Blood Sugar Test Research Articles

Development and feasibility study of a community pharmacy intervention to support self-management of patients with type 2 diabetes, in Cyprus

Abstract Introduction The pharmacists’ role has evolved over the past years towards a more clinical role to support patients in managing various prevalent health conditions.1 Cyprus had one of the highest prevalence of diabetes among other European countries in 2021.2 Motivational interviewing has been shown to be an effective tool in consultations.3 In recent years there has been increasing interest in the potential of mobile technologies in health care. However, effective implementation, management, and evaluation of those interventions aiming to improve type 2 diabetes self-management are still being researched. Aim The aim of this study was to design and implement a mobile health intervention delivered by a pharmacist applying motivational interviewing techniques, aiming to improve the self-management of type 2 diabetes patients. Then, assess primarily the feasibility and acceptability of the interventions and, secondarily, the participants' medication adherence and self-care activity. Methods Type 2 diabetes patients visiting a diabetes clinic in Cyprus were recruited. The intervention included: online communication with the pharmacist, tracking & uploading blood glucose readings, graphical reports, reminders, education, and optimization of pharmacotherapy delivered over an initial face-to-face consultation and up to 3 follow-up telephone appointments at 6-8 weeks intervals. Feasibility was measured by recruitment & retention, use & workability of the intervention, and basic costs. Participants’ & healthcare professionals’ acceptability was assessed via two semi-structured interview schedules based on the Theoretical Framework of Acceptability (Sekhon et al., 2017). Participants’ medication adherence and self-care activity were assessed by Diabetes Self-Care Activities Questionnaire - Greek version before and after the intervention. The study obtained ethical approval from the Cyprus National Bioethics Committee (27/11/2019, reference number EEBK ΕΠ 2019.01.202), the Cyprus Ethics Committee (05/04/2020, reference number 01/20) and the UCL Research Ethics Committee (28/04/2020, reference number Z6364106/2020/04/129). Results Twenty-seven patients agreed to participate, of whom 22 completed the intervention. From the available services, all participants agreed to use online communication, chose education, and the review of patients’ medications. A barrier to the intervention was the pharmacist accessing patients’ data, as HbA1c was accessible in 69% of participants and blood glucose in 90%. Based on study findings, participants valued the motivational interview and pharmacist approach, while healthcare professionals highlighted the benefits of pharmacy service, specifically medication adherence. Participants reported improvements in self-care during the study period in three out of five domains assessed in the DSCAQ– Greek version (blood sugar testing, healthy eating, and foot care), whereas adherence to diabetes medications and physical activity remained the same. Discussion/Conclusion Although the results were not statistically powered, as this was a feasibility study, there was an indication that this individualised and evidence-based intervention, could holistically support diabetes patients. A limitation of the study was that the person who developed and evaluated the intervention was the same as the person who delivered it. However, the findings indicated the potential value of the intervention to patients and healthcare professionals. It also provided information to support the intervention's integration into the Cyprus healthcare system and in other similar settings.

WaveFlex biosensor based on S-tapered and waist-expanded technique for detection of glycosylated hemoglobin.

Glycosylated hemoglobin (HbA1c) is considered a new standard for the detection of diabetes mellitus because it is more accurate than regular blood sugar tests and there is no need to take blood on an empty stomach or at a specific time. In this work, we have developed a novel optical fiber biosensor, referred to as the "WaveFlex biosensor," which operates on the principles of localized surface plasmon resonance (LSPR) plasmonic wave. The sensor is fabricated using an innovative S-tapered and waist-expanded technique, enabling it to effectively detect HbA1c. Compared to the HbA1c sensors currently in use, HbA1c optical fiber sensors possess the characteristics of high sensitivity, low cost, and strong anti-interference ability. The gold nanoparticles (AuNPs), cerium oxide (CeO2) nanorods (NRs), and tungsten disulfide (WS2) nanosheets (NSs) are functionalized to improve the effectiveness of the fiber sensor on the probe surface. AuNPs are utilized to generate LSPR by the excitation of evanescent waves to amplify the sensing signal. The CeO2-NRs can have a strong metal-carrier interaction with AuNPs, enhancing the cascade of CeO2-NRs and AuNPs. The WS2-NSs with layered fold structure have a large specific surface area. Therefore, the combination of CeO2-NRs and WS2-NSs is conducive to the binding of antibodies and the addition of sites. The functionalized antibodies on the fiber make the sensor probe capable of specific selection. The developed probe is applied to test the HbA1c solution over concentrations of 0-1000 µg/mL, and the sensitivity and limits of detection of 1.195×10-5 a.u./(µg/mL) and 1.66 µg/mL are obtained, respectively. The sensor probe is also evaluated using assays for reproducibility, reusability, selectivity, and pH. According to the findings, a novel method for detecting blood glucose based on a plasmonic biosensor is proposed.

