Fasting Glucose Levels Research Articles

Glucose tolerance two years after gestational diabetes classified by old Swedish or new WHO diagnostic criteria

AimTo explore how introduction of the lower WHO gestational diabetes (GDM) glucose criteria in Sweden affected prediabetes/type-2-diabetes (T2D) incidence two years postpartum. MethodsWomen included in the PREvention of PostPartum (PREPP) diabetes study were diagnosed with GDM according to EASD 1991 criteria (GDMOLD; n = 93) or only WHO 2013 criteria (GDMWHO; n = 174). Both groups were further stratified by BMI, and BMI-matched normoglycemic pregnancy controls were included (n = 88). Postpartum assessments included oral glucose tolerance tests (OGTT) and anthropometric measurements. ResultsThere was a higher postpartum incidence of T2D in GDMOLD versus GDMWHO (P < 0.001). Despite similar BMI, GDMOLD exhibited higher fasting and OGTT glucose levels, lower fat-free-mass, and hip circumference compared to GDMWHO. In normal-weight women, both GDM groups displayed higher HOMA-IR and lower fat-free-mass compared to controls, with GDMOLD additionally showing lower HOMA-β, slower insulin release during OGTT, and worse glucose tolerance than GDMWHO. Among obese women, the main differences were lower fat-free-mass and hip circumference in GDMOLD. ConclusionThe lower glucose cut-offs during pregnancy resulted in lower postpartum incidence of T2D, irrespective of BMI. Fat-free-mass emerged as a key determinant in glucose levels across BMI categories, while lower beta-cell function played a significant role in normal-weight women.

Comparison of the Effectiveness of Single Anastomosis Sleeve Ileal Bypass and Roux-en-Y Gastric Bypass in Obese Patients with Type 2 Diabetes.

The rapid increase in obesity and related problems has heightened the importance of obesity and metabolic surgery, resulting in a continuing search for the ideal surgical method. This study aimed to compare the effectiveness of Roux-en-Y gastric bypass (RYGB), which is the gold standard method, and the relatively newer method of single anastomosis sleeve ileal (SASI) bypass. The medical records of patients who underwent RYGB and SASI bypass were reviewed and compared regarding excess weight loss (EWL) and HgA1c, fasting glucose, serum iron, ferritin, hemoglobin (Hgb), and vitamin B12 levels. The body mass index was significantly lower (p = 0.003), and the %EWL was significantly higher (p = 0.023) at 6months postoperative in patients who underwent SASI bypass. Both groups had similar results at the other follow-up visits. The mean HgA1c levels at the 6- and 12-month follow-up visits were significantly lower in SASI patients (p = 0.037 and p = 0.012, respectively). At the 24-month follow-up, no difference was detected in HgA1c levels between the groups (p = 0.476). In patients who underwent RYGB, ferritin (p < 0.001), plasma iron (p = 0.001), and Hgb levels (p = 0.001) were significantly lower at 12, 24, and 12months postoperatively, respectively. SASI bypass is effective and comparable to RYGB in terms of EWL and metabolic control and has the advantage of not producing excluded segments and reducing nutritional deficiencies.

Lipid on stroke in intracranial artery atherosclerotic stenosis: a mediation role of glucose.

Expanding on previous investigations, this study aims to elucidate the role of lipid metabolism disorders in the development of intracranial atherosclerotic stenosis (ICAS) and the determination of stroke risk. The primary objective is to explore the connections between lipid parameters and acute ischemic stroke (AIS), while also examining the potential mediating influence of fasting glucose levels. Retrospectively, we collected data from symptomatic ICAS patients at the First Affiliated Hospital of Soochow University, including their baseline information such as medical histories and admission blood biochemical parameters. Stenotic conditions were evaluated using magnetic resonance imaging, computed tomography angiography, or digital subtraction angiography. The associations between lipid parameters and AIS risks were investigated via multivariate logistic regression analysis. A total of 1103 patients with symptomatic ICAS were recruited, among whom 441 (40.0%) suffered new ischemic events during hospitalization. After adjusting for confounding factors, the RCS curves exhibited a dose-response relationship between the atherogenic index of plasma (AIP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and AIS. Further multivariate analysis revealed significant associations between these parameters and AIS. Furthermore, mediation analysis indicated that fasting blood glucose (FBG) acted as a mediator in the association between lipid parameters (AIP, TC, and TG) and AIS. Higher lipid parameters in ICAS patients, particularly AIP, TC, and TG, were associated with an increased AIS risk. Additionally, FBG may mediate stroke risk in ICAS patients, highlighting the need for further exploration of underlying mechanisms.

Impact of the COVID-19 Pandemic on People Newly Diagnosed with HIV and those Already in -care in Türkiye.

