Capillary Blood Glucose Concentrations Research Articles

Study on the effectiveness of postprandial blood glucose control and glycemic index of acetylated wheat flour in healthy volunteers

Background: The study was conducted to determine the ability to control postprandial blood glucose response and glycemic index of acetylated wheat starch cakes containing 31,2% of resistant starch on 12 healthy volunteers. Material and methods: Research designed using experimental and double-blind methods. During the two days of the clinical trial, after more than 12 hours of overnight fasting, each volunteer consumed a diet consisting of 1 cake containing 50 g of acetylated wheat starch or 50 g of natural wheat starch and 330 ml of filtered water in 15 minutes. Volunteers had determined their capillary blood glucose concentrations at times before meals, 60 and 120 minutes after meals. Results: Blood glucose concentration at 60 minutes after eating acetylated wheat starch cake (G1= 8.6 ± 0.8 mmol/L) was lower than natural wheat starch cake (G1= 11.7 + 1.1 mmol/L) (p < 0.05). Similarly, blood glucose concentration at 120 minutes after eating acetylated wheat starch cake (G2= 7.1 ± 0.7 mmol/L) was lower than natural wheat starch cake (G2= 9.2 ± 1.7 mmol/L) (p < 0.05). The area under the curve of blood glucose concentration after 120 minutes of eating natural wheat starch cake (AUC0-120min= 337.0 min*mmol/L) is doulble times larger than the acetylated wheat starch cake (AUC0-120min= 175.5 min*mmol/L) (p < 0.05). Glycemic index of acetylated wheat starch cake is 52.0. Conclusion: Acetylated wheat starch cake has a low glycemic index, possessing the ability to control postprandial blood glucose effectively, limiting the increase of postprandial blood glucose concentration within the safe range, and it did not cause any digestive disorders in volunteers. This is very meaningful in the application of acetylated wheat starch to process foods not only for diabetic patients but also for pre-diabetic or overweight and obese people to support treatment and improve quality of life. Key words: resistant starch, blood glucose, glycemic index, volunteers.

Effectiveness of hospital-based oral dextrose gel in prevention and treatment of asymptomatic newborns at risk of hypoglycemia

Objective To evaluate the effectiveness of using hospital-based 40% dextrose gel (DG) in preventing and treating asymptomatic hypoglycemia in infants of diabetic mothers (IDM), large for gestational age (LGA), and macrosomic neonates. Methods A medical chart review was conducted to compare data between before (April 2018 to March 2019, epoch 1) and after (September 2020 to November 2021, epoch 2) 40% DG implementation. DG, prepared by the hospital pharmaceutical unit, was applied within 30–45 min after birth, and three additional doses could be repeated during the first 6 h of life in combination with early feeding. The primary outcome was the rate of intravenous dextrose administration. Secondary outcomes were the incidence of hypoglycemia, first capillary blood glucose concentrations, and the length of hospital stay. Results Six hundred forty-three at-risk newborns were included (320 before and 323 after implementation of DG). Maternal and neonatal baseline characteristics were not different between the two epochs. The incidence of hypoglycemia was not different (17.8% in before versus 14.6% in after implementation, p = 0.26). The rate of intravenous dextrose administration after DG implementation was significantly lower than that before DG implementation (3.4% versus 10.3%, p < 0.001, risk reduction ratio = 0.33, 95% CI = 0.17–0.64). The length of hospital stay was not different between the two epochs. Conclusions Implementing a protocol for administration of hospital-based 40% DG can reduce the need of intravenous dextrose administration among IDM, LGA and macrosomic neonates.

The effect of different types of oral or intravenous corticosteroids on capillary blood glucose levels in hospitalized inpatients with and without diabetes

PurposeThis study investigated: (1) the type of corticosteroid associated with the greatest degree of hyperglycemia, assessed using bedside capillary blood glucose monitoring, in hospitalized patients; and (2) the pattern of hyperglycemia throughout the day with the use of each type of corticosteroid. MethodsThis single-center, retrospective study used data from 964 adult inpatients receiving oral or IV corticosteroids. Data on capillary blood glucose concentrations and time taken over 7 days were collected. A mixed model for repeated measures was applied to investigate changes in glucose concentration over time with the use of four different corticosteroids. An autoregressive covariance structure was used to model correlations between repeated measurements. FindingsAcross all 7 days, the mean blood glucose concentration was greater with dexamethasone compared to that with hydrocortisone (mean difference, 16.6 mg/dL [95% CI, 8.1–24.8] [0.92 mmol/L (95% CI, 0.45–1.38)]) or prednisolone (mean difference, 20.0 mg/dL [95% CI, 14.2–25.7] [1.11 mmol/L (95% CI, 0.79–1.43)]). The mean blood glucose concentration was greater with methylprednisolone compared to that with hydrocortisone (mean difference, 23.9 mg/dL [95% CI, 11.3–36.4] [1.33 mmol/L (95% CI, 0.63–2.02)]), and with methylprednisolone versus prednisolone (mean difference, 27.4 mg/dL [95% CI, 16.4–38.3] [1.52 mmol/L (95% CI, 0.91–2.13)]). There were no significant differences in the patterns of hyperglycemia at six time points of the day with each type of corticosteroid. ImplicationsTreatment with oral or IV dexamethasone or methylprednisolone was associated with greater hyperglycemia in comparison to prednisolone and hydrocortisone. More vigorous monitoring and intervention, when necessary, are suggested in adult inpatients receiving corticosteroids, in particular dexamethasone and methylprednisolone.

