Changes In Blood Glucose Research Articles

Variations of Perioperative Cardiac Surgery Blood Glucose and Glycemic Variability in Diabetes and Non-Diabetes

Background: Not only perioperative high blood glucose but also glycemic variability (GV) is significantly associated with mortality in cardiac surgery. Perioperative hyperglycemia in diabetes (DM) patients is well-known, however, there is less information in non-diabetes (non-DM) patients. Objective: The present study objectives were to show the variations of perioperative blood glucose, to compare the characteristics, frequency, and severity of hyperglycemia, and to compare GV between non-DM and DM undergoing cardiac surgery. Materials and Methods: A prospective observational study was conducted between January 2016 and July 2018. Cardiac-surgery patients, age 20 to 80 years, undergoing cardiopulmonary bypass (CPB) were recruited. The differentiation between the DM and the non-DM was based on standard diagnosis. Perioperative blood glucose was measured every 30 minutes by POCT-glucose and controlled by insulin based on the institutional protocol. GV measures were standard deviation (SD), coefficient of variance (CV), and mean absolute glucose (MAG). Characteristics of blood glucose changes were demonstrated, which were related to events or surgical procedure. Comparison of blood glucose, GV, and events of hyperglycemia were carried out using Student t-test or chi-square test as appropriate. Results: Perioperative hyperglycemia were 60% in DM and 30% in non-DM. Hyperglycemia started at the beginning of the operation in DM and in late CPB in non-DM. Inotropes or vasopressors was associated with sharp shooting increases of blood glucose. Hyperglycemia with more severity was commonly found during the early postoperative period in both DM and non-DM. The GV of DM was higher than in non-DM. The average MAG were 31.98 and 28.05 mg/dl/hour in DM and non-DM, which was the only measure that could significantly differentiate DM and non-DM. Conclusion: Perioperative hyperglycemia in cardiac surgery occurred in both non-DM and DM despite the treatment by insulin infusion. Inotropes or vasopressors infusion was significantly related to a sudden hyperglycemia. MAG might be a better monitor of GV than SD and CV during cardiac surgery. Trial registration: Thai Clinical Trials Registry, TCTR 20190411005 Keywords: Hyperglycemia, Glycemic variability, Mean absolute glucose, Cardiac surgery

Type of feeding provided with dextrose gel impacts hypoglycemia outcomes: comparing donor milk, formula, and breastfeeding.

Examine neonatal hypoglycemia (NH) outcomes based on type of feeding provided with first dextrose gel. Retrospective matched cohort study of 99 infants ≥35 weeks gestational age who received dextrose gel in combination with breastfeeding, formula feeding, or donor milk feeding for NH. The exposure was feeding type. The outcomes were: (1) median change in blood glucose (Δ BG) concentration after first gel, (2) odds of second gel, and (3) odds of recurrent NH. Median Δ BG was greater in formula (17.0 mg/dL) and donor milk (19.0 mg/dL) fed vs. breastfed infants (7.0 mg/dL). Donor milk and formula feeding were both associated with lower odds of second gel and recurrent NH. Associations remained significant in late-preterm infants, but only formula feeding remained significant in full-term infants. Formula and donor milk feedings both raised blood sugar concentrations, but the impact differed by gestational age.

Mindfulness Practice for Glycemic Control: Could it be a New Strategy for an Old Problem? A Systematic Review and Meta-Analysis.

The management of type 2 diabetes mellitus (T2DM) requires a complex and organized care that includes patient's lifestyle change. Additionally, emotional well-being is an important part of self-management, and it may impair the individual's adherence. Therefore, equipping the patients with the necessary coping and self-care techniques may be an important step in managing diabetes. To evaluate the effect of interventions using established mindfulness-based protocols on glycemic control of individuals with T2DM. Data sources: Two electronic databases (PubMed and EMBASE) were searched from inception to December 2019. We limited our search to published studies in English, Spanish and Portuguese languages. Randomized clinical trials that assessed the effects of mindfulness in individuals with T2DM were selected. Two authors independently assessed the risk of bias and extracted data from the included trials. Data were pooled using inverse-variance random-effects meta-analyses. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Four randomized trials were included. There were no differences in blood glucose change (mean difference between groups (MD) -0.73mg/dl; 95% CI, -10.49; 9.02; I2 =0%; very low quality of evidence) or glycated hemoglobin (MD 0.05%; 95%CI -0.22 to 0.32; I2 =29%; very low quality of evidence). Although the quality of current evidence is very low, our findings suggest that established protocols involving mindfulness have no effect on blood glucose or glycated hemoglobin in individuals with T2DM. Indeed, large-scale trials are needed to evaluate the contribution of mindfulness to glycemic control in clinical practice. PROSPERO Registration ID: RD42020161940.

The role of alternative sugars on endurance capacity in balb/c mice.

