Changes In Blood Glucose Levels Research Articles

Effect of walnut consumption on markers of blood glucose control: a systematic review and meta-analysis.

Type 2 diabetes mellitus is a chronic disease increasing in global prevalence. Although habitual consumption of walnuts is associated with reduced risk of CVD, there is inconsistent evidence for the impact of walnut consumption on markers of glycaemic control. This systematic review and meta-analysis aimed to examine the effect of walnut consumption on markers of blood glucose control. A systematic search of Medline, PubMed, CINAHL and Cochrane databases (to 2 March 2019) was conducted. Inclusion criteria were randomised controlled trials conducted with adults which assessed the effect of walnut consumption on fasting blood glucose and insulin, glycated Hb and homeostatic model assessment of insulin resistance. Random effects meta-analyses were conducted to assess the weighted mean differences (WMD) for each outcome. Risk of bias in studies was assessed using the Cochrane Risk of Bias tool 2.0. Sixteen studies providing eighteen effect sizes were included in the review. Consumption of walnuts did not result in significant changes in fasting blood glucose levels (WMD: 0·331 mg/dl; 95 % CI -0·817, 1·479) or other outcome measures. Studies were determined to have either 'some concerns' or be at 'high risk' of bias. There was no evidence of an effect of walnut consumption on markers of blood glucose control. These findings suggest that the known favourable effects of walnut intake on CVD are not mediated via improvements in glycaemic control. Given the high risk of bias observed in the current evidence base, there is a need for further high-quality randomised controlled trials.

Blood Glucose Levels in Elderly Subjects with Type 2 Diabetes During COVID-19 Outbreak: A Retrospective Study in a Single Center

Aims: Ideal glycemic control is of great importance for diabetic patients during public health emergencies of infectious diseases as long-term hyperglycemic are not only associated with chronic complications but also vital drivers of common and life-threatening infections. The present study was designed to investigate the changes of blood glucose levels in elderly subjects with type 2 diabetes(T2D) during COVID-19 outbreak. Methods:This retrospective study focused on the T2D outpatients at Fujian Provincial Hospital aged 65 years old and above who received baseline test for fasting plasma glucose and/or glycated hemoglobin (HbA1c) between January 1, 2019 and March 8, 2019 and were followed up on fasting plasma glucose and/or HbA1c in the same period in 2020. The baseline and follow-up data were analyzed with the paired-samples T-test. Results: A total of 135 elderly subjects with T2D with baseline and follow-up fasting plasma glucose and 50 elderly subjects with T2D with baseline and follow-up HbA1c were analyzed, respectively. The baseline and follow-up fasting plasma glucose were 7.08±1.80 and 7.48±2.14 mmol/L, respectively (P=0.008). The baseline and follow-up HbA1c were 7.2±1.7% and 7.4±1.8%, respectively (P=0.158). Conclusions: Elderly subjects with T2D had higher fasting plasma glucose levels during COVID-19 outbreak. We should pay more attension to the management of diabetics during public health emergencies. Funding Statement: None. Declaration of Interests: No conflict of interest has been declared by the authors. Ethics Approval Statement: This retrospective study was approved by the Ethics Committee of Fujian Provincial Hospital. Due to the retrospective nature of the study, informed consent was waived. Subjects information was anonymized at the collection and analysis stage.

Peri‐renal Adipose Tissue Inflammation Possibly Underlies Mild Renal Dysfunction in Early Metabolic Challenge

Cardiovascular disease remains a primary cause of morbidity and mortality in patients with diabetes. Cardiovascular complications in those patients are independent of glycemic control; intensive antihyperglycemic therapy was found to be ineffective in improving the prognosis of these complications. Evidence of vascular function deterioration in prediabetic patients implicates the involvement of mechanisms other than hyperglycemia in the development of cardiovascular dysfunction. Adipose inflammation constitutes a possible mechanism that is involved in the pathogenesis of diabetes and metabolic syndrome. We developed a rat model of mild hypercaloric (HC) stress with a delayed development of hyperglycemia to investigate the mechanism of cadiovascular dysfunction in early stages of metabolic challenge. We previously reported that prior to the development of hyperglycemia, perivascular adipose tissue inflammation was associated with cardiovascular structural and functional anomalies. No changes in blood glucose, body weight or blood pressure levels were observed in this rat model. Systemic inflammation was not detected in this rat model, however following 12 weeks of HC feeding, peri‐renal adipose tissue showed increased oxidative stress and inflammatory cytokine expression (IL‐1b). Moreover, proteinuria and hyperfiltration indicated an early stage of renovascular dysfunction. This renovascular dysfunction manifested as (1) loss of proper endothelial feedback, (2) loss of prostaglandin and nitric oxide activity, and (3) an uncontrolled vasodilation induced by upregulation of epoxyeicosatrienoic acid effect. Moreover, the renovascular dysfunction was associated with significant increases in renal oxidative stress, inflammatory mediators (IL‐1b and TGF‐b1) and culminated in renal structural damage. Glomerulosclerosis was increased following HC feeding as well as significant increases in the expression of a‐smooth muscle actin in proximal tubular cells suggesting possible epithelial to mesenchymal transformation. Ameliorating adipose inflammation by a two‐week treatment with non‐hypoglycemic doses of metformin (100 mg/Kg/day) or pioglitazone (2.5 mg/Kg/day), improved renovascular function and structural nephrotoxicity. These results provide evidence of an early progressive renal damage induced by localized perirenal adipose tissue inflammation in prediabetes.Support or Funding InformationResearch support: AUB‐FM grant #320186

