Changes In Blood Glucose Levels Research Articles

Association between blood glucose level trajectories and 30-day mortality risk in patients with acute ischemic stroke: analysis of the MIMIC database 2001–2019

BackgroundHyperglycemia is one of the most common comorbidities in patients with acute ischemic stroke (AIS). This study aimed to assess the impact of short-term longitudinal blood glucose level change trajectories on the 30-day mortality risk in patients with AIS.MethodsData for AIS patients were obtained from the 2001–2019 Medical Information Mart for Intensive Care (MIMIC) database. The latent growth mixture modeling (LGMM) was utilized to classify a patient’s blood glucose level trajectory within 24 h of admission. Cox regression analyses were applied to examine the relationship between blood glucose levels at admission and blood glucose level trajectories and the risk of 30-day mortality in patients with AIS.ResultsA total of 2,432 patients with AIS were included in this retrospective cohort study, with 30-day mortality occurring in 574 (23.60%) patients. The median glucose levels of all patients were 136.00 (110.00, 178.00) mg/dL. Four blood glucose level trajectories were identified: low level-stable trend (type 1), moderate level-stable trend (type 2), high level-decreasing-increasing trend (type 3), and moderate level-increasing-decreasing trend (type 4). Type 2 blood glucose level trajectory was associated with an increased risk of 30-day mortality compared with type 1 blood glucose level trajectory [hazard ratio (HR) = 1.28, 95% confidence interval (CI): 1.03–1.59), but there were no significant associations between type 3 (HR = 1.16, 95%CI: 0.77–1.74) and type 4 (HR = 1.44, 95%CI: 0.84–2.45) trajectories and 30-day mortality risk. Subgroup analysis demonstrated that the association between type 2 trajectory and 30-day mortality risk was observed in patients aged ≥ 65 years (HR = 1.37, 95%CI: 1.05–1.79), female (HR = 1.42, 95%CI: 1.05–1.94), with (HR = 1.44, 95%CI: 1.02–2.02) or without (HR = 1.42, 95%CI: 1.01–1.99) diabetes, and not using insulin (HR = 2.80, 95%CI: 1.43–5.49).ConclusionAIS patients with consistently high blood glucose levels within 24 h of admission increased the risk of 30-day mortality.

Noninvasive Blood Glucose Monitoring Using Spatiotemporal ECG and PPG Feature Fusion and Weight-Based Choquet Integral Multimodel Approach.

change of blood glucose (BG) level stimulates the autonomic nervous system leading to variation in both human's electrocardiogram (ECG) and photoplethysmogram (PPG). In this article, we aimed to construct a novel multimodal framework based on ECG and PPG signal fusion to establish a universal BG monitoring model. This is proposed as a spatiotemporal decision fusion strategy that uses weight-based Choquet integral for BG monitoring. Specifically, the multimodal framework performs three-level fusion. First, ECG and PPG signals are collected and coupled into different pools. Second, the temporal statistical features and spatial morphological features in the ECG and PPG signals are extracted through numerical analysis and residual networks, respectively. Furthermore, the suitable temporal statistical features are determined with three feature selection techniques, and the spatial morphological features are compressed by deep neural networks (DNNs). Lastly, weight-based Choquet integral multimodel fusion is integrated for coupling different BG monitoring algorithms based on the temporal statistical features and spatial morphological features. To verify the feasibility of the model, a total of 103 days of ECG and PPG signals encompassing 21 participants were collected in this article. The BG levels of participants ranged between 2.2 and 21.8 mmol/L. The results obtained show that the proposed model has excellent BG monitoring performance with a root-mean-square error (RMSE) of 1.49 mmol/L, mean absolute relative difference (MARD) of 13.42%, and Zone A + B of 99.49% in tenfold cross-validation. Therefore, we conclude that the proposed fusion approach for BG monitoring has potentials in practical applications of diabetes management.