Newest And Most Promising Type 1 Diabetes Treatment.

Dear Madam, According to the International Diabetes Federation, Pakistan has the highest diabetes prevalence in the world (1).Ttype 1 diabetes (T1DM), a chronic condition where the pancreas makes little or no insulin. Despite extensive research, cure for T1DM has not been found. Typical treatment uses insulin injections, diet modifications, and exercise to manage blood sugar. This letter concisely explains the latest treatments for T1DM. Conventionally, exogenic insulin substitution was done by testing blood sugar levels after finger pricking. However, modern treatments include automated glucose monitoring technology and insulin pumps. Since T1DM is an autoimmune disease caused by the destruction of B-cells, the replacement of B-cells using allogeneic solid organ pancreas or islet transplantation treats the disease (2). However, this treatment requires lifelong immunosuppression drugs, that could lead to severe infections or nephrotoxicity. Other approaches include targeting T-cells, B-cells, or specific single antigens of which limitations range from side effects due to cytokine storm or inability to identify the key antigen. Even though immunotherapies further refined targeted inflammatory pathways, there is a lack of evidence as to if they can restore immune tolerance. On the other hand, therapies targeting cell-intrinsic metabolism may enhance B-cell survival but may result in B-cell dysfunction (2). Given the grim situation of current T1DM treatments, the artificial pancreas is revolutionary. Specific hybrid artificial pancreas required the patient to count the carbohydrates consumed at mealtime. The modern system uses continuous glucose monitoring technology (a sensor inserted under the skin), delivering insulin via the infusion pump according to the blood glucose level. The modern MiniMed 780G artificial pancreas is the first insulin delivery system to automatically administer bolus correction insulin dosage every 5 minutes and adjust insulin doses based on glucose levels. This technology can rectify insufficient or skipped pre-meal dosages by providing extra insulin. A study of 4120 780G users reported that outcomes matched the recommended goals by the American Diabetes Association’s Standards while commending its ability to achieve low variability in glycemic controls (3). Another prospective study published in 2023 concluded that switching to the 780G improves the restoration of hypoglycemia awareness and metabolic control(4). One notable side effect of this system is localized skin infection(5). In conclusion, treatment options for T1DM are ever-growing. The artificial pancreas shows promising results with milder side effects compared to other treatments. Further advancements are integral.

Chrono-nutrition and its Association with Chronotype and Blood Glucose Control Among People with Type 2 Diabetes

