Blood HbA1c Levels Research Articles

Association of Type‐2 diabetes mellitus with voxelwise tau uptake patterns

AbstractBackgroundDysfunctional insulin signaling and elevated hemoglobin‐A1c (HbA1c) ‐ both associated with type‐2 diabetes mellitus (T2DM) ‐ may result in increased tau hyperphosphorylation, thereby increasing the risk of Alzheimer’s Disease (AD)‐related neuropathology in T2DM patients. Individuals with both AD and T2DM show different profiles of tauopathy compared to individuals with just AD. Here, we evaluated voxelwise tau‐PET patterns with and without T2DM to clarify T2DM‐associated patterns of tau deposition in cognitively intact older adults.MethodWe examined 502 cognitively intact adults from the Health and Aging Brain Study: Health Disparities who had available 18F‐PI‐2620 tau‐PET, florbetaben‐PET (Aβ) (n = 462), MRI T1‐weighted scans (Siemens‐3T), and blood HbA1c levels (n = 492) (Table1). Voxelwise regression models were run in SPM12 using warped 18F‐PI‐2620 standardized uptake value ratio (SUVR) images as the outcome variable (gray matter of the posterior cerebellum reference region) and covarying for age, sex, and education. The first model assessed the effect of T2DM consensus diagnosis on tau uptake. The second model examined the relationship between HbA1c and tau uptake. Both voxelwise regression models were rerun adding global Aβ‐SUVR, obesity, and hypertension as covariates (Figure1).ResultVoxelwise regressions were corrected at voxel p<0.001, cluster FWE p<0.05. T2DM diagnosis was associated with higher 18F‐PI‐2620 uptake in the medial and inferior occipital regions, posterior cingulate, and parahippocampus. Higher HbA1c levels were associated with more 18F‐PI‐2620 uptake in parietal and frontal regions. When covarying for global Aβ‐SUVR, obesity, and hypertension, T2DM diagnosis was associated with 18F‐PI‐2620 uptake in the posterior cingulate. In the HbA1c model, no clusters survived FWE correction after covarying for global Aβ‐SUVR, obesity, and hypertension (Figure1). ConclusionIndependent of common T2DM comorbidities and brain amyloid, T2DM subjects demonstrated a 18F‐PI‐2620 tau uptake pattern that was different from the characteristic age‐associated medial temporal lobe pattern. Our voxelwise approach allowed us to identify regions that may distinguish T2DM‐related pathology from AD‐related changes. The difference in significant clusters between models could be due to HbA1c levels being controlled by medication in some T2DM patients – an area for future study.

Correlation of D-dimer Levels with Fasting Blood Glucose Levels in Patients with Type 2 Diabetes Mellitus

Chronic hyperglycemia in patients with Type 2 Diabetes Mellitus (T2DM) can cause damage to various organs, resulting in both microvascular and macrovascular complications that lead to an increased risk of cardiovascular disease. One of the markers that can detect vascular disorders is D-dimer levels. Fasting blood glucose (FBG) analysis in T2DM patients associated with D-dimer levels is important to know to be used as an indicator in connection with diabetes complications, especially vascular complications. This study aims to determine the correlation between D-dimer levels and FGB. The study was conducted in three hospitals in North Sulawesi province. The study population was T2DM patients (as evidenced by fasting blood glucose >126mg/dL) who examined themselves in the period January-June 2023. Samples were obtained using the total sampling method, where all populations that met the inclusion and exclusion criteria were used as participants. Ninety-four patients with T2DM (62 women and 32 men) were eligible to be participants in this study. Blood pressure, GDP and D-dimer were examined. Based on the results of the blood pressure examination, 40 participants suffered from hypertension and 54 participants did not. The average values of blood glucose, HbA1c and D-dimer levels in hypertensive and non-hypertensive participants are not much different. The results of the analysis using Spearman's rho showed that there was a moderate correlation between D-dimer levels and GDP (p=0.03, r=0.302). In conclusion, although there is a moderate correlation between D-dimer levels and fasting blood glucose levels, D-dimer is not recommended to be used as an indicator of complications in T2DM.

