Blood Glucose Levels Research Articles

Dapagliflozin combined with metformin improves blood glucose, bone metabolism and bone mineral density in elderly patients with type 2 diabetes mellitus complicated with osteoporosis.

The incidence of type 2 diabetes mellitus (T2DM) complicated with osteoporosis (OP) (T2DM-OP) is growing. Dapagliflozin and metformin are commonly prescribed to manage glycemic levels in T2DM patients. We investigated the clinical efficacy of combining dapagliflozin with metformin in elderly patients with T2DM-OP. Totally 144 T2DM-OP patients were prospectively enrolled and allocated into two groups: the Metformin and Dapagliflozin + Metformin groups. Each group received treatment for 12 months. Fasting peripheral blood samples were collected before and after 12 months of treatment. Glycemic parameters and bone metabolic parameters were measured using oral glucose tolerance test, automatic biochemical analyzers, or liquid chromatography. Bone mineral density (BMD) changes at lumbar vertebrae (L1-4), femoral neck (FN) and total hip (TH) were assessed using dual-energy X-ray bone mineral densitometry. Pain severity was evaluated using the visual analog scale (VAS). The total effective rate, fracture incidence, and adverse reaction rate were also evaluated. After 12 months, both groups showed improvements in glycemic parameters, bone metabolic parameters, and BMD at L1-4, FN, and TH, and reductions in VAS scores. The Dapagliflozin + Metformin group exhibited more significant improvements. The overall effective rate was higher and fracture incidence, was lower in Dapagliflozin + Metformin group, with comparable rates of adverse reactions and safety profiles between the two groups. Taken together, treatment with a combination of dapagliflozin and metformin led to improvements in blood glucose levels, bone metabolism, and BMD in elderly patients with T2DM-OP, demonstrating superior efficacy and safety compared to metformin monotherapy.

Blood donation and post donation care: A clinical update

Donating blood is an essential component of healthcare systems, and it is imperative to administer adequate post-donation care to donors in order to safeguard their health and maintain the blood supply's safety. This brief offers a succinct outline of crucial suggestions for persons who have made a blood donation. After receiving a donation, the initial treatment usually involves taking rest, staying hydrated, and having a light meal to replenish blood volume and glucose levels. Adequate fluid intake is crucial for preventing dehydration and promoting the restoration of blood volume. In order to maintain the health and safety of blood donors and guarantee the excellence of donated blood, recommendations frequently advise following dietary limitations, which may include refraining from alcohol and restricting caffeine use. It is highly recommended to cease smoking, as it enhances general well-being and increases the amount of oxygen in the bloodstream. Donors should vigilantly observe the donation location for any unusual symptoms and promptly seek medical aid if needed. Long-term care prioritizes maintaining good physical well-being by promoting a balanced diet, regular physical activity, and adequate rest. Regular blood donors, particularly women, may require iron supplements to avoid iron deficiency anaemia. Donors must strictly adhere to the recommended time intervals between donations in order to maintain blood safety and prevent donor exhaustion. Adhering to post-donation obligations is essential for the well-being of donors, guaranteeing the security of the donated blood, and promoting ongoing blood donation. The objective of present review is to optimise the donor recovery process, mitigate any adverse consequences, and ensure the continuous availability of a safe blood supply for patients in need.

Inhibidores del transportador SGLT2 en el tratamiento de la Diabetes mellitus tipo 2: revisión bibliográfica

