Changes In Blood Glucose Concentration Research Articles

A randomized control trial to establish the feasibility and safety of rapamycin treatment in an older human cohort: Immunological, physical performance, and cognitive effects

Inhibition of the mechanistic target of rapamycin (mTOR) pathway by rapamycin (RAPA), an FDA-approved immunosuppressive drug used as a clinical therapy to prevent solid organ allograft rejection, enhances longevity in mice. Importantly, RAPA was efficacious even when initiated in relatively old animals, suggesting that mTOR inhibition could potentially slow the progression of aging-associated pathologies in older humans (Harrison et al., 2009; Miller et al., 2011). However, the safety and tolerability of RAPA in older human subjects have not yet been demonstrated. Towards this end, we undertook a placebo-controlled pilot study in 25 generally healthy older adults (aged 70–95 years); subjects were randomized to receive either 1 mg RAPA or placebo daily. Although three subjects withdrew, 11 RAPA and 14 controls completed at least 8 weeks of treatment and were included in the analysis. We monitored for changes that would indicate detrimental effects of RAPA treatment on metabolism, including both standard clinical laboratory assays (CBC, CMP, HbA1c) and oral glucose tolerance tests (OGTTs). We also monitored parameters typically associated with aging that could potentially be modified by RAPA; these included cognitive function which was assessed by three different tools: Executive Interview-25 (EXIT25); Saint Louis University Mental Status Exam (SLUMS); and Texas Assessment of Processing Speed (TAPS). In addition, physical performance was measured by handgrip strength and 40-foot timed walks. Lastly, changes in general parameters of healthy immune aging, including serum pro-inflammatory cytokine levels and blood cell subsets, were assessed. Five subjects reported potential adverse side effects; in the RAPA group, these were limited to facial rash (1 subject), stomatitis (1 subject) and gastrointestinal issues (2 subjects) whereas placebo treated subjects only reported stomatitis (1 subject). Although no other adverse events were reported, statistically significant decrements in several erythrocyte parameters including hemoglobin (HgB) and hematocrit (Hct) as well as in red blood cell count (RBC), red blood cell distribution width (RDW), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) were observed in the RAPA-treatment group. None of these changes manifested clinically significant effects during the short duration of this study. Similarly, no changes were noted in any other clinical laboratory, cognitive, physical performance, or self-perceived health status measure over the study period. Immune parameters were largely unchanged as well, possibly due to the advanced ages of the cohort (70–93 years; mean age 80.5). RAPA-associated increases in a myeloid cell subset and in TREGS were detected, but changes in most other PBMC cell subsets were not statistically significant. Importantly, the OGTTs revealed no RAPA-induced change in blood glucose concentration, insulin secretion, and insulin sensitivity. Thus, based on the results of our pilot study, it appears that short-term RAPA treatment can be used safely in older persons who are otherwise healthy; a trial with a larger sample size and longer treatment duration is warranted.

Glycemic Response to Black Beans and Chickpeas as Part of a Rice Meal: A Randomized Cross-Over Trial.

Legumes, such as black beans (Phaseolus vulgaris L.) and chickpeas (Cicer arietinum L.), have a low glycemic index, and may reduce the glycemic load of meals in which they are included. Although the low glycemic response of beans consumed alone has been documented, few studies have examined the glycemic response to traditional food combinations such as black beans and rice or chickpeas and rice. This randomized cross-over study examined the glycemic and insulinemic impact of 50 grams of available carbohydrate from three test meals: plain white rice (control), black beans with rice, and chickpeas with rice among healthy adult women (n = 12, 18–65 years). Treatments were consumed on different mornings, a minimum of 7 days apart. Blood samples were collected at time 0 (fasting), and at 30, 60, 90, and 120 min postprandial, and were subsequently analyzed for glucose and insulin concentrations. Glucose response based on the incremental area under the curve showed a significant difference by treatment (p = 0.027). Changes in blood glucose concentrations were significantly different for the black bean meal and the chickpea meal in comparison to rice alone at 60 min (p = 0.026 and p = 0.024), 90 min (p = 0.001 and p = 0.012) and 120 min post prandial (p = 0.024; black bean meal). Findings indicate that combinations of black beans and chickpeas with white rice improve glycemic response, providing evidence that has promising implications for dietary guidance to reduce postprandial glucose and related health risks through traditional food patterns.