Alternative sugars containing isomaltulose were investigated to confirm the hypothesis that isomaltulose ingestion affects endurance capacity due to slow rates of hydrolysis and absorption rate at the intestine. A swimming time of the control group tends to decrease, but the group administrated with low glycemic index (GI) sweeteners tend to increase gradually. Fructo-oligosaccharide (FOS) and inverted sugar (IS), contained isomaltulose, groups showed a significant difference of change in blood glucose and lactic acid level than control group (p<.05). Serum creatine phosphokinase (CPK) and serum lactate dehydrogenases (LDH) of PAL100 were significantly lower than that of the control group (p<.05). IS showed a significant difference in glutathione peroxidase (GSH-Px) compared to Con and PAL20 (20% isomaltulose) group (p<.05). Consuming FOS seems to increase an endurance capacity since fructose and FOS based in isomaltulose contained syrup showed low absorption rate and GI level. PRACTICAL APPLICATIONS: Sugar is a major energy source for exercise, but it causes excessive intake because of the short duration of sweetness, which causes diseases such as obesity, diabetes, and skin aging. An alternative sugar complex containing isomatulose was found to be a sugar substitute for athletic performance. Athletic performance is not just for athletes or active people. In general, elderly people with low muscle mass have low mobility. Alternative sugars can be a good source of supplements to help them perform smoothly with less intake. Therefore, an endurance test with alternative sugars is and important study for energy supplements industry.

Differential expression of glycoprotein IV on monocyte subsets following high-fat diet feeding and the impact of short-term low-dose aspirin treatment

ObjectiveTo assess the levels of glycoprotein GPIV (CD36) expression on peripheral blood monocyte subsets, in a mouse model of glucose intolerance. Moreover, to determine the effect of; low-dose aspirin (LDA) alone, LDA combined with metformin, or clopidogrel alone, on the expression of CD36 on subsets of circulating monocytes. MethodThe study consisted of two experimental phases. In experiment one, the mice (n = 14) were randomised to receive a low-fat diet (LFD) or a high-fat diet (HFD) for eight weeks. Whereas the secondary phase of the experiment, comprised of twenty-four HFD-fed mice treated with LDA alone (3 mg/kg), or in combination with metformin (150 mg/kg), or clopidogrel alone (10 mg/kg) for six weeks. The surface expression of CD36 on monocytes was measured using flow cytometry. ResultThe levels of CD36 expression on monocytes were upregulated in the HFD-fed compared to LFD-fed group (p < 0.05). In addition, HFD group showed; no significant changes in body weight (p = 0.3848), however, blood glucose (p = 0.0002) and insulin (p = 0.0360) levels were markedly increased following HFD-feeding. Interestingly, all treatments reduced the expression of CD36 on monocytes, decreased fasting blood glucose levels (p = 0.0024) and increased circulating monocyte levels (p = 0.0217) when compared to the untreated HFD group. Moreover, treatment with LDA alone increased basophils levels (p = 0.0272), while when combined with metformin showed an improved effect in enhancing eosinophil levels (p = 0.0302). ConclusionHFD-feeding increased the expression of CD36 on monocyte subsets. LDA as a monotherapy or combined with metformin was as effective as clopidogrel monotherapy, in downregulating the expression of CD36 on monocyte subsets. These treatments may be of relevance in preventing cardiovascular complications associated with impaired glucose tolerance.

Exploring Health-Promoting Attributes of Plant Proteins as a Functional Ingredient for the Food Sector: A Systematic Review of Human Interventional Studies.

The potential beneficial effects of plant-based diets on human health have been extensively studied. However, the evidence regarding the health effects of extracted plant-based proteins as functional ingredients, other than soya, is scarce. The aim of this review was to compile evidence on the effects of extracted protein from a wide range of traditional and novel plant sources on glycemic responses, appetite, body weight, metabolic, cardiovascular and muscle health. A comprehensive search of PubMed, EMBASE and The Cochrane Central Register of Controlled Trials (CENTRAL) was conducted through 23 and 27 March 2020 for randomized controlled trials that featured any of the following 18 plant protein sources: alfalfa, duckweed, buckwheat, chickpea, fava bean, hemp, lentil, lupin, mushroom, oat, pea, potato, pumpkin, quinoa, rapeseed, rice, sacha inchi, sunflower. Only interventions that investigated concentrated, isolated or hydrolysed forms of dietary protein were included. Searched health outcome measures were: change in blood glucose, insulin, satiety hormones concentration, subjective assessment of appetite/satiety, change in blood lipids concentration, blood pressure, body weight and muscle health parameters. Acute and sub-chronic studies were considered for inclusion. Applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach we identified 1190 records. Twenty-six studies met the inclusion criteria. Plant protein sources used in interventions were most often pea (n = 16), followed by lupin (n = 4), fava bean (n = 2), rice (n = 2), oat (n = 2), hemp (n = 2) and lentil (n = 1). Satiety and postprandial glycemic response were the most frequently reported health outcomes (n = 18), followed by blood lipids (n = 6), muscle health (n = 5), body weight (n = 5) and blood pressure (n = 4). No studies on the remaining plant proteins in the extracted form were identified through the search. Most studies confirmed the health-promoting effect of identified extracted plant protein sources across glycemic, appetite, cardiovascular and muscular outcomes when compared to baseline or non-protein control. However, the current evidence is still not sufficient to formulate explicit dietary recommendations. In general, the effects of plant protein were comparable (but not superior) to protein originating from animals. This is still a promising finding, suggesting that the desired health effects can be achieved with more sustainable, plant alternatives. More methodologically homogenous research is needed to formulate and validate evidence-based health claims for plant protein ingredients. The relevance of these findings are discussed for the food sector with supporting market trends.