Measuring capillary blood glucose concentration: Is the first blood drop really the right blood drop?

BackgroundCapillary blood glucose (CBG) is fundamental for diabetes mellitus management. However, it is still unclear whether the first or the subsequent blood drops most accurately reflect patients’ blood glucose levels. Methods128 healthy volunteers were included in this prospective cohort study from November 2021 to December 2021. Capillary blood glucose concentrations of the first four blood drops, measured using glucose meters were compared with venous blood concentrations of the respective donors, measured using an in-lab hexokinase method. ANOVA, the Spearman correlation coefficient and Bland-Altman plots were used to analyze the data. ResultsThe mean plasma glucose concentration was 90.46 mg/dl with an SD of ± 14.416 (5.02 ± 0.8 mmol/l). There were statistically strong correlations among the glucose concentrations of all capillary blood drops (correlation coefficients of r > 0.8). The first capillary blood drops showed the lowest mean difference to plasma blood glucose concentrations (+4.92 mg/dl; +0.27 mmol/l), followed by the third drop (+7.28 mg/dl; +0.4 mmol/l), second drop (+7.30 mg/dl; +0.4 mmol/l) and fourth drop (+8.87 mg/dl; +0.49 mmol/l). ConclusionThere is a strong correlation and good agreement between the different capillary blood drops, making all blood drops equally suitable for blood glucose monitoring. In practice, the given setting (clinical or patient self-monitoring) should be considered upon choosing a specific blood drop.

Glucose and Fructose Supplementation and Their Acute Effects on Anaerobic Endurance and Resistance Exercise Performance in Healthy Individuals: A Double-Blind Randomized Placebo-Controlled Crossover Trial.

The effects of glucose, fructose and a combination of these on physical performance have been subject of investigation, resulting in diverse findings. The aim of this study was to investigate how an individualized amount of glucose, fructose, and a combination of these compared to placebo (sucralose) alter endurance performance on a cycle ergometer, lower and upper body resistance exercise performance at individualized thresholds in healthy young individuals. A total of 16 healthy adults (9 females) with an age of 23.8 ± 1.6 years and a BMI of 22.6 ± 1.8 kg/m2 (body mass (BM) 70.9 ± 10.8 kg, height 1.76 ± 0.08 m) participated in this study. During the screening visit, the lactate turn point 2 (LTP2) was defined and the weights for chest-press and leg-press were determined. Furthermore, 30 min prior to each exercise session, participants received either 1 g/kg BM of glucose (Glu), 1 g/kg BM of fructose (Fru), 0.5 g/kg BM of glucose/fructose (GluFru) (each), or 0.2 g sucralose (placebo), respectively, which were dissolved in 300 mL of water. All exercises were performed until volitional exhaustion. Time until exhaustion (TTE) and cardio-pulmonary variables were determined for all cycling visits; during resistance exercise, repetitions until muscular failure were counted and time was measured. During all visits, capillary blood glucose and blood lactate concentrations as well as venous insulin levels were measured. TTE in cycling was 449 ± 163 s (s) (Glu), 443 ± 156 s (Fru), 429 ± 160 s (GluFru) and 466 ± 162 s (Pla) (p = 0.48). TTE during chest-press sessions was 180 ± 95 s (Glu), 180 ± 92 s (Fru), 172 ± 78 s (GluFru) and 162 ± 66 s (Pla) (p = 0.25), respectively. Pre-exercise supplementation of Glu, Fru and a combination of these did not have an ergogenic effect on high-intensity anaerobic endurance performance and on upper and lower body moderate resistance exercise in comparison to placebo.

Impact of probiotic supplementation on exercise endurance among non-elite athletes: study protocol for a randomized, placebo-controlled, double-blind, clinical trial