Quantitative brain [18F]FDG PET beyond normal blood glucose levels

Introduction SUV measurements from static brain [18F]FDG PET acquisitions are a commonly used tool in preclinical research, providing a simple alternative for kinetic modelling, which requires complex and time-consuming dynamic acquisitions. However, SUV can be severely affected by the animal handling and preconditioning protocols, primarily by those that may induce changes in blood glucose levels (BGL). Here, we aimed at developing and investigating the feasibility of SUV-based approaches for a wide range of BGL far beyond normal values, and consequently, to develop and validate a new model to generate standardized and reproducible SUV measurements for any BGL.Material and methods We performed dynamic and static brain [18F]FDG PET acquisitions in 52 male Sprague-Dawley rats sorted into control (n = 10), non-fasting (n = 14), insulin-induced hypoglycemia (n = 12) and glucagon-induced hyperglycemia (n = 16) groups. Brain [18F]FDG PET images were cropped, aligned and co-registered to a standard template to calculate whole-brain and regional SUV. Cerebral Metabolic Rate of Glucose (CMRglc) was also estimated from 2-Tissue Compartment Model (2TCM) and Patlak plot for validation purposes.Results Our results showed that BGL=100±6 mg/dL can be considered a reproducible reference value for normoglycemia. Furthermore, we successfully established a 2nd-degree polynomial model (C1=0.66E-4, C2=-0.0408 and C3=7.298) relying exclusively on BGL measures at pre-[18F]FDG injection time, that characterizes more precisely the relationship between SUV and BGL for a wide range of BGL values (from 10 to 338 mg/dL). We confirmed the ability of this model to generate corrected SUV estimations that are highly correlated to CMRglc estimations (R2= 0.54 2TCM CMRgluc and R2= 0.49 Patlak CMRgluc). Besides, slight regional differences in SUV were found in animals from extreme BGL groups, showing that [18F]FDG uptake is mostly directed toward central regions of the brain when BGLs are significantly decreased.Conclusion Our study successfully established a non-linear model that relies exclusively on pre-scan BGL measurements to characterize the relationship between [18F]FDG SUV and BGL. The extensive validation confirmed its ability to generate SUV-based surrogates of CMRglu along a wide range of BGL and it holds the potential to be adopted as a standard protocol by the preclinical neuroimaging community using brain [18F]FDG PET imaging.

Before or Concomitant Drinking Greenleaf Juice with Rice Reduces Postprandial Blood Glucose Levels in Healthy Young Women.

The purpose of this study was to examine how green leaf juice drinking affect the postprandial blood glucose. Postprandial hyperglycemia causes vascular endothelial damage and chronic inflammation, promoting atherosclerosis, regardless of the presence of diabetes. Some ingredients in greenleaf juice have been reported to suppress blood glucose levels; however, the effect of greenleaf juice on reducing blood glucose levels in healthy individuals is unclear. We observed changes in postprandial blood glucose levels in 13 healthy young women who drank greenleaf juice before or concomitantly with rice. Compared to water, greenleaf juice consumption reduced blood glucose levels at 90 and 120 min after rice consumption, with no difference regardless of the time of greenleaf juice consumption. Greenleaf juice may be one of the most convenient and cost-effective methods for reducing postprandial blood glucose in healthy people.

The Effect of Aerobic Exercise Frequency on Reducing Blood Glucose in Type 2 Diabetes Mellitus Sufferers in the Lingsar Health Center Working Area in 2024

One of the keys to a person suffering from diabetes mellitus being able to live a healthy life like other people without diabetes is to maintain balanced blood glucose levels within normal limits. One important way to reduce blood glucose levels, especially in type 2 DM sufferers, is exercise. This study aims to identify the effect of aerobic exercise, on changes in blood glucose levels. This research is a pre-experimental research with a one group pre-posttest approach. The research sample was 33 people suffering from type 2 DM at the Lingsar Community Health Center, selected using a simple random sampling technique. Each respondent was given aerobic exercise 3 times a week with a minimum duration of 20 minutes. Data on blood glucose levels before and after the intervention were collected using an observation sheet. The results of the study showed that the average blood glucose before the intervention was 162.2 mg/dL and after the intervention it fell to 156.14 mg/dL. The t-test with a=0.05 showed r=0.000. It can be concluded that there is an effect of aerobic exercise on the respondents' blood glucose levels. Aerobic exercise has been proven to reduce the average blood glucose level after this is done regularly. This study results can be an evidenced base for community nursing to promote regular aerobic exercise among people with DM, to help reduce or control their blood glucose.