Parameter identification in the mathematical model of glucose and insulin tolerance test - the mathematical markers of diabetes

Glucose tolerance test (GTT) is standard diagnostic procedure that tests the efficiency of blood glucose-lowering hormones (insulin, incretins, leptin). Contrary, insulin tolerance test (ITT) is probing efficiency of blood glucose-rising hormones (glucagon, thyroxine, growth hormone, glucocorticoids, adrenalin, noradrenalin). These two hormone systems together maintain blood glucose levels in a narrow range. Various pathophysiological mechanisms give rise to a reversible condition -- prediabetes which then progresses to an irreversible chronic disease -- diabetes, both marked with deviation of blood glucose levels outside the set range. In diagnostic purpose, the patient is given glucose load, and blood glucose is measured right before and 2 hours after load. Measurements are more frequent after insulin injection (ITT) or if both tests are performed on experimental animals. In this paper we analyse the mathematical model for GTT and ITT. The obtained model function is a useful tool in describing the dynamics of blood glucose changes.

Expression of Sirtuin 1 in visceral adipose tissue in Tibetan mini-pigs with obesity and insulin resistance induced by high fat/cholesterol diet

To investigate the role of Sirt1 in visceral adipose tissue in Tibetan mini-pigs with obesity and insulin resistance induced by high fat/cholesterol diet. Twelve male Tibetan mini-pigs were divided into 2 groups randomly: normal control (NC) group, high-fat/cholesterol (HFC) diet group, 6 in each group. After 16 weeks of modeling, fasting body weight and body mass index (BMI) were measured. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured in anterior venous blood, and atherosclerosis index (AI) was calculated. Meanwhile, intravenous glucose tolerance test was conducted to observe the changes of blood glucose and insulin, and the area under the curve (AUC) was calculated. After euthanasia, visceral fat rate was detected, and visceral fat tissue was taken for histopathological observation and fat cell diameter analysis. RT-PCR was used to observe the mRNA expression levels of Sirtuin1 (Sirt1), insulin-like growth factor-1 (IGF-1), glucose transporter 4 (GLUT4), peroxisome proliferator-activated receptor γ (PPARγ), peroxisome proliferator-activated receptor γ-assisted activator 1α (PGC-1α), forkhead box protein O1 (FoxO1), lipolysis-related gene hormone-sensitive lipase (HSL), and fat synthesis-related gene fatty acid synthase (FASN)changes in adipose tissue. Compared with the NC group, the body weight, BMI, TC, LDL-C, HDL-C, AI and visceral fat rate were significantly increased after 16 weeks of high-fat/cholesterol induction in Tibetan mini-pigs(P＜0.05,P＜0.01). Meanwhile, the glucose tolerance curve was significantly delayed and the area under the curve of blood glucose and insulin was significantly increased (P＜0.05). HE pathological observation and quantitative analysis showed that fat cells were hypertrophy and the average cell diameter was increased significantly (P＜0.01). In addition, the mRNA expression levels of Sirt1,PGC-1α, GLUT4, and HSL were all decreased in varying degrees in adipose tissue, among which the mRNA expressions of Sirt1 and HSL were significantly decreased (P＜0.05), while the mRNA expressions of FOXO1, IGF-1, PPARγ, and FASN were significantly increased (P＜0.05, P＜0.01). Tibetan mini-pigs were induced by high fat/cholesterol diet to form obesity model with phenotypic characteristics such as lipid disorder and insulin resistance, whereas Sirt1 plays a key role in visceral fat deposition and insulin sensitivity reduction in obese Tibetan mini-pigs.