Mellitus Diabetes is a chronic condition that affects the global population. In Latin America, it has high prevalence rates and increasingly rising mortality. In Ecuador, 4,895 deaths from this condition were reported in 2017. Sodium-glucose cotransporter inhibitors (SGLT inhibitors) have been shown to be effective in treating diabetes mellitus. These inhibitors help reduce body weight and glycosylated hemoglobin, particularly in patients with good renal function. SGLT2 inhibitors, approved in recent years, block the renal reabsorption of glucose, promoting its excretion through urine. This reduces blood glucose levels and offers additional benefits such as renal protection and decreased cardiovascular risks. Methodology: Non-experimental, bibliographic review. Objective: Analyze the global benefits of SGLT2 transporter inhibitors in the treatment of type 2 diabetes mellitus. Results: The main SGLT2 inhibitors each have specific pharmacokinetic characteristics and therapeutic applications that can be leveraged when treating patients with this condition. Conclusions: Type 2 diabetes mellitus is a chronic condition that requires timely and appropriate treatment with medications that provide clinical benefits to the patient. Considering SGLT2 inhibitors, a novel treatment approach can be offered to diabetic patients, which is generally well tolerated depending on the patient's condition

The mediating role of maternal fasting plasma glucose level and lipid levels in the third trimester of pregnancy between pre-pregnancy BMI and offspring physical development at birth.

The findings of the study indicate that pre-pregnancy BMI is associated with offspring's physical development at birth, with the overweight or obese pre-pregnancy BMI group having an increased risk of macrosomia. The most effective prediction for macrosomia comes from a combination of BMI, FPG, TG, and HDL-C levels. Moreover, the influence of pre-pregnancy BMI on offspring's physical development is partially mediated by FPG, TG, and HDL-C. • Previous research has established correlations between pre-pregnancy BMI and offspring's physical development. • Previous studies have demonstrated that late pregnancy blood lipid and glucose levels significantly predict fetal physical development. • The combination of pre-pregnancy BMI, FPG, TG, and HDL-C is the most effective predictor of macrosomia. • FPG, TG, and HDL-C jointly mediate the effect of pre-pregnancy BMI on physical growth.

Systemic Glucose Homeostasis Requires Pancreatic but Not Neuronal ATP-Sensitive Potassium Channels.

The ATP-sensitive potassium (KATP) channels, composed of Kir6.2 and SUR1 subunits, are essential for glucose homeostasis. While the role of pancreatic KATP channels in regulating insulin secretion is well-documented, the specific contributions of neuronal KATP channels remain unclear due to challenges in precisely targeting neuronal subpopulations. In this study, we utilized a Kir6.2 conditional knockout mouse model to distinguish the roles of KATP channels in different cell types. Our findings demonstrate that deletion of neuronal KATP channels does not impair glucose homeostasis, as glucose-sensing neurons retained their responsiveness despite the absence of functional KATP channels. In contrast, the deletion of KATP channels in pancreatic β cells led to significant hyperglycemia and glucose intolerance, indicating unstable blood glucose levels under varying physiological conditions. Importantly, we showed that restoring KATP channel function exclusively in pancreatic β cells within a global Kir6.2 knockout background effectively reversed glucose regulation defects. This underscores the critical role of pancreatic KATP channels in maintaining systemic glucose homeostasis. Our results challenge the previous hypothesis that neuronal KATP channels are essential for glucose regulation, suggesting that their primary function may be neuroprotective rather than homeostatic. These findings highlight pancreatic KATP channels as key regulators of glucose balance and potential therapeutic targets for correcting glucose dysregulation.

The Evaluation of Biochemical Parameters in Positive COVID-19 RealTime PCR Patients: A Retrospective Study

