Changes In Blood Glucose Levels Research Articles

Impact of early-morning administration of rapid-acting insulin on the increase in blood glucose levels related to the dawn phenomenon in individuals with type 1 diabetes.

An early-morning elevation of blood glucose levels known as the dawn phenomenon and consequent postbreakfast hyperglycemia occur in some individuals with type 1 diabetes (T1D). Whereas insulin pump therapy can mitigate this phenomenon, some individuals prefer or are limited to alternative treatments. We have now assessed the effectiveness of early-morning administration of rapid-acting insulin for amelioration of the dawn phenomenon in individuals with T1D. Thirteen individuals with T1D who experienced the dawn phenomenon as determined by continuous glucose monitoring (CGM) and who received a small dose of rapid-acting insulin on waking were included in this retrospective study. We evaluated the change in sensor glucose levels during a 2-h period from before to after breakfast consumed at 0700h. The change in blood glucose levels during additional time intervals, average daily sensor glucose values, CGM indices, and insulin dose were also evaluated. The early-morning administration of 0.5-1 unit of rapid-acting insulin was associated with a significant reduction in 2-h glucose variability between before (0700h) and after breakfast from a median of 90.7-51.0mg/dL. The glucose variability from 0300 to 0700 or 0900h was also significantly decreased, from 67.7 to 29.0mg/dL and from 172.5 to 78.3mg/dL, respectively. Average sensor glucose levels throughout the day were significantly reduced (from 192.7 to 156.7mg/dL), as was the daily total insulin dose. Early-morning administration of rapid-acting insulin effectively managed the dawn phenomenon and subsequent postbreakfast hyperglycemia in individuals with T1D. The online version contains supplementary material available at 10.1007/s13340-024-00709-6.

Immediate Impact of Switching from Dipeptidyl Peptidase4 (DPP4) Inhibitors to Low-Dose (0.3mg) Liraglutide on Glucose Profiles: A Retrospective Observational Study.

As treatment agents for diabetes, liraglutide is a long-acting glucagon-like peptide1 receptor agonist, and dipeptidyl peptidase4 (DPP4) inhibitors are widely used because of their safety and tolerability. Regular treatment with liraglutide has been reported to significantly reduce blood glucose levels, but the impact of low-dose (0.3mg) liraglutide on blood glucose levels immediately after treatment switching from a DPP4 inhibitor remains unknown. We conducted a single-arm, retrospective, observational study in 55 inpatients with type2 diabetes (T2D) to investigate the changes (Δ) in their blood glucose levels at six time points (6-point) from the day before (day-1) to the day after (day1) by switching the antidiabetic treatment from a DPP4 inhibitor to liraglutide 0.3mg (low-dose liraglutide) once daily. We also attempted to identify factors associated with the blood glucose-lowering effects of liraglutide. The median values of the changes in fasting, preprandial, and postprandial blood glucose levels and the fluctuations in the blood glucose levels expressed as the standard deviation of the 6-point blood glucose levels were significantly lower on day1 than on day-1 (P < 0.05, P < 0.0001, P < 0.0001, P < 0.01, respectively); there were no cases of severe hypoglycemia. The Δblood glucose levels were not associated with the baseline serum hemoglobin A1c values or with any markers of the insulin secreting capacity. There were no associations between the previously used blood glucose-lowering drug and the Δblood glucose levels. Switching from a DPP4 inhibitor to low-dose (0.3mg) liraglutide once daily significantly reduced the blood glucose levels and excursions of the blood glucose levels even from the very day after the treatment switch, with no serious adverse events.

Effects of different types of meals on postprandial glycaemia in healthy subjects.

Nowadays, continuous glycaemic monitoring systems are used primarily for diabetic patients. The most popular continuous glycaemic monitoring (CGMs) measure the glucose concentration in the interstitial fluid every 1 or 5 minutes, providing the patient with 288 or 1,440 measurements in aday. CGM is also useful for observing sudden changes in glycaemia after the introduction of dietary interventions and those related to physical activity. Peri-prandial glycaemia is defined as the change in blood glucose levels depending on the carbohydrate-containing meal consumed. A state of peri-prandial hyperglycaemia begins when blood glucose levels rise above the level of 140 mg/dl (7.8 mmol/l) within 1-2 hours after food intake in healthy people without diabetes. The influence of the peri-prandial glycaemic response is briefly related to the amount and type of food consumed. Optimising the glycaemic profile is important for our health. The purpose of this article is to summarise the current knowledge of the effects of various meals on peri-prandial glycaemia in healthy individuals.