The Effect Of Traditional Chinese Exercise On Diabetic : A Non-randomized Controlled Trial

OBJECTIVE: Clinical practice recommendations issued by the American Diabetes Association in 2019 include the health status and quality of life of people with diabetes as part of their daily care , and believe that it’s important to strengthen physical exercise for diabetic patients. Previous studies have shown that the Baduanjin, a traditional Chinese sport, can regulate blood glucose and blood lipids, weight loss and improve immunity.This study was aimed at investigating the effects and safety of Modified Baduanjin on patients with type 2 diabetes. METHODS: Forty patients were divided into the Modified Baduanjin group (Α group, n=22) and the control group (Β group, n=18) for 12 weeks according to their individual motivation. On the basis of conventional hypoglycemic treatment, Group Α practiced Baduanjin for 30 minutes per day, 4 times per week, while no exercise intervention was given in group Β. The main study outcomes included changes in fasting blood glucose, blood lipids, glycosylated hemoglobin,Quality of Life score( QoL score, 100 in total), muscle endurance, and flexibility after 12 weeks. RESULTS: There were no significant differences in patient characteristics between the two groups at baseline. Group Α in glycosylated hemoglobin (pre 6.56±0.70 vs post 6.28±0.70) , QoL score (pre 80.18±9.02 vs post 86.64±9.91) , muscle endurance (pre 3.76±4.38 vs post 6.91±5.73) and flexibility (pre 2.86±9.69 vs post 5.88±9.75) . All the above results were statistically significant (P<0.05).There were no statistical significance in group Β (P>0.05) . 2) Few changes were found in fasting blood glucose and lipid parameters both in two groups(P>0.05). 3) All patients completed the exercise programme with no adverse effects. CONCLUSION: Chinese traditional exercise is effective and safe in regulating and control the level of blood glucose, enhancing physical fitness and improving the quality of life.

Cardiovascular and metabolic responses to passive hypoxic conditioning in overweight and mildly obese individuals.

Although severe intermittent hypoxia (IH) is well known to induce deleterious cardiometabolic consequences, moderate IH may induce positive effects in obese individuals. The present study aimed to evaluate the effect of two hypoxic conditioning programs on cardiovascular and metabolic health status of overweight or obese individuals. In this randomized single-blind controlled study, 35 subjects (54 ± 9.3 yr, 31.7 ± 3.5 kg/m2) were randomized into three 8-wk interventions (three 1-h sessions per week): sustained hypoxia (SH), arterial oxygen saturation ([Formula: see text]) = 75%; IH, 5 min [Formula: see text] = 75% - 3 min normoxia; normoxia. Ventilation, heart rate, blood pressure, and tissue oxygenation were measured during the first and last hypoxic conditioning sessions. Vascular function, blood glucose and insulin, lipid profile, nitric oxide metabolites, and oxidative stress were evaluated before and after the interventions. Both SH and IH increased ventilation in hypoxia (+1.8 ± 2.1 and +2.3 ± 3.6 L/min, respectively; P < 0.05) and reduced normoxic diastolic blood pressure (-12 ± 15 and -13 ± 10 mmHg, respectively; P < 0.05), whereas changes in normoxic systolic blood pressure were not significant (+3 ± 9 and -6 ± 13 mmHg, respectively; P > 0.05). IH only reduced heart rate variability (e.g., root-mean-square difference of successive normal R-R intervals in normoxia -21 ± 35%; P < 0.05). Both SH and IH induced no significant change in body mass index, vascular function, blood glucose, insulin and lipid profile, nitric oxide metabolites, or oxidative stress, except for an increase in superoxide dismutase activity following SH. This study indicates that passive hypoxic conditioning in obese individuals induces some positive cardiovascular and respiratory improvements despite no change in anthropometric data and even a reduction in heart rate variability during IH exposure.

Relationship between perirenal adipose tissue neuropeptide Y and insulin resistance in nutritional transition model

To observe the changes of neuropeptide Y(NPY) expression in perirenal adipose tissue and its relationship with insulin resistance in the nutritional transition models of refeeding after calorie restriction. SPF Male SD rats, aged 8 weeks, were randomly divided into normal chow group and refeeding with normal chow after calorie restriction for 4 weeks group. NPY gene expression in perirenal adipose tissue were detected by real-time quantitative PCR at the end of 4 and 12 weeks, along with fasting plasma glucose, fasting serum lisulin, free fatty acids and average glucose infusion rate(GIR_(60-120)) of hyperinsulinemic-euglycemic clamp test for 60-120 minutes. NPY gene mRNA expression in perirenal adipose tissue was detected by real-time quantitative PCR. And the relationship between NPY gene expression and insulin resistance was detected by Spearman correlation analysis. The expression level of NPY gene in perirenal adipose tissue in caloric restriction for 4 weeks group was significantly increased by calorie restriction(P&lt;0. 01). After refeeding, the expression level of NPY gene in refeeding with normal group was still slightly increased, which was significantly higher than that in normal group at the end of the experiment(P&lt;0. 01). The levels of fasting plasma glucose and fasting insulin in caloric restriction for 4 weeks group decreased slightly, GIR_(60-120) increased slightly, but there were no statistical differences compared with normal group(P&gt;0. 05), but free fatty acid levels increased significantly(P&lt;0. 01). After refeeding, the levels of fasting insulin, free fatty acid in refeeding with normal group increased significantly, GIR_(60-120) decreased evidently(P&lt;0. 01), but the changes of fasting blood glucose were not obvious. The result of stepwise regression showed that the expression level of NPY gene in perirenal adipose tissue was closely related to GIR_(60-120) and fasting insulin, with R values of-0. 816 and 0. 789 respectively(R~2=0. 892, P&lt;0. 01). The result of correlation analysis showed that in the 4-week group, the mRNA expression level of NPY gene in perirenal adipose tissue was closely related to GIR_( 60-120)、fasting insulin and free fatty acid, with R values of-0. 765, 0. 716 and 0. 657 respectively(P&lt;0. 01). In the 12 week group, the mRNA expression level of NPY gene in perirenal adipose tissue was closely related to GIR_(60-120), fasting insulin and free fatty acid, with R values of-0. 853, 0. 622 and 0. 608 respectively(P&lt;0. 01). The mRNA expression of NPY gene in perirenal adipose tissue was closely related to indicators of insulin resistance. It is an important factor affecting insulin sensitivity.