Acute effects of blood flow restricted aerobic exercise in type 2 diabetes mellitus.

This study aimed to compare the acute effects of aerobic exercise performed with blood flow restriction (BFR), a novel method to increase exercise gains, with blood free flow (BFF) conditions in type 2 diabetes mellitus (T2DM). Fifteen individuals with T2DM performed BFF and BFR (40% of arterial occlusion pressure) cycling exercises 48 hours apart, at equal intensity (45% heart rate reserve) and duration (38 minutes). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), blood glucose, heart rate, and muscle oxygen saturation (SmO2) were assessed before-after and during exercise sessions. SBP, DBP, and MAP in the overload phase were higher in the BFR group than in the BFF group (P = .009, 0.031, and 0.013, respectively). Changes in blood pressure (∆SBP and ∆DBP) were similar between the BFF and BFR groups (P > .05), whereas ∆MAP differed (P = .016). Changes in blood glucose levels and heart rates were not significantly different between the groups. Although SmO2baseline was lower in the BFR group (P = .049), SmO2min and SmO2max did not differ significantly between the BFF and BFR groups. The similar decrease in blood glucose levels between the groups suggests that BFR exercise is favorable in terms of hypoglycemia. The higher blood pressure observed during the BFR exercise remained within safe limits. These results suggest that people with T2DM can safely perform BFR aerobic exercises; however, further studies are required.

Assessing the influence of insulin type (ultra-rapid vs rapid insulin) and exercise timing on postprandial exercise-induced hypoglycaemia risk in individuals with type 1 diabetes: a randomised controlled trial.

The relationship between pre-meal insulin type, exercise timing and the risk of postprandial exercise-induced hypoglycaemia in people living with type 1 diabetes is unknown. We aimed to evaluate the effects of exercise timing (60 vs 120 min post meal) and different insulin types (aspart vs ultra-rapid aspart) on hypoglycaemic risk. This was a four-way crossover randomised trial including 40 individuals with type 1 diabetes using multiple daily injections (mean HbA1c 56 mmol/mol [7.4%]). Participants, who were recruited from the Montreal Clinical Research Institute, undertook 60 min cycling sessions (60% of ) after breakfast (60 min [EX60min] or 120 min [EX120min] post meal) with 50% of their usual insulin dose (aspart or ultra-rapid aspart). Eligibility criteria included age ≥18 years old, clinical diagnosis of type 1 diabetes for at least 1 year and HbA1c ≤80 mmol/mol (9.5%). Participants were allocated using sequentially numbered, opaque sealed envelopes. Participants were masked to their group assignment, and each participant was allocated a unique identification number to ensure anonymisation. The primary outcome was change in blood glucose levels between exercise onset and nadir. Prior to exercise onset, time spent in hyperglycaemia was lower for EX60min vs EX120min (time >10.0 mmol/l: 56.6% [1.2-100%] vs 78.0% [52.7-97.9%]; p<0.001). The glucose reduction between exercise onset and nadir was less pronounced with EX60min vs EX120min (-3.8±2.7 vs -4.7±2.5 mmol/l; p<0.001). A similar number of hypoglycaemic events occurred during both exercise timings. Blood glucose between exercise onset and nadir decreased less with ultra-rapid aspart compared with aspart (-4.1±2.3 vs -4.4±2.8 mmol/l; p=0.037). While a similar number of hypoglycaemic events during exercise were observed, less post-exercise hypoglycaemia occurred with ultra-rapid aspart (n=0, 0%, vs n=15, 38%; p=0.003). No interactions between insulin types and exercise timings were found. EX60min blunted the pre-exercise glucose increase following breakfast and was associated with a smaller glucose reduction during exercise. Ultra-rapid aspart led to a smaller blood glucose reduction during exercise and might be associated with diminished post-exercise hypoglycaemia. ClinicalTrials.gov NCT03659799 FUNDING: This study was funded by Novo Nordisk Canada.

