Changes In Blood Glucose Levels Research Articles

Recombinant growth hormone therapy for cystic fibrosis in children and young adults.

Cystic fibrosis (CF) is an inherited condition causing disease most noticeably in the lungs, digestive tract and pancreas. People with CF often have malnutrition and growth delay. Adequate nutritional supplementation does not improve growth optimally and hence an anabolic agent, recombinant human growth hormone (rhGH), has been proposed as a potential intervention. This is an update of a previously published review. To evaluate the effectiveness and safety of rhGH therapy in improving lung function, quality of life and clinical status of children and young adults with CF. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. Date of latest search: 12 January 2021. We also searched ongoing trials registers: clinicaltrials.gov from the United States - date of latest search 19 Jun 2021; WHO International Clinical Trials Registry Platform (ICTRP) - date of latest search 05 March 2018 (not available in 2021). We conducted a search of relevant endocrine journals and proceedings of the Endocrinology Society meetings using Web of Science, Scopus and Proceedings First. Date of latest search: 21 Jun 2021. SELECTION CRITERIA: Randomised and quasi-randomised controlled trials of all preparations of rhGH compared to either no treatment, or placebo, or each other at any dose (high-dose and low-dose) or route and for any duration, in children or young adults (aged up to 25 years) diagnosed with CF (by sweat test or genetic testing). Two authors independently screened papers, extracted trial details and assessed their risk of bias. We assessed the quality of the evidence using the GRADE system. We included eight trials (291 participants, aged between five and 23 years) in the current version of the review. Seven trials compared standard-dose rhGH (approximately 0.3 mg/kg/week) to no treatment and one three-arm trial (63 participants) compared placebo, standard-dose rhGH (0.3 mg/kg/week) and high-dose rhGH (0.5 mg/kg/week). Six trials lasted for one year and two trials for six months. We found that rhGH treatment may improve some of the pulmonary function outcomes, but there was no difference between standard and high-dose levels (low-certainty evidence, limited by inconsistency across the trials, small number of participants and short duration of therapy). The trials show evidence of improvement in the anthropometric parameters (height, weight and lean body mass) with rhGH therapy, again no differences between dose levels. We found improvement in height for all comparisons (very low- to low-certainty evidence), but improvements in weight and lean body mass were only reported for standard-dose rhGH versus no treatment (very low-certainty evidence). There is some evidence indicating a change in the level of fasting blood glucose with rhGH therapy, however, it did not cross the clinical threshold for diagnosis of diabetes in the trials of short duration (low-certainty evidence). There is low- to very low-certainty evidence for improvement of pulmonary exacerbations with no further significant adverse effects, but this is limited by the short duration of trials and the small number of participants. One small trial provided inconsistent evidence on improvement in quality of life (very low-certainty evidence). There is limited evidence from three trials in improvements in exercise capacity (low-certainty evidence). None of the trials have systematically compared the expense of therapy on overall healthcare costs. When compared with no treatment, rhGH therapy is effective in improving the intermediate outcomes in height, weight and lean body mass. Some measures of pulmonary function showed moderate improvement, but no consistent benefit was seen across all trials. The significant change in blood glucose levels, although not causing diabetes, emphasizes the need for careful monitoring of this adverse effect with therapy in a population predisposed to CF-related diabetes. No significant changes in quality of life, clinical status or side-effects were observed in this review due to the small number of participants. Long-term, well-designed randomised controlled trials of rhGH in individuals with CF are required prior to routine clinical use of rhGH in CF.

The Effect of Exercise Timing on Elevated Postprandial Glucose in Women With Obesity

Background and Aim: This study aimed to investigate the effect of exercise timing on elevated postprandial glucose and after brief interval exercises in women with obesity. Methods & Materials: Ten women with obesity (Mean±SD age = 40.41±3.97 years; weight = 86.66±7.26 kg; and BMI = 33.22±2.20 kg/m2) participated in a crossover design exercise intervention: 1) postprandial aerobic exercise, 2) pre-prandial aerobic exercise, 3) brief periodic exercise, and 4) control. Pre- and postprandial exercise included 30 min of moderate-intensity walking on the treadmill before and after each main meal (1 minute of exercise -30 seconds rest). The brief periodic exercise had three one-minute reps of activity every 30 min for 20 times during the day. Twelve-hour continuous glucose monitoring and two-hour postprandial glucose levels were calculated to examine changes in blood glucose levels. Ethical Considerations: This study was approved by the institutional review board of the University of Isfahan (Ethics Code: IR.UI.REC.1397.119) and conducted in agreement with the ethical principles for biomedical research involving human subjects outlined in the declaration of Helsinki. Results: The findings of this study suggested that brief periodic exercise resulted in a significant decrease in continuous glucose monitoring levels and postprandial glucose compared to the control group as well as pre-prandial exercise (P˂0.05). However, pre- and postprandial exercise did not result in significant changes in continuous glucose monitoring (P˃0.05). In addition, postprandial exercise led to a significant decrease in postprandial glucose compared to the control group (P˂0.05). Conclusion: It seems that brief periodic exercise can have more beneficial effects on postprandial glucose levels, probably due to improved glucose metabolism in skeletal muscle.

