Differences In Fasting Blood Glucose Research Articles

Effects of Dexamethasone on Postoperative Glycemic Control in Patients After Primary Total Joint Arthroplasty: A Randomized Double-Blind Controlled Trial

BackgroundIn patients undergoing total joint arthroplasty, the use of dexamethasone (DEX) may cause perioperative blood glucose (BG) disorders, leading to complications even in patients who do not have diabetes. We aimed to evaluate the effects of different DEX doses on perioperative BG levels. MethodsA total of 135 patients who do not have diabetes were randomized into three groups: preoperative intravenous (IV) injection of normal saline (Group A, the placebo group), preoperative IV injection of 10 mg DEX (Group B), and preoperative IV injection of 20 mg DEX (Group C). Postoperative fasting BG (FBG) levels were designated as the primary outcome, while postoperative postprandial BG (PBG) levels were assigned as the secondary outcome. The incidence of complications was recorded. We also investigated the risk factors for FBG ≥ 140 mg/dL and PBG ≥ 180 mg/dL. ResultsThe FBG levels were higher in Groups B and C than in Group A on postoperative days (PODs) 0 and 1. The PBG levels were lower for Groups A and B compared to Group C on POD 1. No differences in FBG or PBG were detected beyond POD 1. Elevated preoperative glycosylated hemoglobin A1c levels increased the risk of FBG ≥ 140 mg/dL and PBG ≥ 180 mg/dL, respectively. However, preoperative IV injection of DEX was not associated with FBG ≥ 140 mg/dL or PBG ≥ 180 mg/dL. No differences were found in postoperative complications among the three groups. ConclusionsThe preoperative IV administration of 10 or 20 mg DEX in patients who do not have diabetes showed transient effects on postoperative BG after total joint arthroplasty. The preoperative glycosylated hemoglobin A1c level threshold (regardless of the administration or dosage of DEX) that increased the risk for the occurrence of FBG ≥ 140 mg/dL and PBG ≥ 180 mg/dL was 5.75 and 5.85%, respectively.

Effects of Diet, Gender, and Age on Liver Metabolism Upon Feeding a High Fat Diet

Background/Objective: Currently, 30% of the USA population has non-alcoholic fatty liver disease (NAFLD), a condition that is increasing in parallel with the global obesity epidemic and life expectancy and is a risk factor for type 2 diabetes and cardiovascular disease. Aberrant transcriptional control of genes is a hallmark of metabolic disease. Thus, it is of interest to characterize how diet, age, and sex impacts various metabolic and signaling pathways upon progression to NAFLD.
 Methods: A cohort of 7-week or 52-week-old male and female mice (n=8) were assigned a high-fat diet (HFD) or a low-fat diet (LFD) feeding regimen for 10 weeks, after which serum chemistries were obtained. Subsequently, gene expression in hepatic tissue samples was analyzed using RNA-seq and Western Blot.
 Results: In both males and females, HDL, LDL, and total cholesterol were significantly increased with HFD in both age groups. In females, there was no significant difference in fasting blood glucose and insulin levels between any groups, while in males, both markers were significantly increased with HFD. RNA-seq data showed significant changes in gene expression correlating with diet, gender, and age. KEGG pathway analysis showed clustering of genes in fatty acid oxidation and synthesis pathways in mice fed a HFD, without affecting cholesterol synthesis enzymes. In aged mice, genes involved in extracellular matrix-receptor interaction were among the most affected. In males and females, young and aged, Western Blot analysis showed decreased expression of lipogenic enzymes ATP-citrate lyase and fatty acid synthase with HFD, but no changes of enzymes of cholesterol synthesis, confirming the RNA-seq data. No significant alterations were observed in insulin signaling.
 Conclusion and Potential Impact: A HFD leads to a more severe phenotype in males than females, including increased fasting and non-fating glucose as well as insulin, and age exacerbates these abnormalities. Cholesterol is increased in both genders and is also exacerbated by age.