Multivariable Adaptive Artificial Pancreas System in Type 1 Diabetes.

The review summarizes the current state of the artificial pancreas (AP) systems and introduces various new modules that should be included in future AP systems. A fully automated AP must be able to detect and mitigate the effects of meals, exercise, stress and sleep on blood glucose concentrations. This can only be achieved by using a multivariable approach that leverages information from wearable devices that provide real-time streaming data about various physiological variables that indicate imminent changes in blood glucose concentrations caused by meals, exercise, stress and sleep. The development of a fully automated AP will necessitate the design of multivariable and adaptive systems that use information from wearable devices in addition to glucose sensors and modify the models used in their model-predictive alarm and control systems to adapt to the changes in the metabolic state of the user. These AP systems will also integrate modules for controller performance assessment, fault detection and diagnosis, machine learning and classification to interpret various signals and achieve fault-tolerant control. Advances in wearable devices, computational power, and safe and secure communications are enabling the development of fully automated multivariable AP systems.

What Happens to Blood Glucose Concentrations After Oral Treatment for Neonatal Hypoglycemia?

To determine the change in blood glucose concentration after oral treatment of infants with hypoglycemia in the first 48 hours after birth. We analyzed data from 227 infants with hypoglycemia (blood glucose <46.8 mg/dL, 2.6 mmol/L) born at a tertiary hospital who experienced 295 episodes of hypoglycemia. Blood glucose concentrations were measured (glucose oxidase) within 90 minutes after randomization to dextrose or placebo gel plus feeding with formula, expressed breast milk, or breast feeding. The overall mean increase in blood glucose concentration was 11.7 mg/dL (95% CI 10.4-12.8). The increase was greater after buccal dextrose gel than after placebo gel (+3.0 mg/dL; 95% CI 0.7-5.3; P = .01) and greater after infant formula than after other feedings (+3.8 mg/dL; 95% CI 0.8-6.7; P = .01). The increase in blood glucose concentration was not affected by breast feeding (+2.0 mg/dL; 95% CI -0.3 to 44.2; P = .09) or expressed breast milk (-1.4 mg/dL; 95% CI -3.7 to 0.9; P = .25). However, breast feeding was associated with reduced requirement for repeat gel treatment (OR = 0.52; 95% CI 0.28-0.94; P = .03). Treatment of infants with hypoglycemia with dextrose gel or formula is associated with increased blood glucose concentration and breast feeding with reduced need for further treatment. Dextrose gel and breast feeding should be considered for first-line oral treatment of infants with hypoglycemia.

Protein kinase STK25 aggravates the severity of non-alcoholic fatty pancreas disease in mice

Characterising the molecular networks that negatively regulate pancreatic β-cell function is essential for understanding the underlying pathogenesis and developing new treatment strategies for type 2 diabetes. We recently identified serine/threonine protein kinase 25 (STK25) as a critical regulator of ectopic fat storage, meta-inflammation, and fibrosis in liver and skeletal muscle. Here, we assessed the role of STK25 in control of progression of non-alcoholic fatty pancreas disease in the context of chronic exposure to dietary lipids in mice. We found that overexpression of STK25 in high-fat-fed transgenic mice aggravated diet-induced lipid storage in the pancreas compared with that of wild-type controls, which was accompanied by exacerbated pancreatic inflammatory cell infiltration, stellate cell activation, fibrosis and apoptosis. Pancreas of Stk25 transgenic mice also displayed a marked decrease in islet β/α-cell ratio and alteration in the islet architecture with an increased presence of α-cells within the islet core, whereas islet size remained similar between genotypes. After a continued challenge with a high-fat diet, lower levels of fasting plasma insulin and C-peptide, and higher levels of plasma leptin, were detected in Stk25 transgenic vs wild-type mice. Furthermore, the glucose-stimulated insulin secretion was impaired in high-fat-fed Stk25 transgenic mice during glucose tolerance test, in spite of higher net change in blood glucose concentrations compared with wild-type controls, suggesting islet β-cell dysfunction. In summary, this study unravels a role for STK25 in determining the susceptibility to diet-induced non-alcoholic fatty pancreas disease in mice in connection to obesity. Our findings highlight STK25 as a potential drug target for metabolic disease.

