Changes In Blood Glucose Levels Research Articles

Impact of preoperative carbohydrate loading on gastric volume in patients with type 2 diabetes

BACKGROUNDEnhanced recovery after surgery advocates that consuming carbohydrates two hours before anesthesia is beneficial to the patient's recovery. Patients with diabetes are prone to delayed gastric emptying. Different guidelines for preoperative carbohydrate consumption in patients with diabetes remain controversial due to concerns about the risk of regurgitation, aspiration and hyperglycemia. Ultrasonic gastric volume (GV) assessment and blood glucose monitoring can comprehensively evaluate the safety and feasibility of preoperative carbohydrate intake in type 2 diabetes (T2D) patients.AIMTo evaluate the impact of preoperative carbohydrate loading on GV before anesthesia induction in T2D patients.METHODSPatients with T2D receiving surgery under general anesthesia from December 2019 to December 2020 were included. A total of 78 patients were randomly allocated to 4 groups receiving 0, 100, 200, or 300 mL of carbohydrate loading 2 h before anesthesia induction. Gastric volume per unit weight (GV/W), Perlas grade, changes in blood glucose level, and risk of reflux and aspiration were evaluated before anesthesia induction.RESULTSNo significant difference was found in GV/W among the groups before anesthesia induction (P > 0.05). The number of patients with Perlas grade II and GV/W > 1.5 mL/kg did not differ among the groups (P > 0.05). Blood glucose level increased by > 2 mmol/L in patients receiving 300 mL carbohydrate drink, which was significantly higher than that in groups 1 and 2 (P < 0.05).CONCLUSIONPreoperative carbohydrate loading < 300 mL 2 h before induction of anesthesia in patients with T2D did not affect GV or increase the risk of reflux and aspiration. Blood glucose levels did not change significantly with preoperative carbohydrate loading of < 200 mL. However, 300 mL carbohydrate loading may increase blood glucose levels in patients with T2D before induction of anesthesia.

Evaluation of Immunogenicity and Safety of Vero Cell-Derived Inactivated COVID-19 Vaccine in Older Patients with Hypertension and Diabetes Mellitus.

Background: To evaluate the immunogenicity and safety of the COVID-19 vaccine (Vero cell), inactivated, in a population aged ≥60 years with hypertension or(/and) diabetes mellitus. Methods: A total of 1440 participants were enrolled and divided into four groups, 330 in the hypertension group, 330 in the diabetes group, 300 in the hypertensive combined with diabetes group (combined disease group), and 480 in the healthy population group. Two doses of the COVID-19 vaccine (Vero cell), inactivated, were administered at a 21-day interval and blood samples were collected before vaccination and 28 days after the second dose to evaluate the immunogenicity. The adverse events and changes in blood pressure and blood glucose levels after vaccination were recorded. Results: The seroconversion rate of the COVID-19 neutralizing antibodies was 100% for all participants. The post-inoculation geometric mean titer (GMT) in the four groups of the hypertension, diabetes, combined disease, and healthy populations were 73.41, 69.93, 73.84, and 74.86, respectively. The seroconversion rates and post-vaccination GMT in the hypertension, diabetes, and combined disease groups were non-inferior to the healthy population group. The rates of vaccine-related adverse reactions were 11.93%, 14.29%, 12.50%, and 9.38%, respectively. No serious adverse events were reported during the study. No apparent abnormal fluctuations in blood pressure and blood glucose values were observed after vaccination in participants with hypertension or(/and) diabetes. Conclusions: The COVID-19 vaccine (Vero cell), inactivated, showed good immunogenicity and safety in patients aged ≥60 years suffering from hypertension or(/and) diabetes mellitus.

Liraglutide treatment attenuates dysfunction-related changes in the cardiac and cerebral microvasculature in streptozotocin-induced diabetic rats