Coronavirus, a member of the beta coronavirus family, encompasses a range of illnesses from common colds to severe disorders. SARS-CoV-2, transmitted mainly through respiratory droplets that are generated by a patient who is sneezing, coughing and talking, caused the global pandemic COVID-19 in 2020. The virus primarily targets the respiratory system especially in the lung cell, leading to diverse symptoms and severe consequences. This study was carried out in the COVID-19 Isolation Centre in Mukalla City, Yemen, to evaluate biochemical tests in COVID-19 patients. In the retrospective single-centre study on 116 COVID-19 patients, some of biochemical Analysed Parameters were glucose, Liver function tests, renal function tests, lipid profile, and proinflammatory markers; convenience sampling based on existing records for socio-demographics, medical history, and biochemistry were analysed by using a spectrophotometry and Chemiluminescent immunoassay analyser. used SPSS version 25 to analyse data. Most COVID-19 patients in Mukalla City (91.4 % of those over 46 years old) have common symptoms such as fever, cough, and respiratory problems. The study found links between chronic health disorders (hypertension 96.6 %, diabetes mellitus 94.8 %) and greater vulnerability to COVID-19. Blood glucose levels substantially impact COVID-19 occurrences (p 0.0001). Some liver function tests are associated with COVID-19 (total protein, albumin, LDH, and GGT) (p = 0.044, 0.010, 0.0001, and 0.0001, respectively). Urea and creatinine levels imply renal function and their significant association (p=0.001 for both), whereas uric acid had no significant association with COVID-19 (p = 0.134). However, lipid profile tests lack statistical significance; they do identify trends. Proinflammatory markers CRP and ferritin strongly correlate with positive COVID-19 patients (p=0.0001 for both). In conclusion, COVID-19 significantly affects glucose metabolism, liver function, renal dynamics, and inflammatory markers, necessitating vigilant monitoring for clinical care and informing future research.

Protective Effect of Vitamin D Supplementation Against Atherosclerotic Cardiovascular Disease in Type 1 Diabetes Mellitus Model.

Cardiovascular disease (CVD) is a leading cause of mortality on a global scale, with a higher prevalence observed among men. This study investigated the protective effect of vitamin D supplementation on CVD. A cohort of thirty mice was divided into three groups: control, T1 diabetic, and T1 diabetic groups that received vitamin D treatment. For each mouse in the three groups, measurements were taken of body weight, blood glucose levels, glycated hemoglobin (HbA1c), lipid profile, cardiac enzymes, troponin I, adropin, nitric oxide (NO), endothelin-1, and Vascular endothelial growth factor (VEGF). In addition, measurements were taken for the overall lymphocyte count, as well as the CD3+, CD4+, CD8+, CD4+, CD25+, and CD8+ CD25+ cell counts in all mice. The diabetic mice that received vitamin D treatment exhibited significant reductions in blood glucose levels, HbA1c levels, lipid profile, cardiac enzymes, troponin I, endothelin-1, and VEGF levels as compared to the untreated diabetic group (p < 0.01). Furthermore, there was an observed rise in adropin and NO levels in diabetic mice that received vitamin D treatment compared to the untreated diabetic group (p < 0.05). The diabetic mice treated with vitamin D exhibited a substantial decrease in total lymphocyte counts compared to the untreated diabetic and control animals (p < 0.0001). Regarding the CD3+ subset, it was shown that diabetic mice subjected to vitamin D treatment had notably elevated levels of these cells compared to both the untreated diabetic and control groups (p < 0.0001). In addition, the administration of vitamin D resulted in a substantial decrease in the numbers of CD4+ and CD8+ cells in the group of individuals with diabetes (p < 0.0001). The diabetes group that received vitamin D treatment had significantly reduced populations of CD4+ CD25+ and CD8+ CD25+ compared to the untreated diabetic group (p < 0.0001). Vitamin D maintains the integrity of the cardiovascular system through the reduction of blood glucose levels and lipid profile. Moreover, its supplementation prevents atherosclerotic CVD by suppressing inflammatory reactions.

Long-term blood glucose control via glucose-activated transcriptional regulation of insulin analogue in type 1 diabetes mice.

