Fasting Blood Glucose Measurements Research Articles

Abstract P270: Higher Long-Term Fasting Glucose Variability From Childhood is Associated With Poorer Cognitive Function in Midlife: The Bogalusa Heart Study

Background: Elevated fasting blood glucose(FBG) levels have been associated with poorer cognitive function. High FBG variability has also been associated with accelerated cognitive decline in late life. However, the impact of long term FBG variability from childhood on midlife cognitive function (CF) remains understudied. Hypothesis: We hypothesized that there would be an association of higher long-term FBG variability from childhood with poorer midlife CF measures. Aim: We aimed to identify the influence of higher long term FBG variability on midlife CF. Methods: We studied 1,005 midlife Bogalusa Heart Study participants (age at baseline: mean 9.4 years +/- SD 3.5 years; age at neuropsychological(NP) exam: mean 47.9 years+/- SD 5.2 years; 60.4% women(607 of 1005); 33.5 % Black(337 of 1005)) with ≥3 FBG measurements across follow up. Participants having type 2 diabetes mellitus(T2DM) were excluded. T2DM was defined as FBG ≥126 mg/dL or taking diabetes medication. Long-term visit-to visit FBG variability was measured as deviation from age predicted values (DEV) and residual SD (RSD). Using ≥3 FBG measurements, DEV and RSD were obtained from individual growth curves created by fitting random-effects models stratified by race and sex. Participants’ midlife CF was first measured with 10 NP tests, then were classified into 3 distinct NP profiles (optimal, average, and mixed-low) using cluster analysis. Multinomial logistic regression models were used to analyze the associations between long-term FBG variability parameters and NP profiles, adjusting for education status and mean of FBG measures from childhood to midlife . DEV and RSD were standardized to z-scores by race and sex before regression analysis. Tests for interaction according to race and sex were conducted. Results: After adjusting for the mean FBG level and education status, for a 1 SD increase in DEV, the odds of having a mixed-low CF increased by 57.3% (95% CI 1.244, 1.990) and the odds of an average CF increased by 36.9% (95% CI 1.144, 1.640) respectively, compared to optimal CF. After adjusting for the mean FBG level and education status, for a 1 SD increase in RSD, the odds of having a mixed-low CF increased by 56% (95% CI 1.232, 1.974) and the odds of an average CF increased by 37.7% (95% CI 1.147, 1.653), respectively, compared to optimal CF. No significant interactions between long-term FBG variability parameters and race and sex were found. Conclusions: Higher long-term FBG variability was associated with poorer midlife CF. Further studies are needed to identify the role of long-term FBG variability in the association of cardiometabolic risk factors and midlife CF.

Abstract MP30: Sugar-Sweetened Beverages, Fruit Juices, and Whole Fruits Throughout Childhood and Adolescence and Glycemic Outcomes in Late Adolescence in Project Viva

Objective: To investigate sex-specific associations of sugar-sweetened beverages (SSBs), 100% fruit juices, and whole fruit intake throughout childhood and adolescence with insulin resistance and glycemic outcomes in late adolescence. Methods: We used data from Project Viva, an ongoing pre-birth cohort from eastern Massachusetts. We evaluated intake of SSBs, 100% fruit juices, and whole fruit at early childhood (median age: 3.1 yrs), mid-childhood (7.6 yrs) and early teen research visits (12.9 yrs) using food frequency questionnaires. We measured fasting blood glucose, insulin and glycated hemoglobin (HbA1c) levels in late adolescence (17.4 yrs). We estimated insulin resistance with the homeostasis model assessment for insulin resistance (HOMA-IR). We computed sex-specific linear regression models to estimate associations of average consumption of SSBs, fruit juice and whole fruit across the 3 childhood-early teen visits with late adolescence HOMA-IR, fasting glucose and HbA1c adjusting for demographics, socioeconomic status, mother BMI, child BMI z-score, and parental history of type 2 diabetes in early childhood (model 1), and additionally for lifestyle habits and diet quality in early childhood (model 2). Results: A total of 240 girls and 215 boys met eligibility criteria and had an outcome measure in late adolescence. Greater SSB intake throughout childhood and adolescence was associated with higher HOMA-IR, fasting glucose, and HbA1c in boys only (Figure). Also in boys, greater fruit juice intake was associated with higher HbA1c in late adolescence. Effect estimates in girls were of small magnitude and centered to the null, except for fruit juice and HbA1c with associations in the same direction as boys (Figure). We did not observe any association with respect to whole fruits for either sex. Conclusion: Findings suggest that SSBs and fruit juice consumption throughout childhood and adolescence are associated with less favorable glycemic traits in boys, suggesting greater risk of developing diabetes.