Electromagnetic Simulation for the Diagnosis of Lipoprotein Density in Human Blood, a Non-Invasive Approach

With the rise in prevalence of Type II diabetes throughout the world, an increasing need for a portable monitoring system for both blood glucose and lipoprotein concentrations is in demand. Recent work has led to non-invasive wearable devices for monitoring changes in blood glucose concentrations using electromagnetic (EM) waves. However, this still fall short as a means of monitoring cholesterol levels in diabetic patients. The EM study on human tissues emphasized here may also relate to the safety guidelines applied to cellular communications, power lines, and other EM applications. The specific absorption rate (SAR) for the power of the non-ionizing frequency must not exceed a threshold as it impacts DNA and can lead to cancerous tissues. In this study, we used COMSOL software for the investigation of the viability of using EM within the frequency range of 64 MHz-1 GHz as a means of monitoring the transmission properties of human blood and lipoprotein. In this approach, wave equations were solved within blood and lipoprotein boundaries. Research parameters, including frequency range, Power input (SAR), and lipoprotein densities, were investigated. The transmission properties, produced by the electrical and thermal characteristics of these physiological parameters, have led to proper diagnosis of lipoprotein density. Within the frequency range of 64 MHz to 1 GHz, and for a power range of 0.1 to 0.6 SAR, lipoprotein density from 1.00 g/mL to 1.20 g/mL was considered. A 2D model, with an antenna source that supplied the electromagnetic waves to human tissues, was created for the simulations. These were used for the study of the transmission properties of the EM energy into the blood and lipoprotein tissues. While the range of magnetic flux values between simulations varies only slightly or not at all, the distribution of these values is impacted by given parameters. As such, a device capable of comparing magnetic flux values and penetration depths could easily distinguish between samples of different lipoprotein densities. The results obtained in this study can be accommodated non-invasively by human tissues, and can be produced in a practical model using wearable devices. A practical model is proposed for future consideration.

NO EFFECT OF PRE-EXERCISE SUCRALOSE INGESTION ON GASTRIC EMPTYING RATE OF A CARBOHYDRATE-ELECTROLYTE SOLUTION

Ingestion of carbohydrate during exercise is common in order to provide an exogenous substrate for oxidation and to improve performance. The rate at which a solution is emptied from the...

HYPOGLYCEMIC ACTIVITY OF SOME INDONESIAN RICE VARIETIES AND THEIR PHYSICOCHEMICAL PROPERTIES

Diabetes mellitus is a spectrum of inherited and acquired disorders characterized by elevating blood glucose levels. Diabetes is an abnormal carbohydrate metabolism, therefore, diet therapy for diabetics plays a key role in the management of the disease. Most Indonesian people consume rice as source of energy and protein. Generally, diabetics consume very limited rice because they believe that rice is the one of hyperglycemic food, even though different rice varieties have large range of glycemic index. The study aimed to evaluate hypoglycemic properties by using rat assay and chemical characteristics of 10 Indonesian rice varieties, i.e. Pandan Wangi, Rojolele, Bengawan Solo, Cenana Bali, Memberamo, Celebes, Ciherang, Batang Piaman, Cisokan, and Lusi. Taj Mahal, an herbal ponni imported rice, was used as a comparison. Male Sprague Dawley rats (150- 200 g body weight) were used for hypoglycemic assay. The rats were fasted overnight before the blood glucose was measured in the morning. The rats were then feed with 4.5 g rice per kg body weight by oral administration, followed by 1 ml of 10% glucose solution in the next 30 minutes. The blood glucose was measured for the next 30, 60, 90, and 120 minutes. Changes in blood glucose concentrations (mg dl-1) before and after the oral administrations were calculated for each rice variety tested. Results showed that Cisokan and Batang Piaman were categorized as low glycemic responses and Ciherang as high glycemic response, while the other varieties (Memberamo, Cenana Bali, Lusi, Bengawan Solo, Pandan Wangi, Celebes, and Rojo Lele) showed moderate glycemic responses. As the best hypoglycemic activity, Cisokan contained high amylose (27.6%), fat (0.87%), total dietary fiber (6.24%), resistant starch (2.02%), and lowest starch digestibility (52.2%), which are ideal for diabetic’s consumption. Ciherang as the worst hypoglycemic activity had low resistant starch (1.78%), low total dietary fiber (4.52%), and medium amylose (23.0%). This study implies that Cisokan variety is suitable for diabetic’s consumption.