COVID-19 has inevitably influenced health systems. HIV testing rates have been reduced, and access to antiretroviral treatment has been scaled down. We evaluated the impact of COVID-19 on the management of people living with HIV (PLWH) in Türkiye. We conducted a cross-sectional study in three tertiary care hospitals. We compared the baseline characteristics at the first visit and viral suppression rates at the 24th week of new HIV diagnoses during the pandemic with those during the previous two years. To observe the effect of the pandemic on people living with HIV who were already in care, we compared the metabolic and clinical parameters like weight, blood pressure, blood lipid levels, fasting glucose levels, and liver and renal function tests, of the same people before and during the pandemic. The first group included 380 cases (127 diagnosed during the pandemic and 253 diagnosed during the previous year). The demographic characteristics were similar. The newly diagnosed PLWH during the pandemic had significantly higher baseline HIV RNA levels (p=0.005), a lower number of clinical visits (p=0.0005), and a lower number of cases with undetectable viral loads at 24 weeks of treatment (p=0.0005) than those diagnosed during the pre-pandemic period. The second group included 261 individuals with a mean follow-up duration of 24.7 (SD± 3.5; min- max 12-144) months. The comparison of laboratory parameters revealed that in the postpandemic period, virologic suppression was maintained at 90.1%, body mass index (p=0,0001), total cholesterol (p=0,0001), and LDL levels (p=0,0001) increased significantly, and creatinine levels decreased significantly (p=0,0001). Our study showed that COVID-19 deteriorated the HIV management of PLHIV. Strengthening the medical infrastructure of basic services for PLWH is critical for future crises.

EFEKTIVITAS SEDUHAN DAUN ASAM JAWA TERHADAP KADAR HOMA-IR DAN HOMA-β PADA PASIEN DIABETES MELLITUS TIPE 2

This study assessed the impact of tamarind leaf tea on HOMA-IR and HOMA-β levels in patients with Type 2 Diabetes Mellitus (DM). Thirty-two patients aged 20-50 years from Sungai Ambawang District Health Center, who were not using any DM medication, participated. They were divided into control (KN) and treatment (KP) groups, with KP receiving a tamarind leaf tea infusion for 7 days. HOMA-IR and HOMA-β levels were calculated using standardized formulas based on fasting insulin and glucose levels. The Wilcoxon signed-rank test revealed a significant decrease in HOMA-IR levels in the KP group (p&lt;0.05), while no significant change was observed in the KN group. Although no significant difference in HOMA-β levels was found between the two groups, the KP group showed a notable increase by 4. These findings suggest that a 7-day tamarind leaf tea infusion effectively reduced HOMA-IR levels in patients with type 2 DM, although it did not significantly affect HOMA-β levels. This study highlights the potential of tamarind leaf tea as a complementary approach for managing insulin resistance in Type 2 DM patients. Further research is needed to explore the long-term effects and mechanisms of action for improving β-cell function. The conclusion of this study is that steeping tamarind leaves for seven days can reduce HOMA-I levels and slightly increase HOMA-β levels in patients with type 2 Diabetes Mellitus.

Once-Weekly Insulin Icodec in Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Clinical Trials (ONWARDS Clinical Program).