Abstract P507: Adherence to Pediatric Screening Guidelines for Cardiovascular Risk Factors in a Diverse Cohort of Children in Chicago

Background: Preventive screenings in children and adolescents encourage maintenance of optimal cardiovascular health (CVH) early in life, but there may be a gap between recommendations and clinical practice. We evaluated adherence to pediatric guidelines for universal age-based and risk-based screening for body mass index (BMI), blood pressure (BP), lipids, and blood glucose. Methods: We used 2010-2018 ambulatory visit data from children aged 2-12y within CAPriCORN, an electronic health record network from major healthcare systems in Chicago. For each child who attended a well-child visit and met age and/or risk-based criteria, receipt of BMI, BP, lipids, and/or HbA1c or fasting blood glucose measurements were assessed. For each metric, proportion adherence was calculated via generalized estimating equations with an exchangeable correlation structure and was stratified by age, sex, race/ethnicity, and insurance status. Results: This study included 87,549 children who attended 197,559 well-child encounters. Across all encounters, children were 51.5% male and mean (SD) age 6.4 (3.3) years. Universal age-based screening prevalence (95% CI) per 100 eligible children was 77.1 (76.8, 77.3) for BMI, 33.4 (33.1, 33.7) for BP, and 9.6 (9.3, 9.9) for lipids. Risk-based screening prevalence (95% CI) per 100 eligible children was 13.9 (12.2, 15.9) for BP, 6.9 (6.4, 7.5) for lipids, and 13.3 (12.6, 14.1) for blood glucose. Conclusions: Early screening of CVH risk factors could lead to earlier interventions, which could alter CVH trajectories across the lifetime. Low levels of adherence to universal age-based and risk-based CVH screening highlight the gap between recommendations and clinical practice, emphasizing the need to understand and address barriers to screening in pediatric populations.

How Do Genetic and Environmental Factors Influence Cardiometabolic Risk Factors? Findings from the Isfahan Twins Study.

Disease-discordant twins are excellent subjects for matched case-control studies as they allow for the control of confounding factors such as age, gender, genetic background, and intrauterine and early environment factors. Study design: A cross-sectional study. Past medical history documentation and physical examination were conducted for all participants. Fasting venous blood samples were taken to measure fasting blood glucose (FBG) and lipid levels. The ACE model, a structural equation model, was used to assess heritability. This study included 710 twin pairs (210 monozygotic and 500 dizygotic) ranging in age from 2 to 52 years (mean age: 11.67±10.71 years). The study was conducted using participants from the Isfahan Twin Registry (ITR) in 2017. Results showed that in early childhood (2-6 years), height, weight, and body mass index (BMI) were influenced by shared environmental factors (76%, 75%, and 73%, respectively). In late childhood (7-12 years), hip circumference, waist circumference (WC), and low-density lipoprotein (LDL) cholesterol were found to be highly heritable (90%, 76%, and 64%, respectively). In adolescents, height (94%), neck circumference (85%), LDL-cholesterol (81%), WC (70%), triglycerides (69%), weight (68%), and BMI (65%) were all found to be highly or moderately heritable. In adult twins, arm circumference (97%), weight (86%), BMI (82%), and neck circumference (81%) were highly heritable. This study demonstrates that both genetic and environmental factors play a role in influencing individuals at different stages of their lives. Notably, while certain traits such as obesity have a high heritability during childhood, their heritability tends to decrease as individuals transition into adulthood.

Determinants of gastric residual volume before elective surgery in diabetic patients: An observational study.

We investigated factors affecting the low- and high-risk groups for aspiration by measuring gastric volume with ultrasound in diabetic patients who fasted for elective surgery. The study was conducted as an observational study. Sixty-five patients scheduled for elective surgery, aged 18-86 years, with American Society of Anesthesiologists (ASA) scores II-III, and who have diabetes were included after local ethics committee approval. Written informed consent was obtained from all participants. Demographic data of cases were recorded. Patients whose gastric residual volume (GRV) was calculated using the pupils equal, round, reactive to light, and accommodation (PERLA) formula following gastric antrum measurement in the right lateral decubitus and supine position by ultrasound were categorized as low or high risk for aspiration. Thirty-one patients were in the low-risk group, and 34 patients were in the high-risk group. Sex, weight, body mass index (BMI), hemoglobin A1c (HbA1c) values, and duration of diabetes were not statistically significant (p > 0.5). Age (p = 0.006) and fasting blood glucose (FBG) (p = 0.005) were statistically significant. The risk of aspiration decreases with age. Hyperglycemia is related to delayed gastric emptying and a high risk for aspiration. The duration of fasting, GRV, and cross-sectional area (CSA) were statistically significant (p = 0.017, p = 0.000, and p = 0.000, respectively). Gastric emptying might be delayed in diabetic patients resulting in a high risk for aspiration pneumonia. The risk of aspiration increases in young diabetic patients, and preoperative FBG measurements can provide an idea about gastric emptying in diabetic patients. Gastric ultrasound (USG) may contribute to guidelines for determining more appropriate fasting times for other patient populations, such as obese, pregnant, or child patients.

