Changes In Fasting Blood Glucose Research Articles

Moderate Consumption of Red Meat, Compared to Soy or Non-Soy Legume, Has No Adverse Effect on Cardio-Metabolic Factors in Patients with Type 2 Diabetes.

Recently, it has been proposed that red meat consumption could enhance risk of diabetes and worsen lipid profile and glycemic status, in comparison with soy or non-soy legume, but the results of clinical trials are controversial. This study aimed to compare the effect of red meat, soy bean, and non-soy legume consumption on cardio-metabolic factors in patients with type 2 diabetes. This was a randomized controlled clinical trial which included 75 patients with diabetes, aged 40-65 years. Participants were randomly allocated to receive two servings of red meat (control group), soy bean, or non-soy legume, 3 days a week for 8 weeks. All groups also received a balanced-macronutrients weight maintenance diet. Body composition and cardio-metabolic factors including fasting blood glucose (FBG), fasting insulin, glycated hemoglobin (HbA1c), serum lipids, and blood pressure were measured at baseline and endpoint of the study. Quantitative insulin sensitivity check index (QUICKI) score and Framingham risk score (FRS) were also computed. We found no significant differences in changes of FBG, fasting insulin, HbA1c, QUICKI score, serum lipids, FRS, and systolic and diastolic blood pressure among the 3 groups. Within group analysis showed that FRS reduced significantly in all groups (P<0.05). In addition, systolic (P=0.01) and diastolic (P=0.03) blood pressure reduced within red meat group. Compared to soy bean or non-soy legume, moderate consumption of red meat had no adverse effect on cardio-metabolic factors including FBG, fasting insulin, HbA1C, QUICKI score, total cholesterol, low-density lipoprotein , high-density lipoprotein , and blood pressure in adults with type 2 diabetes.

2432-PUB: Predictors of Imminent Glycemic Worsening in Adults with Screen-Detected Diabetes

Reliable clinical indicators of near-term risk of worsening glycemia in type 2 diabetes (T2D) could help guide individual-level interventions. Here we analyzed data from the Early Diabetes Intervention Program (EDIP) to identify predictors of near-term glycemic progression. EDIP evaluated progression of fasting blood glucose (FBG) above 140 mg/dl on consecutive quarterly measurements in individuals with screen-detected T2D and FBG below 140 at study entry (age 52.6 + 11.5 years, 41.9% male, mean entry FBG 121±14 mg/dL; mean 2-hour OGTT glucose 236±30; mean HbA1C 6.4+0.57%). We investigated accessible clinical parameters (weight, glycemia, lipids, and insulin levels) as potential near-term predictors of progression, evaluating absolute levels and yearly changes preceding progression. Variables were evaluated individually in age/sex/race-adjusted analyses and in combination in multivariable Cox progression models. Change over the preceding 1 year in fasting glucose, but not in weight or insulin levels, was predictive of glycemic progression in the subsequent year in adjusted univariate analyses (p&amp;lt;0.03). In multivariable modeling, the FBG concentration (hazard ratio HR 1.14) and the antecedent 1-year change in FBG (HR 0.90) were the strongest predictors of progression, and both retained significance in multivariable models including all specified variables (p&amp;lt; 0.0001). Adding changes in fasting insulin, HOMA-IR, or oral disposition index to the modeling did not change this result. There was a significant correlation between current FBG and the antecedent 1-year change (r=0.587; p&amp;lt;0.01), highlighting that change in FBG was contributing in part via its effect on current FBG. In the EDIP study population with screen-detected T2D, current FBG and antecedent 1-year change in FBG were the best predictors of upcoming glycemic worsening. These data underscore the value of serially monitoring fasting glucose, and suggest a similar monitoring paradigm should be evaluated in prediabetes. Disclosure R.S. Aguirre: None. T.S. Hannon: Advisory Panel; Self; Eli Lilly and Company. R. Considine: None. M. Kirkman: Research Support; Self; Bayer AG, Novo Nordisk A/S, Theracos, Inc. K.J. Mather: Advisory Panel; Self; Roche Diabetes Care. Research Support; Self; Abbott, Merck &amp; Co., Inc., Novo Nordisk A/S, Sanofi.

A Propensity Score Matched Comparison of Brand and Biosimilar Basal Insulin in Non-Critical Hospitalized Patients with Type 2 Diabetes Mellitus.