One hundred years have passed since the discovery of insulin, which is one of the most relevant events of the 20th century. This period resulted in extraordinary progress in the development of novel molecules to improve glucose control, simplify the insulin regimen, and ameliorate the quality of life. In late March 2024, the first once-weekly basal analog Icodec was approved for diabetes mellitus, generating high expectations. Our aim was to systematically review and meta-analyze the efficacy and safety of Icodec compared to once-daily insulin analogs in type 1 (T1D) and type 2 diabetes (T2D). PubMed/MEDLINE, Cochrane Library, and ClinicalTrials.gov were searched for randomized clinical trials (RCTs). Studies were included for the synthesis according to the following prespecified inclusion criteria: uncontrolled T1D or T2D, age ≥ 18 years, insulin Icodec vs. active comparators (Degludec U100, Glargine U100, Glargine U300, and Detemir), phase 3, multicenter, double-blind or open-label RCTs, and a study duration ≥ 24 weeks. The systematic review included 4347 patients with T1D and T2D inadequately controlled (2172 randomized to Icodec vs. 2175 randomized to once-daily basal analogs). Icodec, compared to once-daily basal analogs, slightly reduced the levels of glycated hemoglobin (HbA1c) with an estimated treatment difference (ETD) of -0.14% [95%CI -0.25; -0.03], p = 0.01, and I2 68%. Patients randomized to Icodec compared to those on once-daily basal analogs had a greater probability to achieve HbA1c < 7% without clinically relevant or severe hypoglycemic events in 12 weeks from randomization with an estimated risk ratio (ERR) of 1.17, [95%CI 1.01, 1.36], p = 0.03, and I2 66%. We did not find a difference in fasting glucose levels, time in range, and time above range between Icodec and comparators. Icodec, compared to once-daily basal analogs, resulted in a slight but statistically significant weight gain of 0.62 kg [95%CI 0.25; 0.99], p = 0.001, and I2 25%. The frequency of hypoglycemic events (ERR 1.16 [95%CI 0.95; 1.41]), adverse events (ERR 1.04 [95%CI 1.00; 1.08]), injection-site reactions (ERR 1.08 [95%CI 0.62; 1.90]), and the discontinuation of treatments were similar between the two groups. Icodec was found to work better when used in a basal-only than basal-bolus regimen with an ETD in HbA1c of -0.22%, a probability of achieving glucose control of +33%, a probability of achieving glucose control without clinically relevant or severe hypoglycemia of +28%, more time spent in target (+4.55%) and less time spent in hyperglycemia (-5.14%). The risk of clinically relevant or severe hypoglycemic events was significantly higher when background glinides and sulfonylureas were added to basal analogs (ERR 1.42 [95%CI 1.05; 1.93]). Insulin Icodec is substantially non-inferior to once-daily insulin analogs in T2D, either insulin-naïve or insulin-treated. However, Icodec works slightly better than competitors when used in a basal-only rather than basal-bolus regimen. Weight gain and hypoglycemic risk are substantially low but not negligible. Patients' education, adequate lifestyle and pharmacological interventions, and appropriate therapy adjustments are essential to minimize risks. This systematic review is registered as PROSPERO CRD42024568680.

Evaluation of Some Biochemical Parameters in Women Suffer from Systemic Lupus Erythmatosis

A rise in the number of women suffering from SLE has been noted by researchers. The research comprised 70 patients and thirty healthy normals. They were between the ages of fifteen and fifty-three; the sample was gathered from different clinics in Iraq. The Blood samples were taken for serum isolation. The serumis used for evaluation of serum glucose level, triglyceride level, cholesterol level, alanine transaminase (ALT), aspartate transaminase (AST), urea nitrogen level, uric acid. The results showed that AST and ALT were increased significantly in SLE patients. cholesterol and triglycerides have increased significantly, according to biochemical tests. Serum glucose, urea nitrogen, and uric acid levels changed by a negligible amount. In conclusion, SLE has an effect on liver functions and lipid profile while it doesn’t affect Kidney functions and fasting glucose levels.

Impact of Smoking and Obesity on the Selected Peptide Hormones and Metabolic Parameters in the Blood of Women with Polycystic Ovary Syndrome-Preliminary Study.

We investigated the effects of tobacco smoke exposure and abnormal body weight on selected peptide hormones and their association with metabolic and hormonal disorders in women with polycystic ovary syndrome (PCOS). The study group included 88 women with PCOS and 28 women without the disease. In women with PCOS, chemerin, lipocalin, and apelin concentrations were influenced by overweight and obesity status, with the highest concentrations observed in those with a body mass index (BMI) ≥ 30.0. Exposure to tobacco smoke significantly increased only lipocalin-2 concentration. The disease itself did not affect the concentrations of chemerin, lipocalin, and apelin. Additionally, we found a positive correlation between chemerin concentration and fasting glucose, fasting insulin, and triglycerides levels, while a negative correlation was observed with high-density lipoprotein (HDL-C) concentration. In the smoking subgroup, chemerin concentration was positively correlated with free testosterone concentration and the free androgen index and negatively associated with sex hormone-binding globulin concentration. Our findings indicate that abnormal body weight has a stronger impact than tobacco smoke exposure on metabolic and hormonal disorders in women with PCOS, highlighting the important role of weight control in such individuals. However, smoking appears to be an additional factor that intensifies hormonal disorders associated with adipose tissue.

The undervalued league of insulin resistance testing: uncovering their importance.

Type 2 diabetes, obesity, and several other metabolic diseases are all largely attributed to the problem known as insulin resistance. Diagnosing insulin resistance promptly and accurately is essential for adequately managing and intervening in metabolic disorders. Several diagnostic methods have been developed to assess insulin resistance. However, each method has advantages and disadvantages. The most precise test is the hyperinsulinemic-euglycemic clamp, which examines the direct impact of insulin on glucose uptake by tissues. However, it is primarily utilized in research due to its complexity and intrusiveness. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and the Quantitative Insulin Sensitivity Check Index (QUICKI) are the second most used Insulin resistance tests in the clinical setup. These tests are based on measuring the fasting glucose and insulin levels. The Oral Glucose Tolerance Test (OGTT), Insulin tolerance test, and the Matsuda Index are further diagnostic procedures that shed light on insulin sensitivity. The improved techniques, such as the insulin suppression test and the minimal model analysis, provide substitutes for unique clinical circumstances. Additionally, including extra measurements with these tests, like waist circumference, lipid profiles, and inflammatory markers, can improve the evaluation of insulin resistance. In summary, identifying insulin resistance is essential for the early detection and treatment of various metabolic illnesses. To make educated judgments and improve patient care, healthcare workers should be aware of thedifferent available diagnostic tests and how they are used in each situation. Insulin resistance detection and monitoring will require further study to improve current diagnostic approaches and create novel, less invasive techniques.

