Fasting Blood Glucose Test Research Articles

PEG-rhG-CSF Use Reduces Glucose Level Significantly in Cancer Patients Receiving Chemotherapy

Background: In patients receiving anti-cancer chemotherapy, polyethylene glycolated recombinant human granulocyte-colony stimulating factor (PEG-rhG-CSF) was used for prophylaxis of chemotherapy-induced neutropenia. However, the side effect of PEG-rhG-CSF use on fasting blood glucose (FBG) level remains unclear. Materials and Methods: Cancer patients receiving chemotherapy and PEG-rhG-CSF were enrolled in our study. Baseline glucose (Glucose 1) was measured before PEG-rhG-CSF use, a second FBG test (Glucose 2) was performed after PEG-rhG-CSF use. Mean glucose levels were compared using t test. Results: The time interval between PEG-rhG-CSF use and the second glucose test was 2.4±1.5 days. The mean Glucose 1 was 5.18±0.53 mmol/L, and Glucose 2 was 3.80±1.13 mmol/L. Statistical analysis showed a significant difference between Glucose 1 and 2 existed (P<0.001). Conclusion: Our study identifies a hypoglycemic side effect of PEG-rhG-CSF occurs in cancer patients undergoing anti-cancer chemotherapy. Our results highlight the caution required when using PEG-rhG-CSF for prophylaxis of chemotherapy-induced neutropenia.

Glycemic control rate of type 2 diabetes mellitus in Chinese adults: a multi-centered, retrospective, cross-sectional study

This study aims to clarify the current status of glycemic control in type 2 diabetes mellitus (T2DM) patients in China. This study was a multi-centered, retrospective, cross-sectional study based on electronic medical records. Individuals with T2DM who were admitted to a hospital between January 1, 2018, and December 31, 2018, and had either a fasting blood glucose or HbA1c tests results were included to assess the glycemic control. T2DM patients with fasting blood glucose < 7.0 mmol/L or/and HbA1c < 7.0% were defined as having adequate glycemic control. A total of 19,926 patients from 44 hospitals were included in this study. Among them, male patients were 9796 (49.2%). The mean age of T2DM patients was 62.0 ± 12.9 years and the mean duration of diabetes was 3.0 ± 3.0 years. Totally, 30.7% T2DM patients achieved the adequate glycemic control with fasting blood glucose < 7.0 mmol/L, 44.3% with HbA1c < 7.0%, and 23.0% with both fasting blood glucose < 7.0 mmol/L and HbA1c < 7.0%. T2DM patients with longer duration, admitting to secondary hospitals, and living in the southern and undeveloped regions had lower glycemic control rate. In China, only 23.0% of T2DM patients achieved adequate glycemic control target (both fasting blood glucose < 7.0 mmol/L and HbA1c < 7.0%). Glycemic control should be strengthened for T2DM patients with longer duration, admitting to secondary hospitals, and living in the southern and undeveloped regions.

Feasibility of identifying and describing the burden of early-onset metabolic syndrome in primary care electronic medical record data: a cross-sectional analysis.

The prevalence of metabolic syndrome is growing worldwide, yet remains underinvestigated in Canadian young adults. We sought to explore the use of a harmonized case definition specific to early-onset metabolic syndrome and determine its feasibility in assessing the prevalence of metabolic syndrome among electronic medical record (EMR) data of young adults in Northern Alberta. We conducted a cross-sectional study using a sample of EMR data from young adult patients aged 18-40 years and residing in Northern Alberta, who had an encounter with a participating primary care clinic between June 29, 2015, and June 29, 2018. Physical examination, laboratory investigation and disease diagnosis data were collected. A case definition and algorithm were developed to assess the feasibility of identifying metabolic syndrome, including measures for body mass index (BMI), blood pressure (BP), dysglycemia, hypertriglyceridemia, high-density lipoprotein cholesterol, diabetes and hypertension. Among 15 766 young adults, the case definition suggested the prevalence of metabolic syndrome was 4.4%, 95% confidence interval (CI) 4.1%-4.7%. The most frequent 3-factor combination (41.6%, 95% CI 37.9%-45.3%) of metabolic syndrome criteria consisted of being overweight or obese, having elevated BP and hypertriglyceridemia. Half of metabolic syndrome cases (51.3%, 95% CI 47.6%-55.0%) were missing measures for fasting blood glucose, and one-fifth were missing a hemoglobin A1c (HbA1c) level. Notably, most young adults with a BMI of 25 or greater were missing HbA1c (68.7%, 95% CI 67.6%-69.8%), fasting blood glucose (84.0%, 95% CI 83.2%-84.8%) and triglyceride testing (79.0%, 95% CI 78.1%-79.9%). We have shown that our case definition is feasible in identifying early-onset metabolic syndrome using EMR data; however, the degree of missing data limits the feasibility in assessing prevalence. Further investigation is required to validate this case definition for metabolic syndrome in the EMR data, which may involve comparing this definition to other validated metabolic syndrome case definitions.