HYPOGLYCEMIC ACTIVITY OF SOME INDONESIAN RICE VARIETIES AND THEIR PHYSICOCHEMICAL PROPERTIES

Diabetes mellitus is a spectrum of inherited and acquired disorders characterized by elevating blood glucose levels. Diabetes is an abnormal carbohydrate metabolism, therefore, diet therapy for diabetics plays a key role in the management of the disease. Most Indonesian people consume rice as source of energy and protein. Generally, diabetics consume very limited rice because they believe that rice is the one of hyperglycemic food, even though different rice varieties have large range of glycemic index. The study aimed to evaluate hypoglycemic properties by using rat assay and chemical characteristics of 10 Indonesian rice varieties, i.e. Pandan Wangi, Rojolele, Bengawan Solo, Cenana Bali, Memberamo, Celebes, Ciherang, Batang Piaman, Cisokan, and Lusi. Taj Mahal, an herbal ponni imported rice, was used as a comparison. Male Sprague Dawley rats (150- 200 g body weight) were used for hypoglycemic assay. The rats were fasted overnight before the blood glucose was measured in the morning. The rats were then feed with 4.5 g rice per kg body weight by oral administration, followed by 1 ml of 10% glucose solution in the next 30 minutes. The blood glucose was measured for the next 30, 60, 90, and 120 minutes. Changes in blood glucose concentrations (mg dl-1) before and after the oral administrations were calculated for each rice variety tested. Results showed that Cisokan and Batang Piaman were categorized as low glycemic responses and Ciherang as high glycemic response, while the other varieties (Memberamo, Cenana Bali, Lusi, Bengawan Solo, Pandan Wangi, Celebes, and Rojo Lele) showed moderate glycemic responses. As the best hypoglycemic activity, Cisokan contained high amylose (27.6%), fat (0.87%), total dietary fiber (6.24%), resistant starch (2.02%), and lowest starch digestibility (52.2%), which are ideal for diabetic’s consumption. Ciherang as the worst hypoglycemic activity had low resistant starch (1.78%), low total dietary fiber (4.52%), and medium amylose (23.0%). This study implies that Cisokan variety is suitable for diabetic’s consumption.

Anti-hyperglycemic effect of Canarium schwenfurthii fruit oil on wistar rats

Aim: The effect of oil got from the fruit pulp of Canarium schweinfurthii on normal and STZ-induced diabetic rats was evaluated. Methodology: Twenty four rats were divided into six groups of four each. Group 1 (normal rats) received 5 ml of distilled water, group 2 diabetic rats received STZ + 5 ml / kg b.w glibenclamide; groups 3,4 and 5 STZ-induced diabetic rats received 5 ml, 10 ml and 20 ml per b.w of C.s oil respectively while group 6 STZ-induced diabetic rats received no treatment. All treatments were orally administered using an oral-gastric tube for two weeks. Changes in blood glucose concentration were compared to positive (STZ + glibenclamide) and negative (STZ only) controls. Results: The oil showed positive effect against STZ-induced diabetic rats after 2 hrs at all dose levels tested. Daily administration of 10 ml / b.w of C.s oil showed similar activities as the reference drug (glibenclamide) and glucose reduction compared to STZ only. At 20 ml / b.w daily administration of C.s oil, mortality was observed. Conclusion: In conclusion, Canarium schweinfurthii fruit oil may be considered as a remedy for diabetes mellitus when administered at low doses (10 ml / bw and below) for long-term use. Further research is recommended.