Effects of the Topical Administration of Semaglutide on Retinal Neuroinflammation and Vascular Leakage in Experimental Diabetes.

Background: An unexpected increase in the rate of severe diabetic retinopathy was observed in the Semaglutide in Subjects with Type 2 Diabetes (SUSTAIN)-6 clinical trial. Although this effect was attributed to a rapid decrease in blood glucose levels, a direct deleterious effect of semaglutide on the retina could not be ruled out. In order to shed light on this issue, we have performed a study aimed at testing the direct effect of semaglutide administered by eye drops on retinal neuroinflammation and microvascular abnormalities using the db/db mouse model. Methods: Eye drops containing semaglutide (0.33 mg/mL; 5 μL once/daily) or vehicle (PBS; 5 μL once daily) were administered for 15 days. Results: We found that semaglutide significantly reduced glial activation, as well as the retinal expression of Nuclear factor kB (NF-κB), proinflammatory cytokines (IL-1β, IL-6, IL-18) and Intercellular Adhesion Molecule (ICAM)-1. In addition, semaglutide prevented the apoptosis of cells from the retinal ganglion layer and activated the protein kinase B (AKT) pathway. Finally, a dramatic decrease in vascular leakage was observed in db/db mice treated with semaglutide. All these findings were observed without any change in blood glucose levels and, therefore, can be directly attributed to semaglutide. Conclusions: These experimental findings point to a beneficial rather than a deleterious effect of semaglutide on the retina of subjects with diabetes.

Comparative analysis between portable glucometers and laboratory method for the measurement of glycemia in cattle

Glucose is considered an important source of energy for cells, fetal growth and milk production in ruminants. Some diseases can be diagnosed by changes in blood glucose levels, which can currently be measured by two methods: the laboratory method and the method using portable glucometers. Therefore, the objective of this study was to carry out a comparative analysis of glucose, measured with a portable glucometer for human use and another for veterinary use, with the laboratory method, considered the gold standard, to assess whether portable equipment can be accurate in blood glucose measurement at field, in cattle. Blood was collected from 17 bovines through the coccygeal vein and the samples were placed in a tube with sodium fluoride for colorimetric enzymatic laboratory analysis, and for the measurement of glucose concentration in portable glucometers, 1 drop of blood was used. The data showed normal distribution by the Shapiro-Wilk test (P = 0.128) and in the comparative analysis provided by the Tukey test (P

Association of maternal vitamin B12 and folate levels in early pregnancy with gestational diabetes: a prospective UK cohort study (PRiDE study)

Aims/hypothesisThe prevalence of gestational diabetes mellitus (GDM) is increasing worldwide in all ethnic groups. Low vitamin B12 and low/high folate levels may contribute to GDM risk, but there is conflicting evidence. Our aim is to assess the relationships of early pregnancy vitamin B12 and folate levels with the risk of GDM status at 26–28 weeks of gestation.MethodsThis was a prospective, multi-centre, multi-ethnic cohort study (n = 4746) in the UK. Participants who were eligible to be selectively screened as per the National Institute for Health and Care Excellence (NICE) criteria were included in the study.ResultsGDM prevalence was 12.5% by NICE and 14.7% by International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Folate deficiency (1.3%) was rare but B12 insufficiency (42.3% at <220 pmol/l) and folate excess (36.5%) were common in early pregnancy. Early pregnancy median B12 levels were lower, and folate levels higher, in women who were diagnosed with GDM at 26–28 weeks. B12 was negatively associated with fasting plasma glucose (1 SD: −0.06 mmol/l; 95% CI −0.04, −0.08; p < 0.0001) and 2 h plasma glucose levels (−0.07 mmol/l; 95% CI −0.02, −0.12; p = 0.004). Higher B12 was associated with 14.4% lower RR of IADPSG-GDM (0.856; 95% CI 0.786, 0.933; p = 0.0004) after adjusting for key confounders (age, parity, smoking status, ethnicity, family history, household income and folate status). Approximately half of this association was mediated through BMI. Folate was positively associated with 2 h plasma glucose levels (0.08 mmol/l; 95% CI 0.04, 0.13; p = 0.0005) but its relationship with fasting plasma glucose was U-shaped (quadratic β: 0.011; p = 0.05). Higher folate was associated with 11% higher RR of IADPSG-GDM (adjusted RR 1.11; 95% CI 1.036, 1.182; p = 0.002) (age, parity, smoking status, ethnicity, family history, household income and B12 status). Although no interactions were observed for B12 and folate (as continuous variables) with glucose levels and GDM risk, a low B12–high folate combination was associated with higher blood glucose level and risk of IADPSG-GDM (adjusted RR 1.742; 95% CI 1.226, 2.437; p = 0.003).Conclusions/interpretationB12 insufficiency and folate excess were common in early pregnancy. Low B12 and high folate levels in early pregnancy were associated with small but statistically significant changes in maternal blood glucose level and higher RR of GDM. Our findings warrant additional studies on the role of unmetabolised folic acid in glucose metabolism and investigating the effect of optimising early pregnancy or pre-conception B12 and folate levels on subsequent hyperglycaemia.Trial registration:ClinicalTrials.gov NCT03008824.Graphical abstract