Diabetes in late-life schizophrenia: Prevalence, factors, and association with clinical symptoms

ObjectiveThe prevalence of diabetes mellitus has been found to be higher in patients with schizophrenia. Older patients are the fastest-growing segment of the schizophrenia population. However, few studies have explored diabetes in older patients with schizophrenia. Therefore, this study aimed to determine the prevalence and characteristics of factors associated with diabetes in Chinese patients with late-life schizophrenia (LLS), which has not been reported in previous studies. MethodsA total of 289 inpatients aged 60 or above who met the DSM-IV criteria for schizophrenia were recruited. The severity of psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS). Diabetes was diagnosed by fasting blood glucose tests, or oral glucose tolerance tests. ResultsThe overall prevalence of diabetes in LLS patients was 25.3%. The prevalence of diabetes in female patients was significantly higher than that in male patients (35% vs. 21.53%). Other factors associated with diabetes included higher BMI, greater waistline (only for males), higher levels of triglyceride, and more severe positive symptoms. ConclusionThese results indicate that the prevalence of diabetes in LLS patients is similar to that in the age-matched general population. Female gender, excess weight and abdominal obesity, dyslipidemia, and clinical symptoms can be potential risk factors of diabetes in the LLS patient group.

Diagnostic accuracy of the Finnish Diabetes Risk Score for the prediction of undiagnosed type 2 diabetes, prediabetes, and metabolic syndrome in the Lebanese University

BackgroundRisk scores were mainly proved to predict undiagnosed type 2 diabetes mellitus (UT2DM) in a non-invasive manner and to guide earlier clinical treatment. The objective of the present study was to assess the performance of the Finnish Diabetes Risk Score (FINDRISC) for detecting three outcomes: UT2DM, prediabetes, and the metabolic syndrome (MS).MethodsThis was a prospective, cross-sectional study during which employees aged between 30 and 64, with no known diabetes and working within the faculties of the Lebanese University (LU) were conveniently recruited. Participants completed the FINDRISC questionnaire and their glucose levels were examined using both fasting blood glucose (FBG) and oral glucose tolerance tests (OGTT). Furthermore, they underwent lipid profile tests with anthropometry.ResultsOf 713 subjects, 397 subjects (55.2% female; 44.8% male) completed the blood tests and thus were considered as the sample population. 7.6% had UT2DM, 22.9% prediabetes and 35.8% had MS, where men had higher prevalence than women for these 3 outcomes (P = 0.001, P = 0.003 and P = 0.001) respectively. The AUROC value with 95% Confidence Interval (CI) for detecting UT2DM was 0.795 (0.822 in men and 0.725 in women), 0.621(0.648 in men and 0.59 in women) for prediabetes and 0.710 (0.734 in men and 0.705 in women) for MS. The correspondent optimal cut-off point for UT2DM was 11.5 (sensitivity = 83.3% and specificity = 61.3%), 9.5 for prediabetes (sensitivity = 73.6% and specificity = 43.1%) and 10.5 (sensitivity = 69.7%; specificity = 56.5%) for MS.ConclusionThe FINDRISC can be considered a simple, quick, inexpensive, and non-invasive instrument to use in a Lebanese community of working people who are unaware of their health status and who usually report being extremely busy because of their daily hectic work for the screening of UT2DM and MS. However, it poorly screens for prediabetes in this context.