Brown Seaweed Consumption as a Promising Strategy for Blood Glucose Management: A Comprehensive Meta-Analysis

Diabetes is a chronic condition that can lead to various complications; therefore, there is a need to emphasize prevention and management. Dietary interventions, such as the Mediterranean diet or calorie-restricted regimens, coupled with exercise-induced weight reduction, have been recommended for enhancing diabetes management. Seaweeds contain various functional components, such as polyphenols and fucoidan, which have been reported to exert multiple benefits, including blood glucose regulation, improved intestinal health, and enhanced of lipid profiles. The association between blood glucose and seaweed consumption has been established in previous research. We searched the PubMed, RISS, Google Scholar, ScienceDirect, and Cochrane Library databases to identify relevant studies after applying the selection/exclusion criteria, and 23 studies were ultimately included in this analysis. Comprehensive Meta-Analysis (CMA) software version 4.0 was used to assess statistical significance and heterogeneity. In this meta-analysis, postprandial blood glucose, glycated hemoglobin (HbA1c), and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) levels demonstrated significant improvements in the seaweed group compared to the control group. Conversely, fasting blood glucose and insulin levels did not show significant associations with seaweed consumption. Subgroup analysis revealed that a high dose (1000 mg or more) was more beneficial than a low dose, and seaweeds such as Laminaria digitata, Undaria pinnatifida, Acophyllum nodosum, and Fucus vesiculosus were found to be more effective at improving blood glucose levels than control treatments. Therefore, based on our research, seaweed supplementation appears to be a promising strategy for reducing postprandial blood glucose, HbA1c, and HOMA-IR levels, thereby enabling better blood glucose management and leading to a decreased risk of type 2 diabetes.

Study of the influence of GLP-1 receptor agonists on the metabolic activity of the intestinal microbiota in patients with type 2 DM

The aim: to investigate the peculiarities of the metabolic activity of the intestinal microbiota in patients with type 2 diabetes under the influence of glucagon-like peptide-1 receptor agonist therapy. Materials and methods: 21 patients with type 2 diabetes mellitus were included in the study, the average age was 57.2±8.53 years (M±SD), the HbA1c level was 8.29±0.88 % (M±SD). Patients were prescribed raGLP-1 at the maximum tolerated dose for 6 months. Before and after the course of treatment, indicators of body composition were determined by the bioelectrical impedance method (TANITA BC-545N analyzer, Japan), characteristics of carbohydrate metabolism and the lipid spectrum of blood serum, as well as the concentration of GLP-1, trimethylamine-N-oxide (TMAO) by the immunoenzymatic method, of short-chain fatty acids (SCFA) by the method of chromatographic research. Results. After 6 months of therapy with liraglutide against the background of a statistically significant decrease in fasting blood glucose and HbA1c levels (p<0.05), a decrease in body mass index and waist circumference (p<0.05), a decrease in the content of visceral (p<0.05 ) and total fat (p<0.05) in patients with type 2 diabetes, there was a decrease in the concentration of TMAO in blood serum (p<0.05) and an increase in the concentration of SCFA: acetic, propionic (p<0.05) in the coprofiltrate and a tendency to increase in the level of butyric acids. Data analysis also established an increase in the concentration of endogenous GLP-1 in the blood (p<0.05). Conclusions. The detected changes in microbial metabolites may indicate a positive effect of raGLP-1 on the composition of the intestinal microbiota and its metabolic activity in patients with T2DM, which in turn contributes to the improvement of endogenous secretion of incretins

Trust-based health decision-making recruits the neural interoceptive saliency network which relates to temporal trajectories of Hemoglobin A1C in Diabetes Type 1.

Experimental approaches in neuroeconomics generally involve monetary utility. Utility inthe health domain is relevant in diabetes because constant daily life decisions are critical for self-consequential long-term outcomes. We used fMRI to investigate self-consequent decision-making in the health and economic domains in Type 1 Diabetes Mellitus and controls (N = 50). We focused on two critical phases of decision-making: Investment and Feedback (Positive or Negative). Patients showed larger BOLD activation of limbic, and reward/dopaminergic regions in particular in the health trust game. Importantly, the worse the trajectory of metabolic control (increasing HbA1C), the higher the BOLD activity in regions of the interoceptive saliency network. This was manifested by positive correlations between brain activity during investment in anterior cingulate cortex and insula and HbA1c blood level progression. We conclude that the neural correlates of health-consequent decision-making domain involve limbic and reward related dopaminergic regions in Type 1 Diabetes Mellitus. Furthermore, the temporal trajectory of HbA1C blood levels is correlated with neural risk processing in the saliency network. Evidence for differential risk processing in the health versus the neuroeconomic context, and the discovery of a role for the saliency interoceptive network in metabolic control trajectories suggests a new perspective on the development of personalized interventions.