Cardiac Autonomic Neuropathy and Hemodynamic Dysfunction as a Consequence of Mild Hypercaloric Intake: Modification by Phosphate Supplementation

Cardiac autonomic neuropathy (CAN) has been linked to negative outcomes in diabetic patients, where it is associated with a high risk of cardiac arrhythmia and sudden death. Our previous research showed that prediabetic rats develop CAN in absence of overt signs of metabolic derangement or change in body weight. This was associated with vascular dysfunction and perivascular adipose tissue (PVAT) inflammation, which preceded inflammatory changes in other adipose pools, possibly linked to increased Uncoupling protein 1 (UCP1) and hypoxia‐inducible factor (HIF1‐a) expression. In parallel, phosphate supplementation is a simple intervention to improve body weight, energy metabolism, and glucose tolerance. Moreover, inorganic phosphate acts as a UCP1 inhibitor. Here, we examined the role of phosphate supplementation in ameliorating the early signs of cardiovascular dysfunction in metabolically challenged rats. Male SD rats (5–6 weeks) were randomly allocated into four groups fed either control diet (group 1) or high‐calorie (HC) diet for 12 weeks with three different levels of dietary phosphate; group 2: low phosphate (LP)‐ 0.37 mg/KCal, group 3: intermediate phosphate (IP)‐0.7 mg/KCal, group 4: high phosphate (HP)‐ 1.5 mg/KCal. Daily food intake, body weight, and body composition were recorded. Serum insulin was measured by ELISA. Invasive hemodynamic measurements were done and baroreceptor sensitivity (BRS) was assessed by the vasoactive method. After sacrifice, organs were collected for immunohistochemistry and western blotting. No changes in caloric intake, body weight, blood pressure, and blood glucose levels were observed. However, rats on HC diet showed an increase in serum insulin level and fat/lean ratio. Consistent with our previous work, HC‐feeding was associated with significant reduction in parasympathetic BRS in both the LP and IP groups. This was also accompanied by a reduced left ventricular systolic function. On the cellular level, Oil Red O stain showed a significant increase in the diameter of PVAT adipocytes in LP condition, together with increased expression of HIF‐1α, IL‐1β and UCP‐1. Of note, inflammatory changes observed in the PVAT were not detected in neither white nor brown adipose tissue. Furthermore, higher macrophage infiltration and total ROS score in the PVAT, heart mid‐section and brainstem were observed in LP when compared to control. Our present results highlight a role of phosphate supplementation in the amelioration of the HC induced parasympathetic dysfunction. This could be due to the reported ability of dietary phosphate to improve the assimilation of fat and reduce adipose tissue hypoxia possibly via UCP1 inhibition.Support or Funding InformationFunded by an AUB CRS grantIL1‐UCP1 for perivascular adipose tissue (PVAT), white adipose tissue (WAT), and brown adipose tissue (BAT)Figure 1

The short-term effect of dark chocolate flavanols on cognition in older adults: A randomized controlled trial (FlaSeCo).

Cocoa flavanols in the diet have had positive effects on cognition, blood lipid levels, and glucose metabolism. Cognitively healthy older adults aged 65-75 years were recruited for an eight-week randomized, double-blind controlled trial to investigate the effectiveness of cocoa flavanols on cognitive functions. At baseline, nutrient and polyphenol intakes from diet were assessed with three-day food diaries. The intervention group received 50 g dark chocolate containing 410 mg of flavanols per day, and the control group 50 g dark chocolate containing 86 mg of flavanols per day, for eight weeks. Cognition was assessed with Verbal Fluency (VF) and the Trail Making Test (TMT) A and B as the main outcome measures. Changes in blood lipids and glucose were also measured. The older adults participating numbered 100 (63% women), mean 69 y (range 65 to 74). They were highly educated with a mean 14.9 years of education (SD 3.6). No differences in changes in cognition were seen between groups. The mean change (± SEs) in the time to complete the TMT A and B in the intervention group was -4.6 s (-7.1 to -2.1) and -16.1 s (-29.1 to -3.1), and in the controls -4.4 s (-7.0 to -1.9) and -12.5 s (-22.8 to -2.1)(TMT A p = 0.93; TMT B p = 0.66). No difference was apparent in the changes in blood lipids, glucose levels, or body weight between the groups. The healthy older adults showed no effect from the eight-week intake of dark chocolate flavanols on cognition.