Study on the relationship between dietary quality and the risk of diabetes and prediabetes in urban women

Objective: To explore the relationship between dietary quality and the risk of diabetes and prediabetes among urban women based on alternative healthy eating index-2010（AHEI-2010). Methods: From March to July 2016, a total of 1 061 female residents from 8 cities, Beijing, Guangzhou, Chengdu, Lanzhou, Xuchang, Jilin, Wuhu and Chenzhou in China, were selected by using the multi-stage sampling method. The basic characteristics of all participants were collected by using self-made questionnaire, and the dietary status of the subjects was collected by using 24-hour dietary recall method. AHEI-2010 scores were calculated and the diet was divided into low, medium and high dietary quality group according to the third quartile. All participants received physical examination, systolic blood pressure test, fasting blood glucose test and glycosylated hemoglobin test. Unconditional logistic regression model was used to analyze the relationship between dietary quality and the risk of diabetes and prediabetes. Results: The age of all participants was（48.0±17.5) years old. The median（P25, P75) of AHEI-2010 score was 46.52（40.04, 54.88). The prevalence of diabetes and prediabetes were 13.3%（141 cases) and 50.0%（530 cases), respectively. Unconditional logistic regression analysis showed that after adjusting for age, city, education, diet control, physical activity, energy intake and waist circumference, compared with the low diet quality group, the OR（95%CI) values of medium, high dietary quality group and diabetes risk were 0.96（0.57-1.62) and 0.63（0.36-1.09), respectively; the OR（95%CI) values of medium, high dietary quality group and prediabetes risk were 0.93（0.64-1.35) and 1.28（0.87-1.88), respectively. Conclusion: The dietary quality of urban women based on AHEI-2010 evaluation is not related to the risk of diabetes and prediabetes.

Prevalence of hypertension and selected cardiovascular risk factors among adolescents in selected rural and urban secondary schools in Botswana.

Adolescent hypertension and other cardiovascular risk factors tend to track into adulthood. Consequently, there is a need to determine the prevalence of hypertension and pre-hypertension, and its co-existence with glycaemia, obesity, tobacco and alcohol use among senior secondary school students in Botswana. A cross-sectional study was undertaken between December 2015 and March 2016 among students in selected rural and urban senior secondary schools in Botswana. Data were collected through a self-administered questionnaire, measurements and fasting blood glucose testing. Participants were asked about cigarette smoking, alcohol use and levels of physical activity. Body weight, height, waist circumference, blood pressure and fasting blood glucose levels were measured. Hypertension, pre-hypertension, overweight and obesity were defined based on gender, age and height from normative tables. A total of 252 students with a mean age (standard deviation) of 17.1 (0.9) years participated in the study. Rural students were older than urban students (17.5 vs 16.7 years; p < 0.001). The prevalence of hypertension and prehypertension were 13.1 and 15.5%, respectively. Physical inactivity (37.7%), overweight/obesity (10.3%) and alcohol intake (9.1%) were also prevalent. Cigarette smoking was rare (2.0%). Impaired fasting glucose levels were found in 1.6% of participants, and none had diabetes mellitus. Hypertension ( p < 0.001) and cigarette smoking (p = 0.019) were more prevalent among male than female participants. Female students were more likely to be overweight or obese than male students ( p < 0.001). There were no urban-rural differences in hypertension, pre-hypertension and smoking. Urban students were more likely to drink alcohol than rural students (p = 0.008). Hypertension, overweight/obesity and alcohol intake were common among these adolescents in Botswana. Strategies to reduce the risk factors of cardiovascular diseases should be urgently developed and implemented to prevent cardiovascular disease-related morbidity and mortality in the future.

Interaction between sex and rurality on the prevalence of diabetes in Guyana: a nationally representative study

IntroductionDiabetes prevalence has never been measured in Guyana. We conducted a nationally representative cross-sectional study to estimate the prevalence of diabetes and pre-diabetes, and the association between sex and diabetes.Research...

Prevalência e fatores associados ao diabetes mellitus gestacional em um serviço de alta complexidade

Objetivo: estimar a prevalência e preditores de diabetes mellitus gestacional (DMG) em um serviço de alta complexidade. Metodologia: trata-se de um estudo observacional, analítico, retrospectivo e de coorte realizado em um serviço hospitalar de alta complexidade para gestantes. Dados de 421 gestantes foram incluídos no estudo, sendo a classificação de DMG realizada segundo os critérios da International Association of Diabetes and Pregnancy Study Group (IADPSG). Resultados: a prevalência de DMG foi de 18,5%. Quanto aos fatores de risco, gestantes que tiveram glicemia em jejum alterada tiveram uma probabilidade 16% maior de ter DMG. Alteração no teste oral de tolerância à glicose (TOTG 1h) indicou 6% mais chances para DMG do que aquelas sem alteração no TOTG 1h. Conclusão: a DMG é uma desordem de alta prevalência, associada com desfechos negativos para mães e bebês, sendo considerado um problema de saúde pública. O manejo adequado e precoce, muitas vezes envolvendo mudanças simples no estilo de vida, pode resultar em resultados altamente satisfatórios tanto para as gestantes quanto para seus filhos.