Prevalence of Metabolic Syndrome and its Components in Patients with Controlled Graves’ Disease

Abstract Aim: Our aim was to assess the prevalence of the metabolic syndrome (MetS) and its components in patients with controlled Graves’ disease (GD). Methods: This was a cross-sectional study involving 95 consecutive patients with GD referred to our tertiary care inpatient clinical center meeting the following inclusion criteria: controlled hyperthyroidism, treatment with antithyroid drugs, untreated Graves’ orbitopathy (GO), if present. Patients’ anthropometric parameters were evaluated and laboratory tests were performed with measurement of fasting blood glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, thyroid hormone and antibody levels. The presence of the MetS and its components as defined by the International Diabetes Federation from 2009 were evaluated. Results: In our patient cohort 82.1% were females, 17.9% were males, mean age 50.2 ± 13 years, with median duration of GD 16.5 months. The MetS was observed in 32.6% of our patients, obesity – in 34.7%, hyperglycemia in 38.9%, arterial hypertension – in 36.8%, low HDL-cholesterol – in 23.2% and hypertriglyceridemia – in 13.7%. There was not statistical difference neither between the prevalence of the MetS, nor between the prevalence of its individual components in female and male GD patients. The MetS was significantly more frequent in older patients, as well as abdominal obesity, hyperglycemia and arterial hypertension. There was not statistical difference in the frequency of the MetS and its components between GD patients with and without GO, except for waist circumference, which was significantly higher in patients with GO. Conclusions: The presence of the MetS and its components among GD patients are to great extent similar to those reported in the general population, which underlines the need for their screening and proper treatment in this subpopulation.

Role of Pathology and Point of Care Testing in the Estimation of Fasting Blood Glucose Levels in Type 2 Diabetes Mellitus Patients

Background: Diabetes mellitus (DM) is a global health concern with significant morbidity and mortality. Effective management of type 2 DM necessitates accurate monitoring of fasting blood glucose levels. Traditional laboratory methods, while accurate, are not always convenient for patients, leading to a growing interest in reliable point-of-care testing. Objective: The aim of this study was to compare the accuracy of fasting blood glucose measurements between point-of-care testing using a glucometer and traditional laboratory methods (hexokinase and end-point) to determine the feasibility of home-based patient monitoring. Methods: This comparative cross-sectional study included 150 type 2 DM patients from Farooq Hospital Westwood, Lahore. Participants underwent fasting blood glucose testing using three methods: the hexokinase method, the end-point method, and a glucometer (Accu-check instant S Meter). The Pearson correlation was employed to assess the linear relationship between the methods, while multivariate ANOVA was used to compare the means. Results: The Pearson correlation coefficients indicated a strong positive correlation between the glucometer readings and both laboratory methods, with coefficients of 0.994 for hexokinase and 0.997 for the end-point method. The average fasting blood glucose levels measured were 128.43 mg/dL (±61.257) for hexokinase, 128.59 mg/dL (±61.110) for the end-point method, and slightly lower at 123.59 mg/dL (±58.920) for the glucometer. Conclusion: The study concluded that glucometer readings are highly correlated with traditional laboratory methods, indicating that point-of-care testing can be a reliable alternative for patients to monitor fasting blood glucose levels at home.

Plasma Lipid Profile and Apolipoproteins in Patients with Coronary Artery Diseases and Healthy Persons, in Sana'a City, Yemen