Associated factors of diabetic retinopathy by artificial intelligence evaluation of fundus images in Japan

AbstractThis cross-sectional study aimed to investigate the promoting and inhibitory factors of diabetic retinopathy (DR) according to diabetes mellitus (DM) stage using standardized evaluation of fundus images by artificial intelligence (AI). A total of 30,167 participants underwent blood and fundus examinations at a health screening facility in Japan (2015–2016). Fundus photographs were screened by the AI software, RetCAD and DR scores (DRSs) were quantified. The presence of DR was determined by setting two cut-off values prioritizing sensitivity or specificity. DM was defined as four stages (no DM: DM0; advanced DM: DM3) based on treatment history and hemoglobin A1c (HbA1c) levels. Associated factors of DR were identified using logistic regression analysis. For cutoff values, multivariate analysis revealed age, sex, systolic blood pressure (SBP), smoking, urinary protein, and HbA1c level as positively associated with the risk of DR among all DM stages. In addition to glycemic control, SBP and Fibrosis-4 index might act as promoting factors for DR at all or an earlier DM stage. T-Bil, cholinesterase, and T-cho level might be protective factors at an advanced DM stage.

Factors Associated with Diabetic Complication Index among Type 2 Diabetes Patients: Focusing on Regular Outpatient Follow-up and HbA1c Variability

Preventing diabetic complications involves regular outpatient follow-up and maintaining low variability in hemoglobin A1c (HbA1c) levels. This study investigated the factors associated with diabetic complications, with a specific focus on the impact of regular outpatient follow-up and HbA1c variability, among patients with type 2 diabetes. The study design was secondary data analysis of electronic medical records from a university hospital in Korea. It included patients aged 40-79 with type 2 diabetes who were prescribed diabetes medication within three months of their first HbA1c test by an endocrinologist and were followed up for at least five years. Follow-up regularity, adjusted standard deviation of HbA1c levels, and diabetic complication indices were collected. Data were analyzed using the Chi-square test, independent t-test, repeated measures analysis of variance, and multiple regression analysis. The study included 1566 patients. Lower follow-up regularity was observed in patients of older age, with comorbidities, diabetic complications, insulin treatment, a history of hospitalization, lower baseline estimated glomerular filtration rate (eGFR) and total cholesterol (TC), and higher HbA1c variability. Higher HbA1c variability was observed in younger patients without comorbidity but with insulin treatment, a history of hospitalization, higher baseline blood glucose (BG), HbA1c, TC, and triglyceride levels. HbA1c variability had the strongest influence on BG and HbA1c levels at the five-year follow-up. Baseline eGFR and TC were the most influential factors for their respective levels at the five-year follow-up. Follow-up regularity significantly affected BG, HbA1c, eGFR, and TC at five-year follow-up. It has been shown that several variables besides regular follow-up and HbA1c variability have an influence. However, these are the two that can be corrected through nursing intervention and are important, so intervention on these is important.

Genetic risk scores: are they important for diabetes management? results from multiple cross-sectional studies

BackgroundSeveral genetic risk scores (GRS) for type 2 diabetes (T2DM) have been published, but not replicated. We aimed to 1) replicate previous findings on the association between GRS on prevalence of T2DM and 2) assess the association between GRS and T2DM management in a sample of community-dwelling people from Switzerland.MethodsFour waves from a prospective study conducted in Lausanne. Seven GRS related to T2DM were selected, and compared between participants with and without T2DM, and between controlled and uncontrolled participants treated for T2DM.ResultsData from 5426, 4017, 2873 and 2170 participants from the baseline, first, second and third follow-ups, respectively, was used. In all study periods, participants with T2DM scored higher than participants without T2DM in six out of seven GRS. Data from 367, 437, 285 and 207 participants with T2DM was used. In all study periods, approximately half of participants treated for T2DM did not achieve adequate fasting blood glucose or HbA1c levels, and no difference between controlled and uncontrolled participants was found for all seven GRS. Power analyses showed that most GRS needed a sample size above 1000 to consider the difference between controlled and uncontrolled participants as statistically significant at p = 0.05.ConclusionIn this study, we confirmed the association between most published GRS and diabetes. Conversely, no consistent association between GRS and diabetes control was found. Use of GRS to manage patients with T2DM in clinical practice is not justified.

Cardiovascular risk prediction in a New Zealand cohort of patients with known cardiovascular disease - a regional individual patient-level data linkage study