Evaluation of changes in serum lipid profile and fasting blood glucose levels in patients with gall stone disease before and after cholecystectomy

Background: There is paucity of information regarding the effects of cholecystectomy on serum lipid profile parameters and blood glucose levels in the patients of cholelithiasis. Therefore, this study was undertaken to compare some serum lipid parameters and blood glucose levels in patients of cholelithiasis and effect of cholecystectomy on the same.Methods: The study was conducted on 50 patients of cholelithiasis who were admitted in Surgery department, MLN Medical College over a period of one year and were planned for cholecystectomy. Complete lipid profile (which included total cholesterol, triglycerides, high density lipoproteins (HDL) cholesterol, low density lipoproteins (LDL), very low density lipoproteins (VLDL) and atherogenic index) and fasting blood glucose was evaluated pre-operatively and post-operatively on the 3rd, 7th and further after 1 month of cholecystectomy. Results: Out of 50 patients, maximum of 38% were in their 4th decade with females constituting 82% of total. There was significant elevation in fasting blood glucose and HDL cholesterol on 3rd, 7th and 30th day post-cholecystectomy as compared to pre-operative values (p value<0.0001). Triglyceride and VLDL cholesterol elevated on 3rd and 7th day but it significantly decreased one-month post-cholecystectomy as compared to pre-operative levels (p value<0.0001). However, LDL, total cholesterol and atherogenic index significantly decreased on 3rd ,7th and 30th day post-cholecystectomy.Conclusions: Cholelithiasis is an important cause associated with significant pathological changes in many lipid profile parameters, which will return towards normal after cholecystectomy. This normalization will be a time dependent phenomenon with long term beneficial effects.

11 Tube Feeding Through Surgery, Impact on Glucose Control in Burn Patients

Abstract Introduction The hypermetabolic state experienced by burn patients post injury puts nutritional support at the forefront of these patients’ care. Enhanced Recovery After Surgery (ERAS) algorithms include a radical approach of feeding patients up to surgery with reported advantages like earlier recovery of GI function, among others. The purpose of this study was to assess perioperative blood glucose (BG) levels in patients fed up to and through surgery at our institution. Methods Charts of selected surgical burn patients were reviewed and categorized on the basis of diabetic status and whether they had procedures in which feeds were continued to within four hours of surgery (“fed”) and stopped at least four hours prior to surgery (“unfed”). Percent change in pre- and post-op BG levels were compared between groups. Wilcoxon Rank-Sum and Two-Sample testing were used for statistical analyses. Results See Table 1. Data collection yielded 32 patients with 106 unfed and 92 fed procedures. There was a significantly larger percent change in BG levels from 24-hr pre-op to 12- and 24-hr post-op in the unfed vs. fed groups across all procedures, prior to grouping based on diabetic status (p = 0.014 and p = 0.009, respectively). There was a statistically significant difference in the percent change in BG levels from 24-hr pre-op to 12- and 24-hr post-op in the pre-diabetes group (p = 0.021 and p = 0.026, respectively). Conclusions Our data shows better BG control in fed procedures with lower percent change from pre-op to post-op overall, and in the pre-diabetes group. These findings are in line with ERAS literature. Controlling BG ranges post-op is critical to prevent complications and promote healing. Improved BG control using perioperative nutrition could guide practices related to perioperative workup of burn patients. This is worth further investigation since better BG management has been associated with superior patient outcomes. Applicability of Research to Practice 1) Using enteral nutrition up to and/or through surgery contributes to better glycemic control postoperatively in surgical burn patients. 2) The most pronounced benefits of perioperative enteral nutrition in terms of glycemic control are seen in burn patients with pre-diabetes.

