Blood Glucose Testing Research Articles

Gut microbiome-mediated glucose and lipid metabolism mechanism of star apple leaf polyphenol-enriched fraction on metabolic syndrome in diabetic mice

BackgroundDiabetes is a kind of metabolic syndrome (MetS) that seriously threatens human health globally. The leaf of star apple (Chrysophyllum cainito L.) is an incompletely explored folk medicine on diabetes. And, the effects and mechanisms on diabetes complicated glycolipid metabolism disorders are unknown till now. PurposeThis study aimed to investigate the constituents of star apple leaf polyphenol enriched-fraction (SAP), and elucidate their treatment effects and mechanism on diabetes and accompanied other MetS. MethodsThe components of SAP were tentatively identified by HPLC-Q-TOF-MS/MS. The antioxidant activity was determined by the scavenging of free radicals and hypoglycemic activities by inhibition of α-glucosidase in vitro. HepG2 cells were used for evaluating the alleviation effects of SAP on lipid accumulation. Streptozotocin and high-fat diet induced diabetic mice were grouped to evaluate the effects of different dosages of SAP. 16S rRNA was conducted to analysis gut microbiome-mediated glucose and lipid metabolism mechanism. ResultsIt showed that myricitrin was one of the main active constituents of SAP. SAP not only showed low IC50 on -glucosidase (24.427± 0.626 μg/mL), OH·(3.680± 0.054 μg/mL) and ABTS· (9.155±0.234 μg/mL), but significantly induced the lipid accumulation in HepG2 cells (p < 0.05). SAP at 200 mg/kg·day significantly decreased the blood glucose, insulin and oral glucose tolerance test value (p < 0.05). The insulin resistance indexes and oxidative stress were alleviated after administration. SAP not only attenuated hepatic lipid deposition, but also reversed the hepatic glycogen storage. 16S rRNA sequencing results revealed that the interaction between SAP and gut microbiota led to the positive regulation of beneficial bacteria including Akkermansia, Unspecified S24_7, Alistipes and Unspecified_Ruminococcaceae, which might be one of the mechanisms of SAP on MetS. ConclusionFor the first time, this study explored the regulation effect of star apple leaf polyphenols on the hepatic glycolipid metabolism and studied the underlying mechanism from the view of gut microbiota. These findings indicated that SAP possesses great potential to serve as a complementary medicine for diabetes and associated MetS. It provided scientific evidence for folk complementary medicine on the treatment of diabetes-complicated multiple metabolic disorders.

Xiaoyaosan ameliorates depressive-like behavior and susceptibility to glucose intolerance in rat: involvement of LepR-STAT3/PI3K pathway in hypothalamic arcuate nucleus

BackgroundAccumulating evidence has demonstrated that arcuate nucleus (ARC) of the hypothalamus is likely responsible for the close association between chronic stress, depression, and diabetes. Xiaoyaosan (XYS), a Chinese herbal formula, remarkably improves depressive-like behavior and glucose intolerance, but the mechanism remains unclear. Leptin receptor (LepR) regulates energy expenditure and depression by mediating the action of leptin on the ARC. Therefore, we hypothesized that XYS may regulate depressive-like behavior and glucose intolerance via the leptin and its cascade LepR-STAT3/PI3K pathway in the ARC.MethodsA rat model of depressive-like behavior and susceptibility to glucose intolerance was induced by exposure to chronic unpredictable mild stress (CUMS) for six weeks. XYS (2.224 g/kg) was orally gavaged for six weeks, and fluoxetine (2.0 mg/kg) was administrated to the positive control group. Depressive-like behaviors were assessed using the open field test (OFT), sucrose preference test (SPT) and forced swim test (FST). Fasting blood glucose (FBG) and oral glucose tolerance test (OGTT) were performed to evaluate the effects of XYS on blood glucose. Peripheral leptin and blood lipids were detected using enzyme-linked immunosorbent assay and an automatic biochemical analyzer, respectively. The effects of XYS on the LepR-STAT3/PI3K pathway were detected by quantitative real-time PCR and western blotting.ResultsXYS ameliorated CUMS-induced depressive-like behaviors and elevated blood glucose. XYS improved the food intake but have no significant effects on the body weight. Peripheral leptin and its central receptor were also suppressed by XYS, accompanied by the downregulation of JAK2/STAT3 and PI3K/AKT pathway in the ARC. Additionally, XYS increased AGRP and NPY expression but inhibited POMC in the ARC.ConclusionsXYS improves depressive-like behaviors and susceptibility to glucose intolerance induced by CUMS, which may be achieved by the downregulation of the LepR-STAT3/PI3K signaling pathway in the ARC.