Abstract Background National health databases have been underutilised in the development of cardiovascular disease (CVD) risk prediction equations for people with known CVD, yet can inform population level practice and policy—including identification of health equity gaps, high-risk groups, and high-risk localities. With the recent introduction of novel and expensive preventive cardiovascular drugs, stratifying risk in patients with prior CVD could be required to inform cost-effective use of these medications in the future. Purpose We sought to develop 5-year CVD risk equations in adults with known history of CVD in Aotearoa New Zealand, using data from administrative health databases and characterize distribution of risk according to sex. Methods All people above 18 years of age with a history of CVD hospitalization, living in the Auckland and Northland regions of Aotearoa New Zealand (approximately one-third of the national population) on 1 January 2014 were included. Participants were followed for 5 years (31 December 2018) or until death or the outcome of interest, being any fatal or non-fatal CVD hospitalization (ischemic heart disease, heart failure, ischemic stroke, or peripheral artery disease) during follow-up. Sex-specific 5-year CVD risk prediction equations were developed using multivariable Fine and Gray models taking competing risk of non-cardiovascular death into account. Predictor variables included were age; ethnicity; deprivation level; time since most recent CVD hospitalization, history of smoking, heart failure, atrial fibrillation, chronic renal disease, and diabetes mellitus; use of anti-thrombotic, blood pressure-lowering, and lipid-lowering drugs; and blood levels of glycosylated hemoglobin (HbA1c), non-HDL cholesterol, and creatinine. Results The cohort comprised 42,130 men (median age: 68 years [interquartile range (IQR): 59–76]) and 31,717 women (median age: 70 years [IQR: 60–78]) with 12,875 and 8,734 observed events during follow-up, respectively. Sex-specific 5-year CVD risk prediction equations with excellent calibration (accuracy) were developed (Figure 1). Increasing age; high deprivation level; more recent CVD hospitalization; history of smoking, heart failure, atrial fibrillation, chronic renal disease, diabetes mellitus; use of blood-pressure lowering drugs; and high blood levels of HbA1c, non-HDL cholesterol, or creatinine were predictors of elevated risk. There was a wide range of predicted 5-year risk, with 15% of men and 24% of women having a predicted risk below 15%, and 24% and 20%, respectively, having a predicted risk of 40% or above (Figure 2). Conclusion This study demonstrates that it is possible to develop accurate CVD risk prediction equations from administrative health databases for patients with known CVD. Marked heterogeneity in 5-year risk of a subsequent CVD event emphasise that the current ‘one size fits all’ approach to secondary prevention of CVD requires review.Figure 1Figure 2

Bio‐fabrication and characterization of nano‐silver using Kickxia elatine plant and its anti‐diabetic effect on alloxan‐induced Sprague Dawley rats — An in vivo approach

Diabetes mellitus (DM) is one of the most prevalent, fatal, and non‐contagious diseases. Therefore, researchers are making attempts to develop novel anti‐diabetic drugs using various organic compounds and biomolecules. The idea of using nano‐materials as anti‐diabetic agents seems interesting. The current study aims to develop Kickxia elatine (KE) extract‐based nano‐silver (KE‐AgNPs) and to evaluate their in vivo anti‐diabetic potency in female Sprague Dawley rats. KE‐AgNPs were characterized using UV spectroscopy, X‐ray diffractometer (XRD), scanning electron microscopy (SEM), Electron Diffraction X‐ray Spectroscopy (EDX), and Fourier transforms infrared (FTIR) techniques. The crystalline nature of KE‐AgNPs with a size of 42.47 nm is confirmed by XRD screening. Spherical‐shaped mono‐dispersed KE‐AgNPs with a mean size of 50 nm are validated by SEM examination. The different phyto‐compounds (tannins, alkaloids, flavonoids, proteins, saponins, phenols, carbohydrates, quinones, sterols, fats, and oils) that contribute to the stabilization and reduction of KE‐AgNPs are confirmed by FTIR analysis. EDX showed a strong peak (3.2 keV) that identified Ag as the main component with a 61.67% contribution. The use of Alloxan to induce diabetes resulted in elevated levels of blood sugar, HbA1c, liver, and lipid profile, as well as a drastic reduction in body weight, body organ weight, and Hemoglobin. These modifications were switched following 21 days of treatment of diabetic rats, and a dosage range of 150–450 mg kg−1 BW of KE extract and KE‐AgNPs demonstrated significant inhibition as compared with the diabetic untreated group. The phytochemical analysis of the KE plant was also assessed to examine the phyto‐compounds involved in the anti‐diabetic potential of KE extract and KE‐AgNPs. These findings suggested that, in comparison with the KE extract, KE‐AgNPs have demonstrated promising anti‐diabetic action.