Changes in Biochemical Components of Obesity in Wistar Rats Fed Mentha Piperita-Supplemented High-Fat Diet

The research is designed to assess changes in biochemical components of obesity in Wistar rats fed peppermint-supplemented high-fat diet. Twenty (20) female Wistar rats of about 117.88±10.82g were divided into four (4) groups of five (5) rats each and randomly assigned to the formulated diets. The groups had similar average weights. Groups A and B were fed standard diet and High-fat diet respectively, while groups C and D were respectively fed 4% peppermint-supplemented standard diet and 4% peppermint-supplemented high-fat diet. The changes in weight and blood glucose level were monitored on weekly basis. At the end of six (6) weeks of the experiment, organ to body weight ratio, serum insulin level and HOMA-IR were determined. Markers of hepatic functions (transaminases, total bilirubin, albumin, globulin, conjugated bilirubin and total protein), markers of renal functions (electrolyte concentrations, urea and creatinine), serum activities of antioxidant enzymes (catalase, glutathione peroxidase, reduced glutathione and superoxide dismutase) and serum concentrations of malondialdehyde (MDA) were also determined. No significant (p≤0.05) differences were observed among the groups in weight gain, organ to body weight ratio, blood glucose levels, activities of antioxidant enzymes and serum MDA concentrations. The group fed 4% peppermint-supplemented high-fat diet had significantly (p≤0.05) higher activities of ALT, AST, total cholesterol and low-density lipoprotein cholesterol but significantly (p≤0.05) lower high-density lipoprotein cholesterol when compared with the group fed standard diet or high-fat diet. Serum creatinine and bicarbonate were significantly (p≤0.05) lower in the group fed 4% peppermint-supplemented high-fat diet compared with the group fed the standard diet. It is therefore concluded that including peppermint leaf powder in the diet for a period of 6 weeks may not have a significant impact on the body weight, organ development and glucose utilisation. However, it is important to note that consumption of high-fat diet supplemented with peppermint might lead to dyslipidemia, liver and kidney dysfunctions without altering oxidative balance in Wistar rats.

Effect of denosumab on glucose metabolism in postmenopausal osteoporotic women with prediabetes: a study protocol for a 12-month multicenter, open-label, randomized controlled trial

BackgroundParticipants with prediabetes are at a high risk of developing type 2 diabetes (T2D). Recent studies have suggested that blocking the receptor activator of nuclear factor-κB ligand (RANKL) may improve glucose metabolism and delay the development of T2D. However, the effect of denosumab, a fully human monoclonal antibody that inhibits RANKL, on glycemic parameters in the prediabetes population is uncertain. We aim to examine the effect of denosumab on glucose metabolism in postmenopausal women with osteoporosis and prediabetes.MethodsThis is a 12-month multicenter, open-label, randomized controlled trial involving postmenopausal women who have been diagnosed with both osteoporosis and prediabetes. Osteoporosis is defined by the World Health Organization (WHO) as a bone mineral density T score of ≤ − 2.5, as measured by dual-energy X-ray absorptiometry (DXA). Prediabetes is defined as (i) a fasting plasma glucose level of 100–125 mg/dL, (ii) a 2-hour plasma glucose level of 140–199 mg/dL, or (iii) a glycosylated hemoglobin A1c (HbA1c) level of 5.7–6.4%. A total of 346 eligible subjects will be randomly assigned in a 1:1 ratio to receive either subcutaneous denosumab 60 mg every 6 months or oral alendronate 70 mg every week for 12 months. The primary outcome is the change in HbA1c levels from baseline to 12 months. Secondary outcomes include changes in fasting and 2-hour blood glucose levels, serum insulin levels, C-peptide levels, and insulin sensitivity from baseline to 12 months, and the incidence of T2D at the end of the study. Follow-up visits will be scheduled at 3, 6, 9, and 12 months.DiscussionThis study aims to provide evidence on the efficacy of denosumab on glucose metabolism in postmenopausal women with osteoporosis and prediabetes. The results derived from this clinical trial may provide insight into the potential of denosumab in preventing T2D in high-risk populations.Trial registrationThis study had been registered in the Chinese Clinical Trials Registry. Registration number: ChiCTR2300070789 on April 23, 2023. https://www.chictr.org.cn.

Aerobic Exercise Training Under Normobaric Hypoxic Conditions to Improve Glucose and Lipid Metabolism in Overweight and Obese Individuals: A Systematic Review and Meta-Analysis.