Relationship among serum TIMP-1, sCD40L and peripheral neuropathy in type 2 diabetes

Purpose: To determine the correlation of serum TIMP-1 and sCD40L with peripheral neuropathy in type 2 diabetes (T2DM), and potential targets for pharmacological intervention.Methods: The study enrolled 97 subjects with T2DM. The 41 subjects with simple diabetes were classified as T2DM group, while 56 subjects with diabetic peripheral neuropathy (DPN) were included in the DPN group. A control group consisting of 50 healthy volunteers who conducted health checks during a similar time-period was also included. Clinical data and parameters were compared among the three groups, and TIMP-1 and sCD40L levels were determined. Univariate and multivariate logistic regression analyses were conducted to identify factors affecting DPN. The diagnostic value of TIMP-1 and sCD40L in DPN was also determined.Results: Body mass index (BMI) varied among the three groups (p < 0.05), but age or gender were not significantly different (p < 0.05). Duration of diabetes was longer in DPN group than in T2DM group (p < 0.05). The study also revealed statistically significant differences in fasting blood glucose (FBS), postprandial blood glucose, and glycosylated hemoglobin among the three groups. Tissue inhibitor of metalloproteinase-1 (TIMP-1) and soluble CD40 ligand (sCD40L) were important factors that affected the occurrence of diabetic peripheral neuropathy (p < 0.05).Conclusion: TIMP-1 and sCD40L levels reflect neurovascular injury in patients with diabetes, with potential as targets for pharmacological intervention for peripheral neuropathy. These findings espouse crucial clinical implications for early identification and treatment in type 2 diabetes.

Comparative analysis of glycated haemoglobin, fasting blood glucose and haematological parameters in Type-2 diabetes patients

ObjectiveDiabetes remains a major health problem, and Glycated hemoglobin (HBA1c) and fasting blood glucose (FBG) levels play important roles in its management. Also, chronic hyperglycemia coupled with high HBA1c levels impact inflammation and may alter haematological parameters in diabetes. Hence, the need to assess and correlate HBA1c and FBG levels with selected haematological parameters in patients with type-2 diabetes mellitus as the main objective of this study. The study was cross-sectional involving 384 participants. Five milliliters of blood was collected from each participant and analyzed for HBA1c, FBG levels and full blood count which were correlated statistically.ResultsFrom the data obtained and analyzed, there were statistically significant correlations between HBA1c and neutrophil count (p < 0.013), plateletcrit (p < 0.036), mean platelet volume (p < 0.019) and platelet distribution width (p < 0.002). There were also significant differences in FBG (p < 0.014), neutrophil count (p < 0.029), red cell distribution width (p < 0.046), mean platelet volume (p < 0.032) and platelet distribution width (p < 0.013) between diabetes patients with HBA1c less than 7.0% and HBA1c more than or equal to 7.0%. The outcome of the study indicates significant correlation of HBA1c with selected haematological parameters. This could make routine haematological parameters a cost-effective means of predicting poor glucose control in diabetes mellitus patients.

Efficacy and safety of Buyang Huanwu decoction for diabetic peripheral neuropathy: a systematic review and Metaanalysis.

To evaluate the efficacy and safety of Buyang Huanwu decoction (BYHWD) in treating diabetic peripheral neuropathy (DPN). Eight electronic databases, including China National Knowledge Infrastructure Database, Wanfang Database, China Science and Technology Journal Database, Chinese Biomedical Literature Database, Cochrane Library, Embase, Web of Science, and PubMed, were searched for randomized controlled trials (RCTs) of BYHWD to treat DPN. We identified all RCTs related to BYHWD and those on the treatment of DPN with the combination of mecobalamin. RevMan software was used for the statistical analysis. Twentyone RCTs with a total of 1945 patients were included. The methodological quality of the literature included was low. Metaanalysis showed that the efficacy of the treatment group was significantly better than that of the control group in the treatment of DPN with BYHWD [risk ratio () = 0.33, 95% (0.27, 0.40), 11.25, 0.000 01]. The median nerve of median motor nerve conduction velocity (MNCV) [mean difference () = 4.16, 95% (1.35, 6.98)] and median sensory NCV (SNCV) [(= 3.28, 95% (2.35, 4.22)] were improved in the treatment group. The MNCV in the common peroneal nerve [(= 1.63, 95% (0.39, 2.87)] and SNCV [(= 4.56, 95% (3.16, 5.97)] were significantly higher than those in the control group ( 0.01). Plasma viscosity [(= －0.15, 95% (－0.20, －0.09), 5.17, 0.01)], whole blood high shear [(= 0.83, 95% (1.56, －0.11), 2.26, 0.02)]and whole blood low shear [(= 1.61, 95% (2.28, 0.94), 4.68, 0.01)] decreased significantly after treatment. There was no significant difference in fasting blood glucose [(= 0.42, 95% ( 0.89, 0.05), 1.76, 0.08)] between the treatment and control groups; postprandial blood glucose [(= 0.62, 95% ( 1.19, 0.05), 2.12, 0.03)] decreased significantly. No significant difference was found in the blood lipid levels between the treatment and control groups, including triglycerides [(= 0.21, 95% (0.52, 0.10), 1.34, 0.18)] and cholesterol [(= 0.13, 95% ( 0.27, 0.00), 1.92, 0.06)]. Of the 21 RCTs, only five reported adverse reactions, and four studies reported the length of followup. No serious adverse events were reported. None of the studies reported the quality of life and economic conditions. Our study suggests that BYHWD has a significant therapeutic effect on DPN. Highquality, largescale RCTs are needed to provide more reliable evidence.