Glucose indices as inflammatory markers in children with acute surgical abdomen: a cross-sectional study

Background Glycaemic dysregulation potentiates the pro-inflammatory response and increases oxidative injury; therefore, preoperative hyperglycaemia is linked to increased mortalities. In addition, inflammation is accompanied by higher glycated haemoglobin (HbA1c) levels, and the relationship between this and random blood sugar (RBS) could be non-linear. Methods This is a cross-sectional study. Non-diabetic paediatric patients with acute surgical abdomen, presenting to the emergency surgical services were enrolled, over a period of 6 months. They were all screened for their random blood sugar and HbA1c levels. Results Fifty-three cases were studied. The prevalence of glycaemic dysregulation in the enrolled children was high. Abnormal HbA1c was observed in 66% of the study group. Stress hyperglycaemia was observed in 60% of the enrolled children. There was a significant correlation (r = 0.770, p-value: < 0.001) between RBS and the total leucocytic count (TLC). The TLC cutoff value for predicting stress hyperglycaemia was 13,595 cells/mm3. The cutoff value of RBS for predicting leukocytosis was 111.5 mg/dl. Median RBS level was significantly higher in complicated appendicitis (169.5 mg/dl), compared to uncomplicated appendicitis (118.0 mg/dl). Conclusion HbA1c and RBS could be used as inflammatory markers for surgical acute abdomen and its degree of severity, respectively. HbA1c rises in a considerable number of cases with surgical acute abdomen, irrespective of the disease stage. However, as the disease progresses, the random blood sugar rises due to stress hyperglycaemia, thus becoming a surrogate inflammatory marker.

A comparison with micro albuminuria indicates whether urine and serum kidney injury molecule-1 can predict the onset of early diabetic nephropathy (DN).

Diabetic nephropathy (DN) is the most frequent consequence of DM and a significant contributor to chronic kidney disease, a multifactorial illness. Kidney injury molecule-1 (KIM-1) is a sensitive and accurate indicator of kidney damage and a predictive indicator. Aim: The present investigation aimed to examine serum and urine KIM-1 as a DN early marker. Patients and methods: The present study included 150 participants, among whom 50 non-diabetic participants were chosen as controls. One hundred diabetic participants were split into two groups based on their urine albumin/creatinine ratio (ACR) as participants with normoalbuminuria (T2DM patients without nephropathy) and microalbuminuria (T2DM patients with nephropathy). The blood glucose, HbA1c, s.urea, and creatinine levels in serum and urine were measured using standard laboratory techniques, and Elisa Essay measured serum and urine KIM-1 levels. Results: There was a distinct variation in the mean serum and urine KIM-1 between the control and diabetics without microalbuminuria (P = 0.001). Serum KIM-1 correlated with ACR (P = 0.669) in people with diabetes with microalbuminuria. Urine KIM-1 was less correlated than serum KIM-1 (p = 0.257). A strong association was found between ACR and serum KIM1 in people with diabetes with microalbuminuria and a low correlation between ACR and urine KIM-1 in people with diabetes with microalbumin. Conclusion: According to the current investigation, diabetic groups with microalbuminuria had higher serum and urine levels of KIM-1 than the control groups. Additionally, there was a favorable correlation between serum KIM-1 and the length of diabetes. More extensive multicentric trials are also needed to assess the efficacy of serum and urine KIM-1 as a DN early marker. Keywords: Serum /Urine KIM-1; Dibetic nephropathy; Microalbumin; DM type2

Prediabetic HbA1c and Cortical Atrophy: Underlying Neurobiology.

To investigate the relationship between blood glycated hemoglobin (HbA1c) and cerebral cortical thickness (CT) and identify potential cellular mechanisms involved. A cohort of 30,579 adults age 45 to 81 (mean ± SD: 64 ± 7.5) years with available data on brain MRI and blood HbA1c levels was analyzed. The relationship between HbA1c and CT was probed using independent spatial profiles of cell-specific gene expression. Lastly, a genome-wide association study was conducted on the shared variance between HbA1c and CT. The HbA1c-CT association was noncontinuous, emerging negatively within the prediabetic range (39.6 mmol/mol). This association was strongest in brain regions with higher expression of genes specific to excitatory neurons and lower expression of genes specific to astrocytes and microglia. A significant locus implicated mitochondrial maintenance and ATP generation. Effective glycemia control at prediabetic levels is warranted to preserve brain health and prevent prediabetes-related neurobiologic perturbations.

The preconception health status of nongravid women aged 18 to 45 years in Arima, Trinidad: a cross-sectional study