Hepatoprotective potential of taxifolin in type 2 diabetic rats: modulation of oxidative stress and Bcl2/Bax/Caspase-3 signaling pathway.

Diabetes mellitus (DM) is a global metabolic problem. Several factors including hyperglycemia, oxidative stress, and inflammation play significant roles in the development of DM complications. Apoptosis is also an essential event in DM pathophysiology, -with B-cell lymphoma 2 (Bcl-2) and Bcl-2 associated X (Bax) determining apoptotic susceptibility. The present study aimed to elucidate the protective effects of two doses of taxifolin (TXF) on liver damage in diabetic rats and explore the possible mechanisms of action. DM was induced in eighteen rats through intraperitoneal injections of 50mg/kg streptozotocin and 110mg/kg nicotinamide. Diabetic rats received daily oral intubation of 25 and 50mg/kg TXF for 3 months. In the untreated diabetic group, there was a significant increase in fasting and postprandial glucose levels, glycosylated hemoglobin A1C (HbA1c), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6), while insulin and adiponectin levels decreased significantly. Both TXF doses mitigated hyperglycemia, regulated cytokine production, and increased insulin level. Gene expressions and protein levels of Bax, caspase 3, and cytochrome c were significantly increased, while Bcl-2 was significantly decreased in the livers of diabetic rats, effects that were significantly ameliorated after TXF treatment. The results of the TUNEL assay supported the apoptotic pathway. Additionally, TXF significantly decreased lipid peroxidation and enhanced antioxidant enzyme activity in diabetic rats. Liver enzymes and histopathological changes also showed improvement. TXF mitigated diabetes-associated hepatic damage by reducing hyperglycemia, oxidative stress, inflammation, and modulating anti-/pro-apoptotic genes and proteins. A dose of 50mg/kg TXF was more effective than 25mg/kg and is recommended for consumption.

Gene-Environment Interactions Significantly Alter the Obesity Risk of SH2B1 rs7498665 Carriers.

Src homology 2 B adaptor protein 1 (SH2B1) gene and variants have been found to be associated with common obesity. We aimed to investigate the association between the common missense variant SH2B1 rs7498665 and common obesity risk as well as interactions with lifestyle variables in an Israeli population. An adult cohort (n=3,070; ≥18 years) with the SH2B1 rs7498665 variant and lifestyle, behavior (online questionnaire), and blood glucose data was analyzed. Associations between this variant, obesity risk (body mass index [BMI] ≥25 and ≥30 kg/m2), and interactions with behavioral and lifestyle factors (stress levels, eating habits score [EHS], physical activity [PA], and wine consumption) were investigated. Association and gene-environment interactions were analyzed using binary logistic regressions with interaction. SH2B1 rs7498665 carriers were significantly (P<0.05) more likely to be overweight (BMI ≥25 kg/m2) or obese (BMI ≥30 kg/m2) in recessive (odds ratio [OR], 1.90 and 1.36, respectively), additive (OR, 1.24 and 1.14, respectively), and codominant (OR, 2.00 and 1.41, respectively) genetic models. SH2B1 rs7498665 interacted with lifestyle and behavioral factors as well as glucose levels. PA and moderate wine consumption (1 to 3 drinks/week) reduced obesity risk (OR, 0.35 and 0.71, respectively). Conversely, carriers of two risk alleles who reported high stress levels, had ≥median EHS, and who had a fasting glucose level ≥90 mg/dL had a significantly increased obesity risk (OR, 3.63 and 5.82, respectively). Carrying SH2B1 rs7498665 significantly elevates the risk of obesity. Actionable lifestyle and behavioral factors significantly modulate the rs7498665 genetic predisposition to obesity; PA and moderate wine consumption attenuate the risk, while high stress, EHS, and fasting glucose level increase the obesity risk.