BackgroundSome probiotics appear to improve athletic performance, endurance, and recovery after intense exercise. Other formulations may provide performance-related benefits via immune and gastrointestinal functions in athletic individuals. However, few formulations have been studied for both types of effects among non-elite athletes. The primary objective of this study is to assess the ergogenic effects of a probiotic on high-intensity endurance running performance in non-elite runners. Secondary objectives include assessment of perceived exertion, blood chemistry, immune and stress biomarkers, cold and flu symptoms, and gastrointestinal health after the probiotic intervention.MethodsThis 9-week randomized, placebo-controlled, double-blind, parallel trial will assess the ergogenic effects of a probiotic (5 billion colony-forming units/day, for 6 weeks) in healthy, non-elite runners (N=32; 18–45 years). Participants will be monitored via daily and weekly questionnaires during the 2-week pre-baseline, 6-week intervention, and 1-week washout. Questionnaires will inquire about activity, muscle soreness, gastrointestinal symptoms, cold and flu symptoms, stool form and frequency, and adverse events. During the pre-baseline visit, maximal oxygen uptake (V̇O2 max) is assessed to set appropriate individualized workload settings for the treadmill time-to-exhaustion endurance tests. These time-to-exhaustion endurance running tests will be completed at an intensity of 85% VO2max at baseline and final visits. During these tests, self-perceived exercise effort will be rated via the Borg Rating of Perceived Exertion scale and finger sticks assessing capillary blood glucose and lactate concentrations will be collected every 3 min. Additional questionnaires will assess diet and motivation to exercise. Body composition will be assessed using air displacement plethysmography at the baseline and final visits. Hypotheses will be tested using two-sided tests, and a linear model and with a type I error rate of α=0.05. Primary and secondary outcomes will be tested by comparing results between the intervention groups, adjusting for baseline values.DiscussionThese results will build evidence documenting the role of probiotics on running endurance performance and physiological responses to exercise in non-elite athletes. Understanding the potential mechanisms of probiotic effects and how they mitigate the intestinal or immune discomforts caused by running could provide additional strategy means to help runners improve their performance.Trial registration numberClinicalTrials.govNCT04588142. Posted on October 19, 2020.Protocol version: July 2, 2021, version 1.2

Monitoring rapid metabolic changes in health and type-1 diabetes with breath acetone sensors

Routine detection of health parameters is desirable to recognize the early onset of metabolic diseases (e.g., diabetes mellitus) and to personalize their treatment. Promising are non-invasive, affordable and portable technologies, such as breath sensors. Yet, the selective monitoring of breath markers (e.g., acetone for lipolysis) with sensors to track metabolic changes that can reveal disease-related abnormalities remains challenging. Here, subtle breath acetone changes during fasting, exercise and glucose ingestion are tracked in two model situations: Patients suffering from type-1 diabetes mellitus (T1DM) and healthy subjects (total: 19 volunteers) were monitored using chemoresistive sensors based on Si/WO3 nanoparticles. Specifically, each subject cycled after overnight fasting to stimulate fatty acid oxidation followed by an oral glucose tolerance test (OGTT), as monitored by capillary blood glucose and β-hydroxybutyrate (BOHB) concentrations. The sensor recognized accurately the individual breath acetone patterns before and after OGTT (both R2 = 0.9) at negligible interference, for instance, from glucose ingestion-associated volatiles (e.g., ethanol) or isoprene, as confirmed by high-resolution mass spectrometry. Furthermore, distinct differences in the breath acetone patterns of T1DM over healthy subjects were revealed including higher (t-test, p = 0.006) breath acetone ratio 2 h after starting the OGTT. Worth noting is that after glucose intake, breath isoprene steadily increased for T1DM subjects while it remained rather constant for healthy ones, an intriguing observation that requires more research to clarify its biochemical origin and medical relevance.

Acute effect of flaxseed-enriched snack bars on glycemic responses and satiety in healthy individuals.

The dietary glycemic index (GI) and glycemic load (GL) have garnered scholarly attention for their roles in weight management and glycemic control. Flaxseed is a good source of fiber, lignans, and omega-3 fatty acids. This study evaluated healthy individuals' acute glycemic response and satiety following the consumption of flaxseed-enriched snack bars. Nineteen healthy men and women consumed flaxseed bars or a glucose solution containing 50 g of available carbohydrates. Capillary blood glucose concentrations were obtained through the finger-prick test. The GI and GL values of the flaxseed bars were calculated using incremental area under the glucose response curve. Over 2 h, subjective satiety was examined at 0 (fasting), 15, 30, 45, 60, 90 and 120min following the consumption of flaxseed bars or saltine crackers containing 300 kcal by using a visual analogue scale (VAS). Compared with that of the glucose solution, the glucose concentrations of the flaxseed bars (15-90 min) were significantly lower (p<0.001). The GI and GL values of the flaxseed bars were 30.0±23.0 and 2.3±0.2, respectively. Compared with saltine cracker consumption, flaxseed bars consumption resulted in lower hunger and higher satiety. The satiety index score of the flaxseed bars was 1.6 times higher than that of the saltine crackers. Although further studies are warranted to evaluate the long-term effects of flaxseed-enriched snacks on glycemia and energy balance, our findings suggest that the incorporation of flaxseed into snack bars is a viable strategy for the management of obesity and diabetes.

Blood glucose response after oral lactulose intake in type 2 diabetic individuals.