Abstract P453: Short-term Air Pollution Exposures, Lifestyle Risk Factors, and Glucose Levels: A Family-based Study in China

Introduction: Previous studies have reported the association between ambient air pollution exposures and glucose levels. However, less is known about whether usual lifestyles could modify the association. Hypothesis: We assessed the hypothesis that lifestyles may modify the association between short-term exposure to ambient air pollution and fasting blood glucose levels among Chinese populations. Methods: The analysis was based on a family-based study in Northern China. In addition, data of air pollution from 2014 to 2017 were obtained from the Beijing Municipal Environmental Monitoring Center. A generalized additive model was adopted to estimate the change in blood glucose levels with a 10 μg/m 3 increase in 2-day moving average concentrations of air pollutants (lag0-1) (considering the potential lag pattern effect of air pollution on glucose levels). Interaction analyses were conducted by including a cross-product term of PM 2.5 or PM 10 by lifestyles (smoking, alcohol consumption, BMI, and sedentary lifestyles) in the models. Results: A total of 4,151 participants (2259 females, 1892 males, 58.9±8.7 years) without antidiabetic drugs on the survey day were included in the analysis. We found a 10 μg/m 3 increase in PM 2.5 concentrations and PM 10 concentrations corresponded to 0.06 (95% CI: 0.04-0.09) and 0.06 (95% CI: 0.04-0.08) mmol/L increase in glucose levels, respectively after adjusting for sex, age, education levels, BMI (kg/m 3 ), smoking, alcohol consumption, sedentary lifestyles, family history of diabetes, use of antidiabetic drugs, temperature, and relative humidity. Besides, the results showed higher risks of PM 2.5 and PM 10 among the overweight and obese when compared with the normal weight ( P for interaction less than 0.05). However, drinking status and sedentary lifestyles did not modify the association between PM and glucose levels. Conclusions: Short-term exposures to air pollution were associated with higher blood glucose levels, which could be modified by BMI. Populations with higher BMI may be more susceptible to the adverse effects.

Effect of 0.9% saline and Ringer’s lactate on mean change in blood glucose levels under spinal anaesthesia among diabetic patients

Context: It is common practice to avoid lactate-containing intravenous fluids in diabetic patients as it was hypothesized to cause hyperglycaemia by the conversion of lactate to glucose by hepatic gluconeogenesis. However, absence of sound theoretical basis, conflicting reports from numerous clinical trials and improved understanding of biochemistry have necessitated a closer scrutiny of this hypothesis. Aims: The present study aims to determine the effect of 0.9% saline and Ringer’s lactate on blood glucose levels in the fasting diabetic surgical patients receiving spinal anaesthesia. Settings and design: The study is a prospective randomized trial conducted on adult patients aged 30 – 85 years with well-controlled type 2 diabetes mellitus receiving spinal anaesthesia. Methods and material: 120 patients with well-controlled type 2 diabetes mellitus receiving spinal anaesthesia were randomized to receive either 1 litre of 0.9% saline or Ringer’s lactate. Blood glucose levels were recorded using a glucometer by the pinprick method before and after infusion of 1 litre of the selected intravenous fluid. Statistical analysis: Data analysis was done using SPSS statistical package - Version 22.0. Student’s unpaired ‘t’ test was used to test the significance of difference between quantitative variables. A 'p' value less than 0.05 was taken to denote statistical significance. Results: Mean change in blood glucose levels after infusion of the intravenous fluid in 0.9% saline and Ringer’s lactate groups were 3.68±15.2 mg/dl and - 0.15±16.5 mg/dl, respectively. The difference between the two groups was not statistically significant with a 'p' value of 0.188. Conclusions: Ringer’s lactate solution, when compared to 0.9% saline, does not cause significant change in the mean blood glucose levels in fasting diabetic patients receiving spinal anaesthesia.

Antihyperglycemic effect of the alkaloids extracted from Adiantum capillus in diabetic rats

Background: Biomedical researches have long sought to develop novel therapies that are more effective, less costly and possess fewer side effects, to treat chronic diseases including diabetes mellitus. Adiantum capillus is among the medicinal plants that have been widely used in traditional medicine and are known to have hypoglycemic effects. This study was designed to find the chemical constituent of Adiantum capillus that exerts the hypoglycemic effect. Materials and Methods: Fifty-four rats were split into nine groups. Twelve normal rats were included in the first group; six acted as negative controls and six were administered Adiantum capillus water extract. The second group was comprised of 42 streptozotocin-induced diabetic rats sectioned into seven subgroups of six rats. The first subgroup functioned as a positive control. The second subgroup was administered 100 mg/kg/day of Adiantum capillus aqueous extract for 21 days, while the third and the fourth subgroup received 50 mg/kg/day of metformin and acarbose respectively. The remaining three groups were administered alkaloids (4 mg/kg/day), flavonoids (24 mg/kg/day) and phenolic compounds (30 mg/kg/day) extracted from Adiantum capillus for 21 days. Fasting blood glucose levels, insulin levels, insulin resistance, serum amylase levels, C-peptide levels, liver function and renal function were monitored. Results: The use of an Adiantum capillus aqueous extract in diabetic rats for 21 days effectively controlled blood glucose levels, elevated amylase level and improved renal and liver function. A significant decrease in blood glucose, AST, ALT, ALP and blood urea levels accompanied by significant increase in the serum amylase of diabetic rats was produced by the alkaloids extracted from Adiantum capillus. However, flavonoids and phenolic compounds did not cause any significant change in blood glucose levels. Conclusion:It can be concluded that the alkaloids extracted from Adiantum capillus are the chemical constituent that contributes to the antihyperglycemic effect of the plant.