Effect Of Wearing Lower-body Compression Garments During Prolonged Running On Substrate Oxidation And Running Kinematics

Lower body compression garments (CG) have been suggested previously to provide favorable effects during running. One of explanation for the benefits of wearing CG might be explained by augmented arterial blood flow by external pressure applied. Enhanced muscle perfusion can increase oxygen delivery to exercising muscle, thereby affecting oxygen uptake and substrate oxidation. Furthermore, wearing CG might assist the propulsive force by optimizing running kinematics as a result of the elastic nature of the garment, leading to less metabolic cost of running at a given speed. These insights may be advantageous in situation with prolonged running, which is required large metabolic demand under development of fatigue. However, little information is available for effect of wearing CG during prolonged running (> 1h) on energy metabolism and running kinematics. PURPOSE: To determine influence of wearing CG on energy metabolism and running kinematics during prolonged running. METHODS: Eight physical active male (24 ± 2 yrs, 168.4 ± 5.0 cm, 63.9 ± 5.0 kg, VO2max; 54.8 ± 4.3 mL·kg-1·min-1) completed 2 exercise trial in the different days. The exercise consisted of 120 min of uphill running (7% gradient) at 60 % of VO2max (6.8 ± 0.6 km·h-1). The exercise trials included 1) wearing CG with exerting 15 mmHg [CG]; and 2) wearing garment with exerting below 5 mmHg [CON] to thigh and calf. Respiratory gas variables (carbohydrate oxidation) and running kinematics (step length and frequency, ground-contact time, flight time, joint angles) were assessed every 30 min of exercise. Blood samples were collected to determine blood glucose and lactate, and plasma IL-6 as indication of carbohydrate metabolism. P < 0.05 was considered to be statistically significant. RESULTS: Time course of changes in carbohydrate oxidation, running kinematics and blood glucose and lactate did not differ between the two trials (P > 0.05). Area under the curve (AUC) of plasma IL-6 concentration for 120 min of exercise tended to be lower in the CG trial (803 ± 452 pg·mL-1) compared with in the CON trial (1,219 ± 842 pg·mL-1, P = 0.07). A positive relationship was observed between the AUC of plasma IL-6 concentration and the total carbohydrate oxidation (r = 0.5, P = 0.049). CONCLUSION: Wearing CG did not alter energy metabolism and running kinematics during prolonged running.

Changes in maternal blood glucose and lipid concentrations during pregnancy differ by maternal body mass index and are related to birthweight: A prospective, longitudinal study of healthy pregnancies.

BackgroundMaternal obesity is increasing worldwide but the consequences for maternal physiology and fetal growth are not fully understood.ObjectiveTo study whether changes in glucose and lipid metabolism during pregnancy differ between women with normal weight and overweight/obesity, and investigate which of these metabolic factors are associated with birthweight.DesignProspective, longitudinal study.SettingDepartment of Obstetrics, Oslo University Hospital, Rikshospitalet.Population1031 healthy pregnant women with singleton pregnancies.MethodsBlood samples from early and late pregnancy were analyzed for fasting glucose, insulin and lipids (total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides). Associations between metabolic factors and birthweight (z-scores) were explored by linear regression models. Main Outcome Measures: Group-dependent longitudinal changes in glucose and lipids and their association with birthweight (z-scores).ResultsCompared to women with normal weight (BMI < 25), women with overweight (BMI 25–29.9) and obesity (BMI > 30) had significantly higher fasting glucose (4.54, 4.68 and 4.84 mmol/l), insulin (23, 33 and 50 pmol/l), total cholesterol (4.85, 4.99 and 5.14 mmol/l), LDL-C (2.49, 2.66 and 2.88 mmol/l) and triglycerides (1.10, 1.28 and 1.57 mmol/l), but lower HDL-C (1.86, 1.75 and 1.55 mmol/l). BMI (B 0.05, 95% CI 0.03–0.06, p<0.001), gestational weight gain (GWG) (B 0.06, 0.05–0.08, p<0.001) and an increase in fasting glucose (B 0.30, 0.16–0.43, p<0.001) were positively associated with birthweight, whereas a decrease in HDL-C (B -0.72, -0.96- -0.53, p<0.001) had a negative association with birthweight.ConclusionsOverweight/obesity was associated with an unfavorable metabolic profile in early pregnancy which was associated with increased birthweight. However, modifiable factors like gestational weight gain and an increase in fasting glucose were identified and can be targeted for interventions.