BackgroundPreconception care (PCC) is the term used for activities and interventions designed to address and prevent problems related to pregnancy, the neonatal period and childhood. This study assessed maternal health status prior to conception in Trinidad by means of a screening tool, physical measurements, and laboratory samples.MethodsA cross-sectional study was conducted among women aged 18–45 years at a primary care centre in Arima, Trinidad. A de novo PCC screening tool was used to assess 13 domains of high-risk pregnancy in participants. These domains included dietary details, gynaecological and obstetric histories, and genetic and vaccination histories, among others. Blood pressure, weight, height, and waist circumference were recorded, and a capillary blood sample was used to determine random blood glucose and HbA1c levels. All data were coded and entered into SPSS ver. 21.ResultsA total of 400 nongravid participants were recruited, of whom 366 were included in the final analysis. Most (96.7%) had one or more risk factors for adverse pregnancy outcomes. These included overweight (27%), obesity (35%), central obesity (69.4%), and impaired glucose tolerance/diabetes mellitus (IGT/DM) (26.2%). Additionally, a sedentary lifestyle and diet high in processed food/fats were self-reported by 74.9% and 88.8% of participants, respectively. Only 13.1% had planned to conceive, and of those who had no immediate plans to conceive, 76.4% were currently sexually active, and many (60.7%) did not use birth control techniques. More than half (57.1%) had never had a pap smear. On the other hand, 86.3% knew their HIV status. Self-reported percentages for vaccination were as follows: MMR (100%), tetanus (17.5%), hepatitis B (11.5%) and influenza (2.7%). The majority (82.8%) of participants had not visited the dentist in the past year, with 35.9% of these individuals reporting symptoms of periodontitis. Segments of the population had multiple risk factors; for example, 23.7% of participants were overweight or obese and had an elevated HbA1c level.ConclusionsUnexpectedly, most participants had a risk factor for an adverse pregnancy outcome, and many had multiple risk factors. There is a strong case for enhanced preconception care for women in Trinidad.

Harnessing Code Interpreters for Enhanced Predictive Modeling: A Case Study on High-Density Lipoprotein Level Estimation in Romanian Diabetic Patients.

Diabetes is a condition accompanied by the alteration of body parameters, including those related to lipids like triglyceride (TG), low-density lipoproteins (LDLs), and high-density lipoproteins (HDLs). The latter are grouped under the term dyslipidemia and are considered a risk factor for cardiovascular events. In the present work, we analyzed the complex relationships between twelve parameters (disease status, age, sex, body mass index, systolic blood pressure, diastolic blood pressure, TG, HDL, LDL, glucose, HbA1c levels, and disease onset) of patients with diabetes from Romania. An initial prospective analysis showed that HDL is inversely correlated with most of the parameters; therefore, we further analyzed the dependence of HDLs on the other factors. The analysis was conducted with the Code Interpreter plugin of ChatGPT, which was used to build several models from which Random Forest performed best. The principal predictors of HDLs were TG, LDL, and HbA1c levels. Random Forest models were used to model all parameters, showing that blood pressure and HbA1c can be predicted based on the other parameters with the least error, while the less predictable parameters were TG and LDL levels. By conducting the present study using the ChatGPT Code Interpreter, we show that elaborate analysis methods are at hand and easy to apply by researchers with limited computational resources. The insight that can be gained from such an approach, such as what we obtained on HDL level predictors in diabetes, could be relevant for deriving novel management strategies and therapeutic approaches.

THU330 No Calm After The Storm : Is Blood Glucose Level At Patient Presentation Related To The Stage And Outcome Of Mucormycosis In COVID- 19 Pandemic?

Abstract Disclosure: V. Sharma: None. K. Kriplani: None. I. Tuli: None. S. Sharma: None. Mucormycosis is one of the most aggressive opportunistic fungalinfections. Although conventionally limited to the demographics of severelyimmunocompromised and those with uncontrolled hyperglycemia and/orketoacidosis, in recent times, has propelled to the frontline in investigationsof COVID-19 complications. It can present in 4 stages, with progressiveinvolvement of the nasal mucosa, the paranasal sinuses, the orbit and thebrain. The stage of Mucormycosis at presentation critically influences academicdialogue on its clinical outcome and treatment options. However, prior researchhas failed to evaluate an association of patient factors especially HbA1clevels and Random Blood sugar(RBS) at presentation with the Stage and patientoutcome of Mucormycosis. A total of 75 patients with laboratory confirmedMucormycosis were enrolled in the study. Mean age of the participants was 45.17years of which 85.33% were survivors . Although there was no statisticallysignificant difference between the survivors and non-survivors concerning meanHbA1C and RBS levels, there was a statistically significant association betweenthe Stage of Mucormycosis and the level of HbA1c and RBS at presentation forStages 2b, 2c, 2d,3a, 3b, 3c, 4a, 4b, and 4c. This leads to the understandingthat clinicians must order blood sugar and HbA1c level at presentation as cuesto a better understanding of disease severity. The most common comorbidcondition was diabetes mellitus, however, only coronary artery disease in thepatient was found to be significantly correlated with mortality, while othersincluding diabetes mellitus, hypertension, chronic steroids use,immunocompromised status, and history of COVID-19 had no significantassociation. The patients with a history a COVID reported a statisticallysignificant higher RBS level than those without. Development or worsening ofdiabetes mellitus is on the long list of COVID-19 complications. Prior studiesreported an increased incidence of Mucormycosis cases in COVID-19 patients -both with diabetes (80%) and/or DKA(14.9%)(1). The binding of SARS-CoV-2 toACE2 receptors resulting in beta cell apoptosis and an ensuing cascade ofvirion, redox and cytokine storms are the simplified mechanisms of type 1 and 2diabetes development respectively, in COVID patients(2). Previous literaturesuggests a statistically significant association between stage of Mucormycosisat presentation and serum lipid profile(3), and serum iron and inflammatorymarkers levels(4). According to the data available from various sources, nosuch study compared the levels of RBS and HbA1C with the stageof Mucormycosis. Reference: (1)Hill et al, Metabolism: clinical andexperimental. 2020 Jun;107:154217 (2) Handayani et al, Obes Med. 2021May;23:100333. (3) Vijay et al, J Assoc Physicians India. 2022 Apr;70(4):11-12(4) Rao et al, J Assoc Physicians India. 2022 Apr;70(4):11-12. Presentation: Thursday, June 15, 2023