BACKGROUNDLactulose is approved for the symptomatic treatment of constipation, a gastrointestinal (GI) complication common in individuals with diabetes. Lactulose products contain carbohydrate impurities (e.g., lactose, fructose, galactose), which occur during the lactulose manufacturing process. These impurities may affect the blood glucose levels of individuals with type 2 diabetes mellitus (T2DM) using lactulose for the treatment of mild constipation. A previous study in healthy subjects revealed no increase in blood glucose levels after oral lactulose intake. However, it is still unclear whether the intake of lactulose increases blood glucose levels in individuals with diabetes.AIMTo evaluate the blood glucose profile after oral lactulose intake in mildly constipated, non-insulin-dependent subjects with T2DM in an outpatient setting.METHODSThis prospective, double-blind, randomized, controlled, single-center trial was conducted at the Clinical Research Center at the Medical University of Graz, Austria, in 24 adult Caucasian mildly constipated, non-insulin-dependent subjects with T2DM. Eligible subjects were randomized and assigned to one of six treatment sequences, each consisting of four treatments stratified by sex using an incomplete block design. Subjects received a single dose of 20 g or 30 g lactulose (crystal and liquid formulation), water as negative control or 30 g glucose as positive control. Capillary blood glucose concentrations were measured over a period of 180 min post dose. The primary endpoint was the baseline-corrected area under the curve of blood glucose concentrations over the complete assessment period [AUCbaseline_c (0-180 min)]. Quantitative comparisons were performed for both lactulose doses and formulations vs water for the equal lactulose dose vs glucose, as well as for liquid lactulose vs crystal lactulose. Safety parameters included GI tolerability, which was assessed at 180 min and 24 h post dose, and adverse events occurring up to 24 h post dose.RESULTSIn 24 randomized and analyzed subjects blood glucose concentration-time curves after intake of 20 g and 30 g lactulose were almost identical to those after water intake for both lactulose formulations despite the different amounts of carbohydrate impurities (≤ 3.0% for crystals and approx. 30% for liquid). The primary endpoint [AUCbaseline_c (0-180 min)] was not significantly different between lactulose and water regardless of lactulose dose and formulation. Also with regard to all secondary endpoints lactulose formulations showed comparable results to water with one exception concerning maximum glucose level. A minor increase in maximum blood glucose was observed after the 30 g dose, liquid lactulose, in comparison to water with a mean treatment difference of 0.63 mmol/L (95% confidence intervals: 0.19, 1.07). Intake of 30 g glucose significantly increased all blood glucose endpoints vs 30 g liquid and crystal lactulose, respectively (all P < 0.0001). No differences in blood glucose response were observed between the different lactulose formulations. As expected, lactulose increased the number of bowel movements and was generally well tolerated. Subjects experienced only mild to moderate GI symptoms due to the laxative action of lactulose.CONCLUSIONBlood glucose AUCbaseline_c (0-180 min) levels in mildly constipated, non-insulin dependent subjects with T2DM are not affected by the carbohydrate impurities contained in 20 g and 30 g crystal or liquid lactulose formulations.

Sedentary Behaviors and Physical Activity Habits Independently Affect Fat Oxidation in Fasting Conditions and Capillary Glucose Levels After Standardized Glucose-Rich Meal in Healthy Females.

PurposeSedentary behaviors and muscle inactivity are being growingly recognized as important risk factors for health, adjunctively and independently from a scarce physical activity (PA), although the metabolic mechanism underneath is barely clear. To explore the relation between sedentary behaviors (SBs) and metabolism, we measured the metabolic profile in fasting condition and after oral glucose overload in a group of women, along with objective monitoring of their PA/sedentary lifestyle habits.Subjects and MethodsThirteen women (age: 32.5 ± 16.1 years; BMI: 24.0 ± 3.3 kg/m2), recruited among university students and research staff, underwent indirect calorimetry to assess fat and carbohydrate contribution to energy metabolism, in fasting conditions and after a glucose-rich standard meal (about 45 g of glucose). Glucose concentration in capillary blood was determined in fasting state and 15 and 30 min after meal. Habitual PA and SBs in the previous week were continuously monitored with Actigraph accelerometers.ResultsAfter adjustment for age, the contribution of fat oxidation to metabolic energy sources, normalized for fat-free mass, in fasting conditions was significantly correlated with time spent in sitting/lying position during wake hours (p < 0.001), independent from PA habits, whereas capillary blood peak and change of glucose concentration after the meal were significantly and inversely correlated with average daily moderate to vigorous PA (p = 0.025 and p = 0.019, respectively), independent from average daily sitting/lying time.ConclusionsHere, we report for the first time a direct effect of muscle inactivity on increased fat oxidation in fasting conditions, which can be hypothesized as a preliminary condition for the development of insulin resistance. We also report the direct independent effect of PA on the capacity to respond to a glycemic load, so that SBs and reduced PA appear to concur, although independently, to the increased health risk, as elsewhere observed on an epidemiological ground.

Lemon juice, but not tea, reduces the glycemic response to bread in healthy volunteers: a randomized crossover trial.