171-LB: Evaluation of Universal Diabetes Diagnostic Testing at First Prenatal Visit

Diabetes mellitus (DM) in pregnancy is not routinely screened for in Haiti. If done, screening relies on OGTT at 24-28 weeks (w) of gestation. It is unclear whether this is an optimal approach in Haiti. We aimed to evaluate the implications of a universal DM diagnostic testing before 24 w. All consecutive pregnant women aged ≥18 y without known DM attending their first pregnancy visit in 4 prenatal clinics of Port-au-Prince and surroundings were invited to participate. Using a Contour NextR glucometer, eligible subjects underwent: Fasting blood glucose (FBG) test at 1-23 w and ≥36 w, 75g 2-h OGTT at 24-28 w for FBG &amp;lt;126 mg/dL before 24 w or at 24-35 w-first visit. We used WHO/IADPSG diagnostic criteria for DM in pregnancy (DIP) (FBG ≥126 mg/dL and/or 2h ≥200 mg/dL) and for gestational DM (GDM) (1 or more: FBG 92-125 mg/dL, 1-h BG ≥180 mg/dL, 2-h BG 153-199 mg/dL). A total of 945 women (mean age 29.78 ± 5.77 y, parity 2.04 ± 1.29, pre-eclampsia: 3.80%, caesarian section: 18.75%, preterm birth: 7.13%, single or living alone: 10.13%, family history of DM: 10.11%) were studied. Women with first visit at &amp;lt; and ≥24 w were 332 and 613, respectively. Prevalence of DIP and GDM by first screening period was: 7.20% and 13.02% overall, 12.35% and 13.86% at &amp;lt;24 w, and 4.40% and 12.56% at ≥24 w. Median FBG progressively decreased from 83 mg/dL at ≤5 w to 73 mg/dL at ≥36 w, p=0.0000. Of the 40 women with GDM at &amp;lt;24 w, 20 had GDM confirmed and 20 were normal on OGTT. A cut-off value of FBG &amp;gt;100 mg/dL at &amp;lt;24 w for DM (DIP and GDM) diagnosis on OGTT had: specificity (SP) 98.8%, sensitivity (SE) 19.3%, and positive predictive value (PPV) 78.6%. A cut-off value of FBG &amp;lt;72 mg/dL at &amp;lt;24 w to rule out DM on OGTT had: SP 12.2%, SE 98.3%, and NPV 96.8%. Women with these cut-offs represented 14.9% of those undergoing OGTT after the &amp;lt;24 w screening. Our findings suggest that universal screening for DM before 24 w of gestation leads to diagnosis of DM in about 20% of pregnant women. A rule in/rule out approach using FBG &amp;lt;72 mg/dL and &amp;gt;100 mg/dL values at &amp;lt;24 w can help reduce the number of OGTT at ≥24 w. Disclosure P. Larco: None. E. Jean Baptiste: None. K. Moise: None. M. Charles Larco: None. B.S. Jerome: None. J.E. von Oettingen: None. R. Charles: None.

Association Between Plasma Irisin in Mid-Pregnancy and Postpartum Glucose Levels Among Chinese Women

Abstract Objectives The association between plasma irisin and glucose levels in general population was controversial and few researches longitudinally explored this correlation. We aimed to examine whether mid-pregnancy irisin was associated with postpartum glucose among Chinese women and explore the potential modifiable factors. Methods We conducted a prospective cohort study in Guangzhou, China during 2017–2018 and 453 pregnant women (20–28 weeks) were enrolled. At 6–8 weeks after birth, 94 women with gestational diabetes mellitus (GDM) underwent a 75 g oral glucose tolerance test, and the other 359 women had a fasting blood glucose (FBG) test. Multivariable linear regression, quantile regression, and logistic regression analysis were conducted. Results Mean baseline plasma irisin was 13.73 ng/ml. The prevalence of postpartum impaired fasting glucose (IFG) was 14.35% in all participants. Among women with previous GDM, 23 (24.47%) had impaired glucose tolerance (IGT). We found a significantly negative association between mid-pregnancy irisin and postpartum FBG (β: −0.056 ± 0.024). While quantile regression showed the associations were only significant in high percentiles of FBG (P50 to P95), and the magnitude displayed an increasing trend. In addition, higher baseline irisin was associated with lower risk of postpartum IFG (RR, 0.563; CI, 0.384–0.825). Furthermore, we detected significant interactions between irisin and breastfeeding on FBG and IFG (both Pinteraction &amp;lt; 0.05). But baseline irisin was not significantly associated with postpartum postprandial glucose levels or the risk of IGT in women with GDM. Conclusions Plasma irisin levels during mid-pregnancy were negatively associated with FBG and IFG at 6–8 weeks postpartum among Chinese women, and stronger associations in women with higher FBG values were observed. Moreover, breastfeeding may modify this relationship. Funding Sources This work was supported by the National Natural Science Foundation of China (81,602,862) and the Sanming Project of Medicine in Shenzhen (SZSM201803061).