Evaluation of the Diabetes Screening Component of a National Cardiovascular Risk Assessment Programme in England: a Retrospective Cohort Study

Type 2 Diabetes (T2D) is increasing but the effectiveness of large-scale diabetes screening programmes is debated. We assessed associations between coverage of a national cardiovascular and diabetes risk assessment programme in England (NHS Health Check) and detection and management of incident cases of non-diabetic hyperglycaemia (NDH) and T2D. Retrospective analysis employing propensity score covariate adjustment method of prospectively collected data of 348,987 individuals aged 40–74 years and registered with 455 general practices in England (January 2009-May 2016). We examined differences in diagnosis of NDH and T2D, and changes in blood glucose levels and cardiovascular risk score between individuals registered with general practices with different levels (tertiles) of programme coverage. Over the study period 7,126 cases of NDH and 12,171 cases of T2D were detected. Compared with low coverage practices, incidence rate of detection in medium and high coverage practices were 15% and 19% higher for NDH and 10% and 9% higher for T2D, respectively. Individuals with NDH in high coverage practices had 0.2 mmol/L lower mean fasting plasma glucose and 0.9% lower cardiovascular risk score at follow-up. General practices actively participating in the programme had higher detection of NDH and T2D and improved management of blood glucose and cardiovascular risk factors.

Blood Glucose Level Monitoring Using an FMCW Millimeter-Wave Radar Sensor

In this article, a novel sensing approach is presented for glucose level monitoring where a robust low-power millimeter(mm)-wave radar system is used to differentiate between blood samples of disparate glucose concentrations in the range 0.5 to 3.5 mg/mL. The proposed radar sensing mechanism shows greater capabilities for remote detection of blood glucose inside test tubes through detecting minute changes in their dielectric properties. In particular, the reflected mm-waves that represent unique signatures for the internal synthesis and composition of the tested blood samples, are collected from the multi-channels of the radar and analyzed using signal processing techniques to identify different glucose concentrations and correlate them to the reflected mm-wave readings. The mm-wave spectrum is chosen for glucose sensing in this study after a set of preliminary experiments that investigated the dielectric permittivity behavior of glucose-loaded solutions across different frequency bands. In this regard, a newly-developed commercial coaxial probe kit (DAK-TL) is used to characterize the electromagnetic properties of glucose-loaded samples in a broad range of frequencies from 300 MHz to 67 GHz using two different 50 Ω open-coaxial probes. This would help to determine the portion of the frequency spectrum that is more sensitive to slight variations in glucose concentrations as indicated by the amount of change in the dielectric constant and loss tangent parameters due to the different concentrations under test. The mm-wave frequency range 50 to 67 GHz has shown to be promising for acquiring both high sensitivity and sufficient penetration depth for the most interaction between the glucose molecules and electromagnetic waves. The processed results have indicated the reliability of using mm-wave radars in identifying changes in blood glucose levels while monitoring trends among those variations. Particularly, blood samples of higher glucose concentrations are correlated with reflected mm-wave signals of greater energy. The proposed system could likely be adapted in the future as a portable non-invasive continuous blood glucose level monitoring for daily use by diabetics.

Возможности применения современных устройств для мониторинга гликемии во время беременности

Currently, the management of pregnant women with carbohydrate metabolism disorders is challenging due to the high risk of unfavorable events both for the mother and the child even in insignificant deviations from the target value. In addition to the conventional methods of self-monitoring, continuous glucose monitoring (CGM) is an important tool to control diabetes. CGM in pregnant women provides the detailed information on the type and trends of the changes in blood glucose levels and the fluctuations of glucose levels and also identifies the episodes of latent nocturnal hypoglycemia and postprandial hyperglycemia. The analysis of CGM data allows for correcting insulin therapy, taking a decision on its initiation, and modifying diet and exercise plan. Multiple studies demonstrate the efficacy of CGM in terms of compensating manifest diabetes. As to gestational diabetes, the eligibility of modern glucose monitoring technologies for the prevention of various complications is still controversial. Further studies on the potential use of these devices in gestational diabetes could provide a basis for increasing their application in routine clinical practice. This will improve the management of pregnant women with carbohydrate metabolism disorders.KEYWORDS: diabetes, gestational diabetes, continuous glucose monitoring, flash monitoring, pregnancy, macrosomia, self-monitoring.FOR CITATION: Ushanova F.O., Demidova T.Yu. Potentialities of modern glucose monitoring devices during pregnancy. Russian Medical Inquiry. 2020;4(6):352–357. DOI: 10.32364/2587-6821-2020-4-6-352-357.