IntroductionComparisons between brand and biosimilar basal insulin in hospitalized patients are lacking. We aimed to compare the efficacy and safety of brand insulin glargine vs. biosimilar insulin glargine in non-critical hospitalized patients with type 2 diabetes mellitus (T2DM).MethodsThis retrospective study was conducted using the electronic medical records of 194,006 patients at the Qingdao Endocrine and Diabetes Hospital between January 2006 and December 2017. A total of 476 patients diagnosed with T2DM, hospitalized, and treated with subcutaneous insulin glargine were included. After propensity score matching (1:3), patients who received biosimilar insulin glargine (Basalin) (n = 34) were compared to a matched group of patients who received brand insulin glargine (Lantus) (n = 101). Outcome measures were changes in fasting blood glucose (FBG), the incidence of hypoglycemia, and insulin dose.ResultsCompared to patients who received Basalin, patients who received Lantus achieved more reduction in FBG during insulin treatment (− 1.24 mmol/L vs. − 2.20 mmol/L; p = 0.04) and had a lower mean FBG at the end of treatment (8.20 mmol/L vs. 7.26 mmol/L; p = 0.12). Patients in Basalin and Lantus groups had a comparable mean daily dose of basal insulin at initiation (0.19 vs. 0.18 IU/kg; p = 0.30) and end of treatment (0.21 vs. 0.21 IU/kg; p = 0.99), and a similar duration of basal insulin treatment (16.4 vs. 15.3 days; p = 0.74). Hypoglycemia was infrequent in both Basalin and Lantus treatment (one vs. four patients, respectively; p = 1.00) and no severe hypoglycemic events were reported.ConclusionIn a non-critical hospital setting, subcutaneous treatment with Lantus brought significant FBG improvement without increased hypoglycemic risk.

OREXIN-1-RECEPTOR BLOCKER, SB-334867 MAY AFFECT BODY WEIGHT AND PROTECT AGAINST HYPOGLYCEMIA INDUCED BY PARADOXICAL SLEEP DEPRIVATION IN ADULT MALE RATS

Background: Sleep deprivation (SD) can affect health through its effects on many systems. Orexin is involved in regulation of many physiological functions including sleep. This can give an explanation and a way of protection against some hazards of SD. Aim: To test the protective effect of orexin-1 receptor (OX1R) blocker, SB-334867 on changes in food intake, blood glucose level and insulin sensitivity caused by SD. Method: 72 adult male rats arranged in 4 equal groups: control group, SD group, SD-OX1R blocked group & SD-DMSO group. The 3 SD groups are subjected to 8 days of paradoxical SD using the modified multiple platform method. The SD-OX1R blocked group was injected intraperitoneally daily with single dose of SB-334867 dissolved in 2 ml DMSO and diluted 1:1000 in saline (3 mg/kg/day). The SD-DMSO group was injected by DMSO alone. Food intake, body weight, blood fasting glucose & insulin levels were assessed and insulin resistance was calculated using HOMA-IR formula. Results: The SD and SD-DMSO groups showed loss of weight inspite of increased food intake plus hypoglycemia with increased insulin sensitivity. The SD-OX1R blocked group showed no significant change in food intake but more drop in body weight plus delayed changes in fasting blood glucose and insulin sensitivity. Conclusion: SD can affect health through its effect on food intake and induction of hypoglycemia. OX1R blocker, SB-334867 protects against the increase in food intake and delays increased insulin sensitivity and subsequent hypoglycemia. So, orexin most probably is a mechanism by which SD causes these changes.

Efficacy of behavior change communication using mobile calls on glycemic control among Type 2 diabetic patients in an urban area of Pondicherry, South India: A randomized controlled trial.

CONTEXT:Lifestyle modifications play a major role in controlling blood glucose levels among diabetes mellitus for the prevention of its complications. Mobile phones can be used as an efficient tool for improving the healthy lifestyle through health education.AIMS:The aim of the study is to measure the efficacy of behavior change communication using mobile calls in controlling blood sugar levels, increasing medication adherence, healthy diet, and physical activity among diabetic patients.SETTINGS AND DESIGN:A randomized controlled trial was conducted in an urban area of Pondicherry between 50 (25 per arm) type 2 diabetes patients.SUBJECTS AND METHODS:All participants were interviewed using a structured questionnaire. Fasting blood glucose (FBG) was measured. Single-time health education was given to both groups. The intervention group received a mobile phone calls reminders thrice weekly for 2 months. Changes in FBG, diet, physical activities, and adherence to medications were assessed after 2 months.STATISTICAL ANALYSIS USED:Means and proportions were calculated. Chi-square test and paired t-test were used to calculate the P value.RESULTS:FBG increased significantly in the control group by 25.6 mg/dl (P = 0.03), whereas it was only 6.5 mg/dl in the intervention group (P = 0.56). Adherence to medications was increased significantly in both interventions (+21%) and control (+19%) groups. Number of fruits intake days per week (+1, P = 0.01) and fruits serving per day (+0.5, P = 0.00) have increased significantly in the intervention group. Recreational physical activity was increased in the intervention group but not statistically significant.CONCLUSION:Our study findings suggest that mobile phone calls might help to improve glycemic control. It also suggests that it could improve the adherence to medications and intake of fruits. In the future, studies with large sample size and longer intervention need to be conducted.