Background: Recent studies have revealed conflicting results for low glycaemic index (GI) meals in the prevention and treatment of metabolic disorders. Diurnal variations in glucose homeostasis, which are frequently overlooked in epidemiological studies, may help to explain some of these discrepancies. Food is an external cue to entrain the circadian rhythm, and meal timing is a crucial factor for glucose homeostasis. The study examines the relationship between chrono-nutrition, chronotype, and blood glucose control among people with Type 2 diabetes. Materials and Methods: Chrono-nutrition questionnaire assessed eating window, breakfast skipping, evening latency, evening eating, night eating, and largest meal of patients with Type 2 diabetes. Glycaemic control was assessed using a HbA1c test, fasting blood sugar, and 2-hour post-prandial blood sugar test. Insulin resistance was assessed by fasting triglyceride glucose index (TyG). Results: There was a significant association between late dining with dysglycaemia, irrespective of GI of the meal (p<0.05). Participants who had the largest meal during the active phase had better glycaemic control (p<0.05). Shorter eating windows and evening latency of at least 2 hours not only aided in glycaemic control, but also gave good sleep (p<0.05). Participants with the evening chronotype ate almost twice the amount of carbohydrates and fat at dinner than at breakfast. Evening chronotypes were associated with lesser servings of vegetables and fruits, and greater servings of sweets and caffeinated beverages, in comparison with morning chronotypes. Conclusions: Late diners had significantly worse blood glucose levels, irrespective of the GI of the meal. This may have public health implications, as calorie-dense meals are often consumed during late evenings, which can desynchronise the circadian rhythms. Eating meals as per the circadian rhythm could be an alternative non-pharmacological strategy to prevent diabetes and its complications.

Low dose tacrolimus exposure and early steroid withdrawal with strict body weight control can improve post kidney transplant glucose tolerance in Japanese patients.

The development of diabetes mellitus (DM) after living donor kidney transplantation (KT) is a risk factor for worsening transplant kidney function, cardiac disease, and cerebrovascular disease, which may affect prognosis after KT. At our institution, all patients' glucose tolerance is evaluated perioperatively by oral glucose tolerance tests (OGTTs) at pre-KT, and 3, 6, and 12 month (mo.) after KT. We analyzed the insulinogenic index (ISI) and homeostasis model assessment beta cell (HOMA-β) based on the immunoreactive insulin (IRI) levels to determine how glucose tolerance changed after KT in 214 patients who had not been diagnosed with DM before KT. In addition, we analyzed the body mass index (BMI) which may also influence glucose tolerance after KT. The concentration of tacrolimus (TAC) in blood was also measured as the area under the curve (AUC) to examine its effects at each sampling point. The preoperative-OGTTs showed that DM was newly diagnosed in 22 of 214 patients (10.3%) who had not been given a diagnosis of DM by the pre-KT fasting blood sugar (FBS) tests. The glucose tolerance was improved in 15 of 22 DM patients at 12 mo. after KT. ISI and IRI deteriorated only at 3 mo. after KT but improved over time. There was a trend of an inverse correlation between HOMA-β and TAC-AUC. We also found inverse correlations between IRI and an increase in BMI from 3 to 12 mo. after KT. Early corticosteroid withdrawal or the steroid minimization protocol with tacrolimus to maintain a low level of diabetogenic tacrolimus and BMI decrease after KT used by our hospital individualizes lifestyle interventions for each patient might contribute to an improvement in post-KT glucose tolerance.

The association between anti-glutamic acid decarboxylase IgG and hemoglobin A1C among newly diagnosed type 1 diabetes of some Iraqi children in Karbala City

Abstract Background: Type 1 diabetes mellitus (T1DM) is brought on by immune system dysfunction intolerance, invasion of beta cells by autoreactive immunological T cells, degradation of beta cell activity and survival, and extended exogenous insulin treatment. One of the circulation autoantibodies against antigens of pancreatic cell that produce insulin is glutamic acid decarboxylase (GAD IgG antibody) that indicate the stress and/or death of the islet cell in T1D. A blood glucose monitoring test called hemoglobin A1C (HbA1c) is used to determine the average blood sugar level over three months (February, March, and April of 2022). Objective: The purpose of this study is to assess the frequency of anti-GAD IgG and HbA1c in T1DM children, as well as their correlation. Materials and Methods: Seventy individuals with new-onset T1DM (confirmed by clinical signs, including increased urination, intense hunger, intense thirst, and abrupt weight loss, along with a random blood sugar test that is higher than 200 mg/dL and a fasting blood sugar test that is higher than 126 mg/dL) are male and female, ranging in age from 1 to 12 years. Blood was drawn for the biochemical and immunological tests (including HbA1c, fasting blood sugar, C-peptide, anti-islets antibodies, and anti-GAD antibodies). Results: Ninety-four percent of the T1DM patients had positive anti-GAD IgG with a mean concentration of 147 IU/mL, and 6% had negative anti-GAD IgG with a mean value of 9 IU/mL. At the same time, the findings of the current study’s calculation of HbA1c levels revealed that individuals with newly diagnosed T1DM had a total mean average of HbA1c of 10.53. Conclusion: Specifically in T1D that had arisen in extremely young children, autoimmunity was discovered to take part in the glycemic index expressed by glycated hemoglobin average.