Effect of fat type in baked bread on amylose-lipid complex formation and glycaemic response.

The formation of amylose-lipid complexes (ALC) had been associated with reduced starch digestibility. A few studies have directly characterised the extent of ALC formation with glycaemic response. The objectives of this study were to investigate the effect of using fats with varying degree of saturation and chain length on ALC formation as well as glycaemic and insulinaemic responses after consumption of bread. Healthy men consumed five test breads in a random order: control bread without any added fats (CTR) and breads baked with butter (BTR), coconut oil (COC), grapeseed oil (GRP) or olive oil (OLV). There was a significant difference in glycaemic response between the different test breads (P=0·002), primarily due to COC having a lower response than CTR (P=0·016), but no significant differences between fat types were observed. Insulinaemic response was not altered by the addition of fats/oils. Although BTR was more insulinotropic than GRP (P<0·05), postprandial β-cell function did not differ significantly. The complexing index (CI), a measure of ALC formation, was significantly higher for COC and OLV compared with BTR and GRP (P<0·05). CI was significantly negatively correlated with incremental AUC (IAUC) of change in blood glucose concentrations over time (IAUCglucose) (r -0·365, P=0·001). Linear regression analysis showed that CI explained 13·3 % of the variance and was a significant predictor of IAUCglucose (β=-1·265, P=0·001), but IAUCinsulin did not predict IAUCglucose. Our study indicated that a simple way to modulate glycaemic response in bread could lie in the choice of fats/oils, with coconut oil showing the greatest attenuation of glycaemic response.

Mechanisms Regulating Insulin Response to Intragastric Glucose in Lean and Non-Diabetic Obese Subjects: A Randomized, Double-Blind, Parallel-Group Trial.

Background/ObjectivesThe changes in blood glucose concentrations that result from an oral glucose challenge are dependent on the rate of gastric emptying, the rate of glucose absorption and the rate of insulin-driven metabolism that include the incretins, glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 (GLP-1). The rate of insulin-driven metabolism is clearly altered in obese subjects, but it is controversial which of these factors is predominant. We aimed to quantify gastric emptying, plasma insulin, C-peptide, glucagon and glucose responses, as well as incretin hormone secretions in obese subjects and healthy controls during increasing glucose loads.Subjects/MethodsThe study was conducted as a randomized, double-blind, parallel-group trial in a hospital research unit. A total of 12 normal weight (6 men and 6 women) and 12 non-diabetic obese (BMI > 30, 6 men and 6 women) participants took part in the study. Subjects received intragastric loads of 10 g, 25 g and 75 g glucose dissolved in 300 ml tap water.ResultsMain outcome measures were plasma GLP-1 and GIP, plasma glucagon, glucose, insulin, C-peptide and gastric emptying. The primary findings are: i) insulin resistance (P < 0.001) and hyperinsulinemia (P < 0.001); ii) decreased insulin disposal (P < 0.001); iii) trend for reduced GLP-1 responses at 75 g glucose; and iv) increased fasting glucagon levels (P < 0.001) in obese subjects.ConclusionsIt seems that, rather than changes in incretin secretion, fasting hyperglucagonemia and consequent hyperglycemia play a role in reduced disposal of insulin, contributing to hyperinsulinemia and insulin resistance.Trial RegistrationClinicalTrials.gov NCT01875575