Predictive value of neck circumference for cardiometabolic risk in children

Objective: To investigate the predictive value of neck circumference on cardiometabolic risk in children. Methods: This was a cross-sectional study of natural sources. As the prediction cohort, clinical data were collected from 3 443 children aged 5-14 years who underwent physical examination in the Department of Child Healthcare, Children's Hospital of Nanjing Medical University from July 2021 to September 2022. As the validation cohort for external validation, clinical data were collected from 604 children aged 5-14 years who underwent physical examination in the Department of Child Healthcare, Children's Hospital of Nanjing Medical University from October 2022 to March 2023. Height, weight, neck circumference, waist circumference and body composition were measured in both groups, and body mass index, neck circumference to height ratio (NHtR), waist circumference to height ratio, body fat percentage and skeletal muscle percentage were calculated. Systolic blood pressure, diastolic blood pressure, fasting blood glucose, blood lipid and uric acid and other cardiovascular and metabolic risk indicators were collected in both groups. The prediction cohort was further stratified into clustered and non-clustered groups based on the clustering of cardiometabolic risk factors (CCRF). Various variables between these 2 groups were compared using the Mann-Whitney U test. Pearson correlation and binary Logistic regression were conducted to investigate the correlations between neck circumference and cardiovascular metabolic risk factors. The accuracy of NHtR in predicting the CCRF was evaluated using the area under the curve (AUC) of receiver operating characteristic (ROC). The cutoff value was determined using the Youden index. The validation cohort was then divided into groups above and below the cutoff value, and the detection rate of CCRF between the 2 groups was compared using the χ2 test for validation. Results: In the prediction cohort of 3 443 children (2 316 boys and 1 127 girls), 1 395 (40.5%) children were overweight or obese, and 1 157 (33.6%) children had CCRF. Pearson correlation analysis revealed all significant positive correlations (all P<0.01) between neck circumference and systolic blood pressure (r=0.47, 0.39), diastolic blood pressure (r=0.27, 0.21), uric acid (r=0.36, 0.30), and triglycerides (r=0.20, 0.20) after adjusting for age in both males and females. Among both males and females, neck circumference both showed significant negative correlation (both P<0.01) with high-density lipoprotein cholesterol (r=-0.27, -0.28), and no correlation with fasting glucose levels (r=0.03, -0.03, both P>0.05). After adjusting for gender, age, and body fat percentage, increased body mass index, neck circumference, or waist circumference increased the risks of hypertension (OR=1.23, 1.39, 1.07, all P<0.001), hyperuricemia (OR=1.16, 1.23, 1.05, all P<0.001), hypertriglyceridemia (OR=1.08, 1.16, 1.02, all P<0.01), low high-density lipoprotein cholesterol (OR=1.10, 1.27, 1.03, all P<0.01), and the CCRF (OR=1.51, 1.73, 1.15, all P<0.01). The areas under the ROC curves of NHtR in predicting CCRF was 0.73, with sensitivity and specificity at 0.66 and 0.71, respectively. The corresponding optimal cut-off value was 0.21. Validation with 604 children confirmed that the detection of CCRF in the NHtR≥0.21 group was 3.29 times (60.5% (112/185) vs. 18.7% (79/422),χ2=107.82, P<0.01) higher compared to the NHtR <0.21 group. Conclusions: Neck circumference is associated with cardiovascular metabolic risks such as hypertension, hyperlipidemia, hyperglycemia, and hyperuricemia in children. When the NHtR is ≥0.21, there is an increased likelihood of CCRF.

Abstract Tu122: Induction of Mitochondrial and Endoplasmic Reticulum Stress in Early Response to High-Fat Diet-Induced Hyperglycemia in Mouse Hearts

Background: Diabetic cardiomyopathy (DCM) is the leading cause of mortality in diabetic patients, accounting for about 80% of the death. Mitochondria and endoplasmic reticulum (ER) play a critical role in cardiomyocyte function, yet their interaction and function in diabetic hearts remains unclear. Hypothesis: We hypothesize that mitochondria and ER stress response are essential in maintaining cardiac function and preventing cardiac remodeling during early diabetic insult in the heart. Methods: Utilizing 6-month-old male and female C57BL/6 mice, we divided them into groups receiving a standard chow diet (N=8) and a 60% high-fat diet (HFD, N=8) for four months. Post-diet, we conducted glucose tolerance tests to verify hyperglycemia. We analyzed heart samples for mitochondrial stress (LonP1, ClpX, ClpP, Afg3l2, spg7, GRP75) and ER stress (XbP1, IRE1a, CHOP, PDI, Hspa5, Dnajb9, Hsp90) markers, along with mitochondrial biogenesis (mtDNA, TFAM, Mt-ND4, and Mt COII levels), and whole heart homogenate oxidative potential by electron paramagnetic resonance (EPR) spin probe (CMH). Between the groups, a p-value &lt; 0.05 was considered significant calculated by one-way ANOVA. Results: HFD significantly increased body weight (p&lt;0.0001) and fasting glucose levels (p&lt;0.0001), confirming hyperglycemia. Among the mitochondrial stress response markers, LonP1 was significantly (p&lt;0.05) elevated in HFD hearts compared to the control. However, the ER stress-associated transcription factors, CHOP and XbP1, were significantly upregulated (p&lt;0.05) in female HFD hearts compared to the control and male groups. Further, EPR analysis showed a significant (p&lt;0.0001) four- and two-fold increase in oxidative potential in the heart homogenate of female and male HFD groups, respectively. However, mitochondrial biogenesis was notably higher, observed only in HFD females compared to other groups. Conclusion: Our study indicates that pre-diabetic hyperglycemia enhances gender-specific mitochondrial biogenesis and triggers mitochondrial and ER stress responses, highlighting the importance of mitochondrial-ER interaction in early DCM and suggesting potential therapeutic avenues.