Pemeriksaan Kadar Gula Darah Sewaktu pada Remaja di SMAN 7 Denpasar

People in urban areas tend to have unhealthy lifestyles, especially teenagers. This can trigger various diseases. Health status needs to be considered from an early age, especially paying attention to the intake of sugar in the body. Excess sugar levels in the blood are one of the causes of diabetes mellitus. Measurement of blood sugar (GDS) in adolescents of SMAN 7 Denpasar aims to screen for Diabetes Mellitus (DM) to detect this disease early. The method is done by checking the blood sugar test (GDS), weight, and height. The results of the blood sugar test in this community service activity showed that out of 50 students with a ratio of male and female percentages of 40% and 60% respectively, only 4% were identified with low blood sugar levels while the remaining 96% had normal blood sugar levels. The conclusion of the community service at SMAN 7 Denpasar is that most of the students have normal blood sugar levels.

Charcot arthropathy and acro-osteolysis in a 5-year-old girl with hereditary sensory and autonomic neuropathy type II: A case report

Charcot neuropathic arthropathy is a destructive process that can occur in patients with neuropathy associated with medical diseases such as diabetes. A rare cause of neuropathic arthropathy is congenital insensitivity to pain (CIP) which includes varying degrees of sensory loss and lack of pain perception contributing to absent withdrawal responses. The clinical manifestations of CIP include delayed diagnosis of fractures, joint dislocations, acro-osteolysis, avascular necrosis, osteomyelitis, heterotopic ossification, and Charcot arthropathy. We herein report a case of Charcot arthropathy of ankle joints in a 5-year-old girl with CIP due to underlying hereditary sensory and autonomic neuropathy who had recurrent upper and lower limb fractures with acro-osteolysis. She had an inability to perceive pain from the first year of her life. She also had mild developmental delay. Family history was unremarkable. Blood count, liver and thyroid function tests, erythrocyte sedimentation rate, C-reactive protein, blood electrolytes, blood sugar and other laboratory tests were normal. Charcot neuropathic arthropathy in children is rare and can be a part of congenital diseases like CIP. A high degree of suspicion may lead to early detection and can prevent joint and bone destruction and deformities.

Progress towards the Replacement of the Rabbit Blood Sugar Test for the Quantitative Determination of the Biological Activity of Insulins (USP ) with an In Vitro Assay.

For the quantification of insulin activity, United States Pharmacopeia (USP) general chapter <121> continues to require the rabbit blood sugar test. For new insulin or insulin analogue compounds, those quantitative data are expected for stability or comparability studies. At Sanofi, many rabbits were used to fulfil the authority's requirements to obtain quantitative insulin bioactivity data until the in vivo test was replaced. In order to demonstrate comparability between the in vivo and in vitro test systems, this study was designed to demonstrate equivalency. The measurement of insulin lispro and insulin glargine drug substance and drug product batches, including stress samples (diluted or after temperature stress of 30 min at 80 °C), revealed a clear correlation between the in vitro and in vivo test results. The recovery of quantitative in vitro in-cell Western (ICW) results compared to the in vivo test results was within the predefined acceptance limits of 80% to 125%. Thus, the in vitro ICW cell-based bioassay leads to results that are equivalent to the rabbit blood sugar test per USP <121>, and it is highly suitable for insulin activity quantification. For future development compounds, the in vitro in-cell Western cell-based assay can replace the rabbit blood sugar test required by USP <121>.