FRI099 Advanced Lipoprotein Analysis In Patients With Cushing’s Syndrome

Abstract Disclosure: R.T. Varghese: None. R. McGlotten: None. M. Sampson: None. A. Prakash: None. R. Shamburek: None. A.T. Remaley: None. R. Muniyappa: None. L.K. Nieman: None. Introduction: Cushing syndrome (CS) patients have a higher mortality rate due to increased cardiovascular disease (CVD). Analysis of lipoprotein particles with nuclear magnetic resonance (NMR) spectroscopy provides additional insights into CVD risk beyond the standard lipid panel. The goal of the study was to better characterize the lipid abnormalities in patients with CS by using high-resolution separation of lipoprotein particles. Methods: We measured plasma lipids (Cholesterol, TC; calculated low density lipoprotein, LDL; triglycerides, TG; high density lipoprotein, HDL) by the traditional enzymatic assay and lipoprotein particles by NMR spectroscopy. Measures of inflammation and insulin resistance were also derived from NMR spectra. Values are shown as mean ± SEM or median [IQR]. Results: After initial evaluation, 42 subjects (mean age 47.4 ± 2.5 years; 28 females; weight 85.0 ± 3.1 kg) had Cushing's disease (n=23), ectopic ACTH secretion (n=17), or adrenal adenoma (n=2). Ten patients were on chronic statin therapy, and 14 subjects had type 2 diabetes mellitus (T2DM). The control group comprised 45 subjects without T2DM [mean age 45.4 ± 2.1 years and weight (83.5 ± 2.7) kg]. None in the control group were on statin therapy. Compared to controls, CS patients had significantly higher systolic (135 ±2 vs. 119 ±2 mm Hg, p&amp;lt;0.001) and diastolic blood pressure (79 ±2 vs. 71 ±1 mm Hg, p&amp;lt;0.001), HbA1c (6.1 [5.4-7.5] vs. 5.4 [5.0-5.7], p&amp;lt;0.001), plasma glucose (103 [90-137] vs 94 [89-100] mg/dL, p=0.003), and insulin (17[12-26] vs 11[7-15] uU/mL, p=0.01) levels. Compared to controls, patients with CS had significantly higher triglyceride concentration (116 [84 -146] vs 87 [62-120] mg/dL, p=0.02) and lower LDL concentration (90 [69 -113] vs 108 [90 -125] mg/dL, p=0.04). However, total cholesterol and HDL cholesterol concentrations were not different. LDL particle size in CS was smaller (20.5[20.0-21.0] vs 21.0 [20.7-21.2] nm, p=0.01) and VLDL particle size was larger (49.8 ± 0.9 vs 45.7 ± 1.0 nm, p=0.002) than in controls. No difference was noted between groups in HDL particle number or size or in LDL and VLDL particle number. In the group with CS, a marker of inflammation, GlycA (Glycan N-acetylglucosamine) (494.5 ± 18.2 vs. 382.5 ± 9.0 µmol/L, p&amp;lt;0.001) and Lipoprotein Insulin Resistance score (LPIR) (46.4 ± 3.1 vs. 36.2 ± 3.1, p=0.02) were significantly higher. There were no group differences in branch-chained amino acids (BCCA) levels. These differences remained even when patients with type 2 diabetes and those on statin therapy were excluded. Conclusions: These data suggest that the higher inflammatory and insulin resistance state, dysglycemia, hypertension, and altered lipoprotein profiles may contribute to the increased CV risk in patients with Cushing’s syndrome. Early detection and treatment for these abnormalities may attenuate CV risk. Presentation: Friday, June 16, 2023