To achieve glucose-activated transcriptional regulation of insulin analogue in skeletal muscle of T1D mice, thereby controlling blood glucose levels and preventing or mitigating diabetes-related complications. We developed the GANIT (Glucose-Activated NFAT-regulated INSA-F Transcription) system, an innovative platform building upon the previously established intramuscular plasmid DNA (pDNA) delivery and expression system. In the GANIT system, skeletal muscle cells are genetically engineered to endogenously produce the insulin analogue INSA-F (Insulin Aspart with Furin cleavage sites). The transcription of INSA-F is precisely controlled by a glucose-responsive promoter containing NFAT (Nuclear Factor of Activated T-cells) regulatory motifs, which can be activated in response to changes in extracellular glucose concentrations. This design enables glucose-dependent regulation of insulin analogue expression, mimicking physiological glucose-responsive insulin secretion. T1D mice that received two GANIT treatments over a 2-month experimental period demonstrated significant improvements in glucose homeostasis, glucose tolerance and glycated haemoglobin (HbA1c) levels. Additionally, the treatment effectively reduced oxidative stress and alleviated cardiac and renal fibrosis, while maintaining a favourable biosafety profile. The GANIT system provides significant advantages in terms of efficiency, convenience and cost-effectiveness, making it a promising approach for regulating blood glucose levels and alleviating diabetes-related complications in insulin-deficient diabetes.

Prevalence and determinants of ideal cardiovascular health by sex and region—a population-based study in Peru

IntroductionAttaining what the American Heart Association terms Ideal Cardiovascular Health (ICVH) is viewed as an essential objective for preventing cardiovascular diseases (CVD).ObjectiveTo determine the prevalence of ICVH, stratified by sex and region and its associated factors in the adult population of Peru.Materials and methodsAnalytical cross-sectional study. Data were obtained from the Life Stage Food and Nutrition Surveillance Survey (VIANEV). ICVH can be depicted vis-a-vis the seven metrics of the AHA: blood pressure levels, total cholesterol and glucose levels, smoking status, body mass index, physical activity levels, and dietary intake through the consumption of fruits and vegetables. The variable was categorized as deficient/moderate vs. ideal for regression analysis.ResultsOf the 863 participants examined, findings demonstrated that 38.01% had ICVH. The prevalence is trending lower in correlation with rising age and educational attainment levels and for those inhabitants residing at higher elevations. Likewise, statistically significant variations were observable concerning the prevalence of ICVH contingent on the region of residence and marital status, in particular amongst the feminine inhabitants.ConclusionsThese results demonstrate that the frequency of ICVH in the grown-up inhabitants of Peru is comparatively tiny. Things linked to a lesser frequency of ICVH involve increased age, a higher level of education, living at higher altitudes, and staying married to a woman. These discoveries underscore the need to implement prevention and treatment strategies for CVD distinct for each inhabitant team.

In Vitro and In Vivo Interventions Reveal the Health Benefits of Levan-Type Exopolysaccharide Produced by a Fish Gut Isolate Lactobacillus reuteri FW2

Microorganisms synthesize diverse types of exopolysaccharides (EPSs). EPSs with varying structural and physical properties can demonstrate unique health benefits, which allow for their tailored applications as functional foods such as prebiotics. Levan, a fructose-based EPS, is gaining considerable attention as an effective prebiotic to support the growth of beneficial gut bacteria. Consequently, this enhances digestive health, boosts the immune system, and reduces the risk of chronic diseases. Unfortunately, limited studies are available on levan-type EPSs to demonstrate their role as prebiotics. Therefore, in this study, we conducted in vitro and in vivo experiments, concerning intestinal cell integrity and metabolic syndrome, to assess the therapeutic potential of levan derived from Lactobacillus reuteri FW2. The in vitro experimental results revealed that levan improved the survival of impaired HT-29 epithelial cells of the intestine and also exerted antioxidant effects. In the in vivo experiments, mice fed with levan-supplemented feed exhibited low body weight gain, blood glucose, and serum cholesterol levels compared to the control group. These findings highlight the biotherapeutic potential of L. reuteri FW2-derived levan for improving metabolic syndrome and its associated aspects. It also signifies the need for a further detailed investigation based on clinical trials to include levan in dietary supplements for improved health and well-being.