The inhibition of enzymes that hydrolyze starch during digestion could constitute an opportunity to slow down the release, and ultimately the uptake, of starch-derived glucose. Simple dietary approaches consisting in pairing starch-rich foods with beverages that have the capacity to inhibit such enzymes could be an effective and easily implementable strategy. The objective of this work was to test the impact of black tea and lemon juice on the glycemic response to bread and subsequent energy intake in healthy adults. A randomized crossover study was conducted with equal portions of bread (100g) and 250ml of water, black tea or lemon juice. Capillary blood glucose concentrations were monitored during 180min using the finger-prick method. Ad libitum energy intake was assessed 3h later. Tea had no effect on the glycemic response. Lemon juice significantly lowered the mean blood glucose concentration peak by 30% (p < 0.01) and delayed it more than 35min (78 vs. 41min with water, p < 0.0001). None of the tested beverages had an effect on ad libitum energy intake. These results are in agreement with previous in vitro studies showing that lowering the pH of a meal can slow down starch digestion through premature inhibition of salivary α-amylase. Furthermore, the effect of lemon juice was similar to what has been repeatedly observed with vinegar and other acidic foods. Including acidic beverages or foods in starchy meals thus appears to be a simple and effective strategy to reduce their glycemic impact.

Effect of semolina pudding prepared from starch branching enzyme IIa and b mutant wheat on glycaemic response in vitro and in vivo: a randomised controlled pilot study.

Refined starchy foods are usually rapidly digested, leading to poor glycaemic control, but not all starchy foods are the same. Complex carbohydrates like resistant starch (RS) have been shown to reduce the metabolic risk factors for chronic diseases such as hyperglycaemia and overweight. The aim of the project was to develop a semolina-based food made from a starch branching enzyme II (sbeIIa/b-AB) durum wheat mutant with a high RS content and to measure its glycaemic index using a double-blind randomised pilot study. We report here the amylose, RS and non-starch polysaccharide concentration of raw sbeIIa/b-AB and wild-type control (WT) semolina. We measured RS after cooking to identify a model food for in vivo testing. Retrograded sbeIIa/b-AB semolina showed a higher RS concentration than the WT control (RS = 4.87 ± 0.6 g per 100 g, 0.77 ± 0.34 g per 100 g starch DWB, respectively), so pudding was selected as the test food. Ten healthy participants consumed ∼50 g of total starch from WT and sbeIIa/b-AB pudding and a standard glucose drink. Capillary blood glucose concentrations were measured in the fasting and postprandial state (2 h): incremental area-under-the-curve (iAUC) and GI were calculated. We found no evidence of difference in GI between sbeIIa/b-AB pudding and the WT control, but the starch digestibility was significantly lower in sbeIIa/b-AB pudding compared to the WT control in vitro (C90 = 33.29% and 47.38%, respectively). Based on these results, novel sbeIIa/b-AB wheat foods will be used in future in vivo studies to test the effect of different RS concentrations and different food matrices on glycaemia.

Novel Single-Site Device for Conjoined Glucose Sensing and Insulin Infusion: Performance Evaluation in Diabetes Patients During Home-Use.

This study evaluated a novel diabetes treatment device that combines commercially available continuous glucose monitoring and insulin infusion technology in such a way as to perform insulin delivery and glucose sensing through a single skin insertion site (single-port device). Ten type 1 diabetes patients used the device for up to six days in their home/work environment for open-loop insulin delivery and glucose sensing. On an additional day, the device was used in combination with an algorithm to perform automated closed-loop glucose control under hospital settings. To assess the performance of the device, capillary blood glucose concentrations were frequently determined and a continuous glucose sensor was additionally worn by the patients. The average mean absolute relative deviation from blood glucose concentrations obtained for the sensor of the device was low (median, 13.0%; interquartile range, 10.5-16.7%; n = 10) and did not differ from that of the additionally worn glucose sensor (versus 13.9%; 11.9-15.3%; P = 0.922). Furthermore, insulin delivery with the single-port device was reliable and safe during home use and, when performed in combination with the control algorithm, was adequate to achieve and maintain near normoglycemia. Our data show the feasibility of open- and closed-loop glucose control in diabetes patients using a device that combines insulin delivery and glucose sensing at a single tissue site. The reduction in device size and invasiveness achieved by this design may largely increase patient convenience and enhance acceptance of diabetes treatment with continuous glucose monitoring and insulin delivery technology.

Maximal Exercise Blood Pressure and Glycemic Responses: Association with Resting Parameters in Healthy Young Adults.