Effects of Caffeine mixed with Alpha Lipoic Acid in Preventing Streptozotocin-induced Diabetes in Rats: In Silico and In vivo Study

Objective: This study aimed to investigate the combined effects of caffeine and Alpha Lipoic Acid (ALA) on oxidative stress, due to chronic hyperglycemia, in a model of diabetic rats induced with streptozotocin (STZ) (in silico and in vivo approaches). Material and Methods: This In silico study investigated the interaction between caffeine and ALA against insulin receptors and enzymes of Glutathione Peroksidase-1 (GPx-1), with molecular docking. Male, Wistar rats were included using a quasi-experimental research design, with post-test only and a control group (in vivo). This study measured the end result of a 6-week-induction on body weight, fasting blood glucose, Malondialdehyde (MDA) and GPx-1 enzyme from 25 rats. Results: Molecular docking found the interactions of caffeine and GPx-1 consisting of an energy bond of -5,06 kcal/mol, hydrogen and hydrophobic bond. Additionally, it showed the interaction of ALA and GPx-1 containing an energy bond of -5.16 kcal/mol, hydrogen bonding and hydrophobicity. However, there were no significant difference in body weight, fasting blood glucose, MDA and GPx-1 levels of the ALA-caffeinated diabetic rats compared to diabetic rats.Conclusion: Caffeine and ALA have the potential to activate GPx-1 enzymes (in silico study). However, the use of a caffeine and ALA combination resulted in no significant difference in fasting blood glucose and oxidative stress conditions when compared to diabetic rats without additional induction (in vivo study).

Relationship Between Neck Circumference and Risk Factors of Metabolic Syndrome in a Bushehr Elderly Health Study.

Metabolic syndrome includes a set of metabolic disorders such as obesity, high blood pressure, hypertriglyceridemia, lipid disorders, and glucose intolerance. In this cross-sectional (descriptive-analytical) study, 2,426 people were selected from the 60 years old and above population of Bushehr for a second-phase investigation of the relationship between neck circumference (NC) and cardiometabolic risk factors in the elderly people. The data (mean and standard deviation) were analyzed using STATA MP Version 15 software. The results of the study showed that the average age of all elderly participants in the study was 69.34 ± 6.39 years. The mean and standard deviation of the NC index in men, women, and all participants were 39.31 ± 2.89, 34.86 ± 2.84, and 37.00 ± 3.62, respectively. The mean and standard deviation of most laboratory indicators (triglyceride [TG], total cholesterol [TC], low-density lipoprotein [LDL], high-density lipoprotein [HDL]) were significantly higher in women, and there was no significant difference in fasting blood glucose (FBG) between men and women. NC index in the total population was significantly associated with all risk factors of metabolic syndrome (body mass index, systolic blood pressure, diastolic blood pressure) and laboratory indicators (FBG, TG, TC, LDLC, and HDL). The present study shows that the NC index can be a good predictor for the diagnosis of metabolic syndrome and visceral adipose tissue in the elderly.