Background: Cardiovascular disease (CVD) is the primary cause of all disease loads and accounts for almost half of all fatalities. The early detection of coronary artery disease (CAD) has drawn a lot of attention because it is anticipated that the global burden of cardiovascular disease will rise by almost 75% by 2020. They are easily oxidized, which causes an increase in affinity for arterial proteoglycans and a decrease in affinity for LDL receptors. It demonstrates significant CAD importance.
 Objective: The measurement of plasma lipid profiles and apolipoproteins (ApoA-1, ApoB, and Apo B/A-1 ratio) in healthy individuals and patients suffering from coronary artery disease.
 Methods: In this cross-sectional comparative study, 90 Yemeni subjects aged 45 to 70 years were divided into three groups: Group I: 30 cases as CAD positive (CAD+). Group II: 30 cases CAD negative (CAD -). Group III: 30 healthy person was as control. A standardized questionnaire was administered to collect demographic and clinical data from participants. Venous blood (10 ml) was collected from each individual and divided into two portions. The first portion was 5 ml in plain tubes, ApoA-1 and Apo B vacuum tubes for freezing at -20°C until analysis. 5ml in a plain tube for measuring fasting blood glucose, and lipid profile.
 Results: ApoB and Apo B/A ratios were significantly higher in CAD+ and CAD− subjects compared to controls. In addition, ApoB and Apo B/A ratios were significantly higher in CAD+ subjects compared to CAD- subjects. (P. value =0.002). In contrast, Apo A-1 was significant in CAD+ compared to CAD- and controls, and not significantly different between CAD and controls P. value = (0.001, 0.032). Furthermore, FBS and LDL-c were significantly higher in CAD+ compared to CAD subjects (P value = 0.05). In contrast, HDL-c was significantly lower in CAD+ compared to CAD and controls, with no significant difference between CAD and controls (P value=0.038, 0.004, 0.70). However, TG was not substantially different between CAD- and controls, but it was significantly greater in CAD+ compared to controls (P. value =0.002, 0.09, 0.31). Nevertheless, there was no difference in TC between study groups (P. value = 0.08, 0.12, 0.98).
 Conclusions: The degree of CAD is significantly positively correlated with WHR. More important than overall obesity, abdominal obesity is a risk factor for coronary heart disease (CHD). A significant positive connection has been observed between the Apo B/Apo A ratio and CAD. One thing to think about as a CAD risk factor is Apo B.

Effects of conditioned media derived from human Wharton’s jelly mesenchymal stem cells on diabetic nephropathy and hepatopathy via modulating TGF-β and apelin signaling pathways in male rats

BackgroundDiabetic nephropathy and hepatopathy are health problems described by specific renal and hepatic structure and function disturbances. The protective effects of the stem cell secretome have been shown in several kidney and liver diseases. The current study aims to evaluate the capability of conditioned media derived from human Wharton’s jelly mesenchymal stem cells (hWJ-MSCs-CM) to alleviate diabetic complications.MethodsTwenty Sprague Dawley rats were made diabetic through injection of STZ (60 mg/kg, i.p.). At week 8, diabetic rats were divided into two groups: treated [DM + hWJ-MSCs-CM (500 µl/rat for three weeks, i.p.)] and not treated (DM). At the 11th week, three groups (control, DM, and DM + hWJ-MSCs-CM) were kept in metabolic cages, and urine was collected for 24 h. The serum samples were maintained for measuring fasting blood glucose (FBG) and kidney and liver functional analysis. The left kidney and liver parts were kept at -80 °C to assess apelin and transforming growth factor-beta (TGF-β) expression. The right kidney, pancreas, and liver parts were used for histopathologic evaluation.ResultsDM was detected by higher FBG, microalbuminuria, increased albumin/creatinine ratio, and pancreas, renal, and hepatic structural disturbances. Diabetic hepatopathy was determined by increasing liver enzymes and decreasing total bilirubin. The TGF-β gene expression was significantly upregulated in the diabetic kidney and liver tissues. Apelin gene expression was significantly downregulated in the diabetic liver tissue but did not change in kidney tissue. Administration of hWJ-MSCs-CM improved renal and hepatic functional and structural disturbances. Moreover, CM therapy significantly decreased TGF-β expression and enhanced apelin expression in the kidney and liver tissues.ConclusionHuman WJ-MSCs-CM may have protective effects on diabetic renal and hepatic complications. These effects may happen through the regulation of TGF-β and apelin signaling pathways.

Longitudinal trajectories of metabolic and inflammatory markers in youth with emerging mood disorders

Abstract Metabolic and inflammatory dysfunction is prevalent in middle-aged people with major mood disorders, but less is known about young people. We investigated the trajectories of sensitive metabolic (Homeostatic Model Assessment for Insulin Resistance [HOMA2-IR]) and inflammatory markers (C-reactive protein [CRP]) in 155 young people (26.9 ± 5.6 years) accessing mental health services. We examined demographic and clinical correlates, longitudinal trajectories and relationships with specific illness subtypes. Additionally, we compared the HOMA2-IR with fasting blood glucose (FBG) for sensitivity. We observed a significant increase in HOMA2-IR and CRP over time with higher baseline levels predicting greater increases, although the rate of increase diminished in those with higher baseline levels. Body mass index predicted increases in HOMA2-IR (p < 0.001), but not CRP (p = 0.135). Multinomial logistic regression revealed that higher HOMA2-IR levels were associated with 2.3-fold increased odds of the “circadian-bipolar spectrum” subtype (p = 0.033), while higher CRP levels were associated with a reduced risk of the “neurodevelopmental psychosis” subtype (p = 0.033). Standard FBG measures were insensitive in detecting early metabolic dysregulation in young people with depression. The study supports the use of more sensitive markers of metabolic dysfunction to address the longitudinal relationships between immune-metabolic dysregulation and mood disorders in young people.