Self-care management among children and adolescents with diabetes mellitus in Malaysia.

The study aimed to evaluate diabetes self-care among diabetic children and adolescents and compare with glycaemic control. Summary of Diabetes Self-Care Activities (SDSCA) questionnaire was distributed to patients aged 10-18years with types 1 and 2 diabetes mellitus (DM) at paediatric diabetes clinics in Malaysia. Haemoglobin A1c levels were measured after questionnaire completion. A total of 106 patients completed the questionnaire with a mean age of 13.91 (± SD 2.48) years. Mean haemoglobin A1c and SDSCA score were 9.78 (± SD 2.43)% and 19.09 (± SD 5.81), respectively. Type 1 DM patients had significantly higher haemoglobin A1c (10.11 95% CI [9.62, 10.59] vs 8.38 95% CI [7.13, 9.62]). Total score was higher in type 1 DM although not statistically significant (19.32 95% CI [18.21, 20.43] vs 18.08 95% CI [14.28, 21.87]). Blood glucose testing score was significantly higher in type 1 DM (5.24 95% CI [4.82, 5.66] vs 3.50 95% CI [2.23, 4.77]). There was statistically significant negative correlation between score in diet subcategory and haemoglobin A1c. In conclusion, self-care activities among diabetic children and adolescents are still suboptimal. Self-care activities on blood glucose testing are significantly better in type 1 DM. Diet section correlated well with glycaemic control necessitating further research.

Analysis of competition and the level of dominance in the antidiabetics market of Russia

Introduction. Amid reports of a growing number of diabetic patients, the antidiabetics market players positioning is highly important for companies and the country’s leadership. The regulatory measures and management decisions depend on the competitive situation in the market. Aim. Analysis of the changes in the level of dominance on the markets for antidiabetics and blood glucose monitors and meters. Materials and methods. The distribution of these markets by product groups, as well as by commercial and public procurement segments has been taken into account. The Herfindahl-Hirschman and Linda indices, the adjusted Hall-Tideman index, concentration ratios and the SV matrix (strength/variety) were used as analysis tools, and the calculations were made on the basis of IQVIA data for the period from 2004 to the 3rd quarter of 2022. Results. The dominance of three foreign companies that fell into the B4 and G quadrants was detected in the insulin and insulin analogues market. The glucose-lowering drugs market is the most competitive, it fell into the RO quadrant more often than other markets, and the dominant group, depending on the segment, included foreign and domestic companies with different frequency. The dominance of both three foreign and one Russian companies in the B4 and G quadrants, as well as a larger number of companies, was identified in the market for other alimentary tract and metabolism products. Several foreign and one Russian company that were identified into the B4 and G quadrants steadily dominated in the markets for blood glucose test strips, glucose monitors and meters and accessories, and lancets. Conclusions. The antidiabetics market is highly concentrated in its segments. The results show the historical development of the studied markets, the role of the commercial and public procurement segments in them, and serve as the foundation for studying the impact of environmental events on the Russian antidiabetics market.

National survey of educational impact on pharmacy learners by volunteering at camps for children with diabetes

IntroductionCurrent literature on pharmacy students' and residents' experience attending camps for children with diabetes focuses on the experience at an individual campsite. The objective of this study was to examine the demographics and gains in understanding that pharmacy learners achieve when volunteering as medical staff at camps for children with type 1 diabetes (T1D). MethodsNational listservs were used to identify pharmacists who precept pharmacy students and residents at diabetes camps. These self-identified pharmacists shared pre- and post-camp electronic surveys with their respective pharmacy learners. Statistical analysis was completed using SPSS Version 25 (IBM, Corp.). ResultsEighty-six pharmacy learners completed the pre-camp survey and 69 completed the post-camp survey. Most were Caucasian, in their fourth professional year, and participated in residential camps that lasted six and one-half days on average. Learners consistently engaged in patient care activities including: carbohydrate counting (87%), bolus insulin dose calculations (86%), treatment of hypo/hyperglycemic episodes (86%), blood glucose testing (83%), blood sugar trend evaluation (78%), basal insulin dosing calculations (74%), and insulin pump site changes (72%). Learners demonstrated statistically significant gains in every index measured with the exception of glucometer use. Eighty-seven percent indicated they learned how to appropriately manage T1D, 37% gained empathy for those living with T1D, and 13% learned how to work in a medical team. ConclusionsPharmacy learners who volunteered at diabetes camps experienced large gains in their understanding of concepts and devices, comfort with performing patient care tasks, and compassion for children and their families living with T1D.