Hypertension and hyperglycemia are known components of the metabolic syndrome. Massive adrenergic stimulation during high-intensity exercise has been associated to high blood pressure (BP) and blood glucose concentration. The predictive value of exercise-induced hypertension is an area of active research. An exaggerated and persistent hyperglycemia induced by intense exercise has been described in type-1 diabetics. For healthy subjects is not clear if BP and glycemic responses during maximal exercise are correlated with resting BP and glycemic values within the span of normal range. PURPOSE: To find the association between resting and maximal exercise BP and glycemic responses in healthy young adults. METHODS: An exploratory analysis was conducted on 145 young adults (63 female) aged 18-25 deemed healthy by medical and anthropometric evaluation (body mass index 18.4 - 24.9) as well as laboratory tests, including a complete metabolic profile. All subject had normal resting BP, glycated hemoglobin A1c (HbA1c) and fasting glucose concentration (FG) values. On a separate day subjects performed a maximal ramp cardiopulmonary exercise test (CPET) on a cycle ergometer; capillary blood glucose concentration (cBG) and BP were measured every 2.5 minutes. Pearson product-moment correlations between resting and exercise parameters were assessed with a significance level <0.05. Separate analysis were made for males and females. RESULTS: The analysis for the female group is presented: at maximal workload, cBG was correlated with HbA1c (r=0.29, p= 0.016) while diastolic BP was correlated with resting diastolic BP (r=0.26, p=0.034). Overall, maximal cBG was correlated with HbA1C (r= 0.27, p= 0.025) and FG (r=0.27, p=0.026) and maximal systolic BP was correlated with resting systolic BP (r=0.27, p=0.0009). CONCLUSIONS: For healthy young females BP and glycemic parameters at rest were positively associated with cBG and BP responses at or near maximal workloads during CPET. In otherwise healthy adults with resting BP and BG values in the upper limit of normal, acute intense exercise could play a role unmasking early subclinical cBG and BP changes in the metabolic syndrome continuum. The predictive and prognostic role of these findings remains to be determined. Supported by COLCIENCIAS Grant number 120356934972, 713-2013.

Ingesting a 12% Carbohydrate-Electrolyte Beverage Before Each Half of a Soccer Match Simulation Facilitates Retention of Passing Performance and Improves High-Intensity Running Capacity in Academy Players.

This study investigated the influence of ingesting a 12% carbohydrate plus electrolyte (CHO-E) solution providing 60g of carbohydrate before each half of a 90-min soccer match simulation (SMS) protocol on skill performance, sprint speed, and high-intensity running capacity. Eighteen elite academy (age: 18 ± 2 years) soccer players ingested two 250-ml doses (pre-exercise and at halftime) of a 12% CHO-E solution or electrolyte placebo administered in a double-blind randomized cross-over design. During an indoor (artificial grass pitch) SMS, dribbling, passing, and sprint performance were assessed, and blood was drawn for glucose and lactate analysis. High-intensity running capacity was assessed following the SMS. Dribbling speed/accuracy and sprint speed remained unchanged throughout the SMS. Conversely, passing accuracy for both dominant (mean percentage difference [95% confidence interval, CI]: 9 [3, 15]) and nondominant (mean percentage difference [95% CI]: 13 [6, 20]) feet was better maintained during the SMS on CHO-E (p < .05), with passing speed better maintained in the nondominant foot (mean percentage difference [95% CI]: 5.3 [0.7, 9.9], p = .032). High-intensity running capacity was greater in CHO-E versus placebo (mean percentage difference [95% CI]: 13 [6, 20], p = .010). Capillary blood glucose concentration was higher in CHO-E than placebo at halftime (CHO-E: 5.8 ± 0.5mM vs. placebo: 4.1 ± 0.4mM, p = .001) and following the high-intensity running capacity test (CHO-E: 4.9 ± 0.4mM vs. placebo: 4.3 ± 0.4mM, p = .001). Ingesting a 12% CHO-E solution before each half of a match can aid in the maintenance of soccer-specific skill performance, particularly on the nondominant foot, and improves subsequent high-intensity running capacity.

Clinical and progressive profile of skin and soft tissue lesions in diabetics in 2017 at the dressing room of the Marc Sankale Center in Dakar