Apelin as a potential marker in Iraqi children with Type 1 Diabetes Mellitus

Objective: This study aims to evaluate apelin levels and their correlation with key metabolic parameters in pre-pubertal and pubertalindividuals with type 1 diabetes in Iraq, providing insights into apelin's role in diabetes pathogenesis and its potential as an early diagnostic marker for cardiovascular disease. Methods: Ninety children, divided into pre-pubertal T1DM, pubertal T1DM, and healthy subjects, underwent measurements of variousbiochemical parameters, including apelin, fasting blood glucose, lipid profile, and thyroid hormones. Results: Positive correlations (P < 0.01) were found between apelin levels and FSB, TG, BMI, HbA1c, TC, TSH, and a negative correlation with HDL-C in pubertal and pre-pubertal groups, revealing potential links between apelin, glucose, and insulin sensitivity. Conclusion: The study suggests apelin's involvement in diabetes pathogenesis, highlighting its rise in adulthood as an indicator of diabetes complications and its potential use as a diagnostic marker for early detection of cardiovascular disease in individuals with T1DM.

Ambient ozone pollution impairs glucose homeostasis and contributes to renal function decline: Population-based evidence

Particulate matter pollution could increase the risk of kidney disease, while evidence for ozone exposure is less well-established. Here, we aimed to evaluate the effect of ozone pollution on renal function and explore mechanisms. We first conducted a cross-sectional study based on Wuhan Chronic Disease Cohort Study baseline information. We recruited 2699 eligible participants, estimated their residential ozone concentrations, collected fasting peripheral blood samples for biochemical analysis and calculated the estimated glomerular filtration rate (eGFR). The linear regression model was applied to evaluate the long-term association between ozone pollution and eGFR. Then, we recruited another 70 volunteers as a panel with 8 rounds follow-up visits. We calculated the eGFR and measured fasting blood glucose and lipid levels. The linear mixed-effect model along with mediation analysis were performed to confirm the short-term association and explore potential mechanisms, respectively. For the long-term association, a 10.95 μg/m3 increment of 3-year ozone exposure was associated with 2.96 mL/min/1.73 m2 decrease in eGFR (95%CI: −4.85, −1.06). Furthermore, the drinkers exhibited a pronounced declination of eGFR (−7.46 mL/min/1.73 m2, 95%CI: −11.84, −3.08) compared to non-drinkers in relation to ozone exposure. Additionally, a 19.02 μg/m3 increase in 3-day ozone concentrations was related to 2.51 mL/min/1.73 m2 decrease in eGFR (95%CI: −3.78, −1.26). Hyperglycemia and insulin resistance mediated 12.2% and 16.5% of the aforementioned association, respectively. Our findings indicated that higher ozone pollution could affect renal function, and the hyperglycemia and insulin resistance linked to ozone might be the underlying mechanisms.

Novel Insight Into the Relationship of Vitamin D Hydroxylase and Vitamin D With Obesity in Patients With Type 2 Diabetes Mellitus.

In patients with type 2 diabetes mellitus (T2DM) and obesity, there is often a vitamin D deficiency, which is crucial for many physiological processes. The enzyme 25-D hydroxylase activates vitamin D, and its status has been linked to glucose and lipid metabolism in these patients. This study investigates the correlation between the levels of 25-D hydroxylase and 25-hydroxyvitamin D, and their impact on glucose and lipid metabolism in Saudi patients with T2DM and obesity. This study involved 150 Saudi participants (ages 35-70) of both genders from King Faisal Medical Complex in Taif. The participants were divided into control, type 2 diabetic, and obese diabetic patient groups, with 50 subjects in each group. Serum levels of 25(OH) vitamin D and 25-D hydroxylase were measured using ELISA. In contrast, an automatic analyzer for chemistry tests was used to measure fasting blood glucose (FBG), aspartate transaminase(AST), alanine transaminase (ALT), and lipid profile levels. Hemoglobin A1c (HbA1c)% was analyzed using the automatic glycosylated hemoglobin analyzer. In addition, the body mass index (BMI) value was calculated using the equation (BMI = weight in kilograms/height in meters squared). In obese with T2DM and T2DM patient groups, there were significant increases (p < 0.0001) in BMI, FBG, HbA1c%, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), AST, and ALT levels and significant decreases (p < 0.0001) in 25(OH) vitamin D, 25-D hydroxylase, and high-density lipoprotein cholesterol (HDL-C) levels compared to the control group. There were significant positive correlations between vitamin D with 25-D hydroxylase and HDL-C and negative correlations with HbA1c%, FBG, TC, TG, LDL-C, ALT, AST, and BMI in the studied patient groups. This study shows that lower levels of the enzyme 25-D hydroxylase are linked to reduced vitamin D levels in people with T2DM and obese diabetic patients. Additionally, there was a notable correlation between vitamin D levels and BMI, lipid profile, FBG, HbA1c%, AST, and ALT levels.