Substituted piperazine conjugated to quinoline-thiosemicarbazide as potent α-glucosidase inhibitors to target hyperglycemia

Diabetes mellitus, particularly type 2 diabetes, is a growing global health challenge characterized by chronic hyperglycemia due to insulin resistance. One therapeutic approach to managing this condition is the inhibition of α-glucosidase, an enzyme involved in carbohydrate digestion, to reduce postprandial blood glucose levels. In this study, a series of thiosemicarbazide-linked quinoline-piperazine derivatives were synthesized and evaluated for their α-glucosidase inhibitory activity, to identify new agents for type 2 diabetes management. Structure-activity relationship (SAR) analysis revealed that the nature and position of substituents on the aryl ring significantly impacted the inhibitory potency. Among the synthesized derivatives, the 2,5-dimethoxy phenyl substitution (7j) exhibited the most potent activity with an IC50 value of 50.0 µM, demonstrating a 15-fold improvement compared to the standard drug acarbose. Kinetic studies identified compound 7j as a competitive inhibitor, with a Ki value of 32 µM. Molecular docking simulations demonstrated key interactions between compound 7j and the active site of α-glucosidase, while molecular dynamics simulations confirmed the stability of the enzyme-ligand complex, reflected in low RMSD and RMSF values.

Consequence of War on Diabetic Mellitus patients in Tigray region, Ethiopia: a longitudinal study

BackgroundStudies of the world health organization indicated that Diabetes is on the rise. The occurrence of diabetes is steadily increasing everywhere, most markedly in the world’s middle and low-income countries. The aim of this study is to explore the consequence of war on the sugar level of diabetic mellitus patients.MethodsA retrospective longitudinal study with a sample of 67 diabetic mellitus patients was used. As a result, longitudinal different models, which are generalized linear mixed effects and nonlinear mixed effect models were fitted on the continuous response variable, the Sugar Level of the diabetic patients.ResultsThe results depicted that Blood Sugar Level of the patients increases over time. Moreover, as age, weight, medication, total cholesterol, high density lipoprotein (HDL), creatinine and linear time effect increase, Blood Sugar Level increases significantly, whereas triglyceride and low density lipoprotein increase, Blood Sugar Level of the adult Diabetes mellitus patients decreases.ConclusionThe war has significant effect on the poor control of blood glucose level of the adult diabetic patients in Tigray region, Ethiopia. Due to the war, siege or blockages, in return there were rare of medicine, the patients were not taking their medicines on time, and they did not get enough insulin as well.

Galactooligosaccharide-Metabolism-Related Genes of Bifidobacterium pseudocatenulatum Contribute to the Regulation of Glucose and Lipid Metabolism in Type 2 Diabetic Mice.

This study investigated whether the galactooligosaccharide (GOS)-metabolism-related genes (GOS-cluster) in Bifidobacterium pseudocatenulatum contribute to alleviating glucose and lipid metabolic disorders in type 2 diabetic mice. Genomic analysis of 69 B. pseudocatenulatum strains based on the GOS-cluster, combined with in vitro fermentation experiments, revealed that high-GOS-cluster strains (≥24 MFS, ≥39 GOS-cluster) demonstrated superior GOS utilization and bile salt tolerance. In vivo, the high-GOS-cluster strains resulted in a significant reduction of blood glucose levels by 18.52 to 32.01% compared to the model group. Mechanistic studies showed that these strains significantly activated the FXR/FGF15/GSK3β and FXR/SREBP1/FAS signaling pathways. Species-specific quantification of B. pseudocatenulatum, metabolomics, and network analysis suggested that GOS treatment increased the abundance of B. pseudocatenulatum, particularly strains rich in the GOS-cluster, with a 32.03% increase compared to strains with a low GOS-cluster. This indirectly increased choloylglycine hydrolase levels and altered the profiles of primary and secondary bile acids, resulting in an increase in FXR agonists, such as glycocholic acid, cholic acid, and deoxycholic acid. These findings suggest that the presence of the GOS-cluster is a crucial factor in determining whether a B. pseudocatenulatum strain can prevent or ameliorate type 2 diabetes.