Mechanisms of Glucose Absorption in the Small Intestine in Health and Metabolic Diseases and Their Role in Appetite Regulation.

The worldwide prevalence of metabolic diseases such as obesity, metabolic syndrome and type 2 diabetes shows an upward trend in recent decades. A characteristic feature of these diseases is hyperglycemia which can be associated with hyperphagia. Absorption of glucose in the small intestine physiologically contributes to the regulation of blood glucose levels, and hence, appears as a putative target for treatment of hyperglycemia. In fact, recent progress in understanding the molecular and cellular mechanisms of glucose absorption in the gut and its reabsorption in the kidney helped to develop a new strategy of diabetes treatment. Changes in blood glucose levels are also involved in regulation of appetite, suggesting that glucose absorption may be relevant to hyperphagia in metabolic diseases. In this review we discuss the mechanisms of glucose absorption in the small intestine in physiological conditions and their alterations in metabolic diseases as well as their relevance to the regulation of appetite. The key role of SGLT1 transporter in intestinal glucose absorption in both physiological conditions and in diabetes was clearly established. We conclude that although inhibition of small intestinal glucose absorption represents a valuable target for the treatment of hyperglycemia, it is not always suitable for the treatment of hyperphagia. In fact, independent regulation of glucose absorption and appetite requires a more complex approach for the treatment of metabolic diseases.

Association between body mass index changes and other risk factors for cardiovascular disease in patients with type 2 diabetes mellitus

Objectives: To investigate the association between body mass index (BMI) changes and other risk factors for cardiovascular disease in patients with type 2 diabetes mellitus (T2DM). Methods: Based on the T2DM cohort in rural communities of Zhejiang province, baseline and follow up information of height, weight, blood pressure, glycated hemoglobin (HbA1c), TC, TG, LDL-C and HDL-C of the T2DM patients were collected. After excluding those who died during the follow-up period, lost follow-up or had incomplete information, a total of 8 953 T2DM patients were included in the final analysis. Multiple linear regression and Cox proportional hazards regression models were used for analysis. Results: At baseline survey, 40.97% of the T2DM patients were overweight and obese. Compared with those with normal BMI, the SBP, DBP and TG level were significantly higher, while HDL-C level was significantly lower in the overweight and obese T2DM patients (P<0.01). During the follow-up period, the blood glucose control rate in the patients increased by 15%, and the levels of HbA1c decreased in the patients with different BMI changes at different degrees. Compared with the patients who kept normal BMI, the HbA1c level decrease had a smaller range, while the SBP and DBP increase had a larger range in the patients with persistent overweight and obesity, and their substandard rates of HbA1c, SBP, DBP, TG, HDL-C levels were 1.142 (1.057-1.233) times, 1.123 (1.055-1.196) times, 1.220 (1.128-1.320) times, 1.400 (1.282-1.528) times and 1.164 (1.069-1.267) times higher. The changes of blood pressure, blood lipids and other related indicators in the patients whose BMI became abnormal were similar to those of the patients with persistent overweight and obesity; Compared with the patients whose BMI were kept normal, the differences in changes and substandard rate of blood glucose level, blood pressure level in the patients whose BMI became normal were not significant (P>0.05). The change value of BMI was positively correlated with the change value of SBP, DBP, TG and LDL-C, while negatively correlated with the change value of HDL-C (P<0.05). Conclusions: Abnormal changes in BMI are associated with the adverse changes of blood glucose level, blood pressure, and blood lipids level and other cardiovascular disease risk factors. Keeping normal BMI would benefit the positive outcome of cardiovascular adverse factors.

Morphological Analysis of the Hindbrain Glucose Sensor-Hypothalamic Neural Pathway Activated by Hindbrain Glucoprivation.