Abstract 18239: Diabetes Status Does Not Modify the Association Between Prolonged Exposure to Elevated Fasting Blood Glucose and Midlife Cognitive Function

Introduction: The association between type 2 diabetes mellitus (T2DM) and cognitive function(CF) has been well established. However, whether the impact of elevated fasting blood glucose(FBG) levels on CF according to T2DM status remains unclear. Hypothesis: We hypothesized that the impact of elevated FBG on midlife CF would be greater in people with T2DM than in those without T2DM. Methods: We studied 673 midlife participants of the Bogalusa Heart Study (age at baseline 36.7 ± 4.4 years, follow-up period 12.6 ± 1.0 years, age at midlife 49.2 ± 4.5 years, 63% women, 30.2% Black) with ≥3 measurements of FBG across the follow up period. Midlife T2DM status was defined as having FBG≥ 126 mg/dL or taking anti-diabetic medications at the time of midlife neuropsychological (NP) examination. Elevated FBG was defined as FBG≥ 100 mg/dL. Exposure duration of elevated FBG (ED_FBG) was defined as the time interval from initial detection of elevated FBG to midlife NP examination. Participants were classified into 3 distinct NP profiles (optimal, average, and mixed-low) using cluster analysis based on their NP performance, with mixed-low signifying worse CF. Associations between ED_FBG and NP profiles were analyzed using multinomial logistic regression models, adjusting for education status. Stratified analysis of the multinomial regression models according to midlife T2DM status, race and sex were performed. Results: Prevalence of midlife prediabetes and T2DM were 34.0% (n=229) and 11.1 % (n=75), respectively. A total of 120 participants (17.8%) were exposed to ED_FBG during the follow-up period. Mean ED_FBG was 9.1 ± 3.2 years. Mean ED_FBG was significantly longer in Black participants and men. The OR for having a mixed-low CF compared to optimal CF was 1.09 for a 1-year increase in ED_FBG (95% CI 1.02, 1.16), adjusted for education status. Stratified analysis according to midlife T2DM status, race, and sex did not yield significant results. Conclusions: Prolonged exposure to elevated FBG from early adulthood was associated with worse midlife cognitive function regardless of midlife T2DM status. Therefore, even among those without T2DM, prolonged exposure to elevated FBG may affect cognition.

Dose-dependent anti-hyperglycemic & anti-dyslipidemic potential of aqueous leaves extract of Typha elephantina in-vivo and in-vitro

Diabetes mellitus is among the fundamental causes of illness and millions of deaths around the globe are directly attributed to it each year. Current antidiabetic medications often lack sustained glycemic control and carry significant risks of side effects. As a result, the use of plant-based treatments has gained popularity. In this experimental study, we evaluated the aqueous extracts (LQE) of Typha elephantina (also known as Elephant grass) leaves collected from freshwater marshes, for their potential anti-hyperglycemic and anti-hyperlipidemic antioxidant effects in healthy streptozotocin caused diabetic-mice. We employed glucose adsorption tests at different glucose levels and glucose diffusion tests to assess the in-vitro antidiabetic action of plant extract. For the in-vivo trail, we measured fasting blood glucose (FBG), glucose tolerance (GTT), as well as long-term anti-diabetic, anti-hyperlipidemic, and antioxidant activities. Our results from the glucose diffusion test indicated that the extract was highly effective at both low glucose concentrations (5 mmol L) and high glucose concentrations (100 mmol L). However, the glucose-diffusion ability reached its peaked at an excessively high dosage of the aqueous extract, suggesting a dose-related effect. Similarly, we observed that high doses of TEL.AQ extracts (400 mg/kg body weight) significantly reduced blood glucose levels in healthy mice during the glucose tolerance test (GTT) at 3 h and fasting blood glucose studies (FBG) at 6 h. Furthermore, the high-dose TEL.AQ extract effectively reduced liver-related serum markers and blood-glucose concentration (BGC) in severely chronic diabetic rats. The extract dosage also influenced lipid profile, conjugate and unconjugated bilirubin levels, cholesterol, triglycerides, HDL, and total bilirubin levels. Additionally, after administering a high extract dose, we observed considerable improvement in the liver homogenate markers CAT, POD, and SOD. In contrast, the extract at a low dosage(100 mg/kg),showed minimal, while a moderate dose (200 mg/kg), yielded promising results.