Tanatogenetic role of type 2 diabetes in neurosurgical patients

To define the tanatogenetic significance of 2 type diabetes in neurosurgical patients. Forty-three patients aged 22-75 years, who had died after neurosurgery, were examined. Case histories and the time course of changes in blood glucose levels were analyzed. The manifestations of macroangiopathy were taken into account at autopsy; those of microangiopathy were considered at microscopy of the internal organs and tissues; Van Gieson and periodic acid-Schiff staining was additionally applied. The expression of insulin, glucagon, synaptophysin, S100 proteins, and neurofilament protein was found in the pancreas. The number and volume of islets and an insulin-to-glucagon ratio were morphometrically estimated. Type 2 diabetes mellitus was identified in 28 (65.1%) patients: 11 (25.6%), 8 (18.6%), and 9 (20.9%) with clinically obvious, subtle, and latent types, respectively; while it was as a background underlying disease in 3 (7.0%) patients. Among the immediate causes of death, there was a preponderance of local angiogenic complications (hemorrhages, infarctions, swelling, and displacement of the brain) (64%). Indurative pancreatitis was not inferior to cardiovascular diseases among complications and concomitant diseases and was detected in most diabetic patients (n=24, or 85.7%) and in 6 (a quarter) patients with acute pancreatic necrosis, which was the immediate cause of death in 2 cases. In the places of paravasal sclerosis, there was a reduction in the terminals of nerve fibers as a manifestation of diabetic neuropathy. Type 2 diabetes mellitus was much more frequently encountered in the most critically ill and dead neurosurgical patients than in the general population and was embodied in the pattern of immediate causes of death. Diabetic neuropathy with a reduction in the terminals of nerve fibers can serve as a substantial basis not only for vascular, but also for ductal dystonia and dyskinesia, which can become an important factor in the pathogenesis of chronic pancreatitis in patients with diabetes mellitus.

Evaluation of the Cardiac Effects of a Water-Soluble Lectin (Wsmol) from Moringa Oleifera Seeds

ResumoFundsamento As sementes de Moringa oleifera , que são utilizadas para clarificação de água, contêm uma lectina chamada WSMoL que tem mostrado atividade antibacteriana e imunomoduladora in vitro . Devido ao seu valor nutritivo e potencial terapêutico, as folhas e as sementes dessa árvore são consumidas em algumas comunidades. Algumas lectinas de plantas não são tóxicas para mamíferos, mas tem sido relatado que outras são prejudiciais quando ingeridas ou administradas por outros meios.Objetivo Como um dos passos necessários para determinar a segurança de WSMoL, nós avaliamos os possíveis efeitos cardiotóxicos desta proteína purificada.Métodos Durante 21 dias consecutivos, a WSMoL foi administrada a camundongos por gavagem. Foram investigadas as funções eletrofisiológicas, mecânicas e metabólicas in vivo e ex vivo por meio de registros eletrocardiográficos, ressonância magnética nuclear e respirometria de alta resolução.Resultados O tratamento com WSMoL não induziu alterações nos níveis de glicose no sangue ou peso corporal em comparação com o grupo controle. Adicionalmente, as relações peso cardíaco/peso corporal e peso cardíaco/comprimento tibial estavam semelhantes em ambos os grupos. A ingestão de lectina também não modificou a tolerância à glicose ou resistência à insulina. Não foram observadas alterações nos parâmetros eletrocardiográficos ou na duração do potencial de ação cardíaco. Os corações dos camundongos dos grupos controle e WSMoL mostraram função ventricular esquerda preservada. Além disso, a WSMoL não induziu alterações na função mitocondrial (em todos os casos, p > 0,05).Conclusões A administração de WSMoL demonstrou ter um perfil de segurança cardíaca. Estes resultados contribuem à avaliação de segurança do uso de sementes de M. oleifera para tratar água, visto que essa lectina está presente na preparação empregada por algumas populações com esse fim. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

Effects of cold stress, alprazolam and phytomedicine in combination with stress on blood glucose and haematogical parameter of the male albino rat