Lowered glucose availability, sensed by the hindbrain, has been suggested to enhance gluconeogenesis and food intake as well as suppress reproductive function. In fact, our previous histological and in vitro studies suggest that hindbrain ependymal cells function as a glucose sensor. The present study aimed to clarify the hindbrain glucose sensor-hypothalamic neural pathway activated in response to hindbrain glucoprivation to mediate counterregulatory physiological responses. Administration of 2-deoxy-D-glucose (2DG), an inhibitor of glucose utilization, into the fourth ventricle (4V) of male rats for 0.5 hour induced messenger RNA (mRNA) expression of c-fos, a marker for cellular activation, in ependymal cells in the 4V, but not in the lateral ventricle, the third ventricle or the central canal without a significant change in blood glucose and testosterone levels. Administration of 2DG into the 4V for 1 hour significantly increased blood glucose levels, food intake, and decreased blood testosterone levels. Simultaneously, the expression of c-Fos protein was detected in the 4V ependymal cells; dopamine β-hydroxylase-immunoreactive cells in the C1, C2, and A6 regions; neuropeptide Y (NPY) mRNA-positive cells in the C2; corticotropin-releasing hormone (CRH) mRNA-positive cells in the hypothalamic paraventricular nucleus (PVN); and NPY mRNA-positive cells in the arcuate nucleus (ARC). Taken together, these results suggest that lowered glucose availability, sensed by 4V ependymal cells, activates hindbrain catecholaminergic and/or NPY neurons followed by CRH neurons in the PVN and NPY neurons in the ARC, thereby leading to counterregulatory responses, such as an enhancement of gluconeogenesis, increased food intake, and suppression of sex steroid secretion.

Pemberian Nasi Beras Merah (Oriza Nivara) dan Nasi Beras Hitam (Oriza Sativa L. Indica) terhadap Perubahan Kadar Glukosa pada Penderita Diabetes Melitus

This study aims to determine the effect of giving brown rice (Oryza nivara) and black rice (Oryza Sativa L. Indica) to changes in blood glucose levels in people with diabetes mellitus in Kendari City. This research method was carried out with a quasi-experimental design with a pre-post test design test. The results of the study on checking blood glucose levels before and after giving brown rice (Oryza nivara) and black rice (Oryza sativa L. indica) within one week obtained P-Value = 0.000 from P-Value &lt;0.05, while in comparison between brown rice (Oryza nivara) and black rice (Oryza sativa L. indica) on changes in blood glucose in people with diabetes mellitus in Kendari City obtained P-Value = 0.19 from P-Value &lt; 0.05. In conclusion, there is an effect of giving red rice (Oryza nivara) and black rice (Oryza sativa L. indica) on changes in blood glucose in people with diabetes mellitus in Kendari City.&#x0D; &#x0D; Keywords: Diabetes Mellitus, Blood Glucose Level, Black Rice, Brown Rice

Haematological and Blood Glucose Evaluation in Rats Treated with Methanolic Root Bark Extract of Chrysophyllum Albidum

Aim: This study investigated the outcome of administration of the methanolic root bark extract of Chrysophyllum albidum orally on normal blood glucose levels and haematological indices in rats. Materials and methods: Twenty adult rats were grouped into 4 groups of 5 rats each. The control group (A) was administered distilled water of 0.5 ml while the treatment groups B, C and D received 200, 400 and 600 mg/kg body weight of methanolic root bark extract of C. albidum respectively for 21 days. Before the commencement of the experiment, blood glucose was checked for all the groups. Blood was collected at the end of the test period to analysed changes in blood glucose levels and haematological parameters. Results: The RBC, PCV, Hb, MCH, MCV, lymphocytes, monocytes, basophils were not significantly (P&lt;0.05) different in all the extract doses when compared with the control group. Furthermore, WBC, eosinophils, neutrophils and platelets counts were significantly increased (P&lt;0.05) in all the groups treated with the extract in a dose-dependent form when compared to that of the control. Also, a significant (P&lt;0.05) reduction in blood glucose in groups administered with 400 and 600 mg/kg body weight of the C. albidum relative to the control group was noted. However, a significant (P&lt;0.05) increase in body weight of all groups treated with the extract when compared with the control group was also noted. Conclusion: The results suggest that methanolic root bark extract of C. albidum may be used to boost thrombopoiesis and also has hypoglycemic properties.