Therapeutic Effect of Okra (Abelmoschus esculentus Moench) Pods Extract on Streptozotocin-Induced Type-2 Diabetic Mice

The aims of this study were to determine the effect of various fractions of okra pods extract (VOPE) to the changes of fasting blood glucose, serum insulin, and GLUT4 density on streptozotocin-induced type-2 diabetic mice. This study employed 36 male Balb/c strain mice. The samples were divided into seven groups, KN (normal control), KD (diabetic control), KA (acarbose control), EK (crude extract), NP (non-polar), SP (semipolar), and EP (polar). VOPE and acarbose were administered orally for 14 days in streptozotocin-induced type2 diabetic mice. Mice with type-2 diabetes mellitus were induced by the intraperitoneal injection of multiple low-dose streptozotocin (30 mg/kg body weight) daily for five consecutive days. On 15th day, mice were terminated. The data of fasting blood glucose, serum insulin, and GLUT4 density were analyzed and interestingly it showed that the administration of VOPE could ameliorate the fasting blood glucose, serum insulin, and GLUT4 density. Therefore, it can be suggested that VOPE can be regarded as a promising antidiabetic agent in the streptozotocin-induced diabetic mice.

Effect of Bedtime Melatonin Administration in Patients with Type 2 Diabetes: A Triple-Blind, Placebo-Controlled, Randomized Trial.

Melatonin is widely available as over the counter product. Despite promising effects of melatonin supplementation on glycemic control, there is a significant heterogeneity between studies. The current study aimed at determining the effect of melatonin on fasting blood glucose (FBG), insulin resistance/sensitivity indices, glycosylated hemoglobin A1c (HbA1c), and high sensitivity C-reactive protein (hs-CRP) among type 2 diabetes mellitus (T2D) population during 8 weeks in a randomized, triple-blind, placebo-controlled trial. Thirty four subjects with the mean age ± standard deviation of 57.74 ± 8.57 years and 36 subjects with the mean age of 57.61 ± 9.11 years were allocated to 6 mg nightly melatonin and placebo groups, respectively. Melatonin and placebo groups were matched by age, gender, body mass index, and duration of diabetes. Also, there was no significant difference in laboratory findings except for HbA1c, which was lower in the placebo group (7.00 ± 0.89% vs 7.60 ± 1.47%, P=0.042). After trial completion, the increase of serum levels of melatonin was greater in the intervention than the placebo group (3.38 ± 1.33 vs 0.94 ± 1.28 ng/L, P=0.192). Moreover, compared to placebo group, among melatonin users, homeostasis model assessment of insulin resistance (HOMA1-IR) tended to be unfavorable at the end of follow-up [-0.51 (-1.76-0.81) vs. 0.28 (-1.24-1.74), P=0.20]; the similar trend was also shown for insulin sensitivity index (HOMA1-S) [2.33 (-3.59-12.46) vs. -2.33 (-10.61-9.16), P=0.148]. No differences were observed in FBG, HbA1C, and hs-CRP changes between the trial groups. The current study did not support the improving effect of melatonin on glucose homeostasis.

The Effect of Vitamin D3 and Co-enzyme Q10 Supplementation on Metabolic Biomarkers in Women with Clomiphene Citrate Resistant Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) one of the most common endocrine disorders in women of reproductive age, the pathogenesis of PCOS imitated to be as a vicious cycle involving both hyperandrogenaemia and insulin resistance/hyperinsulinemia. Vitamin D deficiency (VDD) is common among women with PCOS (approximately 67%–85% women with PCOS have VDD). Vitamin D3 and CoQ10 could affect glucose metabolism and insulin sensitivity and improve metabolic abnormalities in PCOS. The study was designed to evaluate the effect of combining oral vitamin D3 tablet or CoQ10 capsule with clomiphene citrate on metabolic biomarkers in women with clomiphene citrate resistance PCOS patients. A prospective interventional randomized-controlled, open-label study include 41 PCOS patients aged range (18-34)years who are clomiphene citrate resistant divided into two groups, group 1 (n=24) whose endogenous vitamin D status less than 20ng/ml receive clomiphene citrate 100mg daily(for 5 days monthly induction) plus vitamin D 10000IU daily (2 months) and group 2 (n=17) whose endogenous vitamin D status equal or more than 20ng/ml receive clomiphene citrate 100mg daily(for 5 days monthly induction) plus CoQ10 200mg daily (2 months). Fasting blood samples were taken at baseline and 2 months after intervention to measure metabolic biomarkers [fasting serum insulin (FSI), fasting blood glucose (FBG), homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI)]. After 2 months both interventions result in non-significant change in FSI and FBG while HOMA-IR and QUICKI decreased by both interventions, but the decrease is significant only with CoQ10 supplementations. In conclusion, Vitamin D and CoQ10 supplementation result in improvement in HOMA-IR and QUICKI but the improvement was more obvious in CoQ10 group.