Testosterone with Silymarin Improves Diabetes-obesity Comorbidity Complications by Modulating Inflammatory Responses and CYP7A1/ACC Gene Expressions in Rats.

The co-morbidity of DMOB has become increasingly problematic among the world's population because of a high-calorie diet and sedentary lifestyle. DMOB is associated with lower testosterone (TN) levels, the male sex hormone. The phytochemical compound silymarin (SN) exerts antidiabetic activity by modifying β-cells and anti-obesity activity by inhibiting adipogenesis by methylxanthine. The goal of this study was to find out how well testosterone (TN) with silymarin (SN) protects against oxidative stress and inflammation in the liver of the experimental rats with type 2 diabetes (T2D) and obesity (DMOB). The present study evaluates the efficacy of TN and SN combination (TNSN) on the levels of the potential parameters, such as body mass, serum marker enzymes, fasting glucose levels, HbA1c levels, lipid profile, enzymatic and non-enzymatic antioxidants, proinflammatory cytokines, gene expression pathways, and histopathology in a DMOB comorbidity rat model. Male Sprague-Dawley (SD) rats were fed a high-fat diet (HFD) for 20 weeks with an administration of a single dose of streptozotocin (STZ) i.p. injection (30 mg/kg) on the 9th week of the study. The procedure was to develop the DMOB co-morbidity model in the experimental animals. Co-treatment of TN and SN administration were followed throughout the experiment. Rats were sacrificed after overnight fasting to collect serum and liver tissue samples. Samples were analyzed using a clinical chemistry automated analyzer, spectrophotometry, and quantitative real-time PCR (qPCR) methods and protocols. Analyses of body mass changes, serum marker enzymes, fasting glucose levels, HbA1c levels, lipid profiles, enzymatic and non-enzymatic antioxidants, TNF-α, IL-6, adiponectin, CYP7A1, ACC expression pathways, and histopathology showed significant abnormal levels (P ≤ 0.05) in the pathological group. These were efficiently treated to normal by the administration of TNSN. These results concluded that TNSN exerted protective efficacy against the liver abnormalities in the co-morbidity of the DMOB rat model.

Impact of HCV eradication by directly acting antivirals on glycemic indices in chronic hepatitis C patients -a nationwide Taiwan HCV registry

Background/AimsHepatitis C virus (HCV) eradication using antiviral agents augments the metabolic profile. Changes in glycated hemoglobin (HbA1c) levels in chronic hepatitis C patients who receive glecaprevir/pibrentasvir (GLE/PIB) remain elusive. MethodsData from 2417 patients treated with GLE/PIB from the Taiwan HCV Registry were analyzed, and pretreatment HbA1c levels were compared with 3-months after the-end-of treatment levels. A sustained virological response (SVR) was defined as undetectable HCV RNA at 12 weeks after the end of treatment. A significant change in HbA1c level was defined as the 75th percentile of the change in the HbA1c level before and after treatment (decrement >0.2%). ResultsSerum HbA1c levels decreased significantly (6.0 vs 5.9%, P < 0.001). Post-treatment HbA1c levels decreased in all subgroups, except in non-SVR patients (5.7 vs 5.7%, P = 0.79). Compared to patients without significant HbA1c improvement (decrement >0.2%), those with HbA1c improvement were older (60.2 vs 58.6 years, P < 0.001), had higher serum creatinine levels (1.9 vs 1.6 mg/dL, P < 0.001), triglycerides (129.8 vs 106.2 mg/dL, P < 0.001), fasting glucose (135.8 vs 104.0 mg/dL, P < 0.001), and pretreatment HbA1c (7.1 vs 5.7%, P < 0.001) and had a higher proportion of male sex (57.9% vs 50.9%, P = 0.003), diabetes (84.3 vs 16.8%, P < 0.001), more advanced stages of chronic kidney disease (CKD) (15.7 vs 11.1 %, P < 0.001), anti-diabetic medication use (47.3 vs 16.4%, P < 0.001) and fatty liver (49.6 vs 38.3 %, P < 0.001). Multivariate analysis revealed that the factors associated with significant HbA1c improvement were age (odds ratio [OR]/95% confidence intervals [CI]: 1.01/1.00–1.02, P = 0.01), HbA1c level (OR/CI: 2.83/2.48–3.24, P < 0.001) and advanced CKD stages (OR/CI: 1.16/1.05–1.28, P = 0.004). If the HbA1c variable was not considered, the factors associated with significant HbA1c improvement included alanine aminotransferase level (OR/CI, 1.002/1.000–1.004, P = 0.01), fasting glucose level (OR/CI: 1.010/1.006–1.013, P < 0.001), and diabetes (OR/CI: 3.35/2.52–4.45, P < 0.001). ConclusionsThe HbA1c levels improved shortly after HCV eradication using GLE/PIB. The improvement in glycemic control can be generalized to all subpopulations, particularly in patients with a higher baseline HbA1c level or diabetes.