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Novo Nordisk Background Diabetes mellitus (DM) induces cardiac and cerebral microvascular dysfunction via increased glycation, oxidative stress and endothelial activation. Liraglutide, a glucagon-like peptide-1 receptor analogue, inhibited the reactive oxygen species producing enzyme NOX2 and adhesion molecules in isolated endothelial cells. Here we have studied how Liraglutide affects advanced glycation, NOX expression and inflammatory status of the cardiac and cerebral microvasculature in vivo in diabetic rats. Methods DM was induced in Sprague Dawley rats (n=15) via intraperitoneal streptozotocin (STZ) injection (60 mg/kg body weight). 10 control rats remained non-diabetic. From day 9 post-STZ injection, Liraglutide (200 µg/kg bodyweight; n=7) or vehicle (n=8) was injected subcutaneously daily until termination on day 29. The advanced glycation end-product N-ε-(carboxymethyl)lysine (CML), NOX2, NOX4, ICAM-1 and VCAM-1 were subsequently analysed using immunohistochemistry and quantified to compare Liraglutide treatment to placebo. Results DM increased CML, NOX2, ICAM-1 and VCAM-1 in the intramyocardial vasculature, although not significant for NOX2. NOX4 was not significantly increased in the ventricles and absent in the atria. In the cerebral vasculature, CML, NOX2 and NOX4 were significantly increased, but not ICAM-1 and VCAM-1. Liraglutide significantly reduced the DM-associated CML accumulation and expression of NOX2, ICAM-1 and VCAM-1 in the intramyocardial, and CML, NOX2 and NOX4 in the cerebral vasculature. Liraglutide had these effects without changing blood glucose levels or body weight. Conclusions Our study implies that Liraglutide protects the cardiac and cerebral microvasculature against diabetes-induced dysfunction, independent of a blood glucose lowering effect in a type 1 diabetes rat model.

FINERENONE PREVENTS RENAL AND VASCULAR DAMAGE IN A NOVEL MODEL OF TYPE 1 DIABETES MELLITUS

Objective: The non-steroidal mineralocorticoid receptor antagonist (MRA), finerenone (FIN) improves renal and cardiovascular outcomes in patients with chronic kidney disease (CKD) in type 2 diabetes (T2D). We explored the effects of FIN in a novel model of CKD in type 1 diabetes (T1D). Design and method: We employed the Munich Wistar Frömter (MWF) rat model of non-diabetic CKD with mild hypertension and albuminuria to generate a novel model of CKD with T1D. This was achieved by an intra-peritoneal injection of streptozotocin (15 mg/kg) and additional exposure to a high-fat/high-sucrose diet. Oral treatment with FIN (10 mg/kg/day in rat chow) in diabetic animals (MWF-DKD-FIN) was compared to a group of diabetic rats receiving no treatment (MWF-DKD-Control) and a group of non-diabetic untreated MWF rats (MWF). Dietary exposure with or without pharmacological treatment was maintained for 6 weeks (n = 7–10 animals per group). Results: After 6 weeks, MWF-DKD-Control and MWF-DKD-FIN exhibited significantly elevated blood glucose levels (271.7 ± 67.1 mg/dl and 266.3 ± 46.8 mg/dl) as compared to MWF (110.3 ± 4.4 mg/dl; p &lt; 0.05). MWF-DKD-Control showed a 10-fold higher expression of renal damage markers Kim-1 and Ngal compared to MWF. This upregulation was significantly suppressed in MWF-DKD-FIN. FIN treatment resulted in a significant reduction of blood pressure and pulse wave velocity compared to MWF-DKD-Control (p &lt; 0.05). Vascular function studies showed an improvement in endothelial function in MWF-DKD-FIN compared to MWF-DKD-Control due to a reduction in pro-contractile prostaglandins, oxidative stress, and inflammatory cytokines (including IL-1, IL-6, TNFalpha and TGFbeta). FIN induced no changes in blood glucose levels, glucose tolerance or the increase in HOMA index compared to MWF-DKD-Control. Conclusions: Our data show that treatment with FIN improves renal and vascular damage in a new rat model of CKD with T1D. These beneficial effects associated with a reduction in inflammation and oxidative stress and was independent from changes in glucose homeostasis.

LEVERAGING TECHNOLOGY TO SUPPORT PEOPLE LIVING WITH HYPERTENSION AND DIABETES DURING THE COVID-19 PANDEMIC

Objective: The aim of this study is to analyse the impact of a digital self-care intervention during the Covid-19 pandemic on the control of hypertension and diabetes in low-income populations comorbid with these conditions. Design and method: This was a retrospective study of 665 people in Nigeria (213 male, 431 female. Mean age - 58 years) with comorbid diabetes and hypertension enrolled on mDoc's digital self-care CompleteHealth™ platform from March 2020 till November 2021. Through the virtual platform, they were able to track their blood pressure and fasting blood glucose levels as well as co-create action plans with goals suited to achieve the best health outcomes with a virtual health coach. They were given personalised guidance and health education to help control their conditions. The change in blood pressure and fasting blood glucose level was calculated as the difference between the baseline value of the metric (the first value entered on CompleteHealth™) and the average of subsequent values entered on the platform. Results: 600 people (90.2%) had at least 1 interaction with a virtual health coach for a total of 10,030 interactions with the coach-led multidisciplinary team. Of the 665 people included in the study, 407 (61,2%) entered a subsequent blood pressure value, with systolic and diastolic blood pressure declining by an average of 6.25 mmHg and 4.27 mmHg respectively. 68.3% of these people had controlled blood pressure at the end-line, up from 41.8% at the baseline. 50.6% of these people saw an improvement in both systolic and diastolic blood pressure of 19.52 mmHg and 12.63 mmHg respectively. Of the 266 people (40%) who entered multiple blood glucose levels, 31.95% had controlled blood glucose levels with an average decline of 15.5 mmol/L. 58.65% saw an improvement in their blood pressure value of 44.44 mmol/L. Conclusions: Our findings suggest that digital self-care can play a key role in supporting low-income populations living with diabetes and hypertension during the COVID-19 pandemic where restrictions exist on in-person service provision.