The Effect of Vitamin D3 and Co-enzyme Q10 Supplementation on Metabolic Biomarkers in Women with Clomiphene Citrate Resistant Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) one of the most common endocrine disorders in women of reproductive age, the pathogenesis of PCOS imitated to be as a vicious cycle involving both hyperandrogenaemia and insulin resistance/hyperinsulinemia. Vitamin D deficiency (VDD) is common among women with PCOS (approximately 67%–85% women with PCOS have VDD). Vitamin D3 and CoQ10 could affect glucose metabolism and insulin sensitivity and improve metabolic abnormalities in PCOS. The study was designed to evaluate the effect of combining oral vitamin D3 tablet or CoQ10 capsule with clomiphene citrate on metabolic biomarkers in women with clomiphene citrate resistance PCOS patients. A prospective interventional randomized-controlled, open-label study include 41 PCOS patients aged range (18-34)years who are clomiphene citrate resistant divided into two groups, group 1 (n=24) whose endogenous vitamin D status less than 20ng/ml receive clomiphene citrate 100mg daily(for 5 days monthly induction) plus vitamin D 10000IU daily (2 months) and group 2 (n=17) whose endogenous vitamin D status equal or more than 20ng/ml receive clomiphene citrate 100mg daily(for 5 days monthly induction) plus CoQ10 200mg daily (2 months). Fasting blood samples were taken at baseline and 2 months after intervention to measure metabolic biomarkers [fasting serum insulin (FSI), fasting blood glucose (FBG), homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI)]. After 2 months both interventions result in non-significant change in FSI and FBG while HOMA-IR and QUICKI decreased by both interventions, but the decrease is significant only with CoQ10 supplementations. In conclusion, Vitamin D and CoQ10 supplementation result in improvement in HOMA-IR and QUICKI but the improvement was more obvious in CoQ10 group.

Jadenu Substituting Exjade in Beta Thalassemia Major (BTM) Patients with Iron Overload: Effect on Serum Ferritin Concentration, Liver Iron Content and Biochemical Profiles

Thalassemia major (TM) requires chronic blood transfusions ultimately cause iron overload and subsequently end-organ damage unless corrected. Iron chelation has been proven to decrease organ dysfunction and improve survival in transfusion-dependent β-thalassemia. However, taking iron chelation therapy every day has sometimes been a challenge in patients. Deferasirox is a once-daily, oral iron chelator that developed out of a need for a long-acting chelator. The approved mode of administration requires taking deferasirox on an empty stomach with water, apple juice, or orange juice to limit variation in bioavailability. This required administration schedule might not be palatable for patients. Additionally, approximately one-quarter of patients experience mild to moderate gastrointestinal symptoms, which may pose additional challenges.Jadenu is a new oral formulation of Exjade tablets for oral suspension. While Exjade is a dispersible tablet that must be mixed in liquid and taken on an empty stomach ,Jadnu can be taken in a single step, with or without a light meal, simplifying administration of treatment and allows greater convenience and may be associated with fewer gastrointestinal side effects versus the original formulation. This may significantly improve compliance. In addition, the new formulation may be associated increased bioavailability.Jadenu is 36% more bioavailable than the original formulation, Exjade®. Therefore, to convert from Exjade to Jadenu the dose of Jadenu should be about 30% lower, rounded to the nearest whole tablet. To date, the new formulation of deferasirox has only been evaluated in pharmacokinetic studies in healthy volunteers. No clinical data are available yet in patients taking this formulation.The objective of this study was to compare the effect of Jadenu substituting Exjade on serum Ferritin concentration, liver iron content and biochemical profile in (BTM) patients with iron overload.Patients and Methods:Twelve adult patients with BTM were studied. All patients were on regular packed cell transfusion therapy monthly to keep their Hb not less than 9 g/dl before transfusion. They were on Exjade therapy (30 mg/kg per day) for 5 years or more before changing them to Jadenu therapy (14-28mg/kg/day).We evaluated Serum ferritin and the liver iron (LIC) measured by the Ferriscan method. Investigations included measuring hepatic functions (alanine transferase (ALT), aspartate transferase (AST), alkaline phosphatase (ALP) and albumin) , creatinine and fasting blood glucose (FBG) every clinic visit (q 3 months). In addition thyroid function (free T4 (FT4), thyrotropin (TSH), 25 OH vitamin D and PTH levels were measured before and one year after starting Jadenu therapy. Patients were monitored for gastrointestinal and other reported side-effects related to the drugs. All patients were on vitamin D 800 U/day and folic acid 5 mg / day.Paired t student test was used to compare lab results before versus after Jadenu treatment. Linear regression equation was used to investigate possible relation between variables.ResultsA year after treating patients with Jadenu serum ALT decreased (non-significant) but there was no significant change in circulating concentrations of creatinine, albumin, ALP or FBG. (Table 1) Apart from some gastrointestinal complaints reported in 3 patients that did not require discontinuation of therapy, patients did not have any other side effects.There was a non-significant decrease in LIC and ferritin levels after 1 year of using Jadenu. Thyroid and parathyroid hormone did not change during Jadenu therapy. (Table 2)A positive significant correlation was found between serum ferritin level and LIC measured by ferriscan method. LIC and serum ferritin level were correlated significantly with ALT level ( r = 0.31 and 0.45 respectively, p < 0.05) . No significant correlation was detected between LIC and other biochemical or hormonal levels.This study showed that the use of Jadenu after Exjade was associated with non-significant decrease in liver iron and ALT. There was no change in FBG, creatinine albumin or thyroid function. No side effects required discontinuation of the medicine.Conclusion:Jadenu is more palatable and improve quality of life for patients with BTM, however it was associated with minimal decrease in LIC and ALT level suggesting marginal improvement of iron chelation probably due to easier administration. DisclosuresNo relevant conflicts of interest to declare.