Loss of the transcriptional repressor Rev-erb\u03b1 upregulates metabolism and proliferation in cultured mouse embryonic fibroblasts

The transcriptional repressor Rev-erbα is known to down-regulate fatty acid metabolism and gluconeogenesis gene expression. In animal models, disruption of Rev-erbα results in global changes in exercise performance, oxidative capacity, and blood glucose levels. However, the complete extent to which Rev-erbα-mediated transcriptional repression of metabolism impacts cell function remains unknown. We hypothesized that loss of Rev-erbα in a mouse embryonic fibroblast (MEF) model would result in global changes in metabolism. MEFs lacking Rev-erbα exhibited a hypermetabolic phenotype, demonstrating increased levels of glycolysis and oxidative phosphorylation. Rev-erbα deletion increased expression of hexokinase II, transketolase, and ribose-5-phosphate isomerase genes involved in glycolysis and the pentose phosphate pathway (PPP), and these effects were not mediated by the transcriptional activator BMAL1. Upregulation of oxidative phosphorylation was not accompanied by an increase in mitochondrial biogenesis or numbers. Rev-erbα repressed proliferation via glycolysis, but not the PPP. When treated with H2O2, cell viability was reduced in Rev-erbα knockout MEFs, accompanied by increased ratio of oxidized/reduced NADPH, suggesting that perturbation of the PPP reduces capacity to mount an antioxidant defense. These findings uncover novel mechanisms by which glycolysis and the PPP are modulated through Rev-erbα, and provide new insights into how Rev-erbα impacts proliferation.

Effects of Aerobic Exercise on Fasting Blood Glucose and Blood Pressure Levels of Diabetic-Hypertensive Clients at a Diabetes Clinicin Accra, Ghana

Background: Hypertension and diabetes are associated with an increased risk of cardiovascular diseases. Effective interventions are therefore relevant in reducing the morbidity and mortality associated with hypertension and diabetes. We set out to determine the effect of aerobic exercise on type-2 diabetic-hypertensive clients at a diabetes clinic in Accra.Method: Twenty-one participants were recruited from the National Diabetes Management and Research Center in Korle-Bu in Accra.Participants undertook 30 minutes of aerobic exercise comprising, warm up, ergonomic cycling and cool down, three times a week for a period of eight weeks. Fasting blood glucose and blood pressure levels were measured and changes with respect to exercise were analysed. The mixed model ANOVA was used to test for the differences in the weekly blood pressure and blood glucose levels while the paired t-test was used to compare the baseline and final readings of blood pressure and blood glucose levels. Pearson’s correlation test was used to determine the relationship between age and change in blood pressure and blood glucose levels after eight weeks of exercise.Results: Mean systolic blood pressure reduced from 142mmHg to 135mmHg while the mean diastolic blood pressure also reduced from 89mmHg to 84mmHg post exercises. The baseline and eighth week post exercise average blood glucose level were 8.0 mmol/L and 5.2 mmol/L respectively. There were significant differences in baseline and week eight systolic (p = 0.0017), and diastolic (p = 0.006) blood pressure as well as blood glucose (p=0.0027) levels. There was also a significant positive correlation between age and change in blood glucose level (p = 0.036).Conclusion: Aerobic exercise reduces the fasting blood glucose level and blood pressure in type-2 diabetic-hypertensives. Diabetic-hypertensives should therefore be encouraged to participate in aerobic exercises.

A Subsidized Healthy Food Prescription Program for Adults With Type 2 Diabetes Who Are Experiencing Food Insecurity: Protocol for a Randomized Controlled Trial

ObjectivesIt is vital for individuals with type 2 diabetes (T2DM) to adhere to a healthy dietary pattern to maintain optimal blood glucose levels and overall health. Increasing costs of healthy foods, however, are a barrier to maintaining healthful dietary patterns, particularly for individuals with T2DM who are experiencing food insecurity. Poor diet quality may result in difficulties maintaining optimal blood glucose levels, leading to higher rates of diabetes complications, and increased acute care usage and costs. Although the adverse impacts of food insecurity on maintaining optimal blood glucose levels are well documented, effective strategies to this among individuals with T2DM are lacking. One approach is providing subsidies to purchase healthy foods through subsidized healthy food prescription programs. These programs may help reduce food insecurity and improve diet quality, thereby improving blood glucose levels and reducing diabetes complications over time. MethodsA parallel group randomized controlled trial will examine the effectiveness of a subsidized healthy food prescription program compared to a healthy food prescription alone in improving average blood glucose levels (primary outcome), and other secondary outcomes among 404 adults who are experiencing food insecurity and persistent hyperglycemia. The subsidized healthy food prescription program consists of two core elements: 1) A one-time healthy food prescription pamphlet that outlines an evidence-based healthy dietary pattern; 2) A healthy food subsidy of $1.50/day/household member to purchase healthy foods in participating supermarkets for 6 months. At baseline and 6-month follow-up, participants will provide responses to sociodemographic and health-related items, and a variety of patient-reported outcomes. Biochemical and physical measurements will also be obtained. ResultsThe study’s theory of change posits that reducing food insecurity and improving diet quality will be key mediators in improving blood glucose levels, which may reduce diabetes complications, and healthcare usage and costs over time. ConclusionsThe results of this study will demonstrate if a subsidized healthy food prescription program results in meaningful changes in average blood glucose levels and other clinically relevant outcomes. Funding SourcesAlberta Innovates, Alberta Health Services.