N-Acetylcysteine Enhances the Recovery of Ischemic Limb in Type-2 Diabetic Mice

Critical limb ischemia (CLI) is a severe complication of diabetes mellitus that occurs without effective therapy. Excessive reactive oxygen species (ROS) production and oxidative stress play critical roles in the development of diabetic cardiovascular complications. N-acetylcysteine (NAC) reduces ischemia-induced ROS production. The present study aimed to investigate the effect of NAC on the recovery of ischemic limb in an experimental model of type-2 diabetes. TALLYHO/JngJ diabetic and SWR/J non-diabetic mice were used for developing a CLI model. For NAC treatment, mice received NAC (1 mg/mL) in their drinking water for 24 h before initiating CLI, and continuously for the duration of the experiment. Blood flow, mechanical function, histology, expression of antioxidant enzymes including superoxide dismutase (SOD)-1, SOD-3, glutathione peroxidase (Gpx)-1, catalase, and phosphorylated insulin receptor substrate (IRS)-1, Akt, and eNOS in ischemic limb were evaluated in vivo or ex vivo. Body weight, blood glucose, plasma advanced glycation end-products (AGEs), plasma insulin, insulin resistance index, and plasma TNF-a were also evaluated during the experiment. NAC treatment effectively attenuated ROS production with preserved expressions of SOD-1, Gpx-1, catalase, phosphorylated Akt, and eNOS, and enhanced the recovery of blood flow and function of the diabetic ischemic limb. NAC treatment also significantly decreased the levels of phosphorylated IRS-1 (Ser307) expression and plasma TNF-α in diabetic mice without significant changes in blood glucose and AGEs levels. In conclusion, NAC treatment enhanced the recovery of blood flow and mechanical function in ischemic limbs in T2D mice in association with improved tissue redox/inflammatory status and insulin resistance.

Acute Myocardial Infarction in Hyperglycemic Patients with Undiagnosed Diabetes Mellitus. A Clinical Study

Study Design: Current study was conducted from February,2022 to May, 2022 at Emergency, Medical and Cardiological units of The University of Lahore Teaching Hospital Lahore. The aims and objectives of this study was to identify the frequency rate of myocardial infraction in diabetic type-2 patients. Materials and Methods: Sample size: Total 125 individuals were selected for current study, and divided them into three different groups. In Group-A 25 normal individuals, while in Group-B 20 non-diabetic patients with myocardial infraction. Where as in Group-C 80 patients were diabetic with myocardial infraction were selected respectively. Biomarkers: Blood-glucose level, Systolic and Diastolic blood pressure, Troponin I - levels, ECG. Presentation of Data: The collected raw data were bio statistically presented through SPSS version 2020.Variation within the groups were elaborated with the application of mean standard deviation and significant changes were considered according to the (P&lt;0.05). Results: The findings of current study were significant(P&lt;0.05) and a remarkable change in blood glucose level, Systolic and Diastolic blood pressure, Troponin I - levels, ECG of group-B (140.0±0.01, 160±0.03, 90±0.03, 0.07±0.01) and group-C (250.2±0.02, 195±0.02, 105±0.02, 0.20±0.01) were measured and compared with group-A (138.0±0.01, 120±0.01, 75±0.01, 0.03±0.00) respectively. Conclusion: In acute myocardial infarction high blood glucose levels are typical and are linked to a higher risk of mortality in diabetic patients than non-diabetic patients. Keywords: Acute myocardial infarction, Diabetes mellitus, Macrovascular, Troponin-I

MO411: SGLT2 Inhibitors Use in Chronic Kidney Disease-Better Cardiometabolic Profile