Guo, Hai, Linjie Cheng, Dilihumaier Duolikun, and Qiaoling Yao. Aerobic exercise training under normobaric hypoxic conditions to improve glucose and lipid metabolism in overweight and obese individuals: a systematic review and meta-analysis. High Alt Med Biol. 24:312-320, 2023. Background: Obesity is a critical public health issue around the world, reaching epidemic proportions in some countries. However, only a few studies have examined the effects of hypoxic training on metabolic parameters in an obese population. This systematic review and meta-analysis aimed to determine the effects of aerobic exercise training under normobaric hypoxic conditions versus normoxic training in improving glucose and lipid metabolism in obese individuals. Methods: A systematic search of PubMed, EMBASE, Web of Science, and Wan Fang databases (up to August 2021) was performed to identify randomized controlled trials (RCTs) of overweight or obese human subjects eligible for inclusion. Main study endpoints were changes in body mass index (BMI), waist/hip (W/H) ratio, leptin, blood glucose and insulin levels, as well as blood lipids between hypoxic and normoxic conditioning. Results: Fourteen RCTs with a total of 413 subjects qualified for inclusion. Pooled analyses revealed that BMI (d = 0.38), W/H ratio (d = 0), blood glucose (d = 0.01), and triglyceride (d = -2.27) were not significantly different between aerobic exercise training under hypoxic and normoxic conditions. However, significant differences were found in heart rate at rest (d = -4.50) between aerobic exercise training under hypoxic versus normoxic conditions. Conclusions: In conclusion, no significant benefits were noted in aerobic exercise training under hypoxic conditions over normoxic conditions in overweight or obese individuals. However, the maximum training heart rate mm was significantly higher under hypoxic conditions than under normoxic conditions. Future studies with larger samples controlling for exercise-related parameters, and addressing the potential modifying effects of level of hypoxia, sex, or age on the role of hypoxic exercise training are warranted. PROSPERO registration number: CRD42020221680.

Analisis Drug Related Problems dan Pengaruhnya terhadap Pengendalian Glukosa Darah pada Pasien Covid-19 dengan Komorbiditas Diabetes Melitus Tipe 2

This study aims to anayze the effect of drug related problems (DRPs) on glycemic control in COVID-19 patients with comorbid diabetes mellitus type 2. This research is a cross-sectiona study using retrospective data obtained from secondary data from the medica records of Covid-19 patients. with type 2 diabetes mellitus. The research location was at Jati Padang Hospita. The sample consisted of 76 medica records with total sampling method. Data collected using PCNE V9.00 were then tested using the Wilcoxon test comparing initia GDS in hospita with GDS at the end of patient discharge, the Chisquare test which correlated changes in GDS with patient clinica outcomes and the Spearman test which linked changes in GDS with DRPs, characteristics of Covid-19 patients with diabetes mellitus predominant age 46-55 years (30.3%), predominant sex mae (51.3%), length of stay 6-10 days (64.5%), profile of drug use that is often used antivira, antibiotics, vitamins and supplements, symptomatic and antidiabetic (100%). The most common comorbidities were hypertension (60.4%), the incidence of DRPs (92.1%), the most common fina GDS was hyperglycemia (≥ 200 mg/dL) (65.8%). 58 patients were discharged with a negative sample (76.3%). The results of the Wilcoxon test on blood glucose showed differences in blood glucose at the beginning and at the end. The results of the Chi-square test between changes in blood glucose and the patient's clinica outcome (p&gt;0.05) showed that there was no significant relationship between changes in blood glucose levels and the patient's clinica outcome. Spearmen's correlation test results (p&gt;0.05) showed a significant relationship between DRPs and changes in patient's blood glucose. The correlation between the incidence of DRPS and blood glucose (0.169) shows a weak relationship. It can be interpreted that DRPs do not realy affect changes in blood glucose in patients at Jati Padang Hospital.&#x0D; &#x0D;

The Role of Sodium and Glucose in the Prognosis of Patients with Aneurysmal Subarachnoid Hemorrhage: A Literature Review of New Evidence