Prevalence of Dysglycaemia and Diabetes Mellitus amongst Adults in High-burden Kidney Disease Areas of Jigawa State, Nigeria

Abstract Background: Dysglycaemia and diabetes mellitus (DM) are important and preventable risk factors associated with kidney diseases, cardiovascular complications, and mortality worldwide. Aim: This study aimed to identify the prevalence and factors associated with dysglycaemia and diabetes among adults in high-burden kidney disease areas of Jigawa State, Northwest Nigeria. Methods: A cross-sectional survey of representative sample of 361 adults, aged ≥18 years, was conducted in four local government areas (LGAs) of Jigawa State, considered to have a high burden of kidney disease requiring hemodialysis. Data were collected using a modified World Health Organization STEPS questionnaire using a multistage sampling technique and were analyzed using IBM SPSS Statistics for Windows, version 22.0, with statistical significance set at P ≤ 0.05. Results: The minimum age of the respondents was 18 and the maximum was 102 with a median of 45 (interquartile range = 30–80) years. The majority of the respondents 89.5% were &gt;24 years of age. The prevalence of dysglycemia and DM in the high-burden LGAs was 10.5% and 3.6%, respectively. Dutse LGA had the highest prevalence of dysglycemia 16.7%, followed by Hadejia LGA with a prevalence of 12.2%. On the other hand, Hadejia LGA had the highest prevalence of DM 7.7%, followed by Jahun LGA with a prevalence of 3.3%. Age ≥40 years, family histories of diabetes, being overweight, alcohol ingestion, and previous blood sugar tests were identified as factors associated with DM. The odds of developing diabetes were significantly higher among those with a reported history of alcohol consumption, family history of diabetes, and overweight. Conclusion: Dysglycaemia and diabetes are significant public health problems, and many people who have the conditions are unaware they have them. Family history of diabetes, alcohol ingestion, and overweight are important risk factors. The government and all the relevant stakeholders should prioritize community screening and other relevant interventions for early detection and timely management of cases.

Hepatoprotective and anti-hyperglycemic effects of ferulic acid in arsenic-exposed mice.

Arsenic is a toxic metalloid that increases the risk of hepatotoxicity and hyperglycemia. The objective of the present study was to assess the effect of ferulic acid (FA) in mitigating glucose intolerance and hepatotoxicity caused by sodium arsenite (SA). A total of six groups including control, FA 100mg/kg, SA 10mg/kg, and groups that received different doses of FA (10, 30, and 100mg/kg), respectively just before SA (10mg/kg) for 28 days were examined. Fasting blood sugar (FBS) and glucose tolerance tests were conducted on the 29th day. On day 30, mice were sacrificed and blood and tissues (liver and pancreas) were collected for further investigations. FA reduced FBS and improved glucose intolerance. Liver function and histopathological studies confirmed that FA preserved the structure of the liver in groups received SA. Furthermore, FA increased antioxidant defense and decreased lipid peroxidation and tumor necrosis factor-alpha level in SA-treated mice. FA, at the doses of 30 and 100mg/kg, prevented the decrease in the expression of PPAR-γ and GLUT2 proteins in the liver of mice exposed to SA. In conclusion, FA prevented SA-induced glucose intolerance and hepatotoxicity by reducing oxidative stress, inflammation, and hepatic overexpression of PPAR-γ and GLUT2 proteins.

Biochemical indicators and the Peradeniya Organophosphate Poisoning scale in prediction and prognosis of organophosphorus poisoning: An observational prospective study

Objective: To study the value of some biochemical indicators and Peradeniya Organophosphate Poisoning scale in prediction and prognosis of organophosphorus poisoning. Methods: This was a hospital-based prospective, observational study. Various biochemical tests viz. complete blood count, random blood sugar, liver and renal function tests, creatine phosphokinase, and electrolytes were performed. Patients were assessed based on the Peradeniya Organophosphate Poisoning scale. All the patients were followed till the end point like recovery/death. Results: Out of the 100 patients, 72% were males and 28% were females. The majority of the patients were farmers and 21 to 30 years of age. Suicidal was the most common manner (92, 92%). Based on the Peradeniya Organophosphate Poisoning scale, 47% were mild, 34% moderate, and 19% severe. Serum creatinine, creatine phosphokinase, serum glutamic-oxaloacetic transaminase, serum glutamic pyruvic transaminase, and alkaline phosphatase levels showed a significant correlation with severity. Conclusions: Some biochemical indicators such as creatine phosphokinase, alkaline phosphatase can be used as prognostic markers of organophosphorus poisoning. The Peradeniya Organophosphate Poisoning scale can be used for assessing severity of the poisoning.