Evaluation of a potential bidirectional influence of metabolic syndrome and apical periodontitis: An animal-based study.

This study aimed to explore the possible bidirectional interrelations between fructose-induced metabolic syndrome (MS) and apical periodontitis (AP). Twenty-eight male Wistar rats were distributed into four groups (n = 7, per group): Control (C), AP, Fructose Consumption (FRUT) and Fructose Consumption and AP (FRUT+AP). The rats in groups C and AP received filtered water, while those in groups FRUT and FRUT+AP received a 20% fructose solution mixed with water to induce MS. The groups AP and FRUT+AP had the pulp of their right mandibular first molar exposed to induce AP. Food consumption, murinometric measurements, blood glucose levels and glucose tolerance were monitored. Fifty-six days after the start of the experiment, the animals were euthanized, and serum samples were collected for metabolomic analysis. Mandibles, livers and right kidneys were also collected. The area and volume of the periapical lesions were calculated using micro-computed tomography. Histopathological evaluation was performed. Kruskal-Wallis followed by the Student-Newman-Keuls or Mann-Whitney tests and one-way anova followed by Tukey's or Independent t-test were used for non-parametric and parametric data, respectively (p < .05). Multivariate analysis and variable importance in projection score were applied to assess metabolite profile differences among groups (p < .05). FRUT and FRUT+AP groups showed significantly increased fluid intake, body mass, abdominal circumference, blood glucose levels, liver weight and visceral fat weight (p < .05), indicating the development of MS. The analyses of the metabolite profile suggest increasing glucose, histidine, lactate, fatty acid and phenylalanine in the FRUT+AP group. There were no significant differences in volume and area of periapical lesions in micro-CT analyses (p = .1048 and p = .7494, respectively). Histopathological analysis of the hemimandibles demonstrated areas of inflammatory response, necrosis and microabscess in the periapical region. Hepatic histopathological observations indicated notable differences in cell appearance, with the FRUT and FRUT+AP groups showing signs of microsteatosis. Kidney analysis revealed Bowman's space dilation in the FRUT and AP groups, while the FRUT+AP group exhibited retracted Bowman's space, suggesting a possible alteration in renal filtration capacity. MS had no impact on the progression of AP in rats. However, AP exacerbated the systemic state affected by MS, with changes in liver and kidney tissues and metabolite levels.

Comparative study on blood pressure and metabolic improvements in hypertensive patients using copper bianstone scraping.

To evaluate the effectiveness and feasibility of the copper bianstone scraping combined with Chinese modified termination hypertension dietary therapy program by comparing and analyzing the improvement of blood pressure, blood lipids and blood glucose in hypertensive patients who received copper bianstone scraping combined with Chinese modified termination hypertension dietary therapy intervention. We selected 160 cases of hypertensive patients from July 2022 to March 2024 for the study. They were divided into 80 cases in the comparison group and 80 cases in the observation group according to whether or not they underwent copper bianstone scraping combined with Chinese modified dietary therapy for termination of hypertension. In the comparison group, conventional Chinese dietary therapy with improved termination of hypertension was used, and in the observation group, copper bianstone scraping combined with Chinese dietary therapy with improved termination of hypertension (DASH) was used on the basis of the comparison group. Differences in vitamin D, Homocysteine and serum calcium levels, blood pressure, blood glucose and lipid levels were compared between the 2 groups. The decreases of glycosylated hemoglobin, fasting blood glucose and 2-hour postprandial blood glucose in the observation group were greater than those in the comparison group; the decreases of blood pressure and BMI in the observation group were greater than those in the comparison group. The difference in comparison was statistically significant (P-value < 0.05). After the intervention, the improvement of homocysteine, vitamin D, serum calcium, albumin, hemoglobin and transferrin in the observation group was greater than that in the comparison group, and the difference was statistically significant (P-value < 0.05). Copper bianstone scraping combined with Chinese modified termination of hypertension dietary therapy in hypertensive patients has a better effect, can effectively improve the patient's blood glucose and lipid levels, improve the nutritional status of the patient, can be promoted in the rehabilitation management of hypertension.