AbstractThe present study aims to review the influence of glycemia and natremia on the propensity to develop complications, worse prognosis, and mortality risk in patients with aneurysmal subarachnoid hemorrhage (aSAH). This is an integrative literature review guided by the guiding question: “Do changes in blood glucose levels or plasma sodium concentration influence in-hospital morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage?”. The search for articles was performed on the PubMed platform, limiting the selection to works published in English in the period from 2017 to 2022. The results found demonstrate that the role of sodium ions in changes in the prognosis of patients is complex, with hypernatremia being the main factor described to worse outcomes. In contrast, the part of hyponatremia is controversial and may not have prognostic value, and serum sodium concentration is increasingly an important item to be evaluated in patients with aSAH. As for glucose, the variability of this substrate, both hyperglycemia and hypoglycemia, may be correlated with in-hospital and long-term mortality in patients with aSAH. Thus, the present study concludes that changes in blood glucose values and plasma sodium concentration influence the in-hospital morbidity and mortality of patients with aSAH. However, it is emphasized that the analysis of the independent influence of each of the related predictors must be done with caution due to the heterogeneity of the results found.

Hypoglycemic activity of Syzygium cumini (L.) Skeels seed extracts: an approach to in vitro, in vivo, and in silico studies

This research is carried out to explore the hypoglycemic activity of Syzygium cumini seed extracts by in vitro, in vivo, and in silico methods. For in vitro studies the α-amylase and α-glucosidase enzyme inhibition assays were employed. For in vivo studies 30 alloxan induced Wistar rats were used. They were orally administered with glibenclamide and low/high dose of the extracts and were monitored regularly for the change in blood glucose levels for about 28 days. The in silico molecular docking was conducted to evaluate the binding interaction of 1,2,3-Benzenetriol with human pancreatic α-amylase and α-glucosidase. It was found that all the extracts were able to inhibit the α-amylase and α-glucosidase enzymes. Among which the acetone extract showed greater inhibition with 72.52 ± 0.51% and 63.02 ± 0.73% for both the enzymes, respectively. There was significant (p < 0.05) reduction in blood glucose levels in the rats administered with glibenclamide and extracts. In silico docking results revealed that the compound 1,2,3-Benzenetriol exhibited the highest binding affinity for human pancreatic α-amylase with binding energy −7.7 kcal/mol. Thus suggesting the utilization of S. cumini seeds in the management of diabetes mellitus. Communicated by Ramaswamy H. Sarma

FRI636 Sleep Architecture In Diabetic Patients With Sleep Apnea On Metformin

Abstract Disclosure: M. Varma: None. M. Eghbali: None. D. Hung: None. A. Sahai: None. Background: Metformin, commonly used medication to treat Type II Diabetes Mellitus (DM) improves insulin sensitivity, reduces glucose production in liver and absorption by intestines. Type II DM patients often have higher BMI with increased incidence of sleep apnea. Metformin consuming patients sometimes report insomnia. Blood glucose levels affect sleep duration; therefore Metformin-related changes in blood glucose levels may affect sleep. Metformin prescriptions grew from 40 million in 2004 to 90 million in 2020. This has improved long term vascular complications outcomes in diabetics. Coincidentally the number of patients using sleeping aids has increased. Melatonin sales have doubled since 2004, approximating 821 million USD in sales in 2020. With diabetes and Metformin each causing significant changes in sleep, we aimed to examine sleep architecture in known diabetic patients on Metformin presenting with excessive daytime sleepiness and fatigue. Hypothesis: We hypothesize that Metformin affects sleep and influences sleep architecture in diabetic patients. Methods: Sleep architecture in 29 Type II DM patients taking Metformin, with symptoms of excessive daytime sleepiness, snoring, and fatigue was examined. Patients underwent overnight polysomnography which included six channel EEG, Electrooculogram, Electromyogram EKG, and pulse oximetry, respiratory and flow monitoring in a sleep lab. Sleep staging done using AASM guidelines. Data on age, gender, BMI, medications and sleep stages N1, N2, N3 and REM was collected. Data analyzed and shown as mean + SD, t test p&amp;lt;0.05 significant. Results: All patients had OSA diagnoses per AASM guidelines. The average age of patients with DM and OSA on Metformin therapy was 63 years, average BMI was 36. AASM stage distribution was N1 2.69 % + 0.02, N2 59.31% + 0.15, N3 12.22 % + 0.09, (Normal 25%) with 5.71% +0.06 REM sleep (normal 25%). All stages of sleep were reduced with significant reduction in deep sleep (N3) and REM sleep. Conclusion: Diabetic patients on Metformin had alterations in sleep architecture with significantly reduced restorative phases of deep and REM sleep. Sleep apnea reduces N3 and REM sleep, but diabetic pts had a more significant decrease. Although Metformin improves long term outcomes in diabetes associated complications, it alters sleep patterns. Altered sleep patterns further modify insulin release and over prolonged periods worsen glycemic control. Often patients on Metformin need additional medication like insulin for metabolic control. In part the progression of insulin resistance can be from altered sleep. Better understanding the effects of Metformin on sleep is needed to prevent long-term deteriorating effects on sleep while maintaining effective metabolic control. Presentation: Friday, June 16, 2023