Exercise and Sport Participation for Individuals with Type 1 Diabetes

Exercise and Sport Participation for Individuals with Type 1 Diabetes

Insulin pulsatility after the intravenous glucose bolus

OBJECTIVE: The aim of the study was to assess whether sudden change in blood glucose concentration in healthy subject would produce insulin secretory pattern similar to one in type 2 diabetic subjects (T2D). DESIGN: The concept of the study was to 'reset' the pancreas and empty the stored insulin pool, so that subtle derangements of the pulsatile insulin secretion could be studied. METHODS: The study group included 6 control and 7 T2D subjects. For insulin and glucose determination, blood was sampled for 60 minutes with 2 minutes inter-sample interval. To increase blood glucose an intravenous glucose bolus was given (0.3 g/kg body weight). RESULTS: The average glucose level in the T2D group was significantly higher, but the average insulin concentration was not different between the groups. Insulin half-life, pulse amplitude, number of pulses and interpulse interval did not differ between the groups. CONCLUSIONS: Therefore, the sudden increase in blood glucose causes insulin secretory pattern to become similar in the healthy and in the T2D subjects. However, the defect in the insulin secretion or glucose sensing inherent to β-cell exists, as the insufficient quantity of insulin is secreted in response to the increased glucose level.

Modeling and Measurement of Correlation between Blood and Interstitial Glucose Changes.

One of the most effective methods for continuous blood glucose monitoring is to continuously measure glucose in the interstitial fluid (ISF). However, multiple physiological factors can modulate glucose concentrations and affect the lag phase between blood and ISF glucose changes. This study aims to develop a compensatory tool for measuring the delay in ISF glucose variations in reference to blood glucose changes. A theoretical model was developed based on biophysics and physiology of glucose transport in the microcirculation system. Blood and interstitial fluid glucose changes were measured in mice and rats by fluorescent and isotope methods, respectively. Computer simulation mimicked curves were fitted with data resulting from fluorescent measurements of mice and isotope measurements of rats, indicating that there were lag times for ISF glucose changes. It also showed that there was a required diffusion distance for glucose to travel from center of capillaries to interstitial space in both mouse and rat models. We conclude that it is feasible with the developed model to continuously monitor dynamic changes of blood glucose concentration through measuring glucose changes in ISF with high accuracy, which requires correct parameters for determining and compensating for the delay time of glucose changes in ISF.

Anti-hyperglycemic effect of Canarium schwenfurthii fruit oil on wistar rats

Aim: The effect of oil got from the fruit pulp of Canarium schweinfurthii on normal and STZ-induced diabetic rats was evaluated. Methodology: Twenty four rats were divided into six groups of four each. Group 1 (normal rats) received 5 ml of distilled water, group 2 diabetic rats received STZ + 5 ml / kg b.w glibenclamide; groups 3,4 and 5 STZ-induced diabetic rats received 5 ml, 10 ml and 20 ml per b.w of C.s oil respectively while group 6 STZ-induced diabetic rats received no treatment. All treatments were orally administered using an oral-gastric tube for two weeks. Changes in blood glucose concentration were compared to positive (STZ + glibenclamide) and negative (STZ only) controls. Results: The oil showed positive effect against STZ-induced diabetic rats after 2 hrs at all dose levels tested. Daily administration of 10 ml / b.w of C.s oil showed similar activities as the reference drug (glibenclamide) and glucose reduction compared to STZ only. At 20 ml / b.w daily administration of C.s oil, mortality was observed. Conclusion: In conclusion, Canarium schweinfurthii fruit oil may be considered as a remedy for diabetes mellitus when administered at low doses (10 ml / bw and below) for long-term use. Further research is recommended.

Molecular interaction between glimepiride and Soluplus®-PEG 4000 hybrid based solid dispersions: Characterisation and anti-diabetic studies