Hidden educational inequalities in high blood pressure and high blood glucose levels in Kerala: evidence from the National Family Health Survey (2019–2021)

ObjectiveThis study assesses educational inequalities in measured as well as self-reported high blood pressure (BP) and high blood glucose (BG) in the southern Indian state of Kerala, which is known...

Efektivitas Ekstrak Strobilanthes crispus terhadap Kadar Glukosa Darah Puasa dan Pasca Tes Toleransi Glukosa Oral pada Rattus norvegicus Diabetes Melitus

Introduction. The 2018 Riskesdas data shows that the prevalence of diabetes mellitus is increasing each year. Strobilanthes crispus leaves are known for lowering blood glucose levels. This study aimed to determine the difference in the effectiveness of S. crispus leaves ethanolic extract on fasting blood glucose (FBG) and post-oral glucose tolerance test (OGTT). Methods. True experimental study using post-test only control group design and Rattus norvegicus as experimental animals. Rattus norvegicus were selected by random sampling which were then divided into 4 groups (K, P1, P2, P3), each group consisted of 5 animals. The animals were subsequently induced with diabetes mellitus via a single injection of 160 mg/kgBW/IP alloxan. Group K was given 0.5% NaCMC solution at a dose of 1 ml/200 g BW/day/oral/day. Group P1, P2, and P3 received extract at a dose of 100, 400, 600 mg/kg BW/oral/day for 21 days using oral gavage. Statistical analysis was performed using ANOVA, Tukey, Brown-Forsythe, and Kruskal-Wallis tests. Results. Mean FBG level in group K, P1, P2, P3 were 338.40 mg/dL, 270.80 mg/dL, 200.00 mg/dL, and 138.60 mg/dL, respectively. Mean value of 60 minutes OGTT blood glucose level in group K, P1, P2, P3 were 355.60 mg/dL, 289.00 mg/dL, 188.00 mg/dL, and 164.40 mg/dL, respectively. Meanwhile, mean value of 120 minutes OGTT blood glucose level in group K, P1, P2, P3 were 346.60 mg/dL, 236.20 mg/dL, 175.40 mg/dL, and 117.20 mg/dL, respectively. The hypothesis test results showed a significant difference in 120 minutes OGTT blood glucose level (p= 0.031). Conclusion. The use of ethanol extract from S. crispus leaves is more beneficial in reducing blood glucose levels in 120 minutes OGTT compared to FBG level and 60 minutes OGTT level, with the highest reduction observed in the group given a dose of 600 mg/kgBW/oral/day compared to control.

Carotid baroreceptor stimulation prevents oxidative stress by inhibiting MAO-A and prevents cardiac remodeling in obese rats.

Sympathetic nervous system overactivation and abnormal lipid metabolism are featured in obesity and may lead to cardiac remodeling. The effects of carotid baroreceptor stimulation (CBS) on cardiac remodeling in obese rats and the underlying mechanisms were explored. An obesity model was induced by 16-week high-fat diet feeding. A CBS device was implanted at the 8th week. Body weight and blood pressure measurements, electrocardiography, echocardiography, and glucose and insulin tolerance tests were conducted before sampling. Plasma analysis and histological and biological analyses of left ventricle were also performed. Neonatal rat cardiomyocytes cocultured with 3T3-L1 in transwell chambers were used to investigate the mechanisms. CBS alleviated several manifestations of obesity, including increased body weight, high blood pressure, hyperlipidemia, and enhanced sympathetic activity. In obese hearts, norepinephrine levels decreased, and the monoamine oxidase A (MAO-A) and reactive oxygen species level increased; these changes, as well as cardiac fibrosis, lipid metabolic disorders, and heart dysfunction, were inhibited by CBS. Neonatal rat cardiomyocytes incubated with norepinephrine showed MAO-A upregulation, increased reactive oxygen species levels, lipid metabolic disorders, and inflammatory response, which were inhibited by clorgyline, a selective MAO-A inhibitor. CBS effectively suppresses sympathetic nervous system activity and oxidative stress mediated by MAO-A and prevents cardiac remodeling in obese rats.