Prevalence of Diabetes and Diabetic Retinopathy in Far-western Province of Nepal.

Although diabetes is emerging as growing public health problem, there is limited population based data about the prevalence of the disease in Nepal. This cross-sectional population-based survey, conducted in the Far-western province of Nepal from April 2020 to April 2021, used standardized RAAB + DR methodology. Diabetes was diagnosed on the basis of treatment history and random blood sugar test results of greater than 200 mg/dl. Diabetic retinopathy screening was done by ophthalmologists. All relevant data were imported into the RAAB software package (RAAB V.6) for analysis. Among 4615 study population, 2.8 % (n=129) had diabetes, and 35.7% (n=46) of the diabetics were newly identified cases. Of the known diabetics, 61.4% (n=51) never had an eye examination, and only 27.7% (n=23) of cases had their eye checked for DR in the last year. Fundus examination showed 13.2 % (n=17) of the diabetic patients to have some form of diabetic retinopathy and 6.2% (n=8) had diabetic maculopathy. Only 0.8% (n=1) of the cases were categorized as sight-threatening DR but a greater number of diabetes patients had severe visual impairment or blindness (3.9%) as compared to non-diabetic patients (1.8%). Prevalence of diabetes and DR were relatively lower in Far-western Nepal. However poor coverage of screening examinations have left many of these cases undetected in the communities. Effective community-based diabetes and DR screening and referral programs can help to detect and treat diabetes and DR early on to prevent vision loss and other diabetic complications.

Detection of acetone in the human breath as diabetes biomarker based on PPy/WO3 nanocomposite sensor by FFT continuous cyclic voltammetry method

AbstractThis research represents a novel detection method of acetone level in the exhaled breath samples (RH=88 %) based on polypyrrole/tungsten oxide (PPy/WO3) nanocomposite sensor. The PPy/WO3 sensor was fabricated by the deposition of nanocomposite on/between interdigitated electrodes (IDEs) through electrospray coating and was then characterized by FE‐SEM imaging. In this detection method, the coulometric signal of the sensor was calculated using Fast Fourier Continuous Cyclic Voltammetry (FFTCCV), where cyclic voltammetry (CV) was applied to the sensor in the defined potential rang and then charge changes of the sensor was obtained by integration of the current in all scanned potential ranges. FFTCCV method enhances the sensitivity of the sensor when exposed to the gas mixtures containing acetone. In addition to its fast coulometric response time (≤5 s) in the two linear ranges of 0.7–2.8 ppm and 2.8–28.2 ppm (R2=0.99), FFTCCV method provides the low detection limit of 70 ppb, and high sensitivity toward acetone at the optimum values of the parameters. The fabricated sensor showed great selectivity toward acetone when exposed to humid air and some exhaled gas like carbon dioxide, ammonia, methanol, ethanol and alkyl amines. The results were very satisfying as the sensor was capable to detect different acetone levels in human exhaled breath as non‐invasive diagnosis of diabetes with a good correlation (R2≃0.9) to the routine blood sugar test taken by different commercial glucometers results.