Effect of mini low carbohydrate diet and eating speed in obese adults on fasting blood glucose

Link of Video Abstract: https://youtu.be/FcVVr3DoiOs Background: Obesity is an issue with public health that affects people worldwide and raises morbidity and mortality rates. In addition to dietary factors, non-nutritional factors like meal frequency and duration also contribute to the increased risk of obesity. This study aims to evaluate the duration of meals that will be compared between obese subjects who receive a mini low carbohydrate diet and those who do not. Methods: Used a cross-sectional, quasi-experimental design in this study. Seven days of testing on 70 obese subjects who met the inclusion criteria for this study were conducted in November at the Palangka Raya city health center. Using a stopwatch to time the length of each meal in seconds and fasting blood glucose tests. Paired T-test and Independent Sample T-test are used in statistical analysis, while Wilcoxon and Mann-Whitney tests are used in the non-parametric analysis. Data were analyzed using SPSS version 20.0 for Windows. Results: Blood glucose levels and eating speed did not correlate significantly in the mini low carbohydrate diet (M-LCD) group (p&gt;0.05), but they correlated significantly in the control group (CG) (p&lt;0.05). There was a significant difference in fasting blood glucose of the M-LCD and CG groups (p&lt;0.05). Conclusion: There was no correlation between meal speed and fasting glucose levels in the M-LCD group, but there was a significant difference between the M-LCD and CG groups' fasting blood glucose levels.

Abstract 323: Rspo2 Overexpression Attenuates Hepatic Lipid Accumulation And Atherosclerosis

Aims: We have recently reported elevated RSPO2 levels in human and murine atherosclerotic arteries and discovered its anti-lymphangiogenic potential. However, the precise role of RSPO2 in atherosclerosis is not known. In this study, we investigated the effects of RSPO2 overexpression on hepatosteatosis and atherosclerosis development. Methods and Results: Atheroprone ♂ and ♀ Apoe -/- mice were injected with AAV8- GFP or AAV8- Rspo2 , fed a Western diet for 12 weeks, and analyzed for hepatic lipid accumulation and atherosclerotic lesion formation. Our quantitative RT-PCR data revealed increased Rspo2 mRNA expression in the liver, kidney and spleen of AAV8- Rspo2 -injected mice compared with control mice. Oil Red O (ORO) staining showed reduced hepatic lipid deposition in mice injected with AAV8- Rspo2 compared with AAV8- GFP mice. Additionally, there were reduced levels of hepatic triglyceride, non-esterified fatty acid, and lipid peroxidation in Rspo2 -overexpressing mice. Rspo2 overexpression reduced hepatic fibrosis and macrophage accumulation as indicated by reduced expression of SMA and CD68 in liver tissue. Additionally, decreased mRNA expression of proinflammatory and cholesterol metabolism-related genes was found in liver of AAV8- Rspo2 -injected mice. En face ORO staining of aortae and aortic root sections demonstrated suppressed atherosclerosis in mice with Rspo2 overexpression. Interestingly, AAV8- Rspo2 -injected mice had decreased weight gain over the course of Western diet feeding in comparison to control mice, however, no differences in fasting blood glucose and plasma total cholesterol levels were observed between the two groups. Conclusions: Taken together, these findings suggest that global Rspo2 overexpression in hypercholesterolemic mice suppresses hepatic lipid accumulation and reduces atherosclerosis.

Effects of Mixed Nut Consumption on Blood Glucose, Insulin, Satiety, and the Microbiome in a Healthy Population: A Pilot Study.

Nuts contain many health-promoting nutrients, fiber, and phytochemicals. Nut consumption has been reported to improve several chronic disease risk factors. Most studies to date have investigated single variety nut consumption. A nut mixture may offer a more diverse array of nutrients over single variety nuts. The primary outcome of this study was to examine the effects of mixed nut consumption on postprandial glucose, insulin, and satiety in healthy young adults. Exploratory outcomes include the effects of daily nut consumption on stool microbiome and bowel movement patterns. Twenty participants were randomized to consume either 42 g of mixed nuts or 46 g of potato chips daily for 3 weeks. Mixed nut consumption did not alter postprandial blood glucose and insulin, while potato chip consumption increased glucose and insulin (P < .05). There were no significant differences in fasting blood glucose or insulin for either snack after 3 weeks of daily consumption. Both snacks increased satiety while there were no significant differences in body weight, body fat, blood pressure, waist-to-hip ratio, or anxiety. After 3 weeks of snack consumption, both groups significantly reduced straining during bowel movements while the mixed nut group slightly increased stool amount. There were no significant changes in microbiome composition for either group; however, there was a nonsignificant trend toward increased Firmicutes to Bacteroidetes ratio in the potato chip group and an opposite trend in the mixed nut group. The results of this study suggest that mixed nuts are a healthy alternative for blood sugar control. The study was registered at ClinicalTrials.gov, Number: NCT03375866.