Efficacy and safety of substituting teneligliptin with hydroxychloroquine in inadequately controlled type 2 diabetes subjects with combination therapy of teneligliptin, metformin and glimepiride with or without other antidiabetic therapy: The TENE-HYQ SHIFT Study

Introduction. To confirm the efficacy and safety of substituting teneligliptin with hydroxychloroquine in inadequately control type 2 diabetes patients (T2DM) despite treatment with teneligliptin, metformin and glimepiride with or without other antidiabetic therapy. Material and methods. This is a multicentre observational, retrospective, 24 week clinical study performed in type 2 diabetes patients with HbA1c in the range of 7.5% to 9.5%. This patients were on teneligliptin 20 mg in addition of metformin and glimepiride with or without other antidiabetic therapy. Teneligliptin 20 mg treatment was replaced by hydroxychloroquine 400 mg. The primary endpoint was change in fasting blood glucose (FBG), postprandial blood glucose (PPBG) and HbA1c from baseline to week 24. The secondary outcome of the study was the proportion of patients who achieved good glycaemic control (HbA1c Results. Total of 500 patients’ data was analysed and after 24 week of follow up these patients presented with significant decrease in HbA1c (–1.1 ± 0.17%; p = 0.000); FBG (–29.87 ± 8.9 mg/dl), PPBG (–56.89 ± 9.2 mg/dl) with 52% of patients had achieved HbA1c levels Conclusions. In T2DM patients inadequately controlled on teneligliptin 20 mg along with combination of metformin and glimepiride with or without other antidiabetic therapy, substitute with hydroxychloroquine 400 mg may be a simple yet effective therapeutic option with clinical benefit beyond strict glycemic control without compromising patient’s safety.

Renoprotection Provided by Dipeptidyl Peptidase-4 Inhibitors in Combination with Angiotensin Receptor Blockers in Patients with Type 2 Diabetic Nephropathy.

Background:Treatment with the dipeptidyl peptidase-4 inhibitors (DPP4i) and angiotensin receptor blockers (ARBs) in patients with type 2 diabetic nephropathy (DN) has not been well characterized. This study aimed to assess the renoprotection of this combined treatment in DN patients.Methods:A total of 159 type 2 DN patients from 2013 to 2015 were enrolled retrospectively from a prospective DN cohort at the National Clinical Research Center of Kidney Diseases, Jinling Hospital (China). Fifty-seven patients received DPP4i and ARB treatment, and 102 patients were treated with ARBs alone. All patients were followed up for at least 12 months. Statistical analyses were performed using Stata version 12.0.Results:There were no significant differences at baseline for age, sex, body mass index, duration of diabetes, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), and estimated glomerular filtration rate (eGFR) between the two groups. Antihypertensive and antidiabetic medication use was similar in each group except calcium channel antagonists (P = 0.032). No significant changes in FBG and HbA1c were observed in the two groups after treatment. The eGFR decreased slower in the DPP4i + ARB group than in the ARB group at 12 months (Δ12 months: −2.48 ± 13.86 vs. −6.81 ± 12.52 ml·min–1·1.73m–2, P = 0.044). In addition, proteinuria was decreased further in the DPP4i + ARB group than in the ARB group after 24 months of treatment (Δ24 months: −0.18 [−1.00, 0.17] vs. 0.32 [−0.35, 0.88], P = 0.031). There were 36 patients with an eGFR decrease of more than 30% over 24 months. After adjusting for FBG, HbA1c, and other risk factors, DPP4i + ARB treatment was still associated with a reduced incidence of an eGFR decrease of 20% or 30%.Conclusions:The combined treatment of DPP4i and ARBs is superior to ARBs alone, as evidenced by the greater proteinuria reduction and lower eGFR decline. In addition, the renoprotection of DPP4i combined with ARBs was independent of glycemic control.