The relationship between gut microbiota, short-chain fatty acids, and glucolipid metabolism in pregnant women with large for gestational age infants.

To elucidate the association between gut microbiota, short-chain fatty acids (SCFAs), and glucolipid metabolism in women with large for gestational age (LGA) infants. A single-center, observational prospective cohort study was performed at a tertiary hospital in Wenzhou, China. Normal pregnant women were divided into LGA group and appropriate for gestational age (AGA) group according to the neonatal birth weight. Fecal samples were collected from each subject before delivery for the analysis of gut microbiota composition (GMC) and SCFAs. Blood samples were obtained at 24-28 weeks of gestation age to measure fasting blood glucose and fasting insulin levels, as well as just before delivery to assess serum triglycerides, total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein. The GMC exhibited differences at various taxonomic levels. Within the Firmicutes phylum, genus Lactobacillus, genus Clostridium, species Lactobacillus agil, and species Lactobacillus salivarius were enriched in the LGA group. Microbispora at genus level, Microbispora rosea at species level belonging to the Actinobacteria phylum, Neisseriales at order level, Bartonellaceae at family level, Paracoccus aminovorans, and Methylobacterium at genus level from the Proteobacteria phylum were more abundant in the LGA group. In contrast, within the Bacteroidetes phylum, Prevotella at genus level and Parabacteroides distasonis at species level were enriched in the AGA group. Although there were few differences observed in SCFA levels and most glucolipid metabolism indicators between the two groups, the serum HDL level was significantly lower in the LGA group compared to the AGA group. No significant relevance among GMC, SCFAs, and glucolipid metabolism indicators was found in the LGA group or in the AGA group. Multiple different taxa, especially phylum Firmicutes, genus Prevotella, and genus Clostridium, might play an important role in excessive fetal growth, and LGA might be associated with the lower serum HDL level.

Implicit HbA1c Achieving 87% Accuracy within 90 Days in Non-Invasive Fasting Blood Glucose Measurements Using Photoplethysmography.

To reduce the error induced by overfitting or underfitting in predicting non-invasive fasting blood glucose (NIBG) levels using photoplethysmography (PPG) data alone, we previously demonstrated that incorporating HbA1c led to a notable 10% improvement in NIBG prediction accuracy (the ratio in zone A of Clarke's error grid). However, this enhancement came at the cost of requiring an additional HbA1c measurement, thus being unfriendly to users. In this study, the enhanced HbA1c NIBG deep learning model (blood glucose level predicted from PPG and HbA1c) was trained with 1494 measurements, and we replaced the HbA1c measurement (explicit HbA1c) with "implicit HbA1c" which is reversely derived from pretested PPG and finger-pricked blood glucose levels. The implicit HbA1c is then evaluated across intervals up to 90 days since the pretest, achieving an impressive 87% accuracy, while the remaining 13% falls near the CEG zone A boundary. The implicit HbA1c approach exhibits a remarkable 16% improvement over the explicit HbA1c method by covering personal correction items automatically. This improvement not only refines the accuracy of the model but also enhances the practicality of the previously proposed model that relied on an HbA1c input. The nonparametric Wilcoxon paired test conducted on the percentage error of implicit and explicit HbA1c prediction results reveals a substantial difference, with a p-value of 2.75 × 10-7.

Effect of Coccinia grandis (Linn.) Voigt extract on glucose metabolism markers in a prediabetic population: A double-blind randomised clinical trial