IntroductionLe but de notre étude était de déterminer le profil clinique et évolutif des lésions de la peau et des parties molles des sujets diabétiques suivis à la salle de pansement.MéthodesIl s'agissait d'une étude observationnelle descriptive et analytique menée du 1er janvier au 31 décembre 2017 à la salle de pansement du centre Marc Sankale de Dakar. Notre étude a porté sur les sujets diabétiques ayant consultés à la salle de pansement.RésultatsAu total, 37173 actes de soins ont été enregistrés au centre Marc Sankale. Les activés de soins à la salle de pansement représentaient 16418 cas soit une prévalence de 14,16%. L'âge moyen était de 56,6 ± 12 ans et le sex ratio (H/F) de 0,88. Le diabète de type 2 prédominait (78,97%) et la durée moyenne du diabète était de 8,06 ± 7,9 ans. La glycémie capillaire moyenne était de 2,4 ± 1 g/l. La neuropathie diabétique était présente chez 72,33% des cas. Les lésions se situait aux membres dans 93,98% (1185 cas). Les lésions les plus représentatives étaient l'ulcère (46,76%), l'abcès (13,46%), le phlegmon (13,20%), la gangrène (8,41%), l'érysipèle (3,78%), le mal perforant (3,53%), l'intertrigo (3,95%). Les lésions étaient infectieuses (61,41), non infectieuses (33,50%), vasculaires pures (1,57%) et Mixtes (3,70%). Sur les 1189 patients 7,57% avaient présentés une ostéite. Les germes retrouvés étaient des bactéries grams positifs (12,70%), grams négatifs (23,80%). L'amputation était corrélée à la topographie de la lésion (p=0.00), au type de lésion (p=0.000), à l'ancienneté du diabète (p=0,02), au type de diabète (p=0,008), à la présence d'ostéite (p=0,006). L'amputation etait mineur (43,33%), et majeur (37,43%). Nous avons enregistré 70 décès (5,89%).ConclusionLes lésions de la peau et des tissus mous restent dominées par le pied diabétique. La mortalité est non négligeable et le risque d'amputation était statistiquement corrélé à la topographie, au type de lésion, à l'ancienneté et le type de diabète et à l'existence d'ostéite.

PL - 036 Interactive effects of exercise and metformin on lactic metabolism in type 2 diabetes

Objective Lactic acidosis is typically caused by an imbalance in lactic metabolism. This may be attributed to several reasons and is usually a result of complex interactions. There may be an increased risk for lactic acidosis in type 2 diabetes mellitus (T2D) patients when metformin treatment and physical exercise are combined since both metformin and exercise acutely affect lactic metabolism. As timing of exercise following metformin ingestion may determine the magnitude of long-term metabolic adaptations, this study aimed to test the acute effects of exercise performed at different times following metformin ingestion on lactic metabolism in T2D patients with a randomized crossover time series study design.&#x0D; Methods Participants were recruited from two clinical health-care centers in China using a two-step screening procedure. First, approximately 2 523 patients with T2D were screened from the local diabetes database and clinical outpatient registration with inclusion criteria being men and women (30–65 years old) diagnosed with T2D no more than 5 years ago and treated with metformin (maximal daily dose of 2000 mg). Out of 100 potential participants who met the inclusion criteria, 56 were interested and invited to a laboratory visit. Finally, 34 patients participated in the study and of those, 26 patients (14 women and 12 men, mean age = 53.8 ± 8.6 years) completed all testing procedures.&#x0D; All patients visited the laboratory on 4 occasions, each separated by at least 48 hours. Initially a control visit was performed and consisted of metformin administration only (Metf) and a maximal incremental cycle ergometer test in the afternoon. Thereafter, all participants performed a high-intensity interval training session (HIIT, 3 minutes at 40% followed by 1 minute of 85% of maximum power output) 30 minutes (EX30), 60 minutes (EX60), and 90 minutes (EX90) post breakfast and metformin administration, respectively, in a randomized order.&#x0D; Serum lactate and glucose concentrations were assessed enzymatically, while insulin was assessed by an electrochemiluminescence immunoassay and superoxide dismutase (SOD) activity was determined by spectrophotometry. Measurements were performed before breakfast as well as both before and immediately after each exercise bout. In addition, capillary blood glucose concentrations were measured immediately after sampling using Omron AS1 glucose test strips (HGM-114) and lactate concentrations were assessed by ARKRAY Lactate Pro 2 test strips throughout each measurement day. Dietary intake was standardized on the evening prior to each laboratory day as well as between 8:00 a.m. and 4:00 p.m. during each testing day. This trial is registered with ChiCTR-IOR-16008469 on 13th of May 2016.&#x0D; Results During all three-exercise sessions, the capillary lactate concentrations were significantly increased to a similar extent. However, sixty minutes following metformin administration, serum lactate levels began to accumulate to the highest level, where 30% of patients showed lactate concentrations above resting values (≥2 mmol·L-1). The increased lactate concentrations were statistically associated with increased glucose when exercise was performed 60 minutes post metformin administration (r=0.384, p=0.048). Furthermore, in EX60 and EX90 lactate concentrations were 19% and 8% higher, respectively, compared to EX30. In addition, we found that after exercise but not before exercise, the lactate level was positively correlated with SOD (EX30 r=0.478 and p=0.012, EX60 r=0.562 and p=0.002, EX90 r=0.562 and p=0.003, respectively).&#x0D; Conclusions We found that the changes of lactate concentrations were related to the timing of exercise post meal and after metformin ingestion. Thus, timing of exercise appears to be an important factor to be considered when prescribing exercise for T2D patients treated with metformin. In the present study, the optimal timing of HIIT exercise was 30 minutes after metformin administration, which was indicated by a minimized fluctuation of both glucose and lactate levels in T2D patients. Our results also suggest that lactic metabolism and oxidative stress could be among the main underlying molecular mechanisms that elucidate the combinational therapy of exercise and metformin treatment on T2D. Since both acute exercise and metformin may induce opposite effects on ATP production and reactive oxygen species formation, it is important to conduct further studies in an attempt to define the “safe time” for exercise after metformin administration.