Two Glucose-Lowering Mechanisms of Canagliflozin Depending on Body Weight Changes in Drug-Naïve Subjects with Type 2 Diabetes

ObjectivesThe aim of this study was to investigate the relations between the changes in body weight and those of glycemic and non-glycemic parameters in drug-naïve subjects with type 2 diabetes mellitus (T2DM) treated with canagliflozin monotherapy.MethodsSubjects received 50–100 mg/day canagliflozin monotherapy for 3 months (n = 36), and were then divided into two groups: (1) those who lost weight [changes in (Δ)BMI ≤ − 0.45, p < 0.00001: Group L(ost), n = 20); and (2) those who did not lose weight [ΔBMI > − 0.45, p = non-significant: Group N(eutral), n = 16]. At 3 months, the levels of glycemic and non-glycemic parameters were compared with those at baseline.ResultsSignificant reductions of BMI levels (− 2.1%, p < 0.00001) were observed for the overall subjects. At baseline, fasting blood glucose (FBG) and HbA1c levels were significantly higher, and homeostasis model assessment-B (HOMA-B) levels were significantly lower in Group N versus Group L. Similar reductions of HbA1c (Group L: 9.54 ± 2.58% to 7.54 ± 1.27%, p < 0.05; Group N: 11.23 ± 2.27% to 9.19 ± 1.64%, p < 0.0002) and homeostasis model assessment-R (HOMA-R; Group L: − 32.3%, p < 0.005; Group N: − 36.5%, p < 0.02) levels were seen in these two groups. However, other parameters showed distinct regulatory patterns. (1) Group L: significant reductions in uric acid (UA) levels (− 6.9%, p < 0.02) were observed. Significant correlations between the changes in FBG and HOMA-R (R = 0.458, p < 0.05) were seen. (2) Group N: significant increases in HOMA-B (+ 69.4%, p < 0.007) and reductions in free fatty acid (FFA; − 25.8%, p < 0.02) levels were observed. Significant negative or positive correlations between the changes in (Δ)FBG and ΔHOMA-B (R = − 0.557, p < 0.03), and between ΔFBG and ΔHOMA-R (R = 0.458, p < 0.05) were seen.ConclusionsThese results indicate that (1) body weight changes with canagliflozin were not associated with its glycemic efficacy; and (2) distinct glucose-lowering pathways may exist with canagliflozin, reducing insulin resistance in those who lose weight and enhancing β-cell function, as well as reducing insulin resistance, possibly via the decreased FFA levels, in those who do not lose weight.

The effect of drinking cold water on fasting blood glucose, urea, uric acid, creatinine, liver transaminase enzymes activities, lipid profiles and thyroid hormones in ratsfiles and thyroid hormones in rats

Background: The current study was designed to investigate the changes of fasting blood glucose (FBG ), urea, uric acid, creatinine, aminotransferase (AST), alanine aminotransferase (ALT), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), very low-density lipoprotein cholesterol (VLDL-c), high-density lipoprotein cholesterol (HDL-c), thyroid-stimulating hormone (TSH), thyroxin (T4) and triiodothyronine (T3) of rats after long-term drinking of cold water. Materials & Methods: In this experimental study, 12 adult male Wistar rats weighting 220-200 g were used. The rats were divided into 2 equal groups including, control and experimental groups. The control and experimental groups received normal water (20 ° C) and cold water (4 ° C) for 60 days, respectively. At the end of the 60 days, blood was taken from the heart of animals. After separating the serum, concentration of FBG, urea, uric acid and creatinine, ALT, AST, TG, TC, HDL-c were assayed by spectrophotometer and LDL-c, VLDL-c were calculated by the Friedewald formula. The serum concentrations of TSH, T4 and T3 were identified by ELISA. Results: Results showed that cold water significantly increased the levels of ALT,AST,TG, LDL,VLDL,TSH,T4 and T3 (P<0.05) and had no significant effect on urea, uric acid, creatinine, TC and HDL levels in experimental group compared to control group. Conclusion: Cold water can have a devastating effect on the metabolism of the body in the long-term. Although more studies are needed.

Effect of Coenzyme Q10 on Insulin Resistance in Korean Patients with Prediabetes: A Pilot Single-Center, Randomized, Double-Blind, Placebo-Controlled Study.