Abstract BACKGROUND AND AIMS SGLT2 inhibitors have been shown to reduce kidney and cardiovascular events and slowing the decline of renal function in chronic kidney disease. We have examined the effect of SGLT2 inhibition in our cohort of ambulatory patients METHOD We have included patients with chronic kidney disease, with or without diabetes, fulfilling the criteria for SGLT2 prescription (dapagliflozin and empagliflozin). Eligible patients were started on SGLT2 inhibitors from January to August 2021. Blood pressure, estimated pulse wave velocity, kidney function according to KDIGO; estimated glomerular filtration rate (GFR), chronic kidney disease (CKD) EPI and albuminuria, as well as metabolic profile (lipids, HbA1C, uric acid) measurements were done at the beginning and follow-up. Exclusion criteria were recurrent urinary infection, CKD stage 4 and more, immunosuppressive therapy, diabetes mellitus type 1. Non-parametric statistical tests were used due to sample size, median, 25 and 75 percentile were stated for continuous variables and number and percentage for categorical variables. RESULTS A total of 49 patients were enrolled, the average age of 66 years (min-max ranging from 25–75 years), with male predominance (N = 32, 65%). 48% of them completed the follow-up of 4 months (ranging from 3 to 6). A total of 22% had a history of myocardial infarction and/or cerebrovascular incident. Two patients were excluded due to intolerance, one due to non-adherence and one patient was transferred to another hospital. Patients mostly had chronic kidney disease accompanied by diabetes mellitus (DM) type II (N = 31, 63%), 5 (10%) had glomerulonephritis and others (N = 4) had CKD of other origins. There was expected fall in eGFR (median 58 versus median 53 mL/min/1.73m²; P = 0.036) and rise in creatinine values (median 111 versus median 119 umol/L; P = 0.045). No significant change in proteinuria [median 0.71 (interquartile range, IQR 0.20–1.23) versus median 0.30 (IQR 0.13–0.59); P = 0.060] nor albuminuria (median 72, IQR 19–720 mg/dU versus median 76 IQR 9–334 mg/dU; P = 0.327) was observed. A total of 35 (92.5%) patients were on RAAS blockade and doses of antihypertensive therapy were not upscaled. There was a statistically significant decline in systolic blood pressure (median 136 versus median 132 mmHg; P = .047) and diastolic blood pressure (median 83 versus median 80.9 mmHg; P = 0.041). There was a significant increase in mean arterial pressure (median 99 versus median 101; P = 0.006) and estimated pulse wave velocity (median 7.65 versus median 8.62; P &amp;lt; .001). There was a trend toward reduction of serum uric acid levels (median 334 mmol/L versus median 265mmol/L; P = 0.182). Glycaemic control was improved with significant change in blood glucose levels (median 6.9 mmol/L versus median 6.1 mmol/L; P = 0.03) as well as Hba1c (median 7.2 versus 6.1, P = 0.013). There were no significant adverse effects in our cohort. CONCLUSION SGLT2 inhibitors can be safely used in patients with chronic kidney disease with benefits on blood pressure and metabolic profile which is of utmost importance in this population of very high risk for cardiovascular, as well as, cerebrovascular events. There was a slight decline in kidney function in our cohort which is expected after the initiation of therapy. The effect on estimated pulse wave velocity was not established in our cohort, probably due to the short period of follow-up. Further follow-up of our cohort is needed to establish the lasting effect of SGLT2 inhibitors.

Modelling System of Two Insulin-Glucose Delays to Achieve the Dynamics of Glucose Changes.

Background: Due to the increased prevalence of diabetes and the irreparable complications of this disease, it is important to measure and monitor the blood glucose levels of diabetic patients. The only way to treat type 1 diabetes is monitoring insulin, and in this type of diabetes, insulin should be injected into the body in order to reduce the patient’s blood glucose as prescribed by the physician at certain times. In addition, the only way to treat type 2 diabetes is through diet and exercise daily.Objective: We aim to use an ordinary differential equation model with two-delays to control the rate of changes in blood glucose levels throughout the day, based on the amount of food that the person consumes.Material and Methods: In this analytical study, we extended an ODE model which is parameterized by data collected in this study to capture dynamics of glucose and insulin. We used global sensitivity analysis method to assess model robustness with respect to parameter perturbations.Results: Our results have shown that utilizing the dynamics of changes in blood glucose levels throughout the day can be used to prevent hypoglycemia and hyperglycemic in the diabetic patients.Conclusion: Dynamic modeling can help us to prevent hypoglycemia and hyperglycemia in the diabetic patients.

Atorvastatin reduces alloxan-induced impairment of aversive stimulus memory in mice.