SAT-659 Micro/Nanoparticles from Antidiabetic Chinese Herbal Medicine Soup Increase Bioavailability of Phytochemicals and Regulate Glucose and Lipid Metabolism

Herbal soups have always been a popular option for treating oxidative stress-related chronic diseases including diabetes. Various components of these soups have been studied in the hope to identify the active principles, mainly focusing on the individual phytochemicals. As we have revealed previously, the micro/nanoparticles (MNPs) formed incidentally during the boiling water extraction of herbal soups may be bioactive and functional. This study aims to elucidate the underlying mechanism of the biological functions of these MNPs. A Chinese herbal medicine soup prepared by Radix Puerariae lobatae, ginger and other three herbs, namely Ge-Gen-Qin-Lian-Tang, was employed here, as it was proven to be effective in treating type 2 diabetes clinically.The soup was separated with high-speed centrifuge (15600×g) to obtain the supernatant (solutes and nanoparticles) and sediments (MNPs), and determined for the content of three bioactive phytochemicals, e.g. puerarin, berberine and baicalin. Their hypoglycemic, hypolipidemic and antioxidant effects were determined on streptozotocin (STZ)-induced Type 2 diabetic Wistar male rats fed on high fat-high sugar diet. The animals were divided into six groups (normal control, diabetic model, whole soup, supernatant, MNPs and metformin, 8 rats each), recording weight, diet, excretion, mental status, etc. The fasting blood glucose and oral glucose tolerance test were conducted regularly. Eight weeks after the administration, the rats were sacrificed after anesthesia. Abdominal aorta blood and tissue samples of pancreas, heart, skeletal muscle, liver, kidney, spleen were collected. The glycated hemoglobin, glucose, lipid, insulin, glucagon, AMPK, SOD, puerarin, berberine, baicalin in blood plasma, insulin in pancreas, SOD in tissues, AMPK in skeletal muscle were measured. Liver tissue sections were observed with HE staining. Statistical analysis (t-test) were performed.The MNPs reduced blood glucose, ameliorated glucose tolerance, elevated insulin secretion and significantly improve glucose and lipid metabolism (P <0.05), showing stronger effects than the supernatant components. Notably, MNPs elevated the AMPK level in skeletal muscle, even more potently than the whole soup. The therapeutic effects of MNPs on the liver damage were even stronger than metformin. Meanwhile, MNPs promoted absorption of puerarin, berberine and baicalin and increase their concentration in blood (P <0.05). Therefore, the MNPs from the herbal soup exhibited more potent effects than the soluble components on ameliorating glucose and lipid metabolism and pancreatic functions of diabetic rats. The actions of these MNPs provide a new perspective for understanding the antidiabetic effects of herbal soups and serve as a vehicle for the multiple phytochemicals to synergistically possess therapeutic effects.

Short-Term Results Suggest That Sleeved Stomach without Resection Is as Effective as Sleeve Gastrectomy in Improving Glucose Control in Type 2 Diabetes Mellitus Sprague-Dawley Rat Model.