Accuracy and feasibility of continuous glucose monitoring system in pancreatectomy patients.

Pancreatectomy patients often experience challenging fluctuations in blood glucose levels; therefore, they require a reliable monitoring system. This study aimed to determine the accuracy and acceptability of a continuous glucose monitoring (CGM) system compared with the intermittent capillary glucose test in patients who have undergone pancreatectomy. Thirty non-diabetic pancreatectomy patients participated. We used the FreeStyle Libre Flash Glucose Monitoring System (Abbott Diabetes Care) for continuous interstitial glucose monitoring. Capillary reference glucose levels were checked four times daily. Accuracy was checked using the Clarke Error Grid. The mean age of the participants was 56.8 ± 12.0 years, of whom 61.3% underwent pancreaticoduodenectomy and 38.7% underwent distal pancreatectomy. Three patients developed pancreatogenic diabetes after pancreatectomy. The clinical accuracy of continuous glucose monitoring compared with capillary glucose was 43.9% in Zone A (clinically accurate zone) and 99.8% in Zone A + B (low risk of error) of the Clarke Error Grid. No device-related adverse events were reported. Patients rated favorable user acceptability on the questionnaire. This pilot study demonstrated that the CGM device is accurate and safe for patients who underwent pancreatectomy, with favorable user acceptability. Despite these challenges, the study proposes that the CGM device is beneficial for monitoring glucose levels after discharge in patients with impaired glucose levels following pancreatectomy.

Analysis of the Adjuvant Therapeutic Effect of Epalrestat Tablets in Enhancing the Treatment of Diabetic Complications

Objective: To evaluate the adjuvant therapeutic effect of Epalrestat tablets on diabetic complications. Methods: 96 patients with diabetic complications who were admitted to the hospital from September 2021 to September 2023 were selected and randomly divided into two groups using a random number table. The observation group was treated with Epalrestat tablets combined with Ginkgo Dipyridolum Injection, while the control group was treated with Ginkgo Dipyridolum Injection only. The total effective rate, blood glucose indicators, oxidative stress indicators, and adverse reaction rates were compared between the two groups. Results: The total effective rates of diabetic nephropathy (DN), diabetic foot (DF), and diabetic peripheral neuropathy (DPN) in the observation group were higher than those in the control group (P &lt; 0.05). After 12 weeks of treatment, the blood glucose indicators in the observation group were lower than those in the control group, and the oxidative stress indicators were better than those in the control group (P &lt; 0.05). The adverse reaction rate in the observation group was lower than that in the control group (P &lt; 0.05). Conclusion: Epalrestat tablets can assist in improving the clinical efficacy of patients with diabetic complications, lowering their blood glucose levels, reducing oxidative stress damage, and decreasing adverse reactions after medication.

Association between stress-induced hyperglycemia ratio and sepsis risk in patients admitted to ICU.

Sepsis is a life-threatening condition characterized by a dysregulated host immune response to infection. Currently, stress hyperglycemia is frequently associated with an unfavorable prognosis in cardiovascular and cerebrovascular disease. During sepsis, the progression of the immune response and inflammation often leads to aberrant metabolic indicators. However, the association between the stress-induced hyperglycemia ratio (SHR) and sepsis in patients admitted to the intensive care unit (ICU) remains uncertain. This study aimed to explore the potential correlation between SHR and sepsis. In this retrospective cohort study, data were obtained from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Patients with recorded glucose and glycosylated HbA1c levels within 24-h ICU admission were identified. The endpoints of the follow-up period were the occurrence of sepsis during ICU stay or ICU discharge. After adjustment for factors including demographics, vital signs and biochemical indicators, the univariate and multivariate logistic regression model was employed to examine the relationship between SHR, baseline blood glucose levels and the risk of sepsis. The associations were further explored in subgroups based on age, gender and presence/absence of type 2 diabetes. Of the total 2,161 patients, with the average age of 64.96 ±16.84 years, 205 (9.49%) had sepsis. After adjustment or confounders, high SHR levels were associated with the risk of sepsis odds ratio (OR) = 1.53, 95% confidence interval (95% CI): 1.07-2.17). Similar results were found in patients aged ≥65 years (OR = 1.91, 95% CI: 1.16-3.17), in men (OR = 1.64, 95% CI: 1.02-2.63) and patients without type 2 diabetes history (OR = 1.58, 95% CI: 1.01-2.48). The baseline blood glucose level did not exhibit a significant association with the risk of sepsis. Elevated SHR levels were correlated with sepsis. Bedside monitoring of SHR may be a valuable tool for clinicians to identify patients at high risk of sepsis, and be beneficial to promptly implement clinical interventions.