A Longitudinal Evaluation of the Effects of Moderate Physical Activity on Health, Metabolic, and Physiological Parameters in Individuals With Type 2 Diabetes Mellitus: A Comprehensive Study.

Background Diabetes mellitus (DM), especially type 2 diabetes mellitus (T2DM), is a serious worldwide health concern that is becoming more common and often develops at a young age, particularly in developing countries. Given the increasing incidence of diabetes in India, efficient management techniques are advantageous. The aim of this study is to evaluate the impact of physical activity on body measurements, biochemical markers, and clinical outcomes in Indian individuals with T2DM. Methodology Utilizing a universal sampling approach, a longitudinal interventional study was performed with T2DM patients at a metropolitan health and training facility over an eight-month duration. Over the course of six months, they were told to walk briskly for 2.5 hours each week. Initial and follow-up evaluations included monitoring arterial pressure, body mass, abdominal circumference, and glucose concentrations. During monthly follow-ups, participants self-reported their compliance. Results The study of 210 participants shows a diverse age distribution with the majority in the 35-54 years range and a higher number of females (56.19%) compared to males (43.81%). Most were Hindu (77.6%), with varying education levels and a predominance of unemployment (69.5%) and marital status (91.0% married). Post-exercise, significant improvements were observed in fasting blood glucose (160.45 to 140.20 mg/dL; p = 0.004), postprandial blood glucose (270.35 to 240.55 mg/dL; p = 0.002), body weight (70.00 to 66.50 kg; p = 0.03), and waist circumference (95.00 to 90.50 cm; p = 0.01). Conclusion The outcomes of this prolonged study reveal thatalong with promoting weight reduction in T2DM patients, regular engagement in moderate exercise can substantially improve both fasting and post-meal blood glucose levels.

Effects of Teprotumumab and Role of Human Leukocyte Antigens Markers in Patients With Thyroid Eye Disease

ObjectiveTo evaluate the effects of teprotumumab on ophthalmologic and biochemical findings and assess potential genetic markers for response to treatment. MethodsThis is a retrospective study. Participants were 18-76 year old. All subjects were treated with teprotumumab. The primary outcome was the change in proptosis before and after teprotumumab treatment. Secondary outcomes include change in other ophthalmic measures and thyroid laboratory tests. Human leukocyte antigens (HLA) markers were analyzed for response to teprotumumab. ResultsTwenty-six patients were included in the final analysis. There was a significant decrease in thyroid stimulating immunoglobulin and thyrotropin receptor antibody levels and significant increases in glycated hemoglobin A1c, fasting glucose, and total T3 levels. There was also significant reduction in proptosis, clinical activity score, retinal nerve fiber layer thickness, ganglion cell analysis, and intraocular pressure. HLA haplotypes were distinct between responders and nonresponders, with HLA-DRB3 02:02:01G, HLA-DRB4 neg, and HLA-DQB1 02:01:01G demonstrating better response to teprotumumab and HLA-A 23:01:01G strongly correlating to nonresponse. ConclusionsPatients with both acute and chronic thyroid eye disease treated with teprotumumab had a significant reduction in thyroid stimulating immunoglobulin and thyrotropin receptor antibody levels and improvement in proptosis, clinical activity score, retinal nerve fiber layer and ganglion cell analysis thickness, and intraocular pressure. HLA may predict responders vs nonresponders. Further studies with longer duration and larger population comparing teprotumumab with steroids or other immunomodulatory agents (tocilizumab, rituximab, etc) may be helpful.

A Study of Association of Insulin Resistance with Pregnancy-induced Hypertension.