Western diet induces mild metabolic impairment and aggravates neuropathology in an experimental mouse model of traumatic brain injury

Traumatic brain injury (TBI) and lifestyle habits such as Western diet (WD) consumption represent two risk factors that affect an individual's health outcome globally. Individuals with TBI have a greater risk of mortality from associated chronic diseases than the general population. WD has been shown to impair cognitive function, decrease the brain's capacity to compensate for insult by affecting recovery as well as induce metabolic syndrome (MetS) which may be a risk factor for poor TBI prognosis. Hence, this study aims to investigate the impact of WD on TBI behavioral outcomes and neuropathology. Eight-week-old male C57BL6 mice were fed either WD or normal chow for 4 weeks prior to TBI induction. At week four, mice underwent either an experimental open-head TBI or a sham procedure. Mice continued their respective diets for four weeks after brain injury. Metabolic, cognitive function, and molecular assessment were performed four weeks after TBI. Results showed that while WD significantly increased fat percentage and elevated plasma cholesterol, there was no change in blood glucose level or body weight, indicating an early stage of MetS. Nevertheless, this was associated with neuroinflammation and impaired cognitive functions. However, there was no significant impact on cardiovascular function and mitochondrial bioenergetics. Importantly, the mild MetS induced by WD triggered basal motor, cognitive deterioration and exacerbated the long-term neuropathology of TBI. Taken together, our work highlights the magnitude of the contribution of lifestyle factors including the type of diet, even in the absence of overt metabolic consequences, on the neurobehavioral prognosis following TBI.

Effect of High-Intensity Interval Training on Blood Glucose Levels in Patients with Type 2 Diabetes Mellitus: A Literature Review

Diabetes Mellitus (DM) is a chronic and progressive disease characterized by elevated blood glucose levels. This study aims to investigate the effect of High-Intensity Interval Training on blood glucose levels in patients with type 2 diabetes mellitus through a literature review. The comprehensive search in the database resulted in 7,737 articles: Pubmed (2,610), Science Direct (4,724), Scopus (282), and Springer (121), and only 11 articles met the criteria for further review. A comprehensive analysis of the included studies reveals the effect of HIIT on blood glucose levels in type 2 DM patients, which can be observed through changes in blood glucose levels and HbA1c following exercise. In conclusion, our findings suggest that HIIT could be an essential intervention for managing blood glucose in Type 2 DM patients.

Perioperative Dexamethasone Split Between 2 Doses Further Reduced Early Postoperative Nausea and Vomiting Than Single-Dose Dexamethasone: A Randomized Blinded Placebo-Controlled Trial

BackgroundWe investigated whether 2 doses of dexamethasone are more effective than a single dose in reducing early postoperative nausea and vomiting (PONV) during total knee arthroplasty (TKA). MethodsA total of 150 patients between June 2021 and June 2022 were randomized into 3 groups: 2 doses of normal saline (group A), a single dose of 10 mg dexamethasone before surgery and normal saline after surgery (group B), and 2 doses of 5 mg dexamethasone during the perioperative period (group C). Primary outcomes were incidences and severity of PONV within 24 hours after surgery, the number and consumption of patients requiring morphine and metoclopramine, and visual analog scale scores for nausea and vomiting at 2, 4, 6, and 24 hours after surgery. Blood glucose levels on days 1, 2, and 3 after operation and incidences of surgical site infection (SSI) as well as gastrointestinal bleeding (GIB) within 45 days after operation were compared. ResultsWithin 24 hours after operation, the number and consumption of patients requiring morphine and metoclopramide in groups B and C were significantly lower than those in group A. Incidences and severity of PONV in groups B and C were significantly lower than those in group A. And these differences between groups B and C were significant. At 2, 4, 6, and 24 hours after operation, there were significant differences in visual analog scale scores of PONV between groups A and B, A and C, as well as B and C. On postoperative days 1, 2, and 3, there were no significant differences in blood glucose levels among the groups, and there were no incidences of SSI or GIB in any group within 45 days after operation. ConclusionDexamethasone significantly reduces PONV within 24 hours after TKA, does not result in significant changes in postoperative blood glucose levels, and does not increase the risk of SSI or GIB, particularly on group C. Registration numberChiCTR2400088512. Registration centerChinese Clinical Trial Registry (ChiCTR). Websitewww.chictr.org.cn.