Blood glucose trajectories and incidence of diabetes mellitus in Ugandan people living with HIV initiated on dolutegravir

BackgroundFollowing reports of anti-retroviral therapy (ART) experienced Ugandan people living with HIV (PLHIV) presenting with diabetic ketoacidosis weeks to months following a switch to dolutegravir (DTG), the Uganda Ministry of Health recommended withholding DTG in both ART naïve and experienced PLHIV with diabetes mellitus (T2DM), as well as 3-monthly blood glucose monitoring for patients with T2DM risk factors. We sought to determine if the risk of T2DM is indeed heightened in nondiabetic ART naïve Ugandan PLHIV over the first 48 weeks on DTG.MethodsBetween January and October 2021, 243 PLHIV without T2DM were initiated on DTG based ART for 48 weeks. Two-hour oral glucose tolerance tests (2-h OGTT) were performed at baseline, 12, and 36 weeks; fasting blood glucose (FBG) was measured at 24 and 48 weeks. The primary outcome was the incidence of T2DM. Secondary outcomes included: incidence of pre-Diabetes Mellitus (pre-DM), median change in FBG from baseline to week 48 and 2-h blood glucose (2hBG) from baseline to week 36. Linear regression models were used to determine adjusted differences in FBG and 2hBG from baseline to weeks 48 and 36 respectively.ResultsThe incidence of T2DM was 4 cases per 1000 PY (1/243) and pre-DM, 240 cases per 1000 person years (PY) (54/243). There was a significant increase in FBG from baseline to week 48 [median change from baseline (FBG): 3.6 mg/dl, interquartile range (IQR): − 3.6, 7.2, p-value (p) = 0.005] and significant reduction in 2hBG (2hBG: − 7.26 mg/dl, IQR: − 21.6, 14.4, p = 0.024) at week 36. A high CD4 count and increased waist circumference were associated with 2hBG increase at week 36.ConclusionWe demonstrated a low incidence of T2DM in Ugandan ART-naïve patients receiving DTG. We also demonstrated that longitudinal changes in BG were independent of conventional risk factors of T2DM in the first 48 weeks of therapy. Restricting the use of dolutegravir in Ugandan ART naïve patients perceived to be high risk for diabetes mellitus may be unwarranted.

The therapeutic effects of attending a one-day outpatient service on patients with gestational diabetes and different pre-pregnancy body mass indices.

This study investigated the effects of attending a one-day outpatient service on the outcomes of patients with gestational diabetes mellitus (GDM) and different pre-pregnancy body mass indices (BMIs). The study recruited 311 pregnant women with GDM into a one-day outpatient service at The Fourth Hospital of Shijiazhuang from September 2019 to December 2021. They were randomly assigned to three groups, based on their pre-pregnancy BMI as follows: group A, BMI < 18.5 kg/m2; group B, 18.5 ≥ BMI > 25.0 kg/m2; group C, BMI ≥25 kg/m2. The following information was collected from all the participants: fasting blood glucose, hemoglobin A1c (HbA1C), insulin dose, gestational weight gain, weight gain after the one-day outpatient service, and perinatal outcomes. The three groups showed significant differences in fasting blood glucose and HbA1C, insulin treatment rate, and the incidence of pregnancy hypertension/preeclampsia and neonatal jaundice (all P < 0.05). The rate of excessive gestational weight gain in all of the groups also reflected significant differences (P < 0.05). Group A showed the lowest weight gain, while group C gained the most weight. There is no significant difference in the incidences of hypertension/preeclampsia, neonatal jaundice, or premature birth between patients with weight loss/no weight gain and those with positive weight gain. One-day diabetes outpatient integrated management may effectively help to manage weight gain and blood glucose in patients with GDM and different pre-pregnancy BMIs. Dietary control after a GDM diagnosis may have helped to avoid weight gain entirely, as well as negative weight gain, but did not increase the risk of maternal and infant-related complications.

Antidiabetic effects of Andrographis paniculata supplementation on biochemical parameters, inflammatory responses, and oxidative stress in canine diabetes.