SAT175 Noninsulinoma Pancreatogenous Hypoglycemia Syndrome As A Complication Of Nissen Fundoplication

Abstract Disclosure: R. Rinn: None. S. Lacount: None. J. Muuse: None. Hypoglycemia is a common condition that is typically diagnosed with Whipple’s Triad (hypoglycemic symptoms, low blood glucose, resolution of symptoms with treatment). It is important to recognize and treat early as it has the potential for lethal outcomes. Dumping syndrome is a rare presentation after Nissen’s fundoplication and predominantly reported in children. Here we present a case of an adult with persistent postprandial hypoglycemia after Nissen Fundoplication. A 79-year-old male with a recent Nissen’s fundoplication presented with repeated episodes of extreme fatigue and diaphoresis after eating. Other complaints included weakness and significant weight loss. Finger stick glucose on multiple checks were found to be in 40s. He was hospitalized and underwent extensive workup with Endocrinology and Gastroenterology. Important labs revealed elevated insulin 10.2, C-peptide level at 7.3 and pro-insulin at 27.7, negative insulin antibodies, a normal Insulin like growth factor (IGF-1) at 74, Beta-hydroxybutyrate level 0.1, and a negative screen for sulfonylureas. He was discharged home on a low carbohydrate diet but continued having repeated Whipple’s triad positive hypoglycemic episodes. In terms of imaging, CT of the abdomen did not reveal a mass, other localization studies were deferred since the episodes were mostly post-prandial concerning for NIPHS than insulinoma. For management, he had minimal response to octreotide and verapamil. His symptoms are currently being managed on acarbose and diazoxide with dietary modifications consisting of high protein and limited complex carbohydrates. Postprandial hypoglycemia as a complication of Nissen’s fundoplication is thought to be secondary to dumping syndrome (DS). DS is divided into two stages- early/osmotic stage and late/ hypoglycemic stage. Both types are caused by a large amount of gastric contents emptying into the duodenum, resulting in vasomotor symptoms from changes in blood pressure, pulse and glucose levels, as well as gastrointestinal symptoms. Glucagon like peptide-1 is responsible for the second phase and the levels are directly related to gastric emptying and inversely related to plasma glucose concentration. Accelerated gastric emptying causes increased GLP-1 levels leading to exaggerated insulin response resulting in rebound severe hypoglycemia. It is important to realize that diet plays an important role in symptom management. After Nissen’s fundoplication, a decrease occurs in the storage capacity of the fundus and gastric distensibility, which causes increased gastric motility with rapid emptying. Dietary modifications include reduction of carbohydrate intake and supplementation of dietary fibers with meals greatly help relieve symptoms associated with dumping syndrome in addition to drug therapy. Presentation: Saturday, June 17, 2023

Effect on Hemoglobin A1c (HbA1c) and Body Weight After Discontinuation of Tirzepatide, a Novel Glucose-Dependent Insulinotropic Peptide (GIP) and Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist: A Single-Center Case Series Study.

Introduction The purpose of this study was to examine changes in blood glucose levels and body weight after discontinuation of tirzepatide, a novel long-acting dual glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 receptor agonist (GLP-1 RA). Methods Nine subjects (five males, four females, age 54.3±5.4 years, body mass index 33.5±3.3 kg/m2) participating with type 2 diabetes in the SURPASS J-mono study were included. Subjects were randomized to tirzepatide 5 mg, 10 mg, 15 mg, or a dulaglutide 0.75 mg group. Fifty-two weeks after randomization, study drug administration was discontinued. To investigate progress after the end of administration, changes in hemoglobin A1c (HbA1c) and body weight were further examined two, four, and six months after discontinuation of the study drug. Results After fifty-two weeks, all tirzepatide groups had improved HbA1c and body weight compared with the dulaglutide group. At two, four, and six months after the end of study drug administration, re-elevation of HbA1c was observed in all groups. Furthermore, in the tirzepatide groups, dose-dependent weight regain was observed from an early stage. Conclusions Compared to dulaglutide, tirzepatide exhibited excellent blood-glucose-improving and weight-reducing effects. However, exacerbation of blood glucose and rebound of weight gain occurred relatively early after administration was ended. For type 2 diabetes patients who need weight loss and are prescribed tirzepatide, these findings suggest a necessity for continuous prescription or careful follow-up when stopping.