An association between dysregulated glucose levels in patients with diabetes mellitus and detrimental effects on the central nervous system, particularly in Alzheimer disease, has been recognized. Atorvastatin treatment has improved memory and cognition in some patients with diabetes mellitus and Alzheimer disease. To determine possible neuroprotective effects of atorvastatin on memory and cognition by measuring changes in an adverse stimulus avoidance learning deficit induced by alloxan in a murine model of diabetes mellitus and impaired memory and cognition. We administered 150 mg/kg and 100 mg/kg alloxan in saline (intraperitoneally, i.p.) at a 48 h interval to produce a model of diabetes mellitus in male BALB/c mice. An oral glucose tolerance test (OGTT) was used to assess blood glucose regulation. After demonstrating hyperglycemia in mice (n = 7 per group) we administered vehicle (saline, i.p.), atorvastatin (10 mg/kg, i.p.), or liraglutide (200 μg/kg, i.p.) for 28 d except for those in a negative control group, which were given saline instead of alloxan, and a group administered atorvastatin alone, which were given saline instead of alloxan followed by atorvastatin (10 mg/kg, i.p.) for 28 d. Locomotor activity was measured 24 h after the final drug treatments, and subsequently their learned behavioral response to an adverse electrical stimulus to their plantar paw surface in a dark compartment was measured using a passive avoidance apparatus (Ugo Basile) in a model of impaired memory and cognition associated with Alzheimer disease. To determine any deficit in their learned avoidance of the adverse stimulus, we measured the initial latency or time mice spent in an illuminated white compartment before entering the dark compartment in the learning trial, and on the day after learning to avoid the adverse stimulus, the retention period latency in the light compartment and time spent in the dark compartment. Atorvastatin alone produced no significant change in blood glucose levels (F4,10 = 0.80, P = 0.55) within 2 h. Liraglutide decreased blood glucose levels after 0.5 h (F4,10 = 11.7, P < 0.001). We found no significant change in locomotor activity in any group. In mice with alloxan-induced diabetes, atorvastatin significantly attenuated the decreased avoidance associated with the diabetes (F4,30 = 38.0, P = 0.02) and liraglutide also significantly attenuated the decreased avoidance (F4,30 = 38.0, P < 0.001). Atorvastatin alone had no significant effect on the adversive learned response compared with vehicle treatment (F4,30 = 38.0, P > 0.05). Atorvastatin significantly decreased the time mice with alloxan-induced diabetes spent in the dark compartment compared with mice in the diabetes group without atorvastatin treatment (F4,30 = 53.9, P = 0.046). Liraglutide also significantly reduced the time mice with alloxan-induced diabetes spent in the dark compartment compared with vehicle-treated mice with alloxan-induced diabetes (F4,30 = 53.9, P < 0.001). Atorvastatin treatment alone had no significant effect on the time mice spent in dark compartment compared with the control group (F4,30 = 53.9, P > 0.05). Atorvastatin significantly attenuated the adverse stimulus avoidance learning deficit in the alloxan-induced murine model of diabetes suggesting decreased impairment of memory and cognition.

Effects of Sacubitril/Valsartan Versus Telmisartan in Type 2 Diabetic or Pre-Diabetic Patients with Hypertension and Without Heart Failure: The Rationale and Design of A Randomized Clinical Trial.

Sacubitril/valsartan has revealed superior glycemic and blood pressure control compared with enalapril and irbesartan in patients with heart failure and type 2 diabetes and in individuals with chronic kidney disease. However, whether the effects of sacubitril/valsartan remain the same in those without heart failure is unknown. A multicenter randomized double-blinded trial will be carried out in five military hospitals in Taiwan for a period of 1 year. Participants with prior cardiovascular diseases and heart failure will be excluded. The purpose of the study is to compare the effects of sacubitril/valsartan (97/103 mg once or twice daily) on the temporal changes in fasting blood glucose, HbA1c, insulin resistance and blood pressure levels with telmisartan (40 mg once or twice daily) in individuals with stage 1-3 hypertension and newly diagnosed type 2 diabetes or prediabetes who have an HbA1c ≥6.0% and a systolic blood pressure ≥130 mmHg or a diastolic blood pressure ≥85 mmHg. The inclusion criteria include the age of 35-70 years, women who are not pregnant, estimated glomerular filtration rate ≥45 ml/min per 1.73m2 and B-type natriuretic peptide levels <400 pg/ml. The sample size is estimated to be 502 participants for randomization according to an assumption of between-person standard deviation in systolic blood pressure of 15 mmHg or in HbA1c of 1.5%, which provides ≥80% power (at p =0.05) to detect a difference in systolic blood pressure of 4 mmHg or in HbA1c of 0.3% at the final follow-up. All participants will receive a comprehensive physical examination and tests for blood cell counts, blood biochemistry, urine analysis, 12-lead electrocardiography and an echocardiography every 3 months. All analyses will be performed based on the intention-to-treat principle among all randomized participants.