High-Intensity Interval Training Improves Aerobic Capacity Without a Detrimental Decline in Blood Glucose in People With Type 1 Diabetes.

We investigated whether 6 weeks of high-intensity interval training (HIT) induced improvements in cardiometabolic health markers similar to moderate-intensity continuous training (MICT) in people with type 1 diabetes (T1D), and whether HIT abolished acute reductions in plasma glucose levels observed after MICT sessions. Two groups of sedentary individuals with T1D (n = 7 per group) completed 6 weeks of thrice weekly HIT or MICT. Pre- and post-training measurements were made of 24-hour interstitial glucose profiles, using continuous glucose monitors, and cardiometabolic health markers [peak oxygen consumption (V˙o2peak), blood lipid profile, and aortic pulse wave velocity (aPWV)]. Capillary blood glucose (BG) concentrations were assessed before and after exercise to investigate changes in BG levels during exercise in the fed state. Six weeks of HIT or MICT increased V˙o2peak by 14% and 15%, respectively (P < 0.001), and aPWV by 12% (P < 0.001), with no difference between groups. There was no difference in incidence or percentage of time spent in hypoglycemia after training in either group (P > 0.05). In the fed state, the mean change (±SEM) in capillary BG concentration during the HIT sessions was -0.2 ± 0.5 mmol/L, and -5.5 ± 0.4 mmol/L during MICT. Six weeks of HIT improved V˙o2peak and aPWV to a similar extent as MICT. That BG levels remained stable during HIT in the fed state but consistently fell during MICT suggests HIT may be the preferred training mode for some people with T1D.

Assessing performance in pre-season wrestling athletes using biomarkers.

IntroductionAlthough regular training introduces the desired changes in athletes’ metabolism towards optimal final performance, literature is rarely focusing on the metabolic responses off-competition. Therefore, the aim of this study was to evaluate biochemical indices during typical preseason training in wrestling athletes.Materials and methodsTwenty male freestyle and Greco-roman wrestlers (14 to 31 years) followed a typical session of the preparatory phase. Capillary blood glucose and lactate concentrations were assessed immediately before and after training. Protein, microalbumin, creatinine and their ratio were estimated the next day in the first morning urine.ResultsPre-training lactate concentrations were lower in Greco-roman than in freestyle wrestlers (1.8 (1.4 – 2.1) vs. 2.9 (2.1 – 3.1) mmol/L). Exertion resulted in a significant increase in lactate concentrations, by 3.2 (2.6 – 4.1) mmol/L in Greco-roman wrestlers and 4.5 (3.4 – 5.3) mmol/L in freestylers. These changes were found to correlate with athlete’s sport experience (rs = 0.71, P < 0.001). Glucose concentrations were also significantly increased by 0.5 (0.1 – 0.8) mmol/L, in correlation with lactate change (rs = 0.49, P = 0.003). Twelve subjects exhibited urine albumin concentrations at 30 mg/L, and thirteen creatinine concentrations around 17.7 mmol/L. The corresponding ratio was found abnormal in 4 cases, especially when creatinine excretion and body fat were low.ConclusionsWrestling training is associated with mobilization of both lactic and alactic anaerobic energy systems. The regular comprehensive monitoring of biochemical markers would be advantageous in determining the efficiency of the preparatory phase and the long-term physiological adaptations towards the competition phase, or athlete’s overtraining.

Assessing the prevalence of dexamethasone use in patients undergoing surgery, and subsequent glucose measurements: a retrospective cohort study

AbstractA single dose of glucocorticoid can cause hyperglycaemia. Hyperglycaemia is associated with poor outcomes in all surgical specialties. Dexamethasone is widely used to prevent postoperative nausea and vomiting. We aimed to assess how many individuals were given dexamethasone as part of their general anaesthetic regimen, and how many had a subsequent capillary blood glucose concentration measured during the next 24 hours.We undertook a retrospective case‐note analysis, set in a single centre teaching hospital, of all patients undergoing surgery during one week in August 2013. In terms of interventions and measurements, we assessed how many patients were given dexamethasone perioperatively and the number of patients who had a capillary blood glucose concentration measured during the subsequent 24 hours.It was found that 373 patients had had a general anaesthetic; 18 sets of case notes were unavailable. A total of 234 patients (66%) had dexamethasone. Twenty of the 355 (5.7%) had a blood glucose measured prior to surgery, 14 of whom had diabetes. Only 16/355 (4.5%) people had a blood glucose level measured during the first 24 hours after surgery. All of these had diabetes.Despite evidence that postoperative hyperglycaemia is associated with harm, and that glucocorticoids are associated with hyperglycaemia, glucose levels are not commonly measured after dexamethasone administration. Copyright © 2017 John Wiley &amp; Sons.