Comparative efficacy of betel leaf chewing (an Ayurveda daily regimen) with Tambula Granule in management of prediabetes: A structured study protocol of a prospective randomized comparative clinical trial

Abstract BACKGROUND: Prediabetes is an emergent global health problem, reflecting the increasing prevalence of type II diabetes. Reviewing prediabetes is crucial due to its increasing prevalence, economic burden, risk factors association, the potential for real lifestyle modification, the necessity for early intervention and treatment, and its public health impact. Betel leaf chewing is deeply rooted in our tradition through Ayurveda and traditional Chinese medicine systems. Integrating traditional knowledge with current scientific research permits an all-inclusive understanding of the therapeutic potential of betel leaf. Such integration can bridge the gap between traditional practices and evidence-based medicine, providing a holistic attitude to metabolic health. OBJECTIVES: The aim of this study is to assess the comparative effectiveness of betel leaf chewing with Tambula granule (TG) on different biochemical parameters such as blood sugar level (BSL), fasting and post-prandial (F, PP), and glycosylated Hb% (HB A1c.) in prediabetes. MATERIALS AND METHODS: This prospective, open-label, randomized, comparative clinical trial will be conducted for 60 days. A total of 100 patients will participate in two groups through computer-generated randomization. Outpatients of age 30–60 years, of either sex, having fasting glucose between 100 and 125 mg/dL or postprandial glucose of 140–199 mg/dL will included in this study after written informed consent. Group A (N = 50) will receive betel leaf chewing with Ayurveda ingredients 3.5 g, BD after meal for 60 days. Group B (N = 50) received TG 3.5 g, BD after meal for 60 days. The primary outcome is to assess changes in blood glucose levels before and after the study. Parameters will be assessed at baseline 15th, 30th, 45th, and 60th day. Laboratory parameters (BSL-F, PP, and HBA1C) will be done at screening/baseline and after completion of the study period, that is, 60 days. DISCUSSION: Conducting a study on the efficacy of betel leaf chewing in prediabetes is vital to exploring alternative therapeutic options, incorporating traditional knowledge with contemporary medicine, understanding the bioactive compounds and mechanisms of action, assessing safety concerns, and providing evidence-based endorsements. This research can contribute to developing comprehensive and holistic approaches to managing prediabetes and preventing diabetes, improving patient care and outcomes in this field. TRIAL REGISTRATION: The trial is prospectively registered with the Clinical Trial Registry of India (CTRI/2021/02/031539, registered on February 25, 2021).

203.2: Changes in portal pressure, blood glucose, and blood pressure levels during islet infusion in pediatric patients: Close monitoring for every five minutes during islet auto-transplantation

203.2: Changes in portal pressure, blood glucose, and blood pressure levels during islet infusion in pediatric patients: Close monitoring for every five minutes during islet auto-transplantation

Effect of sitagliptin combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in early diabetic nephropathy.

Early diabetic nephropathy (DN) is a complication of diabetes mellitus. It mainly affects kidney microvessels and glomerular function, and its timely and effective treatment is critical for early DN. However, the effects of treatments comprising simple Western medicine are not optimal. With the promotion and implementation of integrated Chinese and western medicine treatments, remarkable results have been achieved for many diseases. To this end, we explored the clinical efficacy of integrated traditional Chinese and western medicines for the treatment of early DN. To investigate the effect of sitagliptin tablets combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in patients with early DN. Through a retrospective analysis, 123 patients with early DN were admitted to the endocrinology clinic of the Changzhou NO. 7 People's Hospital from January 2021 to October 2022 and were selected as study subjects. After rigorous screening, 100 patients with early DN were enrolled. The control group (CG, n = 50) and the observation group (OG, n = 50) were divided according to the treatment method. The CG were treated with sitagliptin, and the OG were treated with sitagliptin plus the Yiqi yangyin huoxue decoction. Both groups were treated for 3 mo. For both groups, the baseline data and clinical efficacy were compared, and changes in blood glucose levels, lipid levels, renal function, and hematological indicators before (T0) and after (T1) treatment were assessed. The total effective rate for the OG was 94.00% and that of the CG was 80.00% (P < 0.05). After treatment (T1), the levels of fasting blood glucose, 2 h postprandial glucose, total cholesterol, triacylglycerol, and low-density lipoprotein cholesterol in OG patients were obviously lower than those in the CG (P < 0.05), and cystatin C, homocysteine, urinary microalbumin, and blood creatinine values in OG patients were also obviously lower than those in the CG (P < 0.05); erythrocyte deposition, plasma viscosity, whole blood high shear viscosity, and whole blood low shear viscosity were markedly lower in OG patients than in the CG (P < 0.05). Sitagliptin combined with Yiqi yangyin huoxue decoction has a remarkable effect when used to treat patients with early DN. Further, it is helpful in improving hemorheological indices and controlling disease progression.