Background Although sleeve gastrectomy results in good weight loss and metabolic improvements, it is an irreversible procedure. Therefore, we attempted to assess the possibility of creating a sleeved stomach without resection. Material and Methods. A total of 22 male Sprague-Dawley rats with type 2 diabetes were randomly assigned into 3 different groups: (1) sleeve gastroplasty with gastric remnant-jejunal anastomosis (SGP, n = 8); (2) sleeve gastrectomy (SG, n = 8); and (3) SHAM (n = 6). Body weight, food intake, fasting blood glucose (FBG), hormonal analysis, and oral glucose tolerance test (OGTT) were performed and measured preoperatively and postoperatively. Results During the postoperative period, SGP and SG showed significantly lower food intake and body weight when compared with the preoperative levels, respectively (p value < 0.05). Postoperatively, SGP and SG showed improvements in FBG and glucose tolerance levels compared to their respective preoperative levels (p < 0.05). FBG and glucose tolerance levels did not differ between SGP and SG postoperatively. SG resulted in a reduction in fasting ghrelin levels when compared with the preoperative level (p < 0.05). Fasting insulin levels did not differ preoperatively and postoperatively among all groups. Postoperatively, fasting GLP-1 levels were higher in SGP and SG when compared with the preoperative levels, but no statistical significance was observed. Compared preoperatively, the SGP and SG procedures resulted in a decline in HOMA-IR at postoperative 6th week (p < 0.05). Conclusion Our animal experiment suggested that at least in the short term, sleeved stomach without resection resulted in similar weight loss and improved glucose control effects compared to sleeve gastrectomy.

Blood Glucose Is a Representative of the Clustered Indicators of Multi-Organ Injury for Predicting Mortality of COVID-19 in Wuhan, China

Background: Most patients with Coronavirus Disease 2019 (COVID-19) were mild. Severe patients progressed rapidly to critical condition including multi-organ failure and even death. Identification of early predictive factors is urgently necessary to facilitate appropriate intensive care. Methods: We included all patient admitted to Wuhan Union Hospital and treated by the supportive medical team of Beijing Tongren Hospital as of March 20, 2020. Indicators of injuries for multiple organs, including the heart, kidney and liver, and glucose homeostasis were specifically analyzed for predicting primary outcomes (an intensive care unit (ICU) or death). Findings: The data of 120 patients with a severity equal to or greater than Moderate, discharged from the hospital or died were extracted. After excluding patients with chronic heart, kidney, liver disease and diabetes, 69 patients were included in the final analysis. There were 26 cases with primary outcomes including 16 deaths. Univariable analysis indicated that elevations of fasting blood glucose (FBG), lactate dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBDH), creatine kinase (CK) and creatinine (Cr) were associated with higher odds of primary outcomes and more hazards of death. Cox regression results indicated that FBG≥7mmol/L was the only independent predictor for death (HR = 3.75, 95% CI 1.26-11.15). Cluster analysis found more proximities of FBG (at the time of admission) with LDH, HDDH or Creatinine (at the time after 2-4 days of hospitalization) (r=0.43, 0.43 and 0.50, respectively, P<0.01 for all), indicating that FBG Among patients with primary outcomes, although FBG and LDH levels were much higher on admission, they dramatically decreased subsequently, while in deceased patients they increased continuously. Conclusions: FBG is a representative of the clustered indicators of multi-organ injury and the earliest predictor for poor outcomes and death in COVID patients. As it is easy to perform for clinical practices and self-monitoring, FBG testing will be much helpful for predicting critical condition to facilitate appropriate intensive care. Funding Statement: This study was funded by the National Key RD The Beijing Science and Technology Project. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The Research Ethics Commission of Beijing Tongren Hospital, Capital Medical University (TRECKY2020-013) approved the study and the Ethics Commission waived the requirement for informed consent.

Comparison of neurocognitive changes among newly diagnosed tuberculosis patients with and without dysglycaemia