Leveraging Fitness Tracker and Personalized Exercise Prescription to Promote Breast Cancer Survivors' Health Outcomes: A Feasibility Study.

Purpose: This feasibility study investigated whether a year-long combined fitness wristband-based and personalized exercise prescription intervention improves Chinese breast cancer survivors’ (BCSs) health outcomes. Methods: Ninety-five BCSs (Xage = 44.81 ± 7.94; XBMI = 22.18 ± 3.48) were recruited from Southern region of China and were delivered the exercise intervention across 12 months, using a single group pretest–posttest design. Participants’ lipid profile (e.g., total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides), blood glucose, breast cancer biomarkers (e.g., carcinoembryonic antigen and cancer antigen 15-3), and functional fitness (e.g., strength in arms and legs, endurance, balance, agility, and flexibility) were assessed at baseline and 12-month post-intervention. Results: Thirty-three BCSs successfully completed the intervention. A significant change in blood glucose (mean difference (MD): −0.22, 95% confidence interval (CI): −0.41–−0.03, t = −2.25, p = 0.028) was observed, with participants demonstrating lower levels of blood glucose at the 12-month post-intervention versus the baseline assessment. Notable changes in functional fitness were also discerned, including agility and balance (MD: −0.47, 95% CI: −0.68–−0.26, t = −4.336, p < 0.001), aerobic endurance (MD: 89.25, 95% CI: 73.82–104.68, t = 11.336, p < 0.001), lower-body flexibility (left) (MD: 4.58, 95% CI: −4.4–13.56, t = 4.653, p < 0.001), and lower-body flexibility (right) (MD: 4.84, 95% CI: −4.65–14.33, t = 4.092, p < 0.001). Conclusion: The observations suggested that our behavioral change program might promote certain health outcomes in Chinese BCSs, yet we are unable to recommend such a program given existing limitations. Future randomized control trials with diverse samples are warranted to confirm our findings.

Therapeutic role of bone marrow mesenchymal stem cells in diabetic neuronal alternations of rat hippocampus

As the hippocampus is the main brain region for many forms of learning and memory functions and is acutely sensitive to blood glucose changes, diabetes mellitus, which is a serious metabolic disease, is often accompanied by learning and memory deficits. Through scientific literatures, mesenchymal stem cells (MSCs) promote functional recovery in rats with traumatic brain injury, so the present work was conducted to study MSCs as a possible treatment for the diabetic neuronal degeneration and functional impairment of rat hippocampus. It was carried out using male albino rats: non-diabetic control groups (4, 8, 12 weeks) (n = 15), diabetic groups by i.v. injection of streptozotocin for (4, 8, 12 weeks) (n = 15) and MSCs treatment to diabetic groups for (8, 12 weeks) (n = 10). Hippocampal learning and memory functions were assessed by the Morris Water Maze test and its results were statistically analysed. The rat hippocampal regions (CA1 and CA3) were subjected to histological, ultrastructural examination and morphometrical analyse of pyramidal neurons. Neurons of the diabetic groups showed disturbed function and architecture; shrunken hyperchromatic nuclei and vacuolated eosinophilic cytoplasm (apoptotic changes) also MSCs treatment improved hippocampal learning and memory functions plus its architectural changes; increasing populations and normal regular distribution. It can be concluded that diabetic hippocampal neuronal alternations and functional impairment can be ameliorated by MSCs treatment.

2246-PUB: "There’s a Disconnect Here": A Study Evaluating Blood Glucose Trends at a Youth Diabetes Camp

Introduction: Camp Midicha is an American Diabetes Association summer camp for children aged 8-17 with type 1 diabetes mellitus located in Fenton, Michigan. Blood glucose (BG) levels of campers are closely monitored so that hypoglycemia and hyperglycemia can be treated and ideally prevented. Hyperglycemia is a particular concern for campers who use insulin pumps because of an increased risk for ketoacidosis. It has been previously observed that campers who disconnect their pumps for swimming have higher BG levels later in the day. Swimming occurs for approximately 1.5 hours between lunch and dinner for all campers daily. This study aims to compare trends in BG for campers who wear insulin pumps that are removed prior to afternoon swimming versus those who do not. Methods: This study was conducted as a retrospective review of the camp’s medical records. Trends in BG at lunch and dinner were compared between campers who A) wear a removable insulin pump and B) wear a non-removable pump or utilize insulin injections. This study included all campers at Camp Midicha from 2017 and 2018, encompassing 862 campers. Multivariate linear regression was used to compare the two groups. Results: The average change in BG from lunch to dinner was 38.13 mg/dL for campers who removed their insulin pumps (174.62 to 212.75 mg/dL) and 16.42 mg/dL for campers who did not (177.14 to 193.59 mg/dL). The difference in BG change between the groups was 21.68 mg/dL (P &amp;lt; 0.0001) with variance between the different days analyzed. Conclusion: This study showed a significant difference in the change in BG from lunch to dinner between the two groups despite insulin pumps being disconnected for only 1.5 hours. While the magnitude of this difference may not necessitate follow-up studies to assess potential interventions, further analysis to evaluate differences in BG change between days could be valuable for insulin dosing at future camps. Disclosure M. Randall: None. B.M. Degnan: None.