Patient Compliance Patterns on Therapeutic Success of Type 2 Diabetes Mellitus Medication at La Temmamala Hospital in Sopping, South Sulawesi

Patient compliance is a determining factor for successful therapy, especially for long-term treatment such as diabetes mellitus. Purpose: The aim of this study was to determine the level of adherence and the influence of the characteristics of patients with type 2 diabetes mellitus in using drugs at the Regional General Hospital of La Temmamala, Soppeng. Thirty respondents who met the entry criteria in this study. Data were obtained prospectively. Respondents were interviewed using a demographic questionnaire and an MMAS-8 questionnaire (Morisky Medication Adherence Scale-8). The results of the study showed low compliance level of 43.3%, medium 36.7%, and high 20.0%. Exercising status, co-morbidities, regimen therapy, and checking fasting blood sugar gave significant results on the level of adherence (p&lt;0.05). other factors such as level of educational factors, profession, duration of diagnosis, dietary pattern, smoking, and the varian drug had no effect on compliance (p&gt;0.05). Compliance of most respondents was low (43.3%). Exercise status, comorbidities, regimen therapy, and fasting blood sugar test results are the factors that affect adherence.

Maternal and fetal outcomes of pregnancies associated with single versus double abnormal values in 100 gr glucose tolerance test.

Comparing maternal and fetal outcomes in pregnancies associated with single versus double abnormal values in 100 gr oral glucose tolerance test (OGTT). This cohort study was performed in Arash women's Hospital, Tehran, Iran from 2019 to 2020. Patients with normal fasting blood sugar (FBS) tests were divided into two groups according to their OGTT results. The first group had a single abnormal value in their OGTT and the second group showed two abnormal values. Both groups were followed regularly until the end of pregnancy. Our results showed higher rates of macrosomia (birth of newborns weighed over 4kg) and the need for pharmacological treatment for the management of GDM in the second group (P = 0.05). There were no differences between the two groups in terms of other maternal (polyhydramnios, shoulder dystocia, operative vaginal delivery, atony, postpartum bleeding, cesarean delivery, preeclampsia, and IUFD) and fetal outcomes (Apgar score, seizure, NICU admission, and hypoglycemia in the first 24h). We found no significant differences between pregnant women with single and double abnormal values in 100 gr OGTT regarding maternal and neonatal outcomes, except for macrosomia and need for pharmaceutical treatment.

Benign Hyperplasia of the Anterior Commissure and Left Vocal Cord in a Patient with Type-2 Diabetes Mellitus: A Case Report

Background : A rise in the cell count of an organ or tissue called benign hyperplasia of the anterior commissure. Under a microscope, these cells seem healthy. they are not cancer, but they could develop into it. Cancerous cells can develop from normal cells. The body’s tissues go through irregular cell changes called hyperplasia and dysplasia before the development of cancerous cells. hyperplasia is an increase in the number of cells in an organ or tissue that look regular under a microscope. under a microscope, the cells in dysplasia seem irregular but are not cancerous. Dysplasia and hyperplasia might or might not develop into cancer. There is no overt sex preference for this unusual lesion, which occurs seldom and most frequently on the actual vocal cord in adults in their third, fourth, and fifth decades. Case Presentation : A patient with 42 yr male patient was admitted to a rural tertiary hospital in the E.N.T ward with the chief complaint of change in voice and breathlessness on exertion since eight months, Insidious in onset, hoarseness and difficulty in imitating speech in the morning, chronic sore throat, sometimes with ear pain, weight loss, blood in the sputum. Diagnostic evaluation : Physical examination and investigation of complete blood count, prostates specific antigen test, laryngoscopy, random blood sugar test, urine examination. Therapeutic Management : The doctors provided medical management like antibiotics, nonsteroidal anti-inflammatory drugs, antacids, proteolytic enzymes, steroids and vitamin C. All necessary treatment was given to the patient. Conclusion : Due to conservative management and quality of nursing care patient’s condition was stable and had no active complaints at discharge.