Self-Cascade of ROS/Glucose-Scavenging Immunomodulatory Hydrogels for Programmed Therapeutics of Infected Diabetic Ulcers via Nrf2/NF-κB Pathway.

Diabetic ulcers (DUs) are characterized by a microenvironment with high oxidative stress, high blood glucose levels, and recalcitrant bacterial infections. This microenvironment is accompanied by long-term suppression of endogenous antioxidant systems, which makes their clinical management extremely challenging. To address this issue, a hybridized novel gold-palladium (AuPd) nanoshell of the injectable/injectable hydrogel system UiO/AuPdshells/BNN6/PEG@Gel (UAPsBP@Gel) is developed. The system is capable of acting as a nitric oxide (NO) reactor utilizing synergistic therapy that harnesses NIR-II light-triggered photothermal effects and controlled release of NO gas for synergistic treatment to eradicate biofilm infections at different depths. The AuPd nanoshells exhibits superoxide dismutase (SOD)-, glucose oxidase (GOx)-, and catalase (CAT)-like activities, enabling self-cascade process for scavenging both reactive oxygen species (ROS) and glucose. This activity reshapes the DUs microenvironment, switches on the endogenous antioxidant Nrf2/HO-1 pathway and inhibits the NF-κB pathway, promotes macrophage polarization toward the anti-inflammatory M2 phenotype, and reduces oxidative stress, resulting in efficient immunomodulation. In vitro/in vivo results demonstrate that the UAPsBP@Gel can multifacetedly enhance the epithelial rejuvenation process through wound hemostasis, pro-cellular migration and vascularization. These results highlight that a programmed therapeutic based on UBAPsP@Gel tailored to the different stages of infected DUs can meet complex clinical needs.

100 Years of Insulin: A Historical Perspective.

Diabetes mellitus, a metabolic disease characterized by high blood glucose levels, has increased dramatically in recent years, prompting the need for more affordable diagnoses and treatments. This study aimed to conduct a brief historical and theoretical review on the development of insulin. Scientific and technological data have been retrieved and analyzed with a focus on the development of the active pharmaceutical ingredient insulin and insulin-based medicines. Data have been retrieved from the PubMed database available via the CAPES portal. Diabetes is one of the oldest diseases in the world. The year 2021 marked the 100th anniversary of the discovery of insulin, which transformed diabetes from a fatal disease into a chronic disease. The extraction and purification of insulin from bovine or porcine pancreases from slaughterhouses has enabled the pharmaceutical industry to produce insulin on a large scale. The introduction of insulin analogs in 1996 expanded the options. Currently, commercial insulin consists of human insulin and/or human insulin analogs. The state-of-the-art and technological development of insulin over the last 100 years has been presented in this work. The development of new pharmaceutical technologies has led to the obtainment of improved versions of insulin, as well as the emergence of different types of insulin. Alongside the innovations in the development of the active ingredient and related medicines, new formulations, methods, and routes of administration have emerged based on the pharmacodynamic, pharmacokinetic, and pharmacotechnical modulations of the drug.