Introduction: Diabetes mellitus is a common endocrine disorder that causes hyperglycemia in dogs. Persistent hyperglycemia can induce inflammation and oxidative stress. This study aimed to investigate the effects of A. paniculata (Burm.f.) Nees (Acanthaceae) (A. paniculata) on blood glucose, inflammation, and oxidative stress in canine diabetes. A total of 41 client-owned dogs (23 diabetic and 18 clinically healthy) were included in this double-blind, placebo-controlled trial. Methods: The diabetic dogs were further divided into two treatments protocols: group 1 received A. paniculata extract capsules (50mg/kg/day; n = 6) or received placebo for 90days (n = 7); and group 2 received A. paniculata extract capsules (100mg/kg/day; n = 6) or received a placebo for 180days (n = 4). Blood and urine samples were collected every month. No significant differences in fasting blood glucose, fructosamine, interleukin-6, tumor necrosis factor-alpha, superoxide dismutase, and malondialdehyde levels were observed between the treatment and placebo groups (p > 0.05). Results and Discussion: The levels of alanine aminotransferase, alkaline phosphatase, blood urea nitrogen, and creatinine were stable in the treatment groups. The blood glucose levels and concentrations of inflammatory and oxidative stress markers in the client-owned diabetic dogs were not altered by A. paniculata supplementation. Furthermore, treatment with this extract did not have any adverse effects on the animals. Non-etheless, the effects of A. paniculata on canine diabetes must be appropriately evaluated using a proteomic approach and involving a wider variety of protein markers.

Are Women with Normal-Weight Obesity at Higher Risk for Cardiometabolic Disorders?

This study aimed to evaluate the cardiometabolic abnormalities in women with normal-weight obesity (NWO) in comparison with lean, overweight, and obese women. This cross-sectional study evaluated the assessment of cardiometabolic abnormalities of women with NWO compared to lean, overweight, and obese women. NWO was defined as a BMI < 25 kg.m-2 and a BFP higher than 30%. Anthropometric variables, cardiometabolic abnormality markers (fasting blood glucose (FBG), blood pressure (BP), lipid profile, insulin resistance, and high-sensitivity C-reactive protein (hs-CRP)), and liver enzymes were also examined. Significant differences were observed in HDL concentrations between NWO, lean, and obese participants (p < 0.05). There were no significant differences in FBG, insulin resistance, liver enzymes, or cholesterol between groups (p > 0.05). The prevalence of the abnormal metabolic phenotype was higher in NWO compared to the lean group (4.0% and 24.1%, respectively; p < 0.05). Women with type 2 and 3 obesity had abnormal metabolic profiles (60.9% and 73.9%, respectively) compared to NWO participants (p < 0.01). The NWO group had a significantly higher incidence of cardiometabolic abnormalities compared to the lean participants (p < 0.05), while the type 2 and 3 obese individuals had significantly higher incidences compared to the NWO group (p < 0.001 and p < 0.001, respectively). Individuals with NWO had a significantly higher incidence of cardiometabolic abnormalities when compared to lean participants. These abnormalities strongly relate to BFP and waist circumferences.

Association between Glucose Metabolism and Oral Combined Contraceptive Pills or Cyclic Progestin in Thai Women with Polycystic Ovary Syndrome: A 3-year Observational Study

Objective: To measure the difference in fasting blood glucose (FBG) among Thai women with polycystic ovary syndrome (PCOS), having received either oral combined contraceptive pills (OCP) or cyclic progestin, during 3 years of treatment. Materials and Methods: The data were collected by a retrospective chart review of women with PCOS, who had been treated at Siriraj Hospital before June 2019, backward to the year 2000. The patients were divided into two groups, according to their different treatments, namely: an OCP group and a cyclic progestin group. There were 44 cases in each group, and both groups had received complete hormonal treatment over 3 years. Results: The patients’ baseline characteristics showed a significantly lower body mass index (BMI) and waist circumference (WC) in the OCP group than in the cyclic progestin treatment group. After the 3-year period of treatment, the FBG differences in the OCP group and cyclic progestin treatment group were 3.4±8.4 and 3.6±8.5 mg/dL, respectively; which revealed no statistical significance. Additionally, the difference in the WC and metabolic profile between the studied groups after 3 years of treatment also revealed no significance. However, BMI presented a significant difference between the two hormonal regimens after 3 years of treatment (p-value=0.007), with higher differences in the OCP treatment group. Conclusion: There was no statistically significant difference in FBG between the beginning and at the third year of treatment found in both regimens of hormonal treatment in Thai PCOS women.