1063-P: Impact of Mobile Messaging on Follow-up and Glycemic Control in the Indian Population

Introduction: Diabetes treatment requires the involvement of people with diabetes in the form of regular clinical follow-up for good Glycaemic control and Metabolic health. Newer Communication techniques, such as mobile messaging are now finding their way into diabetes care and treatment. It can assist diabetes patients to maintain a regular follow-up routine and can assist in glycemic control. Materials and Methods: A total of 326 patients were selected by random sampling. They were of age 15-65 years with T1DM and T2DM. Inclusion Criteria: 1. Known case of DM 2. Consent to receive messages Exclusion criteria: 1. Not consenting for messaging 2. Reading Disability. Randomly allocated to two groups of 163 persons each. In the first group, the participants were sent regular messages to remind them of their follow-up dates. The other group was treated as usual and was allowed to come for follow-up on their own. The participants were monitored for follow-up frequency, meeting testing deadlines and resultant glycemic control measured by Hba1c at 3 months and 6 months. The results were tabulated and analysed using SPSS. Result: 17 patients each dropped out from the messaging group and 16 patients dropped out from routine care groups, out of the remaining 297 patients the analysis of data shows: in the messaging group, 63 % maintained their follow-up dates as compared to 42 % in the other group. The number of patients achieving the target goal of 7% HBA1C was better in the messaging group (54%) as compared to the routine group (31%). Blood sugar testing frequency was better in the messaging group as compared to other group. Discussion: With the advent of newer modalities of communication, the ways and means to communicate with patients has improved. These tools if used correctly can not only improve follow-ups but at the same time increase the connection between caregivers and patients. This also can result in better patient outcomes and will lead to reduced complications and financial implications. Disclosure B.Saboo: None. S.Saboo: None. V.Chavda: None. D.Hasnani: None.

The association between bedtime at night and diabetes in US adults: Data from National Health and Nutrition Examination Survey (NHANES) 2015-March -2020 pre-pandemic.

The purpose of this study was to investigate the relationship between bedtime at night and the risk of diabetes in adults. We extracted data from 14,821 target subjects from the NHANES database for a cross-sectional study. The data on bedtime came from the question in the sleep questionnaire: "What time do you usually fall asleep on weekdays or workdays?". Diabetes was defined as fasting blood sugar ≥ 126mg/dL, or glycohemoglobin ≥ 6.5%, or 2-hour Oral Glucose Tolerance Test blood sugar ≥ 200mg/dL, or taking hypoglycemic agent and insulin, or self-reported diabetes mellitus. A weighted multivariate logistic regression analysis was conducted to explore the relationship between bedtime at night and diabetes in adults. From 19:00 to 23:00, a significantly negative association can be found between bedtime and diabetes(OR, 0.91 [95%CI, 0.83, 0.99]). From 23:00 to 02:00, The relationship between the two was positive(OR, 1.07 [95%CI, 0.94, 1.22]), nevertheless, the P values was not statistically significant(p = 0.3524). In subgroup analysis, from 19:00-23:00, the relationship was negative across genders, and in males, the P-values were still statistically significant(p = 0.0414). From 23:00-02:00, the relationship was positive across genders. Earlier bedtime (before 23:00) increased the risk of developing diabetes. And this effect was not significantly different between male and female. For bedtime between 23:00-2:00, there was a trend of increasing the risk of diabetes as the bedtime was delayed.

Does Bad Medical News Reduce Preferences for Generic Drugs?

Policy makers and insurers promote the use of generic drugs because they can deliver large savings without sacrificing quality. But these efforts meet resistance from the public, who perceive generic drugs as inferior substitutes for brand name counterparts. Building on literature showing that negative emotions reduce risk-taking, the authors hypothesize that receiving bad medical news (i.e., negative information about one’s health) prompts patients to favor brand name over generic drugs as means to safeguard their health. The evidence exploits low-density lipoprotein cholesterol test results, where a discontinuity from clinical guidelines enables the authors to estimate the causal effect of bad medical news. Using data covering patients’ prescription drug choices across drug classes, the authors find that patients receiving bad medical news become 8% more likely to choose the brand name alternative. The findings are reinforced by a secondary analysis incorporating the similar context of hemoglobin A1c (blood sugar) testing. The authors also find that bad medical news reduces preferences for generics most strongly among drugs of direct clinical relevance for each test, but the effect also manifests among non–clinically relevant drugs.