Introduction This study aimed to examine whether administration of coenzyme Q10, an antioxidant, improves insulin resistance in patients with prediabetes. The study design was a pilot single-center, randomized, double-blind, placebo-controlled trial. Methods This pilot single-center, randomized, double-blind, placebo-controlled trial included a total of 80 adults (aged ≥20 years) with impaired glucose tolerance. After the initial screening visit, subjects were assigned to either the experimental (n = 40) or placebo (n = 40) group via simple randomization. Insulin resistance was represented as the insulin resistance index estimated by homeostasis model assessment (HOMA-IR). Results After the 8-week treatment period, the coenzyme group exhibited a significant decrease in the HOMA-IR (P < .001). The free oxygen radical and coenzyme Q10 concentrations were found to correlate significantly (P < .001). However, no significant changes in fasting blood glucose, insulin, and glycated hemoglobin levels were observed in either group. Additionally, no adverse events occurred in either group. Conclusion Patients with prediabetes who were administered coenzyme Q10 showed a significant reduction in HOMA-IR values. Therefore, administration of coenzyme Q10 in patients with impaired glucose tolerance may slow the progression from prediabetes to overt diabetes.

Effect of methamphetamine on the fasting blood glucose in methamphetamine abusers.

Methamphetamine is a popular psychostimulant worldwide which causes neurotoxicity and neuroinflammation. Although previous studies have characterized potential associations between addictive drugs and fasting blood glucose, the influence of methamphetamine on the blood glucose is still largely unknown. The present study was designed to investigate the change of fasting blood glucose of methamphetamine abusers and to confirm the impairment of liver and kidney. Fasting blood glucose was significantly decreased in methamphetamine abusers and in a high-fat diet mouse model with methamphetamine treatment discontinuation. Serum level of ALT, creatine kinase and creatinine were increased in methamphetamine abusers. Serum level of ALT and AST were increased in a high-fat diet mouse model after methamphetamine injection, but there was no significant difference in the anatomy of the liver and kidney in high-fat diet treated mice with or without methamphetamine. The levels of ALT and creatinine were also increased in the methamphetamine abusers. This study demonstrated that the level of glucose was decreased in methamphetamine abusers and in high-fat diet-fed mice after methamphetamine treatment discontinuation. The effect of methamphetamine on the levels of blood glucose may provide the evidence that methamphetamine abusers should be keep energy balance due to the low blood glucose.

Combined effects of synbiotic and sitagliptin versus sitagliptin alone in patients with nonalcoholic fatty liver disease.

Background/AimsNon-alcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver diseases in recent years. The aim of this study was to evaluate the effects of sitagliptin with and without a synbiotic supplement in the treatment of patients with NAFLD.MethodsIn total, 138 NAFLD patients aged 18-60 years were enrolled in the study. Patients were randomized to one of the following treatments for 16 weeks: Group I (n=68), sitagliptin 50 mg daily plus placebo (one capsule per day) or group II (n=70) sitagliptin 50 mg daily plus synbiotic (one capsule per day). Changes in fasting blood glucose (FBS), liver enzymes, lipid profile, and body mass index were compared between the groups.ResultsThe mean change in FBS with sitagliptin-placebo from baseline was -10.47±5.77 mg/dL, and that with sitagliptin-synbiotic was -13.52±4.16 mg/dL. There was a significant difference between the groups (P<0.001). The mean change in cholesterol (Chol) was -8.34±28.83 mg/dL with sitagliptin-placebo and -21.25±15.50 mg/dL with sitagliptinsynbiotic. There was a significant difference between the two groups (P=0.029). The administration of sitagliptin-placebo induced an increase of 6.13±27.04 mg/dL in low density lipoprotein (LDL), whereas sitagliptin-synbiotic induced a decrease of 14.92±15.85 mg/dL in LDL. A significant difference was observed between the two groups (P<0.001). On the other hand, in the sitagliptin-synbiotic group, there was significant improvement in aspartate aminotransferase (AST) level compared to the sitagliptin-placebo group (P=0.018).ConclusionsSitagliptin-synbiotic produced greater improvement in FBS, AST, Chol, and LDL compared to sitagliptin alone in patients with NAFLD.

Nicorandil improves cognitive dysfunction in mice with streptozotocin-induced diabetes

To observe the protective effects of potassium channel opener nicorandil against cognitive dysfunction in mice with streptozotocin (STZ)-induced diabetes. C57BL/6J mouse models of type 1 diabetes mellitus (T1DM) were established by intraperitoneal injection of STZ and received daily treatment with intragastric administration of nicorandil or saline (model group) for 4 consecutive weeks, with normal C57BL/6J mice serving as control. Fasting blood glucose level was recorded every week and Morris water maze was used to evaluate the cognitive behavior of the mice in the 4th week. At the end of the experiment, the mice were sacrificed to observe the ultrastructural changes in the hippocampus and pancreas under transmission electron microscopy; the contents of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) in the hippocampus and SOD activity and MDA level in the brain tissue were determined. Compared with the control group, the model group showed significantly increased fasting blood glucose (P<0.001), significantly prolonged escape latency (P<0.05) and increased swimming distance (P<0.01) with ultrastructural damage of pancreatic β cells and in the hippocampus; GIP and GLP-1 contents in the hippocampus (P<0.01) and SOD activity in the brain were significantly decreased (P<0.05) and MDA content was significantly increased in the model group (P<0.05). Compared with the model group, nicorandil treatment did not cause significant changes in fasting blood glucose, but significantly reduced the swimming distance (P<0.05); nicorandil did not improve the ultrastructural changes in pancreatic β cells but obviously improved the ultrastructures of hippocampal neurons and synapses. Nicorandil also significantly increased the contents of GIP and GLP-1 in the hippocampus (P<0.05), enhanced SOD activity (P<0.05) and decreased MDA level (P<0.01) in the brain tissue. Nicorandil improves cognitive dysfunction in mice with STZ-induced diabetes by increasing GIP and GLP-1 contents in the hippocampus and promoting antioxidation to relieve hippocampal injury.