GlucoScreen

Blood glucose measurement is commonly used to screen for and monitor diabetes, a chronic condition characterized by the inability to effectively modulate blood glucose that can lead to heart disease, vision loss, and kidney failure. Early detection of prediabetes can forestall or reverse more serious illness if healthy lifestyle adjustments or medical interventions are made in a timely manner. Current diabetes screening methods require visits to a healthcare facility and use of over-the-counter glucose-testing devices (glucometers), both of which are costly or inaccessible for many populations, reducing the chances of early disease detection. We therefore developed GlucoScreen, a readerless glucose test strip that enables affordable, single-use, at-home glucose testing, leveraging the user's touchscreen cellphone for reading and displaying results. By integrating minimal, low-cost electronics with commercially available blood glucose testing strips, the GlucoScreen prototype introduces a new type of low-cost, battery-free glucose testing tool that works with any smartphone, obviating the need to purchase a separate dedicated reader. Our key innovation is using the phone's capacitive touchscreen for the readout of the minimally modified commercially available glucose test strips. In an in vitro evaluation with artificial glucose solutions, we tested GlucoScreen with five different phones and compared the findings to two common glucometers, AccuChek and True Metrix. The mean absolute error (MAE) for our GlucoScreen prototype was 4.52 mg/dl (Accu-Chek test strips) and 3.7 mg/dl (True Metrix test strips), compared to 4.98 mg/dl and 5.44 mg/dl for the AccuChek glucometer and True Metrix glucometer, respectively. In a clinical investigation with 75 patients, GlucoScreen had a MAE of 10.47 mg/dl, while the AccuChek glucometer had a 9.88 mg/dl MAE. These results indicate that GlucoScreen's performance is comparable to that of commonly available over-the-counter blood glucose testing devices. With further development and validation, GlucoScreen has the potential to facilitate large-scale and lower cost diabetes screening. This work employs GlucoScreen's smartphone-based technology for glucose testing, but it could be extended to build other readerless electrochemical assays in the future.

Performance of Different Glucose Testing Methods Amongst Patients of Gestational Diabetes Mellitus in St. Francis Hospital Nsambya, Kampala, Uganda: A CrossSectional and Descriptive Study

Background: Medical examination detects illness or disease risk factors in individuals otherwise well to treat early on and minimize morbidity and death. In spite of recommended GDM screening during prenatal care worldwide and local standards, it has been shown that the procedure has not been properly implemented. A further difficulty might be the lack of consensus worldwide and on local consistence on GDM screening and diagnosis guidelines. Methods: The study was a hospital based cross-sectional and descriptive study that employed both quantitative and qualitative methods of data collection. A descriptive study was concerned with describing the characteristics of a particular individual, or of a group in a given situation. The study was guided by the primary objective of assessing the extent of GDM monitoring among women receiving antenatal care at St. Francis Hospital Nsambya in Kampala, Uganda. Both Capillary and venous blood samples in which plasma/serum was taken from pregnant mothers and their glucose levels estimated using a One touch (Roche Diagnostics) code 298 and plasma calibrated glucometer and Roche Cobas C311fully automated Chemistry Analyser respectively. Both whole blood glucose and plasma/serum glucose was determined as per the principle of enzyme hexokinase (HK) catalyzes the reaction between glucose and adenosine triphosphate (ATP) to form glucose-6-phosphate (G-6-P) and adenosine diphosphate (ADP). In the presence of nicotinamide adenine dinucleotide (NAD), G-6-P is oxidized by the enzyme glucose-6-phosphate Dehydrogenase (G-6-PD) to 6-phosphogluconate and reduced nicotinamide adenine dinucleotide (NADH). The increase in NADH concentration was directly proportional to the glucose concentration and was measured spectrophotometrically at 340 nm. The data was analysed using the McNemar's test to determine the sensitivity, specificity and the direct cost for performing capillary glucose. Receiver operator characteristic and Area under curve analyses to analyze the predictive power of the constructed equation Sensitivity, specificity, false positive rate and false negative rate was computed to validate the capillary method in testing/detecting Gestational Diabetes Mellitus. Data analysis was performed using the SPSS package Results: The results presented below for both capillary and Venous Blood Glucose were based on the principle of glucose oxidase test. Cutoff for the different blood sugar level were as follows; Normal A1C test being &lt; 5.4% and Diabetes being &gt;5.4%. Based on the Venous Blood Glucose tests method, 89.0% (154/173) respondents tested normal, while 11.0% (19/173) had diabetes. However, capillary blood glucose testing method identified 78.6% (136/173)5 respondents as being normal compared 21.4% (37/173) having diabetes. Results obtained from the process indicate capillary glucose blood test for gestation diabetes having very low sensitivity i.e. 30% for gestation diabetes. The findings of the study will help to create public awareness on disease burden, improved diagnosis, classification, management and health policies by the Ministry of Health about Gestational diabetes among Ugandan mothers. Conclusion: Most of the procedures employed to detect and trace for GDM was found to be painful and stressful. The healthcare providers and managers some lacked required skills and knowledge concerning GDM among women and procedural handling was found to be wanting in one case or another. The GDM prevalence was discovered to be slowly increasing even though it was detected to be at low levels at Nsambya hospital but the situation elsewhere might be different. Most of the GDM risk factors were majorly originating from family background, maternal ages discrepancies, and abuse of alcohol. Most GDM challenges were found to be fueled by lack of proper counseling and screening since it wasn’t routine among health care professionals hence lack of expertise and inconsistencies in handling GDM women. Preparing women for GDM screening and diagnosis would have reduced the risks and health challenges faced by pregnant women if they are well prepared and trained before subjecting them to the GDM testing.