577-P: Choroidal Thickness Is Dependent on BMI and Acute Changes in Blood Glucose

Background: Diabetic retinopathy (DR) is a serious complication of diabetes that can lead to blindness. As diagnosis is often made when cell and vision loss are already existing, detecting retinal changes at early stages is crucial. Due to its high vascularization, changes in the choroid play an important role in the pathogenesis of retinal impairment and therefore might be an early diagnostic target. Aim: The aim of this pilot study was to evaluate BMI- and glucose-dependent changes in choroidal thickness (ChT) of healthy volunteers under standardized conditions. Methods: 18 healthy volunteers aged 19 to 42 years (mean±SEM: 26.2±1.7 years) with a body mass index (BMI) between 20 to 34 kg/m2 (24.9±0.8 kg/m2) were included. During an intravenous glucose tolerance test (ivGTT), blood glucose profiles were measured by a gold-standard laboratory system. Simultaneously, a second researcher assessed ChT by optical coherence tomography (OCT, company Heidelberg Engineering GmbH). Researchers were blinded to measurements done by the other one. Results: In general, ChT was positively correlated with BMI (r=0.229; P=0.045). Moreover, the steeper increase of blood glucose up to minute 6 of the ivGTT was significantly associated with greater ChT (r=0.254; P=0.039). Conclusion: ChT is modulated by BMI and short-term fluctuations in blood glucose in healthy subjects without any history of diabetes. It is tempting to speculate that increased ChT and/or reduced susceptibility to glucose dynamics could be a novel marker for early impairment of posterior eye structures. Ongoing studies evaluate ChT and its glucose-dependent variability in patients with diabetes. Disclosure S. Meyhoefer: None. B. Wilms: None. R. Chamorro: None. A. Pagels: None. H. Grein: None. S.M. Schmid: None. Funding German Center for Diabetes Research

1773-P: Postprandial Hyperglycemia after a High–Glycemic Index Meal Activates Brain Areas Associated with Food Cravings and Overeating in T1D

High vs. low glycemic index (GI) foods elicit late postprandial activation of mesolimbic brain areas, which may contribute to the associated increases in hunger, food intake and cravings. It is unknown whether changes in blood glucose or higher insulin levels mediate this activation and its potential adverse downstream effects. Fifteen men with T1D, mean (SD) BMI 21 (1.4) kg/m2, aged 21 (1.6) yr underwent three conditions in random order: C1 - high GI (GI=84) meal with IV insulin to maintain euglycemia; C2 - macronutrient matched low GI (37) meal with IV insulin to maintain euglycemia; C3 - high GI meal with IV insulin to match C2. Insulin was algorithmically adjusted for 4.5 hr with blood glucose checks every 5 min. Brain imaging (arterial spin labeling) was obtained at baseline, in the early (1 hr) and late (4 hr) postprandial period. This design allowed us to compare high vs. low GI meals with similar glucose response (incremental area under the curve 192 [22] vs. 41 [12], p=0.6) but different insulin doses (25 [2] vs. 17 [1] units, p=0.003; C1 vs. C2) or similar insulin doses (17 [1] units each, p=0.5) with different glucose response (1257 [37] vs. 41 [12] mg/dl*h, p&amp;lt;0.001, C3 vs. C2). As expected, a high GI meal elicits increased hunger and late postprandial activation of brain areas linked to food cravings. This activation was mediated by postprandial hyperglycemia rather than insulin level. Thus, a high GI meal may promote overeating with insulin dose deviations in either direction: 1) via mesolimbic signaling if hyperglycemia results from inadequate insulin coverage, or 2) via compensatory carbohydrate intake if excessive coverage causes hypoglycemia. Disclosure B.S. Lennerz: None. F. Munsch: None. D.C. Alsop: Other Relationship; Self; General Electric, Hitachi America, Ltd., Philips Healthcare, Siemens Corporation. G.M. Steil: Consultant; Self; Eli Lilly and Company. D.C. Simonson: Stock/Shareholder; Self; GI Windows. Stock/Shareholder; Spouse/Partner; Phase V Technologies, Inc. D.S. Ludwig: None.