The objective of this study was to evaluate a novel blend of polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol 6000 grafted copolymer (Soluplus®) and polyethylene glycol (PEG) 4000 for solubility enhancement, physicochemical stability and anti-diabetic efficacy of the produced solid dispersions containing glimepiride, a biopharmaceutics classification system (BCS) class II sulphonylurea. Different batches of glimepiride solid dispersions (SD) were prepared by the solvent evaporation method using the individual polymers and blends of the polymers at different ratios. The Soluplus®-PEG 4000 (sol-PEG) hybrid polymer based glimepiride solid dispersions were characterized by differential scanning calorimetry (DSC), fourier transform infrared (FTIR) spectroscopy, micromeritics and dissolution studies. In vivo anti-diabetic activity was determined by measuring the changes in blood glucose concentrations in albino rats. The solid dispersions showed good flow properties and excellent practical yield. Drug content and release from the different formulations increased when Soluplus® was used as the main matrix polymer. The kinetics of drug release from all the solid dispersions followed first order. Solid state characterization confirmed the formation of amorphous glimepiride solid dispersions in the Sol-PEG hybrid polymer and no strong drug–polymer interaction was observed. The blood glucose reduction in albino rats by the Sol-PEG-Glim SDs was significantly (p<0.05) higher and more sustained when compared with the plain drug sample and commercially available product. Optimized SD batches (SP1 and SP3) showed a reduction in blood glucose level from 100% to 9.81% and 8.97%, respectively, at Tmax of 3h. The Sol-PEG-Glim SD was found to be stable over a period of 6 months (at 40°C, 70% RH) with no significant changes in the drug content. Thus, the Sol-PEG polymeric hybrids represent a promising tool for enhanced delivery of glimepiride.

Changes in blood glucose concentrations over time when administering intravenous insulin in post cardiac surgery in adult intensive care patients

Patients in intensive care units (ICUs) are treated with intravenous (IV) insulin by infusions with the goal of maintaining blood glucose (BG) within a narrow target range. However, as BG is measured intermittently and how the time course of BG concentration changes after altering the insulin infusion rate is unknown. We used an intra-arterial Continuous Glucose Monitoring (CGM) system to study the time course of BG concentrations after changes in IV insulin infusion rates.

Glucose sensing by GABAergic neurons in the mouse nucleus tractus solitarii.

Changes in blood glucose concentration alter autonomic function in a manner consistent with altered neural activity in brain regions controlling digestive processes, including neurons in the brain stem nucleus tractus solitarii (NTS), which process viscerosensory information. With whole cell or on-cell patch-clamp recordings, responses to elevating glucose concentration from 2.5 to 15 mM were assessed in identified GABAergic NTS neurons in slices from transgenic mice that express EGFP in a subset of GABA neurons. Single-cell real-time RT-PCR was also performed to detect glutamic acid decarboxylase (GAD67) in recorded neurons. In most identified GABA neurons (73%), elevating glucose concentration from 2.5 to 15 mM resulted in either increased (40%) or decreased (33%) neuronal excitability, reflected by altered membrane potential and/or action potential firing. Effects on membrane potential were maintained when action potentials or fast synaptic inputs were blocked, suggesting direct glucose sensing by GABA neurons. Glucose-inhibited GABA neurons were found predominantly in the lateral NTS, whereas glucose-excited cells were mainly in the medial NTS, suggesting regional segregation of responses. Responses were prevented in the presence of glucosamine, a glucokinase (GCK) inhibitor. Depolarizing responses were prevented when KATP channel activity was blocked with tolbutamide. Whereas effects on synaptic input to identified GABAergic neurons were variable in GABA neurons, elevating glucose increased glutamate release subsequent to stimulation of tractus solitarius in unlabeled, unidentified neurons. These results indicate that GABAergic NTS neurons act as GCK-dependent glucose sensors in the vagal complex, providing a means of modulating central autonomic signals when glucose is elevated.

Hormonal, electrolyte disturbances and features of hemostasis in term newborn infants of mothers with gestational diabetes mellitus.

The article reviews the available data on investigations in the field of electrolyte (calcium, magnesium), hormonal (insulin, leptin) and hemostasis disturbances in term newborns from women with gestational diabetes; possible mechanisms of their development are also highlighted. The review describes changes in blood glucose concentration in term newborns from women with gestational diabetes, and their impact on the child's condition. In addition to already known factors causing macrosomia and other metabolic disorders in term neonates, the role of leptin (peptide hormone that regulates energy metabolism) is quite discussable. Low leptin levels lead to the development of obesity. It is also confirmed, that leptin influences brain development of the newborn, leading to later cognitive deficits in children from women with GDM. The aim of the review is to summarize the available data on investigations in the field of electrolyte (calcium, magnesium), hormonal (insulin, leptin) and hemostasis disturbances in term newborns from women with gestational diabetes.