The present study conducted to investigate the haematological changes and changes of blood glucose level in male albino rat due to cold stress. In this experiment normal 12:12 light dark phases were maintained for all the groups. Control group was kept at normal room temperature (22 ± 1). A (4°C), B in (0°C), C (4°C and 0.30 mg alprazolam / kg body weight /animal), D (0°C and 0.30 mg alprazolam/ kg body weight/ animal. E2 group was treated with (4°C and 1000 mg/kg body weight methanolic extract of Withania somnifera root extract /animal). F2 group was treated with (0°C and 1000 mg/kg body weight methanolic root extract of Withania somnifera / animal). The blood glucose level was significantly increased in stressed rats compared to the control animals. The results were also consistent with the exposure to the stress and chronic restraint stress. Action of Alprazolam over cold stress treated group significantly reduced the blood glucose level. Whereas methanolic root extract of Withania somnifera in low and high doses also showed significant effects to the control anxiety like effects on blood glucose level. Alprazolam + different stress treated groups in different experiment at conditions show significant changes in its haematological parameters in comparison to the stress treated group. Whereas herbal medicine (i.e., methanolic root extract of Withania somnifera) when applied to different stress treated group showed more significant result, compared to the Alprazolam+ different stress treated groups. The positive safe anti stress effects of the herbal plant medicine prove that the tribal medicines have the potentiality to act effectively and can be used as safe medicine for antistress purposes.

Effect of nutrition education in reducing sodium intake and increasing potassium intake in hypertensive adults.

BACKGROUND/OBJECTIVESHypertension is the major risk factor for cardiovascular disease, a leading cause of deaths in Korea. The objective of this study was to evaluate the effect of a nutrition education in reducing sodium intake and increasing potassium intake in hypertensive adults.SUBJECTS/METHODSSubjects who participated in this study were 88 adults (28 males and 60 females) who were pre-hypertension or untreated hypertensive patients aged ≥ 30 yrs in Gyeonggi Province, Korea. These subjects were divided into 2 groups: a low-sodium education (LS) group and a low-sodium high-potassium education (LSHP) group. Nutrition education of 3 sessions for 12 weeks was conducted. Blood pressure, blood and urine components, nutrient intake, and dietary behavior were compared between the two education groups.RESULTBlood pressure was decreased in both groups after the nutrition education (P < 0.05). In the LSHP group, levels of blood glucose (P < 0.05), total cholesterol (P < 0.01), and low-density lipoprotein-cholesterol (P < 0.05) were decreased after the program completion. Sodium intake was decreased in both groups after the nutrition education (P < 0.05). However, Na/K ratio was only decreased in the LS group (P < 0.05). Intake frequency of fish & shellfish was only significantly reduced in the LS group (P < 0.05), while intake frequencies of cooked rice, noodles & dumplings, breads & snacks, stew, kimchi, and fish & shellfish were reduced in the LSHP group (P < 0.05). Total score of dietary behavior appeared to be effectively decreased in both groups after the education program (P < 0.001).CONCLUSIONSThis education for reducing sodium intake was effective in reducing blood pressure and sodium intake. The education for enhancing potassium intake resulted in positive changes in blood glucose and serum cholesterol levels.

Alanyl-glutamine protects the intestinal barrier function in trained rats against the impact of acute exhaustive exercise.

Strenuous exercise triggers deleterious effects on the intestinal epithelium, but their mechanisms are still uncertain. Here, we investigated whether a prolonged training and an additional exhaustive training protocol alter intestinal permeability and the putative effect of alanyl-glutamine (AG) pretreatment in this condition. Rats were allocated into 5 different groups: 1) sedentary; 2 and 3) trained (50 min per day, 5 days per week for 12 weeks) with or without 6 weeks oral (1.5 g/kg) AG supplementation; 4 and 5) trained and subjected to an additional exhaustive test protocol with or without oral AG supplementation. Venous blood samples were collected to determine gasometrical indices at the end of the 12-week protocol or after exhaustive test. Lactate and glucose levels were determined before, during, and after the exhaustive test. Ileum tissue collected after all experimental procedures was used for gene expression analysis of Zonula occludens 1 (ZO-1), occludin, claudin-2, and oligopeptide transporter 1 (PepT-1). Intestinal permeability was assessed by urinary lactulose/mannitol test collected after the 12-week protocol or the exhaustive test. The exhaustive test decreased pH and base excess and increased pCO2. Training sessions delayed exhaustion time and reduced the changes in blood glucose and lactate levels. Trained rats exhibited upregulation of PEPT-1, ZO-1, and occludin mRNA, which were partially protected by AG. Exhaustive exercise induced intestinal paracellular leakage associated with the upregulation of claudin-2, a phenomenon protected by AG treatment. Thus, AG partially prevented intestinal training adaptations but also blocked paracellular leakage during exhaustive exercise involving claudin-2 and occludin gene expression.