Illness knowledge of type 2 diabetes patients: the Hungarian validation of Diabetes Knowledge Test

According to the Hungarian Central Statistical Office, more than 1 million diabetic patients live in Hungary. It is essential to enhance and sustain the knowledge, skills and self-efficacy of patients. The most widely used measurement of illness knowledge is the 23-item Michigan Diabetes Knowledge Test (DKT). Its first 14 items measure general knowledge: the nutritional value of food, and causes of change in blood glucose level. Its further 9 items are about insulin usage. To examine the reliability and the validity of the Hungarian version of DKT2 as well as its association with sociodemographic and illness-related variables. In our cross-sectional quantitative study, 129 patients (84 women, mean age: 59.67; SD = 12.6) diagnosed with type 2 diabetes mellitus using insulin therapy filled in a questionnaire online. The α coefficient for the test is 0.603, which is acceptable. The mean of the correct answer rate is 81.66%, which resembles the American results, but it is higher than that of other specific groups. Problem areas for our patients included interpreting ketoacidosis, the nutritional value of foods and the effect of foods on blood glucose level. The score of the Hungarian test - in accordance with the literature - correlates negatively with age, positively with the year of insulin-usage and with the number of daily insulin intake and of blood glucose measurement. Illness knowledge was independently predicted only by the number of daily blood glucose measurement. The convergent validity of the Hungarian test is supported by its weak but significant association with Brief Health Literacy Screen questions. The Hungarian DKT2 properly measures the illness knowledge of diabetic patients. Their high level of knowledge can be traced back to the speciality of the subjects as well as to the overall education of insulin users. Nevertheless, our results draw attention to the necessity of enhancing the level of dietetic knowledge of patients. Orv Hetil. 2020; 162(22): 870-877.

Effect of Coronavirus Infection on Fasting Blood Glucose, Kidney Function, and Electrolytes in COVID-19 Patients in the Zawia Region, Western Libya

Background: Coronavirus disease 19 (COVID-19) is a pandemic infectious disease caused by the novel coronavirus. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It is an aggressive virus that spread worldwide and is a systemic disease involving multiple systems, including respiratory, cardiovascular, gastrointestinal, hematopoietic, neurological, immune, and urinogenital systems. Objectives: The present study aimed to evaluate the alteration in fasting blood glucose, serum urea, creatinine, Na+, K+, and Cl- levels among COVID-19 patients in the Zawia region, Western Libya. Materials and Methods: 416 confirmed COVID-19 patients hospitalized in the Isolation Centre located in Zawia city, Libya. From the 1st May 2020 to the 30th March 2021, were enrolled in this prospective study. Covid-19 patients were defined as positive cases after the detection of SARS-CoV-2 RNA in oro-nasopharyngeal swab samples. Demographic data were extracted from electronic medical records and patient files. Also, 30 healthy individuals without any chronic disease or respiratory symptoms were recruited for the control group. Blood samples were collected via vein puncture for estimating biochemical parameters (fasting blood glucose, serum urea, creatinine, Na+, K+, and Cl- concentrations). The statistical significance of differences between groups was evaluated with the Mann- Whitney (U test). Associations between different parameters were evaluated with the Spearman's test. Results: The results showed that coronavirus infection induced a significant increase in fasting blood glucose, serum urea, and creatinine concentrations. Infections also induced a decrease in serum sodium ion concentration, compared with healthy individuals. Seventy-six percent of corona virus-infected patients had hyperglycemia. Similarly, high levels of serum urea, creatinine, Cl-, Na+, and K+ were found in 40.9%, 39.9%, 27.9%, 8.9% and 6.5% of patients, respectively. Hyponatraemia, hypokalaemia, and hypochloremia were found in 35.5%, 13.7%, and 12.9% of patients. There were recorded a significant positive association between fasting blood glucose and serum urea, creatinine, and K+ concentration, between serum urea concentration and serum creatinine, K+, and Cl- concentrations, between serum creatinine and K+, and Cl- concentrations, and between serum Na+ and Cl- concentration, and a significant negative association between fasting blood glucose and serum Na+ and Cl- concentrations and between serum K+ and Na+ concentrations. Conclusion: It can be concluded that coronavirus infections induced increases in fasting blood glucose, serum urea, and creatinine, and a decrease in Na+ concentrations. There was a significant association between different parameters. These biochemical changes may help the clinicians to understand COVID-19 better and provide more clinical treatment options and prevent the serious complications of the disease. Thus, clinicians should pay special attention to fasting blood glucose, kidney function and electrolyte status of COVID-19 patients. Changes in fasting blood glucose, kidney function, and electrolyte levels can be a good indicator of disease progression.