Effects of Adrenaline Containing Local Anesthesia on Blood Pressure and Blood Glucose Levels Undergoing Tooth Extractions – A Comparative Study

Exodontia, the most common dental procedure for damaged or decayed teeth, often utilizes local anesthesia with vasoconstrictors like adrenaline. Although effective, adrenaline can impact blood glucose levels and hemodynamic parameters, particularly in hypertensive and diabetic patients. Objectives: To compare changes in blood pressure and blood glucose levels among healthy, hypertensive and diabetic patients undergoing tooth extraction with adrenaline-containing local anesthesia. Methods: A total of 177 participants were split equally into three groups: healthy, hypertensive and diabetic. Prior to and twenty minutes’ post-injection, blood pressure, and blood glucose levels were measured while a local anesthetic containing 2% lignocaine HCL with 1: 100,000 adrenaline was administered. Sample paired t test and one-way ANOVA were employed in the analysis. Results: Among hypertensive patients, random blood glucose significantly decreased post-procedure (p=0.001), while systolic blood pressure significantly increased (p&lt;0.001) and diastolic blood pressure significantly decreased (p=0.021). Diabetic patients showed a non-significant decrease in glucose levels (p=0.209) but a significant increase in both systolic (p&lt;0.001) and diastolic blood pressure (p=0.002). Healthy patients experienced a significant increase in systolic blood pressure (p=0.015) but no significant changes in glucose levels (p=0.873) or diastolic pressure (p=0.301). Conclusions: Adrenaline in local anesthesia significantly increases systolic blood pressure in all patient groups, with pronounced effects in hypertensive and diabetic patients. Changes in blood glucose were significant only in hypertensive patients, while changes in diabetic patients were non-significant. These findings highlight the need for careful monitoring and personalized management strategies in dental procedures to minimize potential adverse effects and ensure patient safety.

Impact of hospital-community diabetes management intervention in Central Region, Ghana: A retrospective study

ObjectiveEffective diabetes management remains suboptimal in low-resourced countries including Ghana. We determined the effectiveness of hospital-community link diabetes management intervention on glycaemic control and other outcomes. MethodsA retrospective study design, using secondary data from the Ghana-Netherlands for Health Foundation diabetes programme. The z-test was used for proportions, to compare parameters between baseline (2017) and endpoint (2022). The Friedman test was used to assess changes in blood glucose levels, and the multivariable Logistic regression to identify factors associated with blood glucose control. ResultsAnalyses of 251 clinical records showed decline in median blood glucose levels across six years from 8.8 mmol/L (7.2–12.9) in 2017 to 6.5 mmol/L (5.7–7.2) (p = 0.001) in 2022, recording 43 % increase in patients attaining glycaemic control in 2022 (p = 0.001). The Friedman test showed significant reduction in glucose levels (χ2 = 319.2, p = 0.001), with an effect size of 0.25 using the Kendall test. The logistic regression analyses revealed that patients on metformin and Glibenclamide combination were more likely to achieve glycaemic control than those on metformin monotherapy (adjusted OR = 7.30, 95 % CI 2.31–23.01, p = 0.001). ConclusionThe intervention achieved significant reduction in blood glucose levels. Patients with diabetes benefit from the hospital-community link diabetes management intervention regarding glycaemic control.