Down referral and assessing comprehensive diabetes care in primary care settings: An operational research from India

Background and aimsIn this study, we aimed to refer eligible (patients with stable blood sugar and without any history of cardiovascular events or proliferative retinopathy) and willing persons with diabetes (PwDs) to primary healthcare centers (PHCs) from tertiary care and to compare the care indicators. MethodsThis before-after interventional study was conducted among PwDs aged ≥18 years at a tertiary care hospital in South India. Care indicators (regularity to the clinic, waiting time, and blood sugar control status) were assessed before down referral and after three months of follow-ups at PHCs. ResultsOf 204 PwDs referred to PHCs. Among them, 88% (n = 180) registered at PHCs for care and 46% (n = 94, 95% CI 39.1–53.2%) were lost to follow-ups at PHCs. The main reason for loss to follow-ups was the unavailability of medicines at PHCs(n = 41, 44%). Among those who were on regular follow-ups at PHCs, there was no significant difference in fasting blood glucose (FBG) control status compared to tertiary (52%–64.6%, p = 0.083). However, there was a significant improvement in the regularity of clinic visits (75% vs. 100%, p < 0.001), consultation waiting time (90 vs. 60 min, p = 0.028), and waiting time at pharmacy queues (120 vs. 30 min, p < 0.001) between tertiary care and PHCs. However, among those registered at PHCs, only 40.6% (n = 73, 95% CI 33.3–48.1) were willing to continue care at PHCs for their diabetes management. ConclusionPrimary care was better than tertiary care in terms of PwD's regularity of clinic visits and waiting time for care.

An Exploratory Study of the Safety and Efficacy of a Trigonella foenum-graecum Seed Extract in Early Glucose Dysregulation: A Double-Blind Randomized Placebo-Controlled Trial.

This was an exploratory study to assess the safety and efficacy of a specialized Trigonella foenum-graceum L. seed extract for supporting healthy blood glucose metabolism in a pre-diabetic cohort. Fifty-four participants were randomised to receive 500 mg/day of T. foenum-graecum seed extract or matching placebo daily for 12 weeks. Fasting blood glucose (FBG), post-prandial glucose (PPBG), HbA1c, fasting insulin (FI), post-prandial insulin (PPI) and C-peptide were assessed at baseline, week 6 and week 12. Lipid levels, liver enzymes and C-reactive protein (CRP), along with safety markers and tolerability were also assessed at baseline and week 12. By week 12 there was a significant difference in FBG (p &lt; 0.001), PPBG (p = 0.007) and triglycerides (p = 0.030) between treatment groups, with no changes in HbA1c (p = 0.41), FI (p = 0.12), PPI (p = 0.50) or C-peptide (p = 0.80). There was no difference in total cholesterol (p = 0.99), high-density lipoprotein (p = 0.35), low density lipoprotein (p = 0.60) or CRP (p = 0.79). There was no change in safety markers and the treatment was well tolerated. The results of the study indicated that T. foenum-graecum seed extract may influence blood glucose metabolism and larger studies are warranted to evaluate efficacy and potential mechanisms of action.

ODP228 Obesity Induced a Down-Regulation of nNOS in Intrapancreatic Nervous System

Abstract Objective Obesity has become a serious global public health problem. Obesity is frequently preceding and the most important risk factor of type 2 diabetes. Pancreas regulates glucose metabolism and glucose homeostasis, and abnormality of pancreas play an important role in insulin resistance and diabetes. Intrapancreatic nerve innervation modulates insulin release and is tightly linked to the onset and development of diabetes. However, it is not known whether the activity of the intrapancreatic nervous system has been altered before the onset of diabetes. In this study, we examined the intrapancreatic nervous system in rats with obesity looking for the changes induced by obesity. Methods Obese Sprague-Dawley rats were developed with feeding high fat diet for 10 weeks. Using Immunofluorescence method, choline acetyl transferase (ChAT) and nNOS positive neurons in intrapancreatic ganglia were counted. ChAT and nNOS expression in pancreas were also measured with western blot method. Results (1) There was no significant difference in fasting blood glucose between obese rats and normal rats, but oral glucose tolerance test showed that the oral glucose tolerance was impaired in obese rats. (2) In rats fed with normal diet, 80.2%±1.5 neurons in intrapancreatic ganglia were ChAT positive, and in the obese rats, 79.3%±1.8 neurons were ChAT positive. There was no significant difference between the two groups (p&amp;gt;0. 05, n=5). In intrapancreatic ganglia of obese rats, 40%±1.4 neurons were nNOS positive, which was significantly lower than that (60.5%±1.2) of rats fed with normal diet (p&amp;lt;0. 01,n=5). (3) In pancreatic tissue, the relative expression level of ChAT protein was 1. 02±0. 03 in rats fed with normal diet and 0.98±0. 05 in obese rats (p&amp;gt;0. 05, n=5). The relative expression level of nNOS protein was 1.70±0. 08 in normal rats and 1.10±0. 05 in obese rats (p&amp;gt;0. 01, n=5). Conclusion The cholinergic nerves in intrapancreatic nervous system was not altered in obese rats, however, nNOS nerves was down-regulated in obese rats. The down-regulation of nNOS would induce a hyperactivity in intrapancreatic nervous system and this would cause an enhancement of insulin release, which has been observed in obese individuals. Presentation: No date and time listed