Implementing the Golden Hour Protocol to Improve the Clinical Outcomes in Preterm Infants

Purpose: Since premature infants are sensitive to the changes in blood glucose levels and body temperature, maintaining these parameters is important to avoid the risk of infections. The authors implemented the Golden Hour protocol (GHP) that aims to close the final incubator within one hour of birth by implementing early treatment steps for premature infants after birth, such as maintaining body temperature, securing airway, and rapidly administering glucose fluid and prophylactic antibiotics by securing breathing and rapid blood vessels. This study investigated the effect of GHP application on the short- and long-term clinical outcomes.Methods: We retrospectively analyzed the medical records between 2017 and 2018 before GHP application and between 2019 and 2020 after GHP application in preterm infants aged 24 weeks or older and those aged less than 33 weeks who were admitted to the neonatal intensive care unit.Results: Overall, 117 GHP patients and 81 patients without GHP were compared and analyzed. Peripheral vascularization time and prophylactic antibiotic administration time were shortened in the GHP-treated group (&lt;i&gt;P&lt;/i&gt;=0.007 and &lt;i&gt;P&lt;/i&gt;=0.008). In the short-term results, the GHP-treated group showed reduced hypothermia upon arrival at the neonatal intensive care unit (&lt;i&gt;P&lt;/i&gt;=0.002), and the blood glucose level at 1 hour of hospitalization was higher (&lt;i&gt;P&lt;/i&gt;=0.012). Furthermore, the incidence of neonatal necrotizing enteritis decreased (&lt;i&gt;P&lt;/i&gt;=0.043). As a long-term result, the incidence of BPD was reduced (&lt;i&gt;P&lt;/i&gt;=0.004).Conclusion: We confirmed that applying GHP improved short- and long-term clinical outcomes in premature infants aged &lt;33 weeks age of gestation, and we expect to improve the treatment quality by actively using it for postnatal treatment.

ANTIDIABETIC ACTIVITY OF SWARNA MAKSHIKA BHASMA, SHUDDHA SHILAJATU AND THEIR COMBINATION IN STREPTOZOTOCIN-INDUCED DIABETIC WISTAR RATS

Swarna makshika bhasma and Shilajatu are mentioned by Acharya Sushruta in Madhumeha Chikitsa. These two Rasayanas play a role in glucose and insulin metabolism. The present study was undertaken to assess the anti-diabetic activity in Wistar strain albino rats, thirty-six in number divided into six groups. Streptozotocin was given to induce diabetes. Glibenclamide was used as a standard control drug. Doses of all drugs in each group were according to an accepted standard. Mild diabetic rats (blood sugar &gt; 200 mg/dL) were given medication after their body weight and blood glucose levels were determined. The treatment was maintained on days 7, 14, 21, and 28, and biochemical parameters were calculated. From the fourth day of Streptozotocin induction of diabetes, Makshika bhasma, Shuddha shilajatu and their combination, Glibenclamide, were given once daily. After administration, the effects of Swarna makshika bhasma, Shuddha shilajatu, and Combination of Makshika bhasma and Shuddha shilajatu on bodyweight were statistically non-significant. However, there was a distinction between the before and after-effects. The most remarkable changes in blood glucose levels were reported for Makshika bhasma, Shuddha shilajatu, and Makshika bhasma with Shuddha shilajatu. To conclude, the Combination of Shilajatu and Makshika bhasma is the most efficient and remarkably therapy alternative in Madhumeha. Their multifaceted impact makes them a viable method in the long-term control of diabetes.

The Effect of Indonesian Traditional Music on Stress in Type II Diabetes Mellitus Patients