A comprehensive analysis of diabetic patient data before and during the COVID-19 pandemic – Lessons from the MÉRY diabetes database (MDD)

AimsOur study examined changes in average blood glucose levels (ABG), measurement frequency (MF), and data uploading (DU) before and during the COVID-19 pandemic in 882-day spans, which were divided into further 20-week intervals to highlight the pandemic's impact. MethodsT-Tests assessed the statistical significance of blood glucose data from 26,655/20,936 patients and 19.5/16.6 million records during pre-COVID/COVID. ResultsDuring COVID, patients had significantly lower ABG levels (9.1/8.9 mmol/L, p < 0.001). Weekly DU decreased (155,945/128,445, p < 0.05), while daily MF increased (0.83/0.87, p < 0.001). Comparing the last 20 weeks pre-COVID to the first 20 weeks during COVID, ABG levels were lower (9.0 /8.9, p < 0.01), MF increased (0.83 /0.99, p < 0.001), and DU decreased (153,133/145,381, p < 0.05). In the initial 20 weeks of COVID compared to the second 20 weeks of COVID, ABG increased (8.9/9.1, p < 0.01), MF decreased (0.99/0.95, p < 0.001), and DU decreased (145,381/140,166, p < 0.05). Our most striking observation was the temporary dramatic fall in glucose uploads during the first few weeks of COVID. The changes of ABG and MF values were statistically significant, but were not deemed clinically relevant. ConclusionsDespite COVID's prolonged impact, diabetic patients showed improved attitudes. A significant drop in data uploads occurred during the first 20 weeks of COVID; home office and lockdowns apparently disrupted patient routines.

Express analysis of acetone in exhaled air for diagnosing diabetes melli-tus

Exhaled air analysis is an actively developing area of medical non-invasive diagnostics, as it does not involve invasive interventions and can be performed repeatedly. It is known that acetone in exhaled air correlates with blood glucose and is a biomarker of diabetes. The use of analytical systems to analyse acetone in exhaled air in medical institutions will allow for the timely diagnosis of pathological changes in blood glucose levels, the early diagnosis of diabetes, and the monitoring of the effectiveness of treatments. In this study, we described the express analysis of acetone in exhaled air using a mobile diagnostic complex based on microfluidic systems including a PIA gas microchromatograph with a thermochemical detector, a planar chromatographic column, a thermostatically controlled system for the sampling and selective capture of interfering components, operated by electric microvalves, and an automatic dosing system with adjustable blowdown from 0.1 to 5 sec and specialised software. We proposed using a diagnostically significant range of concentrations: from 0.5 ppm to 20 ppm of acetone in exhaled air in the diagnosis of diabetes. The total analysis time is 3 min, retention time for acetone is 60 sec. Testing of the complex confirmed that it allows for the direct determination of acetone in exhaled air. The use of the capture and drying system prevents the loss of the target substance and ensures good convergence of the results. The deviation from the reference value does not exceed 10%. Field testing confirmed the data obtained on model mixtures. The developed mobile diagnostic complex with automatic programmed dosing and the technique for the quantitative determination of acetone in exhaled air (0.5-20 ppm) can be recommended for use in clinical studies in medical institutions.

The Influence of Emodin Succinyl Ethyl Ester on Non-alcoholic Steatohepatitis Induced by a Diet High in Fructose, Cholesterol, and Fat in Mice.