1925-P: Beneficial Effects of a Novel Long-Acting Glucagon Analog, HM15136, on Obesity and Obesity-Related Metabolic Disorders in Animal Models

Obesity is a major risk factor for a number of metabolic disorders such as hyperlipidemia, glucose intolerance, and T2DM. Recent researches indicated a stimulatory effect of glucagon (GCG) on energy expenditure and appetite inhibition, suggesting the utilization of GCG as a pharmacological therapy for obesity and related metabolic disorders. In line with this, we previously observed that chronic treatment of HM15136, a novel long-acting glucagon analog, conferred efficient body weight loss (BWL) in DIO mice. Here, we further investigated the potential benefits of HM15136 in obesity-related metabolic disorders. In DIO mice, time-course change in fat mass, liver triglyceride (TG), and fasting blood glucose (FBG) was determined. Chronic treatment of HM15136 was associated with progressive BWL (-37.5% vs. vehicle (Veh) at day17) and fat mass reduction with little effect on lean mass, confirming its potent anti-obesity effect. Interestingly, despite marginal BWL at initial drug treatment period, significant reduction in blood TG (-56.5% vs. Veh at day2) and subsequent liver TG (-41.5% vs. Veh at day7) was achieved, and maintained thereafter. Moreover, the TG lowering both in blood and liver was followed by sustainable FBG lowering, suggesting that rapid depletion of lipid, the main sources for gluconeogenesis, might contribute to FBG control by HM15136. To evaluate the potential effect on post-prandial glucose control, oral glucose tolerance test (oGTT) was performed, and reduced BG level during oGTT was observed as BWL occurred. Time-dependent reduction in HOMA-IR evidenced the insulin sensitivity improvement. To our knowledge, this is the first study demonstrating the potential benefits of chronic GCG engagement in the management of BW, blood lipid, and even BG. Based on these results, HM15136 may be a novel option for the management of obesity and related metabolic disorders. Human study is ongoing for the clinical relevance of these findings. Disclosure J. Lee: Employee; Self; Hanmi Pharmaceutical. S. Lee: Employee; Self; Hanmi Pharmaceutical. J. Choi: Employee; Self; Hanmi Pharmaceutical. E. Park: Employee; Self; Hanmi Pharmaceutical. J. Lee: Employee; Self; Hanmi Pharmaceutical. S. Lee: Employee; Spouse/Partner; Hanmi Pharmaceutical. S. Bae: Employee; Self; Hanmi Pharmaceutical. D. Kim: Board Member; Self; Hanmi Pharmaceutical. I. Choi: Board Member; Self; Hanmi Pharmaceutical.

848-P: Totum-63 Lowers Fasting Glycemia in Subjects with Prediabetes: A Phase 2A Clinical Trial

Over 1 billion people worldwide suffer prediabetes, which is defined by increased fasting blood glucose (FBG), glucose intolerance and/or higher A1c hemoglobin. Prediabetes is considered a risk factor for type 2 diabetes (T2D). We have developed Totum-63, a plant-based product designed to reduce T2D risk factors. In a phase I/II clinical trial, Totum-63 had shown its safety, good tolerance and beneficial effects on post-prandial glucose control in healthy subjects. The aim of this multicentre, randomised and double-blind placebo-controlled phase IIA trial was to show the efficiency of Totum-63 in reducing FBG (primary endpoint) in 51 volunteers with prediabetes (defined by FBG ≥ 1.1 g/l and 2h OGTT glycemia ≥ 1.1 g/l). Secondary endpoints included blood glucose change following an oral glucose tolerance test (OGTT) and anthropometric parameters. Totum-63 (5g/day) or placebo was given to the participants for 6 months. At the end of the supplementation period, FBG was reduced in Totum-63 group compared to placebo group (difference from baseline: -0.04 ± 0.02 vs. +0.09 ± 0.04 g/l, p&amp;lt;0.05). Similarly, 2-hour OGTT glycemia was improved in Totum-63 group, vs. placebo (difference from pre-protocol value: -0.02 ± 0.07 vs. +0.32 ± 0.17 g/l, p&amp;lt;0.05). Moreover, Totum-63 had a significant lowering effect on body weight (-0.07 ± 0.42 vs. +1.83 ± 0.57 Kg; p&amp;lt;0.05) and waist circumference (-1.67 ± 0.73 vs. +2.81 ± 0.65 cm; p&amp;lt;0.001). To conclude, the primary endpoint of this clinical trial was reached, Totum-63 contributed to lower FBG in individuals with prediabetes. Moreover, the response to an OGTT was improved, as well as body weight and waist circumference, thus making Totum-63 a promising candidate for T2D risk prevention. Disclosure S. Peltier: Board Member; Self; Valbiotis. V. Chavanelle: Employee; Self; Valbiotis. Y.F. Otero: Employee; Self; Valbiotis. M. Bargetto: Employee; Self; Valbiotis. M. Cazaubiel: Board Member; Self; Valbiotis. B. Pereira: None. P. Sirvent: Board Member; Self; Valbiotis. J. Bard: Consultant; Self; Biofortis, Valbiotis. Stock/Shareholder; Self; Valbiotis.