Diabetes mellitus is a metabolic disorder characterized by an increase in blood glucose levels. Changes in blood glucose levels in type II diabetes mellitus patients can be influenced by many factors, one of which is changes in stress level. Patients with diabetes mellitus type II need not only pharmacology treatments but also non-pharmacology treatments and complementary therapy to reduce their stress. Music therapy is one type of complementary therapy. The purpose of this study was to examine the effect of saluang, which is a form of Indonesian traditional music, on reducing the stress of type II diabetes mellitus patients. The design of this study was quasi-experimental one-group pretest-posttest. There were 20 participants, who were all diagnosed as type II diabetes mellitus patients. Data were collected using the Depression Anxiety Stress Scale (DASS). Data were analyzed using paired sample t-tests. The average stress level of the type II diabetes mellitus patients obtained before receiving saluang music therapy was 22.5 (SD 5.0), and after receiving saluang music therapy the value was 14.5 (SD 2.3); this difference was significant (p &lt; 0.01). Therefore, we can conclude that Indonesian traditional music can be used as therapy to reduce the patient stress level. So, it is recommended that saluang be used as a complementary therapy for type II diabetes mellitus patients.&#x0D; Keywords: Indonesian traditional music, saluang, stress, type II diabetes mellitus

Development of IKatp ion channel blockers targeting sulfonylurea resitant mutant KIR6.2 based channels for treating DEND syndrome

The ATP-sensitive potassium channel (KATP) is a key player in regulating insulin secretion in response to changes in blood glucose levels. KATP channels are octamers comprising four Kir6 subunits, which compose the pore of the complex, and four SUR1 or SUR2A/B proteins, which surround the channel pore. A set of gain-of-function mutations in the Kir6.2 subunit encoding KCNJ11 gene can lead to the rare channelopathy DEND syndrome, which is characterized by a combination of developmental delay, epilepsy and severe neonatal diabetes.

Sufficiently Elevated Core Body Temperature May Be Necessary to Maintain Cerebral Blood Flow Response throughout the Morning

In comparison to a carbohydrate-rich breakfast, a nutritionally balanced breakfast reportedly leads to a higher core body temperature because of diet-induced thermogenesis (DIT) and also results in higher task performance. This study aimed to examine the relationships among the core body temperature, blood glucose level, cerebral blood flow, and cognitive performance when the core body temperature is raised to a similar extent as in DIT in the morning. This crossover study included 18 male participants who performed four sets of cognitive tests in the morning with four different foot baths and glucose intake conditions. In elevated body temperature (EBT) conditions, the core body temperature was increased by a foot bath at 42˚C or 39˚C, while in low body temperature (LBT) conditions, it was maintained at 35˚C by a foot bath; the participants received no glucose or two intakes of 20-g glucose for each thermal condition. In addition to the core body temperature measurement, the cerebral blood flow in the dorsolateral prefrontal cortex (DLPFC) was measured using near-infrared spectroscopy. Three blood collections were performed to measure the changes in blood glucose levels. The results revealed that in the EBT conditions, the core body temperature remained 0.3˚C - 0.5˚C higher than that at wake-up time, while the glucose intake conditions increased blood glucose levels which remained higher than those during fasting. No significant between-treatment difference was observed in the results of cognitive tests. However, the blood flow in the DLPFC increased during the second test period in the EBT/glucose and LBT/glucose conditions, whereas during the fourth test period, it increased solely in the EBT/glucose condition. Thus, in addition to the blood glucose level, an elevated core body temperature within the physiological range may be needed for long-term maintenance of the cerebral blood flow response.

PROJECTING OF COMPLEX HEALTH TRAINING FOR MATURE MEN WITH METABOLIC SYNDROME.

The aim: To identify risk factors for metabolic syndrome; to model, justify and experimentally test the effectiveness of a program of complex health training for mature men with MS. Materials and methods: Theoretical - analysis, generalization, pedagogical observation, modelling; empirical - methods of implementation of the results in practice (pedagogical experiment involving 50 mature menwho had no contraindications to training), methods of monitoring and measuring of physical evolvement, body systems functional status (samples: Rufier, Stange), general performance level (Harvard step test), medical indicators (blood glucose level, arterial tension). Results: A complex organized health training program (graduated, systematic, all-round motor activity managed by an instructor) showed better results (24,5 %) compared an independent health training system(15,2 %). Both types of activity contributed to weight loss(CG2 - 10,1 %; EG2 - 15,5 %) and reduction of body parts overall size; functional improvement of cardiovascular and respiratory systems of the male body, in particular in the indicators of the Stange test (CG2 - 29,8 %,EG2 - 33,9 %), Ruffier index (CG2 - 5,8 %, EG2 - 23,0 %) and step test (CG2 - 15,8 %, EG2 - 26,9 %); positive changes in blood glucose levels (CG2 - 20,7 %, EG2 - 31,5 %) andarterial tension (CG2 - 6,2 %, EG2 - 9,8 %); development of different muscle groupsstrength endurance. Сonclusions: Positive changes according to the studied indicators show the decrease in risk factors for mature men metabolic syndrome and thereby preventingcomplications.