BackgroundDiabetes often occurs together with tuberculosis (TB) and both may affect each other negatively. Diabetes may be associated with neurocognitive dysfunctioning in affected patients and may negatively impact treatment adherence and outcomes. This study compared the neurocognitive status between newly diagnosed smear positive tuberculosis patients with dysglycaemia and those with normoglycaemia.MethodsThe current study was a cross-sectional study involving one hundred and forty-six (146) newly diagnosed smear positive TB patients. Oral glucose tolerance test (OGTT) was performed and the results were categorized as either normoglycaemia, impaired glucose tolerance (IGT), impaired fasting glucose (IFG) or diabetes.Neurocognitive functioning among study participants was assessed at the time of TB diagnosis using Cognitive Failure Questionnaire (CFQ), Montreal Cognitive Assessment tool (MoCA), California Verbal Learning Test (CVLT), Brief Symptom Inventory (BSI) and the Spitzer Quality of Life Index (QLI).ResultsThe mean age of the participants (n = 146) was 38.7 years with 78.8% being males and 21.2% females. Using the fasting blood glucose test, the prevalence of impaired fasting glucose and diabetes were 5.5 and 3.4% respectively, both representing a total of 13 out of the 146 participants; whilst the prevalence of impaired glucose tolerance and diabetes using 2-h post-glucose values were 28.8 and 11.6% respectively, both representing a total of 59 out of the 146 participants.There were no significant differences in the mean scores on the neurocognitive measures between the dysglaycaemia and normoglycamic groups using fasting plasma glucose (FPG). However, there were significant differences in the mean scores between the dysglycaemia and normal groups using 2-h postprandial (2HPP) glucose values on Phobic Anxiety (Normal, Mean = 0.38 ± 0.603; dysglycaemia, Mean = 0.23 ± 0.356; p = 0.045), and Montreal Cognitive Assessment (MoCA) scores (17.26 ± 5.981 vs. 15.04 ± 5.834, p = 0.037).ConclusionNewly diagnosed smear positive patients with dysglycaemia were associated with significantly lower mean cognitive scores and scores on phobic anxiety than those with normoglyacaemia. The latter finding must be further explored.

Selection of the cutoff value on tuberculin skin test in diagnosing tuberculosis infection: a population-based cross-sectional study in Eastern China

Objective: To confirm the cutoff induration diameter of tuberculin skin test (TST) so as to decrease the false positive of the TST. Methods: Fasting blood glucose test, TST and Quanti FERON-TB (QFT) Gold In-Tube test were administered to recruit participants at the baseline stage. QFT was used as the gold standard to determine the cutoff of the TST test. Results: Overall, 5 405 participants were enrolled in this study, of whom 1 104 (20.4%) were QFT positive. Among all the 5 405 participants that without stratification, diagnostic value reached the highest when the induration diameter was 10.25 mm with sensitivity and specificity as 0.731 and 0.727, respectively. When the participants were divided into groups as nondiabetics, confirmed diabetics, undiagnosed diabetics, the sensitivities and specificities appeared as 0.701, 0.837, 0.824 and 0.805, 0.821, 0.778 with induration diameters as 11.25 mm, 10.25 mm and 11.25 mm, respectively. Conclusions: Findings of this study confirmed that the specificity of tuberculin test could be significantly improved by using 10-12 mm as the cutoff value for diagnosing the latent tuberculosis infection.

Use of the health services according to social determinants, health behaviors and quality of life among diabetics

The aim of this study was to investigate the use of health services according to social determinants, health behaviors and quality of life among diabetics (n = 416) attended by the Family Health Strategy in a northeastern city in Brazil. Data analysis included descriptive, bivariate and multivariate statistics. Decision Tree modeling was applied using the Chi-squared Automatic Interaction Detector (CHAID) algorithm. Results showed that public health services were used by 80.7% of the sample. The regular use of public health services involved individuals with low or medium schooling (p < 0.001), employed or retired and/or pensioners (p = 0.019), with a high impact of diabetes on quality of life (p = 0.032), and who performed the number of fasting blood glucose tests per year recommended by the Ministry of Health (p < 0.001). The use of health services could be explained by differences related to social determinants, health behaviors and the impact of diabetes on quality of life.

An economic value of the glycated hemoglobin test in diabetes mellitus type 2 diagnosis

BACKGROUND: Diagnostic of diabetes mellitus type 2 (DM2T) in time is very actual for treatment and prevention of potential complications of illness. Fasting blood glucose test (FBG) is a widely used method of primary DM2T diagnose. Glycated hemoglobin (HbA1c) test is an alternative and used more rarely due to expensive.&#x0D; AIM: Modelling of comparative expenditures for DM2T control in cases of primary diagnostic by HbA1c test or FBG test usage in 20-years horizon.&#x0D; METHODS: Retrospective analysis of aggregated epidemiological Russian NATION study data in 810 patients with prediabetes and DM2T with both analysis performed, with sensitivity and specificity of each is detected. The simulation model of DM2T outcomes has been used for Health Technology assessment (direct and indirect costs of Diabetes control during 20 years). Three algorithms of the DM2T treatment were investigated for understanding of expenditures in case on diagnostic on-time and case of late verification with metformin, gliflozines, gliptins, Glucagon-like peptide-1 receptor agonists, basal insulin analogs and their combinations.&#x0D; RESULTS: FBG test has more negative results for DM2T diagnostics in compare with HbA1c analysis (77,4% and 36,5% accordingly). Amount of false negative results in FBG test in 3 times more often occurred in comparison with HbA1c. HbA1c test in 3 times more precisely than FBG test for carbon metabolism abnormalities detection. Diagnostic in time with HbA1c test in compare with late process of illness detection by FBG can cut common expenditures on 26,3-27,7% depending on treatment option due to macrovasular complications decreasing. Disability rate is expected decrease on 21% to 20-th year in case of diagnostic with HbA1c performing instead FBG test.&#x0D; CONCLUSION: HbA1c test has diagnostic advantages in compare with FBG test for primary investigation (dispanserization). Direct and indirect expenditures in average for one patient with DM2T on 20-years horizon including cost of drugs, analysis, complications, disabilities are less in case of diagnostic in time with HbA1c test in comparison with late diagnostics in case of FBG test execution.