Application of nursing intervention under community family responsibility doctor contract mode on insulin therapy in elderly diabetic patients

Objective To explore the effects of nursing intervention under community family responsibility doctor contract mode on insulin therapy knowledge, compliance, self-management ability and glucose control in elderly diabetic patients. Methods From June 2015 to May 2016, 100 elderly diabetic inpatients of Endocrinology Department in Shangqiu First People's Hospital of He'nan Province were selected by convenience sampling. All of the patients were randomly divided into observation group and control group, 50 cases in each group. Patients of control group accepted routine community intervention post discharge. On the basis of control, patients of observation group were treated with signing family responsibility doctor service agreement and community nursing intervention. The follow-up was carried out for six months post discharge. The insulin therapy knowledge, injection compliance of insulin and score of self-management behavior, changes of fasting blood-glucose of patients in two groups were compared. Results Three and six months after intervention, the scores of insulin therapy knowledge and injection compliance of patients in observation group were higher than those in control group; the scores of insulin therapy knowledge and injection compliance of patients in two groups six months after intervention were lower than those three months after intervention with significant differences (P<0.05) . There was an interaction effect between the group factor and time factor in fasting blood-glucose between two groups with a significant difference (F=6.943, P<0.001) . There was an interaction effect between the group factor and time factor in total score of self-management behavior of elderly diabetic patients in two groups with a significant difference (F=6.243, P<0.001) . Conclusions The nursing intervention under community family responsibility doctor contract mode for elderly diabetic patients is conducive for patients to mastering insulin therapy knowledge, improving injection compliance of insulin and self-management ability as well as glucose control. Key words: Diabetes mellitus; Self-management; Family responsibility physicians; Contract mode

Synergestic Effect of Vernonia Amygdalina and Glimepiride on Alloxan Induced Hyperglycaemia

Glimepiride is a sulfonylurea whose mechanism of action is to stimulate insulin release from the beta cell of the pancreas. It is an oral hypoglycaemic agent that is widely used in the management of type 2 Diabetes mellitus in Nigeria. Also, Vernonia amygdalina (VA) is a common shrub consumed in Nigeria. This study was done to investigate the effect of VA and glimepiride in alloxan induced hyperglycaemia. Twenty five (25) adult Wister albino rats of both sexes weighing 200-250g were randomly allocated into five (5) groups with five (5) rats per group. Group 1 was given normal saline alone without inducing hyperglycaemia in the group to serve as normoglycaemic control while animals in group 2, 3, 4 and 5 were given 65mg/kg bodyweight of alloxan monohydrate to induce hyperglycaemia according to the method of Osikwe et al., 2015, Onahinon et al.,2018. After inducing hyperglycaemia, group 2 were given normal saline, group 3, 100mg/kg body weight of VA, group 4, 2mg/kg body weight of glimepiride and group 5, 100mg/kg body weight of VA and 2mg/kg body weight of glimepiride for a duration of 2 weeks. The result showed that the fasting blood glucose of group 1 was 81±2.8 mg/dl. The fast blood glucose of group 2 was 283±8.3 vs 340±20.3mg/dl, group 3 was 304±3.8 198±3.3mg/dl, group 4 was 308±3.3 vs 216±1.5mg/dl and group 5 was 333±8.9 vs 151±5.1mg/dl. There was significant difference in the basal fasting blood glucose and fasting blood glucose after induction (p&lt;0.01). There was significant difference between group 2 and group 3, group 2 and group 4, and group 2 and group 5 (p&lt;0.01). There was no significant difference between group 3 and group 4 (p&gt;0.05) however, the percentage change in fasting blood glucose in group 3 and 4 after hypoglycaemic agents were administered were 34.9% and 29.9% respectively. There was a significant difference between group 5 and group 3, and group 5 and group 4 (p&lt;0.01). The percentage change in fasting blood glucose of group 2, 3, 4, and 5 were 20.1%, -34.9%, -29.9% and -54.7% respectively. It is concluded that there is synergism between VA and glimepiride.