Access to diabetes diagnosis in Brazil based on recent testing and consultation: The Brazilian national health survey, 2013 and 2019.

Screening for undiagnosed diabetes using glucose testing is recommended globally to allow preventive action among those detected. Our aim was to evaluate the access to glucose testing to screen for diabetes in Brazil using self-reported information on recent testing and medical consultation from national surveys of Brazilian adults. The Pesquisa Nacional de Saúde (PNS) was conducted in 2013 and 2019 drawing probabilistic samples of Brazilians aged 18 years and above. To evaluate glucose testing among those undiagnosed, we excluded those self-reporting a previous diagnosis of diabetes. We then defined recent access to diabetes diagnosis by considering the previous two years and choosing the last blood glucose test and the proximal medical consultation reported. We used Poisson regression with robust variance to assess correlates of access, expressing them with adjusted prevalence ratios (PR) and their 95% confidence intervals. Access to recent glucose testing documented that over 70% reported a recent glycemic test, 71% in 2013, and 77% in 2019. These findings are consistent with a wide recent access to medical consultation, 86% and 89% in 2013 and 2019, respectively. Reporting recent glucose testing and medical consultation may better reflect the actual access to medical diagnostic testing. When analyzing this joint outcome, diagnostic access was still wide, 67% and 74%, respectively. Greater access (p< 0.001) was seen for women (PR=1.16; 1.15-1.17), older individuals (PR=1.25; 1.22-1.28), and those with higher education (PR=1.17; 1.15-1.18), obesity (PR=1.06; 1.05-1.08), and hypertension (PR=1.12; 1.11-1.13). In contrast, lower access (p<0.001) was seen for those declaring being Black (PR=0.97; 0.95-0.99) or of mixed-race (PR=0.97; 0.96-0.98), those residing in rural areas (PR=0.89; 0.87-0.90), and not having a private health insurance plan (PR=0.85; 0.84-0.86). Although access to diagnostic testing for diabetes is high in Brazil, partly due to its universal health system, social inequities are still present, demanding specific actions, particularly in rural areas and among those self-declaring as being Black or mixed-race.

A Six Year Review of the Outcome of Pregnancy in Diabetic Patients in Irrua Specialist Teaching Hospital, Irrua, Nigeria

Diabetes mellitus is a common medical condition complicating pregnancy with poor outcome. Early diagnosis and proper blood glucose control may reduce complications. The incidence and outcomes of the disease in Irrua is not known. The aim of this study is to determine the incidence and outcomes of diabetes mellitus complicating pregnancy in Irrua. We carried out a six year retrospective review of the demographic characteristics of the patients, parity, clinical and booking status, number of hospital admissions for blood sugar control and pregnancy outcome of diabetes mellitus complicating pregnancy in Irrua Specialist Teaching Hospital, Irrua between January 1, 2000 and December 31, 2005. Data collected were analysed using SPSS window version 20.0 statistical package. In the study period, there were 5,460 pregnant women who booked for antenatal care in the hospital, out of these, 2,765 attended the antenatal carefully and eventually delivered in the hospital and 30 of them whose pregnancies were complicated with diabetes mellitus were studied. The incidence of diabetes mellitus complicating pregnancy in this study is 10.85 pregnancies per 1000 births. The mean age of the patients was 33 years. Multipara were affected in 62% of cases. Gestational diabetes predominated in 66.7% of cases. There were family history of diabetes in 73.3% of cases. All patients had both dietary and insulin therapy throughout antenatal period. Majority of the patients were admitted for blood glucose control once. Majority of the patients (76.6%) had vaginal deliveries while 23.3% had caesarian deliveries due to fetal and maternal complications. Over 73% of the patients delivered at term. The outcome of pregnancy was poor. The incidence of diabetes mellitus complicating pregnancy in Irrua is 10.85 pregnancies per 1000 births, this is high with relatively poor outcome. Preconceptional counseling, deliberate blood glucose tolerance testing and adequate blood glucose control in pregnancy is recommended.