Nonalcoholic steatohepatitis (NASH) is a subtype of nonalcoholic fatty liver disease (NAFLD) characterized by hepatic steatosis and evidence of hepatocyte injury (ballooning) and inflammation, with or without liver fibrosis. In this study, after 12 weeks of induction, the mice were treated with emodin succinyl ethyl ester (ESEE) for four weeks at doses of 10/30/90 mg/kg/d. The blood analysis of experimental endpoints showed that ESEE exhibited significant therapeutic effects on the progression of disorders of glycolipid metabolism and the induced liver injury in the model animals. Histopathological diagnosis of the liver and total triglyceride measurements revealed that ESEE had a significant therapeutic effect on the histopathological features of nonalcoholic fatty liver disease/hepatitis, such as cellular steatosis and activation of intrahepatic inflammation. Additionally, ESEE was able to improve hepatocyte fat deposition, steatosis, and the course of intrahepatic inflammatory activity. Furthermore, it showed some inhibitory effect on liver fibrosis in the model animals. In summary, this study confirms the therapeutic effects of ESEE on the NAFLD/NASH model in C57BL/6J mice induced by a high-fat, high cholesterol, and fructose diet. These effects were observed through improvements in liver function, inhibition of fibrosis, and inflammatory responses. Changes in blood glucose levels, blood lipid metabolism, liver histopathological staining, liver fibrosis staining, and related pathological scores further supported the therapeutic effects of ESEE. Therefore, this study has important implications for the exploration of novel drugs for nonalcoholic fatty liver disease.

Low blood glucose and fatigue accumulation at peak hours of occupational trauma in secondary industry workers

Objectives. The incidence of occupational traumatic injuries caused by human error has been reported to occur at 11:00 and 8–9 h after commencing work. Impaired attention is closely related to the incidence of these accidents. Therefore, this study aimed to clarify the changes in blood glucose, fatigue and stress response hormone levels over time among workers in a secondary industry. Methods. The blood glucose and subjective fatigue levels of 26 male secondary-industry workers were measured on workdays. In addition, the cortisol and dehydroepiandrosterone levels in saliva were measured on one workday and one holiday. Results. Blood glucose levels at 11:00 and 17:30 on the workday were significantly lower than those at 09:30. Moreover, hypoglycemia was observed in some participants. A significant increase in subjective fatigue levels was observed during the workday. However, no significant differences in salivary cortisol levels were observed between the workday and the holiday at any time point. Conclusions. Blood glucose levels decreased and subjective fatigue levels increased at the time points that occupational accidents were reported to occur most frequently during work. These factors may contribute to human errors due to impaired attentional function.

Association between pathologic complete response and biochemical indicators after neoadjuvant therapy for HER2-positive breast cancer

PurposeThis study investigated the changes in the fasting blood glucose (FBG), fasting triglyceride (FTG), and fasting total cholesterol (FTC) levels during neoadjuvant therapy (NAT) for human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) and the association with pathologic complete response (pCR).MethodsRelevant data from Sichuan Cancer Hospital from June 2019 to June 2022 were collected and analyzed, and FBG, FTG, and FTC were divided into baseline, change, and process groups, which were grouped to analyze the changes after receiving NAT and the association with pCR.Results In the estrogen receptor (ER)-negative subgroup, patients with low levels of FTG in the process group were more likely to achieve pCR compared to high levels, and in the progesterone receptor (PR)-negative subgroup, patients with lower FTG compared to higher FTG after receiving NAT was more likely to achieve pCR.ConclusionsPatients with HER2-positive BC undergoing NAT develop varying degrees of abnormalities (elevated or decreased) in FBG, FTG, and FTC; moreover, the status of FTG levels during NAT may predict pCR in ER-negative or PR-negative HER2-positive BC.Early monitoring and timely intervention for FTG abnormalities may enable this subset of patients to increase the likelihood of obtaining a pCR along with management of abnormal markers.

Impact of the State of Emergency Declaration for Severe Acute Respiratory Syndrome Coronavirus-2 Pandemic Suppression on Individuals with Type 1 Diabetes Mellitus.