Prediction Models of Blood Glucose Change During Aerobic Exercise Using Machine Learning Techniques

PURPOSE: This study aimed to explore the relationship between blood glucose level changes and body characteristics during exercise and to present six models for predicting changes in blood glucose levels during exercise.METHODS: 148 healthy men and women (age: 31.9±9.7 year, fasting blood glucose: 102.1±14.1 mg/dL, &lt;i&gt;p&lt;/i&gt;=.032) participated in the study, and 30 of them participated in the study. Eight variables were selected to build two prediction models: 24-hour ingested carbohydrates, age, blood glucose, heart rate changes, sex, skeletal muscle mass, heart rate recovery after exercise, and resting heart rate. Logistic regression and random forest classifier models were used to predict the changes in blood glucose levels during exercise.RESULTS: A total of six models were created for all participants, male and female. Random forest classification (training set: AUC=0.837, Youden index=0.66; validation set: AUC=0.730, Youden index=0.53) and logistic regression classification models (training set: AUC=0.807, Youden index=0.55; validation set: AUC=0.735, Youden index=0.57) were built.CONCLUSION: The random forest model showed good performance in classifying internal data, whereas the logistic regression classification model demonstrated relatively good performance in classifying validation data.

Real-World Adherence and Effectiveness of Remote Patient Monitoring Among Medicaid Patients With Diabetes: Retrospective Cohort Study.

The prevalence of diabetes in the United States is high and increasing, and it is also the most expensive chronic condition in the United States. Self-monitoring of blood glucose or continuous glucose monitoring are potential solutions, but there are barriers to their use. Remote patient monitoring (RPM) with appropriate support has the potential to provide solutions. We aim to investigate the adherence of Medicaid patients with diabetes to daily RPM protocols, the relationship between adherence and changes in blood glucose levels, and the impact of daily testing time on blood glucose changes. This retrospective cohort study analyzed real-world data from an RPM company that provides services to Texas Medicaid patients with diabetes. Overall, 180 days of blood glucose data from an RPM company were collected to assess transmission rates and blood glucose changes, after the first 30 days of data were excluded due to startup effects. Patients were separated into adherent and nonadherent cohorts, where adherent patients transmitted data on at least 120 of the 150 days. z tests and t tests were performed to compare transmission rates and blood glucose changes between 2 cohorts. In addition, we analyzed blood glucose changes based on their testing time-between 1 AM and 10 AM, 10 AM and 6 PM, and 6 PM and 1 AM. Mean patient age was 70.5 (SD 11.8) years, with 66.8% (n=255) of them being female, 91.9% (n=351) urban, and 89% (n=340) from south Texas (n=382). The adherent cohort (n=186, 48.7%) had a mean transmission rate of 82.8% before the adherence call and 91.1% after. The nonadherent cohort (n=196, 51.3%) had a mean transmission rate of 45.9% before and 60.2% after. The mean blood glucose levels of the adherent cohort decreased by an average of 9 mg/dL (P=.002) over 5 months. We also found that variability of blood glucose level of the adherent cohort improved 3 mg/dL (P=.03) over the 5-month period. Both cohorts had the majority of their transmissions between 1 AM and 10 AM, with 70.5% and 53.2% for the adherent and nonadherent cohorts, respectively. The adherent cohort had decreasing mean blood glucose levels over 5 months, with the largest decrease during the 6 PM to 1 AM time period (30.9 mg/dL). Variability of blood glucose improved only for those tested from 10 AM to 6 PM, with improvements of 6.9 mg/dL (P=.02). Those in the nonadherent cohort did not report significant changes. RPM can help manage diabetes in Medicaid clients by improving adherence rates and glycemic control. Adherence calls helped improve adherence rates, but some patients still faced challenges in transmitting blood glucose levels. Nonetheless, RPM has the potential to reduce the risk of adverse outcomes associated with diabetes.