An Appropriate Energy Intake Proportion of Three Major Nutrients for Treatment of Type 2 Diabetes

To keep good glycemic control and suppress the development of diabetic complication, diet therapy is a very crucial treatment for type 2 diabetes. Recently, the effectiveness of carbohydrate-restricted diet, and the diet for sarcopenia and frailty have been suggested, inducing the paradigm shift of diet for type 2 diabetes. There is insufficient evidence regarding the distribution of nutrients in the diet of patients with type 2 diabetes. Here, we reviewed the current state of evidences and guidelines regarding energy allocation of nutrients for patients who have already developed diabetes. At present, any Japanese and international guidelines did not clearly describe an appropriate energy intake proportion of three major nutrients for treatment of type 2 diabetes. The tailor-made medicine should also be applied to the diet for type 2 diabetes. When setting the nutritional balance of diabetic patients, first, we should fully understand each patient’s current situation and make appropriate adjustments, taking into the account of changes in body weight, blood glucose and lipid levels, patient preferences, and feasibility. J Endocrinol Metab. 2020;10(5):113-117 doi: https://doi.org/10.14740/jem693

Rapid-Acting Insulin Analogues Versus Regular Human Insulin: A Meta-Analysis of Effects on Glycemic Control in Patients with Diabetes

IntroductionThe aim of this meta-analysis was to investigate the impact of rapid-acting insulin analogues (RAIAs) and regular human insulin (RHI) on glycemic control, including long- and short-term glycemic variability as measured by glycated haemoglobin (HbA1c) and pre- and postprandial glucose (PPG).MethodsPubMed was searched for studies published between 1999 and 29 June 2016. Randomised controlled trials of patients with diabetes that assessed the effects of RAIAs or RHI on glycemic control, focusing on preprandial glucose, PPG and HbA1c, were included. Only studies that reported both means and standard deviations for those outcomes were analysed; from these data, weighted mean differences and 95% confidence intervals were generated to yield overall point estimates. The primary outcomes of the meta-analysis were the mean differences between RAIAs and RHI at the end of the study in PPG, preprandial glucose, and HbA1c.ResultsTwenty-seven studies (n = 7452) were included. The difference in PPG between RAIA- and RHI-treated patients was significant—in favour of RAIAs—in patients with type 1 diabetes (T1D) [− 22.2 mg/dL; 95% confidence interval (CI) − 27.4, − 17.0 mg/dL; P < 0.0001] but not in those with type 2 diabetes (T2D). For preprandial glucose, there was a non-significant trend favouring RHIs in T1D; no data were available for patients with T2D. In patients with T1D, the between-group difference in end-of-treatment (EOT) HbA1c favoured RAIAs (− 0.13%; 95% CI − 0.18, − 0.08%; P < 0.0001), but was not significant in patients with T2D. The main study limitations were the small number and heterogeneity of the included studies.ConclusionsThese results demonstrate that RAIAs are more effective at reducing PPG and improving HbA1c than RHIs in T1D. More data are required to assess the effect of these agents on glucose control in T2D.Plain Language SummaryIn patients with diabetes, the risk of complications is increased by poor control of blood glucose levels and high blood glucose variability. Complications may include cardiovascular disease, eye problems and amputation. Control and variability of blood glucose levels can be evaluated using a range of measures, including (i) glycated haemoglobin (HbA1c) level at the end of the treatment period; (ii) change in HbA1c level during the treatment period; (iii) fasting plasma glucose level; (iv) postprandial glucose (PPG) level; (v) change in blood glucose level after a meal. PPG levels following a meal are an important measure of overall metabolic control in diabetes, and reduction of glycemic variability (GV) can be achieved via reductions in PPG. Both rapid-acting insulin analogues (RAIAs; aspart, glulisine and lispro) and regular human insulin (RHI) are widely used in the management of diabetes. Using data from 27 randomised controlled trials involving more than 7000 patients, we investigated the impact of RAIAs and RHI on measures of glycemic control and variability in patients with type 1 diabetes (T1D) or type 2 diabetes (T2D). Our results show that, in patients with T1D, RAIAs are more effective than RHI at reducing PPG excursions and HbA1c. This indicates that glycemic control is better with RAIAs than with RHI. More data are required to assess the effects of RAIAs and RHI on glycemic control and variability in patients with T2D.Electronic Supplementary MaterialThe online version of this article (10.1007/s13300-019-00732-w) contains supplementary material, which is available to authorized users.