Development and validation of risk prediction models for large for gestational age infants using logistic regression and two machine learning algorithms.

Large for gestational age (LGA) is one of the adverse outcomes during pregnancy that endangers the life and health of mothers and offspring. We aimed to establish prediction models for LGA at late pregnancy. Data were obtained from an established Chinese pregnant women cohort of 1285 pregnant women. LGA was diagnosed as >90th percentile of birth weight distribution of Chinese corresponding to gestational age of the same-sex newborns. Women with gestational diabetes mellitus (GDM) were classified into three subtypes according to the indexes of insulin sensitivity and insulin secretion. Models were established by logistic regression and decision tree/random forest algorithms, and validated by the data. A total of 139 newborns were diagnosed as LGA after birth. The area under the curve (AUC) for the training set is 0.760 (95% confidence interval [CI] 0.706-0.815), and 0.748 (95% CI 0.659-0.837) for the internal validation set of the logistic regression model, which consisted of eight commonly used clinical indicators (including lipid profile) and GDM subtypes. For the prediction models established by the two machine learning algorithms, which included all the variables, the training set and the internal validation set had AUCs of 0.813 (95% CI 0.786-0.839) and 0.779 (95% CI 0.735-0.824) for the decision tree model, and 0.854 (95% CI 0.831-0.877) and 0.808 (95% CI 0.766-0.850) for the random forest model. We established and validated three LGA risk prediction models to screen out the pregnant women with high risk of LGA at the early stage of the third trimester, which showed good prediction power and could guide early prevention strategies.

The The Growth Performance and Physiological Status of Comet Goldfish (Carassius auratus) in Aquascape System with Different Aquatic Plant Species

This study aimed to evaluate the physiological performance and status of comet goldfish (Carassius auratus) in aquascape system with different aquatic plant species. Comet goldfish (6.5 ± 0.073 cm length and 9.1 ± 0.1 g weight in average) were reared in aquaria with 10 fish/L density per aquarium for 45 days. The results obtained a positive correlation between SR value and SGR value, followed by a significant different value among the treatments applied (P&lt;0.05). Based on the total chromatophore cells, comet goldfish reared in aquarium containing aquatic plants had a significant different (P&lt;0.05) on the total chromatophore cells compared to aquarium without aquatic plants (control). After blood glucose test, comet goldfish reared with aquatic plants consistently showed a lower blood glucose level than without aquatic plants. The liver SOD level of comet goldfish obtained a significant different value between fish reared with aquatic plants and without aquatic plants, while the MDA value on all treatments was insignificantly different. Also, increased total erythrocytes, total leucocytes, hemoglobin, and hematocrit were found on comet goldfish reared with aquatic plants. This study concludes that aquatic plants in rearing system can improve the survival rate, specific growth rate, health status of comet goldfish due to mutualistic symbiosis discovered between fish and aquatic plants.&#x0D; Key words: aquatic plants, comet goldfish, growth performance, and health status.