Preeclampsia is one of the important causes of maternal and fetal mortality and morbidity. One of the important risk factors for the development of diabetes is insulin resistance (IR). To evaluate the association of IR with pregnancy-induced hypertension (PIH) and its severity. Data from 70 pregnant females who had completed 20 weeks of gestation and developed PIH were analyzed and compared with 30 appropriate controls. All females underwent measurement of fasting glucose level, fasting insulin level, and blood pressure. The mean age of the women in the control group was 26.17 years, and in the study group, it was 27.09 years. All females had completed 20 weeks of gestation. Around 86.6% of women in the control group, 54.1% with a variable degree of preeclampsia, and 48.6% of women with eclampsia were at 33-38 weeks of gestation. At the time of sampling, 13.3% of women in the control group, 45.81% of women with preeclampsia, and 51.3% of women with eclampsia were at 26-32 weeks of gestation. The mean IR among the control group was 1.37, in preeclampsia, it was 2.11, and in eclampsia, it was 3.58 with a p-value of 0.000, which is very highly significant. In this study, the severity of the disease was found to be directly proportional to IR. Pregnancy complicated with preeclampsia and eclampsia showed more IR in comparison to pregnant women with normal blood pressure, and this relationship is independent of the age of pregnant women.

Characteristics of physical and sexual development of girls conceived by assisted reproductive technologies

The objective: to study the characteristics of the physical and sexual development of girls conceived with the help of assisted reproductive technologies (ART).Materials and methods. An examination of 16 teenage girls who were born with the help of ART was carried out. The average age of the girls was 12.0±0.45 (10–13) years. All girls underwent a clinical, functional, hormonal examinations, secondary sexual characteristics were evaluated according to the J. Tanner scale.Blood levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), dehydroepiandrosterone sulfate (DHEA-S), as well as estradiol (E2), testosterone, levels of thyroid hormones triiodothyronine (T3) and thyroxine (T4) were determined by the radioimmunoassay method on the microspectrophotometer “Stat fax” 303 PLUS USA in the first phase of the menstrual cycle.To study the functional activity of the liver, fasting glucose level and oral glucose tolerance test, insulin, alanine aminotransferase and aspartate aminotransferase levels were determined. In order to compare the concentration of hormones, 25 teenage girls of the appropriate age who were born from a spontaneous pregnancy and have a physiological course of the puberty period were additionally examined.Results. According to the ultrasound examination, the length of the right and left ovaries, as well as all echographic indicators, are significantly increased in girls who were born with the help of ART.A study of hormone levels in teenage girls conceived with ART revealed statistically higher levels of LH (5.05±1.17 mIU/ml), DHEA-S (91.9±16.93 μg/dL), E2 (78.13±17.98 pg/ml), which indicates hyperandrogenism and hyperestrogenism of adrenal origin. At the same time, the fasting glucose level and its level after the oral glucose tolerance test were statistically lower than similar indicators in girls born from a spontaneous pregnancy and with the physiological course of puberty, but the fasting insulin level was higher (p&lt;0.05).Conclusions. In girls who were born with the help of assisted reproductive technologies (ART), premature development of secondary sexual characteristics (late precocious puberty) and pronounced hair growth have been identified.Carbohydrate metabolism, enzymatic activity of the liver and functional activity of the kidneys in girls who were born with the help of ART do not differ from similar indicators of girls who were born from spontaneous pregnancy and with the physiological course of puberty.

Empagliflozin’s role in early tubular protection for type 2 diabetes patients

BackgroundPatients with type 2 diabetes often face early tubular injury, necessitating effective treatment strategies. This study aimed to evaluate the impact of the SGLT2 inhibitor empagliflozin on early tubular injury biomarkers in type 2 diabetes patients with normoalbuminuria.MethodsA randomized controlled clinical study comprising 54 patients selected based on specific criteria was conducted. Patients were divided into an intervention group (empagliflozin, n = 27) and a control group (n = 27) and treated for 6 weeks. Tubular injury biomarkers KIM-1 and NGAL were assessed pre- and post-treatment.ResultsBoth groups demonstrated comparable baseline characteristics. Post-treatment, fasting and postprandial blood glucose levels decreased similarly in both groups. The intervention group exhibited better improvements in total cholesterol, low-density lipoprotein, and blood uric acid levels. Renal function indicators, including UACR and eGFR, showed greater enhancements in the intervention group. Significant reductions in KIM-1 and NGAL were observed in the intervention group.ConclusionTreatment with empagliflozin in type 2 diabetes patients with normoalbuminuria led to a notable decrease in tubular injury biomarkers KIM-1 and NGAL. These findings highlight the potential of SGLT2 inhibitors in early tubular protection, offering a new therapeutic approach.