Association of Glycosylated Albumin Level with Gestational Diabetes Mellitus

Background: Gestational Diabetes Mellitus (GDM) is a common medical disorder detected during pregnancy with adverse consequences on the health of the mother and the fetus. Glycosylated hemoglobin (HbA1c) is an important parameter of glycemic control in patients with diabetes mellitus. However, it only reflects the long-term glycemic status, but can’t reflect short term glycemic control. It has also been demonstrated that HbA1c does not reflect glycemic control accurately during pregnancy because of iron deficiency. But Glycosylated Albumin (GA) reflects average blood glucose within 2-3 weeks and is not influenced by iron deficiency. Therefore, glycosylated albumin may be used to measure recent changes in blood glucose level in GDM patients. The aim of the study is to evaluate the association of glycosylated albumin and glycemic status in GDM.&#x0D; Materials and methods: This case control study was carried out in the Department of Obstetrics &amp; Gynecology, Bangabandhu Sheikh Mujib Medical University, BSMMU, Dhaka between August 2017 and December 2018. Atotal of 140 pregnant women between 18-35 years of age attending outdoor antenatal clinic in their second and third trimester of pregnancy were enrolled in this study. Among them 70 diagnosed case of GDM were considered as group I and rest 70 non-diabetic pregnant women were considered as control and group II. Plasma glycosylated albumin was measured in all of these patients. Statistical analysis of the results was obtained by using Windows based computer software devised with Statistical Packages for Social Sciences (SPSS-22).&#x0D; Results: The mean glycosylated albumin was 17.12±2.00 (%) in group I and 12.90±1.03 (%) in group II. The difference was statistically significant (p&lt;0.05) between two groups. There was a positive significant moderate correlation (r=0.643, p=0.001) between glycosylated albumin (%) and 2 hours after 75 gm glucose in GDM patients. There was also a positive significant weak correlation (r=0.258, p=0.031) between GA and FBS in GDM patients.&#x0D; Conclusion: A significant positive association was found between glycemic status in GDM and maternal glycosylated albumin levels. Therefore,glycosylated albumin may be applied to reflect the average blood glucose status in pregnant women with GDM.&#x0D; JCMCTA 2021 ; 32 (2) : 64-69

The impact of diabetes mellitus and hyperglycaemia on the refractive status of the eye

Purpose. Diabetes mellitus is a condition of considerable concern globally, which can affect the visual system in various ways, including changes to visual function, the integrity of the ocular surface and the retinal microcirculation. The aim of this article is to provide an overview on the perspectives around the relationship between diabetes and refractive status. Material and Methods. Narrative literature review. Results. The relationship between diabetes, hyperglycaemia and refractive error has been of interest to clinicians and researchers for more than a century. This review shows that research studies investigating the relationship have varied considerably in their design, methodology, their outcome measures used as well as their reported results. While some uncertainty remains, there is evidence that short-term, drastic changes in blood glucose levels affect the refractive status of human eyes leading to fluctuating and blurred vision. Conclusion. Patients starting glycaemic treatment or under- going adaptation to a new treatment regime may present with considerable refractive changes and visual complaints. Before considering the prescription of spectacle lenses, clinicians should ideally monitor patients in whom glycaemic control has been initiated or is being adjusted until a stabilisation of blood glucose levels has been confirmed. Keywords Diabetes, refraction, refractive error, variability

In-vivo Antidiabetic Activity of Saccharum Spontaneum on STZ- Induced Diabetic Mice

Objectives: Saccharum spontaneum is traditionally used in Arunachal Pradesh, India for the treatment of diabetes mellitus. Review of existing literature, found no scientific investigation on this claim. Therefore, this study was aim to evaluate the antidiabetic effect of ethanolic extract of S. spontaneum on STZ induced diabetic mice.&#x0D; Materials and Methods: Diabetes was induced in male albino mice by single intraperitoneal injection of streptozotocin (100mgkg-1 BW). Initially Starch tolerance test, blood glucose level and area under the curve (AUC) were evaluated after S. spontaneum treatment in diabetic mice. The test extract was administered for three weeks and the antidiabetic activity was evaluated by means of monitoring the change in blood glucose level, body weight and biochemical parameters.&#x0D; Results: The extract showed a significant decrease in the blood glucose level, slight enhancement of body weight after the treatment. Daily oral treatment of extract also showed a significant reduction in the Serum ALT, creatinine and triglyceride when compared to the diabetic control.&#x0D; Conclusion: The results provide supports to the traditional claim made on Saccharum spontaneumand provide evidence that this plant might be a potential source of antidiabetic agent.