Effects of glucagon-like peptide-1 receptor agonists on glucose excursion and inflammation in overweight or obese type 2 diabetic patients.

Currently, the lack of comparative studies between weekly and daily formulations of glucagon-like peptide-1 receptor agonists (GLP-1RAs) for glucose excursion is worth investigation. To investigate the effects of weekly and daily formulations of GLP-1RA on glucose excursion and inflammation in overweight and obese patients with type 2 diabetes. Seventy patients with type 2 diabetes mellitus who were treated at our hospital between January 2019 and January 2022 were enrolled in this retrospective analysis. All patients were treated with metformin. We evaluated changes in blood glucose levels and a series of important indicators in patients before and after treatment with either a weekly or daily preparation of GLP-1RA (group A; n = 33 and group B; n = 37). The degree of decrease in the levels of fasting blood glucose, mean blood glucose, mean amplitude of glycemic excursions, total cholesterol, triglycerides, tumor necrosis factor-α, interleukin-6, and high-sensitivity C-reactive protein after treatment in group A was higher than that in group B (P < 0.05), whereas the 2-h postprandial blood glucose levels decreased more so in group B than in group A (P < 0.001). However, there were no statistically significant differences in the levels of glycated hemoglobin, standard deviation of blood glucose, coefficient of variation, absolute mean of daily differences, percentage of time with 3.9 mmol/L < glucose < 10 mmol/L, and high- and low-density lipoproteins between the two groups (P > 0.05). The incidence of adverse reactions was significantly lower in group A than in group B (P < 0.05). The effect of the weekly preparation of GLP-1RA in controlling blood glucose levels in the patients, suppressing inflammation, and reducing adverse reactions was significantly higher than that of the daily preparations, which is worthy of clinical promotion.

Microneedling with autologous platelet-rich plasma versus topical insulin for treating postacne scars: A split-face comparison

Abstract Post-acne atrophic scars (PAS) are a common complication of acne, and their treatment can be limited in people of color due to dyspigmentation and scarring risks. This split-face study compared the efficacy of microneedling with topical insulin (TI) on one side of the face with microneedling with platelet-rich plasma (PRP) on the other side for the treatment of PAS. The study included 50 participants with Fitzpatrick skin types III to VI who had never been treated for PAS. Both sides of the face showed significant improvement, with the left side (TI) showing a 52% improvement and the right side (PRP) showing a 28% improvement. The treatment was well-tolerated, with no significant adverse effects, and no changes in blood glucose levels were observed. The researchers suggest that combining TI or PRP with microneedling can improve PAS treatment, with TI being a superior option due to its ease of use, low cost, and noninvasive nature.

Association of Met420del Variant of Metformin Transporter Gene SLC22A1 with Metformin Treatment Response in Ethiopian Patients with Type 2 Diabetes.

This study aimed to evaluate whether the M420del variants of SLC22A1 (rs72552763) is associated with metformin treatment response in Ethiopian patients with type 2 diabetes mellitus (T2DM). A prospective observational cohort study was conducted on 86 patients with T2DM who had been receiving metformin monotherapy for <1 year. Patients showing ≥0.5% reduction in HbA1c levels from baseline within 3 months and remained low for at least another 3 months were defined as responders while those patients with <0.5% reduction in HbA1c levels and/or those whom started a new class of glucose-lowering drug(s) because of unsatisfactory reduction were defined as non-responders. In addition, good glycemic control was observed when HbA1c ≤7.0%, and the above values were regarded as poor. Genotyping of rs72552763 SNP was performed using TaqMan® Drug Metabolism Enzyme Genotyping Assay and its association with metformin response and glycemic control were assessed by measuring the change in HbA1c and fasting blood glucose levels using Chi-square, logistic regression and Mann-Whitney U-test. Statistical significance was set at p <0.05. The minor allele frequency of the rs72552763 SNP of SLC22A1 was 9.3%. Metformin response was significantly higher in deletion_GAT (del_G) genotypes as compared to the wild-type GAT_GAT (G_G) genotypes. Furthermore, a significantly lower median treatment HbA1 level was found in del_G genotypes as compared to G_G genotypes. However, the association of rs72552763 with metformin response was not replicated at the allele level. In contrast, the minor del_allele was significantly associated with good glycemic control compared to the G_allele, though not replicated at del_G genotypes level. This study demonstrated that metformin response was significantly higher in study participants with a heterozygous carrier of M420del variants of SLC22A1 as compared to the wild-type G_G genotypes after 3 months of treatment.