Determinant Of Hyperglycemia Research Articles

Hyperglycaemia in newly diagnosed pulmonary tuberculosis patients: a cross-sectional study of the Agona District Hospital

Background: Diabetes mellitus is an important risk factor associated with tuberculosis (TB). This study investigated the prevalence and determinants of hyperglycemia among newly diagnosed pulmonary tuberculosis patients in the Agona Swedru Municipality. Method: A hospital-based cross-sectional study was conducted from December 2015 to April 2016. One hundred (100) newly diagnosed pulmonary tuberculosis patients at the Agona Swedru Municipal Hospital (ASMH) were enrolled for the study. Socio-demographic, clinical and anthropometric measurements were collected and fasting blood glucose (FBG) measured using standard protocols. Data was analyzed using Statistical Package for Social Sciences (SPSS) software version 20.0. Result: Of the 100 participants, 26% had hyperglycemia. The significant factors associated with increased risk of hyperglycemia among participants were history of diabetes mellitus (OR = 8.17, p= 0.004), severity of infection (OR = 23.64, p < 0.001) and duration of symptoms (OR= 2.63, p= 0.042). Conclusion: Hyperglycemia was common among newly diagnosed pulmonary tuberculosis patients. History of diabetes mellitus, severity of infection, and duration of symptoms were the determinants of hyperglycemia in pulmonary tuberculosis. Regular screening of hyperglycemia is essential in the management of tuberculosis. Finally, further studies should be conducted on glucose levels among pulmonary tuberculosis patients using higher sample size to increase the understanding of the subject.

Prevalence and determinants of hyperglycaemia among adults in Bangladesh: results from a population-based national survey

ObjectivesWith the increasing burden of non-communicable diseases in low-income and middle-income countries, biological risk factors, such as hyperglycaemia, are a major public health concern in Bangladesh. Hyperglycaemia is an excess...

Hyperglycaemia during exacerbations of asthma and chronic obstructive pulmonary disease

Hyperglycaemia is a well-known phenomenon among patients with an exacerbation of asthma or chronic obstructive pulmonary disease (COPD). It may be associated with increased risks of death and complications. To define the prevalence and determinants of hyperglycaemia in patients with an exacerbation of asthma or COPD. This was a prospective, cross-sectional study including 153 hospitalised patients with an exacerbation of asthma or COPD. All received inhaled beta-2-adrenergic bronchodilators and oral glucocorticoids in internationally recommend doses. Plasma glucose was measured seven times during the first day. Hyperglycaemia was defined as fasting glucose >6.9 mmol/L or postprandial glucose >11.1 mmol/L. In addition, the family history for diabetes and the Karnofsky performance score were assessed. Height, weight, waist circumference, oxygen saturation, blood pressure, temperature and heart rate were measured. Glycosylated haemoglobin A1c (gHbA1c), C-reactive protein, leucocytes, urea and arterial blood gas values were analysed. Eighty-two per cent of the patients demonstrated hyperglycaemia, with similar prevalence between asthma and COPD. Of the 130 patients without a previous diagnosis of diabetes, 79% showed hyperglycaemia. In binary logistic regression analysis, high gHbA1c, high C-reactive protein and Karnofsky score less than 80% associated with the presence of fasting hyperglycaemia. High gHbA1c and current smoking associated with postprandial hyperglycaemia. Hyperglycaemia is very common among hospitalised patients with an exacerbation of asthma or COPD. It is probably triggered by the medication and the patient's metabolic predisposition mainly determines its presence. Current smoking is the main treatable contributor to hyperglycaemia.

Knockout of Na-glucose transporter SGLT2 attenuates hyperglycemia and glomerular hyperfiltration but not kidney growth or injury in diabetes mellitus

The Na-glucose cotransporter SGLT2 mediates high-capacity glucose uptake in the early proximal tubule and SGLT2 inhibitors are developed as new antidiabetic drugs. We used gene-targeted Sglt2 knockout (Sglt2(-/-)) mice to elucidate the contribution of SGLT2 to blood glucose control, glomerular hyperfiltration, kidney growth, and markers of renal growth and injury at 5 wk and 4.5 mo after induction of low-dose streptozotocin (STZ) diabetes. The absence of SGLT2 did not affect renal mRNA expression of glucose transporters SGLT1, NaGLT1, GLUT1, or GLUT2 in response to STZ. Application of STZ increased blood glucose levels to a lesser extent in Sglt2(-/-) vs. wild-type (WT) mice (∼300 vs. 470 mg/dl) but increased glucosuria and food and fluid intake to similar levels in both genotypes. Lack of SGLT2 prevented STZ-induced glomerular hyperfiltration but not the increase in kidney weight. Knockout of SGLT2 attenuated the STZ-induced renal accumulation of p62/sequestosome, an indicator of impaired autophagy, but did not attenuate the rise in renal expression of markers of kidney growth (p27 and proliferating cell nuclear antigen), oxidative stress (NADPH oxidases 2 and 4 and heme oxygenase-1), inflammation (interleukin-6 and monocyte chemoattractant protein-1), fibrosis (fibronectin and Sirius red-sensitive tubulointerstitial collagen accumulation), or injury (renal/urinary neutrophil gelatinase-associated lipocalin). SGLT2 deficiency did not induce ascending urinary tract infection in nondiabetic or diabetic mice. The results indicate that SGLT2 is a determinant of hyperglycemia and glomerular hyperfiltration in STZ-induced diabetes mellitus but is not critical for the induction of renal growth and markers of renal injury, inflammation, and fibrosis.

Prevalence and Determinants of Hyperglycemia in Very Low Birth Weight Infants: Cohort Analyses of the NIRTURE Study

To investigate the prevalence and determinants of hyperglycemia in the preterm population, as part of the Neonatal Insulin Therapy in Europe (NIRTURE) Trial. We conducted prospective cohort analyses of continuous glucose monitoring data from control infants participating in an international randomized controlled trial. Data were collected from 188 very low birth weight infants (<1500 g). In the first week of life, 80% of infants had evidence of glucose levels >8 mmol/L, and 32% had glucose levels >10 mmol/L >10% of the time. Independent risk factors for hyperglycemia included increasing prematurity, small size at birth, use of inotropes, lipid infusions, and sepsis. There was a lack of association between rate of dextrose infused and risk of hyperglycemia. The prevalence of hyperglycemia in the very low birth weight infant is high, with marked variability in prevalence between infants, not simply related to rates of glucose infused, but to other potentially modifiable risk factors.