databases including MagIran, Irandoc, Medlib, Iran Medex, Science Direct, Scopus, Google and PubMed using keywords. Data were analyzed using STATA software. ResultsAfter the initial search, 23,000 articles were found, of which 33 had the required criteria for the meta-analysis. In the present study, the total sample under review was 1273 individuals, with a mean of 39 samples per study. Overall, the garlic was more influential than placebo in reducing the levels of lipid parameters including triglycerides (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), and fasting blood sugar (FBS) and HbA1C. In the meta-analysis, the concentration of serum TC, LDL, TG, and HDL in the group receiving garlic compared with the placebo showed a significant decreased for 16.87mg/dl (95% CI, −21.01, −12.73) (P=0.001), 9.65mg/dl (95% CI, −15.07, −4.23) (P=0.001), 12.44mg/dl (95% CI, −18.19, −6.69) (P=0.001), and increased for 3.19mg/dl (95% CI, 1.85, 4.53) (P=0.001), respectively. Also, the concentration of serum FBS and HbA1C serum showed a significant decreased for 10.90mg/dl (95% CI, −16.40, −5.40) (P=0.001) and 0.60mg/dl (95% CI, −0.98, −0.22) (P=0.001), respectively. ConclusionGarlic can reduce lipid profile as well as glucose parameters and be therapeutically effective in patients suffering from cardiovascular diseases and diabetes.