Effect of defatted rice bran supplementation on metabolic parameters and inflammatory status in overweight/obese adults with hypercholesterolemia: a randomized, placebo-controlled intervention

BackgroundDefatted rice bran (DRB) is a byproduct of rice bran oil production rich in fiber, protein, and antioxidant compounds that may confer beneficial effects on metabolic profiles in humans. The current study aimed to investigate the effects of DRB supplementation on anthropometric and blood biochemical indices, dietary intake, and inflammatory status in overweight/obese subjects with hypercholesterolemia.MethodsIn a 12-week-randomized placebo-controlled trial, 61 overweight/obese participants with a total cholesterol level > 200 mg/dL were randomly assigned either to 30 g/d DRB (n = 30) or to 10 g/d maltodextrin (n = 31).ResultsDRB intervention significantly reduced systolic and diastolic blood pressure by 4.27 and 4.50%, respectively (126.20 ± 13.63 to 120.60 ± 13.72 mmHg, p = 0.0003 and 80.87 ± 7.38 to 77.17 ± 9.83 mmHg, p = 0.0035). HbA1c also decreased significantly by 3.59% (5.89% ± 0.76% to 5.66% ± 0.62%, p = 0.0001) after DRB supplementation. Total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels also decreased insignificantly by 3.12, 1.32, and 1.53%, respectively, after DRB supplementation. Insignificant differences in fasting blood glucose, insulin, homeostatic model assessment of insulin resistance, quantitative insulin sensitivity check index, hs-CRP and homocysteine levels were also observed after DRB intervention. Reduction in caloric and fat intake were reported in DRB groups.ConclusionsDRB supplementation improved blood pressure and HbA1c levels. It also lowered blood cholesterol, albeit insignificantly. Caloric and fat intake were also significantly lower after DRB supplementation. Further study is needed to evaluate the mechanisms by which DRB improves these metabolic indices.Trial registrationThai Clinical Trial Registration (https://www.thaiclinicaltrials.org/.) Thai Clinical Trial Registration number: TCTR20191020003. Registered 20 October 2019.

Serum retinol binding protein-4 and the risk of hypothyroidism in Egyptian diabetic patients with cardiovascular manifestations

Retinol binding protein-4 (RBP4) levels have been associated with patients of type 2 diabetes (T2DM) including insulin resistance (IR), dyslipidemia, and cardiovascular disease (CVD). The present study examined the relationship between serum levels of RBP4 and the risk factors related to hypothyroidism (Hypo) and CVD in diabetic Egyptian patients. A total of 96 subjects were recruited and divided into 8 groups. Subjects were assessed for different biochemical parameters. In addition, serum levels of RBP4 were measured using specific immunoassays. There was a highly statistically significant difference in fasting blood glucose (FBG) and hemoglobin A1C (HbA1c) between the different patient groups and the control group. Thyroid stimulating hormone (TSH) concentration in the (T2DM+Hyp) group was considerably higher than in the other groups. There were statistically significant variations in TSH levels between all groups and controls. The mean RBP4 value in Group5 (T2DM+Hyp+CVD) was significantly higher than in the other groups. In (T2DM+Hypo+CVD) group, the receiver operating characteristic (ROC) curve revealed that RBP4 had a higher area under curve (AUC), making it a powerful discriminator of those diseases.