Observational study between level of vitamin D, anthropometric status and metabolic profiles in patients with type 2 diabetes mellitus

Introduction. Type 2 diabetes mellitus (T2DM) is currently an important global health disease. At the same time vitamin D deficiency is considered the other public health problem around the world. Some studies suggest involving insufficient or deficiency of vitamin Din the etiopathogenesis of T2DM. Materials and methods. 58 patients, 33 women (56.89%) and 25 men (43.10%) were included in the observational study. Demographics (age, gender), personal anamnestic data (duration of diabetes, micro-and macrovascular complications, therapy with vitamin D supplements), anthropometric and biochemical parameters were assessed. The anthropometric measurement included height (meters), weight (kg) and body mass index (BMI) defined as a ratio of weight to the square of height (kg/m2). Biochemical parameters included the fasting blood glucose, glycated hemoglobin (HbA1c), serum total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, very-low density lipoprotein (VLDL) cholesterol, triglycerides (TG), as well the level 25(OH)D. We followed the correlation between vitamin D levels and the duration of diabetes, BMI, blood glucose levels, HbA1c, TC, LDL-cholesterol, HDL-cholesterol, VLDL-cholesterol, TG. Results. The average values recorded were 11.72 years for the duration of T2DM, 31.77 kg/m2 for BMI, 169.00 mg/dL for blood glucose levels, 8.01% for HbA1c, 200.40 mg/dL for TC, 129.04 mg/dL for LDL-cholesterol, 47.67 mg/dL for HDL-cholesterol, 26.69 mg/dL for VLDL-cholesterol and 160.34 mg/dL for TG. Conclusion. Following statistical analysis, the observational study highlight statistically negative correlation recorded between the level of vitamin D and BMI, glycemic balance (highlighted by the level of fasting blood glucose and HbA1c). The results found nonsignificant correlation between the levels of vitamin D: duration of diabetes and lipid profile.

Lifetide biofeedback intervention in type 2 diabetic patients: a pilot observation

To evaluate the therapeutic efficacy of lifetide biofeedback intervention in patients with type 2 diabetes mellitus (T2DM). We analyzed the changes in average blood glucose, estimated glycosylated hemoglobin (HbA1c), fasting blood glucose and HbA1c levels in 5 patients with T2DM undergoing lifetide biofeedback intervention without the use of hypoglycemic drugs. A transient blood glucose monitoring system was used for drug withdrawal management during the intervention. Compared with those before the intervention, the average blood glucose and fasting blood glucose and HbA1c levels showed no significant changes after the intervention without using hypoglycemic drugs (P>0.05), but the estimated HbA1c was significantly decreased after the intervention (P<0.05). Two patients achieved complete remission, two showed partial remission, and one had substantially improved blood glucose levels. One patient showed a marked increase in extremity temperature after the intervention (P<0.05). Another patient had a significantly increased heart rate variability index (P<0.05) without obvious changes in heart rate after the intervention (P>0.05). By reestablishing the balance in autonomic nervous system regulation and enhancing peripheral microcirculation, lifetide biofeedback intervention helps to maintain stable blood glucose levels, achieve disease remission, and reduce the occurrence of complications in T2DM patients after discontinuation of hypoglycemic drugs without changing their lifestyles.

Association between Altered Thyroid Function and Prediabetes in Diet-Induced Prediabetic Male Sprague Dawley Rats

There is a correlation between the existence of type 2 diabetes mellitus (T2DM) and the development of thyroid disorders. Prediabetes is a progressive state of moderate insulin resistance that often precedes the onset of T2DM. However, the association between prediabetes and thyroid function is unknown. This study assessed changes in markers of thyroid function in diet-induced prediabetes. Twelve male Sprague Dawley rats (n = 12) were randomly assigned into two groups. Rats in the non-prediabetic (NPD) group were fed a standard rat diet, while rats in the prediabetic (PD) were fed a high-fat high-carbohydrate diet for 20 weeks to induce prediabetes. Thereafter, fasting blood glucose levels were measured. Plasma samples were assessed for triiodothyronine (T3), thyroxine (T4), thyroxine peroxidase (TPO) antibody, insulin, and glycated hemoglobin (HbA1c) concentrations. The elevated blood glucose, HbA1c, and plasma insulin levels coincided with increased T3 and reduced T4 levels in the PD group when compared to the NPD group. There was also an increase in the concentration of TPO antibodies in the PD group. Additionally, there was a significant correlation between the thyroid hormone concentrations and HbA1c levels. In conclusion, these results indicated that there is a positive association between thyroid dysfunction and diet-induced prediabetes in rats.