Mitochondrial Efflux of Citrate and Isocitrate Is Fully Dispensable for Glucose-Stimulated Insulin Secretion and Pancreatic Islet β-Cell Function.

The defining feature of pancreatic islet β-cell function is the precise coordination of changes in blood glucose levels with insulin secretion to regulate systemic glucose homeostasis. While ATP has long been heralded as a critical metabolic coupling factor to trigger insulin release, glucose-derived metabolites have been suggested to further amplify fuel-stimulated insulin secretion. The mitochondrial export of citrate and isocitrate through the citrate-isocitrate carrier (CIC) has been suggested to initiate a key pathway that amplifies glucose-stimulated insulin secretion, though the physiological significance of β-cell CIC-to-glucose homeostasis has not been established. Here, we generated constitutive and adult CIC β-cell knockout (KO) mice and demonstrate that these animals have normal glucose tolerance, similar responses to diet-induced obesity, and identical insulin secretion responses to various fuel secretagogues. Glucose-stimulated NADPH production was impaired in β-cell CIC KO islets, whereas glutathione reduction was retained. Furthermore, suppression of the downstream enzyme cytosolic isocitrate dehydrogenase (Idh1) inhibited insulin secretion in wild-type islets but failed to impact β-cell function in β-cell CIC KO islets. Our data demonstrate that the mitochondrial CIC is not required for glucose-stimulated insulin secretion and that additional complexities exist for the role of Idh1 and NADPH in the regulation of β-cell function.

Tyrosine Kinase Inhibitors Reduce Glucose Uptake by Binding to an Exofacial Site on hGLUT-1: Influence on 18 F-FDG PET Uptake.

Positron emission tomography (PET) using 2‐deoxy‐2‐[18F]fluoro‐d‐glucose ([18F]FDG), a marker of energy metabolism and cell proliferation, is routinely used in the clinic to assess patient response to chemotherapy and to monitor tumor growth. Treatment with some tyrosine kinase inhibitors (TKIs) causes changes in blood glucose levels in both nondiabetic and diabetic patients. We evaluated the interaction of several classes of TKIs with human glucose transporter‐1 (hGLUT‐1) in FaDu and GIST‐1 cells by measuring [3H]2‐deoxy‐d‐glucose ([3H]2‐DG) and [3H]FDG uptake. Uptake of both was inhibited to varying extents by the TKIs, and representative TKIs from each class showed competitive inhibition of [3H]2‐DG uptake. In GIST‐1 cells, [3H]FDG uptake inhibition by temsirolimus and nilotinib was irreversible, whereas inhibition by imatinib, gefitinib, and pazopanib was reversible. Molecular modeling studies showed that TKIs form multiple hydrogen bonds with polar residues of the sugar binding site (i.e., Q161, Q282, Q283, N288, N317, and W388), and van der Waals interactions with the H‐pocket site. Our results showed interaction of TKIs with amino acid residues at the glucose binding site to inhibit glucose uptake by hGLUT‐1. We hypothesize that inhibition of hGLUT‐1 by TKIs could alter glucose levels in patients treated with TKIs, leading to hypoglycemia and fatigue, although further studies are required to evaluate roles of other SLC2 and SLC5 members. In addition, TKIs could affect tumor [18F]FDG uptake, increasingly used as a marker of tumor response. The hGLUT‐1 inhibition by TKIs may have implications for routine [18F]FDG‐PET monitoring of tumor response in patients.

Relationship between the changes in thromboxane B2, 6-keto-prostaglandin Fla, and blood glucose levels and progressive ischemic stroke.