BackgroundThere is increasing interest in the use of herbal medicines to prevent and manage the symptoms of type 2 diabetes mellitus (T2DM). Coccinia grandis has been traditionally used for blood glucose regulation and has shown promise in clinical trials for T2DM although it has not yet been assessed as an anti-glycaemic agent in a prediabetic population. ObjectiveThis study aimed to assess the safety as well as the efficacy of a C. grandis extract in reducing blood glucose levels in a non-medicated prediabetic cohort over 12 weeks. MethodsThe study was a single-site, double-blind, placebo-controlled randomised clinical trial conducted in 48 medically diagnosed prediabetic adults aged 27 to 73 years. Participants received either 1000 mg of a dried C. grandis hydroalcoholic extract per day (equivalent to 15 g/day of dried herb) or placebo (control) for 12 weeks. The primary outcome measure was group change scores in fasting blood glucose (FBG) levels measured at baseline, week 6 and week 12. Secondary outcome measures were 2 h post-prandial blood glucose (PPBG), fasting and 2 h post-prandial insulin (FI and PPI), glycated haemoglobin (HbA1c), c-peptide, full blood count (FBC), lipids (triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), emotional states of depression, anxiety and stress (DASS-21), adverse reactions and tolerability. ResultsAt 12 weeks there was a significant difference between the C. grandis and control groups in the change between their pre and post treatment measurements of FBG (p = 0.019, CI -1.272 to -0.105), 2 h PPBG (p = 0.039, CI 0.212 to 1.392) and TG (p= 0.046). Additionally, although non-significant, the difference between the change in PPI levels (p = 0.061) is worthy of further exploration to provide an understanding of the mechanisms of action of C. grandis extract in managing glucose dysregulation. There were no changes in HbA1c, lipids or biochemical markers in either group after treatment. The C. grandis extract was well tolerated and no adverse events were reported over the 12 weeks. ConclusionC. grandis may be a suitable candidate for managing blood glucose dysregulation in those with prediabetes and further studies are warranted.

Dietary branched-chain amino acids intake, glycemic markers, metabolic profile, and anthropometric features in a community-based sample of overweight and obese adults

BackgroundExisting research provides conflicting evidence regarding the relationship between estimated branched-chain amino acid (BCAA) intake and metabolic, glycemic markers, and anthropometric characteristics. This research seeks to examine the association between estimated dietary BCAA consumption and glycemic, and metabolic markers, as well as anthropometric parameters in adults classified as overweight or obese.MethodsIn this cross-sectional analysis, we gathered data from 465 overweight and obese individuals aged between 18 and 37 years. To evaluate dietary data, we employed the food frequency questionnaire, and the BCAA content in foods was determined via the United States Department of Agriculture website. We utilized ELISA kits to measure fasting blood glucose (FBS) and lipid profile markers, and additionally calculated low-density lipoprotein (LDL) and insulin sensitivity markers. We assessed sociodemographic status, physical activity (PA), and anthropometric attributes through a method recognized as both valid and reliable. For statistical analysis, we conducted analyses of covariance (ANCOVA), making adjustments for variables including sex, PA, age, energy, and body mass index (BMI).ResultsUpon adjusting for confounders, those in the highest tertiles of BCAA intake exhibited an increase in weight, BMI, waist circumference (WC), waist-to-hip ratio (WHR), and fat-free mass (FFM). Conversely, they demonstrated reduced fat mass (FM) (%) and FM (kg) compared to their counterparts in the lowest tertiles (P < 0.05). Additionally, there was a noted association between greater estimated BCAA intake and reduced LDL levels. Nonetheless, our findings did not reveal a significant relationship between dietary BCAA and glycemic indices.ConclusionsFrom our findings, an increased estimated intake of BCAA seems to correlate with diminished serum LDL concentrations. To gain a more comprehensive understanding of this association, it is imperative that further experimental and longitudinal studies be conducted.

Socio-Demographic and Clinical Factors Associated with Poor Glycemic Control Among Patients of Type-2 Diabetes Mellitus Presenting at a Tertiary Healthcare Facility

Objective: To identify socio-demographic and clinical factors associated with poor glycemic control in type-2 diabetes mellitus patients at a tertiary healthcare facility. Methodology: This cross-sectional study was conducted at Outpatient department of Medicine, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from February 2022 to July 2022, included 246 known type-2 diabetes patients of both genders, aged 18 to 75, with at least three consecutive days of fasting blood glucose (FBG) measurements. We assessed socio-demographic and clinical characteristics and classified glycemic control according to ADA guidelines: FBG between 80-130 mg/dl as good control and FBG above 130 mg/dl as poor control. We recorded the prevalence of good and poor glycemic control and compared them based on various socio-demographic and clinical factors. Results: Among 246 patients, 152 (61.8%) were male, with a mean age of 46.47±11.55 years and a mean BMI of 23.13±5.01 kg/m². The mean diabetes duration was 9.18±7.50 years, and 132 (53.7%) patients had a disease duration &gt; 5 years. Diabetes-related complications were present in 156 (63.4%) patients. Poor glycemic control was found in 137 (55.7%) patients. Significant associations with poor glycemic control were observed for age (p&lt;0.001), educational status (p&lt;0.001), BMI (p=0.002), residential status (p=0.013), family history of diabetes (p&lt;0.001), diabetes duration (p&lt;0.001), and current diabetes medications (p=0.001). Conclusion: A majority (55.7%) of type-2 diabetes patients in our study had poor glycemic control. Factors such as increasing age, BMI, education level, residential status, family history of diabetes, longer disease duration, and current diabetes medications were significantly associated with poor glycemic control.