Objective To examine the impact of lifestyle changes caused by the first emergency declaration issued in 2020 on glycemic control and body weight changes in Japanese individuals with type 1 diabetes mellitus. Methods This study included Japanese individuals with type 1 diabetes mellitus who visited Tokyo Women's Medical University Hospital between January 2019 and September 2020 (n=278). Seasonal changes in glycated hemoglobin (HbA1c) levels and the body mass index (BMI) were compared. A self-administered questionnaire regarding changes in treatment, diet, exercise, sleep, and telecommuting was used to assess lifestyle changes. Results Although HbA1c levels decreased from winter to summer in 2019 and 2020, the annual change was slightly but significantly greater in 2020 than in 2019. Seasonal changes in the BMI between 2019 and 2020 were also significantly different. An increase in the daily insulin dose, overall blood glucose level, diurnal change in blood glucose level, and food intake were significantly associated with increased HbA1c levels. Furthermore, HbA1c levels decreased with increasing moderate physical activity and sleep duration. The change in the BMI increased with increasing insulin dose, overall high blood glucose levels, and food intake. However, an increase in moderate physical activity was associated with a decrease in the BMI. HbA1c levels were significantly lower after the first emergency declaration in individuals with type 1 diabetes mellitus than that before the emergency declaration, even after accounting for seasonal variations. Conclusion Decreased HbA1c levels were associated with a decreased food intake, increased moderate exercise, and increased sleep duration during the state of emergency. The BMI remained relatively unchanged.

A Non-Toxic Binuclear Vanadium(IV) Complex as Insulin Adjuvant Improves the Glycemic Control in Streptozotocin-Induced Diabetic Rats.

Diabetes mellitus (DM) complications are a burden to health care systems due to the associated consequences of poor glycemic control and the side effects of insulin therapy. Recently. adjuvant therapies, such as vanadium compounds, have gained attention due to their potential to improve glucose homeostasis in patients with diabetes. In order to determine the anti-diabetic and antioxidant effects of the oxidovanadium(IV) complex (Et3NH)2[{VO(OH}2)(ox)2(µ-ox)] or Vox2), rats with streptozotocin (STZ)-induced diabetes were treated with 30 and 100 mg/kg of Vox2, orally administered for 12 days. Vox2 at 100 mg/kg in association with insulin caused a 3.4 times decrease in blood glucose in STZ rats (424 mg/dL), reaching concentrations similar to those in the normoglycemic animals (126 mg/dL). Compared to insulin alone, the association with Vox2 caused an additional decrease in blood glucose of 39% and 65% at 30 and 100 mg/kg, respectively, and an increased pancreatic GSH levels 2.5 times. Vox2 alone did not cause gastrointestinal discomfort, diarrhea, and hepatic or renal toxicity and was not associated with changes in blood glucose level, lipid profile, or kidney or liver function. Our results highlight the potential of Vox2 in association with insulin in treating diabetes.

Impact of early-morning administration of rapid-acting insulin on the increase in blood glucose levels related to the dawn phenomenon in individuals with type 1 diabetes.

An early-morning elevation of blood glucose levels known as the dawn phenomenon and consequent postbreakfast hyperglycemia occur in some individuals with type 1 diabetes (T1D). Whereas insulin pump therapy can mitigate this phenomenon, some individuals prefer or are limited to alternative treatments. We have now assessed the effectiveness of early-morning administration of rapid-acting insulin for amelioration of the dawn phenomenon in individuals with T1D. Thirteen individuals with T1D who experienced the dawn phenomenon as determined by continuous glucose monitoring (CGM) and who received a small dose of rapid-acting insulin on waking were included in this retrospective study. We evaluated the change in sensor glucose levels during a 2-h period from before to after breakfast consumed at 0700h. The change in blood glucose levels during additional time intervals, average daily sensor glucose values, CGM indices, and insulin dose were also evaluated. The early-morning administration of 0.5-1 unit of rapid-acting insulin was associated with a significant reduction in 2-h glucose variability between before (0700h) and after breakfast from a median of 90.7-51.0mg/dL. The glucose variability from 0300 to 0700 or 0900h was also significantly decreased, from 67.7 to 29.0mg/dL and from 172.5 to 78.3mg/dL, respectively. Average sensor glucose levels throughout the day were significantly reduced (from 192.7 to 156.7mg/dL), as was the daily total insulin dose. Early-morning administration of rapid-acting insulin effectively managed the dawn phenomenon and subsequent postbreakfast hyperglycemia in individuals with T1D. The online version contains supplementary material available at 10.1007/s13340-024-00709-6.