Attributes of pharmacy's educational activities according to good pharmacy practice standards from the perspective of patients with diabetes

According to the Good Pharmaceutical Practice (GPP) Standards of Quality of Pharmacy Services, pharmacists should participate in preventive measures to improve the health of the population and prevent disease. The problem of diabetes is becoming increasingly relevant due to its prevalence and a significant number of undiagnosed cases. Patients with diabetes are frequent visitors to pharmacies and have specific needs for treatment.&#x0D; The purpose of the study was to determine the attributes of pharmaceutical educational activities in pharmacies according to the standards of GPP from the perspective of patients with diabetes, as well as to compare the obtained results with similar ones in other countries.&#x0D; The objects of the study were information sources regarding the involvement of pharmacists in the strategy of preventing diabetes in other countries, using literature review and analytical methods. To study the perspective of patients with diabetes, a semi-structured in-depth interview of patients with diabetes who use insulin therapy was applied.&#x0D; Based on research using the semi-structured in-depth interview method, attributes of educational activities were identified in providing pharmaceutical care to patients with diabetes according to GPP standards: identifying individuals with risk factor of diabetes and people with undiagnosed diabetes; group training of diabetes patients in self-management control; and recommendations flu vaccination in the pre-epidemic period. The availability of diabetes risk factor detection and blood glucose testing in pharmacies contributes to early diagnosis and motivates patients to change their lifestyles. Training people with diabetes by qualified specialists are important for diabetes patients. The organasing of the «diabetes self management school» in pharmacies will increase the accessibility of training for diabetes patients and at the same time enhance the role of pharmacists in clinical practice and the social image of the pharmacy. To promote flu vaccination among patients with diabetes, pharmacists should be actively involved in providing information and promoting vaccination.&#x0D; The identified attributes of educational activities in providing pharmaceutical care according to GPP standards have already been implemented in many countries of the world and have demonstrated their high efficiency for the health care system.

Prevalence of Depression in Patients with Type 1 Diabetes between 10 and 17 Years of Age in Jordan.

The study was conducted by distributing the Center for Epidemiological Studies Depression Scale for Children (CES-DC) to adolescents with T1D seen at Jordan University Hospital between February 2019 and February 2020. Demographic, clinical, and socioeconomic data were collected using electronic clinical charts. Possible predictors of depression were assessed using logistic regression analysis. A total of 108 children were enrolled in the study with mean age of 13.7 ± 2.3 years. Fifty-eight children (53.7%) had a CES depression score less than 15, and 50 children (46.3%) had a depression score of 15 or more. The number of diabetes-related hospital admissions and the frequency of self-monitoring of blood glucose (SMBG) were significantly different between the two groups. In the multivariable analysis, both gender and SMBG frequency were statistically significant. Girls were more likely to have a depression score ≥ 15 (OR = 3.41, p = 0.025) than boys. Patients who were rarely testing blood glucose levels were more likely to have a depression score ≥ 15 compared to those who were testing regularly (OR = 36.57, p = 0.002). The prevalence of depressive symptoms is relatively high in adolescents with T1D, especially in those living in developing countries. Longer diabetes duration, higher glycated hemoglobin level, and less frequent blood glucose monitoring are associated with higher depression scores.

Elicitation of domain knowledge for a machine learning model for paediatric critical illness in South Africa.

Delays in identification, resuscitation and referral have been identified as a preventable cause of avoidable severity of illness and mortality in South African children. To address this problem, a machine learning model to predict a compound outcome of death prior to discharge from hospital and/or admission to the PICU was developed. A key aspect of developing machine learning models is the integration of human knowledge in their development. The objective of this study is to describe how this domain knowledge was elicited, including the use of a documented literature search and Delphi procedure. A prospective mixed methodology development study was conducted that included qualitative aspects in the elicitation of domain knowledge, together with descriptive and analytical quantitative and machine learning methodologies. A single centre tertiary hospital providing acute paediatric services. Three paediatric intensivists, six specialist paediatricians and three specialist anaesthesiologists. None. The literature search identified 154 full-text articles reporting risk factors for mortality in hospitalised children. These factors were most commonly features of specific organ dysfunction. 89 of these publications studied children in lower- and middle-income countries. The Delphi procedure included 12 expert participants and was conducted over 3 rounds. Respondents identified a need to achieve a compromise between model performance, comprehensiveness and veracity and practicality of use. Participants achieved consensus on a range of clinical features associated with severe illness in children. No special investigations were considered for inclusion in the model except point-of-care capillary blood glucose testing. The results were integrated by the researcher and a final list of features was compiled. The elicitation of domain knowledge is important in effective machine learning applications. The documentation of this process enhances rigour in such models and should be reported in publications. A documented literature search, Delphi procedure and the integration of the domain knowledge of the researchers contributed to problem specification and selection of features prior to feature engineering, pre-processing and model development.