Coenzyme Q10 administration has no effect on sICAM-1 and metabolic parameters of pediatrics with type 1 diabetes mellitus.

Background: Endothelial dysfunction (ED) plays a key role in the development and progression of microvascular and macrovascular complications in pediatrics with type 1 diabetes mellitus (T1DM). Coenzyme Q10 (CoQ10) is a nutraceutical with a known anti-inflammatory and anti-oxidant activity. This study was conducted to evaluate the potential effect of CoQ10 on ED and various metabolic parameters. Methods: This prospective randomized open-label pilot study was conducted on 49 T1DM pediatric patients. Seven healthy non-diabetic pediatric subjects who didn't receive treatment were included as a control group. Eligible patients were randomly allocated into either group I (n=25); received 100mg of CoQ10 in addition to standard treatment or group II (n=24); received standard treatment only. The levels of; soluble intracellular adhesion molecule-1 (sICAM-1), glycated hemoglobin (HbA1c), fasting blood glucose (FBG), lipid profile, serum creatinine and liver function tests were assessed for both groups at baseline and after 3 months of treatment. Results: At baseline, compared to an age-matched healthy control group sICAM-1 levels were significantly elevated in group II diabetic patients (276.5 (231.6-320.66) vs 221.8 (177.9-267.1ng/ml), p=0.042. After 3 months of treatment no significant difference was observed in sICAM-1, HbA1c, FBG, lipid profile, serum creatinine and liver function tests between the two study groups. A positive correlation was found between sICAM-1 and HbA1c throughout the study (r=0.308, p=0.0054). Conclusion: Administration of CoQ10 for 3 months in T1DM pediatric patients was well tolerated but had no favorable effect on ED or metabolic parameters.

Insulin Resistance Estimated by HOMA IR for Diagnosis of Gestational Diabetes in Squatter Settlement of Karachi

Background: Gestational diabetes mellitus (GDM), one of the most common metabolic disorders of pregnancy, is estimated to raise 16-27% worldwide every 10 years. Researchers, using Homeostasis model assessment test (HOMA IR), a tool for assessing insulin resistance, have found a number of causes. This study was designed to investigate the correlation between insulin resistance and GDM in the second trimester. Methods: This study recruited 84 pregnant women (24 to 28weeks of gestation) from OPD of Gynaecology/Obstetrics and Family Medicine Department, Dr. Ziauddin Hospital Karachi Pakistan from May 2018 to January 2019. A thorough anthropometric measurements and antenatal history was recorded through structured questionnaire after informed consent. After 10 hours fast, venous blood (5ml) was drawn for fasting blood glucose (FBS), insulin levels and Glucose challenge test (GCT) for screening gestational diabetes. Results: Out of 84 subjects, 37 had higher GCT values while 47 had normal level. FBS was found significantly associated (p &lt; 0.05). With GCT among GDM subjects 16(19%) had normal Body Mass Index (BMI) and 18(21.4%) had normal body fat percentage however, 2(2.4%) had high insulin levels and 13(15.5%) high FBS levels. The value HOMA IR, ≤1.29 was found in 38(45.2) healthy mothers and 25(29.8) GDM. Patients’ GCT had positive association with parity, FBS, insulin, HOMA IR and BMI. Conclusion: Linear strong positive correlation was found between insulin resistance and GCT in the second trimester. Patients with significantly higher GCT values and index value of HOMA IR greater than &gt;1.29 are at risk for developing GDM.