Progressive ischemic stroke is a common cerebrovascular disease with high morbidity. This study aimed to investigate the relationship between changes of Thromboxane B2 (TXB2), 6-keto-prostaglandin Fla (6-k-PGFla), and blood glucose (BG) levels with progressive ischemic stroke. A total of 106 patients with progressive ischemic stroke admitted to our hospital from December 2016 to December 2018 were recruited as the observation group, and 110 patients who received physical examination in our hospital during the same period were selected as the control group. The levels of TXB2, 6-k-PGFla, and BG in different groups were compared, the related risk factors affecting the prognosis of patients with progressive ischemic stroke were analyzed, and the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of TXB2, 6-k-PGFla, and BG for the prognostic mortality of patients with progressive ischemic stroke. The levels of TXB2, 6-k-PGFla, and BG in the observation group were significantly higher than those in the control group (P<0.05). The prognostic mortality of participants with abnormally increased expression of TXB2, 6-k-PGFla, and BG was significantly higher than that of patients with normal expression of TXB2, 6-k-PGFla, and BG (P<0.05). Hypertension, diabetes, collateral circulatory disorders, hyperlipidemia, TXB2 (abnormal increase), 6-k-PGFla (abnormal increase), and BG (abnormal increase) were risk factors affecting the prognosis of patients with progressive ischemic stroke (P<0.05). The area under the curve (AUC) of the ROC curve showed that TXB2, 6-k-PGFla, BG, and the combination of them were 0.846, 0.893, 0.835, and 0.971, respectively, showing that the AUC of the combination of them was the largest. Hypertension, diabetes, collateral circulatory disorders, hyperlipidemia, TXB2 (abnormal increase), 6-k-PGFla (abnormal increase), and BG (abnormal increase) are risk factors affecting the prognosis of patients with progressive ischemic stroke. The combined detection of the 3 indicators showed high sensitivity and specificity in evaluating the prognostic mortality of patients with progressive ischemic stroke, indicating that clinicians might improve the early diagnosis rate of progressive ischemic stroke by combining the detection of TXB2, 6-k-PGFla, and BG to predict the prognosis of patients.

The effect of combined supplementation with vitamin D and omega-3 fatty acids on blood glucose and blood lipid levels in patients with gestational diabetes.

To investigate the effects of vitamin D and omega-3 fatty acids on glucose and blood lipid metabolism in gestational diabetes (GDM) women. A total of 150 patients with GDM aged 18-40 who were admitted to our hospital from May 2019 to December 2020 were enrolled in this study. The subjects were divided into test and control groups according to whether they took vitamin D and omega-3 fatty acids. The test group took 40,000 IU of vitamin D and 8,000 mg of omega-3 fatty acids twice a day. Comparative analysis of the changes in blood glucose and blood lipid levels of the two groups of patients was performed after 6 weeks. The t-test was used to compare the differences between groups, and the chi-square test was used to assess percentage differences. Repeated measures variance was used to analyze the effects of vitamin D and omega-3 fatty acids on insulin metabolism markers and blood lipid profiles. After adjusting for baseline age and weight, it was found that the fasting blood glucose (FBG), fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides (TGs), total cholesterol, low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL) in the test group were decreased by 0.3±0.2 mmol/L, 1.0±0.6 uIU/mL, 0.2±0.1, 0.3±0.1 mmol/L, 0.5±0.2 mmol/L, 1.1±0.4 mmol/L, and 0.03±0.01 mmol/L, respectively, while homeostasis model assessment of beta cell (HOMA-β) was increased by 0.4±0.1. Compared to the placebo group, the test group's FBG, insulin, HOMA-IR, TGs, total cholesterol, LDL, and VLDL were all significantly decreased, and HOMA-β was markedly improved. However, no notable statistical difference was observed in the change of high-density lipoprotein (HDL) (P>0.05). Combined supplementation with vitamin D and omega-3 fatty acids for 6 weeks in patients with GDM can effectively reduce blood sugar and blood lipids, improve HOMA-β and insulin resistance, and ultimately effectively improve the glucose and lipid metabolism of patients.

PENGARUH BRISK WALKING EXERCISE TERHADAP PENURUNAN KADAR GULA DARAH PADA PASIEN DM TIPE II DI RUMAH SAKIT GRANDMED LUBUK PAKAM

The silent killer disease that often occurs in humans was Diabetes Mellitus (DM). DM sufferers were generally unaware of this disease condition and when complications were known to have occurred. Control of basic sugar levels was the right way to reduce complications that occur in sufferers. The research objective was to determine the effect of walking exercise on changes in blood glucose levels in patients with type 2 diabetes mellitus. The Methode that used at this research was a pre-experimental design with a one group pretest-posttest design approach. There were 30 people of population of this study with diabetes mellitus taken using a simple random sampling technique which was 21 respondents. The Data analysis using Paired Samples T-test. The results showed that before doing all respondents exeperienced, blood glucose levels before walking exercise 21 people (100 %). After walking exercise decreased by 21 people (66,3%). Paired Sample T- test results obtained a probability value (p = 0.00) &lt;(α = 0.05) which means H1 is accepted. Physical exercise which is carried out 3 times 30 minutes per week can reduce the risk for type 2 DM sufferers to have uncontrolled blood glucose level. Physical exercise is highly recommended for people with type 2 diabetes. To maintain body functions to work properly, the stability of blood sugar levels needs to be maintained.