Pharmaceutical care in the health of Autistic Spectrum disorder

Autism Spectrum Disorder (ASD) is a series of neurological and behavioural complications that destabilize several characteristics of human development. Some patients require psychopharmacological treatment to control symptoms. When these drugs interfere negatively in quality of life, their use deserves special attention. The objective of this article was to verify the importance of the pharmaceutical professional in the monitoring of autistic children and adolescents in a group of autistics of the North of Minas Gerais Association of Support to the Autistic (ANDA). The pharmacotherapeutic profile was determined, and the incidence of medication-related problems was surveyed. For this, an anthropometric evaluation, blood glucose and cholesterol test and verification of adherence to treatment were performed. It was found that the monitoring of the autistic patient by the clinical pharmacist is of fundamental importance, focused on primary health care. The professional should monitor the appearance of dyslipidaemia and other metabolic disorders in autistic patients, especially those who use atypical antipsychotics and who have food selectivity, or motor dysfunction associated with autism.

The Framingham Study on Cardiovascular Disease Risk and Stress-Defenses: A Historical Review

The Framingham Heart Study (FHS) began in 1949 with the goal of defining the epidemiology of hypertensive or arteriosclerotic heart disease in the population of Framingham, Massachusetts, a primarily Caucasian suburb west of Boston with a population of approximately 28,000. The participants were without previous symptoms of heart disease and were followed for the occurrence of Cardiovascular Disease (CVD). The study documented a comprehensive medical history that included current symptoms, family history, past cardiac history, social history, and medications. The medical exam included diagnostic studies of chest X-ray, electrocardiogram (EKG), complete blood count (CBC), uric acid level, blood glucose, urinalysis, and venereal disease research laboratory test; Syphilis (VDRL). Serum lipids, recognized at the time to be associated with cardiovascular disease, were also measured. These included cholesterol, total phospholipids, and the Gofman’s Sf 10–20 fraction. Study participants underwent four examinations at 6-month intervals to document any clinical manifestation of CVD. The present understanding of the epidemiologic factors that influence cardiovascular disease risk (CVD-R) is based on the first report of study results at a 6-year median follow-up and numerous subsequent analyses of long-term follow-up data from the original Framingham cohort as well as their offspring. In this paper, we review the Framingham cohort study with regards to the risk factors of peripheral vascular disease.

Patterns of Postpartum Primary Care Follow-up and Diabetes-Related Care After Diagnosis of Gestational Diabetes

Gestational diabetes (GD) affects up to 10% of pregnancies and increases lifetime risk of type 2 diabetes 10-fold; postpartum diabetes evaluation and primary care follow-up are critical in preventing and detecting type 2 diabetes. Despite clinical guidelines recommending universal follow-up, little remains known about how often individuals with GD access primary care and type 2 diabetes screening. To describe patterns of primary care follow-up and diabetes-related care among individuals with and without GD in the first year post partum. This cohort study used a private insurance claims database to compare follow-up in the first year post partum between individuals with GD, type 2 diabetes, and no diabetes diagnosis. Participants included postpartum individuals aged 15 to 51 years who delivered between 2015 and 2018 and had continuous enrollment from 180 days before to 366 days after the delivery date. Data were analyzed September through October 2021 and reanalyzed November 2022. Primary care follow-up visits and diabetes-related care (blood glucose testing and diabetes-associated visit diagnoses) were determined by evaluation and management, Current Procedural Terminology, and International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes, respectively. A total of 280 131 individuals were identified between 2015 and 2018 (mean age: 31 years; 95% CI, 27-34 years); 12 242 (4.4%) had preexisting type 2 diabetes and 18 432 (6.6%) had GD. A total of 50.9% (95% CI, 49.9%-52.0%) of individuals with GD had primary care follow-up, compared with 67.2% (95% CI, 66.2%-68.2%) of individuals with preexisting type 2 diabetes. A total of 36.2% (95% CI, 35.1%-37.4%) of individuals with GD had diabetes-related care compared with 56.9% (95% CI, 55.7%-58.0%) of individuals with preexisting diabetes. Only 36.0% (95% CI, 34.4%-37.6%) of individuals with GD connected with primary care received clinical guideline concordant care with blood glucose testing 12 weeks post partum. In this cohort study of postpartum individuals, individuals with GD had lower rates of primary care and diabetes-related care compared with those with preexisting type 2 diabetes, and only 36% of those with GD received guideline-recommended blood glucose testing in the first 12 weeks post partum. This illustrates a missed opportunity for early intervention in diabetes surveillance and prevention and demonstrates the need to develop a multidisciplinary approach for postpartum follow-up.